No abstract available.
Acinar Cells* ; Biopsy, Fine-Needle* ; Carcinoma, Acinar Cell* ; Parotid Gland*

Somatostatinoma is rare endocrine tumor that was first described in 1977 by Ganda et al. and Larsson et al. simultaneously. It seems nonfunctioning at clinical level. But it may present with diabetes, diarrhea, cholelithiasis, steatorrhea, indigestion, hypochlorhydria, and anemia. In contrast with pancreatic somatostatinoma, duodenal somatostatinoma, in general, is clinically silent. Duodenal endocrine tumors show similar histologic pattern. Therefore, the definite diagnosis is performed by immunohistochemistry and electron microscopic examination. We have experienced a case of somatostatinoma of duodenum in a 62-year-old male. He has complained generalized pruritus for one year and jaundice for 2 weeks. Grossly, the mass was a intraluminary protruding, polypoid lesion with focal mucosal erosion at immediately distal to Ampulla of Vater. Histologically, it showed tall, cylindrical cells with distinct cell membranes, having granular cytoplasm and small innocent looking nuclei. No mitosis was seen. The tumor cells were arraged in small solid groups and trabeculae, separated by fibrovascular stroma. Immunohistochemically, the tumor cells were strongly positive with somatostatin and negative with several other hormonal and neuroendocrine markers. Ultrastructurally, the cytoplasm contains numerous, homogeneous low electron dense secretory granules, which are essentially similar to those seen in normal delta cells.

BACKGROUND: The serotonin type 3 receptors are diffusely distributed in both the central and the peripheral nervous system. Physiological and pathophysiological processes thought to be mediated by this receptor include nausea and vomiting, peripheral nociception and central antinociception, conditioned aversion response to drugs, anxiety, and cognition. Because of the structural similarity between the nicotinic acetylcholine receptor and the 5HT3 receptor, we investigated the effects of clinically used neuromuscular blockers on the 5HT3 receptor function related with PONV. METHODS: A cDNA clone encoding the full length murine 5HT3a receptor was subcloned into an oocyte expression vector and 50 ng of cRNA transcribed in vitro injected per oocyte. After 24 72 h incubation, oocytes were placed into a recording chamber continuously perfused with frog Ringer's solution and electrophysiological recordings were obtained by the two electrode voltage clamp technique. Serotonin with or without the various drugs were bath applied by a computer controlled solenoid valve. Peak currents induced by the drug applications were measured and dose responses were obtained. RESULTS: The 5HT3 receptor expression in Xenopus oocyte was identified by the pharmacologic tools. Serotonin induced rapid inward currents, and thus was showed dose-dependent: KD = 2.5 micrometer, Hill coefficiency = 2.09. Inhibition by the neuromuscular blockers showed dose-dependence and their inhibitory potency on 5HT3 receptor (IC50) was in order of d-tubocurarine (0.046 micrometer) > vecuronium (16.32 micrometer) > gallamine (1,169 micrometer). CONCLUSIONS: There was a different inhibitory effect of nicotinic cholinergic antagonists, clinically used neuromuscular blockers, on the 5HT3 receptor and a judicious selection of them might contribute to reducing the incidence of PONV clinically.
Anxiety ; Baths ; Cholinergic Antagonists ; Clone Cells ; Cognition ; DNA, Complementary ; Electrodes ; Gallamine Triethiodide ; Incidence ; Nausea ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Nociception ; Oocytes* ; Peripheral Nervous System ; Postoperative Nausea and Vomiting ; Receptors, Nicotinic ; RNA, Complementary ; Serotonin* ; Tubocurarine ; Vecuronium Bromide ; Vomiting ; Xenopus*

BACKGROUND: The serotonin type 3 receptors are diffusely distributed in both the central and the peripheral nervous system. Physiological and pathophysiological processes thought to be mediated by this receptor include nausea and vomiting, peripheral nociception and central antinociception, conditioned aversion response to drugs, anxiety, and cognition. Because of the structural similarity between the nicotinic acetylcholine receptor and the 5HT3 receptor, we investigated the effects of clinically used neuromuscular blockers on the 5HT3 receptor function related with PONV. METHODS: A cDNA clone encoding the full length murine 5HT3a receptor was subcloned into an oocyte expression vector and 50 ng of cRNA transcribed in vitro injected per oocyte. After 24 72 h incubation, oocytes were placed into a recording chamber continuously perfused with frog Ringer's solution and electrophysiological recordings were obtained by the two electrode voltage clamp technique. Serotonin with or without the various drugs were bath applied by a computer controlled solenoid valve. Peak currents induced by the drug applications were measured and dose responses were obtained. RESULTS: The 5HT3 receptor expression in Xenopus oocyte was identified by the pharmacologic tools. Serotonin induced rapid inward currents, and thus was showed dose-dependent: KD = 2.5 micrometer, Hill coefficiency = 2.09. Inhibition by the neuromuscular blockers showed dose-dependence and their inhibitory potency on 5HT3 receptor (IC50) was in order of d-tubocurarine (0.046 micrometer) > vecuronium (16.32 micrometer) > gallamine (1,169 micrometer). CONCLUSIONS: There was a different inhibitory effect of nicotinic cholinergic antagonists, clinically used neuromuscular blockers, on the 5HT3 receptor and a judicious selection of them might contribute to reducing the incidence of PONV clinically.
Anxiety ; Baths ; Cholinergic Antagonists ; Clone Cells ; Cognition ; DNA, Complementary ; Electrodes ; Gallamine Triethiodide ; Incidence ; Nausea ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Nociception ; Oocytes* ; Peripheral Nervous System ; Postoperative Nausea and Vomiting ; Receptors, Nicotinic ; RNA, Complementary ; Serotonin* ; Tubocurarine ; Vecuronium Bromide ; Vomiting ; Xenopus*

