BACKGROUND: Intracoronary stent implantation is a promising modality for establishing the blood flow of complex coronary arterial stenosis. However, previous studies have demonstrated that the angiographically visible thrombus is a high risk factor for possibility of stent thrombosis. So many investigators avoided stent implantation traditionally for thrombus containing lesion because of the potency of thrombogenecity of stent. But recently, advanced rapidly growing technique for stenting and powerful antithrombotic regimens make stent thrombosis rare. Stent implantantion has already been showed a acceptable method for bailout procedure of thrombotic occlusion in patients with angioplasty for acute myocardial infarction and also effective in intimal dissection, suboptimal results and arterial recoil. Accordingly, we investigated the effectiveness of stent implantation in the presence of intracoronary thrombus. METHODS: Eighteen patients(AMI 14, Unstable angina 4) underwent PTCA & stent implantation on culprit arterial lesion in all successfully. The stent group was comprised of Palmatz-Schatz stent 10, Cordis 2, Cook 5 and Jo-Med stent 1. Stent implanted to the lesion of remained thrombus visualization on coronary angiography after PTCA. RESULTS: No major complications were developed during hospitalization in all 18 patients. In all patients no stent thrombosis have occurred within 2 weeks after stent implantation. But one patients have showed intracoronary stent thrombus persistently, so we used intracoronary urokinase infusion for 36 hours but there was no visible thrombus after modified anticoagulation and antithrombotic regimen CONCLUSIONS: We harvested good preliminary results of intracoronary stent implantation in the setting of thrombus containing lesion.
Angina, Unstable ; Angioplasty ; Constriction, Pathologic ; Coronary Angiography ; Hospitalization ; Humans ; Myocardial Infarction ; Research Personnel ; Risk Factors ; Stents* ; Thrombosis* ; Urokinase-Type Plasminogen Activator

In connective tissue diseases, autoantibodies cause pulmonary interstitial inflammation and fibrosis, and patients require treatment with an immunosuppressive agent such as a steroid. Dermatomyositis is an incurable, uncommon form of connective tissue disease that occasionally causes diffuse pulmonary inflammation leading to acute severe respiratory failure. In such cases, the prognosis is very poor despite treatment with high-dose steroid. In the present case, a 46-year-old man was admitted to our hospital with dyspnea. He was diagnosed with dermatomyositis combined with cryptogenic organizing pneumonia (COP) with respiratory failure and underwent treatment with steroid and an immunosuppressive agent, but the COP was not improved. However, the respiratory failure did improve after treatment with intravenous immunoglobulin, which therefore can be considered a treatment option in cases where steroids and immunosuppressive agents are ineffective.
Autoantibodies ; Connective Tissue Diseases ; Cryptogenic Organizing Pneumonia* ; Dermatomyositis* ; Dyspnea ; Fibrosis ; Humans ; Immunoglobulins* ; Immunosuppressive Agents ; Inflammation ; Lung Diseases, Interstitial ; Middle Aged ; Pneumonia ; Prognosis ; Respiratory Insufficiency ; Steroids

BACKGROUND: Germline mutations in the breast cancer-associated genes BRCA1 and BRCA2 confer susceptibility and a lifetime risk of breast. Several morphological and clinical features have been attributed to hereditary tumors. However, in sporadic breast cancer, the interrelationship between the loss of heterozygosity (LOH) of these loci and clinical features remains to be fully elucidated. METHODS: Microdissected paraffin-embedded tissue blocks of 48 cases of surgically resected breast carcinoma were investigated to identify the LOH of BRCA1 and BRCA2 using microsatellite markers. RESULTS: Of 48 cases, 22 (45.9%) exhibited LOH at BRCA1 locus while in 29 out of 48 (60.4%) cases LOH was observed for the BRCA2 region. There was no significant correlation between LOH at BRCA1/2 and the patient's age, tumor size, histologic grade or lymph node metastasis. When comparing the frequency of LOH with the expression of several prognostic factors, such as p53, c-erb B2 protein, estrogen and progesterone receptor using immunohistochemical stain, there was only correlation with LOH at BRCA2 and the progesterone receptor. CONCLUSIONS: Our results suggest that allelic deletion play a role to the development of sporadic breast cancers.
Breast Neoplasms* ; Breast* ; Estrogens ; Germ-Line Mutation ; Loss of Heterozygosity* ; Lymph Nodes ; Microsatellite Repeats ; Neoplasm Metastasis ; Paraffin* ; Receptors, Progesterone

