Spindle cell hemangioendothelioma was first described in 1986 by Weiss and Enzinger as a low grade angiosarcoma resr mbling a cavernous hemangioma and kaposis sarcoma. Recently, it is suggested to be non neoplastic lesion or reactive process arising from pre-existing vascular mal- formation. We report a case of spindle cell hemangioendothelioma in a 9-month-old boy. He had multiple, variable sized, colorful, cutaneous or subcutaneous nodules on the forearm and hand. The tumor first appeared on the forearm as erythematous patches at birth and grew rapidly with- in 3 months. Histopatholgical findings showed that the lesion was composed of thin walled cavernous spaces mixed with spindle cells and occasional epithelioid endothelial cells containing intracytoplasmic vacuole. Most af the endothelial cells lining the cavernous spaces and intracytoplasmic lumina, were positive for factor VIII associated antigen. But the spindle cells were negative. Atypical vascular structures resembling arteriovenous shunts were noted around the tumor suggesting a reactive proliferation due to disturbance of local blood flow. Several turnors were excised. No recurrence has been recognized in the one year- follow-up period.
Endothelial Cells ; Factor VIII ; Follow-Up Studies ; Forearm ; Hand ; Hemangioendothelioma* ; Hemangioma, Cavernous ; Hemangiosarcoma ; Humans ; Infant ; Male ; Parturition ; Recurrence ; Sarcoma, Kaposi ; Vacuoles

BACKGROUND: Phospholipase A2 (PLA2) has been known to be involved in the pathogenesis of acute lung injury (ALI) including ARDS. Since doxycycline has the property of inhibiting secretory group II PLA2, the therapeutic effect of doxycycline hyclate was investigated for gut ischemia/reperfusion (I/R)-induced ALI in Sprague-Dawley rats. METHODS: ALI was induced in Sprague-Dawley rats by clamping of the superior mesenteric artery for 60 min, followed by 120 min of reperfusion. To confirm the pathogenetic mechanisms of this ALI associated with neutrophilic oxidative stress, we measured bronchoalveolar lavage (BAL) protein content and lung MPO, and performed cyto chemical electron microscopy for detection of free radicals, assay of PLA2 activity and cytochrome-c reduction assay. RESULTS: In gut I/R-induced ALI rats, protein leakage, pulmonary neutrophil accumulation, free radical production and lung PLA2 activity were all increased. These effects were reversed by doxycycline hyclate. CONCLUSION: Doxycycline appars to be effective in ameliorating the gut I/R-induced ALI by inhibiting PLA2, thereby decreasing the production of free radicals from neutrophils.
Acute Lung Injury* ; Animals ; Bronchoalveolar Lavage ; Constriction ; Doxycycline* ; Free Radicals ; Lung ; Mesenteric Artery, Superior ; Microscopy, Electron ; Neutrophils ; Oxidative Stress ; Phospholipases A2 ; Rats ; Rats, Sprague-Dawley ; Reperfusion

We report three cases of rat mite dermatitis caused by Ornithonysus bacoti(Hirst, 1913), commonly referred to it as the tropicalrat mite. The first case, a 26-year old female had multiple pinhead sized vesicles with peripheral erythematous macule on the upper arms. The second case, a 34-year-old femal had multiple variable sized vesicles with erythematous base on the extremeties. The third case, a 43-year old male had multiple erythematous macules and papules with central punctum on the trunl: and extremities. Histopathologic sections from lesions of the first and second patient showed moderate perivascular lymphahistiocytic infiltration intermingled with some eosinophils. Causative mites, Ornithonyssus bacoti, female were collected around the skin lesion in rase 1, from the house dust in case 2 and furniture in case 3.
Adult ; Animals ; Arm ; Dermatitis* ; Dust ; Eosinophils ; Extremities ; Female ; Humans ; Interior Design and Furnishings ; Male ; Mites* ; Rats* ; Skin

BACKGROUND: There is considerable controversy about the exact molecular mechanisms of excitatory amino acid receptors in epileptogenesis. METHODS: We used in situ hybridization to examine the hybridization density (HD) of n-methyl- D-aspartic acid receptor type 1 (NMDAR-1) and alpha-amino-3-hydroxy -5-methyl-4-isoxazole-propionate (AMPA) receptor type 2 (GluR-2) mRNA, in the hippocampus obtained from the kainic acid (KA)-induced status epilep-ticus (SE) model. Some Sprague-Dawley rats were injected with KA (10 mg/Kg; I.p.), and others with MK-801 (4 mg/kg) 20 minutes prior to KA. The rats were allowed to have 4-hour SE and were killed at 8 hours or 4 weeks after KA or MK-801/KA injection. HD of NMDAR-1 and GluR-2 mRNA in subfields of the hippocampus was measured by an image analysis system. RESULTS: A typical neuropathological finding of hippocampal sclerosis and spontaneous repetitive seizures (SRS) were observed in the KA injected rats, but not in the MK-801 pretreated rats, killed at 4 weeks. Compared with controls, the rats killed at 8 hours after KA showed increased CA1, CA2, and CA3 NMDAR-1 HD, and stratum granulosum (SG) GluR-2 HD. The increase of NMDAR-1, not GluR-2, HD was blocked effectively by MK-801. The increase of SG GluR-2 HD remained until 4 weeks after the KA injection. CONCLUSIONS: Not only the NMDAR-1activa-tionbut also the GluR-2 activation is an important factor in delaying hippocampal neuronal loss and epileptogenesis. (J Korean Neurol Assoc 19(1):36~44, 2001
alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; D-Aspartic Acid ; Dizocilpine Maleate ; Epilepsy, Temporal Lobe ; Gene Expression* ; Glutamic Acid* ; Hippocampus ; In Situ Hybridization ; Kainic Acid ; N-Methylaspartate ; Neurons ; Rats ; Rats, Sprague-Dawley ; Receptors, Glutamate* ; RNA, Messenger ; Sclerosis ; Seizures ; Temporal Lobe*