PURPOSE: To evaluate the qualitative immunologic changes by ionizing radiation, we studied the altered capacities of the macrophages and lymphocytes to produce cytokines in conjunction with resistance to Listeria monocytogenes (LM) infection in mice. MATERIALS AND METHODS: BALB/c mice and Listeria monocytogenes were used. The mice were infected intraperitoneally with 105LM at 1 day after irradiation (300cGy) and sacrificed at 1, 3, 5 days after infection, and then the numbers of viable LM per spleen in the irradiated and control group were counted. Tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), interleukin-2 (IL-2), and nitric oxide (NO) were assessed after irradiation. RESULTS: Under gamma-ray irradiation with a dose range of 100-850cGy, the number of total splenocytes decreased markedly in a dose-dependent manner, while peritoneal macrophages did so slightly. Cultured peritoneal macrophages produced more TNF-alpha in the presence of lipopolysaccharide (LPS) during the 24 hours after in vitro irradiation, but their capacity of TNF-alpha production showed a decreased tendency at 5 days after in vivo total body irradiation. With 100cGy and 300cGy irradiation, cultured peritoneal macrophages produced more NO in the presence of LPS during the 24 hours after in vitro irradiation than without irradiation. Activated splenocytes from irradiated mice (300cGy) exhibited a decreased capacity to produce IL-2 and IFN-gamma with Concavalin-A stimulation at 3 days after irradiation. When BALB/c mice were irradiated to the total body with a dose of 300cGy, they showed enhanced resistance during early innate phase, but a significant inhibition of resistance to LM was found in the late innate and acquired T-cell dependent phases. CONCLUSION: These results suggest that increased early innate and decreased late innate and acquired immunity to LM infection by ionizing radiation (300cGy) may be related to the biphasic altered capacity of the macrophages to produce TNF-alpha and the decreased capacities of the lymphocytes to produce IL-2 and IFN-gamma in addition to a marked decrease in the total number of cells.
Adaptive Immunity ; Animals ; Cytokines ; Interferon-gamma ; Interleukin-2 ; Listeria monocytogenes* ; Listeria* ; Lymphocytes ; Macrophages ; Macrophages, Peritoneal ; Mice* ; Nitric Oxide ; Radiation, Ionizing* ; Spleen ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Whole-Body Irradiation

BACKGROUND: The properties of hypobaric spinal anesthesia are excellent in sensory and motor block with low concentration solutions, increased venous return, and hemodynamic stability. Much volume is needed with hypobaric spinal anesthesia because low concentration solutions are used. The purpose of this study was to examine the effects of the injected volume on the level of anesthesia in hypobaric spinal anesthesia during a total hip replacement. METHODS: Twenty-seven adult patients scheduled for a total hip replacement were assigned randomly to two groups, one with 0.1% (n = 14), and the other with 0.2% (n = 13) hypobaric tetracaine spinal anesthesia. 8 mg of tetracaine was used for male patients and 7 mg for female patients. Hence the injected volumes were 8 ml for male and 7 ml for female patients in 0.1% solution and 4 ml for male and 3.5 ml for female patients in 0.2% solution, respectively. Epinephrine was mixed to either solution in concentrations of 1:200,000. The speed of injection was fixed at the rate of 0.2 ml/sec. RESULTS: The height of sensory block with the 0.1% was one dermatome higher (T5.7) than with the 0.2% tetracaine solution (T6.7). The time for sensory block (11.4 min vs 12.3 min) and the time for motor block (10.0 min vs 15.0 min) with 0.1% was shorter than that with the 0.2% tetracaine solution. The duration of sensory block and the duration of motor block were not significantly different in either groups. Complete motor block was achieved in all patients. CONCLUSIONS: Both 0.1% and 0.2% hypobaric tetracaine spinal anesthesia are suitable for a total hip replacement. However we got better results with 0.1% than with 0.2% tetracaine such as rapid and high sensory block with rapid motor block.
Adult ; Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Arthroplasty, Replacement, Hip ; Epinephrine ; Female ; Hemodynamics ; Humans ; Male ; Tetracaine*

