Angioedema is a disorder characterized by well-demarcated nonpitting edema involving the tongue, floor of the mouth, larynx, lips, and face. The incidence of angiotensin converting enzyme(ACE) inhibitor related angioedema has been reported to be about 0.1% to 0.2%, and the time of onset is usually during the first week of therapy. These ACE inhibitors include captopril, enalapril, and lisinopril. A 53-year old man with an 8 month history of hypertension previously controlled with atenolol, was presented to the dermatologic department with angioedema of the face and tongue. He had begun therapy with captopril one day before this episode. Even though he was treated with epinephrine and methylprednisolone sodium succinate, the edema gradually progressed and finally dyspnea developed. He was urgently intubated and treated with steroids and pheniramine maleate in the intensive care unit. The edema resolved after 24 hours.
Angioedema* ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Atenolol ; Captopril* ; Dyspnea ; Edema ; Enalapril ; Epinephrine ; Humans ; Hypertension ; Incidence ; Intensive Care Units ; Larynx ; Lip ; Lisinopril ; Methylprednisolone Hemisuccinate ; Middle Aged ; Mouth ; Pheniramine ; Steroids ; Tongue

No abstract available.
Barium* ; Enema* ; Intussusception* ; Ultrasonography* ; Water*

No abstract available.
Appendicitis* ; Wounds and Injuries*

Mutation of the p53 tumor-suppressor gene in exons 4 through 9 was examined in 34 cases of primary advanced gastric cancer using PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism) and the results were compared with p53 protein expression as determined by immunohistochemistry (IHC) using a monoclonal antibody(DO-1). p53 protein detected by IHC was observed in 14 cases (41.2%) and genotypic mutation detected by PCR-SSCP in exons 4-9 was observed in 13 cases (38.2%) One case showed an aberrant band on PCR-SSCP both in Exon 7 and Exon 8/9. p53 alteration detected by either IHC or PCR-SSCP was observed in 19 cases (55.9%), but only 8 cases (23.5%) showed both p53 mutation and protein expression. We also tried to obtain the correlation between relative intensity of the shifted bands on PCR-SSCP and percentage of positive cells by IHC, but a significant correlation was not seen between relative intensity of shifted bands on PCR-SSCP and positve cell ratio. A discrepancy between p53 protein expression and p53 mutation is observed in primary gastric carcinomas. The reason for this discrepancy are not apparent. However, examination of gastric carcinomas for mutations in other exons may identify a better correlation with protein overexpression. The results obtained in this study suggest that the negative reaction for p53 immunohistochemistry may not necessarily mean no genetic alteration of the p53 locus.
Exons ; Immunohistochemistry* ; Stomach Neoplasms

The distribution of transforming growth factor-α (TGF-α) and epidermal growth factor (EGF) in developing mouse embryos of gestational age 8 to 15 days was immunohistochemically (ABC method) studied to investigate the differential expression of these growth factors. Paraffin embedded sections were immunostained with antibodies for TGF-α and EGF. Staining of TGF-α was observed in several organs derived from endoderm, mesoderm and ectoderm in 9-day-old mouse embryos, such as in the heart, optic pit, head mesenchyme, neural tube and primitive gut, and the staining became more intense in 10 to 15-day-old mouse embryos. The staining of EGF was seen in the heart and primitive gut derived from mesoderm and ectoderm respectively, in 9-day-old mouse embryos, but it was observed in other organs as well in 10 to 15-day-old embryos although the intensity was weaker. In the development of heart, immunoreactivity for TGF-α was more intense than EGF, which suggests more active involvement of TGF-α. In the lung, TGF-α staining was observed both in the bronchus and lung bud, whereas EGF staining was seen only the bronchus. In the nervous system, TGF-α was expressed more extensively and more intensively than EGF. In the developing skeletal system, TGF-α staining was stronger and the expression was observed at earlier stage compared with EGF. These results indicate that the activity of TGF-α is more potent than EGF in the development of mouse embryo in general, especially, in the development of mouse heart, nervous system, mesenchyme and skeletal system.
Animals ; Antibodies ; Bronchi ; Ectoderm ; Embryonic Structures* ; Endoderm ; Epidermal Growth Factor* ; Gastrula ; Gestational Age ; Head ; Heart ; Intercellular Signaling Peptides and Proteins ; Lung ; Mesoderm ; Mice* ; Nervous System ; Neural Tube ; Paraffin

A number of noninvasive technics have been advocated as reflecting left ventricular performance. These methods include systolic time intervals, echocardiography and imaging of the left ventricular chamber with radionuclides during systole and diastole. Radionuclide evaluation of left ventricular function by means of the gamma camera and gating currently appears to be the most reliable noninvasive method for approximating angiographic evaluation of left ventricular performance. Utilizing the radionuclide angiography, we measured the left ventricular function in 19 normal healthy control, 60 patients with coronary artery diseases 7 patients with dilated cardiomyopathy, 5 patients with hypertension. 1) Left ventricular ejection fraction decreased in 12 patients with anterior myocardial infarction (39.9+/-11.6%), 17 patients with inferior myocardial infarction (49.9+/-8.4%) and 7 patients with dilated cardiomyopathy (19.0+/-5.8%), and there was a statistically significant difference compared with 19 normal control group (63.5+/-8.2%)(p<0.005). However there were no statistically significant difference between normal control group, patients with hypertension (58.8+/-7.6%) and patients with angina pectoris (60.1+/-6.5%). 2) Left ventricular ejection fraction decreased in both anterior and inferior myocardial infarction, and there was a statisically significant difference between both groups (p<0.01). All 13 patients with acute myocardial infarction had abnormal LVEF (40.5+/-9.1%) whcih was significantly lower than that of 16 patients with old myolardial infarction (50.1+/-10.5%)(p<0.01).
Angina Pectoris ; Cardiomyopathy, Dilated ; Coronary Artery Disease* ; Coronary Vessels* ; Diastole ; Echocardiography ; Gamma Cameras ; Humans ; Hypertension ; Infarction ; Inferior Wall Myocardial Infarction ; Myocardial Infarction ; Radioisotopes ; Radionuclide Angiography* ; Stroke Volume ; Systole ; Ventricular Function, Left*

Adenoid cystic carcinoma is a rare disease of which incidence is 10-15 % of bartholins gland carcinoma. The clinical presentation is characterized by a vulval mass that existed for a prolonged period to the onset of symptoms, usually infection, pain, and burningsensation Histologically, this tumor is characterized by cribriform pattern cell growing and perineural invasion. The obtaining of clear surgical margins is the most important aspect of treatment. Here we report a case of adenoid cystic carcinoma of the Bartholins gland with a brief review of literature.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Incidence ; Rare Diseases

PURPOSE: This study was performed to examine if CT classification of renal blunt injury could aid in expectation of hemodynamic stability and clinical decision of whether to intervene surgically. MATERIALS AND METHODS: Over a 80-month period between July 1987 and March 1994, 41 patients were admitted to our hospital with the diagnosis of renal blunt injury. The renal blunt injuries were classified on Fedede's three-point scale CT classification methods :grade I, contusion, intrarenal hematoma, segmental infarction, and small subcapsular hematoma;grade II, complete or incomplete laceration, large subcapsular hematoma, and renal fracture;grade Ill, shattered kidney and renal pedicle injury. Hemodynamic stability, treatment method and clinical outcome of the patients with different CT grade were analyzed retrospectively. RESULTS: All 34 patients with grade I or II CT findings were hemodynamically stable and were successfully managed with conservative method. Among 7 patients with grade III CT findings, 6 patients were hemodynamically unstable. Out of the 6, One patient with grade IIIb or renal pedicle injury was expired before surgical intervention due to ischemic shock. Four patients were intervened surgically with one failure to thrive. The remaining one patient refused to be intervened surgically, and was discharged against medical advice. Only one out of 7 patients was hemodynamically stable and was managed conservatively. CONCLUSION: The patients with grade I or II CT findings are prone to be hemodynamically stable and to be managed with conservative method. But the patients with grade III CT findings are more likely to be hemodynamically unstable. Therefore patients with grade III CT findings should be closely monitored and be pre- pared for the possibility of immediate surgical intervention
Classification* ; Contusions ; Diagnosis ; Failure to Thrive ; Hematoma ; Hemodynamics ; Humans ; Infarction ; Kidney ; Lacerations ; Retrospective Studies ; Shock ; Wounds, Nonpenetrating

No abstract available.
Ciprofloxacin* ; Mycobacterium tuberculosis* ; Mycobacterium*

No abstract available.
Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Neoplasm Metastasis