BACKGROUND AND OBJECTIVES: The atherosclerotic plaque in the thoracic aorta has been considered as potential source of cerebral embolization. The aim of this study was to evaluate the relation of atherosclerotic plaque burden and aortic distensibility by combined transesophageal echocardiography(TEE) and acoustic quantification(AQ) in patients with cerebral infarction without cardiac origin of emboli. METHODS: The maximal intimal-medial thickness and distensibility of descending thoracic aorta using TEE (a 7.5 MHz multiplane transducer, Hewlett Packard Sonos 2500) and AQ were prospectively measured in 36 patients(mean age ; 61+/-9 years) with cerebral infarction without cardiac origin of emboli and compared with 87 controls(mean age ; 56+/-11 years) without history of cerebral infarction. After the quality of the short-axis images of the aorta was optimized, a software of AQ was activated and gain controls were adjusted. A region of interest was mannually traced around the descending thoracic aorta and then integrated software was used to compute and instantaneously display arotic lumen area as a function of time. Maximal and minimal cross sectional area and fraction area change were calculated as an average from five consecutive heart cycle. RESULTS: There were no statistically significant differences between two groups in gender, hyperlipidemia and smoking, but hypertension and diabetes were more common in the cerebral infarction group. The atherosclerotic intimal-medial thickness above grade 3 was found in 13(36.1 %) out of 36 patients with cerebral infarction and 15(17.2%) out of 87 controls(p<0.05). Aortic areas normalized for body surface area were not statistically different between patients and normal controls, but there were significant differences for elastic indices except compliance. Patients with cerebral infarction had a lower fractional area change(5.7+/-3.2% vs. 7.8+/-4.1%, p<0.05) and higher stiffness index(12.2+/-7.7 vs. 8.0+/-5.1, p<0.05) compared with control group. There was an inverse relationship between the aortic intimal-medial thickness and the fractional area change of descending aorta(r=-0.380, p<0.01). CONCLUSION: The data suggest that the aortic distensibility noninvasively measured by TEE and AQ predicts the atherosclerotic burden. Thus the aortic distensibility may be an additive risk factor for cerebral infarction.
Acoustics* ; Aorta ; Aorta, Thoracic ; Body Surface Area ; Cerebral Infarction* ; Compliance ; Heart ; Humans ; Hyperlipidemias ; Hypertension ; Plaque, Atherosclerotic ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Transducers

BACKGROUND AND OBJECTIVES: The atherosclerotic plaque in the thoracic aorta has been considered as potential source of cerebral embolization. The aim of this study was to evaluate the relation of atherosclerotic plaque burden and aortic distensibility by combined transesophageal echocardiography(TEE) and acoustic quantification(AQ) in patients with cerebral infarction without cardiac origin of emboli. METHODS: The maximal intimal-medial thickness and distensibility of descending thoracic aorta using TEE (a 7.5 MHz multiplane transducer, Hewlett Packard Sonos 2500) and AQ were prospectively measured in 36 patients(mean age ; 61+/-9 years) with cerebral infarction without cardiac origin of emboli and compared with 87 controls(mean age ; 56+/-11 years) without history of cerebral infarction. After the quality of the short-axis images of the aorta was optimized, a software of AQ was activated and gain controls were adjusted. A region of interest was mannually traced around the descending thoracic aorta and then integrated software was used to compute and instantaneously display arotic lumen area as a function of time. Maximal and minimal cross sectional area and fraction area change were calculated as an average from five consecutive heart cycle. RESULTS: There were no statistically significant differences between two groups in gender, hyperlipidemia and smoking, but hypertension and diabetes were more common in the cerebral infarction group. The atherosclerotic intimal-medial thickness above grade 3 was found in 13(36.1 %) out of 36 patients with cerebral infarction and 15(17.2%) out of 87 controls(p<0.05). Aortic areas normalized for body surface area were not statistically different between patients and normal controls, but there were significant differences for elastic indices except compliance. Patients with cerebral infarction had a lower fractional area change(5.7+/-3.2% vs. 7.8+/-4.1%, p<0.05) and higher stiffness index(12.2+/-7.7 vs. 8.0+/-5.1, p<0.05) compared with control group. There was an inverse relationship between the aortic intimal-medial thickness and the fractional area change of descending aorta(r=-0.380, p<0.01). CONCLUSION: The data suggest that the aortic distensibility noninvasively measured by TEE and AQ predicts the atherosclerotic burden. Thus the aortic distensibility may be an additive risk factor for cerebral infarction.
Acoustics* ; Aorta ; Aorta, Thoracic ; Body Surface Area ; Cerebral Infarction* ; Compliance ; Heart ; Humans ; Hyperlipidemias ; Hypertension ; Plaque, Atherosclerotic ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Transducers

