The Dichloromethane(methylene chloride) is a highly volatile liquid used as a solvent, extraction medium, and paint remover. The most significant route of intoxication to dichloromethane is generally inhalation at work site or home, but ingestion is rare. The main toxicological harvard insults from in vivo conversion of dichloromethane to carbon monoxide. We present a case of dichloromethane intoxication following ingestion. A 71 years old male patient ingested 60-70cc of dichloromethane was brought to emergency department after stomach washout via nasogastric tube at other hospital. On arrival at emergency department(approximately 19 hours after ingestion), he was stuporous with a blood pressure 140/90mmHg, heart rate of 92 beats/min, dyspneic, respiratory rate of 24/min and body temperature 36.8 degrees C. His Pupils were isocoric, miotic, and sluggishly reactive. There were mucosal bums and significant secretion in oral cavity. On auscultation, breathing sound was coarse without role on both lung field. The COHb levels were 6.3%at 32 hours after ingestion and normalized to 0.6%at 44 hours after ingestion. Patient was transfered to intensive care unit and supportive care was started with 100% oxygen. On ingestion 4th day, chest X-ray showed pulmonary edema and acute respiratory distress syndrome developed. Patient regained the consciousness on the 11th day. On the 30th day, respiratory function improved and the ventilator was removed. Alveolitis and mild pulmonary fibrosis developed and mild dyspnea was continued. On the 36th day, gastroscopic examinations showed ulceration of esophagus and stomach. On the 76th day, patient was discharged after pulmonary rehabilitation.
Aged ; Auscultation ; Blood Pressure ; Body Temperature ; Carbon Monoxide ; Consciousness ; Dyspnea ; Eating* ; Emergencies ; Emergency Service, Hospital ; Esophagus ; Heart Rate ; Humans ; Inhalation ; Intensive Care Units ; Lung ; Male ; Methylene Chloride* ; Mouth ; Oxygen ; Paint ; Pulmonary Edema ; Pulmonary Fibrosis ; Pupil ; Rehabilitation ; Respiratory Distress Syndrome, Adult ; Respiratory Rate ; Respiratory Sounds ; Stomach ; Stupor ; Thorax ; Ulcer ; Ventilators, Mechanical ; Workplace

Although the distribution of locus ceruleus terminals has been demonstrated in the fundus striati[nucleus accumbens septi] by light microscopy[Jones & Moore, 1977 ; Mason & Fibiger, 1979 ; Streit or et al., 1979 ; Groenewegen et al., 1980], the synaptic organization of its terminals was not clarified. The purpose of the present investigation was to demonstrate the direct monosynaptic connection of the locus ceruleus terminals to the neuronal elements of the fundus stirati, and to clarify the synaptic structures of its terminals by electron microscopy two days after unilateral electric coagulation of the locus ceruleus. In the ipsilateral fundus striati, many axon terminals undergone dark degeneration were observed. These degenerating terminals containing small clear vesicles have asymmetric synaptic contacts with dendritic spines. Already two days after locus ceruleus lesion, distinct features of terminal degenerations appeared in the fundus striati ; enlarged axon terminals with altered synaptic vesicles, decrease of synaptic vesicles detached from the synaptic site, multiplication of dense bodies and infiltration of floccular material. At the same time, a regressive change occurred in which astrocytic processes encircled totally degenerated synapses spiraled around the synaptic remnants. These observations indicate that monosynaptic noradrenertic afferent connections to the fungus striati are confirmed, and the locus ceruleus terminals characterized by small round vesicles might be formed asymmetrical axo-spinous synapses with spiny neurons in the fundus striati.
Animals ; Cats* ; Dendritic Spines ; Fungi ; Locus Coeruleus* ; Microscopy, Electron ; Neurons ; Presynaptic Terminals ; Synapses ; Synaptic Vesicles

