OBJECTIVE: To evaluate the autonomic nervous system function in chronic renal failure patients compared to normal control and to assess the effect of dialysis method and underlying diseases such as diabetes mellitus and hypertension, on autonomic nervous system function in chronic renal failure patients. METHOD: We checked palm and sole skin temperature with digital thermometer, sympathetic skin responses and heart rate variability in chronic renal failure patients (77 persons) and normal control group (77 persons). RESULTS: The amplitude of sympathetic skin response (SSR) and heart rate variability (RRIV) of patients group showed statistically significant difference compared to control group (p<0.05). The diabetic patient group with chronic renal failure showed prolonged latency of SSR in sole but significant differences were shown in amplitude and RRIV (p<0.05). The hypertensive group with chronic renal failure showed prolonged latency of SSR in both palm and sole (p<0.05) but the amplitude and RRIV of those didn,t show statistical difference (p>0.05). CRF without diabetes mellitus and hypertension showed significant difference on amplitude of SSR and RRIV (p<0.05) but autonomic nervous system function tests showed no difference (p>0.05) between hemodialysis and peritoneal dialysis groups. CONCLUSION: SSR test and RRIV could be valuable measure to evaluate autonomic nervous system functions in the patients with chronic renal failure.
Autonomic Nervous System* ; Diabetes Mellitus ; Dialysis ; Heart Rate ; Humans ; Hypertension ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Renal Dialysis ; Skin ; Skin Temperature ; Thermometers

BACKGROUND: The relation of initial depression and weight loss in a low calorie diet(LCD) alone or exercise combination in Korean wamen, was considered and change of emotional state after program was determined in this study. METHODS: Sixty obese females were randomly prescribed a LCD(low calorie diet) alone or a LCD with exercise. Thirty obese females were treated with a LCD of 1,000kcal/d for 8weeks(group A). Another thirtyt obese females were treated with a LCD of 1,000kcal/d combined with supervised aerobic exercise for 8 weeks(group B). Questionnaires including Korean-translated Beck Depression Inventory(BDI), Korean- translated Brief Encounter Psychosocial Instrument(BEPSI) were reported before and after 8weeks fo this study. RESULTS: 21 out of 30 obese females in group A and 25 out of 30 obese females in group B completed the study. At the eighth week, mean weight loss was 5.7+/-2.2kg(8.0%) in group A, and 6.8+/-1.7kg(9.5%) in group B. Depression were decreased after program(decreased BDI score in combined group(6.86+/-6.31: p = 0.0001), group A(5.79+/-4.06:p=0.0001) and group B(7.68+/-7.58:p=0.0001), but no statistically significant difference between group A and B was noted(p=0.3309). Initial BDI score was negatively correlated with the percent of weight loss in group A(r =-0.659: p=0.0012). But initial BDI score was not correlated with the percent of weight loss in group B(r =0.099: p=0.637). In group A and B, the percent of weight loss was not correlated with change of BDI score. In group A and B, the change of BDI score was positively correlated with the initial BDI score(group A;r=0.504:p=0.028, group B;r=0.762:p=0.0001). CONCLUSIONS: Regardless of the exercise combination, LCD therapy seemed to decrease diepression. The degree of weight loss was negatively correlated with initial degree of depression. this negative correlation can be compensated by planned thorough exercise.
Caloric Restriction* ; Depression* ; Exercise ; Female ; Humans ; Weight Loss* ; Surveys and Questionnaires

A 24-year-old man was admitted due to an incidentally detected mass in his left testis, which showed radiopaque calcification on plain X-ray film. Left orchiectomy was performed, and the resected testis contained a well-demarcated, hard mass measuring 1.1 cm. Histological analysis revealed that the tumor was composed of neoplastic cells, fibrotic stroma, and laminated or irregularly shaped calcific bodies. The individual cells had abundant eosinophilic or clear cytoplasm with round nuclei, each of which contained one or two conspicuous nucleoli. They were arranged in cords, trabeculae, clusters, and diffuse sheets. There were several foci of intra-tubular growth patterns, with thickening of the basal lamina. Immunohistochemically, the neoplastic cells were positive for S-100 protein and vimentin, focally positive for inhibin alpha, and negative for cytokeratin, CD10, and Melan-A. In addition to reporting this rare case, we also review the relevant literature regarding large cell calcifying Sertoli cell tumors.
Basement Membrane ; Cytoplasm ; Eosinophils ; Humans ; Immunohistochemistry ; Inhibins ; Keratins ; MART-1 Antigen ; Orchiectomy ; S100 Proteins ; Sertoli Cell Tumor* ; Testis* ; Vimentin ; X-Ray Film ; Young Adult

