BACKGROUND: Cardiac hypertrophy is the compensatory response of the myocadium to increased workload. Compensatory mechanisms come into play when the hypertrophied heart can no longer accommodate the increased demand or persistent stimuli. Although it has been reported that the molecular changes in hypertrophied hearts that initially mediate enhanced function may contribute to the development of heart failure, the structural/biochemical/molecular basis for myocardial contractile failure is still obscure. This study was aimed to clarify the structural basis for relation between hypertrophy and failure. METHOD: Nine pairs of rabbits were sacrificed at 8,12,24,48 hours and 1,2,4,6,8 weeks after experiment aortic constriction. There hearts were studied with routine histopathology. Each heart was weighed and compared with total body weight. Multiple sections were embedded in paraffin, sectioned at 5um, and stained with hematoxylin and cosin and Masson's trichrome and analysed. RESULTS: The heart weight to body weight ratio(g/Kg) increased progressively with time after aortic banding. Banding of the aorta in the rabbit resulted in multifocal areas of myofiber degeneration, necrosis and fibrosis through the wall of the left ventricle, in the papillary muscles of the left ventricle and in the left ventricular portions of the interventricular septum in rabbit of 6 and 8 weeks after aortic banding. By 4 weeks after banding, the foci of necrosis were not observed. CONCLUSION: There findings suggest that the increased necrosis, fibrosis in animals with cardiac hypertrophy induced by banding the aorta may play a role in progression to heart failure.
Animals ; Aorta ; Body Weight ; Cardiomegaly ; Constriction ; Fibrosis ; Heart Failure ; Heart Ventricles ; Heart* ; Hematoxylin ; Hypertrophy ; Necrosis* ; Papillary Muscles ; Paraffin ; Rabbits

No abstract available.
Skull Base* ; Skull*

No abstract available.
Zygomatic Fractures*

OBJECTIVE: The purpose of this study was to review the clinicopathologic features, recurrent rate, survival rate and controversable issues in the treatment of the ovarian malignant germ cell tumors. PATIENTS AND METHODS: From August, 1991 to November, 1998 thirty-one patients with malignant germ cell tumors of the ovary treated in the department of obstetrics and gynecology, Kosin University Medical college, were eligible and assessable. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow up were reviewed retrospectively. RESULTS: The patients with malignant germ cell tumor constituted 6.37% of all ovarian malignancies during this period. Histologic subtypes were 8 dysgerminoma(25.8%), 7 endodermal sinus tumor(22.6%), 10 immature teratoma(32.3%), 3 mixed germ cell tumor(9.7%), 3 choriocarcinoma(9.7%). The age of the patients ranged from 10 to 40 years (mean +/-S.D.; 24.26 +/- 7.51). The most common symptom was abdominal pain(38.7%). Most had stageI(18 cases, 58.0%) or stageIII(5 cases, 16.2%) diseases. All patients underwent surgery as the initial treatment, and nine patients received more than one operation. Postoperative adjuvant chemotherapeutic regimens were VAC, VBP, EP, BEP, EMA, and EMA CO. The mean follow up duration was 26.0(+/- S.D.; +/- 20.3) months. The 2-year and 5-year survival rate were 91.97%(+/- S.E.; +/- 0.05) and 86.86%(+/- S.E.; +/- 0.07).
Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary ; Retrospective Studies ; Survival Rate

Cushing's syndrome associated with nodular adrenal glands will be divided into four main categories: adrenal adenoma, adrenal carcinoma, primary pigmented nodular adrenal dysplasia (PPNAD) and macronodular adrenal hyperplasia(MAH). The term macronodular adrenal hyperplasia is restricted to the presence of multiple nodules visible to the naked eye, ranging in size from 0.5 to 7.0 cm. We report a case of Cushings syndrome caused by bilateral macronodular adrenal hyperplasia (MAH). A 45-year-old man presented with Cushingoid features, hypertension and diabetes mellitus. Urine free cortisol was 449.9 mmol/day(27-276) and were not suppressed after administration of low-dose and high-dose dexamethasone. Plasma ACTH was very low(1.87 pmol/L(18)) and was not stimulated by administration of ovine CRH. In abdominal CT, both adrenal glands were markedly enlarged and nodular in appearance. Pituitary MRI showed no abnormal finding. Bilateral adrenalectomy was done. Histologic examination revealed multiple nodules and internodular hyperplasia. This case and other reports suggested that because of variable biochemical, radiologic and pathologic findings, macronodular adrenal hyperplasia represents a heterogeneous group of patients with varying degrees of adrenal autonomy.
Adenoma ; Adrenal Glands ; Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome ; Dexamethasone ; Diabetes Mellitus ; Humans ; Hydrocortisone ; Hyperplasia ; Hypertension ; Magnetic Resonance Imaging ; Middle Aged ; Plasma ; Tomography, X-Ray Computed

