We report two cases of hyalinizing trabecular carcinoma (HTC) of the thyroid gland. These two patients were euthyroid women aged 36 and 65 years of age. The tumors were encapsulated and measured 0.8 and 4.0 cm in diameter, respectively. Histologically, the tumors were composed of a compact proliferation of cells in a lobular and trabecular pattern with an intervening hyalinized, fibrotic vascular stroma. Occasionally the cells were arrayed in microfollicles. Multiple and serial sections showed cords of tumor cells invading into the capsule in both cases and vascular invasion in one case. These findings suggested that HTCs are a malignant counterpart of hyalinizing trabecular adenoma, similar to conventional follicular tumor. Positive immunostaining of tumor cells for thyroglobulin and negative staining for high molecular weight cytokeratin, cytokeratin 19, neuron specific enolase, chromogranin, and synaptophysin allowed distinction from medullary carcinoma. Even though HTCs are an heterogeneous group of tumors, the present two cases are probably variants of follicular carcinoma rather than papillary carcinoma.
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Female ; Humans ; Hyalin* ; Keratin-19 ; Keratins ; Molecular Weight ; Negative Staining ; Phosphopyruvate Hydratase ; Synaptophysin ; Thyroglobulin ; Thyroid Gland*

Background: Triiodothyronine(T3) is a hormone secreted from thyroid gland which exerts a stimulating effect on metabolism. The disorder of thyroid system brings about several serious diseases like hypothymidism or hyperthyroidism. Therefore, the determination of T in blood is very important on monitoring thyroid function. Methods: Rabbit anti-T3 antibody was generated by immunization of T-BSA as an immunogen and purified hom antisera using Affi-gel protein A kit. The titer and specificity of purified antibody were characterized. To detect T3, competitive ELISA was performed using anti-T3 antibody and T3-HRP conjugate which was synthesized by glutaraldehyde method. The sensitivity and precision assay wer~e deterrnined and compared with that of RIA. Results: The titer of purified anti-T3 antibody was about 1:100 and the optimal dilution of T3- HRP conjugate was 1:1000. When the standard curve was constructed by ELISA, its sensitivity was about 0.5ng/ml. The eoefficient variations of intra- and inter-assay were 4.9~9.3% and 7.5~13.8%, respectively. The results obtained by ELISA and RIA correlated well with each other(n =50, r= 0.97), The linear regression equation was y= 1.09*0.08(P<0.01). Conclusion: We successfully developed a method for the measurement of T3 on ELISA which was based on competitive reaction between antigen(T3) and enzyme labeled antigen(T3-HRP). These results demonstrated that competitive ELISA is a convenient, fast, reproducible and aecurate method for the determinstion of T in serum and can be used as practical alternative to RIA.
Enzyme-Linked Immunosorbent Assay ; Glutaral ; Hyperthyroidism ; Immune Sera ; Immunization ; Linear Models ; Metabolism ; Methods ; Sensitivity and Specificity ; Staphylococcal Protein A ; Thyroid Gland ; Triiodothyronine

