We have studied the genetic differences among four isolates of Trichinella including a new strain of Trichinella spiralis (ISS 623) recently found from a human case who took a badger in Korea. Because they have a different host origin and came from geographically separated regions, we supposed the genetic pattern of the isolates might be different as had been previously reported. It was analysed by PCR-RFLP analysis of the rDNA repeat that can readily distinguish a species or strain from others. Isolated genomic DNA of each isolate of Trichinella larvae was amplified with ITS1 specific primers and digested with restriction endonucleases. The PCR product of ITS1 was confirmed using Southern blot analysis to be a 910 bp fragment. The restriction fragments of each isolate had variable patterns when it was digested with Rsa 1 only. According to the RFLP patterns, the estimated genetic divergence between each isolate was different. In conclusion, four isolates of Trichinella including a new strain of T. spiralis obtained from a Korean patient may have genetic differences in the ITS1 region and the Shanghai isolate was genetically more similar to the Japanese unknown isolate than others in the ITS1 region.
Animals ; *DNA, Helminth ; *DNA, Ribosomal ; Human ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Repetitive Sequences, Nucleic Acid ; Trichinella spiralis/*genetics/isolation & purification

Venous hemangioma is a vascular tumor that has been reported by such diverse names as; "cirsoid aneurysm", "arteriovenous hemangioma", "acral arteriovenous tumor" according to the author's opinions of its origin and histopathologic classification. It is benign and rarely biopsied, and it is also rarely reported in dermatology literature. We present two cases of venous hemangioma. The first case was a 64-year-old man who was presented with an elliptical dark-red plaque with overlying several grouped papules on the left periorbital area which had been present for 7 years. The second case was a 56-year-old man who was presented with a single red papule on the right postauricular area which had been present for 4 months. Histopathologically, there were a well-circumscribed proliferation of thick-walled muscle-containing blood vessels in the dermis. Intermingled with the thick-walled blood vessels, there were also thin-walled dilated blood vessels. In both cases, the thick-walled blood vessels resembled arteries, but they lacked elastic fibers on the Verhoeff van Gieson stain.
Arteries ; Blood Vessels ; Classification ; Dermatology ; Dermis ; Elastic Tissue ; Hemangioma* ; Humans ; Middle Aged

OBJECTIVE: Many evidences raise the possibility that the panic disorder (PD) patients with respiratory subtype (RS) may have characteristic structural abnormalities. We aimed to explore the structural differences between PD patients with and without the respiratory symptoms. METHODS: Patients with PD were recruited from the Department of Psychiatry at Korea University Anam Hospital. Respiratory subtype (RS) was diagnosed when at least 4 out of 5 of the following respiratory symptoms were present during the panic attack: fear of dying, chest pain/discomfort, shortness of breath, paresthesias, and a choking sensation. We acquired high-resolution MRI scans and used FreeSurfer to obtain a measure of cortical thickness for each patient. RESULTS: Cluster based analysis revealed significantly decreased cortical thickness in the left hemisphere in the caudal-middle-frontal, superior frontal, and posterior parietal areas in the RS group. No significant difference was observed in any of the limbic areas. CONCLUSION: Respiratory symptoms of panic disorder were associated with a reduction in cortical thickness in the left frontal and parietal areas. This finding leads to the assumption that the frontoparietal network is the crucial component in a larger cortical network underlying the perception of dyspnea in RS.
Airway Obstruction ; Dyspnea ; Humans ; Korea ; Magnetic Resonance Imaging ; Panic Disorder* ; Panic* ; Paresthesia ; Rabeprazole ; Sensation ; Thorax

OBJECTIVES: To develop a new immunohistochemical marker system for supplementation of the Noyes histological classification of the endometrium in women of child bearing age with regular menstrual cycles, and to employ this system to evaluate pathologic factors involved in endometriosis, and thus to ascertain if it is useful in diagnosis. MATERIALS AND METHODS: Endometrial biopsies were sampled from the posterior fundus of 41 (24 proliferative phases, 17 secretory phases) women with regular menstrual cycles (28-32 days), and each sample was immunhistochemically stained according to Noyes et al (1975) for determination of expression for extrogen receptor (ER), progesterone receter(PR), integrin alpha1, alpha4, beta3, COX-1 and COX-2. Then, the PR, the integrin beta3, and COX-2 which were clearly expressed in the luteal phase was with endometrial samples were obtained from 20 cases of normal patients (group 1) and 25 cases with endometriosis (group 2) after confirming the day of ovulation by sex steroid level measurements 7-8 days after ovulation. RESULTS: In the regular menstruation group the expression of ER showed a tendency to be increased in the proliferative phase and decreased in the secretory phase, and was the highest in the proliferative phase. However, PR in the stromal cells showed no change in the entire menstrual cycle while in the epithelial cells, PR reached a peak in the late proliferative phase and was almost absent in the secretory phase. Integrin alpha 1, alpha4, and beta3 expression in the epithelial cells was absent in the proliferative phase but alpha1 was expressed strongly in the early and mid secretory phases and disappeared in the late proliferative phase, while beta3, appeared after the mid secretory phase and continued to be expressed until the late secretory phase. Expression in the stromal cells was weak overall and did not show any cyclic pattern. COX-1 expression was shown as a cyclic pattern in the stromal and epithelial cells and was partcularly strongly expressed in the mid secretory phase of epithelial cells, and in the mid secretory and menstruation phase of stromal cells. In the endometrial epithelial cells there was strong expression during the entire cycle with stronger expression in the secretory phase compared to the prolferative phase. COX-2 was clearly expressed in the late proliferative, early and mid secretory phased in the stromal cells. No expression was observed in the proliferative phase of the epithelial cells, but which began to appear in the early secretory phase reaching a significant pattern from the mid secretory phase onwards. There was almost no expression in the stromal cells. In the cases with endometriosis showing normal endometrial maturation according to the Noyes classification, PR expression was increased while Integrin-beta3 expression was significantly decreased compared to the normal group. Also, COX-2 expression was slightly decreased in the stromal cells of patients with endometriosis while it was significantly increased in the stromal cells. CONCLUSION: Immunohistochemical markers can supplement the original Noyes classification of histological endometrial dating and therefore ascertain existing pathologic conditions. Particularly for patients with endometriosis with normally mature endometrial cells, changes in COX-2 and integrin expression patterns may assist in elucidating pathophysiologic mechanisms and therefore aid in the diagnosis of abnormal implantation conditions, and consequently determine a treatment modality.
Biopsy ; Child ; Classification ; Diagnosis ; Endometriosis* ; Endometrium* ; Epithelial Cells ; Female ; Humans* ; Integrin alpha1 ; Integrin beta3 ; Luteal Phase ; Menstrual Cycle ; Menstruation ; Ovulation ; Progesterone* ; Prostaglandin-Endoperoxide Synthases* ; Receptors, Progesterone* ; Stromal Cells

OBJECTIVE: We compared the expression pattern of progesterone receptor, integrin 3, cyclooxygenase-2 (COX-2) in in-phased endomerium of patient with the disease related implantation and control group, and tried to confirm the clinical efficacy of the immunohistochemical markers for discrimination of occult uterine receptivity defect in in-phase endometrium. STUDY DESIGN: Endometrial tissues were obtained from 60 women with normal (group 1; n = 20), uterine synechiae (group 2; n = 15), and endometriosis (group 3; n = 25). On 7 ~ 8 days after ovulation (POD 7 ~ 8), sex hormone levels were measured and immunohistochemical staining of PR, integrin 3, and COX-2 expression were performed. RESULTS: PR was decreased in the group 2 and increased in the group 3 comparing with the group 1. integrin 3 expression was significantly decreased in the group 2 and 3. COX-2 expression was significantly decreased in the group 2. But, in the group 3, COX-2 expression was slightly increased in glandular epithelial cells, and significantly increased in stromal cells. CONCLUSIONS: In-phase biopsies from patients with endometriosis and uterine synechiae showed different expression pattern of integrin 3, COX-2, and PR compared to the control. The aberrant expression of immunohistochemical markers be associated with occult uterine receptivity defect and produce the useful diagnostic method.
Biopsy ; Cyclooxygenase 2* ; Discrimination (Psychology) ; Endometriosis ; Endometrium* ; Epithelial Cells ; Female ; Gynatresia ; Humans* ; Ovulation ; Progesterone* ; Receptors, Progesterone* ; Stromal Cells

OBJECTIVE: Notochordal cells in the intervertebral disc interact with nucleus pulposus (NP) cells and support the maintenance of disc homeostasis by regulation of matrix production. However, the influence of notochordal cells has not been evaluated in the annulus fibrosus (AF), which is the primary pain generator in the disc. We hypothesized that the notochordal cell has the capacity to modulate inflammatory mediators secreted by AF cells secondary to stimulation. METHODS: Notochordal and AF cells were isolated from adult New Zealand white rabbits. AF pellets were cultured with notochordal cell clusters or in notochordal cell-conditioned media (NCCM) for 24 or 48 hours with proinflammatory cytokines at varying concentrations. Gene expression in AF pellets were assayed for nitric oxide synthase (iNOS), cyclo-oxygenase (COX)-2, and interleukin (IL)-6 by real time reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: AF pellet in NCCM significantly decreased the iNOS and COX-2 messenger ribonucleic acid (mRNA) levels compared to AF pellets alone and AF pellets with notochordal cells (p < 0.05). AF pellet resulted in dose-dependent iNOS and COX-2 expression in response to IL-1beta, stimulation, demonstrating that 1 ng/ml for 24 hours yielded a maximal response. AF pellet in NCCM significantly decreased the expression of iNOS and COX-2 in response to 1ng/ml IL-1beta, stimulation at 24 hours (p < 0.05). There was no difference in IL-6 expression compared to AF pellets alone or AF pellets with notochordal cell clusters. CONCLUSION: We conclude that soluble factors from notochordal cells mitigate the gene expression of inflammatory mediators in stimulated AF, as expected after annular injury, suggesting that notochordal cells could serve as a novel therapeutic approach in symptomatic disc development.
Adult ; Cytokines ; Gene Expression ; Homeostasis ; Humans ; Interleukin-6 ; Interleukins ; Intervertebral Disc ; Nitric Oxide Synthase ; Notochord ; Prostaglandin-Endoperoxide Synthases ; Rabbits ; Reverse Transcriptase Polymerase Chain Reaction ; RNA

