A total of 212 cases of gastric carcinoma resected at Kang-Dong Sacred Heart Hospital during the period of 4 years from December 1986 to December 1990 were examined according to Borrmann, Mulligan-Rember, Ming and WHO methods based on histopathological investigations. In Mulligan-Rember (M-R) classification, intestinal cell type (IC) was frequently seen in Borrmann type I and II; pyloro-cardiac gland cell type (PC) in II and III, and mucous cell type (MC) in IV and III. Expanding growth pattern was more frequent in IC, infiltrative growth pattern in MC, and PC showed less infiltrative growth than MC. In gross type, the most expanding growth pattern was seen in Advanced gastric carcinoma type (AGC) I and the next one was in AGC II; the ratio of infiltrative versus expanding type was highest in AGC IV and next in AGC resembling early gastric carcinoma (EGC) and AGC III in order. On WHO classification except squamous type, all the papillary type showed expanding growth and infiltrative growth was frequently seen in signet-ring cell, undifferentiated, tubular and mucinous types in order. Lymphoid stroma was more frequently found in expanding type than infiltrative type. The frequency of angioinvasion of tumor cells observed was high in AGC resembling EGC, AGC II, III, IV, I and EGC in order. In WHO classification excluding squamous type, undifferentiated and signet-ring cell types occurred more frequently under the age of 60 and papillary type were more frequnetly seen over the age of 60. But tubular type had no difference between the two age groups. In Ming's classification, expanding type was more frequently seen than infiltrative type over the age of 60.

The coexistence of extraadrenal pheochromocytoma and renal artery stenosis is extremely rare. The mechanisms of renal artery stenosis with pheochromocytoma include direct compression of the tumor mass on the renal artery and catecholamine-induced vasospasm, fibromuscular hyperplasia, and fibrous adhesion. We report a rare case of renal artery stenosis caused by extraadrenal pheochromocytoma in a 29- year-old female. She was admitted to the hospital because of palpitation and headache. She had been treated for hypertension for 2 years. On admission, her plasma epinephrine and norepinephrine levels were elevated as were her plasma renin activity, urinary vanillylmandelic acid (VMA) and metanephrine levels. Through the use of abdominal computed tomography, 131I-MIBG scan, and renal arteriography, a mass was found in the hilus of the left kidney which affected left renal artery stenosis. Surgical removal of the mass and left kidney restored the catecholamine excretion, plasma renin activity, and blood pressure to normal. Electronmicroscopic examination of the mass confirmed the pheochromocytoma.
Angiography ; Blood Pressure ; Epinephrine ; Female ; Headache ; Humans ; Hyperplasia ; Hypertension ; Kidney ; Metanephrine ; Norepinephrine ; Pheochromocytoma* ; Plasma ; Renal Artery Obstruction* ; Renal Artery* ; Renin ; Vanilmandelic Acid

No abstract available.
Ameloblasts* ; Fibroma*

No abstract available.
Ameloblasts* ; Fibroma*

Central pontine myelinolysis (CPM) is well-recognized osmotic demyelination syndrome that is related to various conditions such as rapid correction of hyponatremia and chronic alcoholism. Acute ataxia as a sole clinical sign in CPM is rare. We report a case of a 59-year-old man with dysarthria, intention tremor, and a significant gait ataxia starting after alcohol withdrawal, with radiological evidence of CPM. CPM should be included in the differential diagnosis of alcoholic patients who develop a sudden ataxia. Chronic alcohol abuse is one of the most commonly encountered predisposing factors. Alcohol withdrawal represents an additional vulnerability factor, being responsible for electrolyte imbalances which are not always demonstrable but are certainly involved in the development of CPM.
Alcoholics* ; Alcoholism ; Ataxia ; Causality ; Demyelinating Diseases ; Diagnosis, Differential ; Dysarthria ; Gait Ataxia ; Humans ; Hyponatremia ; Middle Aged ; Myelinolysis, Central Pontine* ; Tremor

