No abstract available.
Multicystic Dysplastic Kidney* ; Ultrasonography, Prenatal*

GTPrS-dependent phospholipase D activity in human neutrophils was investigated using exogenous phospholipid as a substrate. Both cytosolic and membrane- associated phospholipase D activities were identified. The previously described 50 kDa cytosolic activating factor was resolved chromatographically from the cytosolic phospholipase D. Using exogenous phospholipid as substrate along with chromatographically resolved 50 kDa factor and recombinant ADP-ribosylation factor 1, plasma membrane was required for activity, indicating that the activity which was previously seen using endogenous phospholipid substrate was due to a phospholipase D located in the plasma membrane. In addition, ADP-ribosylation factor and the 50 kDa factor activated synergistically. Using neutrophil plasma membranes, a third regulator of neutrophil membrane phospholipase D was identified from bovine brain cytosol. This factor was resolved from ADP-ribosylation factor and Rho A by successive column chromatographies. The brain factor showed a synergistic effect with the 50 kDa neutrophil activator but an additive effect with recombinant ADP- ribosylation factor. Whether or not ADP-ribosylation factor or the brain factor were present, high activities were seen only when the 50 kDa factor was present, indicating that the 50 kDa cytosolic factor is a major activating factor for the neutrophil plasma membrane phospholipase D.
ADP-Ribosylation Factor 1 ; ADP-Ribosylation Factors* ; Brain* ; Cell Membrane ; Chromatography ; Cytosol* ; Fibrinogen ; Humans ; Membranes ; Neutrophils* ; Phospholipase D* ; Phospholipases*

Glucocorticoids are usually given according to a standard dosing protocol regardless of individual difference. We evaluated the pharmacokinetic characteristics of methylprednisolone and the degree of interpatient variation in stable Korean renal transplant recipients during the period of 15-21 days after transplantation. This study included 23 renal transplant recipients, 13 males and 10 females, who received kidneys from living donors with stable graft function and without episode of acute rejection. On the study day at 8 A.M., 16.3mg of ethylprednisolone sodium succinate (i.v.) was administered to each patient instead of usual dose (20mg) of prednisolone (p.o.) after sampling of 7cc of baseline blood and additional blood samples were drawn after starting infusion. Plasma was separated and analyzed for methylprednisolone level using high performance liquid chromatography (HPLC) assay, and parameters for pharmacokinetics were calculated. There was significant interpatient variation in the pharmacokinetics of methylprednisolone in our patients group. There was no significant difference in the pharmacokinetic parameters between patients with and without side effects of steroid. Korean renal transplant recipients had higher volume of distribution than black renal transplant recipients; lower clearance than white renal transplant recipients; longer t1/2 than both black and white renal transplant recipients. Even if the number of patients included in this study was too small to reach conclusion, the differences in the pharmacokinetics of glucocorticoids do not seem to be a significant risk factor for side effects of steroid after transplantation. It may be necessary to individualize the dose of a glucocorticoid to achieve an optimal effect and also we need to establish a new steroid regimen protocol for Korean renal transplant recipients.
Chromatography, Liquid ; Female ; Glucocorticoids ; Humans ; Individuality ; Kidney ; Kidney Transplantation ; Living Donors ; Male ; Methylprednisolone* ; Pharmacokinetics ; Plasma ; Prednisolone ; Risk Factors ; Sodium ; Succinic Acid ; Transplantation* ; Transplants

Ancient schwannoma is a variant of schwannoma characterized by slow progression, degenerative changes, and a higher incidence in older adults. There have been two prior reported cases of ancient schwannoma arising from the distal ulnar nerve at the wrist level, but neither were longstanding or very large. Herein, we report an ancient schwannoma found in the ulnar nerve of the distal forearm that was found to be clinically meaningful in size. A 61-year-old man presented with complaints of tingling sensation of the fourth and fifth fingers and bulging of the ulnar side of the wrist. The patient reported that the mass in his wrist had grown very slowly, starting about 10 years ago, and that he had started experiencing a tingling sensation in his fourth and fifth fingers about 3 years prior, which had become worse in the past year. Based on the results of the preoperative examination, a benign nerve sheath tumor was suspected. As it was thought that the possibility of malignancy was not high, we elected to perform a marginal excision. Pathological examination confirmed ancient schwannoma. At his most recent visit, 3 years after surgery, he reported no recurrence and that he felt better than before surgery, but some tingling sensations remained. As with small ancient schwannoma in the distal wrist, most cases of large ancient schwannoma can be treated without special complications based on an accurate preoperative diagnosis.

