Immunohistochemical study was performed for CEA staining patterns and PCNA indices. And the relationship between immunohistochemical findings and well-known clinical prognostic factors on the purpose of the clinical usefulness was evaluated. In forty seven cases of surgically removed colorectal carcinomas, the results were as follows; CEA staining patterns were apical (17 cases) and cytoplasmic (30 cases) type. Carcinomas with cyto plasmic pattern for CEA revealed more advanced Dukes' stage and more undifferentiated type and higher incidence of lymph node metastasis and were correlated with increased serum CEA levels. But PCNA indices showed no correlation with the Dukes' stage, histologic grade and CEA staining patterns. The cytoplasmic pattern of CEA immunohistochemistry may be a useful marker suggesting more aggressive biologic behavior of the colorectal carcinomas.
Colorectal Neoplasms* ; Cytoplasm ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen*

No abstract available.
Epithelial Cells* ; Maxillary Sinus* ; Mucous Membrane*

Anaphylactic reaction during the perioperative period typically exhibits rapid onset, varying clinical manifestations, and an expected mortality rate of 1.5-9%. Neuromuscular blocking agents are the leading cause of perioperative anaphylaxis. Here, we report a severe case of anaphylaxis that developed in a 66-year-old man due to cisatracurium administration. And he was successfully managed by extracorporeal membrane oxygenation. Cardiopulmonary resuscitation was performed by extracorporeal membrane oxygenation, and the patient was successfully weaned off 24 hours later.
Aged ; Anaphylaxis* ; Cardiopulmonary Resuscitation ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Mortality ; Neuromuscular Blocking Agents ; Perioperative Period

No abstract available.

No abstract available.
Multiple Organ Failure* ; Sepsis*

Infective endocarditis is a disease that is characterized by the vegetations. Although cardiac complications remain the leading cause of death, endocarditis is complex, systemic illness with involvement of virtually all the organs. The spectrum and incidence of cardiovasular, neurologic, renal complications also are presented by direct embolism and immune- mediated phenomena. Systemic embolism is the common and serious complications associated with infective endocarditis. Mycotic aneurysm by septic embolization is known complication of bacterial endocarditis, but mycotic aneurysm of superior mesenteric artery is very rare complication and approximately 10 cases has been reported in the literature. Acute hemorrhagic pericarditis is unusual clinical manifestation of bacterial endocarditis and subject to catastrophic hemodynamic compromise secondary to cardiac tamponade. We report a case of bacterial endocarditis in 23 years old male who developed acute hemorrhagic pericarditis and hemoperitoneum due to rupture of mycotic aneurysm in superior mesenteric artery with brief review of lieratures.
Aneurysm, Infected* ; Cardiac Tamponade ; Cause of Death ; Embolism ; Endocarditis ; Endocarditis, Bacterial* ; Hemodynamics ; Hemoperitoneum* ; Humans ; Incidence ; Male ; Mesenteric Artery, Superior* ; Pericarditis* ; Rupture* ; Young Adult

PURPOSE: The mechanism for the pathogenesis of adriamycin (ADR)-induced cardiomyopathy is not yet known. Different hypotheses include the production of free radicals, an interaction between ADR and nuclear components, and a disruption in cardiac-specific gene expression. Apoptosis has also been proposed as being involved in cardiac dysfunction. The purpose of this study was to determine if apoptosis might play a role in ADR-induced cardiomyopathy. METHODS: Male Sprague-Dawley rats were separated into 2 groups: the control group (C group) and the experimental group (ADR 5 mg/wk for 3 weeks through intraperitoneal injections; A group). Echocardiographic images were obtained at week 3. Changes in caspase-3, B-cell leukemia/lymphoma (Bcl)-2, Bcl-2-associated X (Bax), interleukin (IL)-6, tumor necrosis factor-α, brain natriuretic peptide (BNP), troponin I, collagen 1, and collagen 3 protein expression from the left ventricle tissues of C and A group rats were determined by Western blot. RESULTS: Ascites and heart failure as well as left ventricular hypertrophy were noted in the A group. Ejection fraction and shortening fraction were significantly lower in the A group by echocardiography. The expression of caspase-3, Bax, IL-6, BNP, collagen 1, and collagen 3 were significantly higher in the A group as compared with the C group. Protein expression of Bcl-2 decreased significantly in the A group compared with the C group. CONCLUSION: ADR induced an upregulation of caspase-3, Bax, IL-6, and collagen, as well as a depression in Bcl-2. Thus, apoptosis and fibrosis may play an important role in ADR-induced cardiomyopathy.
Animals ; Apoptosis* ; Ascites ; B-Lymphocytes ; Blotting, Western ; Cardiomyopathies* ; Caspase 3 ; Collagen ; Depression ; Doxorubicin ; Echocardiography ; Fibrosis ; Free Radicals ; Gene Expression ; Heart Failure ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Injections, Intraperitoneal ; Interleukin-6 ; Interleukins ; Male ; Models, Animal* ; Natriuretic Peptide, Brain ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Troponin I ; Up-Regulation ; Ventricular Remodeling