BACKGROUND: Bcl-2 protein is essential for neurodevelopment and it is implicated in various neurodegenerative diseases. However, little is known about the normal developmental expression of Bcl-2 and NeuN protein in hippocampus slice cultures. We performed this study to assess their morphological changes and developmental expressions of Bcl-2 and NeuN protein. METHODS: We cultured the hippocampus of an eight days postnatal Sprague-Dawley (SD) rat in slices of 450 m. We observed the morphological development and differentiation of the hippocampus slices. Additionally, we measured the developmental expression of Bcl-2 and NeuN, -actin protein by western blotting. RESULTS: The hippocampal slice cultures revealed matured structures as early as 6 days in vitro (DIV) and a relatively high degree of tissue organization until 18 DIV. After 21 DIV, there were migration of the cells away from the margins of the slices. NeuN expressions at 7, 13, and 19 DIV were 1.42 +/- 0.38 (meanSD, NeuN/ beta-actin OD ratio, insert number=4, each insert had 5 culture slices), 2.95 +/- 0.53, 1.58 +/- 0.42 respectively. Bcl-2 expression at 6, 12, and 18 DIV were 0.56 +/- 0.18 (mean +/- SD, Bcl-2/beta-actin OD ratio, insert number=4, each insert had 5 culture slices), 1.22 +/- 0.28, 1.03 +/- 0.25. CONCLUSIONS: Organotypic slice cultures of a rat's hippocampus shows morphological maturation within 14 DIV and the highest NeuN and Bcl-2 level at about 13 DIV. It is expected that these findings would be useful as baseline data in the field of research on neuronal development and aging processes.
Actins ; Aging ; Animals ; Blotting, Western ; Hippocampus* ; Neurodegenerative Diseases ; Neurons ; Rats* ; Rats, Sprague-Dawley

The 5-aminolevulinic acid (5-ALA)-induced tumor fluorescence is a useful intraoperative marker for the diagnosis and the detection of various malignancies, but its use in meningioma is only reported infrequently. In meningioma, a complete resection of the tumor mass is crucial for the prevention of recurrence and postoperative morbidities. Deep sylvian meningioma is a rare type of meningioma where complete tumor removal is complicated by its deep anatomical location and close involvement with the middle cerebral artery. From our experience, 5-ALA-mediated fluorescence facilitated a safe excision whilst preserving critical neurovascular structures. To our best knowledge, this is first report from use of 5-ALA in a deep sylvian meningioma.
Fluorescence ; Meningioma ; Middle Cerebral Artery ; Recurrence

OBJECTIVE: The incidence of spinal metastases continues to increase, likely a result of increasing survival times for patients with cancer. This retrospective study was undertaken to analyze the results of surgery and the outcome of patients with extradural metastases in the cervical spine. METHODS: Thirty-three patients with cervical spine metastases who underwent spinal surgery by two surgeon at a single center in a 14-year period(1993-2007) were analyzed. Indications for surgery include intractable pain, neurological deficits, spinal cord compression, and the need for stabilization of impending pathological fractures. Numerous factors affect outcome including the nature of the primary cancer, the presence of fracture or dislocation, approach of surgery, and the severity of spinal cord compression. The change of predominant symptoms and survival time were evaluated after surgery. RESULTS: There were 17 male and 16 female patients aged from 29 to 78 years old(mean age, 59.9 years). Among the metastatic tumors, colon, breast, and liver were the most common primary sites of origin, and lung, kidney, stomach and thyroid were also common. All patients had bony invasion and 24 patients had pathologic vertebral fracture and 6 patients had dislocation. Based on the tumor location, approaches included 12 anterior, 6 posterior and 15 combined. Epidural spinal cord compression on the axial T2-weighted magnetic resonance(MR) image was noted in 31 patients(93.9%). The American Spinal Injury Association(ASIA) impairment scale scores in preoperative state were stable in 29 patients(87.9%) who presented with ASIA Score D and E. The most common predominant symptoms of patients were cervical and/or radiating pain(26 patients) and 23 patients had neurological deficits. At Follow-up, predominant preoperative symptoms improved in 28(84.8%) patients who had pain or neurological deficits. The overall mean survival duration for patients with cervical metastatic tumors after diagnosis was 7.4 months in 28 expired patients and 17.4 months in 5 survived patients. There were four major early and late complications in this study. One patient suffered from the immediate postoperative epidural hematoma and improved after evacuation of hematoma. There were three cases of instrumentation failure. One of them was symptomatic and underwent second-look surgery. CONCLUSION: Surgery for the treatment of cervical spine metastases is effective for improvement of the neurological deficits and relief the local pain in a significant proportion of patients with acceptable complication rates. The tech- nical evolution of cervical implants has improved our ability to achieve long-term rigid fixation, particularly over the cervicothoracic junction.
Aged ; Asia ; Breast ; Cervical Vertebrae ; Colon ; Dislocations ; Female ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Incidence ; Kidney ; Liver ; Lung ; Magnetics ; Magnets ; Male ; Neoplasm Metastasis ; Pain, Intractable ; Retrospective Studies ; Spinal Cord Compression ; Spinal Injuries ; Spine ; Stomach ; Thyroid Gland

