We report a case of dedifferentiated liposarcoma of retroperitoneum as a recurrent form in a 41 year old male. The patient received a extirpation for retroperitoneal mass and diagnosed as myxoid liosarcoma 4 years ago. The patient experienced 3 recurrences over a period of 4 years and diagnosed as myxoid liposarcoma in the second, third recurrence also. Histologically, the mass was composed of several clearly distinct elements : well differentiated liposarcoma, myxoid liposarcoma, myxoid malignant fibrous histiocytoma, poorly differntiated sarcoma, and fibrosarcoma. Immunohistochemically, S-100 protein was expressed in the area of spindle cell sarcoma, well differentiated liposarcoma, and malignant fibrous histiocytoma but alpha-1-antichymotrypsin was only expressed in the area of myxoid malignant fibrous histiocytoma.

No abstract available.
Broad Ligament* ; Female ; Leiomyoma* ; Leiomyosarcoma*

In addition to the central and the peripheral nervous system, calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) has been identified throughout the enteric nervous system. Several functions of the CGRP in gastrointestinal (G-I) tract has been identified, but the effect of CGRP on G-I motility is unclear. The distribution of calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) in the murine small bowel were studied by using immunohistochemistry, also analyzed functionally by using electrophysiological method. Immunohistochemical studies demonstrated that CGRP-LI is localized in both nerve fibers and myenteric ganglion cells in the whole-mount preparation of murine small intestine. Double labelling with CGRP and c-kit investigated by confocal microscope was shown that CGRP-LI enteric nerve fiber surrounded the c-kit positive interstitial cells of Cajal (ICC). Electrophysiological finding revealed that treatment of CGRP inhibited electrical activity on culture ICC. Our results suggest a CGRP innervation of murine small bowel ICC. The released CGRP from enteric nerve terminals may induce relaxation of small bowel through the inhibition of ICC.
Animals ; Calcitonin Gene-Related Peptide* ; Calcitonin* ; Enteric Nervous System ; Ganglion Cysts ; Immunohistochemistry ; Interstitial Cells of Cajal ; Intestine, Small* ; Mice ; Nerve Fibers ; Peripheral Nervous System ; Relaxation

PURPOSE: To determine the MR imaging findings of spinal cord decompression sickness. MATERIALS AND METHODS: We retrospectively analysed the spinal MR images of eight patients (M : 6, F : 2) with decompression sickness affecting the cervical spine (n=1) or thoracic spine (n=7). The observed extent, location, continuity, signal intensity and contrast enhancement pattern of spinal cord lesions were analysed. RESULTS: The chief MR finding was continuous (n=2) or non-continuous (n=3) high signal intensity on T2-weighted images in the posterior paramedian spinal cord. In three cases, additional T2 signal abnormality in the ventral horn of the gray matter was observed. There was no signal intensity abnormality on T1- weighted images or abnormal enhancement on post-Gadolinium T1-weighted images. In one case, cord swelling in addition to T2 signal abnormality was observed. CONCLUSION: MR imaging is useful for evaluating spinal cord lesions in patients with decompression sickness.
Animals ; Decompression Sickness* ; Decompression* ; Horns ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Cord* ; Spine

In order to find out the relationship between arachidonic acid(AA) metabolites and the development of vasospasm following a subarachnoid hemorrhage(SAH), we evaluated the cerebrospinal fluid(CSF) levels of the two main AA metabolites, prostacyclin(PGI2) and thromboxane A2(TXAZ) by measuring their stable degredation products 6-keto-prostaglandin F1alpha(PGF1) and thromboxane B2(TXB2) using radioimmunoassay methods in 32 patients after an aneurysmal rupture and in 11 patients without an aneurysmal rupture as a control group. We compared the data between aneurysmal ruptured patients and control group patients. We also divided the data of the aneurysmal ruptured patients into 3 groups checking them between 1-4, 5-11, and 12-28 days after the SAH, and compared the data among the groups, then the data was also compared between non-vasospasm and clinical or severe angiographic vasospasm groups of patients. The results showed that the AA metabolism was enhanced after the SAH, The TXB2 increased the greatest amount in 1-4 days after the SAH and significantly decreased statistically 12 days after the SAH(p<0.002). This study also showed that the TXB2 level was significantly higher statistically in 1 to 4 days in the clinical or angiogrophically severe vasospasm group than in the non-vasospasm group of patients(p<0.032). PGF1 did not show any statistically significant changes according to the number of SAH days or a difference between the vasospasm and non-vasospasm groups. This result suggests if the AA metabolites are involved in the pathogenesis of cerebral vasospasm, and the lumbar CSF levels of AA metabolites in aneurysmal patients reflect the arterial synthesis of PGI2 and platelet origin of TXA2, the elevation of TXA2 or other vasoconstrictor prostaglandins is more likely to play a major role in the pathogenesis of vasospasm than PGI2 deficiency. The measurements of the CSF TXB2 in 1 to 4 days after a SAH may have an expectant value in the development of clinical or severe angiographic vasospasm(exclude the accompanying intraventricular hemorrhage patients).
Aneurysm* ; Arachidonic Acid ; Blood Platelets ; Cerebrospinal Fluid* ; Epoprostenol ; Hemorrhage ; Humans ; Metabolism ; Prostaglandins I ; Radioimmunoassay ; Rupture ; Subarachnoid Hemorrhage* ; Thromboxane A2 ; Thromboxane B2* ; Vasospasm, Intracranial

