To investigate the properties and mechanism of PAF and TNF on the synthesis of prostaglandin E2 in human amnion, primary monolayer culture method was used for human amnion cell incubation. Amnion cells were incubated with various concentrations of PAF or TNF in Ca++ containing medium for various duration. Then PG E2 concentrations were measured by RIA and analyzed for the effect of PAF and TNF on PG E2 production according to their doses and incubation time. To test the role of Ca++ in E2 production, Ca++ free medium, Ca++ -channel antagonist and cyclo-oxygenase inhibitor were substituted or added in incubation medium. Following results were obtained. The synthesis of PG E2 was significantly enhanced by PAF of 10(-6) mol/L. The TNF also stimulated PG E2 synthesis at concentration of 10(-6)g/ml. The maximal level in PAF(10-6mol/L)-stimulated release of PG E2 was observed after 16 hours in incubation. The TNF(10(-6)g/ml)-induced PG E2 release was maximal after 24 hours of incubation. Combined application of PAF and TNF produced positive effect in PG E2 production. PAF or TNF stimulated-PG E2 production in Ca++ -free media was much lower than that of Ca++ -containing media. The PAF-stimulated PG E2 release was significantly inhibited by Ca++ -channel antagonist but TNF-stimulated PG E2 release was not effected by Ca++ -channel antagonist or cyclo-oxygenase inhibitor. It is strongly suggested us that both PAF and TNF enhance PG E2 release by amnion cell, although Ca++ -channel opening is essential only for PAF stimulation.
Amnion* ; Blood Platelets* ; Dinoprostone* ; Humans* ; Platelet Activating Factor* ; Prostaglandin-Endoperoxide Synthases ; Tumor Necrosis Factor-alpha*

BACKGROUND: The safety of ergonovine provocation for coronary vasospasm (CVS) performed outside the catheterization laboratory has been questioned. We sought to address the issues of safety, feasibility and clinical impact of noninvasive diagnosis of CVS. METHOD AND RESULTS: We retrospectively analyzed the results of bedside ergonovine provocation testing with monitoring of left ventricular regional wall motion abnormalities (RWMAs) by 2-dimensional echocardiography (ergonovine echocardiography, Erg Echo). After confirmation of no significant fixed epicardial coronary artery disease, 1,504 Erg Echo were performed in 1,372 patients from July 1991 to December 1997. Erg Echo was prematurely terminated in 13 patients (0.9%) due to limiting side effects unrelated with myocardial ischemia. Among 1,491 completed tests, 32% (477) showed positive results with development of RWMAs in 467 tests (98%) or ST displacement in ECG in 10 tests (2%). During the test, transient arrhythmias developed in 1.7% (26/1491) including transient ventricular tachycardia (2) and atrioventricular block (4), which were promptly reversed with nitroglycerin. There were no procedure-related death or development of myocardial infarction. On the basis of angiographic criteria in 218 patients, who also underwent invasive spasm provocation test during coronary angiography, the sensitivity and specificity of Erg Echo for the diagnosis of CVS were 93% and 91% respectively. From 1990 to 1997, total 2,073 spasm provocation tests were performed either during invasive coronary angiography in the catheterization or in the echocardiography laboratory. Since 1994, noninvasive Erg Echo became a more popular diagnostic method and comprised more than 95% of all spasm provocation tests in recent 3 years. Erg Echo was also performed safely in outpatient clinic setting without hospital admission in 34% (500/1491). CONCLUSIONS: Erg Echo is highly feasible, accurate and safe for diagnosis of CVS and can replace the invasive spasm provocation test during coronary angiography in the catheterization laboratory.
Ambulatory Care Facilities ; Arrhythmias, Cardiac ; Atrioventricular Block ; Catheterization ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vasospasm* ; Diagnosis* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Ergonovine* ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Nitroglycerin ; Retrospective Studies ; Sensitivity and Specificity ; Spasm ; Tachycardia, Ventricular