PURPOSE: In recent years there has been a considerable increase in the use of chemotherapy as an adjuvant to surgery, radical radiotherapy and in addition to best supportive care. However, the value of chemotherapy in improving survival is still unclear, despite more than 50 randomised trials addressing this question in the different stages of disease. This study was done to evaluate Korean doctors' personal management preference and their beliefs about prognosis in non-small celllung cancer(NSCLC). MATERIALS AND METHODS: A mail survey of Korean respirologists, thoracic surgeons, radiation oncologists, and medical oncologists was performed. Four cases of NSCLC were described and respondents were asked to give their treatment recommendations and to estimate the prognosis in each case. RESULTS: After a complete resection for stage II NSCLC, 27% recommended no adjuvant treatment, 36% recommended radiotherapy, 18% recommended chemotherapy, and 19% recommended both radiotherapy and chemotherapy. After a complete resection for stage IIIA(N2) NSCLC, the vast majority of respondents recommended adjuvant therapy. For an asymptomatic patient with stage IIIB NSCLC, 5% recommended supportive care, 24% recommended radiotherapy, 16% recommended chemotherapy, and 54% recommended chemotherapy combined with radiotherapy. For a patient with stage IV NSCLC, 76% recommended chemotherapy with or without palliative radiotherapy. Doctors' treatment preference was significantly different by their speciliaty in a case with stage II, IIIA(N2), or IV NSCLC. Most respondents believed that chemotherapy would increase survival in NSCLC. Doctors' beliefs about the efficacy of treatment were strongly associated with their treatment recommendations. CONCLUSION: Korean doctors generally preferred relatively aggressive management although their personal preferences varied widely. Team approach is important in deciding the treatment modality because doctors' treatment preference is different by their speciality.
Carcinoma, Non-Small-Cell Lung* ; Surveys and Questionnaires ; Drug Therapy ; Humans ; Postal Service ; Prognosis ; Radiotherapy

BACKGROUND: In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatments progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors ifluencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. METHODS: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline : (a) complaints ; (b) patients who initially complied but gave up of themselves midway during the course of treatment ; (c) noncompliants who refused the treatment. RESULTS: The overall compliance rats was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sell marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage l and ll, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. CONCLUSION: To enhance the compliance, special care including education programs about therapy including complicantion and prognosis are necessary, especially for educationally and economically disadvantaged patients.
Animals ; Cause of Death ; Compliance* ; Education ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Marital Status ; Medical Records ; Occupations ; Prognosis ; Rats ; Retrospective Studies ; Smoke ; Smoking ; Vulnerable Populations

BACKGROUND: Although there are growing evidences linking Chlamydophila pneumoniae infection to myocardial infarction, it remains controversial. The authors intended to assess whether C. pneumoniae infection is associated with myocardial infarction. METHODS: Sera and peripheral mononuclear cells (PMNCs) were collected from 54 cases of acute myocardial infarction (MI), 33 cases of old MI, and 60 normal controls. Anti-C.pneumoniae IgG and IgM antibodies were measured using a microimmunofluorescence (mIF) method, and C.pneumoniae DNA was detected using polymerase chain reaction (PCR). RESULTS: Seropositivity of anti-C.pneumoniae IgM antibody by mIF was shown 5.0% in control group, 29.6% (OR=8.00) in the acute MI and 6.1% (OR=1.23) in old MI group. Seropositivity of anti C.pneumoniae IgG antibody were 60.0 % in control group, 92.6% (OR=8.33) in the acute MI and 87.9% (OR= 4.83) in old MI group. The antibody titers in the acute MI and old MI group tended to be higher compared to those in control group. No C.pneumoniae DNA was detected in any case by PCR. CONCLUSION: The seropositivity and antibody titers were significantly higher in the acute MI and old MI group than in control group, suggesting that C.pneumoniae infection may be a risk factor for myocardial infarction.
Antibodies ; Chlamydial Pneumonia* ; Chlamydophila pneumoniae* ; Chlamydophila* ; DNA ; Immunoglobulin G ; Immunoglobulin M ; Myocardial Infarction* ; Pneumonia ; Polymerase Chain Reaction ; Risk Factors