To restore a tooth with a fracture line extending below the marginal bone level, a surgical crown lengthening procedure accompanied by ostectomy could be considered to expose the fracture line and reestablish the biologic width. However, this procedure could lead to esthetic failure, especially in the anterior teeth. Therefore, orthodontic extrusion, which elevates the fracture line from within the alveolar socket without sacrificing the supporting bone and gingiva, is recommended. This technique allows for the proper placement of the crown on a sound tooth structure, with the reestablishment of the biologic width.Alternatively, surgical extrusion is an one-step procedure that is simpler and less time-consuming than orthodontic extrusion; placing and adjusting the orthodontic appliance does not require multiple visits. This study presents successful restoration in 2 cases with a crown-tooth root fracture of the maxillary central incisor treated using a multidisciplinary approach through orthodontic extrusion or surgical extrusion followed by successful restoration.

Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group(RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of menarch, and prothrombin time. The factor whose level was higher in AMI than in RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAH than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAH and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age uric aci, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.
Adult ; Blood Glucose ; Body Mass Index ; Case-Control Studies* ; Cause of Death ; Cholesterol ; Coronary Disease* ; Discrimination (Psychology) ; Education ; Gangwon-do ; Hematocrit ; Humans ; Inpatients ; Korea ; Leukocyte Count ; Prothrombin Time ; Risk Factors* ; Stroke ; Triglycerides ; Uric Acid

BACKGROUND: Risk for injuries resulting from overinflated or underinflated endotracheal tube cuff warrants adequate cuff inflation technique. Thus, this study was designed to measure the actual intracuff pressures obtained by new estimation techniques. METHODS: 95 adult surgical patients requiring tracheal intubation were randomized to two groups with respect to the endotracheal tube model: Portex(R) (n = 55) and Euromedical(R) (n = 40). After induction of anesthesia, the cuff was inflated using new estimation techniques with two different syringes: PR10 or PR20 (passive release technique using a 10-ml or 20-ml syringe, respectively). Subsequently, an aneroid manometer was used to measure the actual intracuff pressures. These inflation techniques were repeated two times. A direct cuff measurement range of 25 to 40 cmH2O was used as a reference for optimal intracuff pressure. Size 7.0 mm internal diameter (ID) tubes were used for women and size 7.5 mm ID for men. RESULTS: 88 eligible patients were studied: Portex group (n = 50) and Euromedical group (n = 38). With respect to the rate of optimal cuff inflation, PR10 was significantly higher than PR20 in both groups (56% vs. 10% in Portex group; 63.2% vs. 0% in Euromedical group, respectively) (P < 0.05). CONCLUSIONS: When direct intracuff measurement is not available, a new method, named "passive release technique" using a 10-ml syringe, is a useful alternative cuff inflation method.
Adult ; Anesthesia ; Female ; Humans ; Inflation, Economic ; Intubation ; Intubation, Intratracheal ; Male ; Statistics as Topic ; Syringes

PURPOSE: The purpose of this study is to develop a practical method for determining accurate marker positions for prostate cancer radiotherapy using CT images and kV x-ray images obtained from the use of the on-board imager (OBI). MATERIALS AND METHODS: Three gold seed markers were implanted into the reference position inside a prostate gland by a urologist. Multiple digital image processing techniques were used to determine seed marker position and the center-of-mass (COM) technique was employed to determine a representative reference seed marker position. A setup discrepancy can be estimated by comparing a computed COMOBI with the reference COMCT. A proposed algorithm was applied to a seed phantom and to four prostate cancer patients with seed implants treated in our clinic. RESULTS: In the phantom study, the calculated COMCT and COMOBI agreed with COMactual within a millimeter. The algorithm also could localize each seed marker correctly and calculated COMCT and COMOBI for all CT and kV x-ray image sets, respectively. Discrepancies of setup errors between 2D-2D matching results using the OBI application and results using the proposed algorithm were less than one millimeter for each axis. The setup error of each patient was in the range of 0.1+/-2.7~1.8+/-6.6 mm in the AP direction, 0.8+/-1.6~2.0+/-2.7 mm in the SI direction and -0.9+/-1.5~2.8+/-3.0 mm in the lateral direction, even though the setup error was quite patient dependent. CONCLUSION: As it took less than 10 seconds to evaluate a setup discrepancy, it can be helpful to reduce the setup correction time while minimizing subjective factors that may be user dependent. However, the on-line correction process should be integrated into the treatment machine control system for a more reliable procedure.
Axis, Cervical Vertebra ; Humans ; Prostate ; Prostatic Neoplasms ; Radiotherapy