Two cases of abnormalities of the left ventricular wall(left ventricular aneurysm or diverticulum) are presented. A saccular deformity of the left ventricle may be and aneurysm or a diverticulum. In one case, the defect seems to be subcalvular aneurysm(or fibrous diverticulum) or aneurysm of the membranous ventricular septum; this lesion seems to be a natural consequence of spontaneous closure of a defect of the membranous septum. The other case, it seems that the defect is ventricular aneurysm with syndrome of myocardial infarction and normal coronary arteries, or double or accessory chambered left ventricle. The thromboembolic phenomenon was noted on a left frontoparietal lobe of brain. Both cases have the diagnosis supported by cardiac catheterization and angiography. The clinical, angiographic and pathologic characteristic of diverticulum and aneurysm of the heart are reviewed, and an attempt is made to clarify the concept of aneurysm and diverticulum of the heart.
Aneurysm* ; Angiography ; Brain ; Cardiac Catheterization ; Cardiac Catheters ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Diverticulum* ; Heart ; Heart Ventricles* ; Myocardial Infarction ; Ventricular Septum

A patient who had been admitted to the B.N.U.H. with coma and respiratory arrest from possible acute alcohol intoxication, has been treated with intensive care and discharged without any complication. It should be emphasized that a patient with respiratory arrest even due to unknown etiology must have continued intensive care, without giving up the patient.
Coma ; Humans ; Critical Care ; Resuscitation*

A patient who had been admitted to the B.N.U.H. with coma and respiratory arrest from possible acute alcohol intoxication, has been treated with intensive care and discharged without any complication. It should be emphasized that a patient with respiratory arrest even due to unknown etiology must have continued intensive care, without giving up the patient.
Coma ; Humans ; Critical Care ; Resuscitation*

Forth-nine patients with clinically nonfunctioning pituitary adenomas were evaluated clinically, endocrinologically and morphologically in this study.The results obtained were as follows.1) The mean age was 47.1 years(range 23 to 76 years), and 22 were male(44.9%) and 27(55.1%) female.2) The major clinical manifestations of male patients were visual disturbance(72.7%), headache(54.5%), loss of libido(45.5%), but those of female visual disturbance(59.6%), headache(48.1%), amenorrhea(48.1%), loss of body hair(25.9%), and galactorrhea(22.2%).3) All were macroadenomas evaluated by CT scan, and in the male patients 16(72.7%) were grade III and 6(27.3%) grade IV by Hardy classification, and in the female patients 6(22.2%) were grade II, 12(44.4%) grade III, and 9(33.3%) grade IV.4) The elevation of serum prolactin were observed 7(31.8%) out of male, and 24(88.9%) of female.5) Combined stimulation test revealed that GH insufficiency was 89.6%, ACTH 58.9%, LH 58.7%, FSH 51.1 %, and TSH 50.0% and hormone insufficiency more than 4 pituitary hormone was 54.2%.6) Prolactin response to TRH decreased in 12(70.6%) of 17 patients with normal basal prolactin, and 19(76.0%) of 25 with elevated prolactin.7) Immunohistochemistry revealed that null cell adenoma was 57.1%, gonadotrope adenoma 26.5%, plurihormonal adenoma 8.0%, silent corticotrope adenoma 4.0%, thyrotrope adenoma(2.0%), and lactotrope adenoma(2.0%).8) The ultrastructural characteristics examined by electron-microscopy were similar despite of immunohistochemical differences.In summary, the prevalance of clinically nonfunctioning pituitary adenoma was middle aged men and women, and their main symptoms were visual disturbance and headache. Hyperprolactinemia and pituitary hormone insufficiency more than 4 hormone were observed commonly. Most of them were null cell adenoma and gonadotrope adenoma examined by immunohistochemistry. Further study using modern techniques: cell culture, subunit-immunostaining. And Northern blot analysis of mRNA for pituitary hormone or subunit, will be needed to clarify null cell adenomas.
Adenoma ; Adrenocorticotropic Hormone ; Blotting, Northern ; Cell Culture Techniques ; Classification ; Female ; Headache ; Humans ; Hyperprolactinemia ; Immunohistochemistry ; Lymphocytes, Null ; Male ; Middle Aged ; Pituitary Neoplasms ; Prolactin ; RNA, Messenger ; Tomography, X-Ray Computed

BACKGROUND: The detection of micrometastatic cells in patients with breast cancer may aid in determining of prognosis and in developing new therapeutic approaches. In this study, we evaluate an assay to identify breast cancer cells in the bone marrow of patients with breast cancer by using reverse-transcriptase polymerase chain reaction (RT-PCR) assay for cytokeratin 19 (CK-19) transcripts. METHODS: A CK-19 specific-nested RT-PCR assay was developed and optimized by using limited dilutions of an MCF-7 breast-cancer cell line mixed with normal bone-marrow specimens. The optimized assay was then used to examine bone-marrow samples obtained from 60 patients with breast cancer. The specificity was assessed by examining 20 negative controls using malignant hematologic disease. RESULTS: In the sensitivity calibration system, CK-19 expressing tumor cells were detected in the mixture of 10 MCF-7 cells in 107 normal bone-marrow cells. All 20 neagtive control samples failed to amplify. Bone marrow samples from 10 of 60 patients (16.7%) with breast cancer scored positive, indicating micrometastasis of the bone marrow. Seven of the 37 samples from patients whose axillary lymph nodes were negative based on conventional histopathological studies were positive when the CK-19 RT-PCR method was used. CONCLUSION: RT-PCR for CK-19 is a sensitive, specific, and rapid method for detecting micrometastatic mammary carcinoma cells in the bone marrow of patients with breast cancer. It could be helpful in diagnosing and monitoring metastastic breast cancer and detecting of micrometastasis. This method should be evaluated using a larger number of patients for long-term follow-up.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Calibration ; Cell Line ; Hematologic Diseases ; Humans ; Keratin-19 ; Keratins ; Lymph Nodes ; MCF-7 Cells ; Neoplasm Micrometastasis* ; Polymerase Chain Reaction ; Prognosis ; Sensitivity and Specificity

Malignant blue nevus is very rare, but it may represent a variant of malignant melanoma arising in a previously benign cellular blue nevus. It is most commonly found on the scalp of elderly mean, with recent changes, such as loss of the poorly defined border and the development of satellitosis. All of these features were present in our case. However, no malignant change was observed histopathologically. Only a few blue nevus with satellitosis has previously been reported as a benign lesion.
Aged ; Humans ; Melanoma ; Nevus, Blue* ; Scalp

We used in situ hybridization histochemistry with synthetic oligonucleotide probes to examined the effects of unilateral 6-hydroxydopamine lesions (which eliminated tyrosine hydroxylase mRNA containing cells in mesencephalon) on enkephalin, dynorphin, and substance P mRNA exprssion in the striatum. The expression of tyroxine hydroxylase mRNA on ipsilateral substantia nigra pars compacta, which reflect dopamine activity, totally decreased for 2weeks after lesioning. After lesioning 1week, 2weeks, and 4weeks, a significant increase of the expression of enkephalin mRNA in ipsilateral to the lesioned striatum was observed (p<0.05). Substance P mRNA expressions were depressed significantly in ispsilateral to the lesioned striaturm, whereas enkephalin mRNA expressions were elevated in consecutive sections from striatal aresas in all rat model. The effect of lesions on dynorphin mRNA expressions in ipsilateral to the lesioned striatum less robust, but significant decreased tendency was observed (p<0.05). These data show that the expression of enkephalin, dynorphin and substance P mRNA is differentially regulated by mesostriatal dopaminergic system.
Animals ; Basal Ganglia* ; Dopamine ; Dynorphins ; Enkephalins ; In Situ Hybridization ; Models, Animal* ; Neuropeptides* ; Oligonucleotide Probes ; Oxidopamine ; Rats* ; RNA, Messenger ; Substance P ; Substantia Nigra ; Tyrosine 3-Monooxygenase

Henoch-Scholein Purpura(HSP) is a syndrome characterized by nonthrombocytopenic purpura accompanied by a arthralgia, gastrointestinal symptom, or renal involvement. This report describes a 13-year-old boy with hemorrhaic bullous HSP followed by cellulitis as a complication. This unusual cutaneous manifestation of HSP may be a source of diagnostic confusion, but it does not appear to have prognostic implication.
Adolescent ; Arthralgia ; Cellulitis* ; Humans ; Male ; Purpura* ; Purpura, Schoenlein-Henoch

No abstract available.
Foreign Bodies* ; Pulmonary Artery*

There is a growing interest in the factors related to insufficiency fractures. We are going to report three insufficiency fracture cases which are considered to be caused by osteoporosis, rheumatoid arthritis, steroid use and femoral shaft bowing among the patients not taking bisphosphonate. All cases are caused by low energy trauma and among these cases, one patient is being presented with a prodromal symptom and another patient complains of both prodromal symptoms and bilateral lesions.
Arthritis, Rheumatoid ; Femur ; Fractures, Stress ; Humans ; Osteoporosis ; Prodromal Symptoms