BACKGROUNDS: Antiphospholipid antibodies which are frquently found in systemic lupus erythematosus and primary antiphospholipid syndrome are associated with recurrent abortions and thromboembolism. In this study the authors investigated whether antiphospholipid antibodies are found in Graves disease, a representative organ-specific autoimmune disease and what is the clinical implication of the antiphospholipid antibodies if they appear in Graves disease. METHODS: Anticardiolipin antibody and lupus anticoagulant activity were measured in 57 untreated hyperthyroid Graves patients. 42 euthyroid patients with thyroid nodules served as controls. RESULTS: Eight of the 57 patients with Graves disease had anticardiolipin antibody which was significantly more frequent than in control group. Six of the eight patients who had anticardiolipin antibody had IgM type antibody and two had IgG type antibody. All their antibody activity declined with several months of antithyroid drug therapy and finally disappeared when the patients became euthyroid. Presence of anticardiolipin antibody had no relationship with clinical events such as spontaneous abrtion and thromboembolism. CONCLUSION: Anticardiolipin antibody is frequently found in patients with Graves disease. They seem to appear as an epiphenomenon of autoimmunity and they seem not to have any clinical implications.
Abortion, Habitual ; Antibodies, Anticardiolipin* ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Autoimmune Diseases ; Autoimmunity ; Drug Therapy ; Female ; Graves Disease* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Pregnancy ; Thromboembolism ; Thyroid Nodule

Darier's disease is a well-known genodermatosis characterized by recurrent waxy, hyperkeratotic papules usually occurring over the seborrheic area. The major histopathological changes are characteristic acantholysis and dyskeratosis which are diagnostic of the disease with typical clinical features. There are less common variants including the hypertrophic, vesicobullous and linear type. However, comedonal lesions are very rare. We report an unusual case of Darier's disease, which showed prominent comedonal papules and plaques over the face, scalp and upper trunk with the typical findings of Darier's disease.
Acantholysis ; Darier Disease* ; Scalp

We report a case of subcutaneous panniculitic T-cell lymphoma (SPTCL) which occurred in a 10-year-old Korean girl. Her disease presented as multiple erythematous subcutaneous nodules on the right cheek, left chest, abdomen, left flank, both calves, and left shin with systemic symptoms. She had a protracted course of multiple erythematous subcutaneous nodules for 2 months often with spiking fever. Histopathologic findings for the subcutaneous nodules revealed lobular panniculitis-like findings composed of atypical small, bland lymphocytes and histiocytes. Characteristically, atypical lymphocytes rimmed individual fat cells in a lace-like pattern and some histiocytes occasionally phagocytosed WBCs. Bone marrow findings revealed increased phagocytic histiocytes with engulfed hematopoietic cell. The immunophenotypic studies showed CD45RO (UCHLl)+, CD20-, CD4-, CD8+ and CD56+ (focal), lysozyme+, CD45 (LCA)+ and EBV-. She received three cycles of high-dose cyclophosphamide, adriamycin, vincristine, prednisolone (CHOP) and methotrexate, intrathecal methotrexate and one cycle of fludarabine, mitoxantrone and dexamethasone (FND) chemotherapy. She died of acute renal failure during multiple chemotherapy.
Abdomen ; Acute Kidney Injury ; Adipocytes ; Bone Marrow ; Cheek ; Child* ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Glycogen Storage Disease Type VI ; Histiocytes ; Humans ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Methotrexate ; Mitoxantrone ; Prednisolone ; T-Lymphocytes* ; Thorax ; Vincristine

The origins of medullary carcinoma and papillary carcinoma of thyroid are embryologically different. We report a case of simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in the same thyroid gland. In this case, the occurrence of the two tumors may be a coincidence, does not have embryological or genetical significance.
Carcinoma, Medullary ; Carcinoma, Papillary* ; Thyroid Gland*