BACKGROUND AND OBJECTIVES: Many studies have established risk factors for cardiovascular diseases. The Duke treadmill score has gained widespread acceptance for prognosis and diagnosis in cardiac diseases. Recently, changes in heart rate during and after exercise have also been studied to predict the prognosis of cardiac diseases. We examined the relationship between the incidence of cardiovascular events and exercise capacity, achievement of 85% maximal predicted heart rate (MPHR) or heart rate recovery (HRR) after a routine exercise treadmill test. SUBJECTS AND METHODS: We studied 88 patients with chest pain who were over the age of 30. They were referred for exercise treadmill test for assessment of chest pain and underwent symptom-limited, exercise test with a cool down period of 30 seconds. HRR was defined as the difference in heart rate between peak exercise and 1 minute after exercise. Delta heart rate (DHR) was defined as the difference in heart rate between resting and peak exercise. Other parameters in the exercise test were also measured. RESULTS: Cardiovascular events were found in 13 of the 88 patients. In the events group, age, peak heart rate in exercise, ST depression, maximal exercise capacity, HRR, DHR and achievement of 85% MPHR were all significant variables. There was a favorable prognosis in the patients with a value of HRR >22 beats/minute and a value of DHR >83 beats/minute. Even after adjusting for age, sex, ST depression and left ventricular hypertrophy, the parameters of maximal exercise capacity, HRR, DHR, and achievement of 85% MPHR remained predictive prognostic factors in cardiovascular events. CONCLUSION: Parameters in exercise treadmill test, such as maximal exercise capacity, HRR, DHR and achievement of 85% MPHR, appear to provide additional information and are important variables associated with the prediction of risk in cardiac events.
Cardiovascular Diseases* ; Chest Pain ; Depression ; Diagnosis ; Exercise Test* ; Heart Diseases ; Heart Rate* ; Heart* ; Humans ; Hypertrophy, Left Ventricular ; Incidence ; Prognosis ; Risk Factors

PURPOSE: Cytolethal distending toxin (CDT) considered as a key factor of localized aggressive periodontitis, endocarditis, meningitis, and osteomyelitis is composed of five open reading frames (ORFs). Among of them, the individual role of CdtA and CdtC is not clear; several reports presents that CDT is an AB2 toxin and they enters the host cell via clathrin-coated pits or through the interaction with GM3 ganglioside. So, CdtA, CdtC, or both seem to be required for the delivery of the CdtB protein into the host cell. Moreover, recombinant CDT was suggested as good vaccine material and antibody against CDT can be used for neutralization or for a detection kit. MATERIALS AND METHODS: We constructed the pET28a-cdtC plasmid from Aggregatibacter actinomycetemcomitans Y4 by genomic DNA PCR and expressed in BL21 (DE3) Escherichia coli system. We obtained the antibody against the recombinant CdtC in mice system. Using the anti-CdtC antibody, we test the native CdtC detection by ELISA and Western Blotting and confirm the expression time of native CdtC protein during the growth phase of A. actinomycetemcomitans. RESULTS: In this study we reconstructed CdtC subunit of A. actinomycetemcomitans Y4 and generated the anti CdtC antibody against recombinant CdtC subunit expressed in E. coli system. Our anti CdtC antibody can be interacting with recombinant CdtC and native CDT in ELISA and Western system. Also, CDT holotoxin existed at 24h but not at 48h meaning that CDT holotoxin was assembled at specific time during the bacterial growth. CONCLUSION: In conclusion, we thought that our anti CdtC antibody could be used mucosal adjuvant or detection kit development, because it could interact with native CDT holotoxin.
Aggressive Periodontitis ; Animals ; Bacterial Toxins ; Blotting, Western ; DNA ; Edetic Acid ; Endocarditis ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Meningitis ; Mice ; Open Reading Frames ; Osteomyelitis ; Plasmids ; Polymerase Chain Reaction

