In order to evaluate the role of cytopathologic diagnosis of sputum, bronchial washing and bronchial brushing in the diagnosis of lung cancer, we performed this study. The patients included in this study had undergone sputum, bronchial washing and brushing cytology over the 20-month period of 1985 through 1987. The total number of specimens was 5,495 of 2,242 patients, including 4,830 sputa and 665 bronchial washing and brushings. The average number of sputa and bronchial washings and brushings per case was 2.4 and 1.2 respectively. Among them, about 10% were unsatisfactory specimen, and three-fourths were negative specimens. In sputum cytology, the diagnosis of "atypical cells" was given to 3%, "suspicious for malignancy" was given to 1%, and "malignancy" was given to 13%. In bronchial washing and brushing cytology, the diagnosis of "atypical cells", "suspicious for malignancy" and malignancy" was given to 6%, 3%, and 20% respectively. The cases diagnosed as "atypical cells" in cytology were actually malignancy in 95% and 84.8% of sputum and bronchial washing and brushings respectively, and the "suspicious for malignancy" were actually malignancy in 100% in both methods. The detection rates of malignancy were 50.4% and 55.2% in sputum and bronchial washing and brushing respectively, and the specificity was 100% in both methods. The accuracy of cell typing was 92% in sputum and 89.7% in bronchial washing and brushing.
Biopsy, Fine-Needle ; Child* ; Diagnosis ; Humans ; Lung Neoplasms ; Mass Screening* ; Sensitivity and Specificity ; Seoul* ; Sputum

BACKGROUND: Although hypoxic pulmonary vasoconstriction (HPC) and hypoxic coronary vasodilatation (HCD) have been recognized by many researchers, the precise mechanism remains unknown. As isolated arteries will constrict or relax in vitro in response to hypoxia, the oxygen sensor/transduction mechanism must reside in the arterial smooth muscle, the endothelium, or both. Unfortunately, much of the current evidence is conflicting, especially concerning to the dependency of HPC and HCD on the endothelium and the role of the K+ channel. Therefore, this experiment was attempted to clarify the dependency of HPC and HCD on the endothelium and the role of the K+ channel on HPC and HCD. METHODS: HPC was investigated in isolated main pulmonary arteries precontracted with norepinephrine (NE). HCD was investigated in isolated left circumflex coronary artery precontracted with prostaglandin F2 alpha. Vascular rings were suspended for isometric tension recording in an organ chamber filled with Krebs-Henseleit solution. Hypoxia was induced by gassing the chamber with 95% N2 +5% CO2, which was maintained for 15 - 25 min. RESULTS: 1)Hypoxia elicited a vasoconstriction in NE-precontracted pulmonary arteries with endothelium, but a vasodilatation in PGF 2 alpha-precontracted coronary arteries with and without endothelium. There was no difference between the amplitude of the HPC and HCD induced by two consecutive hypoxic challenges and the effect of normoxic and hyperoxic control Krebs-Henseleit solution on subsequent response to hypoxia. 2)Inhibition of NO synthesis by the treatment with Nw-nitro-L-arginine reduced HPC in pulmonary arteries, but inhibition of the cyclooxygenase pathway by treatment with indomethacin had no effect on HPC and HCD, respectively. 3)Blockades of the TEA-sensitive K+ channel abolished HPC and HCD. 4)Apamin, a small conductance Ca2+/-activated K+ (KCa) channel blocker, and iberiotoxin, a large conductance KCa channel blocker, had no effect on the HCD. 5)Glibenclamide, an ATP-sensitive K+ (KATP) channel blocker, reduced HCD. 6)Cromakalim, an K(ATP) channel opener, relaxed the coronary artery precontracted with prostaglandin F2 alpha. The degree of relaxation by cromakalim was similar to that by hypoxia and glibenclamide reduced both hypoxia- and cromakalim-induced vasodilations. 7)Verapamil, a Ca2+ entry blocker, caffeine, a Ca2+ emptying drug; and ryanodine, an inhibitor of Ca2+ release from SR, reduced HPC, respectively. CONCLUSION: HPC is dependent on the endothelium and is considered to be induced by inhibition of the mechanisms of NO-dependent vasodilation while HCD is independent of the endothelium and is considered to be induced by activation of the K(ATP) channel.
Anoxia ; Arteries ; Caffeine ; Coronary Vessels ; Cromakalim ; Dinoprost ; Endothelium ; Glyburide ; Indomethacin ; Muscle, Smooth ; Norepinephrine ; Oxygen ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins F ; Pulmonary Artery ; Relaxation ; Ryanodine ; Vasoconstriction* ; Vasodilation*

"Mig is a gamma interferon-inducible T cell chemoattractant that is a member of the chemokine family of cytokines. In order to gain a better understanding of the molecular mechanisms that regulate expression of the Mig gene, we have characterized the Mig gene and compared its structure and regulatory sequences with that of its ciosest IP10 gene. The genomic organization of the Mig gene reveals three introns that interrupt the transcribed sequence into four functional domains with a single ""CAT""- and ""TATA""-like structure. Primer extension analysis was used to identify the transcriptional initiation site that is located 50 bp upstream to the methionine codon that begins the long open reading frame. Comparison of the intron-exon structure of this gene to the gene for IP10 establishes that both genes are interrupted in precisely the same positions within homologous codons. The similarity of the intron-exon structure of the Mig and IP10 genes further support the hypothesis that Mig and IP10 genes have evolved from a common ancestral gene by gene duplication. The 5'-flanking region of Mig gene shows no overall sequence similarity with that from its closest IP10 gene whose production is also affected by gamma interferon. However, there are regions including a sequence with similarity to the NFxB binding site, AP-1 binding site, and ISRE. The r-RF-1 binding site is well conserved from -204 to -194 from the transcription start site in the Mig gene. Given the importance of IFN-r for effective immunity in tuberculosis and induction of Mig and IP10 genes in macrophages by IFN-r, we demonstrated induction of the genes Mig and IP10 with different message levels in the THP-1 human monocytic cell lines stimulated with whole M. tuberculosis. Despite the very similarity in genomic organization and the overlap in biological activities between MIG and IP10, our data described herein further support the suggestion that these chemokines rnay role nonredundantly in vivo. Moreover, our studies done on the Mig gene should provide the structural framework for future studies and begin to dissect cis-acting DNA sequences that are critical for gene regulation mediated by cell surface receptors."
Base Sequence ; Binding Sites ; Cell Line ; Chemokine CXCL9* ; Chemokines ; Codon ; Cytokines ; Gene Duplication ; Genome ; Humans* ; Interferons ; Introns ; Macrophages ; Methionine ; Open Reading Frames ; Transcription Factor AP-1 ; Transcription Initiation Site ; Tuberculosis

Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.
Acromioclavicular Joint ; Acromion* ; Clavicle* ; Dislocations ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Rotator Cuff ; Tears

No abstract available.
Humans ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Tract Infections* ; Urinary Tract*

The treatment of intra-articular fractures of distal radius is difficult and has various problems. Maximum recovery of wrist function is dependent on accurate and stable reduction of the radial articular surface. We analysed one hundred and five cases of intra-articular fracture of distal radius followed for more than 6 months at Yonsei University from January 1980 to September 1988 and studied the result according to the type of treatment. The results of this study were as follows; 1. The incidence was high in female who aged over 6th decade, and in male who is active aged. 2. The main cause of this injury was fall down(34.3%). 3. In a group of closed reduction and cast immobilization, the functional result was satisfactory in 45.4%. 4. In a group of closed reduction and percutaneous pinning, the functional result was satisfactory in 50%. 5. In a group of open reduction and internal fixation, the functional result was satisfactory in 83. 3%. 6. In a group of external fixation, the functional result was satisfactory in 33.3%. 7. Overall result was mainly correlated with initial severity of the injury and anatomical reduction of the intra-articular surface.
Clinical Study ; Female ; Humans ; Immobilization ; Incidence ; Intra-Articular Fractures ; Male ; Radius ; Wrist

No abstract available.
Activities of Daily Living* ; Humans

Locking of the metacarpophalangeal(MP) joint of thumb in mild hyperextension is relatively uncommon problem. The most frequently recognized cause appears that proximal palmar ligament or volar plate were ruptured tranversely with its distal part riding over the volar prominence of the radial condyle of the first metacarpal head. We experienced two cases of locking of the MP joint of the thumb due to volar plate injury. Closed reduction was failed in both cases and open reduction was done by cutting the constricted ligament hundle over the radial condyle of the first metacarpal head. Our description of this mechanism is supported by expeimental evidence that we obtained from the cadeveric specimens. The height of radial side condyle of first metacarpal head is higher than ulna side of that by 1.76mm in both hands of 16 cadeveric specimen. So we are going to report these cases with a review of the literature, and suggest that the preferable location of surgical incision in open reduction is radial side of metacarpal head.
Hand ; Head* ; Joints ; Ligaments ; Metacarpal Bones* ; Metacarpophalangeal Joint* ; Thumb* ; Ulna ; Palmar Plate

Fixation failure is a major complication of intertrochanteric fracture. The causes of fixation failure were assessed in a series of 80 patients with intertrochanteric fractures, which had been internally fixed with either a sliding hip screw or a Gamma interlocking nail. The overall rate of fixation failure was 16.3%, in which the cutting-out of the implant from the femoral head was the only cause of the instance. The cutting-out rate was influenced by the accuracy of fracture reduction, the position of implant placement within the femoral head, and the bone mineral density. Anatomical reduction and the central placement of implant within the femoral head showed the most excellent results compared to other treatment modalities. Age, gender, fracture type and a kind of fixation implant had no significant effect. Our results showed that the intertrochanteric fractures should be reduced as anatomically as possible and it is essential that the central placement of the implant within the femoral head be obtained.
Bone Density ; Head ; Hip ; Hip Fractures* ; Humans

No abstract available.