No abstract available.
Pneumonia*

No abstract available.
Primary Myelofibrosis*

No abstract available.
Hypertension ; Leigh Disease*

Wilms' tumor is one of the most common primary malignant tumors of the kidney during infancy and childhood and is known to be originated from the primitive cells of metanephric blastema. It presents difficulties when encountered in deciding the presence of anaplasia or in differentiating it from other renal tumors of childhood with different biologic behavior because of its diverse histologic patterns and varying degrees of differentiation. Evaluation of clinical and histopathologic features in terms of prognostication was done of 32 cases of Wilms' tumor which were surgically resected and diagnosed in the period from January 1979 through June 1992. Immunohistochemical reaction for cytokeratin, vimentin, actin and desmin was also analysed on all cases of Wilms' tumor in conjunction with clear cell sarcoma of the kidney(CCSK), malignant rhabdoid tumor of the kidney(MRTK) and congenital mesoblastic nephroma(CMN) to assess the validity of immunohistochemistry in differentiating Wilms' tumor from these renal tumors. Twenty four(75%) cases were diagnosed before the age of 5 and 40.7% were under 2 years old. Mixed type was most common(62.5%), followed by epithelial, blastemal and stromal predominant type in descending order of frequency. Anaplasia was observed in 3 cases(9.4%), two of which were epithelial predominant type and one blastemal predominant type. Treatment modality and presence of anaplasia were significantly correlated with 5 year survival rate of patients. Immunohistochemical stain revealed that all epithelial component of Wilms' tumor were positive for cytokeratin and 56.3% of Wilms' tumor had blastemal component which were positive for both cytokeratin and vimentin. Twenty cases(62.5%) of Wilms' tumor had blastemal component which were positive for cytokeratin with a proportion of more than 5% of reactive cells. Stromal component of Wilms' tumor generally did not show differentiation into the specialized type of tissue and all revealed positive reactions for vimentin among which some revealed positive reactions for actin. Only 3 out of 6 cases with rhabdomyoblastic differentiation were positive for desmin. CCSK, MRTK and CMN which have different biologic behavior and treatment modality compared to Wilm's tumor showed positivity only for vimentin and/or actin. In summary, treatment modality and presence of anaplasia are significantly correlated with patients' survival and the immunohistochemical stain for cytokeratin is very helpful in confirming the presence of blastemal component and useful in the differential diagnosis of Wilms' tumor from other kinds of pediatric renal tumors.
Child ; Male ; Female ; Humans ; Diagnosis, Differential

BACKGROUND: 4-1BB mediated costimulatory signal is a recently identified immunotherapeutic strategy for treating autoimmune diseases without depressing the immune response. In this study, we investigated the expression of 4-1BB and 4-1BBL on the peripheral blood mononuclear cells (PBMC) and we assessed whether the serum levels of soluble (s) 4-1BB and s4-1BBL in the patients with Graves' disease (GD) and compared them with normal subjects. METHODS: Expression of 4-1BB and 4-1BBL on PBMC of GD patients was determined by flow cytometry. The concentrations of s4-1BB and s4-1BBL were assessed in the sera of GD patients by performing ELISA. RESULTS: 4-1BB was constitutively expressed on naive CD4+ and CD8+ T cells of the GD patients and this was increased by stimulation. 4-1BBL was also expressed on the antigen-presenting cells such as CD19+ B cells, monocytes and dendritic cells in GD patients. The serum levels of s4-1BB and s4-1BBL were significantly higher in GD patients than those in controls, and these levels were significantly correlated with the serum levels of thyroid-binding inhibitory immunoglobulin and free T4. CONCLUSION: These results indicate that effector T cells of GD patients can be activated through the 4-1BB-mediated costimulatory signal. Elevated s4-1BB and s4-1BBL levels in the sera of GD patients may affect modulation of the clinical course in GD patients.
Antigen-Presenting Cells ; Autoimmune Diseases ; B-Lymphocytes ; Dendritic Cells ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Graves Disease ; Humans ; Immunoglobulins ; Monocytes ; T-Lymphocytes