No abstract available.
Child* ; Humans ; Humerus*

The model of lymphocyte differentiation described for Lukes-Collins' classification of non-Hodgkin's lymphoma is related particularly to morphological alterations of nuclei of follicular center lymphocytes by antigenic stimulation. The authors carried out ultrastructural and morphometric studies to investigate morphological alterations during lymphocyte transformation on the nuclear profiles of follicular center, parafollicular and mantle zone lymphocytes in ten tonsillectomy cases of chronic hypertrophic tonsillitis. The nuclear parameters measured included nuclear area, contour index, frequency invagination and cleft, depth of invagination and nuclear diameters. Follicular centers contained a mixed population of lymphocytes consisting of untransformed (type 1), partially transformed (type 2) and fully transformed (type 3) lymphocytes. During lymphocyte transformation in both follicular, and parafollicular and mantle zones, the nuclei had a gradual and progressive increase in size. The nuclear contour index of type 2 nuclei of both follicular and parafollicular and mantle zones tended to be higher than those of type 1 and 3, indicating a greater degree of irregularity and variability of nuclear profiles. Invaginated and cleaved lymphocytes were not confined to me transformed lymphocytes. A considerable portion of lymphocytes had invaginations and clefts in parafollicular and mantle zone as well as follicular center. No difference on the depth of invagination was noted in type 1, type 2 and type 3 lymphocytes. The results indicate that some promise of the Lukes-Collins conepts of follicular center cells and the process of lymphocyte transformation in follicular centers may be necessary to revise

BACKGROUND: The morphalogy of fibroblast in culture is important in the discrimination of normal and abnormal cells as well as in recogniring general physiologic status of the cells. There have been many reports on the morphologic clialges in various skin diseases and in response to various drugs. However, we couldnt find any report on the time-sequential morphologic changes of normal fibroblasts in early subculture using light microscopy. OBJECTIVE: The purpose of this study is to describe the time-sequential morphologic changes of normal fibroblhst in early subculture. METHODS: The fibroblaats from 4 normal donors were cultured. We observed the morphologic changes of fibrolMasts in the third passage of subculture using light microscopy at 0-, 30-, 60-, 90-, 120-minutes, 3-, 5-, 24-, 72-hours and days after trypsinization, and electron microscopic exarriioation was done at 21 day-culture. RESULTS & CONCLUSION: Just after trypsinization, the cell were small and round, which divided and increased in number as time went by. At 120-minute culture, many cells had long and thin cytoplasmic elongations and they took stellae,shape at 5-hour culture. At 24-hour culture, several spindle-shaped cells were observec with cell-cell contacts. At 72-hour culture, many spindlle-shaped cells were arranged in medirection, with the appearance of parallel or whorl patterns and showed prominent cell-cell contacts. On electron microscopic examination, there were prominent RER, residial bodies and microfilaments.
Actin Cytoskeleton ; Cytoplasm ; Discrimination (Psychology) ; Fibroblasts* ; Humans ; Microscopy ; Skin Diseases ; Skin* ; Tissue Donors ; Trypsin

BACKGROUND: There are a few methods, including primary intention, deleyed primary closure and secondary intention, to irpair several types of defects. But commonly-used primary intentional repair of a defect after surgical removal of a skin cancer by graft, flap or simple closure has several limitations such as the need of a skillful technique and various complications. OBJECTIVE: We undertook a secondary intention using occlusive dressing with a polyurethane film after skin cancer surgery instead of a primary repair and evaluated its efficacy, particularly in points of simplicity and safety, and cosmetic results. METHODS: We randomly chose 14 cases of skin cancers in 13 patients who had undergone simple surgical excision or Mohs micrographic surgery and then undertook secondary intention with polyurethane film after informed consent. Postsurgical wound care included cleansing with normal saline or boric acid, then covering the defect with antibiotic ointment, gauze and film a at regular intervals.
Humans ; Informed Consent ; Intention* ; Mohs Surgery ; Occlusive Dressings ; Polyurethanes ; Skin Neoplasms* ; Skin* ; Transplants ; Wounds and Injuries