A putative polypeptide hormone identified as amylin[islet amyloid polypeptide] is synthesized and co-localized with insulin in B cells of pancreatic islets in several animal species including man. However, there is growing evidence that somatostatin cells are also expressed and contained amylin in the pancreatic islets of the rat The aim of the present study was to investigate the immunocytochemical expression of the amylin within the endocrine pancreas of the man, rabbit and guinea pig, with special reference to the possible ability of islet cells other than insulin cells to synthesize amylin. For this purpose serial sections of the pancreatic islets were stainedimmunocytochemically using anti-amylin, anti-insulin, anti-glucagon, anti-somatostatin antisera. In serial sections of pancreatic islets of the man and rabbit, it was shown that amylin immunoreactivity occurred in insulin-reactive B cells predominantly located in interior of the islets. In contrast, amylin immunoreacivity appeared in glucagon-reactive A cells peripherally located in the islets of the guinea pig. These results suggest that in both the man and rabbit, amylin is synthesized by B cells for subsequent co-secretion with insulin, and that in guinea pig, amylin is synthesized by A cells for co-secretion with glucagon. It thus appears that amylin release may be mediated by different secretory mechanisms according to animal species.
Amyloid ; Animals ; B-Lymphocytes ; Glucagon ; Guinea Pigs* ; Guinea* ; Immune Sera ; Immunohistochemistry ; Insulin ; Islet Amyloid Polypeptide* ; Islets of Langerhans* ; Rats ; Somatostatin-Secreting Cells

Oxyen consumption of surgical patients was measured by McKesson Metabolar (Model 185) on the Recording Metabolar Chart (M-147) in four groups: group A, at resting state immediately before preanesthetic medication; group B, immediately following induction of anesthesia with thiopental (10 mg./kg.); group C. 30 minutes after surgical ether anesthesia; and group D, when conciousness returned during the stay in the recovery room. The results are as follows: (1) Thiopental reduced oxygen consumtion by 25 per cent. (2) Ether anesthesia reduced, oxygen consumption by 59 per cent. (3) During recovery from anesthesia, oxygen consumption was 28 per cent below the control. (4) Comparing with other data, ether anesthesia reduced oxygen consumption significantly more than fluothane or nitrous oxide did.
Anesthesia ; Anesthesia, General* ; Ether ; Halothane ; Humans ; Nitrous Oxide ; Oxygen Consumption* ; Oxygen* ; Preanesthetic Medication ; Recovery Room ; Thiopental

BACKGROUND: It is important to evaluate the patient presenting with non-traumatic chest pain in emergency department, and it is also difficult to classify appropriately. The purpose of this study is to predict probability of acute myocardial infarction(AMI) and assess the group for low probability of AMI that is target for observation-unit of chest pain in emergency department. METHODS: A prospective, clinical study was performed from March 1998 to August 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. We classified high-probability group and low-probability group of AMI according to Goldman's algorithm and then compared with the final diagnosis. RESULTS: The study included 218 patients. 84 patients(39%) was the high-probability group and 134 patients(61%) was the low-probability group of AMI. As compared with final diagnosis, AMI was 47 patients(56%) among the high-probability group and 1 patient(0.7%) among the low-probability group. We observed sensitivity of 98%, specificity of 78% in predicting AMI. CONCLUSION: The classification according to Goldman's algorithm may be useful predictor of AMI and improve triage for emergency department patient with chest pain. It is also helpful for management of observation-unit of chest pain in emergency department.
Chest Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Thorax* ; Triage

The purpose of this study was to establish the role of apoptosis in the developing renal corpuscle in the prenatal rat kidney. Kidneys from 14-, 16-, 18-, and 20-day-old fetuses[E-14, E-16, E-18, and E-20] were preserved by immersion or perfusion via the heart using Bouin`s fixative. Apoptosis was detected`by in situ nick end labeling method using ApopTag kit. In kidneys from E-14, apoptotic cells and bodies were found only in the mesenchymal tissue surrounding the developing nephrons. In kidneys from E-16, E-18, and E-20, apoptotic cells and bodies were located mainly in the columnar distal epithelium of the renal vesicle[future parietal epithelium] as well as in the parietal epithelium of the renal corpuscles of S-shaped bodies, stage III and IV nephrons. Apoptosis was not observed in the proximal part of renal vesicles or in the podocytes in renal corpuscles. In contrast, strong bel-2 immunoreactivity was present in the proximal part of the renal vesicle and in podocytes in S-shaped bodies, but gradually decreased in stage III and IV nephrons. The distal part of the renal vesicle had weak staining for bcl-2, and there was no bel-2 immunoreactivity in the parietal epithelium of S-shaped bodies, and stage III and IV nephrons. We conclude that bcl-2 is involved in the regulation of apoptosis during the differen-tiation of the parietal epithelium of Bowmann`s capsule.
Animals ; Apoptosis* ; Epithelium* ; Heart ; Immersion ; In Situ Nick-End Labeling ; Kidney* ; Nephrons ; Perfusion ; Podocytes ; Rabeprazole* ; Rats*