No abstract available.
Anesthesia, Spinal* ; Cesarean Section* ; Emergencies* ; Female ; Humans ; Neurofibromatosis 1* ; Pre-Eclampsia* ; Pregnancy

Myoepitheliomas are well-established to occur in the salivary glands, but they have also been described in the breast, upper aerodigestive tract, skin, and soft tissues. We report here on a unique case of primary myoepithelioma that occurred in the right testis of a 28-year-old man. The tumor was entirely confined to the testis and it was clearly separated from the epididymis. Histopathology revealed mixed architectural patterns in which the reticular areas merged into the chondromyxoid stroma. The tumor cells, which were focally immunoreactive to pancytokeratin and S-100 protein, were round to ovoid and spindly arranged in cords, strands, and fascicles. They showed mild nuclear pleomorphism, sparse mitotic figures and a low Ki-67 proliferative index. There was no ductal differentiation in the tumor. To the best of our knowledge, there has been only one case report of a primary testicular myoepithelioma in the English medical literature.
Adult ; Breast ; Epididymis ; Humans ; Male ; Myoepithelioma ; S100 Proteins ; Salivary Glands ; Skin ; Testis

PURPOSE: Proangiogenic and antiangiogenic growth factors are related to control of cancer progression and metastasis. The expression of Factor VIII-Related antigen in liver, that is marker of the vascular endothelial cell antigen, may be an indicator of neovascularization. This study aimed to monitor the change of plasma and tissue levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and endostatin in rat liver carcinogenesis and to determine the possibility of the future predictive indicator and antiangiogenic therapy application. METHODS: Sprague-Dawley Rats received 120 ppm concentration diethylnitrosamine (DEN) in drinking water as a carcinogen and in control and experimental groups, sequentially sacrificed by three and seven rats at 3, 6, 9, 12, 15 and 18 weeks, respectively. The liver tissue was examined with light microscopy, immunohistochemistry and enzyme immunoassay method. RESULTS: In hepatocarcinogenesis, the preneoplastic nodules appeared at 6 weeks after oral 120 ppm concentration DEN administration. The hepatocellular carcinomas and their pulmonary metastatic foci developed at 15 weeks and 18 weeks, respectively. The immunohistochemical staining of Factor VIII-Related antigen was negative in all sinusoids in normal control livers, but focal or scattered expression in preneoplastic nodules and diffuse expression were found in hepatocellular carcinomas. The tissue levels of VEGF and bFGF were found to have a direct correlation with the plasma levels, but not endostatin. The levels of VEGF and bFGF increased slightly in preneoplastic nodules and markedly elevated in hepatocellular carcinoma. However, there was no significant difference between the levels of VEGF and bFGF and the state of metastasis. There was no significant relation between the levels of endostatin and carcinogenesis and progression of the rat liver. CONCLUSION: From the above results, it could be suggested that VEGF and bFGF may play an important role in initiation and progression of hepatocellular carcinomas in rat liver, but not endostatin. Also, there was no correlation between the levels of VEGF and bFGF and the state of metastasis. Therefore, further study to determine the relationship between the angiogenic regulators and its receptors will serve as a promising research in the predictive indicator and antiangiogenic therapy.
Animals ; Carcinogenesis ; Carcinoma, Hepatocellular ; Diethylnitrosamine ; Drinking Water ; Endostatins* ; Endothelial Cells ; Fibroblast Growth Factor 2 ; Immunoenzyme Techniques ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Liver* ; Microscopy ; Neoplasm Metastasis ; Plasma* ; Rats* ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A* ; von Willebrand Factor

Since patients with intracranial neoplasms usually represent their neurological symptoms rather early in the course of the disease, sudden unexpected death due to intracranial neoplasms is an uncommon event seen only exceptionally in medicolegal autopsy practice. Although meningiom is one of the most common primary intracranial neoplasms, sudden death due to the tumor is an uncommon event. We report a sudden, unexpected death of a 56-year-old female with an undiagnosed olfactory groove meningioma. It is assumed that peritumoral edema is related to the sudden death among the several mechanisms.
Female ; Humans