BACKGROUND AND OBJECTIVES: Failure of vascular smooth muscle apoptosis and inflammatory response in pulmonary arterial hypertension (PAH) is a current research focus. The goals of this study were to determine changes in select gene expressions in monocrotaline (MCT)-induced PAH rat models after human umbilical cord blood derived mesenchymal stem cells (hUCB-MSCs) transfusion. MATERIALS AND METHODS: The rats were separated into 3 groups i.e., control group (C group), M group (MCT 60 mg/kg), and U group (hUCB-MSCs transfusion) a week after MCT injection. RESULTS: TUNEL assay showed that the U group had significantly lowered positive apoptotic cells in the lung tissues, as compared with the M group. mRNA of caspase-3, B cell leukemia/lymphoma (Bcl)-2, interleukin (IL)-6, tumor necrosis factor (TNF)-alpha and vascular endothelial growth factor (VEGF) in the lung tissues were greatly reduced at week 4 in the U group. Immunohistochemical staining of the lung tissues also demonstrated a similar pattern, with the exception of IL-6. The protein expression of caspase-3, Bcl-2 VEGF, IL-6, TNF-alpha and brain natriuretic peptide in the heart tissues were significantly lower in the U group, as compared with the M group at week 2. Furthermore, the protein expression of VEGF, IL-6 and BNP in the heart tissues were significantly lower in the U group at week 4. Collagen content in the heart tissues was significantly lower in the U group, as compared with M group at weeks 2 and 4, respectively. CONCLUSION: hUCB-MSCs could prevent inflammation, apoptosis and remodeling in MCT-induced PAH rat models.
Animals ; Apoptosis ; Caspase 3* ; Collagen ; Fetal Blood* ; Gene Expression* ; Heart ; Humans* ; Hypertension ; Hypertension, Pulmonary* ; In Situ Nick-End Labeling ; Inflammation ; Interleukin-6* ; Interleukins ; Lung ; Mesenchymal Stromal Cells* ; Models, Animal* ; Monocrotaline ; Muscle, Smooth, Vascular ; Natriuretic Peptide, Brain ; Rats* ; RNA, Messenger ; Stem Cells ; Tumor Necrosis Factor-alpha* ; Umbilical Cord* ; Vascular Endothelial Growth Factor A*

BACKGROUND AND OBJECTIVES: The aims of this study are to introduce an intranasal repair technique of nasal septal perforation using a free composite graft of the auricular cartilage and the temporalis muscle fascia and to determine its efficacy by evaluating the treatment outcome. MATERIALS AND METHOD: Nine symptomatic patients (7 males and 2 females, aged 23 to 66 years) with nasal septal perforation were included in this study. They were all refractory to conservative treatments and they underwent surgery. Preoperative symptoms, etiology, size and location of septal perforations, and postoperative improvement of symptoms and perforations were retrospectively evaluated with a mean follow-up period of 21.7 months. RESULTS: Preoperative symptoms included nasal obstruction, crust formation, rhinorrhea, epistaxis and foul odor. Septal perforation was assumed to have resulted in three patients from septal surgery, trauma and idiopathic causes, respectively. In all patients, the perforation size was 20 mm or less (mean: 12.2x8.4 mm) in diameter and located at the cartilagenous portion, not near the nasal dorsum. The perforations were completely repaired in 6 of 9 patients after surgery. Perforations of 1 and 3 mm in diameter remained in 2 and 1 of the 3 patients showing incomplete closure, respectively. However, clinical symptoms disappeared in 8 of 9 (88.9%) patients, postoperatively. CONCLUSION: This technique may be an effective method for the repair of nasal septal perforation when the perforation is not located near the nasal dorsum and that its size is 20 mm or less in diameter, as the technique offers a cosmetic advantage and produces a satisfactory postoperative outcome by obviating difficulty in intranasal suture.
Ear Cartilage* ; Epistaxis ; Fascia* ; Female ; Follow-Up Studies ; Humans ; Male ; Nasal Obstruction ; Nasal Septal Perforation* ; Nasal Septum ; Odors ; Retrospective Studies ; Sutures ; Temporal Muscle ; Transplants* ; Treatment Outcome

BACKGROUND: Rapid adrenocorticotropin (ACTH) stimulation test using 250ug of ACTH (1-24) has been used as a standard test in the initial assessment of adrenal function. However, it has recently been suggested that a rnaximal cortisol response can be achieved with a much lower ACTH dose, and reducing the dose might further enhance the sensitivity of the test in the detection of mild adrenal insufficiency. This study was performed to evaluate the role of low-dose (lug) ACTH stimulation test in the assessment of adrenal function and the diagnosis of subtle adrenal insufficiency. METHODS: Twenty-two subjects with suspected adrenal insufficiency due to long-term corticosteroid use were included in this study. The correlations between clinical features and the serum cortisol responses to low dose (lug) and high dose (250 ug) ACTH stimulation were evaluated. RESULTS: In high dose test, 10 (67%) out of 15 subjects with clinical features of adrenal insufficiency showed decreased serum cortisol response (peak cortisol level <18 ug/dL), but 5 (33%) subjects showed normal response (peak cortisol level > 18ug/dL). On the other hand, 14 (93%) subjects with clinical features of adrenal insufficiency showed decreased serum cortisol response in low dose test, while only one showed normal response. In 7 subjects without clinical features of adrenal insufficiency, 5 subject (71%) showed normal response, and 2 subjects (29%) showed decreased response in both low and high dose tests. CONCLUSION: These results suggest that the 1-ug low dose ACTH stimulation test might be more sensitive than conventional 250-ug test in the detection of mild adrenal insufficiency. Further studies are needed to determine the optimal dose of ACTH and the criteria for normal response to ACTH stimulation.
Adrenal Insufficiency* ; Adrenocorticotropic Hormone* ; Cosyntropin ; Diagnosis* ; Hand ; Hydrocortisone