BACKGROUND: Since the exact pathogenesis of sepsis-induced ARDS has not been elucidated, the mechanisms of enhanced neutrophilic respiratory burst were probed in endotoxin primed neutrophils associated with the roles of phospholipase A2 (PLA2), platelet activating factor (PAF) and apoptosis. METHODS: In isolated fresh human neutrophils, effects of the inhibition of PLA2 and PAF on the apoptosis were examined by the method of Annexin-FITC/dual PI flow cytometry. The roles of PLA2 and PAF on the neutrophilic respiratory burst were also examined by measuring oxidant generation in cytochrome-c reduction assay. Activities of the PLA2 and lysoPAF acetyltransferase (lysoPAF AT) of the neutrophils were determined to understand the effect of endotoxin on these enzymatic activities which may be related to the neutrophilic respiratory burst and apoptosis. In addition, the role roles of PLA2 and PAF in neutrophilic adhesion to bovine endothelial cells were examined in vitro by neutrophil adhesion assay. To investigate the effect of oxidants on pulmonary surfactant, cytochemical ultrastructural microscopy was performed. To inhibit PLA2 and PAF, non-specific PLA2 inhibitor mepacrine (100 nM) and WEB 2086 (100 nM) or ketotifen fumarate (10 kg/ml) were used respectively in all in vitro experimental sets. WEB 2086 is PAF receptor antagonist, and ketotifen fumarate is a lyso PAF AT inhibitor. RESULTS: The mapacrine treatment, provided after the endotoxin (ETX) treatment, resulted in increased apoptosis of neutrophils (p<0.001) while treatments of WEB 2086 and ketotifen did not. The inhibition of PLA2 and PAF decreased (p<0.001) production of oxidants from PMA-stimulated neutrophils. While endotoxin increased the PLA2 activity of neutrophils (p<0.01), mepacrine supressed (p<0.001) the activity, provided after treatment of ETX. The lyso PAF actyltransferase activity (lyso PAF AT) increased(p<0.01) after treatment of ETX. In contrast, mepacrine, WEB 2086 and ketotifen showed a tendency of decreasing the activity after treatment of ETX. The Treatment of ETX increased (p<0.001) neutrophil adhesion to endothelial cells, which was reversed by inhibition of PLA2 and PAF (p<0.001). The binding of oxidants to pulmonary surfactant was identified histologically. CONCLUSIONS: The enhanced neutrophilic respiratory burst by ETX plays a pivotal role in the pathogenesis of ARDS in term of oxidayive oxidative stress. Increased production of oxidants form neutrophils is mediated by the activations of PLA2 and lyso PAF AT.
Apoptosis* ; Endothelial Cells ; Flow Cytometry ; Humans ; Ketotifen ; Microscopy ; Neutrophils* ; Oxidants ; Oxidative Stress ; Phospholipases A2 ; Platelet Activating Factor ; Pulmonary Surfactants ; Quinacrine ; Respiratory Burst*

This is to report a case of the homogeneous transplantation of the single articular surface and its supporting bone of the proximal one third of the humerus and humeral head for the treatment of the giant cell tumor involving the proximal humerus.
Giant Cell Tumors ; Humeral Head ; Humerus

Diastematomyelia is an uncommon congenital malformation of the vertebral axis characterized by a localized longitudinal separation of the spinal cord with an interposed septum. It may be found in association with congenital scoliosis. The Authors experienced a case of congenital scoliosis with diastematomyelia. Diastematomyelia was surgicallv resected and scoliosis was corrected by Dwyer operation 5 months later. The results of both operations were satisfactory in 10 months follow up.
Follow-Up Studies ; Neural Tube Defects ; Scoliosis ; Spinal Cord

Two hundred and eighty six cases of the fracture of the tibial shaft treated at Orthopedic Department of the Chosun University Hospital during the period from January 1974 to December, 1978. The following results were obtained. 1. Most common cases of the tibial shaft fractures were traffic accidents (66.1%). 2. The incidence of trauma was high in the young man, most frequent in the 2nd and 3rd decade (43.0%). 3. The evaluation was done according to the classification of Ellis. Among 286 cases of the fractures of tibial shaft, 139 being mild severity, 70 moderate severity and 77 major severity. 4. The group of mild severity at the fracture of upper 1/3 of tibial shaft was shown the best prognosis and the average healing period was 9.3 weeks. 5. The wound infections in the open fractures of tibial shaft were revealed 37 cases (35%) and 8 cases of chronic osteomyelitis (8%). 6. Of 54 cases, we experienced 38 cases of delayed union (13.3%), 16 cases of non-union (5.6%) and the highest rate of delayed or non-union was shown in the group of major severity at the fracture of lower 1/3 of tibiai shaft. 7. The open reduction by the compression plating reduced the time of healing period and delayed the time of healing period by the intramedullary nailing.
Accidents, Traffic ; Classification ; Fracture Fixation, Intramedullary ; Fractures, Open ; Incidence ; Orthopedics ; Osteomyelitis ; Prognosis ; Wound Infection

