No abstract available.
Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

No abstract available.
Krukenberg Tumor*

A 3 year and 3 months old boy with recurrent infections since his age of 5 months was presented with clinical data and autopsy findings. He was the 4th product of healthy parents. His elder brother died of recurrent perianal abscess and sepsis at his age of 3 years. His 2nd elder sister died on the 14th day of life probably from the complication of BCG vaccination. Beginnig with perianal abscesses at his age of 5 months, he has been continuously suffering from recurrent infections such as arthritis, ostomyelitis, pneumonia, epididymitis, subcutaneous abscesses and perianal abscesses. In spite of meticulous supportive and aggressive antibiotic therapy persistent positive cultures for staph. Aureus, klebsiella, E. Coli, Enterococcus and coliform bacilli from different sited were noted. Erythrocyte sedimentation rate of 25 to 40 were constant. White cell count varied frem 15500 to 33400 with polymorphonucleocytes predominance. NBT test showed persistent low scoring of 2% throught the course. He finally died of pneumonia and empyema. At postmortem examination, multiple abscesses and grnulomas of right lung and multipe granulomas in the liver, spleen, lymph node, bone, marrow, adrenal gland, kidney and intestinal wass were noted. At microscopic examination histiocytic granulomas with lipid containing histiocyte infiltrations were noted in every organs described including brain.
Abscess ; Adrenal Glands ; Arthritis ; Autopsy ; Blood Sedimentation ; Bone Marrow ; Brain ; Cell Count ; Empyema ; Enterobacteriaceae ; Enterococcus ; Epididymitis ; Granuloma ; Granulomatous Disease, Chronic* ; Histiocytes ; Humans ; Infant ; Kidney ; Klebsiella ; Liver ; Lung ; Lymph Nodes ; Male ; Mycobacterium bovis ; Parents ; Pneumonia ; Sepsis ; Siblings ; Spleen ; Vaccination

Human papillomavirus(HPV) has been implicated in the development of uterine cervical cancer. Detectioe of the small amounts of HPV DNA in cervical cells has been very difficult. The polymerase chain reaction(PCR) is a new technique that can specifically amplify target DNA to facilitate its detectiion. PCR technique wes used to detect HPV types 16 and 18 in cervical specimeas obtained from nnormal cervix(20 cases), dysplasia(25 cses), carcinoma in situ(21 cases), microinvasive cancer(ll cases), and invasive cancer(46 cases). And then, case of invasive carcinoma of the uterine cervix were analyzed to determine that the presence of specific human papillomavirus DNA in the neoplasm was a contributing factor to their outcome. The detection rate of HPV 16 DNA in normnal cervix, dysplasia, ClS, microinvasive cancer, and invasive squamous cell carcinoma were 50.0%, 36.0%, 81.0%, 45.5%, and 58.7%, respectively. The detection rate of HPV 18 DNA in normal cervix, dysplasia, CIS, microinvasive cancer, and invasive squamous cell carcinoma were 0.0%, 8,0%, 4.8%, 0.0%, and 19.6%, respectively. of the factors evaluated in invasive cervical cancer, adenocarcinomatous component(p= 0.004) and tumor grade(p=0.015) were found to be correlated with HPV l8 infection. 5 of 8 women whose tumors contained glandular elements had HPV 18 DNA, whereas only 4 of 38 women whose tumors contained only squamous elements showed this infection. 6 of 9 women of HPV l8 infected tumors were grade 3 tumors as compared to only 7 of 28 of HPV 16 infected tumors. Age at diagnosis and nodal status in relation to HPV type 18 exhibited a trend but were not statisitically significant. These observations suggest that HPV type 18 may be associated with a more aggressive form of cervical cancer than HPV type 16.
Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; DNA ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Polymerase Chain Reaction* ; Uterine Cervical Neoplasms*

