BACKGROUND: Nitric Oxide (NO) has been discovered to be an important endothelium-derived relaxing factor. The exogenous inhaled NO may diffuse from the alveoli to pulmonary vascular smooth muscle and produce pulmonary vasodilation, but any NO that diffuses into blood will be inactivated before it can produce systemic effects. To examine the effects of NO on pulmonary and systemic hemodynamics, NO was inhaled by experimental dogs in an attempt to reduce the increase in pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) induced by hypoxia in dogs. METHODS: Eight mongrel dogs were studied while inhaling 1)50% O2 (baseline), 2)12% O2 in N2 (hypoxia), 3)followed by the same hypoxic gas mixture of O2 and N2 containing 20, 40 and 80 ppm of NO, respectively. RESULTS: Breathing at FIO2 0.12 nearly doubled the pulmonary vascular resistance from 173 56dyn sec cm-5 to 407 139dyn sec cm-5 and significantly increased the mean pulmonary artery pressure from 16 3mmHg to 22 4mmHg. After adding 20~80 ppm NO to the inspired gas while maintaining the FIO2 at 0.12, the mean pulmonary artery pressure decreased (p<0.05) to the level when breathing oxygen at FIO2 0.5 while the PaO2 and PaCO2 were unchanged. The pulmonary vascular resistance decreased significantly and the right ventricular stroke work index returned to a level similar to breathing at FIO2 0.5 by addition of NO into the breathing circuit. Pulmonary hypertension resumed within 3~5 minutes of ceasing NO inhalation. In none of our studies did inhaling NO produce systemic hypotension and elevate methemoglobin levels. CONCLUSIONS: Inhalation of 20~80 ppm NO selectively induced pulmonary vasodilation and reversed hypoxic pulmonary vasoconstriction without causing systemic vasodilation and bronchodilation. Methemoglobin and NO2 were within normal limit during the study.
Animals ; Anoxia ; Dogs ; Endothelium-Dependent Relaxing Factors ; Hemodynamics* ; Hypertension, Pulmonary ; Hypotension ; Inhalation* ; Methemoglobin ; Muscle, Smooth, Vascular ; Nitric Oxide* ; Oxygen ; Pulmonary Artery ; Respiration ; Stroke ; Vascular Resistance ; Vasoconstriction* ; Vasodilation

Psoriasis is a relatively common disorder that affects at least 1-2% of the population, however, the pathogenesis is not fully understood yet. Histopathologically, psoriatic lesion is characterized by hyperplasia of keratinocyte, intraepidermal neutrophil accumulation and activated T lymphocyte infiltration in the dermis. Among many cytokines, IL-8 is known to play a role for the activation and migration for neutrophil and T lymphocyte and for the proliferation of keratinocyte. We performed immunohistochemical staining with anti-IL-8 monoclonal antibody for the active lesion, stable lesion and normal-looking skin of ten psoriatic patients and ten healthy controls. Strong expression of IL-8 in the epidermis and dermis was noted from the active as well as stable psoriatic skins. In the normal-looking skin of the psoriatic patients, only faint expression which is not different from healthy control skin, was noted. These observations indicate that the expression of IL-8 is increased in psoriatic lesion, and IL-S is important for the initiation and maintenance of psoriasis.
Cytokines ; Dermis ; Epidermis ; Humans ; Hyperplasia ; Interleukin-8* ; Keratinocytes ; Lymphocytes ; Neutrophils ; Psoriasis ; Skin*

Mitochondrial DNA (mt DNA) and the non-recombining region of the Y chromosome are passed down, unaltered, from generation to generation, matrilineally and patrilineally, respectively. Therefore, the Y-chromosome DNA and mtDNA are known as lineage markers, and they play important roles in studies based on human migration and evolutionary history. Y-chromosome DNA is used in forensic analysis to identify individuals involved in cases of sexual assault. In this paper, we review the methods of statistical evaluation of lineage markers used in forensic identification. We also review the combined approach of autosomal and lineage marker evidence.
DNA ; DNA, Mitochondrial ; Human Migration ; Y Chromosome