LPS and IFN-r induce nitric oxide synthase in macrophages and the resultant NO causes apoptotic cell death in the activated macrophages. NO production and apoptosis were inhibited by N-monomethyl L-arginine (NMMA), a competitive inhibitor of NO synthase. To study the role of BCL-X proteins, RAW 264.7 cells were transfected with the expression vectors with human bcl-Xl or bcl-Xs cDNAs, respectively. Stable transfectants were selected and confirmed by RT-PCR. NO production in response to LPS and IFN-r caused apoptosis in RAW 264.7 cells and vector transfected control cells within 24 hr. Both NO production and apoptosis were inhibited by N(G)-monomethyl L-arginine (NMMA). In contrast, bcl-Xs transfectant appeared slightly susceptible and bcl-X(L)< transfectant appeared slightly resistant, although NO production was similar to control cells. These results suggest that bcl-X proteins play roles in both positive and negative regulation of apoptosis induced by NO.
Apoptosis* ; Arginine ; bcl-X Protein* ; Cell Death ; DNA, Complementary ; Humans ; Macrophages* ; Nitric Oxide ; Nitric Oxide Synthase

BACKGROUNDs: A retrospective study was performed to define objective radiologic parameters in diagnosing epiglottitis on soft-tissue lateral neck radiographic study. METHODS: Parameters of soft-tissue structures(epiglottis width, third vertebral body width, ratio of epiglottic width to third vertebral body width) in 30 adult patients compared with those of age and sex-matched controls with foreign body in throat whose radiographic reading was normal. RESULTS: Epiglottis width of more than 11mm, ratio of epiglottis width(EW) to the third vertebral body width(C3W) of more than 0.5 were, respectively, found to be 100% sensitive and specific in differentiating between patients with and without epiglottitis. CONCLUSION: These preliminary results suggest that EW/C3W ratio of more than 0.5, EW of more than 11mm, respectively, may be useful in the diagnosis of epiglottitis in adult patients.
Adult* ; Diagnosis* ; Epiglottis ; Epiglottitis* ; Foreign Bodies ; Humans ; Neck ; Pharynx ; Retrospective Studies

No abstract available.
Animals ; Guinea Pigs* ; Guinea* ; Perilymph*

In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*

The association of contiguous or "collision" tumors in the same biopsy specimen is uncommon, but often reported in foreign literature. Although some of these associations may arise from the involvement of related cell types, most are fortuitous. There are two or more common lesions juxtaposed by coincidence. The most commonly malignant association, basal cell carcinoma and melanoma, is very difficult to diagnose clinically. In this report, we describe a 80-year-old woman with squamous cell carcinoma and lentigo maligna arising at the same site on the left cheek. To the best of our knowledge, this is the first report of collision tumor comprising squamous cell carcinoma and lentigo maligna in Korean dermatological literature.
Aged, 80 and over ; Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Cheek ; Female ; Humans ; Hutchinson's Melanotic Freckle* ; Lentigo* ; Melanoma

Immediate reconstruction of a breast after a curative mastectomy is a good alternative to a breast conserving operation and can be accomplished without altering the cancer-ablative purpose. The transversus rectus abdominis myocutaneous(TRAM) flap has proven to be the most useful autogenous tissue for restoring a breast. We evaluated 14 cases of breast cancer in which the patient underwent immediate TRAM flap reconstruction by the same surgeons who had performed the curative mastectomy. Immediate TRAM reconstruction was performed safely in all stages of breast cancer, although the majority of the patients were in stage 2. Partial necrosis of the myocutaneous flap(1 case), partial necrosis of the breast skin(1 case), hematoma(2 cases), and wound infection(1 case) developed as postoperative complications and were controlled by conservative management. Postoperative chemotherapy and chemoradiation therapy were performed in 7 cases and 4 cases, respectively, without any discernible adverse influence on the myocutaneous flap. The majority of the patients were satisfied with the reconstructed breast. Based on these results, we suggest that immediate breast reconstruction using the pedicled TRAM flap can be accomplished by the surgeon who performed the mastectomy: and will enhance cosmetic appearance without any adverse impact on curabilitly.
Breast Neoplasms ; Breast* ; Drug Therapy ; Female ; Humans ; Mammaplasty* ; Mastectomy* ; Myocutaneous Flap ; Necrosis ; Postoperative Complications ; Rectus Abdominis ; Wounds and Injuries