No abstract available.
Myelodysplastic Syndromes* ; Neutrophils* ; Pyoderma Gangrenosum* ; Pyoderma*

PURPOSE: Endothelial cells (ECs) are exposed to continuous shear stress due to the blood flow. Heat shock protein (hsp) 70 is a well-known stress-response protein. The objective of this study is to investigate the expression of hsp70 in human umbilical vein endothelial cells induced by shear stress. METHOD: The pattern of hsp70 was investigated by the in vitro laminar flow system and its image was analyzed by PV-WAVE software program. The image of heat shock-induced hsp70 expression was analyzed and compared with that of shear stress-induced hsp70 expression. RESULT: Under the condition of shear stress produced by flow, the ECs change their morphology and lineup along the flow direction. As to expression of flow stress-induced hsp70, it was accumulated in perinuclear region of endothelial cells, which is different from heat shock-induced hsp70 exression. CONCLUSION: ECs alignment along the direction of the flow shear stress and changes their phenotype are due to the remodeling of the actin microfilaments. Perinuclear expression of hsp70 may play an important roles in this shear stress induced remodeling response.
Actin Cytoskeleton ; Endothelial Cells* ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Human Umbilical Vein Endothelial Cells ; Phenotype

BACKGROUND: Mushroom poisonings are infrequent but potentially fatal. Most fatalities are due to the amatoxin containing species, particularly Amanita phalloides, Amanita virosa, Amanita verna which cause fulminant hepatic failure often with encephalopathy. METHODS: We experienced twenty two patients with acute mushroom poisoning admitted to Dong San hospital, Keimyung University through emergency department between January 1990 and September 1997. RESULTS: Mean age of the patients was 40.0 years and the ratio of male to female was 1 : 0.83. Seasonal distribution is 10 patients in July, 3 in August and 9 in September. The mean interval between ingestion and early symptom onset was 9.7 hours. Most of the patients had early gastrointestinal symptoms; abdominal pain, nausea, vomiting and diarrhea. except for a patient with associated mental change. The subsequent symptoms and signs follow up admission were fulminant hepatic failure(72.7%), renal failure(31.8%), mental change(27.3%), acute pancreatitis(9.1%), pericardial effusion(4.5%) and erythematous rash(4.5%). The outcomes of the patients were recovery(72.7%), death(18.2%) and hopeless discharge(9.1%). CONCLUSION: The patients who have mushroom poisoning are misdiagnosed as having viral gastroenteritis and are discharged frequently. The doctors and people should be educated not to overlook the severity of mushroom poisoning.
Abdominal Pain ; Agaricales* ; Amanita ; Diarrhea ; Eating ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Liver Failure, Acute ; Male ; Mushroom Poisoning* ; Nausea ; Seasons ; Vomiting

We have reviewed 1211 burn patients who had visited our emergency department of Keimyung University Dongsan medical center between April 1995 to March 1997. The following results were obtained; 1) On age and sex distribution, the highest incidence of age group was under 10 year and old in 321 cases(26.5%). Male was affected more frequently than female, the incidence being 847 cases(70.1%) and 364 cases(29.9%). The ratio of male to female was 2.3:1. 2) No monthly and seasonal differences could be recognized. We found winter season having the highest 319 cases(26.3%), followed by autumn, spring and summer. 3) An analysis of causes in burns showed that flame burns were 527 cases(43.1%), scalding burns, 486 cases(40.2%), electrical burns, 96 cases(8.1%) and chemical burns, 48 cases(4.1%). 4) Domestic accidents accounted for 639 cases(52.7%), occupational for 286 cases(23.6%), traffic accidents for 160 cases(13.2%), suicides for 122 cases(10.1%), formentation for 4 cases(0.4%). 5) Most of patients 699 cases(57.7%) were affected with 2nd degree burn in depth, 1st degree for 413 cases(34.1%) and 3rd degree for 99 cases(8.2%). 6) The trunk was the anatomical region most commonly affected followed by upper and lower limbs. 7) 243 cases(20.5%) of all were accompanied by some complications. The main complications were would infection noted in 212 cases(17.5%), pneumonia in 179 cases(14.8%), acute renal failure in 160 cases(13.2), contracture in 155 cases(13.0), urinary tract infection in 24 cases(2.0%), Curling ulcer in 20 cases(1.6%) in order. 8) The over-all mortality rate was 73 cases(6.1%). The mortality rate of the patients with inhalation injury were 33 cases(45.3%). Causes of death were due to sepsis in 54 cases(4.5%), ARDS in 11 cases(0.9%), acute renal failure in 5 cases(0.4%), upper GI bleeding in 2 cases(0.2%), purmonary edema in 1 cases(0.1%).
Accidents, Traffic ; Acute Kidney Injury ; Burns* ; Burns, Chemical ; Cause of Death ; Contracture ; Duodenal Ulcer ; Edema ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Incidence ; Inhalation ; Lower Extremity ; Male ; Mortality ; Pneumonia ; Seasons ; Sepsis ; Sex Distribution ; Suicide ; Urinary Tract Infections

This study was designed retrospectively to evaluate Ranson's criteria and APACHE II scores as a predictor of mortality in patients with acute pancreatitis. Acute pancreatitis is a common disorder. From mild disease to multiorgan failure, it is a disorder that has numerous causes, an obscure pathogenesis. An accurate history and through physical examination will often raise clinical suspicion of acute pancreatitis in the differential diagnosis of a patient with acute abdominal pain. The retrospective analysis by chart review of 86 cases of acute pancreatitis who visited emergency department of Dongsan hospital from Jan to Dec 1996. The results were as follows. The majority of the patients with acute pancreatitis presented with chief complaints of abdominal pain. The male patient outnumbered female by the ratio of 2.9:1. The highest incidence of age group was between 40 and 50. The majority of our patients had past histories of either chronic alcoholic or gallbladder problems e.g.. the number being 53 cases(61.6%) and 31 cases(36%) respectively. Among 7 patients who had changes in consciousness, 5 were expired. Of those expired, 3 patients had less than 90 mmHg of systolic blood pressure. The overall mortality rate was 10.5%(9 cases). It has been known that acute pancreatitis would be the results of traumatic and non-traumatic causes. The exact mechanism of its pathophysiolgy has not been known yet, but it has been well known that the majority of patients who in forties and fifties had history of alcoholic abuse, the rest being mainly gallbladder problem and, some other diseases implicated too. The relationship of acute pancreatitis with familiar Ranson's criteria was such that 3 patients of the Ranson's out of 9 death were noted to have more than 3 of the criteria, but another 3 had less than 3. Among the 60 patients in whom the required physiologic variables were available out of total 86 patients studied, 9 were expired and 51 survived, average APACHE II scores for the survival and the expired being 6.92+/-3.99 & 18.11+/-5.68 respectively (P<0.05). We concluded that the APACHE II score could be used to better than Ranson's criteria to predict hospital mortality in patients with acute pancreatitis.
Abdominal Pain ; Alcoholics ; APACHE ; Blood Pressure ; Consciousness ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Gallbladder ; Hospital Mortality ; Humans ; Incidence ; Male ; Mortality ; Pancreatitis* ; Physical Examination ; Retrospective Studies

Granular cell tumors are rare disease can be which found in virtually any body site, including the tongue, skin, subcutaneous tissue, breast, rectum and vulva. However, they are rarely seen on the scalp. We report here on a rare case of granular cell tumor on the scalp. A 55-year-old woman presented with a non-tender, firm papule on the scalp. We removed the papule with excisional biopsy. Histopathologic examination showed well-circumscribed, non-capsulated nodule that consisted of large polygonal cells with abundant eosinophilic granular cytoplasms. The tumor cells were positive for S-100 protein staining. We diagnosed this case as granular cell tumor.
Biopsy ; Breast ; Cytoplasm ; Eosinophils ; Female ; Granular Cell Tumor ; Humans ; Middle Aged ; Rare Diseases ; Rectum ; S100 Proteins ; Scalp ; Skin ; Subcutaneous Tissue ; Tongue ; Vulva

Intracranial pial arteriovenous fistulas are rare vascular lesions of the brain. These lesions are composed of one or more direct arterial feeders with a single draining vein and usually have associated venous varix or giant venous aneurysms. Pial fistulas can be treated by endovascular occlusion or by microneurosurgery and endovascular treatment offers a simple and safe option. We report a case of pial fistulas treated with embolization using n-butyl cyanoacrylate (NBCA) and Lipiodol mixture in association with a balloon in the afferent artery to slow down the flow within the fistula.
Adhesives ; Aneurysm ; Arteries ; Arteriovenous Fistula* ; Brain ; Cyanoacrylates ; Ethiodized Oil ; Fistula ; Varicose Veins ; Veins

