The result of forty cases of rheumatoid arthritis according to New York criterion, who underwent multiple operations(up to 10) in multiple joints hetween 1983 and 1986 were evaluated in 3 years and 8 months in average(range; 18 months to 5 years 2 months)postoperatively. The joints operated upon were knee, ankle, shoulder, elbow, wrist and finger joints. The surgery performed were 65 arthroscopic synovectomies, 17 total joint replacement(16 knees and 1 elbow) and 7 arthrodesis(1 knee, 1 ankle and 5 wrists). There were 10 males and 30 females, 27 “clsssic” and 13 “definite” rheumatoid arthritis according to the classification of American Rheumatism Association.Functional capacity of the patient was graded as I, II,III and IV according to the ARA. The final clinical results were graded as “excellent”, “good”, “fair” and “poor” according to the modified citeria of Sledge et al(20). The relationship between number of cases of recurred synovitis and various factors such as sex, classification according to the ARA, number of joints involoved and extent of synovectomy in the knee joint was analyzed statistically with chi-square test of the contingency table.The results are as follows; 1. The final results were 22 “excellent”(55.0%), 16 “good”(40.0%) (altogether 95% of cases were satisfactory) and 2 fair (5.2%), but there was no “poor” result. 2. All cases showed functional improvement, the commonest mode of improvement being from preoperative grade II to postoperative grade I(19 out of 40 cases, 47.5%). 3. There were 9 cases of recurrence of synovitis following arthroscopic synovectomy(22.5 %). They were controlled by medication in 2 cases, and by reoperation in 5 cases (resynovectomy ; 3, joint replacement; 1, arthrodesis ; 1). 4. The factors such as sex, classification and number of joints involved were not significantly correlated c the recurrence rate although there was a tendency of frequent recurrences in cases of female, classic RA and multiple joint involovement (P>0.05). 5. In the knee joint there was significantly less recurrence rate in total synovectomy cases (1/20, S.0%) than in anterior synovectomy cases (7/22, 31.8%) (P<0.01). 6. There was no recurrence following total joint replacment or arthrodesis. In conclusion the combined surgery of arthroscopic synovectomy, joint replacement and arthrodesis in the multiple joints was effective in relief of pain and effusion and improvement of functional capcity of the rheumatoid patient if proper medical treatment was given postoperatively.
Ankle ; Arthritis, Rheumatoid ; Arthrodesis ; Classification ; Elbow ; Female ; Finger Joint ; Humans ; Joints ; Knee ; Knee Joint ; Male ; Recurrence ; Reoperation ; Rheumatic Diseases ; Shoulder ; Synovitis ; Wrist

BACKGROUND: Intravenous urography(IVU) has long been accepted as the primary radiologic study for the diagnosis of renal colic. But the IVU does pose disks of contrast material reactions and exposure to radiation. Recently, IVU has been challenged as a first line modality and ultrasonography proposed as a replacement. We, therefore, felt obliged to re-evaluate the IVU, KUB and ultrasonography as diagnostic tools. METHODS: We evaluate the sensitivity and specificity of ultrasound, IVU and KUB in detecting urinary calculi in suspected acute renal colic, a prospective study of 69 patients, both sides of kidney and ureter, who visited urban university hospital emergency center from September 1997 to January 1998. Our sonographic criteria far a positive examination consisted of visualization of urinary tract calculus and/or hydronephrosis and/or urinoma. RESULTS: In Ultrasonography, the accuracy, sensitivity and specificity were 94, 94 and 94%. In IVU and KUB, they were 90, 81, 98% and 71, 43, 96%. CONCLUSION: Ultrasonography is very useful diagnostic tool in initial evaluation of acute renal colic.
Calculi ; Diagnosis ; Emergencies ; Humans ; Hydronephrosis ; Kidney ; Prospective Studies ; Renal Colic* ; Sensitivity and Specificity ; Ultrasonography* ; Ureter ; Urinary Calculi ; Urinary Tract ; Urinoma