We report a case of accidental intrathecal administration of Nucomyt(R)(acetylcysteine), a mucolytic agent used for intratracheal instillation. A 21-year-old healthy female with a complete syndactyly at the 4th and 5th toes was scheduled for a web release under spinal anesthesia. Immediately after accidental intrathecal administration of Nucomyt(R)2.4 ml instead of bupivacaine for spinal anesthesia, tonic extension developed at first in the lower extremities and then the upper extremities, too. Thiopental sodium 200 mg was injected intravenously twice. Endotracheal general anesthesia with N2O- enflurane-vecuronium was maintained for the operation for about two hours. For about 1 hour after emergence of general anesthesia, tonic extension intermittently developed in the lower extremities and was controlled with midazolam. Mild elevated blood pressure, tachycardia, tachypnea, high fever (up to 38.5degrees C) and respiratory acidosis occurred. Thirty minutes later, she became mentally clear with a normal neurologic examination. No delayed sequelae were detectable at a follow-up visit 1 month and 1 year after surgery.
Acetylcysteine* ; Acidosis, Respiratory ; Anesthesia, General ; Anesthesia, Spinal ; Blood Pressure ; Bupivacaine ; Female ; Fever ; Follow-Up Studies ; Humans ; Lower Extremity ; Midazolam ; Neurologic Examination ; Syndactyly ; Tachycardia ; Tachypnea ; Thiopental ; Toes ; Upper Extremity ; Young Adult

Interstitial cells of Cajal (ICC) are the pacemalkers in gastrointestinal muscles, and these cells also mediate or transduce inputs from the enteric nervoius system. Immunolabelling of interstitial cells of ICC in intestinal wall is recently developed by using specific marker, anti-c-kit antibody. Immunohistochemistry was done for c-Kit-positive ICC network in attempt to provide a morphological basis for the mechanism regulating gastro-intestinal movement. Cryosection and whole-mount preparations of mouse ileum and colon were immunolabelled using the anti-c-Kit. Immunolabelled specimens were observed under a confocal laser scanning microscopy. According to three dimensional reconstruction study, it was found that the c-Kit-positive cells were widely distributed in the intestinal wall: (1) circular muscle layer, (2) myenteric plexus, (3) deep muscular plexus in ileum, (4) submucosal plexus and longitudinal muscle layer in colon. The characteristic profiles of ICC containing c-Kit-positive cells provide a morphological basis upon the mechanism regulating gastro-intestinal motility.
Animals ; Colon ; Ileum ; Immunohistochemistry ; Interstitial Cells of Cajal* ; Intestines* ; Mice* ; Microscopy, Confocal ; Muscles ; Myenteric Plexus ; Submucous Plexus

