The purpose of this study was to investigate the inhibitory role of vitamin A with respect to activation of Ito cells in fibrosis of the rat liver induced by common bile duct ligation(CBDL). The liver was examined by immunohistochemical staining for a-smooth muscle actin,the known marker of activated Ito cells, and light and electron microscopy after CBDL andCBDL with intraperitoneal injection of retinoic acid (Sigma, USA) 1 mg/Kg in 3 times per week. The results were sumrrlerized as follows: After CBDL, the bile ductules were markedly proliferated in the periportal areas extending toterminal hepatic veins. Interstitial fibrosis and inflammatory cell infiltration appeared, however,cholestasis was minimal. Retinoic acid treatment with CBDL decreased bile ductular proliferationand interstitial fibrosis compared to CBDL only. After CBDL, proliferated and activated Ito ceIs showing positive reaction in smooth muscle actin were present in the periductular andperisinusoidal areas, and areas of increased interstitial fibrosis. Activated ito cells weredecreased in number after CBDL with vitamin A treatment. Electron microscopically,intracytoplasmic fat droplets and the cytoplasmic processes of Ito cells were decreased afterCBDL. Myofibroblasts were frequently appeared in the interstitial fibrosis after CBDL. But,intracytoplasmic fat droplets of Ito cells were well preserved, and myofibroblasts were found lessfrequently after CBDL with vitamin A treatment. The results suggest that vitamin A plays an inbitory role in the activation and fibrogenesis ofIto cells after CBDL.
Rats ; Animals

The effect of spinal anesthesia with hyperbaric bupivacaine with and without 1: 1000 epinephrine were studied in 35 patients. Patients in group A received 0.4% hyperbaric bypivacaine 20 mg and patients in group B received the same anesthetic, only 0.2 mg of epinephrine was mixed to it. The following results were obtained. 1) The highest level of sensory loss was similar in both groups. 2) The duration of sensory loss was significantly longer in group B(391+/-12.9 vs 289+/-18.8min, p<0.05) The duration of motor block was also significantly longer in group B than group A(254 +/-13.7 vs 17l+/-4.4 min). 3) The systolic blood pressure significantly decreased at 20-40 minutes after spinal anesthesia in both groups. 4) The pulse rate in group A significantly increased at 2-10 minutes after spinal anesthesia and in group B, it decreased significantly at 45-50 minutes after spinal anesthesia.
Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine* ; Epinephrine* ; Heart Rate ; Humans

Morphological changes of hepatic microcirculation, especially in the peribiliary plexus, in cirrhotic livers of rats induced by repeated intraperitoneal injections of N-diethyinitrosamine (DEN) (100mg/kg/week) were studied by scanning electron microscopy. Control rats were treated with saline. The livers were perfused with saline and injected with methyl-methacrylated resin (Mercox CL-2B) through the thoracic aorta. Diffuse nodular changes mimicking human cirrhosis were seen in the livers six weeks after injections of DEN. The cirrhotic livers showed an increase of vascular channels composed mainly of venous branches around the regenerating nodules and increased arterioloportal anastonloses. Peribiliary plexi of the cirrhotic livers had more vessels than those of the controls. Many dilated veins and ramificating portal vein branches were also Present. Direct connections between peribiliary plexi and sinusoids or between peribiliary plexi and portal veins were increased in the cirrhotic liver. These results suggest that the peribiliary plexi in experimentally induced cirrhotic liver might play a role in a collateral circulation under a state of portal hypertension.
Humans ; Rats ; Animals

In an attempt to evaluate the cardiotoxicity of bupivacaine, beating rate, tetrazolium MTT and lactate dehydrogenase activity were investigated in the medium containing bupivacaine for 24 hours after neonatal rat myocardial cells were cultured for 72 hours. Light and electron microscopic studies were also carried out. The results were as follows ; 1) Beating rate decreased dose-dependently, and beating cells were not observed over 10(-4) M concentration of bupivacaine. 2) MTT50 value was 0.32 ug/ml (1,000 uM). 3) The amount of lactate dehydrogenase released into the medium was 192% of control cells at 10(-3) M concentration of bupivacaine. 4. In light microscopy, myocardial cells were decreased in number dose-dependently, and showed a few cytoplasmic processes and lots of granules in cytoplasm at 10 M concentration of bupivacaine. 5. Electron microscopy of bupivacaine-treated cells showed smooth endoplasmic reticulum, destruction of mitochondria and Golgi apparatus and increase of vacuoles and dense bodies. It also showed dilatation of rough endoplasmic reticulum and loss of myofibrils. These results suggest that high concentration of bupivacaine (> or = 10(-4) M) induee remarkable toxicity on cultured rat myocardial cells.
Animals ; Bupivacaine* ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum, Rough ; Endoplasmic Reticulum, Smooth ; Golgi Apparatus ; L-Lactate Dehydrogenase ; Microscopy ; Microscopy, Electron ; Mitochondria ; Myofibrils ; Rats* ; Vacuoles