BACKGROUND: Atherosclerosis is the most important disease that may cause ischemic syndrome in many organs including heart. It is supposed that apoptosis of vascular smooth muscle cells(VSMCs) is closely related to the progression and rupture of atheromatous plaque. Recent studies have documented evidence for elevated level of nitric oxide(NO) within advanced human atheroma and evidence of regression of atheroma by NO. So this study is designed to evaluate whether exogenous NO from NO donors can induce apoptosis of cultured rat VSMCs and which proapoptotic gene(s) is involved in this type of apoptosis. METHODS: Rat VSMCs were cultured and used for experiment at passage 5 through 7. For NO donor, sodium nitroprusside (SNP) and S-nitroso-N-acetylpenicillamine(SNAP) of 0.5, 1, 2, 4mM were exposed to subconfluent VSMCs. The cells were harvested at 6, 12, 24, 48, 72hours after exposure of NO donors. Apoptosis was to be identified by 4, 6-diamidino-2-phenylindole dihydrochloride(DAPI) staining of nuclei and in-situ nick end labeling(TUNEL). The amount of fragmented DNA was analyzed semiquantitatively by diphenylamine(DPA) assay. Immunocytochemical(ICC) staining and western bolt analyses were designed to detect apoptosisrelated gene products, such as Bax-a, Fas and Bcl-2. RESULTS: 1) Decreased mitotic activity was shown after 12 hours exposure of exogenous NO donors, and condensation and margination of chromatin was identified agter 24 hours exposure, by DAPI staining. 2) Percent DNA fragmentation assessed by DPA method was 0,2,9,48,45% at 0,6,12,24,48 hours after exposure of 2mM of NO donors respectively. 3) The expression of Bax-a and Bcl-2 proteins was demonstrated in apoptotic cells by ICC staining. 4) The expression of Bax-a protein in cells under 24 hours exposure of NO donors was elevated by more than 18% of control level on densitometric analysis of western blot. The level of Bcl-2 was suppressed by 26% of control. So, Bax-a/Bcl-2 ratio in cells under exposure of NO donors was elevated to 2.0 from 1.2 of control level. CONCLUSIONS: Exogenous NO from NO donors can induce apoptosis of cultured rat VSMCs, and it is considered that bax-a and bcl-2 genes are involved in this type of apoptosis.
Animals ; Apoptosis* ; Atherosclerosis ; Blotting, Western ; Chromatin ; DNA ; DNA Fragmentation ; Genes, bcl-2 ; Heart ; Humans ; Muscle, Smooth, Vascular* ; Nitric Oxide ; Nitroprusside ; Plaque, Atherosclerotic ; Rats* ; Rupture ; Tissue Donors

OBJECTIVE: In order to evaluate the prevalence of cytomegalovirus infection to terminally failing heart, cytomegaloviral DNA was detected in the explanted hearts of transplantation recipients. METHODS: DNA extractions were performed from explanted failing hearts(N=22) and normal hearts (N=5) and polymerase chain reactions(PCRs) were done for detection of late gene sequence coded pp150 phosphoprotein. The products were confirmed with electrophoresis on 1% agarose gel. In order to improve the sensitivity of detection in cytomegaloviral genome, nested PCRs were executed with the primers designed for the original 607 bp products. RESULTS: All patients had IgG anti-cytomegalovirus antibody and did not have IgM anti-cytomegalovirus antibody. Cytomegaloviral genomes in myocardium were detected by polymerase chain reaction. The 607bp products by PCRs were found in both explanted failing hearts(3 cases/22, 13.5%) and normal hearts(1 case/5, 20.0%). In nested PCRs, 186bp products were found in both failing hearts(LV 4/22, LA 3/20, RV 5/22, HA 0/17) and normal hearts(LV 2/5, LA 1/4, RV 1/5, RA 2/5). There was no significant change in the presence of cytomegaloviral DNA between failing and normal hearts. Total positivity of cytomegaloviral genome in explanted hearts was 44.4% according to nested PCR results. CONCLUSION: Cytomegalovirus was rarely observed in explanted hearts of terminal heart failure and nested PCR could enhance the sensitivity of cytomegaloviral genome detection. But cytomegalovirus might have no direct causal relationship in the development of terminal heart failure.
Cardiomyopathy, Dilated ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Electrophoresis ; Genome ; Heart Failure ; Heart* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Myocardium ; Polymerase Chain Reaction ; Prevalence* ; Sepharose