PURPOSE: Aggregatibacter actinomycetemcomitans was associated with localized aggressive periodontitis, endocarditis, meningitis, and osteomyelitis. The cytolethal distending toxin (CDT) of A. actinomycetemcomitans was considered as a key factor of these diseases is composed of five open reading frames (ORFs). Among of them, An enzymatic subunit of the CDT, CdtB has been known to be internalized into the host cell in order to induce its genotoxic effect. However, CdtB can not be localized in host cytoplasm without the help of a heterodimeric complex consisting of CdtA and CdtC. So, some studies suggested that CdtC functions as a ligand to interact with GM3 ganglioside of host cell surface. The precise role of the CdtC protein in the mechanism of action of the holotoxin is unknown at the present time. The aim of this study was to generate recombinant CdtC proteins expression from A. actinomycetemcomitans, through gene cloning and protein used to investigate the function of Cdt C protein in the bacterial pathogenesis MATERIALS AND METHODS: The genomic DNA of A. actinomycetemcomitans Y4 (ATCC29522) was isolated using the genomic DNA extraction kit and used as template to yield cdtC genes by PCR. The amplifed cdtC genes were cloned into T-vector and cloned cdt C gene was then subcloned to pET28a expression vector. The pET28a-cdtC plasmid expressed in BL21 (DE3) Escherichia coli system. Diverse conditons were tested to opitimize the expression and purification of functional CdtC protein in E. coli. RESULTS: In this study we reconstructed CdtC subunit of A. actinomycetemcomitans Y4 and comfirmed the recombinant CdtC expression by SDS-PAGE and Western Blotting. The expression level of the recombinant CdtC was about 2% of total bacterial proteins. CONCLUSION: The lab condition of procedure for the purification of functionally active recombinant CdtC protein is established. The active recombinant CdtC protein will serve to examine the role of CdtC proteins in the host recognition and enzyme activity of CDT and investigate the pathological process of A. actinomycetemcomitans in periodontal disease.
Aggressive Periodontitis ; Bacterial Toxins ; Blotting, Western ; Clone Cells ; Cloning, Organism ; Cytoplasm ; DNA ; Edetic Acid ; Electrophoresis, Polyacrylamide Gel ; Endocarditis ; Escherichia coli ; Meningitis ; Open Reading Frames ; Osteomyelitis ; Periodontal Diseases ; Plasmids ; Polymerase Chain Reaction ; Proteins ; Pyridines ; Thiazoles

No abstract available.
Diarrhea* ; Hypokalemia* ; Vipoma

BACKGROUND: Cerebral ischemia causes an increase in extracellular potassium ([K+]e) through activation of the KATP channel. This increase in [K+]e could result in neuronal depolarization and a reversal of the glutamate uptake system in glia. This may further contribute to the excessive concentrations of glutamate and asparate in the extracellular space during ischemia. If the early rise in [K+]e during ischemia could be attenuated, less excitotoxic neuronal damage may be the result. However, activation of KATP channels has been shown to attenuate the anoxia induced depolarization in the hippocampus and may reduce the release of excitatory neurotransmitters during cerebral ischemia. In this study, we address the question of whether KATP channel modulation affects [K+]e and whether it is related with extracellular glutamate concentrations. METHODS: After approval by the Animal Care and Use Committee, 18 New Zealand white rabbits were anesthetized with halothane and mechanically ventilated to maintain normocarbia. Microdialysis catheters were inserted into the left dorsal hippocampus and perfused with artificial cerebrospinal fluid at 2 ml/min. K+ sensitive microelectrodes were inserted into the contralateral hippocampus. A pneumatic tourniquet was placed loosely around the neck. Animals were randomized to receive glibenclamide (n=5, KATP blocker, 3.7 mg/kg) or cromakalim (n=5, KATP opener, 0.5 mg/kg). The control group (n=6) had neither drug. Ten-minute period of global cerebral ischemia was produced by inflation of the tourniquet combined with induced hypotension. Hippocampal [K+]e was measured throughout the periischemic period and glutamate concentrations in dialysate were determined by high-performance liquid chromatography. Peak levels were compared by ANOVA. RESULTS: Glutamate concentration significantly increased during ischemia period for all groups (p<0.05). In glibenclamide treated animals, brain glutamate concentration increased markedly during early reperfusion (t=I+15) compared to other groups (p<0.05). There were no statistical differences on ischemia-induced increases in [K+]e among the three groups. CONCLUSIONS: Although it was not possible to demonstrate an effect of modulators of the ATP sensitive K+ channel on [K+]e, glibenclamide increased glutamate during reperfusion. This paradoxical increase in glutamate after administration of a K+ channel blocker suggests that the mechanism of glutamate release is not related to [K+]e change.
Adenosine Triphosphate ; Animals ; Anoxia ; Brain ; Brain Ischemia ; Catheters ; Cerebrospinal Fluid ; Chromatography, Liquid ; Cromakalim ; Extracellular Space ; Glutamic Acid* ; Glyburide ; Halothane ; Hippocampus* ; Hypotension ; Inflation, Economic ; Ischemia* ; KATP Channels ; Microdialysis ; Microelectrodes ; Neck ; Neuroglia ; Neurons ; Neurotransmitter Agents ; Potassium ; Rabbits ; Reperfusion ; Tourniquets