BACKGROUND: Several abnormalities of the autonomic regulation of the heart have been noted after acute myocardial infarction(AMI). Measurement of heart rate(HR) variability has been reported to provide indirect, noninvasive estimate of the cardiac efferent parasympathetic activity. The purposes of this study were to get the information on heart rate variability after AMI and to determine its relation to clinical and hemodynamic data. METHODS: We measured HR variability in 28 patients(23 men and 5 women : mean age, 56.6+/-10.4 years) 3-15days after AMI, in 25 patients with unstable angina and in 21 normal subjects by using triangular interpolation of the frequency distribution histogram om normalto-normal RR intervals from Holter tapes. RESULTS: HR variability was lower in AMI than unstable angina patients(357.9+/-118.6 versus 426.1+/-122.5 msec : p<0.05) and normal subjects(525.1+/-137.4 msec : p<0.025). There was no difference for infarct site, thrombolytic therapy, presence of Q-wave. HR variability was significantly related to mean 24-hour HR, left ventricular ejection fraction(all p<0.0001), left ventricular end diastolic diameter(p<0.05). HR varability was lower in patients belonging to Killip class 2-4 and who reqired the use of diuretics or digitalis(all p<0.05). CONCLUSION: After AMI, HR variabillity was reduced and significantly related to clinical and hemodynamic indexes of severity. Measurement of HR variability early after AMI may offer important clinical information for the early high stratification of patients.
Angina, Unstable ; Autonomic Nervous System ; Diuretics ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Infarction* ; Thrombolytic Therapy

PURPOSE: The purpose of this study is to evaluate the CT and MR findings of brain absecss with emphasis on the thickeness and signal intensity of abscess wall. MATERIALS AND METHODS: Twenty CT scans and seven MR studies of 23 patients with brain abscess (27 abscesses) were retrospectively reviewed with respect to thickeness and signal intensity of abscess wall, shape and size of abscess, etc. Thickness of abscess wall was measured in the greatest abscess diameter on the CT scans and MR images obtaihed after intravenous administration of contrast material. RESULTS: Enhancing abscess wall was 2mm--6mm (average 3mm) thick. The abscess wall was uniform in thickness in 14 cases (52%), thinner in the roedial wall than lateral wall in 8 cases (30%), and thicker in the medial wall than lateral wall in 5 cases (18%). Signal intensity of abscess wall was isointense relative to gray matter on Tl-weighted MR images and hypointense on both proton- and T2-weighted MR images in 7 out of 8 lesione (88%). The inner margin of the abscess wall was smooth in 14 (52%) and irregular in 13 lesions (48%). The outer margin was smooth in 15 (55%) and irregular in 12 lesions (45%). The size of the abscesses was variable, ranging from lcm to 6cm in diameter. They were round (16 cases), elliptical (6 cases), or multilobulated (5 cases) in shape. Satellite or daughter abscesses were found in 5 patients. CONCLUSION: Abscess wall showed variable thickness in the medial and lateral walls with no specific findings. Other CT and MR findings were also nonspecific, although hypointensity of abscess wall on T2-weighted MR images may be helpful in diagnosis of brain abscess.
Abscess* ; Administration, Intravenous ; Brain Abscess* ; Brain* ; Diagnosis ; Humans ; Nuclear Family ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVES: MDM-2 is an oncoprotein that inhibits p53 tumor suppressor protein. Amplication and over- expression of its protein have been observed in human malignancies, and these abnormalities have a role in tumorigenesis through inactivation of p53 function. To elucidate the role of p53 and MDM-2 protein in cervical neoplasia we investigated the expression rates of MDM-2 and p53 protein in surgically resected specimens. METHEDS: Immunohistochemical studies using anti-p53 and anti-MDM-2 protein in the paraffin embedded section of 62 cases including cervical intraepithelial neoplasm(CIN) and invasive cervical cancer were performed. RESULTS: Expression rates of p53 protein were 25% in CIN I& CINII, 20% in CINIII, and 44% in invasive carcinoma, respectively. The MDM-2 protein were 33% in CIN I & CIN II, 16% in CIN III, and 48% in invasive carcinoma, respectively. There was no evident correlation between p53 positivity and MDM-2 positivity(p>0.05). However, correlation between MDM-2 negativity and p53 negativity was statistically significant(p=0.002) CONCLUSION: These data suggest that the expression of p53 protein is presumed to be necessarily correlated with MDM-2 protein expression in cervical neoplasia.
Carcinogenesis ; Humans ; Paraffin ; Proto-Oncogene Proteins c-mdm2* ; Tumor Suppressor Protein p53 ; Uterine Cervical Neoplasms

