No abstract available.
Humans ; Peptic Ulcer*

Serum alkaline phosphatase (AP) activity is elevated in hepatobiliary disease, bone disease, pregnancy and certain neoplasms. Recently we experienced marked elevation of serum AP activity after administration of albumin preparation in nephrotic patients who suffered from hypovolemic symptoms. So serum AP activity and the isoenzymes in the albumin preparations & patient's serum after the administration of albumin preparation were studied. Serum AP activity was significantly higher after administration of albumin preparation (318+/-101 IU/L) then before (123+/-43 IU/L). The predominant isoenzyme after administration of albumin was placental type, while liver and bone type was predominant before administration. AP activity in albumin preparation was high (2,133+/-1,410 IU/L) and the isoenzyme was mostly placental type. So we concluded that marked elevation of serum AP activity after administration of albumin was traced to the placental type AP isoenzyme in some albumin preparations which was manufactured from the plasma of placental origin. Elevated serum AP activity like these may lead to erroneous interpretation. Manufactures should notify alkaline phosphatase activity in albumin preparations of placental origin.
Administration, Intravenous* ; Alkaline Phosphatase* ; Bone Diseases ; Humans ; Hypovolemia ; Isoenzymes ; Liver ; Plasma ; Pregnancy

The application of fine needle aspiration (FNA) cytology to the soft tissue tumors had been neglected. In recent years, however, FNA has been used increasingly in the preoperative diagnosis of these tumors due to its usefulness and accuracy. We present 3 cases of liposarcoma, myxoid, myxoid with round cell, and pleomorphic, diagnosed by FNA cytology with histologic confirmation. Good correlation between his- tologic and FNA cytologic findings was found. Although the cytologic appearances of liposarcomas varied with histologic type, the main criterion was the presence of atypical multivacuolated lipoblast with characteristically scalloped nuclei.
Biopsy, Fine-Needle ; Child* ; Diagnosis ; Humans ; Hypertension, Renovascular* ; Liposarcoma ; Liposarcoma, Myxoid ; Pectinidae

BACKGROUND: Histamine, released from mast cells in atheromatous plaque, has been known to cause cardiac ischemia or sudden cardiac death in atherosclerosis patient. Previous reports have suggested that histamine induced coronary vasoconstriction was due to increase in IP(3) and DAG, which induce release of Ca2+ from SR and increase the Ca2+ sensitivity of contractile element via activation of PKC. Recently, it was reported that application of histamine cause depolarization of intestinal smooth muscle, which may contribute to histamine-induced contraction via augmenting Ca2+ influx through activation of Ca2+ channels. However, the underyling mechanism of histamine-induced depolarization and its contribution to the magnitude of coronary vasoconstriction are still uncertain. METHOD: To elucidate the underlying mechanism of Ca2+ influx change during histamine-induced vasoconstriction, we examined the effect of Ca2+ channel antagonist and PKC blocker on histamine-induced contractions, and then measured the effect of PKC antagonist on whole cell K+ current using patch clamping method in rabbit coronary smooth muscle cells. RESULTS: Application of histamine induced phasic and tonic constraction of coronary rings via activation of H(1) receptors. Pretreatment of Ca2+ channel antagonist (nifedipine, 1 microM) or PKC blockers (10 nM staurosporine and 10 microM Go6976) markedly inhibited histamine-induced tonic contraction, which suggest that the magnitude of tonic contraction depend on the Ca2+ influx. Application of 4-AP, a blocker of voltage-dependent K+ channels, increased resting tone of coronary rings, and combined treatment of nifedipine blocked this 4-AP induced increase of resting tone. Application of active analoge of DAG (1,2-DiC(8)) significantly inhibited the activity of voltage-dependent K+ current in single smooth muscle cell, meanwhile the inactive analogue of DAG (1,3-DiC(8)) has no apparent effect on the activity of voltage-dependent K+ current. Furthermore, pretreatment of calphostin C (1 microM), a blocker of PKC, diminished the 1,2-DiC(8)-induced inhibition of K+ current. CONCLUSION: PKC dependent inhibition of voltage-dependent K+ current may be responsible for the maintaining of histamine-induced tonic contraction in rabbit coronary artery.
Atherosclerosis ; Constriction ; Coronary Vessels* ; Death, Sudden, Cardiac ; Histamine ; Humans ; Ischemia ; Mast Cells ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Nifedipine ; Protein Kinase C ; Staurosporine ; Vasoconstriction

