Silicone gel breast implants may induce local(fibrous capsular contracture) or systemic(rheumatoid arthritis, systemic sclerosis, etc) complications. The exact mechanism of fibrous capsular contracture has not been fully understood. In the present study, we tried to find out the effect of silicone gel on the fibroblast proliferation which has been known as a major contributing factor in fibrous capsular contracture formation. In vitro, activated macrophages are known to secrete monokines which affect fibroblast proliferation and collagen synthesis. And tumour necrosis factor-alpha(TNF-alpha) and interleukin-6(IL-6), which were released by macrophages, were reported as potent stimulator of fibroblast proliferation. The goal of this study is to investigate the role of macrophages and tumour necrosis factor-alphaor interleukin-6 in the interaction of fibroblasts and silicone gel. We designed four groups, two experimental and two control, using Institute for Cancer Research(ICR) mouse peritioneal macrophage and silicone gel. For the preparation of the conditioned medium of macrophages, peritoneal macrophages were prepared and cultured for 24 hours on the silicone gel-coated and naked (not coated) surface [silicone gel-macrophage conditioned medium(SCM; experimental group) and normal polystyrene-macrophage conditioned medium(NCM; control group) respectively]. To correct the effect of 10% fetal bovine serum which was included in Rapid Prototyping and Manufacturing Institute (RPMI) 1640 medium and draw the effect only by macrophages, the RPMI 1640 medium with 10% fetal bovine serum was cultured by the same method on the silicone gel-coated and naked surface (silicone gel-macrophage free conditioned medium; SFM and normal polystyrene-macrophage free conditioned medium; NFM respectively). Each conditioned medium was added onto NIH 3T3 fibroblasts culture at a final 25% concentration of total culture medium and followed by the cultivation for 24 hours. For antibody neutralizing experiments, each conditioned medium was preincubated with polyclonal rabbit anti-mouse TNF-alpha antibody or polyclonal rat anti-mouse IL-6 antibody for 1 hour and then, conditioned medium with antibody was added to the culture medium of NIH 3T3 fibroblasts by the same method. After 24 hours cultivation, total number of viable fibroblast(cell growth), DNA synthesis and collagen synthesis of fibroblasts with each medium were measured by sulforhodamine B(SRB) assay, 3H-thymidine and 3H-proline incorporation respectively. The results were as follows: 1. In the experiment about the effect of the conditioned medium on the fibroblast activity, the experimental group(SCM), compared with the control group(NCM), showed a significant increase of the cell growth (p<0.01), a significant decrease of DNA synthesis(p<0.001), but no significant difference in the collagen synthesis. 2. In the experiment about the effect of polyclonal rabbit anti-mouse TNF-alpha antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.01), but no significant difference in the collagen syn thesis. 3. In the experiment about the effect of polyclonal rat anti-mouse IL-6 antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.0001), but no significant difference in the collagen synthesis. In conclusion, culture supernatants (conditioned medium) of peritoneal macrophages, activated by silicone gel, stimulate the NIH 3T3 fibroblast proliferation. TNF-alpha and IL-6, products of macrophage, are involved in the stimulation of NIH 3T3 fibroblast proliferation in an in vitro condition.
Animals ; Arthritis ; Breast Implants ; Collagen ; Contracture ; Culture Media, Conditioned ; DNA ; Fibroblasts* ; Interleukin-6* ; Macrophages ; Macrophages, Peritoneal* ; Mice ; Monokines ; Necrosis ; Rats ; Scleroderma, Systemic ; Silicone Gels* ; Tumor Necrosis Factor-alpha*

Preoperative and postoperative echocardiography were performed in 33 patients with isolated ostium secondum atial septal defect(ASD), confirmed by right heart catheterization and operation at Seoul National University Hospital from November 1980 to June 1982. The ratio of right ventricular enddiastolic dimension to leftventricular enddiastolic dimension(RVED/LVED) was compared to the pattern of interventricular septum, before and after operation. In patients with persistent paradoxical septal motion during 2wks after operation, repeated echocardiograms were performed upto 9 months, postoperatively. The results obtained are as follows: 1) The ratio of RVED/LVED in patients with ASD, was 0.95+/-0.35(mean+/-standard deviation), which was significantly larger than that of 14 normal subjects(p<0.005). 2) There was statistically correlation between the ratio of pulmonary blood flow to systemic blood flow(QP/QS) and the ratio of RVED/LVED(r=0.44, p<0.025). 3) Thirty three patients were divided into 3 groups according to the pattern of intervent ricular septal motion.(Group "M": Patients with normal septal motion, Group "B": Patients with paradoxical type B septal motion, Group "A": Patients with paradoxical type A septal motion) Preoperatively, the ratio of RVED/LVED was 0.68+/-0.28 in Group "N" (N=9), and 0.88+/-0.23 in Group B (N=9) and 1.14+/-0.34 io Group "A" (N=15). In Group "A, the ratio of RVED/LVED was significantly larger than of Group "N" (p<0.005). Postoperatively, the ratio of RVED/LVED was 0.51+/-0.13 in Group "N" (n=23), and 0.68+/-0.15 in Group "B" (n=7), and 0.79+/-0.14 in Grop "A" (n=3). In Group "A" and Group "B, the ratio of RVED/LVED was significantly larger than that of Group "N" (p<0.005, p<0.01). 4) Postoperative RVED index(18.9+/-4.9) was significantly decreased, compared with preoperative RVED index(27.6+/-8.9) (p<0.005). But there was no significant change in LVED index, before and after operation. 5) Among 10 patients with persistent paradoxical septal motion, repeated echocardiograms were performed in 5 patients. Interventricular septal motion was normalized in 4 out of 5 patients. Thus the ratio of RVED/LVED has significant correlation with QP/QS and the pattern of interventricular septal motion. These results suggest the evidence that interventricular septal motion is determined by septal position at enddiastiole.
Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Heart Septal Defects, Atrial* ; Humans ; Seoul

