The purpose of this study is to investigate the morphologic changes of the sinusoidal endothelial cells and the associated structures of the cirrhotic rat liver induced by repeat intraperitoneal injections of N-diethylnitrosamine (DEN) (100 mg/kg/week). One day to 6 weeks later, rat livers were observed under the light, transmission and scanning electron microscopy, and immunostained with laminin antibody. Two weeks after DEN treatment, the fibrillar material in Disse's space was noted, and then a basement membrane-like structure was found at 4 weeks after treatment. Laminin was detected in perisinusoidal areas after 4 weeks. Laminin was strongly positive on the fibrous septum and in the sinusoidal wall of cirrhotic nodules after 6 weeks of treatment. The diameters and numbers of sinusoidal endothelial fenestrations did not change significantly until 2 weeks. They decreased within 4 weeks, and then the sinusoidal endothelium was poorly fenestrated at 6 weeks after DEN treatment. These results suggest that as fibrosis develops in cirrhosis, the deposit of extracellular matrix such as laminin within Disse's space is a major contributing factor in the structural alteration of sinusoidal endothelial cells, and the capillarization of the sinusoidal endothelial cells may be a contributor to impairment of the hepatic function in cirrhosis.
Rats ; Animals

The depressive symptoms are frequent and important ones in the elderly population. We studied the various factors affecting the severity of depressive symptoms in the elderly population. The Korean elderly (more than 65 years old; n=490) in Seoul area (city) were studied on the identifying data and medical and psychiatric history, Mini-Mental State Examination (MMSE) Geriatric Depression Scale (GDS) Korean Depression Scale(KDS: under development)were also administered. In our study, the significant effect of sex, age, education, marital status, and the status of medical security on the severity of depressive symptoms were not found. Significantly higher GDS and KDS scores were found in the elderly who have more than one physical illness, subjective memory complaints, and seven life events. To examine the strength of association of these variables of depression, we conducted logistic regression. Depressive symptoms were associated with 1)the loss of spouse, 2)a current physical illness, and 3)low socioeconomic status. These results showed that depression in the elderly may be correlated with the loss of spouse, a current physical illness, and low socioeconomic status.
Aged* ; Depression* ; Education ; Humans ; Logistic Models ; Marital Status ; Memory ; Seoul ; Social Class ; Spouses

BACKGROUND: Asthmatic patients frequently suffer cold-weather-associated respiratory symptoms. The sensitivity, specificity, accuracy and diagnostic value of isocapnic hyperventilation of cold air(IHCA) using a multistep method was investigated in patients suspected to have asthma. METHOD: One hundred and 29 adult patients who had an IHCA performed between july 1999 and December 2000, had an methacholine bronchoprovocation test because of a clinical suspicion of asthma. RESULTS: According to strict criteria, 50 were defined as asthmatics and 79 as symptomatic nonashmatics. There were no differences in age, sex and smoking state between the asthmatic and symptomatic nonasthmatic groups. There was a significant decrease in the percentage reduction in the forced expiratory volume in 1 second(FEV1) after the IHCA between the asthmatics(-10.0±6.8%) and the symptomatic nonasthmatics(-2.3±2.5%). The factors associated with a reactivity to IHCA were FEV1/FVC, FEF25-75/FVC and FEV1(% of predicted). The accuracy was highest using a 7% fall in FEV1; the sensitivity was 76% and the specificity 96%. CONCLUSION: IHCA is a specific, although not a sensitive, test for diagnosing asthma in adult patients. Furthermore, the diagnostic cut-off value of the different methods of IHCA need to be determined.
Adult* ; Asthma* ; Forced Expiratory Volume ; Humans ; Hyperventilation* ; Methacholine Chloride ; Sensitivity and Specificity ; Smoke ; Smoking