OBJECTIVE: Moyamoya disease (MMD) is an uncommon cerebrovascular disorder, characterized by progressive occlusion at the terminal portion of the internal carotid artery. Incidence of the disease is high in East Asia and familial MMD accounts for about 15% of the disease. Although the pathogenesis is unknown, association of HLA class I or II alleles with MMD has been reported with conflicting results. We investigated whether there is a difference in HLA class II association between familial and non-familial forms of the disease. METHODS: A total of 70 Korean children with MMD, including 16 familial cases (10 probands), and 207 healthy controls were studied. Among familial cases, only 10 probands were used for the HLA frequency analysis. High resolution HLA-DRB1 and DQB1 genotyping was performed using polymerase chain reaction (PCR)-sequence specific oligonucleotide hybridization and PCR-single strand conformation polymorphism methods. RESULTS: The phenotype frequencies of HLA-DRB1*1302 (70.0%) and DQB1*0609 (40.0%) were significantly increased in familial MMD compared to both controls [vs. 15.5%, corrected p (pc) = 0.008, odds ratio (OR) = 12.76; vs. 4.3%, pc = 0.02, OR = 14.67] and non-familial MMD patients (vs. 14.8%, pc = 0.02, OR = 13.42; vs. 1.9%, pc = 0.02, OR = 35.33). The frequencies of DRB1 and DQB1 alleles in non-familial MMD patients were not significantly different from those in controls. CONCLUSION: Our findings suggest that the genetic polymorphism of HLA class II genes or other closely linked disease relevant gene(s) could be a genetic predisposing factor for familial MMD.
Alleles ; Carotid Artery, Internal ; Cerebrovascular Disorders ; Child ; Chimera ; Far East ; Genes, MHC Class II ; HLA-DQ Antigens ; HLA-DR Antigens ; HLA-DRB1 Chains ; Humans ; Incidence ; Moyamoya Disease ; Odds Ratio ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Genetic

BACKGROUND: Propofol and ketamine had been used for anesthesia induction and for total intravenous anesthesia. The nature of any hypnotic interactions occurring between propofol and ketamine are unknown. A comparison of maternal and neonatal effects among propofol-ketamine combination, ketamine and propofol were studied when used for anesthesia induction in Cesarean section. METHODS: Forty five patients in ASA class I or II scheduled for Cesarean section randomly assigned to either propofol 2 mg/kg (n=15), ketamine 1 mg/kg (n=15) or propofol 1 mg/kg - ketamine 0.5 mg/kg combination group (n=15) as an induction agent. Maternal systolic and diastolic blood pressure, heart rate, Apgar score and umbilical blood gas analysis were measured. RESULTS: Before intubation, systolic and diastolic pressure were decreased in propofol group but increased in ketamine and propofol-ketamine combination group. Heart rate were increased in all three groups. But there were no significant differences among three groups (p<0.05). After intubation, there were significant increase in systolic, diastolic pressure and heart rate in three groups but no significant differences among three groups (p<0.05). And there was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. CONCLUSIONS: Propofol-ketamine combination was found to be similar to propofol or ketamine only in the effects on the mother and neonate. But propofol-ketamine gained more stable hemodynamic change than propofol or ketamine before intubation. Therefore propofol-ketamine appears to be a suitable alternatives to propofol or ketamine as an induction agent for anesthesia in Cesarean section.
Anesthesia ; Anesthesia, Intravenous ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Depression ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Ketamine* ; Mothers ; Pregnancy ; Propofol*

To investigate the effect of tumor removal and administration of OK432 on the splenic natural killer (NK) cell activity in the subcutaneous tumor bearing rats, NK cell activity assay using a 4-hour 51Cr release assay and flow cytometric analysis for NK cell population were performed. The results were as follows: 1. Splenic NK cell activity and population in the subcutaneous tumor bearing rats decreased along with the growth of the tumor. 2. The rats with subcutaneous tumor removal showed decrease of splenic NK cell activity, but splenic NK cell population was not decreased. 3. In the rats with subcutaneous tumor removal and OK432 administration, splenic NK cell activity was significantly increased 1 week after administration of OK432 and then gradually returned to normal, whereas increase of NK cell population was not significant. In the present study, splenic NK cell activity was significantly decreased despite removal of subcutaneous tumor. But with the administration of OK432, splenic NK cell activity returned to normal. Considering the role of NK cells on the first line of defense against the metastatic implantation of circulating tumor emboli, we suggest that perioperative administration of immunopotentiator such as OK432 may improve the patient's outcome after surgery of human neoplasm.
Animals ; Humans ; Killer Cells, Natural* ; Picibanil* ; Rats* ; Spleen

