BACKGROUND: Although hypochlorhydria, hypergastrinemia and antiparietal cell antibody have been well documented in the patients with hyperthyroidism, a cause of hypochlorhydria or hypergastrinemia is unknown at the present time. Therefore, in order to clarify an inhibitory mechansim of gastric acid secretion in the patients with hyperthyroidism, interrelationship among hypochlorhydria, hypergastrinemia and antiparietal cell antibody was investigated in this study. METHODS: The gastric secretory function, fasting and postprandial plasma concentrations of gastrin and titer of antiparietal cell antibody in the plasma were determined in the patients with hyperthyroidism and normal subjects. Immunoblot analysis was performed to identify the gastric membrane protein, a possible gastric antigen to antiparietal cell antibody. Using a immunocytochemical technique with electron microscopy, intracellular structure of the parietal cell reacted with antiparietal cell antibody was observed. RESULTS: The basal and pentagastrin-stimulated maximal acid output were reduced in the patients with hyperthyroidism. The fasting and postprandial plasma concentrations of gastrin were markedly elevated in the patients. The plasma gastrin concentration in the patients with the antiparietal cell antibody was higher than that of the norrnal subjects as well as the patients without the antibody not only in the fasting state but also in the postprandial state. However, the plasma gastrin concentration of the patients without the antiparietal cell antibody was elevated in the fasting state only. There was no difference in the gastrin content of the antral mucosa between the norrnal subjects and the patients. The antiparietal cell antibody was detected in 5 (38.5 %) out of 13 patients by using the indirect immunofluorescence method. Patient IgG dose-dependently inhibited rabbit gastric H (+),K (+)-ATPase activity. Among proteins of the rabbit gastric mucosa membrane, four high molecular weight proteins (91, 140, 170 and 210 K dalton) were reacted to the patient IgG. The patient IgG positive peroxidase-antiperoxidase (PAP) activity was electron microscopically detected on the intracellular cannalicular membrane of the parietal cell CONCLUSION: We conclude that hypochlorhydria and hypergastrinemia in the patients with hyperthyroidism are partially related to the antiparietal cell antibody and that the antigen to the antiparietal cell antibody may be H (+),K (+)-ATPase in the intracellular canalicular membrane of the parietal cell.
Achlorhydria ; Fasting ; Fluorescent Antibody Technique, Indirect ; Gastric Acid* ; Gastric Mucosa ; Gastrins ; Humans ; Hyperthyroidism* ; Immunoglobulin G ; Membrane Proteins ; Membranes ; Microscopy, Electron ; Molecular Weight ; Mucous Membrane ; Plasma ; Rabeprazole

It is assumed that the frequency of the meniscus tear on the right and the left knee and the mechnism of injuries in westerners are different from those in easterners. The writer had experienced 32 cases of the meniscus tear in National Police Hospital, during the period from 1973 to 1977, and inquired into its frequency and cause based on appropriate references. This is the report on the result of our study. 1. Out of 32 cases, 21 cases were found in the group of 20 to 29 years of age. 2. Eleven years of age with a discoid type was noticed as the youngest. 3. Out of 32 cases, 20 cases were found on the lateral meniscus and 12 on the medial, showing every five lateral cases to every three medial cases. 4. Out of 32 cases, 17 cases were found on the right knee joint with 14 lateral and 15 on the left knee joint with 9 medial. 5. Out of 32 cases, 27 cases were found on the male and 5 on the female, showing 5. 4 male cases to every one female case. 6. Out of 32 cases, 29 cases had the apparent history of trauma. 7. Transverse tear was found more frequent on the lateral meniscus and longitudinal or bucket handle tear was found more frequent on the medial meniscus.
Clinical Study ; Female ; Humans ; Knee ; Knee Joint ; Male ; Menisci, Tibial ; Police ; Tears

PURPOSE: Optic disc harmatoma is usually seen in tuberous sclerosis patients, but, it may be seen in otherwise normal people. Visual acuity is usually not affected by this lesion. METHODS: We experienced a 40-year-old woman with optic disc hamartoma who presented with acute visual defect. With oral triamcinolone 48mg/day, her visions recovered to normal in 2 weeks. RESULTS: Her age, symptom, and course of disease supported the diagnosis of optic neuritis. CONCLUSION: We report this patient as a case of optic disc hamartoma combined with optic neuritis.
Adult ; Diagnosis ; Female ; Hamartoma* ; Humans ; Optic Neuritis* ; Triamcinolone ; Tuberous Sclerosis ; Visual Acuity

