PURPOSE: The purpose of this study was to ascertain whether radiation adaptive response could be induced by Tc-99m-methylene diphosphonate (Tc-99m-MDP) in peripheral lymphocytes of patients undergoing bone scintigraphy. MATERIALS AND METHODS: Lymphocytes from 22 patients (6 males, 16 females, mean age 50+/-14 years) were collected before and after bone scintigraphy using 740 MBq Tc-99m-MDP. Lymphocytes from 10 controls (6 males, 4 females, mean age 43+/-7 years) were also collected. They were exposed challenge dose of 2 Gy gamma rays using a cell irradiator Number of ring-form and dicentric chromosomal per 600 cells (chromosomal aberrations) was counted under the light microscope. RESULTS: Chromosomal aberrations in patients before bone scintigraphy (385.1+/-30.5) was not different from that of controls (367.8+/-36.6). However, chromosomal aberrations in patients after bone scintigraphy was significantly decreased 192.6+/-22.1 (p=0.0001). CONCLUSION: Low dose gamma-irradiation by Tc-99m-MDP used for bone scintigraphy induces a cytogenetic adaptive response in peripheral lymphocytes.
Chromosome Aberrations ; Cytogenetics ; Female ; Gamma Rays ; Humans ; Lymphocytes* ; Male ; Radionuclide Imaging* ; Technetium Tc 99m Medronate

The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.
Abortion, Habitual ; Abortion, Induced ; Autoantibodies ; Family Characteristics ; Female ; Histocompatibility ; Humans ; Immunotherapy* ; Infertility* ; Lymphocytes* ; Oocytes ; Pregnancy ; Research Personnel ; Spermatozoa

Dieulafoy's vascular malformation is a rare cause of massive gastrointestinal bleeding. Most often it occurs in stomach within 6 cm from the gastroesophageal junction. Only a few cases have been reported to occur in the small intestine and colon. Occasionally, Dieulafoy's lesion of small intestine is difficult to recognize because of rarity, a paucity of symptoms and negative findings on barium studies. Therefore, this lesion needs to be considered in a patient with massive lower gastrointestinal bleeding. We report a case of Dieulafoy's vascular malformation in ileum 2 m proximal to ileocecal value in a 41-year-old woman who visited emergency clinic because of hematemesis, dizziness and vomiting. Small intestine revealed a wide-caliber artery within the submucosa showing intimal thickening, medial muscular hypertrophy and thrombosis.
Adult ; Arteries ; Barium ; Colon ; Dizziness ; Emergencies ; Esophagogastric Junction ; Female ; Hematemesis ; Hemorrhage* ; Humans ; Hypertrophy ; Ileum* ; Intestine, Small ; Stomach ; Thrombosis ; Vascular Malformations* ; Vomiting

OBJECTIVE: This study was performed to investigate whether 1) estrogen induces the change of vascular tone in endothelium-denuded human uterine artery, and 2) endothelium-independent vascular reactivity may be mediated by intracellular calcium ion modulation. METHODS: The uterine arteries from 34 premenopausal women were obtained at the time of hysterectomy due to various indications and endothelium was denuded. Vascular reactivity was monitored by using Isometric force transducer and recorded by physiograph. Endothelial integrity was assessed by sequential administration of 1micrometer norepinephrine(alpha-adrenergic stimulant) and 10 micrometer acetylcholine (endothelium -dependent vasorelaxant). Integrity of smooth muscle was measured by administration of 10 micrometer sodium nitroprusside (endothelium - independent vasorelaxant) and 10 micrometer tamsulosin(alpha-adrenergic blocker). A dose-dependent action of estrogen was measured on denuded uterine arteries, pretreated with norepinephrine and potassium chloride. In media contained denuded uterine arteries pretreated with 70mM potassium chloride and estradiol(3X10-5M), nitric oxide and its inhibitor, N-nitro-L-arginine methyl ester(L-NAME) was administered, respectively, in order to verify the vasodilation effect. Statistical tests were performed at the 5% level of significance using the SPSS PC+ package. RESULTS: Acethylcholine has little effect but sodium nitroprusside & talmsulosin showed marked relaxation, which suggested loss of endothelial function and adequacy of smooth muscle function. The contraction by norephinephrine(1 M) revealed estrogen induced relaxation which was concentration-dependent from 3 10-8M to 3 10-5M in concentration of 17 -estradiol. The contraction by high potassium solution 70mM was also inhibited by estrogen in concentration-dependent manner. This vasorelaxant effect of estrogen on endothelium-denuded uterine artery was not affected by addition of nitric oxide(NO) precursor, L-arginine and nitric oxide synthase(NOS) inhibitor, L-NAME. CONCLUSION: The results of this study revealed that estrogen has vasorelaxant effect on endothelium endothelium-denuded uterine artery by calcium antagonistic property through direct inhibitory effect on receptor- and voltage dependent calcium ion channels of smooth muscles. This vasorelaxant effect of estrogen on endothelium-denuded uterine artery was NO independent.
Acetylcholine ; Arginine ; Calcium ; Calcium Channels ; Endothelium* ; Estrogens* ; Female ; Humans* ; Hysterectomy ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitroprusside ; Norepinephrine ; Potassium ; Potassium Chloride ; Relaxation ; Transducers ; Uterine Artery* ; Vasoconstriction* ; Vasodilation

No abstract available.
Tissue Expansion Devices*

This study was undertaken to evaluate the clinical usefulness of magnetic motor evoked potential (MEP) in the diagnosis of stroke and predicting the motor improvement following stroke. The cortical, cervical and lumbar stimulations were performed in the case of 24 healthy controls and 24 to a target muscle between after transcranial stimulation and after cervical or lumbar stimulation. There was no case showing no response in controls. But in 11 out of 24 ischemic patients, we could not get cortical MEP. Mean CMCT of abductor pollicis brevis muscle was not significantly different in controls and stroke patients in whom MEPs were recorded. There were significant differences between mean CMCT of normal controls and that of stroke patients showing MEPs in AH Muscle. MEP Results from testing the stroke patients were correlated with site of lesion, degree of motor weakness and motor improvement after 1 to 2 months. These results suggest that magnetic MEP is easy and useful in electrophysiological test of central motor pathway and is useful indicator for representing the motor weakness and predicting the motor outcome in acute ischemic stroke patients.
Diagnosis ; Evoked Potentials, Motor* ; Humans ; Stroke*

Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age 53+/-12 years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% per year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary a disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of cardiac event rates between patients with normal and abnormal coronary angiograms.
Chest Pain* ; Coronary Artery Disease ; Coronary Vessels ; Death ; Female ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Prognosis ; Thorax* ; Tomography, Emission-Computed, Single-Photon

It has been shown that both rest and stress myocardial perfusion imagings with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age 57+/-9 years) and 120 patients (79 males, 41 females, mean age 59+/-10 years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by> or =50%. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35%and 68%, respectively. Those of rest-stress protocol were 96%, 47%, and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using Tc-99m agents were comparable and were very sensitive tests in detecting coronary artery diseases.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion Imaging ; Perfusion* ; Phenobarbital ; Sensitivity and Specificity ; Technetium ; Tomography, Emission-Computed, Single-Photon

Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

Hailey-Hailey disease(benign familial chronic pemphigus) is a rare autosomal dominant disorder characterized by blisters at sites of friction such as the neck, axillae and groin which are caused by suprabasal epidermal acantholysis. We report two cases of Hailey-Hailey disease in the one family. One of the two cases has asymptomatic multiple longitudinal white bands in the fingernails associated with typical skin lesions. The nail lesions have not been described until reported by Burge in 1992 and it may be a characteristic finding in Hailey-Hailey disease.
Acantholysis ; Axilla ; Blister ; Friction ; Groin ; Humans ; Nails ; Neck ; Pemphigus, Benign Familial* ; Skin