A survey was performed in order to determine the infection status of the metacercariae of heterophyid fluke in two goby species, Boleophthalmus pectinirostris and Scartelaos sp., collected from Gangjin-gun, and Shinangun, Sooncheon-shi, Jeollanam-do, Republic of Korea. A total of three metacercariae of Heterophyopsis continua was found in only one B. pectinirostris (10.0%) from Gangjin-gun. Heterophyes nocens metacercariae were detected in 24 B. pectinirostris (96.0%) and 14 Scartelaos sp. (63.6%) from Shinan-gun. Heterophyopsis continua metacercariae were found in 11 B. pectinirostris (44.0%) and 21 Scartelaos sp. (95.5%) from Shinan-gun. Stictodora fuscata metacercariae were detected in 18 B. pectinirostris (72.0%) from Shinan-gun. No metacercariae were detected in 20 B. pectinirostris from Sooncheon-shi. From the above results, this study is the first to prove that B. pectinirostris and Scartelaos sp. serve as the second intermediate hosts of some heterophyid flukes in Korea.
Trematoda/*isolation & purification ; Perciformes/*parasitology ; Korea ; Animals

To evaluate the establishment of Mungyong Saejae Natural Ecology Park located in the northwestern Gyongbuk Province, a scientific survey for the mushroom flora of the park was carried out from May to December of 1999. A checklist of the Aphyllophorales collected from the park was prepared. The list included 67 species of 44 genera belonging to nine families in the Aphyllophorales. Among them, seven species, Antrodia malicola, Ceriporia purpurea, Oligoporus leucospongia, Perenniporia tephropora, Phanerochaete xerophila, Sistotrema diademiferum and Vuilleminia comedens, were confirmed as new to Korea and are registered here as unrecorded species along with descriptions and microscopic drawings.
Agaricales ; Antrodia ; Checklist ; Ecology ; Humans ; Korea ; Phanerochaete ; Polyporales*

BACKGROUND: We previously demonstrated that a GRE/TRE composite sequence, which is located between 200 bp and 220 bp relative to the transcriptional start site of rat TRH gene, is responsible for the dexamethasone (DEX)- and TPA-induced transcriptional activation, and the transcriptional activation by DEX is mediated by interaction between glucocorticoid receptor (GR) and a TRE-binding transcriptional factor such as c-Jun. However, a non-specific binding with the transciption factors can not be excluded as the mutants used in the previous report could not inhibit the binding of GR and c-Jun completely, and it remains unclear which one of the two TRE-like sequences is critical for the interaction of the two transcription factors. METHODS: Luciferase expressing plasmids that contain a part of rat TRH promoter including the composite GRE sequence or its mutants were transfected into HeLa cells by Fugene 6. After the cells were incubated overnight with DEX or/and TPA, the luciferase activity was measured in a chemiluminometer. A gel retardation assay was performed after binding of the labeled composite sequence or its mutants with GR and c-Jun. RESULTS: DEX and TPA increased the transcriptional activity of the wild type composite sequence by 3 folds and 4 folds, respectively, and the combined stimulation increased the activity by 10 folds. The mutants of which all 6 nucleotides of the GRE half site were replaced and removed almost did not bind to GR and eould not enhance the transcriptional activity at all in response to DEX. The GRE-deleted mutant bound to c-Jun with a remarkably lower affinity and showed a lower response to TPA, whereas the GRE-replaced mutant bound to c-Jun with a similar affinity and showed a similar response to TPA compared to those of the wild type. In response to the combined simulation with DEX and TPA, the mutants showed 30-40% of the trancriptional activity of the wild type. Basal transcriptional activity of all the TRE mutants was significantly lower than that of the wild type. While they almost could not bind to c-Jun, their binding affinity to GR was comparable to that of the wild type. Whereas the DEX- and TPA-induced transcriptional activity of 5 TRE mutant was 10% and 15% of that of the wild type, it responded to those agents in a similar pattern as the wild type. The 3 TRE mutant and the mutant of both TRE sites did not respond to DEX and TPA. The GRE-deleted mutant hardly formed the DNA-protein complex as did the wild type, while the GRE -replaced mutant could form the complex in a less amount with nuclear extract of HeLa celL CONCLUSION: These results suggest that GRE/TRE composite sequence of rat TRH gene specifically binds to GR and c-Jun, providing a site for interaction between the two transcription factors, and that both TRE sites play an important role in basal transcription, and that the 3 TRE site is more critical in the interaction between GRE and TRE for DEX-induced transcriptional activation. (J Kor Endocrinol 14:278-292, 1999)
Animals ; Dexamethasone ; Electrophoretic Mobility Shift Assay ; HeLa Cells ; Humans ; Luciferases ; Mutagenesis, Site-Directed* ; Nucleotides ; Plasmids ; Rats* ; Receptors, Glucocorticoid ; Response Elements* ; Transcription Factors ; Transcriptional Activation

BACKGROUND: We previously demonstrated that the promoter of rat TRH gene has GRE half site (TGTTCT) between -210 bp and -205 bp flanking with similar sequences of TPA response element (TRE), TAGTCA, at a distance of several base pairs from the GRE half site. It promps us to hypothesize that this composite GRE/TRE sequence can provide a site for interaction between glucocorticoid receptor (GR) and c-Jun. Thus, we investigated whether the composite sequence mediates transcriptional regulation induced by dexamethasone (DEX) and 12-O-tetradecanoyl phobol-13-acetate (TPA), and whether it binds GR and c-Jun. METHODS: A luciferase expressing plasmids that contain a part of rat TRH promoter including the composite sequence or their mutants were transfected into HeLa cells by Fugene 6. After the cells were incubated overnight with DEX and TPA, the luciferase activity was measured in a chemiluminometer. A gel retardation assay was performed after binding of the labeled composite sequence or its mutants with GR and c-Jun. RESULTS: DEX increased the transcriptional activity of the plasmid containing the wild type GRE by 2.5 folds, and TPA increased the transcriptional activity by 4 folds. The simultaneous stimulation with DEX and TPA synergistically increased the transcriptional activity by 10 folds. Two mutants whose GRE half sits were altered showed no responses to DEX, and suppressed the TPA-induced or both agents-induced transcriptional activity by 50%. Two mutants whose TRE-like sites were altered suppressed the DEX-induced transcriptional activity by 20%, TPA-induced trarptional activity by 25%, and both agents-induced transcriptional activity by 50%. Gel retardation assay showed that the composite sequence fonned a complex with GR and its mutants bound to GR with remarkably less affinity. c-Jun also bound to the composite sequence to form two cornplexes with less affinity compared to the AP-1 consensus sequence. The mutants of the TRE-like sequence bound to c-Jun with a significantly lower affinity compared to that of the wild type. Simulateous binding of the composite sequence with GR and c-Jun did not form any larger complex. The complex of GR and the composite sequence was much smaller than that formed by c-Jun, suggesting that GR binds to the composite sequence as a monomer. CONCLUSION: These results suggest that the composite sequence of GRE half site and TRE-like site on the promoter of rat TRH gene provides binding sites for GR and c-Jun, which mediate the interaction between two signal transduction pathways. (J Kor Soc Endocrinol 14:265-277, 1999)
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Animals ; Base Pairing ; Binding Sites ; Consensus Sequence ; Dexamethasone ; Electrophoretic Mobility Shift Assay ; HeLa Cells ; Humans ; Luciferases ; Plasmids ; Rats ; Receptors, Glucocorticoid ; Response Elements ; Signal Transduction ; Transcription Factor AP-1

CD44 is a family of transmembrane glycoproteins involved in cell-cell and cell-matrix interactions. Expression of CD44 isofonns (splice variants) has been shown to be associated with poor prognosis in several human cancers. We evaluated the expression patterns of the CD44 isofortn (CD 44 splice variant v6) in infiltrating ductal carcinoma of the breast by immunohistochemical and RT-PCR method. Paraffin embedded blocks from seventy-five cases of mastectomized samples were analyzed immunohistochemically using monoclonoal antibody against CD44v6. CD44v6 was detected in fifty-seven cases (76%) of the tumor samples. Adjacent normal myoepithelial cells and ductal epithelial cells revealed focal positive reaction to CD44v6. Thirtytwo cases (80.0%) with lymph nodal metastasis revealed overexpression of CD44v6 monoclonal antibody, but twenty-five cases (71.4%) without nodal metastasis also showed positive reaction to CD44v6 monoclonal antibody, and there is no statistically significant value. Other prognostic factors of infiltrating ductal carcinoma, such as tumor size, histologic grade and hormonal receptors did not show any significant correlation with CD44v6 expression. The RT-PCR studies for 9 cases of infiltrating ductal carcinoma showed the same band patterns both in the normal and tumor tissues. From the above results, it is concluded that the expression of CD44v6 is not a valuable prognostic marker of infiltrating ductal carcinoma of breast.
Breast* ; Carcinoma, Ductal* ; Epithelial Cells ; Glycoproteins ; Humans ; Neoplasm Metastasis ; Paraffin ; Prognosis

Fourtyone patients fo gallbladder and bile duct diseases were studied clinically and sonographically.Tweentynine (Seventyone percent) patients were distributed between age fourty to fiftynine and male to femaleratio was 1:1.4. The order of frequency of biliary tract disease was cholelithiasis, acalculous cholecystitis, CBDstone and CBD cancer. Sonographic findings of cholelithiasis were strong echo with posterior shadowing, faintinternal echoes without shadowing, gallbladder wall thickneing and anechoicity of the gallbladder wall. Instead ofsmall proportion of gallbladder distension and wall anechoicity, faint internal echoes without shadowing were seenin ten of nineteen cases of cholelithiasis. On choledocholithiasis, meniscus sign at the junction of the stone andgallbladder wall was identified in most cases and was helpful to differentiation stone from malignancy. The degreeof CBD dilatation was more severe in malignancy than in CBD stones and ascaris in CBD. Sonographic examination wasuseful in detection of gallbladder and bilicary tree pathology and the cause of biliary tract obstruction could beidentified.
Acalculous Cholecystitis ; Ascaris ; Bile Duct Diseases ; Biliary Tract Diseases ; Biliary Tract ; Choledocholithiasis ; Cholelithiasis ; Dilatation ; Gallbladder ; Humans ; Male ; Pathology ; Shadowing (Histology) ; Trees ; Ultrasonography

In the present study the effect of exercise on the conversion rate of ingested glucose to glycogen in the different types of hindlimb skeletal muscles in Sprague-Dawley male rats was studied. The amounts of synthetized glycogen from ingested glucose of fast-twitch white (WV), fast-twitch red (RV), mixed type of fast-twitch white and red (EDL), and slow-twitch (SOL) muscles were determined at 30 and 90 min. after ingestion of 25% glucose solution which contained 14C-glucose(2 ml(luCi)/100gm B.W.) in control and exercise loaded rats. The result was summarized as follows: The about 55% at 30 min. and 70% at 90 min. after glucose ingestion were absorbed from gastrointestinal tract. This result shows no effects of exercise on absorption rate from gastrointestinal tract. The amount of synthetized glycogen of SOL from ingested glucose at 30 and 90 min. after glucose ingestion were highest, whether WV were lowest in hindlimb skeletal muscles in control and exercise loaded rats. In the exercise loaded rats, the amounts of synthetized glycogen of SOL, RV, and EDL at 90 min. after glucose ingestion was much higher than control rats, but not different in WV between exercise-loaded and control rats. At 30 min. after glucose ingestion, only SOL of exercise loaded rats was higher than control rats. In the control rat, the synthesis of glycogen was almost completed during initial 30 minutes. On the other hand, in the exercise loaded rat, except WV was opposite result of control rats, i.e., amounts of synthetized glycogen were major during late period. The amount of synthetized glycogen of liver at 30 and 90 min. after glucose ingestion in exercise loaded rats was higher than control rats. The rate of glycogen synthesis in control and exercise loaded rats were higher between 30-90 minute than initial 30 minutes.
Absorption ; Animals ; Eating ; Gastrointestinal Tract ; Glucose* ; Glycogen* ; Hand ; Hindlimb* ; Humans ; Liver ; Male ; Muscle, Skeletal* ; Muscles ; Rats* ; Rats, Sprague-Dawley

Pseudomyxoma peritonei is a poorly understood condition characterized by mucinous ascites and multifocal peritoneal mucinous tumors. Pseudomyxoma peritonei is most commonly associated with mucinous tumors of the ovary and appendix. When two lesions are morphologically similar, it is difficult to determine whether one reflects a metastasis or whether the tumors are independent. Many studies concluded that most cases in which both the appendix and ovary were involved were primary appendiceal tumor with secondary involvement of the ovary, but we have experienced one case of pseudomyxoma peritonei originated from independent primary borderline mucinous tumors of the ovary and appendix. So we report this case with the brief review of literatures
Appendix* ; Ascites ; Female ; Mucins* ; Neoplasm Metastasis ; Ovary* ; Pseudomyxoma Peritonei*