PURPOSE: To compare clinical outcomes when using open or arthroscopic release for recalcitrantlateral epicondylitis. MATERIALS AND METHODS: A total of 34 cases were followed up for an average of 16 months. Open release was performed in 21, and arthroscopic release in 13. In the open release group, arthroscopic examination was performed first in 7. Intraarticular and extraarticular lesions of the extensor tendon were compared. Pain was evaluated using the Visual Analog Scale, and function was evaluated using the assessment of Nirschl and Pettrone. RESULTS: In arthroscopic findings, 6 out of 20 cases were nearly normal, 6 showed fraying, 4 a linear tear, and 4 avulsion. Some (3 of 5) cases with nearly normal arthroscopic findings had mucinoid degeneration detected during the open procedure. Overall, 86% of open release and 85% of arthroscopic release showed satisfactory results. CONCLUSION: The extraarticular and intraarticular surfaces of the extensor origin had diverse appearances, and both procedures showed satisfactory results. Therefore, arthroscopic release is a useful treatment option for recalcitrant lateral epicondylitis.
Elbow ; Tendons

OBJECTIVE: Endometriosis is a common gynecologic disorder characterized by the presence of endometrial tissue outside the uterine cavity. Many theories have been suggested to explain the mechanism for the development of this disease. Although no single theory can explain all cases of endometriosis, retrograde menstruation theory has gained the widest acceptance. But the discrepancy between the incidence of retrograde menstruation and prevalence of endometriosis suggests that additional factor(s) may determine susceptibility to endometriosis in the peritoneal cavity and the survival and implantation of endometrial cells seem to be related with immunologic factors. For evaluation of the immunologic factors, we investigated the effects of peritoneal fluid from patients with advanced endometriosis (EPF) on the HLA-DR expression of monocytes. METHODS: EPF (n=20) and peritoneal fluid from the control group (CPF) (n=10) were collected prior to main laparoscopic operation. CPF were obtained from fertile women with various gynecologic problem other than endometriosis, such as dermoid cyst and carcinoma in situ of the uterine cervix. Peripheral blood mononuclear cells were collected by density-gradient centrifugation of whole blood over a peripheral blood mononuclear cell separation medium (Histopaque-1077), and THP-1 cells derived from a monocyte/macrophage cell line (Korean Cell Line Bank, Seoul, Korea) were cultured in RPMI-1640 medium. The expression of HLA-DR was evaluated by confocal microscopy, and the levels of IL-10, TGF-beta and VEGF were measured by standard enzyme-linked immunosorbent assay kits (R and D system). RESULTS: Compared to CPF, the addition of 10% EPF (n=10) to culture medium significantly reduced the percentage of HLA-DR positive cells in cultures of a THP-1, monocytic cell line at 48 hours. The effect of EPF was dose-dependent, and similar effect was observed in the peripheral blood monocytes. An inverse correlation was found between the HLA-DR expression level and IL-10 concentration in EPF (r=-0.518; P=0.019) and in the supernatant of peripheral blood monocyte cultured in EPF (n=20) (r=-0.459; P=0.042). IL-neutralizing antibody significantly abrogated the effect of EPF on HLA-DR expression level. CONCLUSION: These results suggest that HLA-DR expression level on monocytes is down-regulated by EPF, and that IL-10 may be one of the factors in EPF to modulate HLA-DR expression level.
Ascitic Fluid* ; Carcinoma in Situ ; Cell Line ; Cell Separation ; Centrifugation ; Cervix Uteri ; Dermoid Cyst ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; HLA-DR Antigens* ; Humans ; Immunologic Factors ; Incidence ; Interleukin-10 ; Menstruation Disturbances ; Microscopy, Confocal ; Monocytes* ; Peritoneal Cavity ; Prevalence ; Seoul ; Transforming Growth Factor beta ; Vascular Endothelial Growth Factor A

To produce bioactive compound enriched yeast using medicinal Gugiga (Lycium chinensis Mill), several edible Saccharomyces species were cultured in Gugija extracts added yeast extract, peptone and dextrose medium (GE - YEPD medium) at 30degrees C for 24 hr, and their growth were determined. Growth of Saccharomyces cerevisiae K-7 and Sacchromyces cerevisiae ACTC 7904 were better than those of the other yeasts. Two yeasts were selected and then determined their some physiological functionalities after cultivated the yeasts in the GE - YEPD medium and compared those grown on YEPD medium. Antihypertensive angiotensin I-converting enzyme (ACE) inhibitory activity of S. cerevisiae K-7 grown on GE - YEPD medium was about 20% higher than that grown on YEPD medium. Superoxide dismutase-like activity of S. cerevisiae ACTC 7904 was also about 12% more high. However, the other physiological functionalities were almost same or lower. Optimal addition concentration of Gugija extract was 10%, and maximally growth and ACE inhibitory activity of S. cerevisiae K-7 were shown when the strain was cultured in 10% Gugija extracts containing YEPD medium at 30degrees C for 12 hr.
Angiotensins ; Glucose ; Peptidyl-Dipeptidase A ; Peptones ; Saccharomyces ; Saccharomyces cerevisiae ; Sprains and Strains ; Superoxides ; Yeasts