Fibrous dysplasia is a bone condition characterized by the replacement of normal bone tissue and the medullary cavity by abnormal fibrous tissues. Craniofacial fibrous dysplasia causes facial asymmetry compromising the aesthetics as well as vision and hearing. A 21-year-old male visited the clinic due to vertical orbital dystopia and exophthalmos that had developed over the previous 2 months. The patient was diagnosed with a fibrous dysplasia of the frontal, ethmoid bones and superior orbital wall. By a bicoronal incision on the scalp, the radical resection of the lesions was done. After harvesting the remaining frontal bone, we did the autogenous reconstruction using split calvarial bone graft. Postoperatively, the vertical orbital dystopia and exophthalmos significantly improved. The patient is satisfied with the surgical outcomes and has not reported any recurrence.

Fibrous dysplasia is a bone condition characterized by the replacement of normal bone tissue and the medullary cavity by abnormal fibrous tissues. Craniofacial fibrous dysplasia causes facial asymmetry compromising the aesthetics as well as vision and hearing. A 21-year-old male visited the clinic due to vertical orbital dystopia and exophthalmos that had developed over the previous 2 months. The patient was diagnosed with a fibrous dysplasia of the frontal, ethmoid bones and superior orbital wall. By a bicoronal incision on the scalp, the radical resection of the lesions was done. After harvesting the remaining frontal bone, we did the autogenous reconstruction using split calvarial bone graft. Postoperatively, the vertical orbital dystopia and exophthalmos significantly improved. The patient is satisfied with the surgical outcomes and has not reported any recurrence.

OBJECTIVE: To compare the performance of superparamagnetic iron oxide (SPIO) -enhanced magnetic resonance (MR) imaging at 1.5T and dual-phase spiral computed tomography (CT) for the depiction of small hypervascular hepatocellular carcinomas (HCCs). MATERIALS AND METHODS: Forty-three patients with 70 small nodular HCCs (5-20 mm; mean, 13.7 mm) were examined. Diagnosis was based on the results of surgical biopsy in 22 patients and by the combined assessment of MR imaging, lipiodol CT, alpha feto-protein levels, and angiographic findings in 21. MR imaging consisted of respiratory-triggered turbo spin-echo T2-weighted imaging, T1-weighted fast low-angle shot, and T2* -weighted fast imaging with steady-state precession imaging before and after SPIO enhancement. CT imaging was performed with 5-mm collimation and 1: 1.4 pitch, and began 30 and 65 secs after the injection of 150 mL of contrast medium at a rate of 3 mL/sec. Two blinded observers reviewed all images independently on a segment-by-segment basis. Diagnostic accuracy was evaluated using receiver operating characteristics (ROC) analysis. RESULT: The mean areas (Az) under the ROC curves were 0.85 for SPIOenhanced MR imaging and 0.79 for dual-phase spiral CT (p < .05). The mean sensitivity of SPIO-enhanced MR imaging was significantly higher than that of CT (p < .05), i.e. 70.6% for MR imaging and 58.1% for CT. MR imaging had higher false-positive rates than dual-phase spiral CT, but the difference was not statistically significant (3.7% vs 3.3%) (p > .05). CONCLUSION: SPIO-enhanced MR imaging is more sensitive than dual-phase spiral CT for the depiction of small hypervascular hepatocellular carcinomas.

BACKGROUND: Angiogenesis is one of the most important factors in the progression and me-tastasis of malignancies. Angiogenesis is a multistep process requiring the interaction of numerous factors able to stimulate the growth and development of new vessels. But, understanding of the mechanism involved in VEGF expression is unclear. METHODS: Expressions of p53 and VEGF, and neovasculiarization were examined in 19 cases of surgically resected non-small cell carcinoma of the lung by the immunohistochemical staining. Furthermore, VEGF mRNA expressions were quantified in all cases using the real-time quantitative RT-PCR. These results were compared with clinicopathologic parameters such as histologic grade and stage. RESULTS: Tumors with high aberrant p53 expressions showed significantly higher VEGF mRNA ex-pressions and microvessel counts than those with low p53 expressions. Expressions of p53 as well as VEGF and micovessel counts were closely associated with the tumor stage, but not with the histologic grade and other clinical parameters. CONCLUSIONS: These results suggest that aberrant p53 expression may play a role in the regulation of VEGF expression and may be involved in controlling angiogenesis in non-small cell carcinoma of the lung.
Growth and Development ; Lung* ; Microvessels ; RNA, Messenger* ; Vascular Endothelial Growth Factor A*