The study of microsatellite instability (MSI) has provided the evidence to support asequential, progressive pathway for the development of cancer. In this study, we analyzed the role of MSI at chromosome 11p15.5 using microdissection of paraffin-embedded tissue from 68 matched normal and breast tumor samples. Components of intraductal, invasive and metastatic foci in lymph node were assessed for MSI using the polymorphic markers D11S922, tyrosine hydroxylase (TH) and D11S988. We found that MSI at D11S922 was relatively high incidence than other two markers and increased during breast cancer progression. The overall frequency of MSI at D11S922 was 26.7% in pure intraductal carcinoma, 36.4% in invasive carcinoma, and 40.0% in invasive carcinoma with metastases. We observed no significant correlation between MSI at chromosome 11p15.5 and the patient's age, tumor size, histological grade, or lymph node metastasis. We compared the MSI incidence with the expression of prognostic markers, such as p53, c-erb B2, estrogen receptor, and progesterone receptor, and found no significant correlation. We suggest that the MSI of chromosome 11p15.5 is increased during breast cancer progression, but long-term follow-up study would establish whether MSI at chromosome 11p15.5 could be useful as a potential prognostic marker for breast cancer.
Breast Neoplasms/*genetics/metabolism/pathology ; Carcinoma, Ductal, Breast/*genetics/metabolism/pathology ; Carcinoma, Intraductal, Noninfiltrating/*genetics/metabolism/pathology ; *Chromosomes, Human, Pair 11 ; Female ; Humans ; Immunohistochemistry ; Microsatellite Repeats ; Prognosis ; Protein p53/metabolism ; Receptor, erbB-2/metabolism ; Receptors, Estrogen/metabolism ; Receptors, Progesterone/metabolism

Radial glia are transdifferentiated into astrocytes within the developing brain and spinal cord. The neural retina contains Muller cells, which are retinal radial glia. Some of the cells that surround the optic nerve head among Muller cells in the chicken retina are called peripapillary glial cells (PPGCs). PPGCs express different molecules compared to typical Muller cells. However, an antigenic PPGC phenotype has not yet been clearly established. In this study, we classified the antigenic PPGC phenotypes and identified the differentiation stages of these cells. At embryonic day (E)8, alphaB-crystallin-positive PPGCs had a bipolar shape with long processes that traversed entire layers of the retina. Pax2 and vimentin were expressed in alphaB-crystallin-positive PPGCs. Glial fibrillary acidic protein (GFAP) immunoreactivity was not observed in PPGCs. At E18, alphaB-crystallin immunoreactivity disappeared from the vitread processes of PPGCs. However, the PPGC cell bodies and ventricular processes contained alphaB-crystallin protein, and the PPGCs retained the same Pax2-positive/vimentin-positive/GFAP-negative profile as that seen at E8. At post-hatch day 120, alphaB-crystallin and Pax2 immunoreactivity was not observed, but vimentin and GFAP expression was clearly observed in the presumptive location of the PPGCs. Furthermore, these two proteins overlapped within that location. Considering that vimentin expression is prolonged until the post-hatching period in chicken brain, these findings suggest that Pax2-negative/vimentin-positive/GFAP-positive PPGCs are phenotypically identical to mature astrocytes in this avian species.
Astrocytes ; Brain ; Chickens ; Glial Fibrillary Acidic Protein ; Neuroglia ; Optic Disk ; Phenotype ; Proteins ; Retina ; Retinaldehyde ; Spinal Cord ; Vimentin