BACKGROUND: Familial hypercholesterolemia(FH) is an autosomal dominant inharited disorder. Total cholesterl level of FH heterozygotes is two to fourfold higher than that of normal population. Substained hypercholesterolemia results in cholesterol deposition on various organs or tissues and Achilles tendon xanthoma due to cholesterol deposition is one of the specific clinical findings of FH. One of the lipid lowering drugs, 3-hydroxy-3-methylglutaryl coenzyme A(HMG Co-A) reductase inhibitor effectively lowers the blood cholesterol level in patients with FH, but whether the cholesterol deposition can be regressed by the lipid lowering drugs is rarely reported. This study attemted to determine whether the tendon xanthoma can be regressed by lipid lowering drugs commonly used in patients with FH. METHODS: We analyzed procepectively the serum lipid levels of patients with heterozygous FH before and after lipid lowering therapy with HMG Co-A reductase inhibitor alone(Lovastatin or Pravastatin) or in combination with bile acid sequestrating resin(Cholestyramine). The Achilles tendon thickness was measured radiographically by using soft tissue technique. RESULT: Total 18 patients with heterozygotes FH(M : F=8 :10, mean age; 51.7+/-9.0 years) were treated with the HMG Co-A reductase inhibitor alone or combined with bile acid sequestrating resin and followed for mean 31.9+/-11.9 months. During that period, serum total cholesterol and low density lipoprotein cholesterol significantly fell from 329+/-42 mg/dl to 230+/-29 mg/dl and from 246+/-56 mg/dl to 151+/-28 mg/dl, respectively(p<0.001). Serum high density lipoprotein level increased and maintained 15.3% higher than basal level(p<0.01). Achilles tendon thickness decreased significantly from 13.3+/-3.1 mm to 11.9+/-3.2 mm(p<0.001) with percent reduction of 9.8+/-10.5%(range; 3.1-36.4%). The amount of change of tendon thickness was significantly correlated only with percent reductionof LDL(p=0.029) and female sex(p0.020) on univariate analysis, but it was found to be significantly correlated only with percent reduction of LDL on multivariate analysis(r=0.514,p=0.029). CONCLUSION: Achilles tendon xanthoma can be regressed by effective lipid lowering therapy with HMG Co-A reductase inhibitor alone or with bile acid sequestrating resin in patients with heterozygous FH. the regression of tendon xanthoma is likely to be related to reduction of serum LDL.
Achilles Tendon* ; Bile* ; Cholesterol ; Cholesterol, LDL ; Female ; Heterozygote ; Humans ; Hypercholesterolemia ; Hyperlipoproteinemia Type II* ; Lipoproteins ; Oxidoreductases* ; Tendons ; Xanthomatosis*

BACKGROUND: Pulmonary venous flow(PVF) is closely related to left atrial pressure(LAP) and percutaneous mitral commissurotomy(PMC) reduces LAP rapidly. However, PVF pattern in mitral stenosis(MS) with sinus rhythm after PMC remains to be elucidated. METHODS: Transesophageal echocardiographic pulsed Doppler examination was performed within 24 hours before and after PMC to evaluate PVF pattern in 10 patients of MS with sinus rhythm. RESULTS: Before PMC, both peak velocity(PV) and velocity time integral(VTI) during systole had significant negative correlations with mean LAP(r=-0.70, r=-0.79, respectively). After PMC, both systolic PV and VTI increased significantly without significant changes in diastolic PV and VTI. However, there was no significant correlation between systolic PV and mean LAP, and between systolic VTI and mean LAP after PMC. CONCLUSION: In mitral stenosis with sinus rhythm, these data suggest that systolic PVF decreases with increase of mean LAP and PMC could reverse this change without affecting diastolic PVF. However, acute hemodynamic changes of left atrium induced by PMC may contribute to the absence of correlation between mean LAP and systolic PVF after PMC.
Echocardiography* ; Heart Atria ; Hemodynamics ; Humans ; Mitral Valve Stenosis ; Systole