We report a case of coronary arteriovenous fistula in a female adult confirmed by aortography. The fistulous communication was between right coronary artery and right ventricle. This is the first case report of adult patient with coronary arteriovenous fistula in Korea.
Adult ; Aortography ; Arteriovenous Fistula* ; Coronary Vessels ; Female ; Heart Ventricles ; Humans ; Korea

The objective of this study was to evaluate the effect a chewable tablet containing sodium flouride and lauroyl sodium sulfate on removing plaque and inhibiting gingival inflammation. A randomized parallel study was designed. 100 voluteers participated in the study. There were two test groups each with 30 subject. Test group A was instructed to brush once in the morning, and to use the tablet once in the afternoon and once in the evening. Test group B was instructed to use the tablet three times a day without brushing. There were two control groups each with 20 subjects. Control group A was instructed to brush once in the morning only. Control group B was instructed not to brush all. Two weeks before the test period, the subjects received through tooth cleaning and polishing. At baseline, GI, PI, BOP, and GCF of the Ramfjord teeth were measured in all groups. Bacteria culture was done with the plaque sampled from tooth with the deepest pocket. After 5 days, clinical indices were measured and the bacterial culture was repeated. Control group B was dropped from the study after this period. All the other groups remained and the indices and the culture was repeated after 2 weeks, and 3weeks. Also whether the oral mucosa showed signs of irritation was monitored throughout the test period. Test group A showed less PI, GI, BOP, probing depth, GCF than test group B or control group A. Especially, PI and the BOP was significantly less than that of the group that was instructed to brush once a day. This implies that the added use of this tablet aids in plaque removal in people who brush just once a day. Test group A showed increase of cocci, decrease of motile rods, and decrease of spirochetes after 14-21 days. And this was significantly different from the control group A. At no time of the test period did any of the subjects show signs of irritation of the oral mucosa or adverse reactions. Following conclusions could be obtained from this study. This chewable tablet for enhanced oral hygiene could be used as an adjunct to oral hygiene in people who do not brush adequately. The use of this tablet decreased the number of subgingival bacteria, and this could be effective in plaque removal and for prevention of gingival inflammation.
Bacteria ; Dental Plaque ; Gingivitis ; Inflammation* ; Mouth Mucosa ; Oral Hygiene ; Periodontitis ; Sodium Fluoride* ; Sodium* ; Spirochaetales ; Tooth

PURPOSE: We conducted this study to compare the surface physical properties of four commercial preparations of artificial exogenous pulmonary surfactants in vitro which have been used in both the prevention and treatment of respiratory distress syndrome in newborn infants. METHODS: We tested four surfactants : a) Surfacten (Tokyo Tanabe, Japan) and Newfactan (Yuhan, Korea) : reconstituted bovine lung extract, b) Curosurf (Cheisi, Italy) : porcine lung mince; chloroform-methanol extract; liquid-gel chromatography, and c) Exosurf (Wellcome, USA), synthetic surfactant composed of colfosceril, palmitate, hexadecanol, and tyloxapol. We measured the surface adsorption rate, spreading rate, and surface tension(ST)-area diagram by using modified Wilhelmy balance and minimum(min-ST) and maximum ST(max-ST) by Pulsating Bubble Surfactometer. RESULTS: The adsorption rate of Surfacten is less than 30mN/m and those of Newfactan, Curosurf, and Exosurf are more than 30mN/m. The spreading rate of Surfaten and Newfactan are less than 30mN/m, and those of Curosurf and Exosurf are more than 30mN/m. The min-ST of Surfacten and Newfacten are less than 10mN/m, and those of Curosurf and Exosurf are more than 10mN/m. According to high performance of surface physical activities, which are compared with in vitro criteria of effective artificial surfactant, they are as follows; Surfacten>Newfactan>Curosurf>Exosurf. CONCLUSION: There are some differences between the surface physical properties of the four surfactant preparations. The natural surfactants appear to be superior to synthetic surfactant in vitro. Among the natural surfactants, Surfacten showed the best surface physical activities of spreading, adsorption and ST-lowering properties.
Adsorption ; Chromatography ; Humans ; Infant, Newborn ; Lung ; Motor Activity ; Pulmonary Surfactants* ; Surface-Active Agents

PURPOSE: To produce a new generation of artificial pulmonary surfactant(PS), surfactant protein (SP)-B from human PSwas isolated, and the amino acid sequences of these proteins were studied. Artificial peptides of human SP-B were synthesized. New artificial PS preparations which were cornposed of phospholopids and two artificial synthetic SP-B peptides were made, and the surface physical properties of these new PS preparations were tested. METHODS: The purities of SP-B were assessed by SDS-polyacrylamide gel and the amino acid sequences of these proteins were determined. We synthetized two peptides SP-1 and SP-2 and the amino acid sequences were as follows,' SP-1: RMLPQLVCRLVLRCSMD, SP-2: RMLP- QLVCRLVLRCSM. Surface physical properties of newly artificial PSs, which were composed of a mixture of phospholipid(PL) and SP-1 or SP-2(sample A; PL+SP-1, sample B; PL+SP-2), were measured by surface spreading, adsorption rate, and surface tension-area diagram. RESULTS: The amino acid sequence of human SP-B was obtained. We produced the artificial peptides of SP-B and prepared the new generation PS(sample A and sample B). The order of the superiority of spreading and adsorption rate was Surfacten Absorption ; Adsorption ; Amino Acid Sequence ; Humans ; Peptides* ; Pulmonary Surfactants

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Perfusion*

Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia caused by insulin autoantibodies in the absence of exogenous insulin administration. Some drugs containing sulfhydryl compounds are known to initiate the onset of IAS. A 67-year-old female who had diabetes for 5 years visited the outpatient clinic at our institution due to diabetic peripheral polyneuropathy. She was prescribed alpha-lipoic acid (ALA), which contains two sulfur atoms. Two weeks later, she complained of recurrent hypoglycemic symptoms. We detected a high level of insulin and high titers of insulin autoantibodies. Her human leukocyte antigen (HLA) genotype included the DRB1*0406 allele, which indicates a high level of susceptibility to IAS. She was treated with prednisolone. After this episode, she experienced two more hypoglycemic events after taking ALA for diabetic neuropathy in other hospitals. As ALA can be used to treat diabetic peripheral polyneuropathy, physician discretion is advised based on the possibility of IAS due to ALA in diabetic patients.
Aged ; Alleles ; Ambulatory Care Facilities ; Autoantibodies ; Diabetic Neuropathies ; Female ; Genotype ; Humans ; Hypoglycemia ; Insulin Antibodies ; Insulin* ; Leukocytes ; Polyneuropathies ; Prednisolone ; Sulfhydryl Compounds ; Sulfur ; Thioctic Acid*

Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia caused by insulin autoantibodies in the absence of exogenous insulin administration. Some drugs containing sulfhydryl compounds are known to initiate the onset of IAS. A 67-year-old female who had diabetes for 5 years visited the outpatient clinic at our institution due to diabetic peripheral polyneuropathy. She was prescribed alpha-lipoic acid (ALA), which contains two sulfur atoms. Two weeks later, she complained of recurrent hypoglycemic symptoms. We detected a high level of insulin and high titers of insulin autoantibodies. Her human leukocyte antigen (HLA) genotype included the DRB1*0406 allele, which indicates a high level of susceptibility to IAS. She was treated with prednisolone. After this episode, she experienced two more hypoglycemic events after taking ALA for diabetic neuropathy in other hospitals. As ALA can be used to treat diabetic peripheral polyneuropathy, physician discretion is advised based on the possibility of IAS due to ALA in diabetic patients.
Aged ; Alleles ; Ambulatory Care Facilities ; Autoantibodies ; Diabetic Neuropathies ; Female ; Genotype ; Humans ; Hypoglycemia ; Insulin Antibodies ; Insulin* ; Leukocytes ; Polyneuropathies ; Prednisolone ; Sulfhydryl Compounds ; Sulfur ; Thioctic Acid*

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas has been recently reported. It is very rare, therefore clinical behavior and prognosis has not yet been characterized. We experienced a case of ITPN of the pancreas which presented with acute pancreatitis and treated with Whipple's operation. Histopathologic finding showed papillary hyperplasia with carcinomatous change. The tumor recurred after 47 month of operation, and she underwent total pancreatectomy. Pathologic finding revealed tubulopapillary growth with high grade dysplasia. Immunohistochemial staining was not performed, however gross and microscopic findings were compatible with ITPN of the pancreas. We report a case of ITPN of the pancreas.
Hyperplasia ; Pancreas* ; Pancreatectomy ; Pancreatitis* ; Prognosis