PURPOSE: To evaluate value of superparamagnetic iron oxide (SPIO) as a negative oral contrast agent in MR cholangiopancreatography (MRCP). MATERIALS AND METHODS: Forty-eight patients with suspected biliary tract or pancreatic diseases and six healthy volunteers were enrolled in this study. All MR images were obtained using a 1.5 T MR unit. MRCP using fat-suppressed half-Fourier acquisition single-shot turbo spin echo (HASTE) and turbo spin echo (TSE) techniques were performed and reconstructed with maximal intensity projection (MIP). To determine the most optimal concentration of SPIO to obliterate the high signal intensity of water, a phantom experiment was conducted with various concentrations of SPIO-water mixture. Two radiologists evaluated pre- and postcontrast MRCPs. The contrast enhancement was assessed on the basis of loss of signal intensity in the stomach and duodenum. RESULTS: In the phantom experiment, a significant increase of percentage of signal intensity loss (PSIL) occurred in concentration of 22.4 ugFe/ml (Feridex 1 ml diluted with water 500 ml). Postcontrast MRCP showed an improved image quality compared with precontrast images. The rate of improvement in the diagnosis of diseases of the common bile duct and pancreatic duct was 25% (12/48). CONCLUSION: In patients with suspected biliary tract and pancreatic diseases, the SPIO is useful as a negative oral contrast agent for MRCP and provides an improvement of image quality.
Biliary Tract ; Common Bile Duct ; Diagnosis ; Duodenum ; Healthy Volunteers ; Humans ; Iron* ; Pancreatic Diseases ; Pancreatic Ducts ; Stomach ; Water

Localized scleroderma is a connective-tissue disorder that is limited to the skin and subcutaneous tissue, sometimes involving muscles beneath the cutaneous lesions. Although it is usually a self-limiting disease, complications like growth failure, joint contractures, deformities and functional impairment may occur resulting in significant morbidity. Herein we report a 9-year-old girl who presented with hemiatrophy as a major clinical feature associated with widespread multiple hyperpigmented sclerotic plaques. The patient proved to be a relatively rare case of hemiatrophy secondary to extensive generalized morphea also having complicating features of joint contracture and growth failure of involved extremities.
Child ; Congenital Abnormalities ; Contracture ; Extremities ; Female ; Humans ; Joints ; Muscles ; Scleroderma, Localized* ; Skin ; Subcutaneous Tissue

Allergic contact dermatitis that is attributable to contact with environmental sensitizers boine by a second individual, especially in marital or sexual relationships, has been described as connubial contact dermatitis. Severely pruritic multiple erythematous plaques, vesicles and bullae in a 35-year-old woman occurred on the face, posterior area of the neck, breasts, buttock, and both upper arms. No direct contact to allergens was obtained. However her husband had eaten some cooked sprouts from a lacquer tree for lunch at a restaurant the day before her eruption, then he caressed her that night. A patch test with extracts of lacquer tree in ethanol(2%), crushed extracts of lacquer tree (as is), and urushiol(0.002% pet.) on the patients back showed strong positive reactions.
Adult ; Allergens ; Arm ; Breast ; Buttocks ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Female ; Humans ; Lacquer ; Lunch ; Neck ; Patch Tests ; Restaurants ; Rhus* ; Spouses ; Trees

BACKGROUND: Endotoxin stimulates nitric oxide synthase (NOS) and the free radical nitric oxide (NO) is produced by NOS, which vasodilates the smooth muscle of pulmonary vessels. Otherwise, endotoxemia stimulates the release of cyclooxygenase (COX) products, which may modify hypoxic pulmonary vasoconstriction (HPV). We also observed the effect of nonselective NOS inhibition by NG-nitro-L-arginine methyl ester (L-NAME) on receptor-mediated acetylcholine (Ach)/bradykinin (BK) induced vasoconstriction and receptor independent HPV in E.coli lipopolysaccharide (LPS) induced septic isolated rat lungs. METHODS: Four hours before surgical instrumentation for lung isolation, we administered saline (1 ml) to the control group (n = 15), E.coli LPS (20 mg/kg) to the LPS group (n = 14) and LPS (30 mg/kg) the nitric oxide synthase inhibitor, L-NAME (15 mg/kg) to the LPS + L-NAME group (n = 14), intraperitoneally. In 43 isolated rat lungs perfused with physiologic salt-albumin- blood mixture, angiotensin II 0.2 microgram was injected into the perfusion circuit, to confirm pulmonary vascular reactivity in each isolated lung. HPV responses were induced by three hypoxic challenges for 5 minutes separated by 5 minutes of ventilation with a normoxic gas mixture. We observed the pulmonary arterial pressure at each challenge, ten minutes after the last HPV, 0.01, 0.1, 1.0 microgram of Ach and 1, 3, 10 microgram of BK were injected. PAP and static lung compliance were measured. RESULTS: The baseline pulmonary artery pressure in the LPS group higher than in the controls and HPV in the LPS group was changed compared to the controls but in the LPS + L-NAME it was higher than in the controls. The administration of Ach 0.1, 1.0 microgram and BK 3, 10 microgram causedpulmonary vasoconstriction and the vasoconstrictions of BK were dosage-dependent. Lung stiffness in the LPS and LPS + L-NAME groups were higher than those of the controls. CONCLUSIONS: Vascular constriction of pulmonary vessels and increased lung stiffness by Ach and BK might be the result of the endothelial injury. But pulmonary vasoconstriction and stiffness by Ach and BK were similar in the LPS and LPS + L-NAME groups, showing that factors other rather than excessive NO production might be involved in endothelial injury.
Acetylcholine ; Angiotensin II ; Animals ; Arterial Pressure ; Constriction ; Endotoxemia ; Lung Compliance ; Lung* ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Perfusion ; Prostaglandin-Endoperoxide Synthases ; Pulmonary Artery ; Rats* ; Surgical Instruments ; Vasoconstriction* ; Ventilation