BACKGROUD: It is known that patients with depression can have physical and social dysfunction. Even though adolescents spend most of their time in school, researches on the relationship between adolescent depression and school adjustment are lacking. Therefore, this research surveys depression of adolescents and deals with the relationship between depression and school adjustment or school achievement. METHOD: Questionnaires were distributed to 572 students in one coed high school located in Incheon. Depression tendency was based upon BDI as cut off point 21. School adjustment was based on school related adjustment scale and the dass standing following the first semester. RESULTS: 25% (143) of 572 responses belonged to the depression tendency group. The school related adjustment scale of the depression tendency group averaged 80.06 14.78, while that of the non-depression tendency group averaged 91.78 14.98. The relationship between depression tendency and school adjustment was statistically significant(P<0.001). The relationship between depression tendency and school lifereated adjustment, school environment related adjustment, school friend related adjustment, school teacher related adjustment or school instruction-related adjustment was statistically significant(P<0. 001). In addition, the relationship between depression tendency and dass standirg was statistically significant (P<0.001). CONCLUSIONS: There was a significant relationship between depression tendency and school adjustment or school achievement. As a result, family physicians as primary care physicians need to consider examination of psychiatric symptoms such as depression tendency as well as physical symptoms, when consulting with adolescents who have trouble adjusting to school or those who bave low school achievements.
Adolescent ; Depression* ; Friends ; Humans ; Incheon ; Physicians, Family ; Physicians, Primary Care ; Surveys and Questionnaires

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly due to M llerian duct malformation. The most common clinical presentation is pelvic pain and dysmenorrhea shortly after menarche, in associated with the finding of a vaginal or pelvic mass. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patient. The simple and adequate treatment of the condition is incision of the obstructed vaginal septum providing adequate drainage of the retained blood. We report a case of uterus didelphys with obstructed hemivagina with brief review of the literature.
Diagnosis ; Drainage ; Dysmenorrhea ; Female ; Fertility ; Humans ; Menarche ; Pelvic Pain ; Uterus*

It has been known that the retromolar foramen is a rare anatomic variation observed in the retromolar triangle, a small triangular shaped region posterior to the mandibular third molar. Due to the neurovascular bundle passing through the retromolar foramen, this anatomical structure must be kept in mind during surgical approaches regarding the retromolar area and mandible. Therefore, the authors investigated the morphology of retromolar triangle and the existence and location of retromolar foramen in Korean. And these results were compared with that of other races. We used 308 sides of 154 Korean dry mandibles, unknown gender and age. The retromolar triangle presented predominantly a triangular shape (84.1%), and the maximum height and width were 13.7 mm and 7.1 mm, respectively. In 144 of the 308 sides, the retromolar foramen was observed (46.8%). The existence of the retromolar foramen was seen the same frequency in both sides, and based on a midsagittal line of the retromolar triangle, the retromolar foramen located in more buccal side (75%) than lingual side. The mean distance between the retromolar foramen and the distal edge of the last tooth were found to be 10.3 mm and 6.9 mm, respectively for the second and third molars. According to the present study, the northeast Asians including Korean population show the highest rate of the incidence of the retromolar foramen than other races. The findings suggest that practitioners should take the retromolar foramen into account in surgical procedures involving the retromolar area to protect the patient from the complications such as bleeding or nerve damage.
Anatomic Variation ; Asian Continental Ancestry Group ; Continental Population Groups ; Hemorrhage ; Humans ; Incidence ; Mandible* ; Molar, Third ; Tooth