Angiogenesis is a series of processes that include endothelial proliferation, migration and tube formation. Vascular endothelial growth factor (VEGF) is regarded as a potent mediator of angiogenesis, vascular permeability and tumor cell growth in renal cell carcinoma. This study was designed to evaluate the expression of VEGF and the microvessel count (MVC) and to determine their prediction efficacies for prognosis in renal cell carcinoma. The relationship between the expression of VEGF and MVC were evaluated immunohistochemically in 50 patients with renal cell carcinoma who received a radical nephrectomy at Wonju Christian Hospital between 1989 and 1997. Microvessels were identified by immunostaining endothelial cells for CD-31 antigen. The mean follow-up was 96 months (3 - 133 months). Overall 5-year survival rate was 71.5%. VEGF was expressed in the tumor cell cytoplasm. Of the 50 tumors, 23 (46%) were weak to strongly positive for VEGF but 27 (54%) were unreactive. The respective 5-year survival rates for patients with positive and negative expressions of VEGF were 70% and 73% (p > 0.05). The overall mean MVC was 13.4 in a 400x field. Mean MVCs were significantly higher in VEGF-positive tumors (17.6 +/- 12.1) than in VEGF-negative tumors (9.9 +/- 5.4), and the MVCs of the high vascular density group and the low ascular density groups were significantly different. The 5-year survival rates of patients with high vascular density and low vascular density were 59% and 86%. The median survival period for patients with MVCs higher than or equal to 10 vessels/field was 85 months, whereas for those with MVCs lower than 10 vessels/field the median survival time was 102 months. These results suggest that MVC may be a better prognostic factor in renal cell carcinoma than the expression of VEGF.
Adult ; Aged ; Carcinoma, Renal Cell/*blood supply/*metabolism ; Endothelial Growth Factors/*metabolism ; Female ; Human ; Kidney Neoplasms/*blood supply/*metabolism ; Lymphokines/*metabolism ; Male ; Middle Age ; Neovascularization, Pathologic/*pathology ; Prognosis

No abstract available.
Fallopian Tubes* ; Female ; Mucous Membrane* ; Sterilization*

Beta-lapachone (beta-Lap; 3,4-dihydro-2, 2-dimethyl-2H-naphthol[1, 2-b]pyran-5,6-dione) is a novel anti-cancer drug under phase I/II clinical trials. beta-Lap has been demonstrated to cause apoptotic and necrotic death in a variety of human cancer cells in vitro and in vivo. The mechanisms underlying the beta-Lap toxicity against cancer cells has been controversial. The most recent view is that beta-Lap, which is a quinone compound, undergoes two-electron reduction to hydroquinone form utilizing NAD(P)H or NADH as electron source. This two-electron reduction of beta-Lap is mediated by NAD(P)H:quinone oxidoreductase (NQO1), which is known to mediate the reduction of many quinone compounds. The hydroquinone forms of beta-Lap then spontaneously oxidizes back to the original oxidized beta-Lap, creating futile cycling between the oxidized and reduced forms of beta-Lap. It is proposed that the futile recycling between oxidized and reduced forms of beta-Lap leads to two distinct cell death pathways. First one is that the two-electron reduced beta-Lap is converted first to one-electron reduced beta-Lap, i.e., semiquinone beta-Lap (SQ).- causing production of reactive oxygen species (ROS), which then causes apoptotic cell death. The second mechanism is that severe depletion of NAD(P)H and NADH as a result of futile cycling between the quinone and hydroquinone forms of beta-Lap causes severe disturbance in cellular metabolism leading to apoptosis and necrosis. The relative importance of the aforementioned two mechanisms, i.e., generation of ROS or depletion of NAD(P)H/NADH, may vary depending on cell type and environment. Importantly, the NQO1 level in cancer cells has been found to be higher than that in normal cells indicating that beta-Lap may be preferentially toxic to cancer cells relative to non-cancer cells. The cellular level of NQO1 has been found to be significantly increased by divergent physical and chemical stresses including ionizing radiation. Recent reports clearly demonstrated that beta-Lap and ionizing radiation kill cancer cells in a synergistic manner. Indications are that irradiation of cancer cells causes long-lasting elevation of NQO1, thereby sensitizing the cells to beta-Lap. In addition, beta-Lap has been shown to inhibit the repair of sublethal radiation damage. Treating experimental tumors growing in the legs of mice with irradiation and intraperitoneal injection of beta-Lap suppressed the growth of the tumors in a manner more than additive. Collectively, beta-Lap is a potentially useful anti-cancer drug, particularly in combination with radiotherapy.
Animals ; Apoptosis ; Benzoquinones ; Cell Death ; Electrons ; Humans ; Hydroquinones ; Injections, Intraperitoneal ; Leg ; Mice ; NAD ; Naphthoquinones ; Necrosis ; Radiation Tolerance ; Radiation, Ionizing ; Reactive Oxygen Species ; Recycling ; Substrate Cycling