Though the occurrence of multiple primary malignant tumor is a rare finding but the reported cases of it has increased in recent years. We collected multiple primary cancer of different organ, tissue and the multicentric origin of bilaterally paired organs. This paper reports 6 cases of multiple primary malignant tumors which were experienced at Yeungnam university hospital in Taegu during the past 2 years with review of journals. The results were as follows. 1. The incidence of multiple primary cancer was 0.31% for 2 years (1987-1988). 2. The ratio between male and female was 1:1 and mean age of incidence was 54.1 years. 3. The ratio between synchronous and metachronous (interval more than 6 months) was 1:1. 4. The time interval between first and second cancer was average 2.7 years in metachronous cases. 5. The most frequent involved organ was stomach, breast and colon in order of frequency. 6. The incidence of familial cancer associations was found in one out of 6 cases. 7. The test of DNCB, multitest CMI and ratio of T4 to T8 were performed in 4 cases but there was no definitive evidence of abnormality. We concluded that every effort should be made to discover the presence of synchronous malignancies in the patients who are being treated for a known tumor, and also special care should be given to detect new metachronous lesions is required.
Breast ; Colon ; Daegu ; Dinitrochlorobenzene ; Female ; Humans ; Incidence ; Male ; Neoplasms, Second Primary ; Stomach

OBJECTIVE: We previously described that Diva is highly expressed in matured metaphase II (MII) oocytes compared to immature germinal vesicle (GV) oocytes in mouse.1 We report here that the expression of Diva transcript as well as protein is oocyte-specific. To elucidate its physiological role in oocyte, the binding partner(s) of Diva has been identified by using immunoprecipitation (IP) followed by Mass Spectrometry. METHODS: NIH/3T3 cells were transiently transfected for 24 h with either empty vector for control or FLAG-tagged mouse Diva construct, and IP was performed with anti-FLAG antibody. The immuno-isolated complexes were resolved by SDS-PAGE on a 12% gel followed by Coomassie Blue staining. For in-gel digestion, 15 bands of interest were excised manually and digested with trypsin. All mass spectra were acquired at a positive reflector mode by a 4700 Proteomics Analyzer (Applied Biosystems, Framingham, MA). Proteins were identified by searching the NCBI nonredundant database using MASCOT Peptide Mass Fingerprint software (Matrixscience, London). RESULTS: Diva-associated complexes were formed in FLAG-tagged mouse Diva-overexpressed NIH/3T3 cells via IP using anti-FLAG-conjugated beads. Among the excised 15 bands, actin and actin-binding proteins such as tropomyosin, tropomodulin 3, and alpha-actinin were identified. Binding between Diva and actin or tropomyosin was confirmed by IP followed by Western blot analysis. Both bindings were also detected endogenously in mouse ovaries, indicating that Diva works with actin and tropomyosin. CONCLUSIONS: This is the first report that immuno-isolated Diva-associated complexes are related to actin filament of the cytoskeletal system. When we consider the association of Diva with actin and tropomyosin, oocyte-specific Diva may play a role in modulating the cytoskeletal system during oocyte maturation.
Actin Cytoskeleton ; Actinin ; Actins ; Animals ; Blotting, Western ; Dermatoglyphics ; Digestion ; Electrophoresis, Polyacrylamide Gel ; Female ; Immunoprecipitation ; Mass Spectrometry* ; Metaphase ; Mice ; Microfilament Proteins ; Oocytes ; Ovary ; Proteomics ; Tropomodulin ; Tropomyosin ; Trypsin

No abstract available.
Mycobacterium chelonae* ; Mycobacterium* ; Skin*

No abstract available.
Cicatrix, Hypertrophic* ; Skin*