BACKGROUND: Angiogenesis is one of the most important factors in the progression and me-tastasis of malignancies. Angiogenesis is a multistep process requiring the interaction of numerous factors able to stimulate the growth and development of new vessels. But, understanding of the mechanism involved in VEGF expression is unclear. METHODS: Expressions of p53 and VEGF, and neovasculiarization were examined in 19 cases of surgically resected non-small cell carcinoma of the lung by the immunohistochemical staining. Furthermore, VEGF mRNA expressions were quantified in all cases using the real-time quantitative RT-PCR. These results were compared with clinicopathologic parameters such as histologic grade and stage. RESULTS: Tumors with high aberrant p53 expressions showed significantly higher VEGF mRNA ex-pressions and microvessel counts than those with low p53 expressions. Expressions of p53 as well as VEGF and micovessel counts were closely associated with the tumor stage, but not with the histologic grade and other clinical parameters. CONCLUSIONS: These results suggest that aberrant p53 expression may play a role in the regulation of VEGF expression and may be involved in controlling angiogenesis in non-small cell carcinoma of the lung.
Growth and Development ; Lung* ; Microvessels ; RNA, Messenger* ; Vascular Endothelial Growth Factor A*

BACKGROUND: Although a magnetic resonance imaging (MRI) is highly sensitive for changes associated with ischemic stroke, the detection of an acute ischemic lesion is usually impossible within 6 hours of the stroke onset on a conventional MRI. The perfusion MRI is a new imaging technique for diagnosing acute ischemic stroke. We evaluate the clinical usefulness of the perfusion MRI in predicting the final infarct extent in 18 patients with acute middle cerebral artery (MCA) territory ischemic stroke. METHOD: The perfusion MRI was performed within 6 hours after the stroke onset in all patients with a single-section dynamic contrast-enhanced T2*-weighted imaging in conjunction with a conventional routine MRI and MR angiography. Time-concentration curves and cerebral blood volume (CBV) maps were calculated from the dynamic MR imaging data by using numerical integration techniques. We compared findings of CBV maps with infarction on a follow-up CT or MRI. RESULTS: In 14 of 18 patients, the CBV in the occluded MCA territory were decreased. In the remaining 4 patients with a reversible ischemic neurologic deficit (RIND) or transient ischemic attack (TIA), the CBV were increased in 3 and normal in 1. Out of 14 patients with a decreased CBV, two had focal regions of increased CBV within the affected territory, indicating reperfusion hyperemia. The regions of increased or decreased CBV were eventually converted to infarction on follow-up images in all 14 patients. Out of 4 patients with RIND or TIA, one showed focal infarction in centrum semiovale on a follow-up image. CONCLUSIONS: The perfusion MRI was useful for the assessment of hemodynamic change about cerebral perfusion and may predict the extent of final infarction in acute MCA territory ischemic stroke. These results suggest that the perfusion MRI may play an important role in the diagnosis and management of acute ischemic stroke.
Angiography ; Blood Volume ; Diagnosis ; Follow-Up Studies ; Hemodynamics ; Humans ; Hyperemia ; Infarction ; Ischemic Attack, Transient ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Neurologic Manifestations ; Perfusion* ; Reperfusion ; Stroke*

Cranial mononeuropathies, manifesting particulary as opthalmoplegia or facial palsy, are common entities in the dia-betic population. However, sequential multiple cranial neuropathies due to diabetes are much less common. It is often associated with other conditions such as a brain tumor or head trauma. A 61-year-old diabetic man presented with ptosis, opthalmoplegia, and facial palsy which were manifestations of multiple cranial neuropathies involving the left 3rd, 4th, 6th, and 7th cranial nerves throughout five weeks. The pupils were not involved. The neurologic evaluation included a CSF study and a brain MRI with MRA. None of them produced any significant results. Blink reflexes revealed evidence of a left facial nerve lesion. The blood glucose was strictly controlled and steroid therapy was administered. The ptosis of the patientanjx left eyelid improved during treatment and he was discharged after 13 days. In a follow-up examination 3 months after onset, focal neurological deficits including opthalmoplegia and facial palsy on the left side were greatly improved and barely noticeable.
Blinking ; Blood Glucose ; Brain ; Brain Neoplasms ; Cranial Nerve Diseases* ; Cranial Nerves ; Craniocerebral Trauma ; Diabetes Mellitus* ; Eyelids ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mononeuropathies ; Pupil