BACKGROUND: Extracellular ATP, released from platelets and nerve endings, plays significant roles in the regulation of circulation. The effects of ATP depend on the location of the vessels and the species of experimental animals. Until now, studies were limited to arteries, so we compared the effects of ATP in rat vena cava with those in the aorta and attempted to identify the characteristics of their receptors. METHODS: Vascular rings were isolated from the rat inferior vena cava and descending thoracic aorta. Endothelial cells were preserved or removed by gentle rubbing. The isometric contractions were recorded on polygraph using a force transducer. RESULTS: In the vena cava ring precontracted by 100 nM norepinephrine (NE), ATP elicited relaxations in a dose-dependent manner. These effects were abolished by removal of the endothelium or pretreatment with a nitric oxide synthase inhibitor. Relaxations to ATP in the vena cava (EC50 :9.9 microM) were less potent than those in the aorta (1.7 microM). The relative order of potencies was ADP>ATP>AMP>adenosine, but the maximal relaxation to ADP was smaller than to ATP. ATP-induced vasorelaxation was blocked by suramin, a nonselective antagonist for P2 purinoceptor and reactive blue-2, a P2Y blocker. At basal tension, ATP contracted the vena cava dose-dependently and these effects were potentiated by endothelium-removal. Contractions in the vena cava were also less potent than in the aorta, and the order of potencies was alpha, beta-MeATP>UTP>ATP>ADP>AMP=adenosine. ATP-induced vasoconstriction was blocked by suramin and alpha, beta-MeATP, a desensitizing antagonist of P2X purinoceptor, and potentiated by pretreatment with UTP. CONCLUSION: These results suggest that ADP and ATP acts on P2Y1- and P2Y2-purinoceptor in the endothelium, respectively and induces vasorelaxation of the vena cava, which is mediated by nitric oxide. Since ATP and UTP induced vasoconstriction in endothelium-denuded condition, it may be mediated by the activation of the P2X and P2Y4, 6 purinoceptor on smooth muscles, respectively.
Adenosine Diphosphate ; Adenosine Triphosphate ; Animals ; Aorta ; Aorta, Thoracic ; Arteries ; Endothelial Cells ; Endothelium ; Isometric Contraction ; Muscle, Smooth ; Nerve Endings ; Nitric Oxide ; Nitric Oxide Synthase ; Norepinephrine ; Rats* ; Receptors, Purinergic P2 ; Receptors, Purinergic P2X ; Receptors, Purinergic* ; Relaxation ; Suramin ; Transducers ; Uridine Triphosphate ; Vasoconstriction ; Vasodilation ; Vena Cava, Inferior*

Pseudo-kaposi's sarcoma is a vasoproliferative disorder that may resemble Kaposi's sarcoma, clinically and histologically. In most cases, it has been associated with congenital or iatrogenic arteriovenous fistula and chronic venous insuffiency. We present a 36-year-old male patient with pseudo-Kaposi's sarcoma caused by a deed vein thrombosis in the absence of any detectable underlying etiologic factors.
Adult ; Arteriovenous Fistula ; Humans ; Male ; Sarcoma ; Sarcoma, Kaposi* ; Thrombosis ; Veins ; Venous Thrombosis*

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel