A case of multiple myeloma associated with adenocarcinoma of the stomach was review. A 59-year, old Korean man had been abmitted to St. Mary's Hospital in January 1984, with chief complaint of posterior neck pain, and intermittent headache for one year prior to amission. Osteo lytic punched-out lesions were noted on skull and other skeletal x-ray films. Bone marrow aspirates revealed diffuse infiltration of mature and immature plasma cells. Laboratory findings revealed anemia and Bence-Jones proteinuria. Immunoelectrophoresis revealed findings consistent with IgA-lamda type multiple myloma. Alkylating agents and steroids were tried with some clinical improvements. In August 1985, the patient revisited outpatient clinic with chief complaints of epigastric pain and neck mass. Endoscopic biopsy and excision biopsy of the cervical lymph node were performed. By microscopic examination, adenocarcinoma of the stomach and metastasis of multiple myeoma to the supraclavicular lymph nodes were confirmed. Subtotal gastrectomy was performed. By gross and microscopic revealed metastasis to the regional lymph nodes.
Male ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

BACKGROUND: The measurement of nonspecific bronchial hyperreactivity is valuable for diagnosis and management of bronchial asthma. Methacholine or histamine is used for the pharmacologic provocation test. Usually a methacholine bronchial provocation test is performed by a dosing technique with counted number of breaths. A dosimeter is indispensable in the dosing technique. Recently a timed tidal breathing technique which dose not need an expensive dosimeter was introduced. We measured the degree of nonspecific bronchial hyperreactivity to histamine using a simple timed tidal breathing technique. METHOD: Forty two healthy volunteers, 12 patients with bronchial asthma(BA), 10 patients with rhinitis(RH) and 10 patients with upper respiratory infection(URI) participated in the study. The subject's nose was clipped and inhalation continued during tidal breathing for 2 minutes via a face mask. FEV1 was measured at 30 seconds, 90 seconds after inhalation and inhalation of next solution was continued until there was a fall in FEV1 of 20%. Histamine PC20 was defined as the concentration at 20% fall of FEV1 and it was obtained from the log dose-response curve by linear interpolation. RESULTS: Inhalation of serial dilution of histamine could be performed in all patients without significant side of effects. The geometric mean±standard deviation of histamine PC20 in healthy volunteers is 8.27±2.22mg/ml, BA group 0.33±3.02mg/ml, RH group 0.85 ±3.24mg/ml, and URI group 1.47±1.98mg/ml. CONCLUSION: Histamine bronchial provocation test using timed tidal breath method is a simple and suitable tool for management of patients with bronchial hyperreactivity.
Asthma ; Bronchial Hyperreactivity ; Bronchial Provocation Tests* ; Diagnosis ; Healthy Volunteers ; Histamine* ; Humans ; Inhalation ; Masks ; Methacholine Chloride ; Nose ; Respiration*

Bacterial endocarditis is a disease with protean manifestations whose presentation has recently changed greatly. Right-sided endocarditis associated with congenital heart lesions is now relatively less common. Patients with ventricular septal defect are at risk for right-sided endocarditis, but its incidence is low in children and adolescents. The organism is frequently a staphylococcus and the clinical course is dominated by septic pulmonary infarction and septicemia. We reported two cases of pulmonic vegetation and pulmonary infarction associated VSD with brief review of literature.
Adolescent ; Child ; Endocarditis ; Endocarditis, Bacterial ; Heart ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Pulmonary Infarction* ; Sepsis ; Staphylococcus

The aortic dissection is an acute aortic syndrome, caused by an intimal tear and subsequent splitting of the media by the pulsatile blood flow. Though there would be differences in the origin of aortic dissection and therapeutic modalities, the intermediate and long-term prognoses are poor. Endovascular Stent-graft implantation is a revolutionary technique in the treatment of aortic dissection. The endovascular stent grafting in aortic dissection is less invasive and feasible method and is an effective tool for closing the entry site and promoting clot formation, reducing the size of the false lumen. Therefore, endovascular Stent-graft implantation makes possible the desirable remodelling of aorta. We report 33 year-old male with aortic dissection in the thoracic aorta, which was treated with endovascular Stent-graft implantation. Over the favorable remodelling, his dissection was healed completely by the endovascular treatment using Stent-graft.
Adult ; Aorta ; Aorta, Thoracic* ; Blood Vessel Prosthesis ; Humans ; Male ; Prognosis

BACKGROUND: Previous reports have suggested that alleles at the plasminogen activator inhibitor-1 (PAI-1) gene are associated with increased risk of developing coronary artery disease, including myocardial infarction and stroke through their effect on PAI-1 levels. Method: We attempted to search English literatures for all reports of possible effects of PAI-1 gene on cardiovascular disease in human published prior to November 1998. We used a Mantel-Haenszel method (fixed effect model) and random effect model, respectively, to perform a meta-analysis of 7 case-control studies that provided information related to the effects of PAI-1 gene on risk of cardiovascular disease. RESULTS: From 7 studies for diagnosed cardiovascular disease, the relative frequencies of the three genotypes among controls was (5G/5G) (homozygous normal), 24.5%; (4G/5G) (heterozygous), 48.2%, and (4G/4G) (homozygous for the mutant, 675 GGGG), 27.3%. These relative frequencies in cases were 21.7% for 5G/5G, 48.0% for 4G/5G, and 30.3% for 4G/4G. In fixed effect model, compared with those with genotype (5G/5G), the overall odds ratio (OR) for cardiovascular disease among those with (4G/5G) was 1.12 (95% CI, 0.93 to 1.34), and it was 1.20 (1.01 to 1.44) for the (4G/4G) genotype. For five studies with myocardial infarction as the outcome, the overall OR of myocardial infarction was 1.20 (0.99 to 1.47) for those with (4G/5G) and 1.24 (1.00, 1.54) for those with (4G/4G) genotypes, respectively. CONCLUSION: Our findings provide support for the weak association between PAI-1 gene and cardiovascular disease, in particular, myocardial infarction.
Alleles ; Cardiovascular Diseases* ; Case-Control Studies* ; Coronary Artery Disease ; Genotype ; Humans ; Myocardial Infarction ; Odds Ratio ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Polymorphism, Genetic* ; Stroke

No abstract available.
Drug Therapy, Combination* ; Metoclopramide* ; Ondansetron* ; Prospective Studies* ; Vomiting*

The objective of this experiment is to observe structural differences in the orthodontic movement of vital (control group) and devitalized (experimental group) teeth in the mongrel dogs. The 5 utilized dogs in this experiment were approximately 1 year of age and their average weight was about 12Kg. Endodontic therapy was performed on the 2nd premolars in upper & lower jaws of each animal under the general anesthesia by intravascular injection of 25mg/Kg of pentobarbital sodium. The canals of the teeth were obturated by using gutta percha in conjunction with root canal sealer (AH26 Densply). One of the roots in the 2nd premolars was hemisected to make an extraction space for the devitalized teeth to be moved. The edgewise technique was employed for the movement of the teeth. Orthodontic models and intraoral roentgenograms were taken before and after orthodontic tooth movement. The open coil springs (.010 x .040) were used at interbraket space in order to provide equal forces (75gm) between the teeth in each arch wire. After 13 weeks of active orthodontic tooth movement, dogs were sacrified and the experimental results were examined through the intraoral radiography, microscopic examination and scanning electromicroscopic examination at the root surface. From the results of the study, the following conclusions may be drawn: 1. The root resorption and cemental deposition were observed within the pressure and tension site in both group. 2. The root resorbed lacunae were observed in the cementum and/or into the dentin in both group. 3. The prominent osteoblastic activities were observed on the alveolar margin in the tension site in both group. 4. A few of blood vessels were observed in the pressure site, but also lots of blood vessels were observed in the tension site especially in the periphery of the alveolar bone in both group. 5. In the pressure site, resorbed lacunae were formed with deep and narrow cavity in the control group; the shallow and wide cavity in the experimental group. 6. In the pressure site, the repaired cementum or cementoid tissue was lined on cementum in the experimental group, but not in the control group. 7. There was no significant difference between external root resorption of endodontically and vital teeth when both were subjected to orthodontic forces.
Anesthesia, General ; Animals ; Bicuspid ; Blood Vessels ; Dental Cementum ; Dental Pulp Cavity ; Dentin ; Dogs* ; Gutta-Percha ; Jaw ; Osteoblasts ; Pentobarbital ; Radiography ; Root Resorption* ; Tooth Movement* ; Tooth* ; Tooth, Nonvital

We performed dual color fluorescence in situ hybridization (FISH) for the bcr/abl fusion in CML using the peripheral blood smears without destruction of cell morphology to determine the bcr/abl fusion. Two patients of CML, one patient in accelerated phase and one patient in chronic phase, were selected. The blood smears were fixed in absolute methanol. FISH was performed with the Mbcr/abl translocation DNA probe mixture and the slides were stained with Wright's stain after FISH. The blood smears of both cases revealed distinct signals without destruction of cellular morphology. The normoblasts and lymphocytes revealed beautiful fused bcr/abl signals as well as granulocytes in both cases. The results provide a novel finding that the normoblasts and lymphocytes in CML are also neoplastic clonal cells which has not been demonstrated with a single-cell approach before.
DNA ; Erythroblasts* ; Fluorescence* ; Granulocytes ; Humans ; In Situ Hybridization ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Lymphocytes* ; Methanol

PURPOSE: To evaluate the significance of T2-weighted MR imaging(T2WI) in the diagnosis of pituitarymicroadenoma. MATERIAL AND METHODS: We retrospectively evaluated the MR imaging findings of 30 cases of pituitarymicroadenoma. Diagnosis was made on the basis of surgery, serum hormonal level, and the presence of mass lesion onMR (T1WI and T2WI), and conventional as well as dynamic contrast enhanced T1WI images were obtained. In each MRsequence, signal intensity and detectability of the tumor were evaluated. We also determined whether diagnosis waspossible on both T1WI and T2WI. In eight cases, histopathologic findings (cellularity, fibrosis, and cysticchange) were correlated with T2 signal intensity of the tumor. RESULTS: T2WI, T1WI, and dynamic and conventionalenhanced T1WI detected the tumor in 21 cases (70%), 21 cases (70%), 28 cases (93.3%), and 22 cases (73.3%),respectively. On T2WI, pituitary microadenomas showed a high signal in 18 cases (60%), an iso-signal in nine(30%), and a low signal in three (10%) compared with normal pituitary gland. In 20 cases (66.7%), diagnosis ofpituitary microadenoma was possible on both T1WI and T2WI, but in one case, the tumor was detected only on T2WI.Three cases with fibrosis, as seen on histopathologic examination showed an iso or low signal on T2WI. CONCLUSION: T2WI is useful in the diagnosis of pituitary microadenoma Decreased signal intensity on T2WI may suggestfibrosis.
Diagnosis* ; Fibrosis ; Magnetic Resonance Imaging ; Pituitary Gland ; Retrospective Studies

BACKGROUND: We studied clinical and angiographic findings of 16 Korean patients who had isolated laft coronary ostial steonsis and compared them with those of the patients with non-ostial left main stenosis. The aim of this study is to find the characteristics of the patients with isolated left voronary ostial stenosis. METHODS: Medical records and coronary angiograms were reviewed. We divided the patients with left main stenosis into four groups by lesion location and associated lesion. Clinical and angiographic findings of each group were compared. RESULTS: Twenty four patients(0.15%) had left coronary ostial stenosis and among them sixteen patients(0.1) had an isolated lesion. Their mean age was 48 years and 62% were female. Only 6 patients had coronary risk factors. Two patients were diagnosed as having Takayasu's srteritis. At treadmill exercise test, 7 out of 11 patients lhowed positive results at stage I. Eight patients had undergone surgical treatment. Comoared with the patients who had non-ostial left main stenosis, left ostial group showed lower mean age, female preponderance and lower incidence of coronary risk factors. There was no difference in the results of treadmill exercise test and hemodynamic parameters. CONCLUSION: Isolated left coronary ostial stenosis in Korea also predominantly occured in young female patients who had less risk factors as previous reports. But the incidence of this lesion and nonatherosclerotic origin seemed to be higher. And most of the patients with the left coronary ostial stenosis had isolated ostial stenosis.
Constriction, Pathologic* ; Exercise Test ; Female ; Hemodynamics ; Humans ; Incidence ; Korea* ; Medical Records ; Risk Factors