OBJECTIVE: It has been reported that the presence of a pharmacologically inactive foreign substance, polystyrene latex bead, in subarachnoid space activates a non-specific immunological response and elicits arterial narrowing. In vivo study was undertaken to characterize vascular reactivity of bead-induced constriction. METHODS: The spasm models similar to that by subarachnoid blood injection were created by injection of bead(5 volume% or 10 volume %) into rabbit cisterna magna. The basilar artery was visualized using transclival exposure, and its diameter was monitored using videomicroscopy on day two after cisternal injection. Consequently, many kinds of vasodilators such as papaverine, endothelin receptor antagonist, nicardipine, H7, dibutyryl-c-AMP, 8-bromo-c-GMP, nitroglycerine, forskolin, calcitonin gene-related peptide, and cromakalim were topically applied to determine what vasodilators attenuate arterial constriction induced by bead in 31 rabbits. RESULTS: Injection of bead elicited an arterial constriction, reducing arterial diameter to 78.5% of resting tone in 5 volume% and 67.7% in 10 volume%. ATP-sensitive potassium channel activator, cromakalim, inhibited 5 volume% or 10 volume% bead induced constriction. This effect achieved statistical significance (p<0.05) at a concentration of 10nM. However, other vasodilators did not make a significant vasodilatation of bead induced constriction. CONCLUSION: These results suggest that inactivation of ATP-sensitive potassium channel by inflammation is possibly responsible for the polysytrene latex bead-induced vasospasm, and support the concept that targeting vascular potassium channels can be of benefit in preventing the development of vasospasm.
Basilar Artery ; Calcitonin Gene-Related Peptide ; Cisterna Magna ; Colforsin ; Constriction ; Cromakalim ; Inflammation ; Latex* ; Microscopy, Video ; Microspheres* ; Nicardipine ; Nitroglycerin ; Papaverine ; Polystyrenes* ; Potassium Channels ; Rabbits ; Receptors, Endothelin ; Spasm* ; Subarachnoid Space ; Vasodilation ; Vasodilator Agents

OBJECTIVE: It has been reported that the presence of a pharmacologically inactive foreign substance, polystyrene latex bead, in subarachnoid space activates a non-specific immunological response and elicits arterial narrowing. In vivo study was undertaken to characterize vascular reactivity of bead-induced constriction. METHODS: The spasm models similar to that by subarachnoid blood injection were created by injection of bead(5 volume% or 10 volume %) into rabbit cisterna magna. The basilar artery was visualized using transclival exposure, and its diameter was monitored using videomicroscopy on day two after cisternal injection. Consequently, many kinds of vasodilators such as papaverine, endothelin receptor antagonist, nicardipine, H7, dibutyryl-c-AMP, 8-bromo-c-GMP, nitroglycerine, forskolin, calcitonin gene-related peptide, and cromakalim were topically applied to determine what vasodilators attenuate arterial constriction induced by bead in 31 rabbits. RESULTS: Injection of bead elicited an arterial constriction, reducing arterial diameter to 78.5% of resting tone in 5 volume% and 67.7% in 10 volume%. ATP-sensitive potassium channel activator, cromakalim, inhibited 5 volume% or 10 volume% bead induced constriction. This effect achieved statistical significance (p<0.05) at a concentration of 10nM. However, other vasodilators did not make a significant vasodilatation of bead induced constriction. CONCLUSION: These results suggest that inactivation of ATP-sensitive potassium channel by inflammation is possibly responsible for the polysytrene latex bead-induced vasospasm, and support the concept that targeting vascular potassium channels can be of benefit in preventing the development of vasospasm.
Basilar Artery ; Calcitonin Gene-Related Peptide ; Cisterna Magna ; Colforsin ; Constriction ; Cromakalim ; Inflammation ; Latex* ; Microscopy, Video ; Microspheres* ; Nicardipine ; Nitroglycerin ; Papaverine ; Polystyrenes* ; Potassium Channels ; Rabbits ; Receptors, Endothelin ; Spasm* ; Subarachnoid Space ; Vasodilation ; Vasodilator Agents

Purpose: The purpose of our study is to examine early radiographic findings and clinical signs of failure of the microstructure surface HA-coated acetabular cup. Material and methods: This study included 41 revisions of 204 THA with hydroxyapatite-coated acetabular cup from April 1992 to November 1996. Radiolucent line around cups, change in the cup angle and osteolysis were evaluated in serial radiographs. Acetabular cup was defined as loosening if any movement occurred at the bone and socket interface by manual rotation and extension force intraoperatively or migration of more than 2 mm and change of the cup angle by more than 5 degrees in radiographs. Results: The radiolucent line was observed in 12 of the 41 hips at an average of 55.4 months postoperatively and was most commonly located in zone III. All of the 12 hips showing radiolucent lines were classified as loosening by radiographically in 8 cases and intraoperatively in 4 cases. Radiographic loosening occurred at an average of 28.8 months after the appearance of a radiolucent line. Inguinal pain was noted in 18 of the 19 cases revised for acetabular cup loosening. Conclusion: The most important radiographic finding for the early diagnosis of loosening was progressive radiolucent lines, which occurred most frequently in zone 3.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Early Diagnosis ; Hip ; Osteolysis