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Although advances have been made in the treatment of MS, such as the use of IFN-β, glucocorticoids and stem cells, the therapeutic effects of these treatments are not sufficient. In the present study, we evaluated whether the combination of methylprednisolone (MP) and human bone marrow-derived mesenchymal stem cells (BM-MSCs) could enhance the therapeutic effectiveness in experimental autoimmune encephalomyelitis (EAE), a model for MS. EAE was induced by immunizing C57BL/6 mice with myelin oligodendrocyte glycoprotein 35-55 (MOG 35-55). The immunized mice received an intraperitoneal injection of MP (20 mg/kg), an intravenous injection of BM-MSCs (1 × 10⁶ cells) or both on day 14 after immunization. Combination treatment significantly ameliorated the clinical symptoms, along with attenuating inflammatory infiltration and demyelination, compared to either treatment alone. Secretion of pro-inflammatory cytokines (IFN-γ, TNF-α, IL-17) was significantly reduced, and anti-inflammatory cytokines (IL-4, IL-10) was significantly increased by the combination treatment as compared to either treatment alone. Flow cytometry analysis of MOG-reactivated T cells in spleen showed that combination treatment reduced the number of CD4⁺CD45⁺ and CD8⁺ T cells, and increased the number of CD4⁺CD25⁺Foxp3⁺ regulatory T cells. Furthermore, combination treatment enhanced apoptosis in MOG-reactivated CD4⁺ T cells, a key cellular subset in MS pathogenesis. Combination treatment with MP and BM-MSCs provides a novel treatment protocol for enhancing therapeutic effects in MS.
Animals ; Apoptosis ; Central Nervous System ; Clinical Protocols ; Cytokines ; Demyelinating Diseases ; Encephalomyelitis, Autoimmune, Experimental* ; Flow Cytometry ; Glucocorticoids ; Humans* ; Immunization ; Injections, Intraperitoneal ; Injections, Intravenous ; Mesenchymal Stromal Cells* ; Methylprednisolone* ; Mice ; Multiple Sclerosis ; Myelin-Oligodendrocyte Glycoprotein ; Spleen ; Stem Cells ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Therapeutic Uses

Sudden manhood death syndrome (SMDS) is a disorder found in southeast Asia, particularly Thailand, Philippines and Japan, which causes sudden cardiac death during sleep. In Korea, SMDS cases have been occasionally encountered in forensic autopsy practice. However, the incidence and pathogenesis has been rarely studied. This study to review chronologically the proposed pathogenesis of SMDS; pathology of cardiac conduction system, sleeping and breathing disorder, K+ and thiamine deficiency, mental stress, testosterone, hyperlipidemia, and narrow circumference of coronary artery. Brugada syndrome and SMDS are phenotypically, genetically and functionally the same disorder and Brugada syndrome has been a subject of intensive study since its early description in 1992. While Brugada syndrome is an inherited cardiac disorder caused by mutations in the SCN5A gene encoding the cardiac sodium channel alpha-subunit. less than 20% of its patients are known to be associated with SCN5A mutations. Moreover, the postmortem molecular screening of SCN5A mutations on formalin fixed paraffin embbeded cardiac tissues from SMDS cases has not been rewarding due to technical problems. The role of structural heart disease and sodium channel dysfunction in the induction of electrical instability in SMDS and Brugada syndrome is still debatable.
Asia, Southeastern ; Autopsy ; Brugada Syndrome ; Coronary Vessels ; Death, Sudden, Cardiac ; Formaldehyde ; Heart Diseases ; Humans ; Hyperlipidemias ; Incidence ; Japan ; Korea ; Mass Screening ; Paraffin ; Philippines ; Respiration ; Reward ; Sodium Channels ; Testosterone ; Thailand ; Thiamine Deficiency

Esophageal perforation continues to be associated with high mortality - 20% to 30% - despite advances in surgical techniques. Traditional surgery has been the mainstay of treatment for perforation, but recent advances in endoscopic closure devices has increased therapeutic options for selected patients. Our patient had a fishbone-induced esophageal perforation. He was treated successfully with endoscopic clipping, antibiotics and parenteral nutrition. We report this case and provide a review of the relevant literature.
Anti-Bacterial Agents ; Esophageal Perforation ; Foreign Bodies ; Humans ; Parenteral Nutrition