OBJECTIVE: To investigate whether suppression of right inferior frontal gyrus (Broca's homologue) by 1 Hz repetitive transcranial magnetic stimulation (rTMS) can improve speech recovery. METHOD: We applied low frequency rTMS on right Broca's homologue twice a week for 6 weeks in eight subcortical aphasia patients who were 3 months to 3 years poststroke onset. They were tested with Korean Version-Western Aphasia Battery before and after procedure. Also, they were tested with Parallel Short Forms for the Korean-BostonNaming Test and Animal Naming Test serially for outcome measure. rTMS was performed with intensity of 80% of motor threshold for 10 min (600 pulses) at 1 Hz frequency. RESULTS: Significant improvement was observed in picture naming at post-rTMS only in nonfluent aphasia patients but not in fluent aphasia patients. CONCLUSION: rTMS may provide a novel treatment for aphasia by possibly modulating the distributed, bi-hemispheric language network.
Animals ; Aphasia* ; Aphasia, Broca ; Aphasia, Wernicke ; Humans ; Outcome Assessment (Health Care) ; Transcranial Magnetic Stimulation*

Amyloidosis is the definition for a group of diseases that have, in common, the infiltration of one or more tissues by an abnormal protein material-the amyloid substance, which is detected histologically by their green polarization color after Congo red staining. Despite increased interest on basic nature of amyloidosis by recent immunohistochemical or experimental study, the knowledge about the incidence and neurotoxic effect of cerebral amyloid or concomitant occurrence with brain tumor is still inchoate. We examined the incidence and clinico-pathologic characteristics of the patients with amyloid deposits in supratentorial meningiomas. Particularly about their neurotoxic effect to adjacent brain is considered one of the possible cause of seizure in 33 patients who underwent resection surgery for meningioma at the Keimyung University during the past three years. The pathological review and subgrouping by histologic type were done in all 33 specimens with sufficient size of paraffin block, defined by their morphology and polarization color after Congo red staining for diagnosis of amyloid deposits localized in the tumor. Immunohistochemical studies using monoclonal antibodies for amyloid-A protein(AA) and beta-amyloid(A beta) were evaluated to identify subtypes of amyloidosis. The rate of incidence of amyloid deposit in meningioma was 21%, i.e. seven out of thirty three cases. All laboratory findings and clinical studies did not suggest a systemic form. Seizure occurrence was one out of seven cases(14%), which was of no statistical significance. Immunohistochemical study for AA subtype was all negative, but showed all positive for A beta protein around the vessels. Recent reports has also demonstrated that Amyloid precusor protein(APP) and A beta is related in Alzheimer's disease, hereditary cerebral hemorrhage with amyloidosis-Dutch type(HCHWA-D) and amyloid angiopathy. Our research data indicates that the incidence of amyloid deposit is as high as 21% in supratentorial meningiomas. It seems that it is one of the possible cause of seizure. Nonsystemic microdeposits of amyloid and their subtype and it's relationship to neurotoxic effect in meningiomas remain to be confirmed by immunoelectron microscopic examination or immunohistochemical methods.
Alzheimer Disease ; Amyloid* ; Amyloidosis ; Antibodies, Monoclonal ; Brain ; Brain Neoplasms ; Cerebral Hemorrhage ; Congo Red ; Diagnosis ; Humans ; Incidence ; Meningioma* ; Paraffin ; Plaque, Amyloid* ; Seizures

PURPOSE: Endothelial cells (ECs) are exposed to continuous shear stress from their birth and also respond to the hemodynamic environmental changes which may be localizing factor in vascular diseases, such as atherosclerosis. The hemodynamic shear stress is implicated in the pathogenesis of atherosclerosis, thrombosis, and also restenosis. The objective of this study is to investigate the morphological and molecular biological changes of vein ECs under complicated flow flield which could occur in the anastomosis site of the autogenous vein bypass graft. METHOD: We developed a laminar flow chamber for the normal vessel and a sudden expansion flow chamber to simulate the recirculation or the stagnation zone of vascular graft. RESULT: Normal flow shear stress transformed ECs from random oriented polygonal, cobblestone shape to elongated shape aligned along the flow direction. However the stagnation and flow separation zone could not show the morphologic change of ECs and could be the region of low shear stress prone for intimal hyperplasia and atherosclerosis initiation. CONCLUSION: It also represents that the ECs can sense the magnitude and the direction of the flow shear stress and change their phenotype through the remodeling of the actin microfilaments.
Actin Cytoskeleton ; Atherosclerosis ; Endothelial Cells ; Hemodynamics ; Human Umbilical Vein Endothelial Cells* ; Humans* ; Hyperplasia ; Parturition ; Phenotype ; Thrombosis ; Transplants ; Vascular Diseases ; Veins