Lipomas of the heart are benign neoplasms and have rarely been described. Due to the fact that they normally cause no symptoms, diagnosis is often purely accidental. Because of the rarity of these tumors, it seems worthwhile to present an example studied at autopsy. It was associated with the sudden death of a 15-year-old boy. The tumor arose from the wall of the left ventricle and occupied the pericardial cavity, measuring 13x7x6 cm in size. The tumor was whitish-yellow, translucent, and soft. Microscopically, the tumor was composed of mature adipose tissue which extended between muscle fibers. This current case, the giant cardiac lipoma is believed to produce disturbances of the conduction system and distrubances of cardiac filling.

No abstract available.
Toluene* ; Xylenes*

No abstract available.
Thyroid Gland* ; Thyroiditis*

Deposition of monosodium urate crystal in joints and periarticular soft tissue is regarded as one of the characteristics of chronic gouty arthritis. In spine, however, only nineteen cases of tophaceous deposits have been reported to date suggesting the rarity of clinical symptoms secondary to involvement of spine. Authors report a case of spinal stenosis due to hypertrophy of ligament flavum with monosodium urate deposits. The patient was 65 years of age with chronic gouty arthritis who underwent a decompressive laminectomy at L4-5. At surgery, hypertrophied ligament flavum that was covered with chalky amorphous materials was noted without any evidence of radiologic features. Microscopically, a portion of ligament flavum had been focally destoryed by amorphous material deposits that were surrounded by a thin layer of mononuclear and giant cells along with occasional sprinkling of chronic inflammatory cells and negative birefringence on polarizing microscopy.
Arthritis, Gouty ; Birefringence ; Giant Cells ; Humans ; Hypertrophy* ; Joints ; Laminectomy ; Ligaments* ; Microscopy ; Spinal Stenosis* ; Spine ; Uric Acid*

PURPOSE: Hypothalamic hamartomas are non-neoplastic malformations which are composed of hyperplastic neuronal tissue of varying size. Clinically, they are characterized by gelastic seizure, precocious puberty, and behavioral and psychiatric disorders. This study was performed to examine the various features of hypothalamic hamartomas such as neurologic manifestations, other clinical manifestations, and EEG and brain MRI findings. Response to AEDs or outcome of operation on hypothalamic hamartoma was evaluated. METHODS: Eleven patients who were admitted to Seoul National University Children's Hospital from July 1986 to January 1997 and diagnosed as hypothalamic hamartoma by brain MRI or CT were enrolled in this study. Clinical manifestations and EEG were reviewed retrospectively through the medical records. The size and type of the hypothalamic hamartoma on brain MRl were analyzed. RESULTS: 1) The range of age at visit was 1yr 9mo to 17yr 2mo (mean 10yr 8mo), and the age at onset was 1yr 1mo to 14yr to 2mo (mean 5yr 8mo). Six patients were male and five were female. 2) The clinical manifestations included gelastic seizure (n=9), behavioral and psychiatric disorders (n=9), other types of seizure (n=8), and precocious puberty (n=6). Other types of seizure were complex partial seizure (n=3), generalized tonic seizure(n=3), and infantile spasm (n=2). 3) The interictal EEG findings included focal spike discharges (n=8), diffuse delta slowings (n=1), hypsarrhythmia (n=1), and normal record (n=1). The focal spike discharges originated from the temporal (n=2), fronto-temporal (n=1), occipital (n=3), or frontal area(n=2). 4) The brain MRI showed that the size of the hypothalamic hamartomas was 2.47+/-1.12cm, and the origin of the tumors was tuber cinereum (n=6) or tuber cinereum and mamillary body (n=5). All lesions were isointense on T1-weighted image relative to normal gray matter, with a sessile attachment to the hypothalamus, and were not enhanced by Gadolinium. 5) Operations were done in 5 cases, those were subtotal removal of the tumor (n=4), and gamma knife radiosurgery (n=1). Seizures were not completely controlled in all but one case on which gamma knife radiosurgery was done. CONCLUSIONS: The hypothalamic hamartomas presented variable clinical pictures including gelastic seizure, precocious puberty, and behavioral and psychiatric disorders. The gelastic and other types of seizure associated with hypothalamic hamartomas were refractory to medication and might be controlled by total removal of the tumor.
Brain ; Electroencephalography ; Female ; Gadolinium ; Hamartoma* ; Humans ; Hypothalamus ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging* ; Male ; Mamillary Bodies ; Medical Records ; Neurologic Manifestations ; Neurons ; Puberty, Precocious ; Radiosurgery ; Retrospective Studies ; Seizures ; Seoul ; Spasms, Infantile ; Tuber Cinereum

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*