This study was carried out to investigate the direct neurotoxicity of alcohol on CNS and the effects of piracetam or vitamins on ultrastructural changes of the rat cerebellar and hippocampal neurons during long-term alcohol treatment. To evaluate the results, quantitative analysis were done for light and electronic microscopic findings. On the light microscopy, red degeneration of pyramidal cells and Purkinje cells was found more apparently in the alcohol only treated group than in the control group. On the electron microscopy, increased lipofuscin pigments wee found in cerebellum and hippocampus. In quantitative analysis, vitamins significantly reduced red degeneration in both hippocampus and cerebellum. However, piracetam significantly reduced red degeneration in cerebellum but not in hippocampus. Lipofuscin pigments in Purkinje cells and pyramidal cells were significantly reduced in the alcohol with piracetam treated group than the alcohol only treated group. However, vitamin had no significant reducing effect of lipofuscin pigments in Purkinje cells and pyramidal cells. According to the results, it is concluded that vitamins deficiency might cause red degeneration of pyramidal cell after long-term alcohol treatment, but increment of lipofuscin pigments in pyramidal and Purkinje cell may be caused by alcohol itself or its metabolite rather than vitamins deficiency. Piracetam seems to improve cognitive function impairment caused by alcohol consumption.
Alcohol Drinking ; Animals ; Cerebellum ; Hippocampus ; Lipofuscin ; Microscopy ; Microscopy, Electron ; Neurons* ; Piracetam* ; Purkinje Cells ; Pyramidal Cells ; Rats* ; Vitamins*

Pneumocystis carinii is the most common cause of diffuse pulmonary infiltrates in the immunocompromised patients. Microscopically, Pneumocystis carinii pneumonia(PCP) shows characteristic frothy intraalveolar exudate and interstitial lymphocytic and plasma cell infiltrate. However, sometimes the only histologic finding of PCP on routine hematoxylin-eosin stain is that of diffuse alveolar damage(DAD), when we can miss the diagnosis without aid of special stains. We report a case of Pneumocystis carinii pneumonia presenting as DAD in a 50-year old man after chemotherapy due to malignant lymphoma. Open lung biopsy specimen reveals the early stage of DAD without any characteristic findings, such as foamy exudate. However many cysts of Pneumocystis carinii were found on Gomori's methenamine silver(GMS) stain. Therefore, GMS stain should be routinely performed on all biopsy specimens obtained from immunocompromised patients.
Male ; Humans ; Cysts ; Biopsy

OBJECTIVES: Risperidone and clozapine beling to a new generation of antipsychotics that are reportedly more effective and better tolerated than conventional neuroleptics. However, each of these agents costs far more per unit than conventional neuroletics. The purpose of our retrospective study was to ascertain the total cost and effectiveness of treatment before and after administration of risperidone and clozapine in 'revolving door' schizophrenia patients. METHOD: Data collected on revolving door schizophrenics for 2 years before clozapine and risperidone treatment and for at least 2 years after clozapine and risperidone treatment. Direct cost of inpatient and outpatient treatment was measured. Effectiveness was scaled as 'years of mild disability gained'. RESULT: Both risperidone and cloazpine result in higher costs and additional benefits to patients, for example, increased mild disability, reduced number of relapse, and reduced hospital length-of-stay. An ICER of risperidone was less than Rc and ICER of clozapine was greater than Rc. According to decision-analytic this model, risperidone had favorable cost-effectivenss ratios relative to clozapine. CONCLUSION: We have assumed that risperidone is more cost-effective than clozapine.
Antipsychotic Agents ; Clozapine* ; Cost-Benefit Analysis* ; Humans ; Inpatients ; Outpatients ; Recurrence ; Retrospective Studies ; Risperidone* ; Schizophrenia

No abstract available.
Carcinoma, Renal Cell* ; Prognosis*

No abstract available.
Carcinoma, Renal Cell* ; Prognosis*

PURPOSE: The age-related clinical expression of acute idiopathic thrombocytopenic purpura (acute ITP) in children is unclear. In particular, information about acute ITP during the first year of life is limited. To find several features distinguishing infants from older children with acute ITP. We evaluated the clinical features, laboratory data, treatment outcomes of childhood acute ITP. METHODS: We retrospectively analysed the data of newly diagnosed 61 children with acute ITP at Pusan National University Hospital between January 1999 and December 2003. RESULTS: The mean age at the diagnosis of childhood acute ITP in our study was 4.7+/-3.9 years of age. In the age groups less than 1, 1~10 and older 10 years there were 14 (23.0%), 37 (60.6%), 10 (16.4%) cases, respectively. Male to female ratio was 1.6 : 1. The mean platelet count at the diagnosis of acute ITP in infants was significantly lower compared to the older age groups (P=0.001). Infants responded favorably to initial intravenous immunoglobulin treatment compared to the older age groups (P < 0.05). In infants, platelet count began to rise rapidly after initial intravenous immunoglobulin treatment. Among the 61 cases who were followed up over 6 months, 14 cases (23.0%) progressed to chronic ITP. Chronic ITP was seen significantly less frequently in infants (7.4%) than other age groups (P < 0.05). CONCLUSION: Infants with acute ITP tend to respond favorably to initial intravenous immunoglobulin treatment. Also, they are less likely to develop chronic ITP compared to the older children.
Busan ; Child* ; Diagnosis ; Female ; Humans ; Immunoglobulins ; Infant* ; Male ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Retrospective Studies