BACKGROUND: The safety of ergonovine provocation for coronary vasospasm (CVS) performed outside the catheterization laboratory has been questioned. We sought to address the issues of safety, feasibility and clinical impact of noninvasive diagnosis of CVS. METHOD AND RESULTS: We retrospectively analyzed the results of bedside ergonovine provocation testing with monitoring of left ventricular regional wall motion abnormalities (RWMAs) by 2-dimensional echocardiography (ergonovine echocardiography, Erg Echo). After confirmation of no significant fixed epicardial coronary artery disease, 1,504 Erg Echo were performed in 1,372 patients from July 1991 to December 1997. Erg Echo was prematurely terminated in 13 patients (0.9%) due to limiting side effects unrelated with myocardial ischemia. Among 1,491 completed tests, 32% (477) showed positive results with development of RWMAs in 467 tests (98%) or ST displacement in ECG in 10 tests (2%). During the test, transient arrhythmias developed in 1.7% (26/1491) including transient ventricular tachycardia (2) and atrioventricular block (4), which were promptly reversed with nitroglycerin. There were no procedure-related death or development of myocardial infarction. On the basis of angiographic criteria in 218 patients, who also underwent invasive spasm provocation test during coronary angiography, the sensitivity and specificity of Erg Echo for the diagnosis of CVS were 93% and 91% respectively. From 1990 to 1997, total 2,073 spasm provocation tests were performed either during invasive coronary angiography in the catheterization or in the echocardiography laboratory. Since 1994, noninvasive Erg Echo became a more popular diagnostic method and comprised more than 95% of all spasm provocation tests in recent 3 years. Erg Echo was also performed safely in outpatient clinic setting without hospital admission in 34% (500/1491). CONCLUSIONS: Erg Echo is highly feasible, accurate and safe for diagnosis of CVS and can replace the invasive spasm provocation test during coronary angiography in the catheterization laboratory.
Ambulatory Care Facilities ; Arrhythmias, Cardiac ; Atrioventricular Block ; Catheterization ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vasospasm* ; Diagnosis* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Ergonovine* ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Nitroglycerin ; Retrospective Studies ; Sensitivity and Specificity ; Spasm ; Tachycardia, Ventricular

No abstract available.
Nose* ; Osteotomy*

Twenty-three isolates of Fusarium spp. were obtained from decayed citrus fruits in the fields and storages in 1998-1999. Of them, six and five isolates belonged to F. proliferatum and F. moniliforme, respectively, which were the most common. F. solani and F. sambucinum had each two isolates, F. equiseti had one isolate and seven isolates were unidentified. They produced symptoms of two types in pathogenicity test: those with leathery, beige to light or dark brown, and sunken lesions without surface mycelium (type-1) and those with lesions covered with white, beige or pink surface mycelium (type-2). Four of six isolates identified to F. proliferatum and two unidentified isolates produced type-1 lesions, and all isolates identified to F. moniliforme, F. solani, F. sambucinum, F. equiseti and five unidentified isolates produced type-2 lesions.
Citrus* ; Fruit* ; Fusarium* ; Mycelium ; Virulence

45,X/47,XYY mosaicism is a rare sex chromosomal disorder with clinical information limited to 25 cases in the literature. We report an unusual mosaic Turner syndrome case in a 35-year old Korean woman with a phenotypic female, primary amenorrhea, short stature, immature secondary sexual characteristics. Cytogenetic analysis including G- and Q-banding revealed 45,X/47,XYY mosaicism, and SRY gene was demonstrated by polymerase chain reaction(PCR). Prophylactic bilateral gonadectomy was performed because the presence of Y-chromosomal sequences in Turner stigmata may predispose this patient to gonadoblastoma formation.
Adult ; Amenorrhea ; Christianity ; Chromosome Disorders ; Cytogenetic Analysis ; Female ; Genes, sry ; Gonadoblastoma ; Humans ; Mosaicism ; Turner Syndrome*

Although intraocular involvement in Hodgkin's disease is infrequent, there were reported iridocyclitis, exudative retinal detatchment, retinal hemorrhage, necrotizing retinitis, anterior and posterior uveitis, perivascular chorioretinitis. We report a 61 years old male patient with Hodgkin's disease who developed retinal lesion with decreased visual acuity in his right eye during a period of quiscence in his disease, 10 months since diagnosed. On first ophthalmic examination, best corrected vision of right eye was 0.6 and 1.0 on left eye. Fundus examination of the left eye was normal; however, the right eye revealed cotton wool patches, retinal edema, and intraretinal hemorrhage along the superior temporal venules. Fluorescein angiography showed blockage of choroidal flush in early phase and focal area of hyper fluorescence with perivascular leakage of dye in late phase. The results of TORCH test were negative, and the patient didn't have hypertension, diabetes mellitus, and bleeding tendency. Therefore we this case presumed perivascular retinitis associated with Hodgkin's disease.
Chorioretinitis ; Choroid ; Diabetes Mellitus ; Fluorescein Angiography ; Fluorescence ; Hemorrhage ; Hodgkin Disease* ; Humans ; Hypertension ; Iridocyclitis ; Male ; Middle Aged ; Papilledema ; Retinal Hemorrhage ; Retinaldehyde ; Retinitis* ; Uveitis, Posterior ; Venules ; Visual Acuity ; Wool

We present a case of pulmonary artery catheter (PAC) placement through the right internal jugular vein, bridging vein and coronary sinus in a patient with previously unrecognized persistent left superior vena cava (LSVC) and diminutive right superior vena cava. A 61-year-old male patient was scheduled for mitral valve repair for regurgitation. Preoperative transthoracic echocardiography revealed dilated coronary sinus, but no further evaluations were performed. During advancement of the PAC, right ventricular and pulmonary arterial pressure tracing was observed at 50 and 60 cm, respectively. Transesophageal echocardiography ruled out intracardiac knotting and revealed the presence of the PAC in the LSVC, entering the right ventricle from the coronary sinus. Diminutive right superior vena cava was observed after sternotomy. The PAC was left in place for 2 days postoperatively without any complications. This case emphasizes that the possibility of LSVC and associated anomalies should always be ruled out in patients with dilated coronary sinus.
Arterial Pressure ; Catheterization, Swan-Ganz* ; Catheters ; Coronary Sinus ; Echocardiography ; Echocardiography, Transesophageal ; Heart Ventricles ; Humans ; Jugular Veins ; Male ; Middle Aged ; Mitral Valve ; Pulmonary Artery ; Sternotomy ; Vascular Malformations ; Veins ; Vena Cava, Superior*

We tried to correlate brain CT findings with clinical state at admission and outcome at discharge in 42 selected cases from 94 adult patients under the diagnosis of tuberculous meningitis at Seoul National University Hospital during last four years from 1981. Their clinical state at admission and outcome at discharge were classified into three groups by severity of symptoms, respectively. The final outcome of them were well correlated with their clinical states at admission. Observed abnormal brain CT findings in this series were hydrocephalus (74%), dirthy cisternal enhancement (52%), infraction (38%), periventricular low density (36%), and tuberculoma (19%). The poorer the clinical state at admission and outcome at discharge, the more frequent the abnormal brain CT findings, especially of periventricular low density and infraction. But periventricular low density without infarction seemed to affect more deleterious effect on clinical state at admission than on final outcome.
Adult ; Brain* ; Diagnosis ; Humans ; Hydrocephalus ; Infarction ; Seoul ; Tuberculoma ; Tuberculosis, Meningeal*

The purpose of this study is to describe the magnetic resonance imaging (MR) findings of metastatic brain tumors with emphasis on the signal intensities of the lesion on MR. Thirty four patients with intracranial metastases were studies with MR imaging. The diagnosis was established on the basis of either brain biopsy or combination of brain MR findings and the presence of primary tumors. The primary tumors include lung cancer (n=18), breast cancer (n=3), stomach cancer (n=3), rectal cancer (n=1), renal cell carcinoma (n=1), hepatocellular carcinoma(n=1), ovarian cancer (n=1), thyroid cancer (n=1), melanoma (n=1) and unknown primary sites (n=4). The parenchymal lesions were solitary in 35% (12/34) and multiple in 65% (22/34). The size of the lesions was variable, ranging from several millimeters to 5cm in diameter. The corticomedullar junction of the cerebral heispheres was the most common location of the lesions (68%). The signal intensity of solid portion of the lesions was usually either isointense (44%) or hypointense (29%) on T1-weighted images, whereas it appeared in isointense (47%), hypointense (8%) or hyperintense (11%) on proton density-weighted or T2-weighted images. The remaining cases showed mixed signal intensities. The enhancement patterns were variable including nodular (<1cm) (6%), homogenous (19%), heterogeneous (10%), ring-like enhancement (22%) or mixed pattern(43%). The size of surrounding edema was larger than the tumor diameter in 76%. In conclusion, although there are no specific MR findings of intracranial metastasis except multiplicity, intracranial metastasis should be included in differential diagnosis with high priority, when a solitary mass showing isointensity on boty T1-and T2-weighted images with massive surrounding edema, especially in the corticomedullary junction of the cerebral hemispheres is encountered.
Biopsy ; Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Carcinoma, Renal Cell ; Cerebrum ; Diagnosis ; Diagnosis, Differential ; Edema ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Neoplasm Metastasis ; Ovarian Neoplasms ; Protons ; Rectal Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms