No abstract available.

No abstract available.

No abstract available.
Gaucher Disease* ; Humans ; Siblings*

Until several years ago it was generally agreed that anihypertensive medication should be stopped a few weeks before anesthesia and surgery in order to regain the compensatory function of cardiovascular system during anesthesia and surgical stress. However the present concept is that the better the hypertension is controled the more the patient's chances of surving anesthesia and it is recommended that antihypertensive medication should be continued to the time of anesthesia. The authors have experienced cases of hypertensive patients undergoing various kinds of operation and have-analyzed these cases according to the degree of hypertension, sex, department, anesthetic agent and technique, previous anesthetic medication, abnormal ECG finding and arterial blood pressure changes after anesthesia, at Jeonbug National University Hospital from January 1977 to June 1979. The results were as follows: 1) The number of hypertensive cases was 326 (12. 3%) out of 2664 total patient who received various surgical operations. 2) Only a few patients(16cases, 0. 5%) received antihypertensive medication before surgery. 3) The degree of hypertension was mostly class 1 or 2(274 patients, 78%) according to the severity index of Elwood 4) Most of the patients (253 cases, 74%) revealed elevated blood pressure after induction of anesthesia.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Electrocardiography ; Humans ; Hypertension ; Jeollabuk-do

Microscopic polyangiitis (MPA) is characterized by pauci-immune necrotizing small vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. The kidney is the most often affected organ in the majority of patients with MPA, and renal manifestations are usually the first symptoms. Glomerular capillaries are affected most often, resulting in necrotizing glomerulonephritis, usually in a crescent formation, with no or few immune deposits able to be demonstrated at the sites of vasculitis and glomerulonephritis. We report a case of microscopic polyangiitis in both legs with pitting edema in a 50-year-old female. Laboratory findings showed hematuria, proteinuria, and a positive peripheral antineutrophil cytoplasmic antibody. A renal biopsy revealed pauci-immune splitting and necrotizing capillary loop walls necrotizing vasculitis and membranoproliferative glomerulonephritis (MPGN). With a diagnosis of MPA, she has been managed with high dose steroid and cyclophosphamide. To our knowledge, this is the first reported case of MPA with MPGN.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Capillaries ; Cyclophosphamide ; Edema ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glycosaminoglycans ; Hematuria ; Humans ; Inflammation ; Kidney ; Leg ; Microscopic Polyangiitis ; Middle Aged ; Proteinuria ; Vasculitis

We experienced a case of secondary renal amyloidosis diagnosed by renal biopsy in a patient who had been diagnosed as RA two years ago. A 62-year old man was admitted to neurology departement because of right hemiplegia. During conservative care at neurology department, he was consulted to us because of aggravated generalized edema and proteinuria. He was diagnosed as rheumatoid arthritis and ulcerative colitis two years ago, and then he had taken prednisolone, methotrexate, mesalazine regularly. At physical examination, there was no abnormal finding except pretibial pitting edema and right hemiplegia. In urinalysis, specific gravity was 1.025, pH was 5.5, protein was 4+ and RBC 0-1/ HPF and WBC 0-1/HPF. Total protein of 24 hour's urine was 5.5 g/day. The blood BUN and creatinine level were 16.4 mg/dL, 0.4 mg/dL and cholesterol level were 154 mg/dL, total protein and albumin were 4.4 g/dL and 1.9 g/dL. Serum RA factor and CRP showed high level as 94.90 IU/mL and 118.00 mg/L. On urine electrophoresis, albuminuria was dominant but M-spike was not founded. On urinalysis taken at the time of first diagnosis of rheumatoid arthritis two years ago, proteinuria was negative and serum albumin levels was 3.6 g/dL. At that time, there was no evidence of nephropathy. In renal biopsy, electron microscope showed heavy nonbranching amyloid fibrils accumulated in mesangium and polarized light microscopy after Congo-red staining revealed apple-green birefringent amyloid deposits in glomeruli and blood. So we diagnosed renal amyloidosis associated with RA.
Albuminuria ; Amyloid ; Amyloidosis* ; Arthritis, Rheumatoid* ; Biopsy ; Cholesterol ; Colitis, Ulcerative ; Creatinine ; Diagnosis ; Edema ; Electrophoresis ; Hemiplegia ; Humans ; Hydrogen-Ion Concentration ; Mesalamine ; Methotrexate ; Microscopy, Polarization ; Middle Aged ; Neurology ; Physical Examination ; Plaque, Amyloid ; Prednisolone ; Proteinuria ; Serum Albumin ; Specific Gravity ; Urinalysis

Parkinson's disease animal model was developed by the destruction of the striatonigral dopaminergic system. The morphological changes in the dopamine depleted striatum after the transplantation of the fetal mesencephalic dopaminergic neurons or tyrosine hydroxylase cDNA transfected human neural stem cells (C4-TH cells) were studied. Male Sprague-Dawley rats, weighting 250~300 gm, were used. To make unilateral lesion of nigrostriatal tract, 6-OHDA (6 microgram/microliter) was injected into the medial forebrain bundle. Two weeks after the lesion surgery, the effect of the 6-OHDA lesion was assessed by monitoring apomorphine (0.5 mg/kg, s.c)-induced turning behavior and confirmed by the lack of TH-immunoreactivity on tissue sections. Either cell suspension from ventral mesencephalic tissue obtained from embryonic day 14 fetus or C4-TH cells was grafted into the rostral striatum. After grafting, rats were tested with apomorphine every 2 weeks for 6 weeks. The grafted rats showing behavioral recovery were sacrificed and analysed by TH, neuropeptide Y (NPY), and parvalbumin (PV) immuno- histochemistry. TH-immunoreactive (ir) neurons were located around the graft and their processes extended into the striatum. The TH-ir axon terminals made a symmetrical synapse with the dendrites of the striatal neuron. Cell bodies either NPY- or PV-ir striatal neuron were observed around the graft and extended their processes into the graft. TH-ir C4-TH cells were also distributed along the needle track such as the transplanted fetal dopaminergic neurons, but had smaller soma and fewer processes than those. It is concluded that the grafted dopaminergic cells are survived in the dopamine depleted striatum and recovered the rotational behavior of Parkinson's disease animal model.
Animals ; Apomorphine ; Carisoprodol ; Cell Transplantation* ; Dendrites ; DNA, Complementary ; Dopamine ; Dopaminergic Neurons ; Fetus ; Humans ; Male ; Medial Forebrain Bundle ; Models, Animal* ; Needles ; Neural Stem Cells ; Neurons ; Neuropeptide Y ; Oxidopamine ; Parkinson Disease* ; Presynaptic Terminals ; Rats* ; Rats, Sprague-Dawley ; Synapses ; Transplantation ; Transplants* ; Tyrosine 3-Monooxygenase

BACKGROUND/AIMS: This study reviewes the clinicopathological features, prognosis, and differences in the expression of p53 and Ki-67 immunochemical staining in squamous cell and adenosquamous carcinoma of the stomach. METHODS: From January 1995 to June 2005, 2,282 cases of gastric carcinoma were resected surgically in our hospital and 191 additional cases were resected by endoscopic mucosal resection. Retrospective pathologic review and immunochemical staining of p53 and Ki-67 were performed. RESULTS: The study consists of eight cases (0.032%) of primary squamous cell carcinoma (one case) and adenosquamous carcinoma (seven cases) without early gastric cancer. Six cases (75.0%) were male and two cases were female. The mean age was 66 year-old. The clinical presentation and physical findings did not differ from those of adenocarcinoma. The mean tumor size was 5.2+/-1.7 cm. Macroscopically, five were Borrmann type 3 (62.5%) and three were type 2. At the initial diagnosis, six (75%) were stage IV based on TNM tumor staging. Six cases (75%) progressed despite the therapy while two cases responded to the treatment. The median survival time was 11.0 months (range 4.3+/-17.7). Overexpression of p53 was seen in five cases (62.5%) and their survival was poor when compared to the p53-negative group (p=0.04). The mean Ki-67 labeling index was 70.0+/-20.8%, and was not associated with p53 staining (p>0.05). CONCLUSIONS: Adenosquamous and squamous cell carcinoma of the stomach are very rare. They tend to be at advanced stages on initial diagnosis, and progress rapidly. They show p53 protein overexpression and high Ki-67 labeling index, which might be related to poor prognosis.
Adult ; Aged ; Carcinoma, Adenosquamous/chemistry/mortality/*pathology ; Carcinoma, Squamous Cell/chemistry/mortality/*pathology ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/*analysis ; Male ; Middle Aged ; Stomach Neoplasms/chemistry/mortality/*pathology ; Survival Rate ; Tumor Suppressor Protein p53/*analysis