OBJECTIVES: In large-scale field trials, randomization by cluster is frequently used because of the administrative convenience, a desire to reduce the effect of treatment contamination, and the need to avoid ethical issues that might otherwise arise. Cluster randomization trials are experiments in which intact social unit, e.g., families, schools, cities, rather than independent individuals are randomly allocated to intervention groups. The positive correlation among responses of subjects from the same cluster is in matter in cluster randomization. This thesis is to compare the results of three randomization methods by standard error of estimator of treatment effect. METHODS: We simulated cholesterol data varing the size of the cluster and the level of the correlation in clusters and analyzed the effect of cholesterol-lowering agent. RESULTS: In intra-cluster randomization the standard error of the estimator of treatment effect is smallest relative to that in inter-cluster randomization and that in individual randomization. CONCLUSIONS: Intra-cluster randomization is the most efficient in its standard error of estimator of treatment effect but other factor should be considered when selecting a specific randomization method.
Cholesterol ; Ethics ; Humans ; Random Allocation*

PURPOSE: Computed tomographic(CT), ultrasonographic(US) findings of solid and papillary epithelial neoplasm of the pancreas were correlated with pathologic findings for the better understanding of this disease entity. METHODS AND MATERIALS: A retrospective review of CT and US of 14 cases of solid and papillary epithelial neoplasm of the pancreas was carried out in terms of the margin, internal architecture, caicification and septation, and this was correlated with gross pathologic findings. RESULTS: CT and US findings were well defined round masses consisting of both solid and cystic components. Five cases were cystic, four cases were solid and five cases were mixed. Cystic portion of the tumor represented variable degree of hemorrhagic necrosis. Six cases contained foci of calcification, which were linear, marginal and amorphous. Marginal calcification interfered US examination of the mass in three cases. Internal septurn was demonstrated in four cases on CT, one case on US and three cases on gross specimen. CONCLUSIONS: Our results indicate that calcification and internal septurn were considered as a part of radiologic findings in solid and papillary epithelial neoplasm of the pancreas.
Necrosis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Retrospective Studies

BACKGROUND AND OBJECTIVES: It has been reported that various inflammatory and immune reactions are involved in the development and progression of atherosclerosis. We tried to investigate whether the TNF receptor superfamilies are involved in the development and progression of atherosclerosis. MATERIALS AND METHOD: Thirteen carotid atheroma specimens(frozen sections : 10 cases, paraffin section : 5 cases) were obtained from the patients who underwent carotid endarterectomy at Samsung Medical Center and one normal aortic tissue was obtained from a transplantation donor in brain death. In the carotid endarterectomy specimens and a normal aortic tissue , the expressions of R110(TR1), 139(TR2) and DR3(TR3), members of the TNF receptor superfamilies were evaluated by immunohistochemical staining with monoclonal antibodies. Simultaneously, we evaluated the expressions of foam cells, smooth muscle cells, T-lymphocytes and B-lymphocytes. RESULTS: Immunohistochemical analysis identified a strong expressions of foam cells and smooth muscle cells in all atheroma. But, the expression of T-lymphocytes was minimal and that of B-lymphocytes was rare. The expression of DR3(TR3) was seen in all atheroma as strongly positive. The expression of 139(TR2) was observed well in frozen sections, but not in paraffin sections. Whereas, that of R110(TR1) was observed in paraffin sections as weakly positive, but not in frozen section. The areas where the TNF receptor superfamilies were expressed correlated to the area of foam cell presence. The expression of DR3 also correlated with expression of smooth muscle cells. In normal aortic tissue, the expression of inflammatory cells or TNF receptor superfamilies was not observed except smooth muscle cells which were observed in normal artery. CONCLUSION: Foam cells and smooth muscle cells were abundantly present in atheroma. The TNF receptor superfamilies are expressed in the atheroma and the region of expression was coincident with the presence of foam cells.
Antibodies, Monoclonal ; Arteries ; Atherosclerosis ; B-Lymphocytes ; Brain Death ; Endarterectomy, Carotid ; Foam Cells ; Frozen Sections ; Humans ; Myocytes, Smooth Muscle ; Paraffin ; Plaque, Atherosclerotic* ; Receptors, Tumor Necrosis Factor* ; T-Lymphocytes ; Tissue Donors ; Tumor Necrosis Factor-alpha*

Peutz-Jeghers syndrome is an autosomal dominant inherited syndrome characterized by mucocutaneous pigmentation and gastrointestinal hamartomatous polyps. The most important complications that increase morbidity are intussusception, bleeding and obstruction. Most patients with Peutz-Jeghers syndrome may undergo multiple laparotomies for complications such as intussusception or bleeding every 2 to 3 years during adolescence and early adulthood. To decrease the relaparotomy rate, intraoperative endoscopy may be useful in the treatment of complications that are related to Peutz-Jeghers syndrome. Use of intraoperative endoscopy can lead to a healthier life and to a longer life expectancy for the patient. We describe a case of Peutz-Jeghers syndrome, who underwent polypectomy by total gut endoscopy in an 11-year-old girl presented with intestinal obstruction and anemia. During the course of the operation, the endoscope was inserted per the enterostomy and colostomy sites, and 16 polyps in the small and large intestine were removed endoscopically using a snare.
Adolescent ; Anemia ; Child* ; Colostomy ; Endoscopes ; Endoscopy* ; Enterostomy ; Female ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intestine, Large ; Intussusception ; Laparotomy ; Life Expectancy ; Peutz-Jeghers Syndrome* ; Pigmentation ; Polyps ; SNARE Proteins