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

After clinical adjustment of dental casting restoration, re-polishing procedure is recommanded because the smooth gold sureface is lost. But there is the possibility to get more loose contact than that intended by loss of gold alloy according to the kinds of polishing materials and polishing time. Therefore in this study I polished type II gold alloy with 390gm force, 20,000rpm speed, and 8 kinds of gold alloy polishing materials, fabricated by 4 companies and then measured the amount of loss of gold alloy with Surfcorder SEF30D and observed alloy surfaces polished by 3 brown rubber points with SEM. The amount of loss of gold alloys polished with 8 kinds of polishing materials and the degree of smoothness of gold alloys according to polishing time and polishing materials were compared. The following results were obtained : 1. When the amount of loss of gold alloys polished with 3 kinds of brown rubber point was compared, Alphalex brown point had the most amount of alloy loss, followed in decreasing order by Shofu brown point and Eveflex brown point. There was statistically significant difference in the amount of alloy loss according to polishing materials. 2. When the amount of loss of gold alloys polished with 5 kinds of green rubber point was compared, Shofu green point had the most amount of alloy loss, followed in decreasing order by Alphaflex green point, Dedeco green clasp polisher, and Eveflex green point. There was statistically significant difference in the amount of alloy loss according to polishing materials except Alphaflex green point and Dedeco green clasp polisher. 3. When the amount of loss of gold alloys polished with all kinds of rubber point was compared, there was no significant difference in Eveflex brown point, Alphaflex green point, and Dedeco green claps polisher. 4. When average amount of alloy loss per 1 revolution by polishing materials was compared, Alphalex brown point had the greatest value as 0.329micrometer and Shofu supergreen point had the lowest value as 0.022micrometer. 5. When the degree of sureface smoothness of gold alloy polished with 3 kinds of brown rubber point was compared, in Alphalex brown point surface roughness was completely lost after 20 seconds polishing time, in Shofu brown point 30 seconds, in Eveflex brown point 40 seconds. But in every gold alloys fine scratch formed by rubber points was observed. Based on the results of this study, as rubber polishing materials used in polishing of dental casting restoration after clinical adjustment influenced on the tightness of occlusal or proximal contact, we should make dental casting restoration with minimum error through careful laboratory procedure and form very smooth surface of restoration with tripoli and rouge after use of silicone polishing materials.
Alloys* ; Gold Alloys ; Rubber* ; Silicones

After clinical adjustment of dental casting restoration, re-polishing procedure is recommanded because the smooth gold sureface is lost. But there is the possibility to get more loose contact than that intended by loss of gold alloy according to the kinds of polishing materials and polishing time. Therefore in this study I polished type II gold alloy with 390gm force, 20,000rpm speed, and 8 kinds of gold alloy polishing materials, fabricated by 4 companies and then measured the amount of loss of gold alloy with Surfcorder SEF30D and observed alloy surfaces polished by 3 brown rubber points with SEM. The amount of loss of gold alloys polished with 8 kinds of polishing materials and the degree of smoothness of gold alloys according to polishing time and polishing materials were compared. The following results were obtained : 1. When the amount of loss of gold alloys polished with 3 kinds of brown rubber point was compared, Alphalex brown point had the most amount of alloy loss, followed in decreasing order by Shofu brown point and Eveflex brown point. There was statistically significant difference in the amount of alloy loss according to polishing materials. 2. When the amount of loss of gold alloys polished with 5 kinds of green rubber point was compared, Shofu green point had the most amount of alloy loss, followed in decreasing order by Alphaflex green point, Dedeco green clasp polisher, and Eveflex green point. There was statistically significant difference in the amount of alloy loss according to polishing materials except Alphaflex green point and Dedeco green clasp polisher. 3. When the amount of loss of gold alloys polished with all kinds of rubber point was compared, there was no significant difference in Eveflex brown point, Alphaflex green point, and Dedeco green claps polisher. 4. When average amount of alloy loss per 1 revolution by polishing materials was compared, Alphalex brown point had the greatest value as 0.329micrometer and Shofu supergreen point had the lowest value as 0.022micrometer. 5. When the degree of sureface smoothness of gold alloy polished with 3 kinds of brown rubber point was compared, in Alphalex brown point surface roughness was completely lost after 20 seconds polishing time, in Shofu brown point 30 seconds, in Eveflex brown point 40 seconds. But in every gold alloys fine scratch formed by rubber points was observed. Based on the results of this study, as rubber polishing materials used in polishing of dental casting restoration after clinical adjustment influenced on the tightness of occlusal or proximal contact, we should make dental casting restoration with minimum error through careful laboratory procedure and form very smooth surface of restoration with tripoli and rouge after use of silicone polishing materials.
Alloys* ; Gold Alloys ; Rubber* ; Silicones