Mineralizing pulmonary elastosis is a result of chronic alveolar hemorrhage forming iron encrustation of a pulmonary elastic tissue. It has been reported as a complication of some diseases such as bronchiectasis, idiopathic pulmonary hemosiderosis, and cardiac failure. It is extremely rare to occur with a giant cell carcinoma as we experienced. A 59 year-old man visited our hospital for cough and blood tinged sputum. A chest CT scan revealed 10 9 6 cm sized round mass in the left upper lobe. He had lobectomy of left upper lobe, but died of respiratory failure at the postoperative eighteenth day. The lung showed a necrotic tumor and a yellow tan consolidation around the mass. Microscopically, the tumor was composed of nests or syncytia of large bizarre cells and tumor giant cells, and was diagnosed as a giant cell carcinoma. Interestingly, in the surrounding lung parenchyma there were a lot of foreign body type giant cells phagocytizing iron encrustated elastic fibers, which were easily identified by elastic van Gieson and prussian blue stains. Those degenerated elastic fibers appeared in pulmonary interstitial tissue as well as blood vessel walls. The authors concluded tumoral hemorrhage and necrosis resulted in mineralizing pulmonary elastosis.
Blood Vessels ; Bronchiectasis ; Carcinoma, Giant Cell* ; Coloring Agents ; Cough ; Elastic Tissue ; Giant Cells* ; Giant Cells, Foreign-Body ; Heart Failure ; Hemorrhage ; Hemosiderosis ; Humans ; Iron ; Lung ; Middle Aged ; Necrosis ; Respiratory Insufficiency ; Sputum ; Tolnaftate ; Tomography, X-Ray Computed ; Triacetoneamine-N-Oxyl

BACKGROUNR/AIMS: Heterogeneity of liver cell populations within the hepatic lobules can affect xenobiotic reaction. In this study, we attempt to clarify the stereological distribution of the y-GTP positive foci in hepatic lobule initiated by diethylnitrosamine and promoted by phenobarbital. METHODS/METERIALS: To the five Sprague-Dawley rats, one day after birth, diethylnitrosamine (0.15 pmole/pn) was intraperitoneally injected and by the weaning at four weeks of life, 0.035% phenobarbital in drinking water was fed for four weeks, at which time the rats were sacrified to obtain the livers. Livers were fixed in fresh cold ethanol acetic acid. Ihe 200 cotmecutive tissue sections were stained by histochemistry for y-GIP and countastained with toluidine blue ar HkE. Employing Zeiss microprojector, y-GTP foci wae traced. And then the largest cross-sectian (size class: 65-165 pm in diameter) of 52 y-GTP foci were selected. Using microscopic grid, distances fiom center of y-GlP foci to nearest centtal vein and bile ductule was measured. As a control group, out of 52 random points determined by rareken digit table, the distances were measured by the same romr. RESULT: the diameter Aom the central points of y-GIP positive foci to the neatest bile ductules was measured as 0.234620+0.14899mm (mean+SD) and the diameter from random points to the neatest bile ductules was measured as 0.303080+0.19582mm (mean+SD). Y-GTP positive foci located within 0.3mm diameter fram bile ductules were counted as 73.1% of 52 foci, whereas that of random points were only 55.8%. Accoring to Aequency table analysis by Shapiro-Wilk W test, there was significant difference by W-value (0.812065) and p-value (0.0144866). CONCLUSION: Stereologically, y -GTP positive foci initiated by diethylnitros;unine, promoted by phaxkarbital in neonatal Spague-Dawley rats were non-rarxlanly distributed in peripcetal atea (Rappaport zone I) in hepatic lobule during hepatocarcinogenesis.
Acetic Acid ; Animals ; Bile ; Diethylnitrosamine ; Drinking Water ; Ethanol ; Liver* ; Parturition ; Phenobarbital ; Population Characteristics ; Rats* ; Rats, Sprague-Dawley* ; Tolonium Chloride ; Veins ; Weaning