No abstract available.
Humans ; Inpatients*

PURPOSE: To investigate the coronary angiographic findings of left atrial thrombi associated with mitral stenosis. MATERIALS AND METHODS: In 98 patients who had undergone coronary angiography and in whom the presence of left atrial thrombi was confirmed by surgery or repeated transesophageal echocardiography, evaluated the pattern, origin and location of abnormal vasculature suggestive of left atrial thrombi such; abnormalities included neovascularity, staining, dye collection and fistula. RESULTS: Abnormal vasculature was observed in 70 patients (71.4%). It arose from the left circumflex artery in 66 patients (including the sinus nodal branch in four), the right coronary artery in 14 (including the sinus nodal branch in 7 and conal branch in 2), the left anterior descending artery in one, and the left main coronary artery in one. The patterns of abnormal vasculature arising from the left coronary artery were fistula in 50, dye collection in 32, staining in 29 and neovascularity in 24; those arising from the right coronary artery were fistula in four, dye collection in two, staining in four and neovascularity in nine. Abnormal vasculature located at the anterior third of the left atrium in 50 cases, the middle in 20, and the posterior region in 12. CONCLUSION: The abnormal vasculature suggested by left atrial thrombi most commonly arose from the left circumflex artery and was located at the anterior one-third of the left atrial cavity. Fistula was the most common finding of left atrial thrombi, and for that these detection of the abnormal vasculature thrombi give rise to, selective coronary angiography was the useful modality.
Arteries ; Coronary Angiography ; Coronary Vessels ; Echocardiography, Transesophageal ; Fistula ; Heart Atria ; Humans ; Mitral Valve Stenosis*

Ion channel inhibitors are widely used for pharmacological discrimination between the different channel types as well as for determination of their functional role. In the present study, we tested the hypothesis that 4-aminopyridine (4-AP) could affect the large conductance Ca2+ -activated K+ channel (BKCa) currents using perforated-patch or cell-attached configuration of patch-clamp technique in the rabbit pulmonary arterial smooth muscle. Application of 4-AP reversibly inhibited the spontaneous transient outward currents (STOCs). The reversal potential and the sensitivity to charybdotoxin indicated that the STOCs were due to the activation of BKCa. The BKCa currents were recorded in single channel resolution under the cell-attached mode of patch-clamp technique for minimal perturbation of intracellular environment. Application of 4-AP also inhibited the single BKCa currents reversibly and dose-dependently. The membrane potential of rabbit pulmonary arterial smooth muscle cells showed spontaneous transient hyperpolarizations (STHPs), presumably due to the STOC activities, which was also inhibited by 4-AP. These results suggest that 4-AP can inhibit BKCa currents in the intact rabbit vascular smooth muscle. The use of 4-AP as a selective voltage-dependent K+ (KV) channel blocker in vascular smooth muscle, therefore, must be reevaluated.
4-Aminopyridine* ; Charybdotoxin ; Discrimination (Psychology) ; Ion Channels ; Membrane Potentials ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle* ; Patch-Clamp Techniques ; Pulmonary Artery

PURPOSE: To evaluate the coronary angiographic findings of patients with Kawasaki disease and to investigatethe natural course of aneurysms of the coronary artery. MATERIALS AND METHODS: Between June 1989 and January1996, we evaluated the coronary angiographic findings of 12 consecutive children with Kawasaki disease whosecoronary artery was abnormal. On initial study, we retrospectively analysed the size, configuration, and locationof 35 coronary aneurysms, and in five children, follow-up coronary angiography was performed at intervals of 17 to28 (mean, 23) months. Seventeen aneurysms detected on initial study were evaluated for subsequent change. RESULTS: Initial coronary angiography showed the aneurysms to be diffuse in 7 cases(20%), saccular in 7(20%), fusiform in17(49%), and tubular in 4(11%). They were large in 10 cases (29%), medium in 22(63%), and small in 3(9%) ; theirlocation in the coronary artery was proximal(71%), middle in 6(17%), and distal in 4(11%). The right coronaryartery was involved in 18 case(51%), and the left coronary artery in 17(49%). Follow-up study showed that theaneurysm had regressed in 11 cases (65%), persisted in 2(12%), and progressed to stenosis in 1(6%) and occlusionin 3(18%). Two(50%) of the four large aneurysms showed complete occlusion. On the other hand, medium and smallaneurysms showed regression in 9(82%) and in all cases, respectively. Diffuse-type aneurysms were complicated byocclusion in 2 cases (50%) and stenosis in 1(25%). On the other hand, six fusiform aneurysms (75%) and allsaccular and tubular aneurysms had regressed. CONCLUSION: In patients with kawasaki disease, informationregarding the size and configuration of coronary aneurysms may be useful for predicting the natural course andprognosis of coronary artery disease.
Aneurysm ; Arteries ; Child ; Constriction, Pathologic ; Coronary Aneurysm ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Follow-Up Studies ; Hand ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies

Klippel-Trenaunay syndrome is a rare congenital mesodermal abnormality characterized by varicose veins, cutaneous hemangiomas, soft tissue and bony hypertrophy of limb. Potential complications such as deep venous thrombosis and pulmonary thromboembolism have not been reported in Korea to date. We demonstrate the case of a 48-year-old woman with Klippel-Trenaunay syndrome with extensive varicose veins on right lower limb, hypertrophy of left big toe and basilar artery tip aneurysm, complicated with acute submassive pulmonary thromboembolism treated successfully with intravenous thrombolytic therapy.
Aneurysm ; Basilar Artery ; Extremities ; Female ; Heart Failure ; Hemangioma ; Humans ; Hypertrophy ; Intracranial Aneurysm ; Klippel-Trenaunay-Weber Syndrome* ; Korea ; Lower Extremity ; Mesoderm ; Middle Aged ; Pulmonary Embolism* ; Thrombolytic Therapy* ; Toes ; Varicose Veins ; Venous Thromboembolism ; Venous Thrombosis

Primary leptomeningeal melanomas(PLMs) are rare aggressive central nervous system(CNS) tumors without systemic foci. It can be very difficult, however, to clearly distinguish PLMs from those that have metastasized. We report a case of malignant leptomenigeal melanoma occurring in the right temporal convexity of a 77-yearold woman. Almost all malignant CNS melanomas in the old are secondary to the cutaneous melanoma and can cause diverse neurological manifestations; certain clinical findings of the presented case-namely, the patient's age, vague neurologic findings and absence of cutaneous lesions -are therefore interesting. Thorough clinical checkups, including whole-body bone scan, whole spine MRI, abdominal ultrasound, and tumor marker studies to find extracranial lesions revealed no abnormalities. Based on these clinical findings, we suppose-though are not certain-that the tumor of the presented case is a PLM.
Female ; Humans ; Magnetic Resonance Imaging ; Melanoma* ; Neurologic Manifestations ; Spine ; Ultrasonography

BACKGROUND: As the result of renal transplantation improving, also increasing the number of graft failure which will be a candidate for second renal transplantation. The purpose of this study is to evaluate the factors that influence the survival of retransplanted kidney. METHODS: Among 775 renal transplantations that have been performed in Dongsan Medical Center until August 2007, 225 cases were failed their graft function and 59 of them were retransplanted during their follow up period. Graft survival of retransplanted kidney was compared with primary renal transplantation and factors that affecting the survival of kidney retransplantation were evaluated. RESULTS: Main causes of graft failure of first kidney transplantation were chronic rejection, followed by recurrence of original disease of recipient and acute vascular rejection. Mean survival time was 72.6 months (15 days~161 months). One and 5 years graft survivals were 94.6%, 90.7%, and patient survivals were 100.0%, 97.8%, respectively. Among the factors which showed significance in univariate analysis, short interval between failure of first transplantation and retransplantation, and graft failure due to chronic rejection were statistically significant unfavorable factors for survival of retransplanted kidney. CONCLUSIONS: Kidney retransplantation showed similar graft and patient survival compare to the first one. However, retransplantation should be performed after enough time after graft failure and should be cautious in a patient who lost their graft due to chronic rejection.
Follow-Up Studies ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation ; Recurrence ; Rejection (Psychology) ; Survival Rate ; Transplants