Nitroblue tetrazolium dye reduction test is now widely used for early detection of bacterial infection. Practically nitroblue tetrazolium dye reduction test (N.B.T. test) gives certain clue to rule out any possibility of aseptic inflammation. Authors performed N.B.T. test for 80 orthopaedic diseases and 40 controls, and the results were as followings: 1. Forty-one of 60 subjects with bacterial infection had more than 10% formazan positive neutrophils, and 18 of 20 subjects without bacterial infection showed less than 10%. formazan positive neutrophils, The groups of the elevated N.B.T. responses were mainly the subjects who had osteomyelitis, soft tissue inflammation, pyogenic arthritis, and bone and joint tuberculosis. 2. The mean proportion of N.B.T. positive neutrophils was 3.8±2.78% in 40 controls, 4.7±4.23% in 20 nonifectious group 12.7±10.3% in 12 chronic osteomyelitis, 12.5±10.7% in 15 treated bone and joint tuberculosis, 20.9±15.65% in 15 untreated bone and joint tuberculosis and 20±10.70% in 11 pyogenic arthritis and 7 other soft inflammatory group. 3. In noninfectious group, 7 of 8 subjects with elevated ESR and 3 of 4 subjects with elevated body temperature revealed N.B.T. responses less than 10%. 4. In 23 subjects with the elevated N.B.T. responses as well as leukecytosis, 22 subjects were the groups of bacterial infection and rest 1 was noninfectious in nature. 5. Therefore, the N.B.T. test is found to be useful for the purposes of the early diagnostic aid of the bacterial infection and differential diagnosis between bacterial infections and other diseases.
Arthritis ; Bacterial Infections ; Body Temperature ; Diagnosis, Differential ; Inflammation ; Neutrophils ; Nitroblue Tetrazolium ; Osteomyelitis ; Tuberculosis, Osteoarticular

Massive pulmonary embolism is a major cause of morbidity and death in hospital. Most episodes of acute pulmonary embolism occurred from multiple emboli. When pulmonary embolism is suspected, the definitive diagnosis is pulmonary arteriography, but high degree of certainty can also be achieved with ventilation-perfusion scanning. The therapeutic modalities available for patients with acute pulmonary embolism are prophylatic and definitive therapy. Prophylatic therapy including anticoagulant with heparin is used to prevent further emboli episodes that might be fatal. Definitive therapy for pulmonary embolism including thrombolytic agents and pulmonary embolectomy attempts to dissolve and remove the resolution of the pathophysiologic sequelae of pulmonary embolism. We experienced a case of acute massive pulmonary embolism which occupied the pulmonary arteries bilaterally. Patient with orthopedic surgery one month before developedd dyspnea and chest tightness. Eventhough continuing enough amount of anticoagulant therapy, rapid hemodynamic deterioration and severe hypoxia occurred progressively. Urgent pulmonary embolectomy was succeeded and he has been followed up at out patient department.
Angiography ; Anoxia ; Diagnosis ; Dyspnea ; Embolectomy ; Fibrinolytic Agents ; Hemodynamics ; Heparin ; Humans ; Orthopedics ; Pulmonary Artery* ; Pulmonary Embolism* ; Thorax