BACKGROUNDS: Recent experimental studies demonstrate massive leukocytes extravasation at sites of cerebral ischemia even with the first hours of disease. Leukocytes are now considered to potentiate ischemic neural damage by microvasculature obstruction and generation of neurotoxic substances. Adhesion molecules mediate adhesion between endothelial cells and leukocytes as a precondition for extravasation of leukocytes at sites of tissue injury. We conducted a prospective study to investigate the serum level of ICAM-1, P-selectin, and E-selectin in patients with acute ischemic stroke, and with atherosclerosis. METHODS: Serum was sampled from patients within 24 hrs of acute ischemic stroke(n=20), from patients with previous (> 1 month) transient or persistent ischemic neurologic deficit associated with atherosclerosis(n=22), and control patients without a history of vascular disease(n=20). Concentrations of soluble ICAM-1(sICAM-1), P-selectin(sP-selectin), and E-electin(sE-selectin) were measured by enzyme-linked immunosorbent assay(ELISA). RESULTS: Compared with control subjects, sICAM-1 and sE-selectin were significantly elevated in patients with acute ischemic stroke and in previous symptomatic atherosclerosis(p=0.0001 and p=0.004). The serum level of sP-selectin in patients with acute ischemic stroke was higher than that in patients with previous symptomatic atherosclerosis and control subjects(p=0.0004). CONCLUSIONS: The results suggest a chronic elevation of ICAM-1 and E-selectin in patients with previous symptomatic atherosclerosis and also acute changes of them in patients with acute ischemic stroke. These findings indicate that acute changes of serum P-selectin occurred in response to acute ischemic stroke.
Atherosclerosis ; Brain Ischemia ; Cell Adhesion Molecules ; E-Selectin ; Endothelial Cells ; Humans ; Intercellular Adhesion Molecule-1 ; Leukocytes ; Microvessels ; Neurologic Manifestations ; P-Selectin ; Prospective Studies ; Stroke*

Malignant Mixed Mullerian tumors(MMMTs) are unusual neoplasms occumng mostly in the uterus and, ralely, they arise in the ovary. The clinical features of malignant mixed mullerian tumor of the ovary are similiar to other ovarian malignancies. The clinical course is rapidly progressive and fatal. The optimal treatment modalities has remained elusive. The most reliable prognostic criterion is the initial tumor stage and the overall survival was poor. We experienced two cases of malignant mixed miillerian tumor of the ovary, so we report these cases with a brief review of the concerned literatures.
Female ; Ovary* ; Respiratory Sounds ; Uterus

Adult ; Anti-Bacterial Agents ; Communicable Diseases ; Debridement ; Early Diagnosis ; Extremities ; Fascia ; Fasciitis, Necrotizing ; Gangrene ; Head ; Humans ; Male ; Mortality ; Neck ; Necrosis ; Perineum ; Subcutaneous Tissue

This study examined the late pathological finding, clinical manifestation, and mortality in thirty-two rats with cerebral infarction induced by common carotied artery ligation. Thirty-two rats were divided into three group : Group A-a unilateral common carotid artery ligation group of twelve animals, Group B-a total common carotid artery ligation one side and partial common carotid artery ligation another side of eighteen animals, and Group C-bilateral common carotid arteries ligation of two animal. All animals surviving for 3 weeks were sacrified by intracardial injection of 2 M KCI 5cc and 2.5cc of 2% T.T.C. solution was infused into each common carotid arteries. The brain was rapidly rmoved and sectioned coronally and examined with the aid of a stereoscopic microscope for degree of T.T.C. stain and infarction. Brain was fixed and examined histologically. The results were as follows : 1) Mortality rate of each group : a unilateral common carotid artery ligation group was 16.67%, a total. Common carotid artery ligation on side and partial common carotid artery ligation another side group was 77.78%, and bilateral common arteries ligation group was 100%. 2) Clinical manifestation was showed as follows : hemiparesis, circling movement, abnormal seizure like activity, and ptosis. 3) Percent hemispheric volume infarction(%HVI) was 40%(mean value) in unilateral total common carotid artery ligation and 60% in total ligation one side and 46.25% in partial ligation another side. 4) The pathological change was signigicantly visible in bilateral ligation group.
Animals ; Arteries ; Brain ; Carotid Artery, Common* ; Cerebral Infarction ; Dyskinesias ; Infarction ; Ligation* ; Mortality ; Paresis ; Rats* ; Seizures

The autors reported a giant aneurysm in the cavernous portion of the internal carotid artery which occurred after head trauma. The patient was a 24 year old man who had suffered massive epistaxis with hyoptension about 25 days after a traffic accident. On plain skull X-ray, there was evidence of a basal skull fracture and a linear fracture at the right frontotemporal area. The computed tomographic scan revealed round, well enhanced density in the sellar region. During a reattack of massive epistaxis, emergency carotid angiography showed a right cavernous-internal carotid artery aneurysm with a small extravasation of dye into the sphenoid sinus.
Accidents, Traffic ; Aneurysm* ; Angiography ; Carotid Arteries ; Carotid Artery, Internal ; Craniocerebral Trauma ; Emergencies ; Epistaxis* ; Humans ; Skull ; Skull Fractures ; Sphenoid Sinus ; Young Adult