Carcinoma of the parathyroid gland is rare, comprising only 0.1% to 5% of all patients with primary hyperparathyroidism. It presents with severe hypercalcemia, bone disease, palpable neck mass, renal involvement and etc. Since the initial operation offers the best chance for cure, preoperative localization and intraoperative recognition of parathyroid cancer are essential. Recently parathyroid imaging has been described with 99mTc-sestamibi as an alternative to 201Tl. This newer agent has many physical and dosirnetric advantages and represents higher detection sensitivity than 201Tl-99mTc subtraction scan. We experienced a 41-year-old man presenting with recurrent hyperparathyroidism in spite of 2 previous operations. In preoperative localization, there was no abnormal uptake in 201Tl-99mTc subtraction scan but 99mTc-sestamibi scan revealed metastatic foci on right cervical area. He was successfully treated with modified radical neck dissection.
Adult ; Bone Diseases ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Neck ; Neck Dissection ; Parathyroid Glands ; Parathyroid Neoplasms* ; Technetium Tc 99m Sestamibi*

Background: Whole body scan using 131-iodine is performed to detect local recurrence or metastasis after thyroidectorny in differenciated thyroid cancer patients. The sensitivity of this procedure is related to the dose of radiopharmaceutical administered. It was reported that 131I posttreatment whole body scan demonstrate foci of tracer uptake not previously observed in diagnostic scan in 10~30% of cases. Posttreatment scans were most likely to reveal new foci in young patients(<45) and patients who had previously received radioactive iodine therapy. Method: We observed the frequency of discordant posttreatment scans and analysed the clicnical significance in 33 differenciated thyroid cancer patients who were admitted for radioiodine ablation from June, 1995 to April, 1996. Results: In 7 cases(21.2%), post treatment scan demonstrated cme or more foci of uptake and revealed less sites of uptake than diagnostic scan in 3 cases(9.1%). In one case with elevated thyroglobulin level and negative diagnostic scan, post treatment scan revealed new uptake sites with thyroid bed and cervical 1ymph node. The sites of discordant uptake were cervical lymph nodes in 4 cases and rnediastinal lymph node in one case, lung in one case, thyroid bed and cervical lymph nodes in one case, 3 cases of 7 pts(43%), demonstrated ane or more foci of uptake in post treatment scan, had history of previous radioiodine treatent. Conclusion: Post treatment scan confirmed uptake into remnant and metaststic tissues identified on the corresponding low dose diagnostic scans. Scanning after high dose radioiodine treatment frequently demonstrated one or more foci of uptake, especially in patients with previous radioiodine treatment, which were not visualized on the diagnostic low dose scan. Treatment scan may be useful for detection of remnant tissue or metastatic lesion in patients with elevated thyroglobulin and negative diagnostic scan.
Humans ; Iodine ; Lung ; Lymph Nodes ; Methods ; Neoplasm Metastasis ; Recurrence ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Whole Body Imaging

A 17-year-old man presented to us with a chief complaint of decreased visual acuity accompanied by central scotoma. There was nothing unusual in his medical history other than a recent oratorical contest. At the time of initial diagnosis, the corrected visual acuity was 20/20 in the right eye and 20/100 in the left eye. No significant findings were apparent on ophthalmic evaluation. On fundoscopy, there was a dumbbell-shaped macular bleed with a well-defined margin in the left eye. The clinical course was closely monitored along with drug therapy. Four weeks post presentation, the pre-retinal hemorrhage had nearly resolved. On fluorescein angiography, no significant findings were observed. In the left eye, the corrected visual acuity had improved to 20/25. Valsalva retinopathy is a pathology that occurs when a sudden increase in intra-thoracic pressure or abdominal pressure occurs in an otherwise healthy person. Here we report a case of Valsalva retinopathy occurring following an oratorical contest along with a review of the relevant literature.
Adolescent ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Male ; *Music ; Remission, Spontaneous ; Retinal Diseases/diagnosis/*etiology ; Tomography, Optical Coherence ; *Valsalva Maneuver ; Visual Acuity

No abstract available.
Animals ; Compensation and Redress* ; Flunarizine* ; Rats*

OBJECTIVE: To investigated whether lowering oxygen tension affects invasion of cultured trophoblast. METHODS: Trophoblasts were isolated from the normal placenta in early pregnancy(6-10 weeks in gestation). Isolated trophoblasts were cultured under normoxic(5% CO2, 95% humid air in incubator) and hypoxic(MERCK, 1% O2, 99% CO2) conditions for 24, 48 and 72 hours, respectively. The proliferation ability was measured using [H3] thymidine assay. Total RNA was extracted from the cultured trophoblasts. The expressions of matrix metalloproteinase(MMP-2) and tissue inhibitor of metallo- proteinase(TIMP-2) were determined by reverse transcription- polymerase chain reaction(RT-PCR) and Northern blot analysis. The invasiveness of cultured trophoblast was observed using in vitro invasion assay. RESULTS: [H] thymidine assay indicated that cellular DNA synthesis was not affected by the culture condition. The expression of MMP-2 mRNA was decreased at 24 hours and then progressively increased in the time-dependent manner in each culture condition. The expression of TIMP-2 was decreased in the time-dependent manner under hypoxic condition. In vitro invasion assay revealed that the cultured trophoblasts under hypoxic condition has more invasive ability than them under normoxic condition. CONCLUSION: These data suggests that hypoxic condition may stimulates the invasion of trophoblast in the human placentation. And MMP-2 and TIMP-2 may be related to control their invasiveness under hypoxic condition.
Blotting, Northern ; DNA ; Humans ; Oxygen ; Placenta ; Placentation ; RNA ; RNA, Messenger ; Thymidine ; Tissue Inhibitor of Metalloproteinase-2 ; Trophoblasts*