BACKGROUND: It has been known that the sero- logic markers of infectivity and viral replication in patients with hepatitis B virus(HBV) infection are hepatitis B e antigen(HBeAg), HRV DNA and HBV DNA polymerase. METHODS: In order to clarify the relationship between chronic liver diseases and HBV infection, and the mechanism of chronicity in HBV related liver diseases, the expression patterns of hepatic HBeAg by imrnunohistochemical stain and histologic activity index(HAI) were studied from 10% formalin fixed paraffin embedded tissues in 114 patients performed liver biopsy. RESULTS: The results were as follows: 1) Incidence of serum HReAg positivity in HBsAg positive patients was 74.6% and that of hepatic HBeAg expression was 77.6% among serum HBeAg positive cases. Hepatic HBeAg expression was 72.4% in serum HBeAg negative cases. 2) In serum HBeAg positive cases, almost all infected hepatocytes exhibited cytoplasmic HBeAg expression and half of patients showed nuclear HBeAg expression, but cytoplasmic HBeAg expression was solely predominant in serum HBeAg negative cases. Hepatic HBeAg expression showed a decreasing trend from AVH and CPH, through CAH, to cirrhosis with or without HCC, which was a consistent finding with serum HBeAg in decreasing manner. Hepatic HBeAg expreassion was highly sustained in about 60-90% of cases, regardless of duration of their illnesses. 3) HAI showed slighf3y higher tendency in patients with hepatic HBeAg negative expression than in positive cases. CONCLUSION: The above results suggest that HBeAg may play a role as a viral target antigen for immune-mediated liver injury and may be also related to the pathogenetic mechanism of chronicity in chronic hepatitis B.
Biopsy ; Cytoplasm ; DNA ; Fibrosis ; Formaldehyde ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Hepatocytes ; Humans ; Incidence ; Liver ; Liver Diseases ; Logic ; Paraffin

Choanal atresia is a rare congenital anomaly involving unilateral or bilateral posterior nasal choanal obstruction. Multiple associated anomalies have been described. We describe the case of a 1-month-old boy with bilateral choanal atresia, misdiagnosed after CT as a midline meningocele because the floor of the midline anterior cranial fossa was not ossified and secretion had accumulated in the obstructed posterior nasal choana.
Choanal Atresia* ; Cranial Fossa, Anterior ; Diagnosis* ; Humans ; Infant, Newborn ; Male ; Meningocele

OBJECTIVES:Nitric Oxide(NO) is a toxic, inorganic, gaseous free radical produced during the metabolism of L-Arginine by NO synthase(NOS). It has been implicated in a rapidly growing number of physiological and pathophysiological processes such as cytotoxic effects against microbes and tumor cells, blood vessel dilation and neurotransmitter. Recently there is growing evidence implicating NO in immune regulation, inflammation, autoimmunity, and arthritis. We performed this study to determine a role for nitric oxide in inflammatory arthritis especially rheumatoid arthritis(RA). METHODS: We measured (1) the concentrations of nitrite, a breakdown product of nitric oxide, in serum and synovial fluid from patients with RA and osteoarthritis(OA) and in the serum of controls (2) the concentrations of nitrite in the supernatant of cultured synovial tissue with RA and OA and (3) determined whether human chondrocytes and synoviocytes can synthesize nitric oxide and if so, how production is regulated by cytokines and antirheumatic drugs. RESULTS: 1) Serum nitrite concentrations in patients with RA and OA were higher than in controls. In both disease groups synovial fluid nitrite was higher than serum nitrite. Serum and synovial fluid nitrite concenrations in RA were higher than those in OA. However, those findings are not statistically significant. 2) Although these findings are not statistically significant, the concentration of nitrite in the supernatant of cultured synavial tissue with RA was higher than that in OA. 3) IL-1beta and TNF-alpah induced the biosynthesis of NO by chondrocytes and synoviocytes. IGF-1 and TGF-beta failed to provoke the production of NO. The biosynthesis of NO required an induction period of approximately 6 hours and was inhibited by L-NMMA and cycloheximide. Dexamethasone, indomethacin, gold sodium thiomalate and methotrexate had no effect on the induction of NO biosynthesis. CONCLUSION: These results suggest a role for nitric oxide as an inflommatory mediator in inflammatory arthritis.
Antirheumatic Agents ; Arginine ; Arthritis* ; Arthritis, Rheumatoid ; Autoimmunity ; Blood Cells ; Chondrocytes ; Cycloheximide ; Cytokines ; Dexamethasone ; Gold Sodium Thiomalate ; Humans ; Indomethacin ; Inflammation ; Insulin-Like Growth Factor I ; Metabolism ; Methotrexate ; Neurotransmitter Agents ; Nitric Oxide ; omega-N-Methylarginine ; Synovial Fluid ; Transforming Growth Factor beta