OBJECTIVE: Recently, chronic renal failure has become a major public health problem all around the world, and the number of patients in Korea affected by this disease has sharply increased since the 1980's. Between 3% and 50% of all cases of chronic renal failure may be induced by toxic agents. The purpose of our study was to investigate the occupational hazards associated with chronic renal failure, in order to use the findings as a reference for further epidemiologic studies. METHODS: The author conducted a questionnaire and reviewed the medical records of chronic renal failure patients (161 people out of 238) in Gyeongju-si and Pohang-si from March 2 to 31, 2003. Those cases of chronic renal failure which were related to work were classified as either 'probable case' if they were of unknown origin or 'suspected case' if they were of known origin and were related to hypertension or diabetes mellitus. RESULTS: The study subjects consisted of 92 males (57.1%) and 69 females (42.9%). The causalities listed in the medical records were diabetes mellitus in 55 cases (40.4%), hypertension in 28 cases (20.6%), chronic glomerulonephritis in 14 cases (10.3%), and other diseases. There were 10 cases (6.2%) that were believed to be related to the patients' occupations. The hazards that these 10 patients had previously been exposed to were silica, organic solvents, tin, copper, lead, cadmium, and other hazards. CONCLUSIONS: Through this study, 10 cases that were reportedly related to occupational chronic renal failure were discovered. Further studies such as a case-control study of occupational risk factors related to chronic renal failure will be needed.
Cadmium ; Case-Control Studies ; Copper ; Diabetes Mellitus ; Dialysis ; Epidemiologic Studies ; Female ; Glomerulonephritis ; Gyeongsangbuk-do ; Humans ; Hypertension ; Kidney Failure, Chronic* ; Korea ; Male ; Medical Records ; Occupational Diseases ; Occupations ; Public Health ; Questionnaires ; Risk Factors ; Silicon Dioxide ; Solvents ; Tin

BACKGROUND: The cause of blood pressure (BP) variation is difficult to identify because genes and environment interact to produce the BP phenotype. Different genetic background and culture in a population make different gene frequency and environment for hypertension. Therefore, we studied the determinants of BP with reference to genes, metabolic factors and environmental factors in Korean population. METHODS: A study was carried out in two hundred fifty- eight patients (mean age 49, females 74%) with newly detected hypertension. Twenty-four hour ambulatory blood pressure monitoring (Accutracter II, Suntecr) was performed as an index of the magnitude of BP. The contributory factors studied were angiotensin-converting enzyme (ACE), angiotensinogen (AGT ; T174M and M235T) gene as a genetic factor, alcohol and smoking habitus, exercise, sodium intake as an environmental factor, and body mass index (BMI), insulin, lipid, renin, and aldosterone as a intermediate phenotype. RESULTS: 1) Genetic factors : There were no significant associations between ACE and AGT polymorphisms and the magnitude of BP. 2) Environmental factors : Alcohol and weight were significantly correlated with daytime systolic BP (r=.13, p=.04 and r=.15, p=.02), diastolic BP (r=.17, p=.01 and r=.12, p=.05), and nighttime diastolic BP (r=.15, p=.02 and r=.11, p=.01). Sodium intake, as assessed by fasting spot urine Na/K ratio in the morning, was not related to the magnitude of BP. 3) Intermediate phenotype : Plasma aldosterone level was significantly correlated to daytime diastolic BP (r=.16, p=.03), nighttime systolic BP (r=.17, p=.03), and nighttime diastolic BP (r=.16, p=.04). In women, plasma aldosterone was reversely correlated to urine Na/K ratio (r=-.42, p=.001). CONCLUSIONS: The magnitude of blood pressure in essential hypertension seems to be mainly determined by weight, alcohol intake, and plasma aldosterone level.
Aldosterone ; Angiotensinogen ; Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Body Mass Index ; Fasting ; Female ; Gene Frequency ; Humans ; Hypertension* ; Insulin ; Phenotype ; Plasma ; Renin ; Smoke ; Smoking ; Sodium

Lumbar disc surgery is a common operation with rare vascular complications. The authors report a case of iliac arteriovenous(AV) fistula and pseudoaneurysm as a complication of lumbar disc surgery. A 52-year-old man underwent lumbar disc surgery 14 months prior to the admission. His chief complaints were progressive pain and swelling on the left lower limb. Contrast medium enhanced computed tomography(CT) scan showed dilatation in both iliac veins, right iliac AV fistula, and an pseudoaneurysm. Angiogram demonstrated a pseudoaneurysm originated from the right common iliac artery, associated left iliac vein compression, and dilatation in both iliac veins. The patient was treated with an endovascular stent placement. Angiogram obtained after stent grafting demonstrated elimination of the pseudoaneurysm, occlusion of the AV fistula, and right iliac artery patency. One month after the stent placement, his leg pain and swelling were improved markedly. A high suspicion based on clinical signs, CT scan, and angiography are important in the early detection of AV fistula. An endovascular stent placement is considered a promising treatment in select patients with iliac AV fistulae and pseudoaneurysms.
Aneurysm, False* ; Angiography ; Arteriovenous Fistula* ; Blood Vessel Prosthesis ; Dilatation ; Fistula ; Humans ; Iliac Artery ; Iliac Vein ; Leg ; Lower Extremity ; Middle Aged ; Stents ; Tomography, X-Ray Computed

In order to assess the sensitively and specificity of the pulsed Doppler echocardiography in the aortic regurgitation, 44 patients with valvular heart diseases were examined by pulsed Doppler echocardiography. Every patient was examined in sequence of clinical examination including the physical, M-mode & 2D echocardiographic examination, Doppler technique and then angiocardiography. The obtained results were; 1) Pulsed Doppler echocardiography was very useful in the diagnosis of the aortic regugitation(sensitivity:100%, specificity:90%). 2) Pulsed Doppler echocardiography was especially useful in the detection of the aortic regurgitation in patients who were not detected by physical and conventional echocardiographic examination.
Angiocardiography ; Aortic Valve Insufficiency* ; Diagnosis* ; Echocardiography ; Echocardiography, Doppler, Pulsed* ; Heart Valve Diseases ; Humans ; Sensitivity and Specificity

Chin ; Humans ; Lip ; Malocclusion ; Mandible ; Orthognathic Surgery ; Prognathism