PURPOSE: To evaluate 5-year survival rate, patterns of failure and complications of cervical cancer treatment, fifty nine patients treated by curative cancer were analyzed retrospectively. METHODS AND MATERIALS : From March 1986 to May 1990, fifty nine patients with histologically proven uterine cervical cancer were analyzed. According to FIGO stage, there were 2 patients (3.4%) in stage Ib, 2 patients (3.4%) in stage IIa, 31 patients (52.5%) in stage IIb, 15 patients (25.4%) in stage IIIb, 9 patients (15.3%) in stage IV, External RT was per formed by 6 MVLINAC with daily 1.8 Gy, 5 times per week and followed by ICR, A point dose of ICR was calculated to 30-43.66 Gy (median : 34.6Gy). These techniques delivered total A point dose of 80.4 to 109.8 Gy (median : 85Gy). Patients had been followed up from 2 to 110 months (median : 61 months) RESULTS: The overall 5-year survival rate & disease free survival rate were 55.9% and 55.0 % respectively. According to FIGO stage, the 5-year survival rate for less than Iia, IIb, IIIb, IV were 75.0%, 74.8%, 26.7%, 33.3%, respectively. In univariate analysis, the 5-year survival rate for stage IIb and below versus stage llla and above revealed 74.8%, 29.2% respectively (p<0.005). According to FIGO stage, the 5-year survival rate for less than lla, llb, lllb, IV were 75.0%, 74.8%, 26.7%, 33.3%, respectively. In univariate analysis, the 5-year survival rate for stage llb and below versus stage llla and aboce revealed 74.8%, 29.2% respectively (p<0.005). According to the hemoglobin level during RT, the 5-year survival rate of was 73.3% for patients with Hg 10 gm/dL or higher, in contrast to 0% for those with lower than 10 gm/dL (p<0.005). In 18 patients with nonbulky tumor (<5 cm), the 5-year survival rates were 71.8%. The 5-year survival rates for 18 patients with 5 cm or greater in tumor diameter were 22.2% (p<0.005). The 5-year survival rate for patient age of above 50 years and below were 65.3%, 34.2% respectively (p<0.05). ECOG performance status, pathologic finding, total dose, total treatment time were not statistically significant factors. The significant prognostic factors affecting overall 5-year survival rate by multicariate analysis showed the hemoglobin level during RT (p=0.0001), tumor size (p=0.0390), FIGO stage (p=0.0468) Total recurrence rate was 23.7%; local failure 15.2% (9/59), distant metastasis 6.8% (4/59), local and distant metastasis 1.7% (1/59). According to the RTOG/EORTC Soma Scales, the late complication rate was 23.8% (14/59). The late complication rate of colorectum and genitourinary tract were 15.3% (9/59), 8.5% (5/59), respectively : 10 patients(17.0%) were grade 2, 3 patients (5.1%) were grade 3 and one patient (1.7%) (1/59). According to the RTOG/EORTC Soma Scales, the late complication rate was 23.8% (14/59). The late complication rate of colorectum and genitourinary tract were 15.3% (9/59), 8.5% (5/59), respectively : 10 patients (17.0%) were grade 2,3 patients (5.1%) were grade 3 and one patient(1.7%) was grade 4. The late complications were radiation proctitis, rectal bleedint, radiation colitis, diarrhea and radiation cystitis in decreasing order. CONCLUSION: For improvement of therapeutic results, prospective randomized trials are recommended to discover new prognostic factors and more aggressive radiation therapeutic methods are needed for poor prognostic patients. The adjuvant chemotherapy or radiation-sensitizing agents must be considered to inhibit regional and distant metastasis.
Carisoprodol ; Chemotherapy, Adjuvant ; Colitis ; Cystitis ; Diarrhea ; Disease-Free Survival ; Humans ; Neoplasm Metastasis ; Proctitis ; Radiation-Sensitizing Agents ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms* ; Weights and Measures

Cardiac transplantation has become an acceptable therapy for patients with end stage heart disease over the last decade. We experienced a case of heart transplantation to the 50 year old female patient. We used sterile technique all the time to reduce the incidence of infection. Anesthesia was induced and maintained with fentanyl 100 ug/kg. After cardiopulmonary bypass, blood products, inotropics and vasodilators were given to maintain myocardial contractility and cardiac output. The patient recovered uneventfully and discharged on 29th postoperative day.
Anesthesia* ; Cardiac Output ; Cardiopulmonary Bypass ; Female ; Fentanyl ; Heart Diseases ; Heart Transplantation* ; Heart* ; Humans ; Incidence ; Middle Aged ; Vasodilator Agents