PURPOSE: The aim of this study was to conduct a histologic evaluation of irradiated calvarial defects in rats 4 weeks after applying fibroblast growth factor-2 (FGF-2) with hyaluronan or biphasic calcium phosphate (BCP) block in the presence or absence of adjunctive hyperbaric oxygen (HBO) therapy. METHODS: Twenty rats were divided into HBO and non-HBO (NHBO) groups, each of which was divided into FGF-2 and BCP-block subgroups according to the grafted material. Localized radiation with a single 12-Gy dose was applied to the calvaria of rats to simulate radiotherapy. Four weeks after applying this radiation, 2 symmetrical circular defects with a diameter of 6 mm were created in the parietal bones of each animal. The right-side defect was filled with the materials mentioned above and the left-side defect was not filled (as a control). All defects were covered with a resorbable barrier membrane. During 4 weeks of healing, 1 hour of HBO therapy was applied to the rats in the HBO groups 5 times a week. The rats were then killed, and the calvarial specimens were harvested for radiographic and histologic analyses. RESULTS: New bone formation was greatest in the FGF-2 subgroup, and improvement was not found in the BCP subgroup. HBO seemed to have a minimal effect on new bone formation. There was tendency for more angiogenesis in the HBO groups than the NHBO groups, but the group with HBO and FGF-2 did not show significantly better outcomes than the HBO-only group or the NHBO group with FGF-2. CONCLUSIONS: HBO exerted beneficial effects on angiogenesis in calvarial defects of irradiated rats over a 4-week healing period, but it appeared to have minimal effects on bone regeneration. FGF-2 seemed to enhance new bone formation and angiogenesis, but its efficacy appeared to be reduced when HBO was applied.
Animals ; Bone Regeneration ; Calcium ; Fibroblast Growth Factor 2 ; Hyaluronic Acid ; Hyperbaric Oxygenation ; Membranes ; Osteogenesis ; Oxygen ; Parietal Bone ; Radiotherapy ; Rats ; Skull ; Transplants

BACKGROUND: It is important that hospitals conduct disaster drills to ensure prompt response in case of a pandemic and thereby prevent a biological disaster. METHODS: In a university hospital of Seoul, a drill was arranged by the members of the drill preparation team who were a part of the response team for infection control of novel influenza A (H1N1). The drill preparation team designed the scenario for the drill, made plans to resolve the potential problems that could occur during that scenario, and organized a survey team and a survey methodology. The scenario consisted of 2 modules: (1) for an intensive care unit and (2) for an emergency care center. The surveyors and field participants were evaluated after the drill exercise. RESULTS: This drill was conducted to improve the response to outbreaks of new infectious diseases. The drill event showed that the communication among the members responsible for the infection control was effective. However, the drill revealed certain drawbacks in the process; this drawbacks involved availability of adequate quarantine space, education on using personal protective equipments, assignment of medical and nonmedical staff, management of visitors, and installment of air-conditioners, heaters, and ventilation units in the areas with H1N1 outbreak. CONCLUSION: This drill helped to improve the process of infection control and overcome the drawbacks in the current process, and thereby helped in achieving positive outcome during the actual pandemic situation when the number of hospital visits and admissions because of H1N1 pandemic had rapidly increased. Although disaster plans and drills are not actively performed, the drill for infection control is essential because the risk for an outbreak of a new infectious disease is increasing.
Communicable Diseases ; Surveys and Questionnaires ; Dietary Sucrose ; Disasters ; Disease Outbreaks ; Emergency Medical Services ; Humans ; Infection Control ; Influenza, Human ; Intensive Care Units ; Mandrillus ; Pandemics ; Quarantine ; Ventilation

Double-chambered right ventricle (DCRV) is a congenital cardiac anomaly in which the right ventricle is divided into two chambers by anomalous hypertrophied muscle bundles that cross the right ventricular cavity. DCRV may be associated with other congenital cardiac anomalies, most commonly with ventricular septal defect. We report two cases of DCRV without other congenital cardiac anomalies with review of literatures. We performed echocardiography, cardiac catheterization and right ventricular angiogram to confirm the diagnosis.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography ; Heart Septal Defects, Ventricular ; Heart Ventricles*

Myocardial calcification is usually classified as either dystrophic or metastatic. Dystrophic calcification is more common and usually occurs in the area of prior myocardial infarction. It is found in 8% of patients who have been survived longer than 6 years after myocardial infarction. The most common site of calcification is in the anterior wall of the left ventricle or apical and anterolateral aspect in the aneurysm of the left ventricle. We report the case of a 50-years old man with a typical dystrophic calcification of the endocardium in area of myocardial necrosis.
Aneurysm ; Calcinosis ; Echocardiography ; Endocardium ; Heart Ventricles ; Humans ; Middle Aged ; Myocardial Infarction* ; Necrosis