BACKGROUND: Loss of myocardium due to acute myocardial infarction may cause acute heart failure and future left ventricular dysfunction. During heart failure, homeostatic mechanism will be activated and the renin-angiotensin system may play a role in congestive heart failure. Its primary components are angiotensinogen, renin, angiotensin converting enzyme, and angiotensin. According to the recent improvement of molecular biologic technique, it is possible to know the angiotensinogen nucleotidde sequence, amino acid sequence, and tertiary structure and to detect very small amount of material from tissue. The aim of the present study was to examine the change of expression of the liver angiotensinogen mRNA, a component of the circulation renin-angiotensin system in rats after myocardial infarction. METHODS: Female Sprague-Dawley rats(body weight 200-250g) were anesthetized and subjected either to left coronary artery occlusion or to sham operation. And the rats were sacrificed at 1 hours, 4 hours, 18 hours, 24 hours, 3 days, 7 days, 1 week, 2 weeks and 3 weeks. Northern blot analysis was performed. RESULTS: The liver angiotensinogen amRNA levels were elevated at 4 hours, 18 hours, 24 hours after myocardial infarction and reduced to control values at 3 days(max 5-fold). The liver angiotensinogen mRNA levels were lesser elevated at 4 hours, 18 hours, 24 hours after sham operation(max 1.8-fold). CONCLUSION: The renin-angiotensin system is one of the major regulators of blood pressure and fiuid and electrolyte homeostasis. It appears that the circulating renin-angiotensin system is activated acutely after myocardial infarction and is then turned off at cardiovascular compensation.
Amino Acid Sequence ; Angiotensinogen* ; Angiotensins ; Animals ; Blood Pressure ; Blotting, Northern ; Compensation and Redress ; Coronary Vessels ; Female ; Heart Failure ; Homeostasis ; Humans ; Liver* ; Myocardial Infarction* ; Myocardium ; Peptidyl-Dipeptidase A ; Rats* ; Rats, Sprague-Dawley ; Renin ; Renin-Angiotensin System ; RNA, Messenger* ; Ventricular Dysfunction, Left

BACKGROUND: CarboMedics and St.Jude Medical bileaflet valves are in widespread use but few noninvasive studies about the two types of valves were performedd. The aim of this study was to assess the characterisics of the normally functioning CarboMedics and St.Jude Medical prosthesis in the mitral position. METHODS: Patients with normally functioning CarboMedics and St.Jude Medical valve in the mitral position were included. They underwent transthoracic and transesophageal echocardiography 7 to 14days after mitral valve replacement. With the use of color flow Doppler transesophageal echocardiography, we measured the length, width, and area of maximal physiologic regurgitation and by using 2-D transesophageal echocardiography, we measured the opening and closing angles of the bileaflet valves and we tried to elucidate whether spontaneous echo contrast is present in the left atrium. RESULTS: 31 pateints underwent mitral valve replacement with CarboMedics and 10 patients with St.Jude Medical. The length of maximal physiologic regurgitation ranged from 11mm to 44mm in carboMedics mitral valve and from 12mm to 36mm in St.Jude Medical mitral valve. The area ranged from 0.19cm2to 3.48cm2in CarboMedcs and from 0.58cm2to 4.49cm2in CarboMedics and The mean opening and closing angles are 83.2(+/-1.1)degrees, 22.3(+/-1.3)degrees in CarboMedics and 86.5(+/-1.2)degrees 26.2(+/-3.2)degrees in St.Jude Medical. Spontaneous echo contrast was positive in 66% of patients, of whom patioents with atrial fibrillation showed nuch higher revalence of SEC than patients with sinus rhythm. CONCLUSION: These finding valve will give us a reference valvue for the evaluation of prosthetic valve function in mitral position.
Atrial Fibrillation ; Echocardiography* ; Echocardiography, Transesophageal ; Heart Atria ; Humans ; Mitral Valve* ; Prostheses and Implants