To evaluate the characteristics of MR findings in osteomyelitis, retrospective MR image interpretations were made in 18 patients with osteomyelitis proved either either by surgery(n=17) or clinical course(n=1). Osteomyelitis was acute in five patients, subacute in five, chronic in seven, and healed in one. Area of active inflammation had low marrow marrow signal intensity on T1-weighted images, high signal intensity on T2-weighted images inhomogeneously. It has been said that morrphologic characteristics of osteomyelitis in MR improved the accuracy in diagnosis of osteomyelitis and that gadolinium enhanced MR image further assisted in the planning of surgery. Out study was performed to observe the signal intensity change or morphologic change of bone marrow, cortex, periosteal reaction, and soft tissue which are specific for osteomyelitis. Multiple inhomogensous round marrow lesions were noted with central high signal intensity and peripheral low signal intensity on T1-weighted images, and central low signal intensity and peripheral high signal intensity on T2 weighted images in two patients. Intra and extraosseous abscesses showed rim enhancement after gadopentetate dimeglumine injectron. The signal intensity of the relatively higher than the internal area of the abscess on T1-weighted images. Cortical bone destruction showed high signal intensities T2-weighted images with destruction patterns of fine radial, circumferential, vertical or wedge shaped. MR imaging, by displaying specific signal intensities and morphological changes of bone marrow, cortex, periosteal reaction and soft tissue, would be an aid in early diagnosis and in planning for appropriate conservative and operative therapeutic procedures for osteomyelitis.
Abscess ; Bone Marrow ; Diagnosis ; Early Diagnosis ; Extremities* ; Gadolinium ; Gadolinium DTPA ; Humans ; Inflammation ; Magnetic Resonance Imaging* ; Osteomyelitis* ; Retrospective Studies

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans

The changes of phospholipase D (PLD) activity were investigated during the courses of apoptotic process induced by tumor necrosis factor (TNF)-alpha or anti-Fas/Apo1 antibody in human premyelocyte HL-60 and murine B cell lymphoma A20 cells. The treatment of recombinant TNF-alpha to HL-60 cells resulted in the increased PLD activity as determined by the phosphatidylethanol formation in the presence of 1% ethanol. The enhancement of PLD activity was also observed in the anti-Fas/Apo1 monoclonal antibody-treated A20 cells. However, the activity of PLD was maximized when HL-60 and A20 cells were treated with either TNF-alpha or anti-Fas/Apo1 monoclonal antibody for 6 h. Both TNF-alpha and anti-Fas/Apo1 monoclonal antibody increased PLD activity in a dose-dependent manner up to 200 U/ml and 200 ng/ml, respectively. When the intracellular activity of protein kinase C (PKC) was interrupted by treatment of calphostin-C, both the PLD activation and the apoptosis induced by TNF-alpha and anti-Fas/Apo1 monoclonal antibody appeared to be inhibited. Since PKC is reported to activate PLD, the results indicate that the intracellular signaling cascade via PLD may play a role in the induction of apoptosis induced by TNF-alpha and anti-Fas/Apo1 monoclonal antibody.
Animal ; Antibodies, Monoclonal/pharmacology ; Antigens, CD95/metabolism* ; Antigens, CD95/immunology ; Apoptosis* ; DNA Fragmentation ; Dose-Response Relationship, Drug ; Enzyme Activation ; HL-60 Cells ; Human ; Leukemia, Promyelocytic, Acute ; Lymphoma, B-Cell ; Mice ; Naphthalenes/pharmacology ; Phospholipase D/metabolism* ; Protein Kinase C/antagonists & inhibitors ; Receptors, Tumor Necrosis Factor/metabolism* ; Signal Transduction ; Tumor Necrosis Factor/pharmacology*

Authors report herein a case of a 27-year-old male patient who had been suffering from chronic ulcerative dermatitis with scar-like changes and successive involvement of the ankles, limb folds, nape and abdomen, and no tendency to heal from age 4. At the age 14, an immunologic study showed a selective IgA deficiency with partial T-lymphocyte inactivation. Ten years later, at age 24, he showed a severe form of morphea over a generalized area and disabling joint contractures, and was diagnosed as disabling pansclerotic morphea with an IgA value that returned to a near normal level. At the age 27, an adult-fist, 7×6×4cm sized, squamous cell carcinoma with an easy bleeding tendency like an overgrowing granulation tissue vascular tumor had developed on the chronic ulcerative lesion on the posterior aspect of the right ankle for 2 months. Aggressive metastatic lesion occurred on the right popliteal area 3 months later. He died 1 month thereafter.
Abdomen ; Adult ; Ankle ; Carcinoma, Squamous Cell* ; Contracture ; Dermatitis ; Epithelial Cells* ; Extremities ; Granulation Tissue ; Hemorrhage ; Humans ; IgA Deficiency ; Immunoglobulin A ; Joints ; Male ; Scleroderma, Localized* ; T-Lymphocytes ; Ulcer*