Submacular hemorrhage from various causes induces the irreversible damage to the retina, leading to poor visual outcome. Surgery for removal of submacular hemorrhage was performed but the general results were not satisfactory in spite of better surgical technique. We took this study to identify the effectiveness and safety of intravitreal injection of tissue plasminogen activator(tPA) and SF6 for displacement of submacular hemorrahge. Thirteen patients who have submacular hemorrhage had undergone intravitreal injection of tPA and SF6 and positioned face down for about 1 week. Postoperative complication, best corrected visual acuity, final visual acuity, amount of displacement related to the duration of submacular hemorrhage and causal diseases were checked retrospectively. The average age of the patients was 64. Six eyes(46.2%) improved visual acuity by 2 lines or more, and 2 eyes(15.4%) lost visual acuity 2 lines or more. Complications included vitreous hemorrhage in 2 eyes, increased intraocular pressure in 2 eyes. Causes were trauma in 3 eyes and age-related macular degeneration in 10 eyes. The final visual results after 5 months or longer were related with macular lesion. Complete displacement was achieved in 10 eyes, partial displacement in 4 eyes at 1 month. The authors concluded that brief prone position after intravitreal injection of tPA and SF6 is rapid and effective method for displacement of submacular hemorrhage.
Hemorrhage* ; Humans ; Intraocular Pressure ; Intravitreal Injections* ; Macular Degeneration ; Plasminogen ; Postoperative Complications ; Prone Position ; Retina ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage

In this article, the statement of ethical statement about animal experiment was omitted.

The widespread application of coronary angiography and poen heart surgery have resulted in more frequent detection of patients with coronary artery anomaly. In 0.6 to 1.2 percent of individials, the coronary arteries arise aberrantly from the aorta. Anomalous origin of the left coronary artery from the fight coronary sinus with subsequent coursing between the aorta and pulmonary artery is a rare and sometimes fatal coronary amonaly. This anomaly has been reported in young and healthy men who died suddenly during or immediately forllowing vigorous physical exercise. The exact mechanism of sudden death is unclear. It is believed to be related to either extrinsic compression of the left coronary artery or distorsion of the vessel orifice, with resultant global ischemia and ventricular fibrllation. A 13-years old healthy boy, who was completely asymptomatic until he had sudden chest pain after running, arrived at hospital with typical clinical picture of acute myocardial infarction. The electrocardiography taken on admission demonstrated pathologic Q wave changes on lead I, aVL, V2, V3 and V4. Cardiac enzymes were elevated. The selective coronary angiography demonstrated that left coronary artery arose from the right coronary sinus. The anomalous left coronary artery passed posterioly around aortic root to reach its normal position in the interventricular groove. We report the patient with anomalous origined left coronary artery which causes the acute myocardial infarction.
Adolescent ; Aorta ; Chest Pain ; Coronary Angiography ; Coronary Sinus* ; Coronary Vessels* ; Death, Sudden ; Electrocardiography ; Exercise ; Humans ; Ischemia ; Male ; Myocardial Infarction* ; Pulmonary Artery ; Running ; Thoracic Surgery

Steroid sulfatase (STS) is an enzyme responsible for the hydrolysis of aryl and alkyl sulfates. STS plays a pivotal role in the regulation of estrogens and androgens that promote the growth of hormone-dependent tumors, such as those of breast or prostate cancer. However, the molecular function of STS in tumor growth is still not clear. To elucidate the role of STS in cancer cell proliferation, we investigated whether STS is able to regulate the integrin signaling pathway. We found that overexpression of STS in HeLa cells increases the protein and mRNA levels of integrin β1 and fibronectin, a ligand of integrin α5β1. Dehydroepiandrosterone (DHEA), one of the main metabolites of STS, also increases mRNA and protein expression of integrin β1 and fibronectin. Further, STS expression and DHEA treatment enhanced phosphorylation of focal adhesion kinase (FAK) at the Tyr 925 residue. Moreover, increased phosphorylation of ERK at Thr 202 and Tyr 204 residues by STS indicates that STS activates the MAPK/ERK pathway. In conclusion, these results suggest that STS expression and DHEA treatment may enhance MAPK/ERK signaling through up-regulation of integrin β1 and activation of FAK.
Androgens ; Breast ; Cell Proliferation ; Dehydroepiandrosterone ; Estrogens ; Fibronectins ; Focal Adhesion Protein-Tyrosine Kinases ; HeLa Cells ; Humans* ; Hydrolysis ; Phosphorylation ; Prostatic Neoplasms ; RNA, Messenger ; Steryl-Sulfatase* ; Sulfates ; Up-Regulation ; Uterine Cervical Neoplasms*

No abstract available.
Infarction* ; Retrospective Studies*