BACKGROUND/AIMS: Gastritis cystica profunda (GCP) is a rare disease that is characterized by a hyperplastic and cystic dilatation of the pseudopyloric gland with submucosal invasion. GCP is regarded as a benign lesion. However, there is some controversy regarding its malignant potential. This study reviewed the clinical features and association with malignancy. METHODS: From January 2001 to June 2005, 1,010 cases of resected and 1,228 cases of an endoscopic mucosal resection or polypectomy were examined. RESULTS: Thirty-nine cases (1.7%) were confirmed pathologically and were not associated with prior gastric surgery mostly. The mean age was 60.0+/-11.4 years old and there were 29 male patients. The body was most commonly located on the longitudinal axis (57.1%). Eleven cases (28.2%) were not associated any other gastric lesion, the majority of which were the polypoid type (82.0%). However, two cases were found as a hypertrophic mucosal fold, and a submucosal tumor, respectively. Seventeen cases (43.6%) were associated with early gastric cancer. CONCLUSIONS: Despite its rarity, GCP should be considered when an endoscopically polypoid lesion or submucosal tumor (SMT) is found. Because of its association with early gastric cancer or adenoma, more study will be needed to examine the relationship between GCP and gastric carcinogen
Adenoma ; Axis, Cervical Vertebra ; Dilatation ; Gastritis* ; Humans ; Male ; Rare Diseases ; Stomach Neoplasms

PURPOSE: The incidence rate and the mortality rate of gastric cancer have decreased in developed countries over the last several decades. On the other hand, they remain high in far eastern countries such as Korea, Japan, China and in many developing countries. The cure of patients with gastric carcinomas can be achieved mostly through complete surgical resection, but most gastric cancer patients are in advanced stages when diagnosed and have poor prognoses. therefore, the development of an effective systemic therapy is essential for far advanced gastric cancer patients. Until recently, the most commonly used combination chemotherapy was based on 5-flurouracil or cisplatin, but the results were not satisfactory, so recently etoposide, adriamycin and cisplatin (EAP-II) combination chemotherapy was introduced in patients with advanced gastric cancer. Early studies showed a high response rate and the ability to convert unresectable cases to resectable ones, but later studies couldn`t duplicate the result. the purpose of this study was to evaluate the relative efficacy&toxicity of EAP-II chemotherapy and ELF chemotherapy which is based on 5-flurouracil. MATENRIALS AND METHODS: Between July 1992 and July 2002, sixty-five patients with inoperable advanced gastric cancer were enrolled for this study. Thirty-seven patient received EAP-II chemotherapy:etoposide (20 mg/m2 IV for 1~5 days), adriamycin (20 mg/m2 IV for 1~5 days) and cisplatin (20 mg/m2 IV for 1~5 days) and Twenty-eight patients receieved ELF chemotherapy:etoposide (100 mg/m2 IV for 1~3 days), leucovorin (20 mg/m2 IV for 1~5 days) and 5-FU (500 mg/m2 IV for 1~5 days). Each treatment schedule for each group was repeated every four weeks: EAP-II means 3.4 cycles per patient: ELF means 4.1 cycles per patient RESULTS: Total respones rates were 5.4% in the ELF group and 3.6% in the EAP group (P-value>0.05). The median times to progression were 144 days in the ELF group and 92 days in the EAP-II group (P-value>0.05), and the median overall survival times were 189 days in the ELF group and 139 days in the EAP-II group (P-value>0.05). The difference in the survival curves for the two regimens was not statistically significant. Non-hematologic toxicitis&hematologic toxicitis were more frequently observed for the EAP-II regimen. Anemia: 27.6% in ELF vs 54% in EAP-II; Leukopenia: 8.5% in ELF vs 19% in EAP-II; nausea&vomiting: 45.9% in ELF vs 67.8% in EAP-II. CONCLUSION: EAP-II regimen is not superior to ELF regimen in the tratment of inoperable advanced gastric cancer.
Anemia ; Appointments and Schedules ; China ; Cisplatin ; Developed Countries ; Developing Countries ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination ; Etoposide* ; Fluorouracil ; Hand ; Humans ; Incidence ; Japan ; Korea ; Leucovorin* ; Leukopenia ; Mortality ; Prognosis ; Retrospective Studies* ; Stomach Neoplasms*