No abstract available.
Aneurysm ; Hemoptysis

Desmoplastic trichiepithelioma is a solitary tumor of the hair follicle with female preponderance, most commonly located on the face. Clinically the lesions appear annular and firm with a raised border and a depressed nonulcerated center, but the appearance is not so distinctive to hair follicle tumors that definite dignosis is established by the histopathologic findings. We report herein a case a case of desmoplastic trichoepithelioma in a 21-yeaar-old woman who had an asymptomatic hard, annular lesion, 0.4cm sized in diameter with a raised border and a depressed center on the right cheek. Histopathologic findings showed narrow strands of basaloid cells, horny cysts and desmoplastic stnoma, the features corresponding to the desmoplastic trichoepithelioma.
Cheek ; Female ; Hair Follicle ; Humans

BACKGROUNDS: Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional (PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometirc data and polysomnographic recordings between the two types of sleep apnea syndrome. MATERIALS: Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometirc data and polysomnographic data were analyzed, statistically. RESULTS: Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6±46.0min, p<0.05). Sleep efficiency was high in the PP group(89.6± 6.4%, 85.6±9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower(17.0±10.6, 28.5±13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7 ±1.8%, p<0.05) than in the NPP group. CONCLUSION: Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.
Apnea ; Humans ; Obesity ; Oxygen ; Polysomnography ; Respiration ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep, REM

It has been well known that ischemia reperfusion injury to skeletal muscle following an acute arterial occulusion causes significant morbidity and mortality. The skeletal muscle, which contains high energy phosphate compounds, has ischemic tolerance. During the ischemia, the ATP is catalyzed to hypoxanthine anaerobically and hypoxanthine dehydrogenase is converted to xanthine oxidase. During reperfusion, the hypoxanthine is catalyzed to xanthine by xanthine oxidase under O2 presence and that results in production of cytotoxic oxygen free radicals. The authors perform the present study to investigate the effects of allopurinol, the inhibitor of xanthine oxidase, on reperfused ischemic skeletal muscles by measuring of the immunoreactivities and exzyme activities of superoxide dismutase(SOD) and the formation of malondialdehyde(MDA). A total of 104 healthy Sprague-Dawley rats weighting from 200 gm to 250 gm were used as experimental animals. Under urethane(3.0mg/kg., IP) anesthesia with 3.0mg/kg of urethane, lower abdominal incision was made and the right and left common iliac artery were ligated by using vascular clamp for 2 hours. Both the quandriceps femoris muscles were obtained at 0 hour, half hour, 1 hour, 3 hours, 6 hours and 12 hours after the removal of vascular clamp. In the allopurinol pretreated group, 50mg/kg of allopurinol was administered once a day for 2 days and before 2 hours of ischemia. The specimens were sectioned in 14µm thickness with cryostat and homogenated ischemia. The specimens were sectioned in 14 µm thickness with cryostat and homegenated in the phosphate buffer. The immunoreactivities and enzyme activities of SOD were observed. The results were as follows: 1. The immunoreactivitiy and enzyme activity of SOD are decreased and the MDA level is increased in the 2 hours inchemic quadriceps femoris muscle of rats. 2. During the reperfusion of ischemic quadriceps femoris muscle of rats, the immunoreactivities of SOD in the half hour reperfused ischemic group and the enzyme activities of SOD in the 1 hour reperfused group are the highest and the immunoreactivities and enzyme activities of 6 hours reperfused ischemic group are the lowest. 3. Pertreatment of allopurionl decreased the immunoreactivities and enzyme activities of SOD during the ischemia and reperfusion of the quadriceps femoris muscles of rat. This results suggest that the allopurinol decreases the damages of skeletal muscles of rate during ischemia and reperfusion.
Adenosine Triphosphate ; Allopurinol ; Anesthesia ; Animals ; Free Radicals ; Hindlimb ; Hypoxanthine ; Iliac Artery ; Ischemia ; Mortality ; Muscle, Skeletal ; Muscles ; Oxygen ; Quadriceps Muscle ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase ; Superoxides ; Urethane ; Xanthine ; Xanthine Oxidase

No abstract available.
Carcinoma, Squamous Cell* ; Lung Neoplasms* ; Lung* ; Small Cell Lung Carcinoma*