New antidepressants have become available for clinical use in the 1990s. Before this decade, the drugs available to treat depression consisted essentially of monoamine oxidase inhibitors, tricyclic antidepressants, and lithium. Following the introduction of SSRIs, the options have expanded and now include SSRIs nefazodone, venlafaxine, mirtazapine, reboxetine, tianeptine. Newer antidepressants possess a variety of pharmacological characteristics that are relevant to the choice of an antidepressant for clinical use. This review summarizes some of the major pharmacological characteristics among the drugs.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Depression ; Lithium ; Monoamine Oxidase Inhibitors ; Venlafaxine Hydrochloride

The genetically determined CYP2D6 activity may be considered to be associated with antipsychotic induced extrapyramidal side effects with inter-individual variation. Genetic polymorphism of CYP2D6 was determined by polymerase chain reaction(PCR) and Mspl restriction fragment length polymorphisms(RFLP) for 194 schizophrenics. Subjects with a 334bp band were classified a1a1, those with 229bp and 105bp bands a2a2, and those with all three bands a1a2. We did not identify schizophrenic subject with poor metabolizer. 194 schizophrenic patients previously treated neuroleptic medication, were assessed by Extrapyramidal Symptom Rating Scale(ESRS). The cases were composed of 33 akathisia, 47 parkinsonism, 21 tardive dyskinesia. These results are similar to the previous understanding that the poor metabolizer is very rare in Orientals compared to Caucasians, therefore, it considered that CYP2D6 genotypes have maybe no association with schizophrenia and extrapyramidal side effects in Koreans.
Antipsychotic Agents* ; Cytochrome P-450 CYP2D6* ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Genotype ; Humans ; Movement Disorders ; Parkinsonian Disorders ; Polymorphism, Genetic ; Psychomotor Agitation ; Schizophrenia

BACKGROUND: In anemic patients, it has been usually traditional practice to correct the anemic state with preoperative blood transfusion. But now, there is an increasing tendency of refusing blood transfusion due to the transfusional complications, especially AIDS etc. The purpose of this study is to survey the effects of anesthesia in anemic patients with normal cardiopulmonary function compared to non-anemics. METHOD: 40 patients with uterine myoma were divided into two groups, an experimental group of 20 patients with hemoglobin concentration of 8~10 gm% and a control group of 20 patients with hemoglobin concentration higher than 10 gm%, and their blood pressure, pulse rate and arterial oxygen saturation were monitored and compared. RESULTS: There were no significant differences between two groups in blood pressure, pulse rate and arterial oxygen saturation. CONCLUSION: Preoperative blood transfusion, in patients with moderate anemia, does not seem to be a mandatory practice.
Anemia ; Anesthesia ; Blood Pressure ; Blood Transfusion* ; Heart Rate ; Humans ; Leiomyoma* ; Oxygen

BACKGROUND: Squamous cell carcinoma(SCC) is one of the most conimon forms of skin cancer that arises from the surface epidermis. Although many authors have reported on the incidence and clinical features of SCC, we could not find any reports concerning the widerange of histopathologic features of a number of cases of SCC in Korean dermatologic literature. OBJECTIVE: We examined the histopathologic features of SCC. METHOD: Twenty six biopsy specimens from 26 patients with SCC were examined microscopically including the tumors themselves and surrounding epidermis and dermis on routine histologic staining. RESULTS: Grade 1 tumor was found in 15 cases, grade 2 in 8 casese, and grade 3 in 3 cases. Eighteen cases showed keratin pearls, and 11 cases showed squamous eddies. P cantholysis of tumor cells was found in all 26 cases, but glandular structure was found only in 5 cases. The epidermis overlying the tumor showed hyperkeratosis and parakeratosis in all 26 cases, follicular plug in 13 cases, and ulceration in 18 cases. The dermis beneath the tumor showed vessel dilataticn, hemorrhage, and infiltration of inflammatory cells in all 26 cases, and basophilic degeneration in 1.3 cases, fibrosis in 20 cases, lichenoid reaction in 6 cases, and necrosis in 6 cases. Rare dermal findings were abscess, foreign body reaction calcification and Russell body. CONCLUSION: The histopathologic findings of SCC were variable not inly those of the tumors themselves, but also those of the surrounding epidermis and dermis.
Abscess ; Basophils ; Biopsy ; Carcinoma, Squamous Cell* ; Dermis ; Epidermis ; Fibrosis ; Foreign-Body Reaction ; Hemorrhage ; Humans ; Incidence ; Necrosis ; Parakeratosis ; Skin Neoplasms ; Ulcer