In situ hybridization (ISH) using single-stranded DNA probe (ssDNA probe) is a useful method for observing the specific transcripts in cells, since it is convenient to prepare probe which is specific and sensitive. In this study, ssDNA probe for detection of alphaB-crystallin (aBC) mRNA, transcript of a heat shock protein, was prepared and aBC mRNA-expressed cells were spatiotemporally observed in the retina of the developing chick embryos. Single-stranded antisense probe produced by reverse transcription and polymerase chain reaction was identified as a specific probe for aBC mRNA in comparison to negative control using sense probe and immunohistochemistry for aBC protein. In the ISH experiment, aBC mRNA was expressed only in the peripapillary glial cells which are a specific cell type located in the avian retina adjacent to the optic nerve at E12 and E14 retinas. At E16, a small number of aBC mRNA-expressed cells were identified in the nerve fiber layer (NFL) of the retina. At E18, aBC mRNA-expressed cells were observed in the ganglion cell layer (GCL) as well as the NFL. At E20, the number of aBC mRNA-expressed cells was increased in the GCL and the NFL. Based on the same localization of nkx2.2 immunoreactive cells and aBC mRNA-expressed cells, aBC mRNA-expressed cells were identified as oligodendrocytes. These results indicate that ssDNA probe for aBC mRNA detection is very useful tool for oligodendrocyte research such as distribution, migration and differentiation of the cells.
DNA, Single-Stranded ; Ganglion Cysts ; Heat-Shock Proteins ; Immunohistochemistry ; In Situ Hybridization ; Nerve Fibers ; Neuroglia ; Oligodendroglia ; Optic Nerve ; Polymerase Chain Reaction ; Retina ; Reverse Transcription ; RNA, Messenger

The nationwide prevalence of major depressive disorder in Korea is lower than most countries, despite the high suicide rate. To explain this unexpectedly low prevalence, we examined the functional disability and quality of life in community-dwelling subjects with significant depressive symptoms not diagnosable as depressive disorder. A total of 1,029 subjects, randomly chosen from catchment areas, were interviewed with the Center for Epidemiologic Studies Depression scale, Mini International Neuropsychiatric Interview, WHO Quality of Life scale, and the WHO Disability Assessment Schedule. Those with scores over 21 on the depression scale were interviewed by a psychiatrist for diagnostic confirmation. Among community-dwelling subjects, the 1-month prevalence of major depressive disorder was 2.2%, but the 1-month prevalence of depressive symptoms not diagnosable as depressive disorder was 14.1%. Depressive disorders were the cause of 24.7% of work loss days, while depressive symptoms not diagnosable as depressive disorder were the cause of 17.2% of work loss days. These findings support the dimensional or spectrum approach to depressive disorder in the community and might be the missing link between the apparent low prevalence of depressive disorder and high suicide rate in Korea.
Adolescent ; Adult ; Analysis of Variance ; Depression/*diagnosis/epidemiology ; Female ; Humans ; Interviews as Topic ; Male ; Mental Health ; Middle Aged ; Prevalence ; *Quality of Life ; Young Adult

BACKGROUND: There are conflicting data in the literature regarding aspirin resistance. This study evaluated the effect of biochemical aspirin resistance on initial stroke severity in acute stroke patients who had taken aspirin. METHODS: We reviewed acute ischemic stroke patients who were already on aspirin. Biochemical aspirin resistance was defined as an aspirin reaction unit score of > or =550, as evidenced by the VerifyNow-Aspirin assay, which was performed after 4 days of continuous aspirin medication. Initial stroke severity was evaluated using National Institutes of Health Stroke Scale (NIHSS) scores at day 4, which were dichotomized into mild (0-7) and severe (> or =8). Modified Rankin Scale scores were determined at 3 months. The Alberta Stroke Program Early CT Scores (ASPECTS) were assessed on initial diffusion-weighted imaging (DWI). We examined the relationships between biochemical aspirin resistance and initial stroke severity. RESULTS: Nine of 106 patients (8.5%) had biochemical aspirin resistance. The initial stroke severity was significantly associated with DWI-ASPECTS (p<0.001), initial C-reactive protein level (p=0.005), biochemical aspirin resistance (p=0.009), and stenosis or occlusion of the relevant artery (p=0.029). Multivariate analysis showed that biochemical aspirin resistance [odds ratio (OR), 15.24; 95% confidence interval (CI), 2.49-93.31; p=0.003] and initial C-reactive protein level (per 1 mg/dL; OR, 2.43; 95% CI, 1.47-4.00; p=0.001) were independently associated with initial stroke severity (NIHSS score > or =8). However, biochemical aspirin resistance was not associated with clinical outcome at 3 months (p=0.366). CONCLUSIONS: Biochemical aspirin resistance was independently associated with initial stroke severity. This suggests that detection of biochemical aspirin resistance in acute ischemic stroke is useful when choosing the optimal treatment.
Alberta ; Arteries ; Aspirin ; C-Reactive Protein ; Constriction, Pathologic ; Humans ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Stroke