Little is known about the natural history and management of choroidal neovascularization (CNV) which developed as a complication of laser photocoagulation for central serous chorioretinopathy (CSC). We experienced two patients with CNV which developed after laser treatment for CSC. Submacular membranectomy was performed on both cases after the confirmation of subretinal CNV with optical coherence tomography. One patient received photodynamic therapy for recurrent CNV. The vision of both patients has been improved over 6 months of follow up. These cases suggest that active intervention, including submacular surgery, improves the visual prognosis of this condition.
Adult ; Choroid Diseases/*surgery ; Choroidal Neovascularization/etiology/*surgery ; Diagnostic Techniques, Ophthalmological ; Female ; Human ; Interferometry ; Laser Coagulation/*adverse effects ; Light ; Male ; Retinal Diseases/*surgery ; Tomography ; Treatment Outcome ; Visual Acuity

BACKGROUND: Selecting the appropriate patients and reducing stroke onset to endovascular recanalization therapy (ERT) time are essential elements of a successful ERT. Since ERT is available only in large hospitals, proper patients transfer is important. The purpose of study is to examine the suitability of the transfer of acute stroke patients. METHODS: We retrospectively reviewed the medical records of patients who diagnosed as acute ischemic stroke from January to December in 2017. Patients were divided into two groups based on transfer (direct visit vs. transfer) and Alberta Stroke Program Early computed tomography (ASPECT) score (≥8 vs. <8) respectively. Each group was assessed by demographics, type and rate of reperfusion therapy, onset to reperfusion therapy time, stroke risk factors and neurological deficit severity. Interhospital distance and transfer time was calculated in transferred patients. RESULTS: Among the 455 patients, the 228 (50.2%) patients underwent interhospital transfer. The ratio of reperfusion therapy was not significant different between direct visit and transferred group (34.8% vs. 37.3%, p=0.397). The transferred patients tended to be older (p=0.003), female (p=0.001), more hypertension (p=0.019), less transient ischemic attack (p=0.001), longer onset to ERT time (178.55±85.92 vs. 131.48±82.89; p=0.001) lower ASPECT score (6.72±2.04 vs. 8.01±1.65; p<0.001) and higher National Institute of Health Stroke Scale (NIHSS) (p<0.001) and modified Rankin Scale (mRS) (p<0.001). High ASPECT score (≥8) patients were more direct visited (63.9%), shorter onset to ERT time (p=0.047), lower initial NIHSS and mRS (p<0.001), and greater in differences between mRS at admission and 3 months later (p=0.016). CONCLUSIONS: This study suggests emergency and interhospital transfer of acute stroke patients is inefficient, and systematization of transfer is necessary.
Alberta ; Demography ; Emergencies ; Endovascular Procedures ; Female ; Humans ; Hypertension ; Ischemic Attack, Transient ; Medical Records ; Neuroimaging ; Patient Transfer ; Reperfusion ; Retrospective Studies ; Risk Factors ; Stroke

To evaluate the role of nitric oxide (NO) in IFN-gamma production and apoptosis of splenocytes in genetically different strains of mice with toxoplasmosis, BALB/c (a toxoplasmosis resistant strain) and C57BL/6 (a toxoplasmosis susceptible strain) mice were infected with Toxoplasma gondii cysts orally and subsequently injected intraperitoneally with aminoguanidine, an iNOS inhibitor (AG; 35 mg/kg per mouse daily for 14 days). When BALB/c or C57BL/6 mice were infected with T. gondii without AG treatment, number of brain cysts, NO and IFN-gamma production by splenocytes, and percentages of apoptotic splenocytes were increased compared to uninfected control mice without AG treatment. AG treatment increased the number of brain cysts, and reduced NO and IFN-gamma production in T. gondii-infected C57BL/6 mice. In contrast, in T. gondii-infected BABL/c mice, the number of brain cysts, and NO and IFN-gamma production of splenocytes was not altered by treatment with AG. However, the percentages of apoptotic splenocytes in T. gondii-infected BALB/c or C57BL/6 mice were not affected by AG treatment. These results suggest that NO modulates IFN-gamma production in T. gondii-infected C57BL/6 mice, and that NO is involved in mediating a protective response in toxoplasmosis susceptible, but not resistant, mice strain during acute infection.
Animals ; Apoptosis/drug effects/*immunology ; Comparative Study ; Female ; Guanidines/*pharmacology ; Interferon Type II/*biosynthesis ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Nitric Oxide/*biosynthesis ; Nitric-Oxide Synthase/*antagonists & inhibitors ; Research Support, Non-U.S. Gov't ; Species Specificity ; Spleen/immunology ; Toxoplasmosis, Animal/*immunology

No abstract available.
Drug Therapy*

Protein-calorie malnutrition is common in CAPD patients and is associated with increase in morbidity and mortality in CAPD patients. There are many causes of malnutrition in CAPD patients, and it is well known that a large amount of protein losses through peritoneal membrane is one of them. To investigate the effect of the peritoneal membrane transport characteristics on the nutritional status in long-term CAPD patients, we conducted a cross- sectional study on clinically stable 115 patients (63 males and 52 females) who have been on CAPD for more than 2 years, and assessed nutritional status by subjective global assessment (SGA), biochemical, anthropometric and urea kinetic parameters. Patients were divided into 4 groups according to the results of standard peritoneal equilibration test (PET). The results were as follows: 1) The patients were divided into 4 groups according to the PET results: high transporter (n=16, 14%), high average transporter (n=38, 33%), low average transporter (n=50, 43%), and low transporter (n=11, 10%). 2) The mean age of the patients was 50.1+/-11.6 years (range, 19-75) with sex ratio (M:F) 1.2:1 and mean duration of dialysis was 57.5+/-27.8 months (range, 24-135). The mean body weight (Bwt) was 59.2+/-8.9kg, percent ideal body weight (%IBW) was 104.7+/-15.6%, %lean body mass (LBM)/Bwt was 82.1+/-11.1%, and malnourished patients by subjective global assessment (SGA) were 32.2% (38/115). 3) The mean BUN, creatinine, total protein, and albumin level of the patients were 54.5+/-13.1mg/dL, 12.3+/-3.0mg/dL, 6.7+/-0.8g/dL, and 3.8+/-0.6g/dL, respectively. 4) There were no significant differences in age, sex ratio, CAPD duration, peritonitis rate, %LBM/ Bwt, and SGA among the 4 groups. 5) Total protein (g/dL) and albumin (g/dL) levels in high transporters were 6.4+/-0.5, 3.5+/-0.4, respectively, and they were significantly lower than those of low transporters (7.2+/-0.6, 4.2+/-0.5) (P<0.05). 6) 24 hour dialysate protein (g/day) and albumin (g/day) losses were significantly higher in high transporters (8.10+/-1.85, 4.19+/-1.23) compared to those of low transporters (5.07+/-1.85, 2.78+/-0.99) (P<0.05). 7) The level of IGF-1 (ng/mL) was significantly lower in high transporters (150.5+/-86.2) compared to that of low transporters (310.3+/-162.1) (P<0.05). 8) The level of BUN (mg/dL), Cr (mg/dL) were also lower in high transporters (45.4+/-13.1, 10.1+/-2.0) than those of low transporters (61.6+/-18, 14.7+/-2.7), but there were no significant differences in Hct, total cholesterol, prealbumin, and transferrin among the 4 groups. 9) There were no statistically significant differences in Kt/Vurea, RRF, NPCR, dietary calorie and protein intakes among the 4 groups. 10) Anthrometric parameters such as TSF, BSF, MAC and LBM measured by three different methods (LBMCr, LBMimp, LBManthro) didn't show any significant differences among the 4 groups. In conclusion, increased peritoneal permeability may not adversely affect SGA and anthropometric status of long-term CAPD patients, although it is associated with lower serum albumin, creatinine, and IGF-1 level. Clinical significance of these findings remains to be elucidated.
Body Weight ; Cholesterol ; Creatinine ; Dialysis ; Humans ; Ideal Body Weight ; Insulin-Like Growth Factor I ; Male ; Malnutrition ; Membranes ; Mortality ; Nutritional Status* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Permeability ; Prealbumin ; Protein-Energy Malnutrition ; Serum Albumin ; Sex Ratio ; Transferrin ; Urea

There had been total 20 patients with early onset(4 months~2 years) primary nephrotic syndrome in the Department of Pediatrics, Seoul National University Children's Hospital, during the period from March 1987 to February 1993. We analysed clinical courses, response to treatment, pathological findings and prognosis of the patients And the results were as follows; 1) The initial responders to steroid treatment were 10(50%), of whom 3 became late nonresponders. Of the 10 initial nonresponders, 8 revealed continuing nonresponsiveness. 2) Incidence of hypertension was significantly higher in the intial nonresponders than in the initial responders. 3) Renal biopsies were performed in 9 initial nonresponders and 2 late nonresponders. And the results were 6 with minimal change lesion, 4 with focal segmental glomerulosclerosis and 1 with mesangiocapillary glomerulonephritis. 4) Six continuing or late nonresponders received methylprednisolone pulse therapy or cyclophosphamide. And partial remission was induced in 4 of them. 5) The overall 3 year maintenance rate of normal renal function was 81%(100% in the initial responders and 64% in the initial nonresponders). In conclusion, the initial steroid responsiveness and prognosis were poorer in patients with early onset nephrotic syndrome than in patients with usual childhood nephrotic syndrome.
Biopsy ; Cyclophosphamide ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension ; Incidence ; Methylprednisolone ; Nephrotic Syndrome* ; Pediatrics ; Prognosis ; Seoul