BACKGROUND: The heat shock proteins (HSPs) are stress-responsive genes present in all species and play a major role in many cellular processes. These proteins are highly conserved molecules whose expression is induced in eukaryotic cells by a variety of environmental stresses. These proteins can also be expressed in virally transformed cells and cancer cells. Especially, HSP70 is found at a higher level in growing cells than in resting cells. Sulphomucin is secreted by immature foveolar cells of stomach and expressed in gastric adenocarcinomas. Also, it is known that the population of sulphomucin-producing cells increases with long-lasting stress. The purpose of this study was to determine HSP70 and sulphomucin expressions in gastric adenocarcinoma and the significance of expressions. METHODS: Thirty-one paraffin-embeded surgical specimens of gastric adenocarcinomas were obtained from April 1992 to March 1995 and were selected for analysis. The expressions of HSP70 and sulphomucin were analyzed by immunohistochemical staining with HSP70 monoclonal antibody and the Spicer (HID) method. RESULTS: The expressions of HSP70 and sulphomucin were positive in 13 (42%) cases and 11 (35%) cases, respectively. The expression of HSP70 correlated with neither clinopathological factors nor sulphomucin expression. There was a significant correlation not only between sulphomucin expression and histologic differentiation (p=0.001) but also between disease-free survival and sulphomucin expression. CONCLUSIONS: Sulphomucin expression in gastric adenocarcinoma may be useful as a prognostic factor of gastric adenocarcinomas.
Adenocarcinoma* ; Disease-Free Survival ; Eukaryotic Cells ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Stomach

L-type Ca2+ channels play an important role in regulating cytosolic Ca2+ and thereby regulating hormone secretions in neuroendocrine cells. Since hormone secretions are also regulated by various kinds of protein kinases, we investigated the role of some kinase activators and inhibitors in the regulation of the L-type Ca2+ channel currents in rat pituitary GH3 cells using the patch-clamp technique. Phorbol 12,13-dibutyrate (PDBu), a protein kinase C (PKC) activator, and vanadate, a protein tyrosine phosphatase (PTP) inhibitor, increased the Ba2+ current through the L-type Ca2+ channels. In contrast, bisindolylmaleimide I (BIM I), a PKC inhibitor, and genistein, a protein tyrosine kinase (PTK) inhibitor, suppressed the Ba2+ currents. Forskolin, an adenylate cyclase activator, and isobutyl methylxanthine (IBMX), a non-specific phosphodiesterase inhibitor, reduced Ba2+ currents. The above results show that the L-type Ca2+ channels are activated by PKC and PTK, and inhibited by elevation of cyclic nucleotides such as cAMP. From these results, it is suggested that the regulation of hormone secretion by various kinase activity in GH3 cells may be attributable, at least in part, to their effect on L-type Ca2+ channels.
Adenylyl Cyclases ; Animals ; Cell Line* ; Colforsin ; Cytosol ; Genistein ; Neuroendocrine Cells ; Nucleotides, Cyclic ; Patch-Clamp Techniques ; Phorbol 12,13-Dibutyrate ; Phosphotransferases ; Protein Kinase C ; Protein Kinases* ; Protein Tyrosine Phosphatases ; Protein-Tyrosine Kinases ; Rats* ; Vanadates

BACKGROUND AND OBJECTIVES: Tympanic membrane perforation is an important clinical problem found in various populations of the world. In large number of cases, acute traumatic perforations heal spontaneously, and in the healing process, stem cells appear to play an important role. However, no studies have been reported regarding somatic stem cells in the tympanic membrane. Herein, we tried to show that guinea pig's tympanic membrane contains cells that display the characteristic features of stem cells. MATERIALS AND METHOD: The tympanic membrane was obtained from the guinea pig. The cells were cultured in a medium with epidermal growth factor (EGF) and fibroblast growth factor (FGF). Proliferating cells were checked with stem cell markers, bromodeoxyuridine (BrdU) and nestin. Differentiated cells from stem cells are checked with betaIII tubulin and S-100. RESULTS: We observed that some of the cultured cells from the tympanic membrane were stained with both stem cell markers, BrdU and nestin. And we observed that these cells differentiated into neuron and gilal cells, which expressed betaIII tubulin and S-100, respectively. CONCLUSION: These results suggest that the tympanic membrane of guinea pigs may have neural stem cells. Further study is needed for finding the origin of stem cells.
Adult ; Adult Stem Cells ; Animals ; Bromodeoxyuridine ; Cells, Cultured ; Epidermal Growth Factor ; Fibroblast Growth Factors ; Guinea ; Guinea Pigs ; Humans ; Intermediate Filament Proteins ; Nerve Tissue Proteins ; Neural Stem Cells ; Neurons ; Stem Cells ; Tubulin ; Tympanic Membrane ; Tympanic Membrane Perforation