OBJECTIVE: We aimed to investigate the factors associated with suicidality among the elderly, focusing pain as the potential correlate. METHODS: This study was a community-based, cross-sectional study that included 413 elderly subjects aged 60 years and over with depression. Suicidality and pain were evaluated using Suicidal Ideation Scale and Geriatric Pain Measure, respectively. Participants were classified into two groups : 1) those with mild-to-moderate pain ; 2) those with severe pain. The risk of suicidality was determined using logistic regression, adjusting for age, sex, education, literacy status, marital status, living arrangement, the type of medical insurance, employment status, and the number of chronic medical illnesses. RESULTS: Among all subjects with depression, fifty-one (12.3%) presented clinically significant levels of suicidality. Those with severe pain were more likely to have suicidal idea (adjusted odds ratio : 20.49 ; 95% confidence interval : 8.15-51.51 ; p value : < 0.001) than those with mild-to-moderate pain, after adjusting for other variables. Other sociodemographic and clinical variables were not associated with the risk of suicide after adjustment. CONCLUSION: The severity of pain was strongly and independently associated with suicidality in the elderly individuals. This study suggests that the pain management should be emphasized to lower the rate of suicide in those experiencing depression in the late-adulthood.
Aged* ; Chronic Disease ; Cross-Sectional Studies ; Depression ; Education ; Employment ; Humans ; Insurance ; Logistic Models ; Marital Status ; Odds Ratio ; Pain Management ; Residence Characteristics ; Suicidal Ideation ; Suicide

CD44 is a transmembrane protein that acts as a receptor for an adhesion molecule, hyaluronic acid. The type of cells expressing CD44 and roles of CD44 are still controversial and need to be elucidated. The aim of the present study was to examine the type of cells expressing CD44 and the changes in their distribution in the retina and the cerebellum of the developing and adult chicken. Embryonic day 14 (E14) and post-hatch day 90 (P90) chickens were used in this study. CD44-immunoreactive (ir) cells were observed both in the retina and the cerebellum of the two developmental stages examined. In the retina of E14, CD44-ir cells were mainly located in the nerve fiber layer. In adults, most of the CD44-ir cells were in the nerve fiber layer and some were dispersed in other layers of the retina. In the cerebellum of E14, CD44-ir cells were distributed throughout the cerebellar cortex, including the external and internal granular layers. CD44-ir cells were more frequently found in the cerebellum of P90 adult chickens than in that of E14 embryos. At higher magnification, CD44-ir cells showed ramified cytoplasmic processes irradiating from their cell bodies. In the retina and in the cerebellum of all ages examined, double staining showed that most of the CD44-ir cells also expressed RCA-1, a marker of microglia. In contrast to that, at the same locations, GFAP and CD44 were not co-expressed in cells. When the adult retina was stimulated by LPS, CD44 immunoreactivity increased, and CD44-ir cells were also RCA-1-positive. The present results indicated that CD44 was expressed in microglia of the retina and the cerebellum of the developing and adult chicken even in normal conditions, and microglial CD44 expression was increased upon LPS stimulation.
Adult* ; Cell Body ; Cerebellar Cortex ; Cerebellum* ; Chickens* ; Cytoplasm ; Embryonic Structures ; Humans ; Hyaluronic Acid ; Microglia* ; Nerve Fibers ; Retina*