No abstract available.
Myasthenia Gravis* ; Pregnancy*

To evaluate the predictive value of serum fibronectin and roll-over test for pregnancy induced hypertension (PIH), we studies 79 patients between the twenty-eighth and thirty-second week of gestation from October 1995 to May 1996. The results were as follows . 1) There was no significant difference of mean diastolic pressure difference in roll-over test and serum fibronectin levels between 13 PIH patients and 66 controls. Between two groups of patients, mean diastolic blood pressure differences were 14.3+/-3.9mmHg, 12.0+/-4.4mmHg and mean serum fibronectin levels were 231.2+/-90.8 pg/ml, 196.5+/-61.2 pg/ml respectively(p> 0.1). 2) For prediction of PIH, the sensitivity, the positive predictive value and the negative predictive value of roll-over test were 8%, 14% and 83%.
Blood Pressure ; Female ; Fibronectins* ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy*

The term myxosarcoma is currently not used in standard classification for soft tissue tumors, but restricted to cardiac tumors. Primary cardiac myxosarcoma is a very rare disease and is difficult to differentiate from myxoma clinically and pathologically. We report a case of left atrial myxosarcoma with widespread systemic metastasis in a 21-yr-old male. The patient presented with sudden onset of intermittent dyspnea and orthopnea. Echocardiography showed a mobile, pedunculated tumor, 7.5x5x2 cm in size, at left atrium. Histologically, the excised tumor showed an amorphous finely fibrillar and mucinous stroma, in which irregular cords and clusters of lepidic cells and large stellate cells with plump vesicular nuclei resembled the usual type of cardiac myxoma were noted. And it showed focally cellular area with great nuclear pleomorphism and frequent mitoses. The patient received combination chemotherapy, peripheral blood stem cell collection transplantation and operations for systemic metastases in the brain, skeletal muscle and lung. He is alive at present 37 months after initial diagnosis and has no more new metastatic lesion.
Adult ; Case Report ; Heart Neoplasms/therapy ; Heart Neoplasms/pathology* ; Human ; Male ; Myxosarcoma/therapy ; Myxosarcoma/secondary* ; Myxosarcoma/pathology*

Pleuropulmonary blastoma (PPB) is an unusual intrathoracic blastoma presenting in childhood and characterized by a biphasic neoplastic population of undifferentiated, small round blastemal cells and larger spindle-shaped sarcomatous cells with entrapped benign epithelial-lined structures. We experienced the cytologic features of PPB in imprint smear from the pleural-based huge mass of the middle lobe of the right lung in a 4-year-old boy. The smears showed high cellularity composed of small ovoid blastemal elements and scattered spindle mesenchymal tumor cells. Lobectomy and pathologic investigation confirmed the diagnosis. PPB seems to be a tumor in which accurate diagnosis may be achieved by cytology if appropriate clinical information were given. Timely and accurate diagnosis of PPB by cytology paves the way for attempting preoperative treatment in future cases.
Child, Preschool ; Diagnosis ; Humans ; Lung ; Male

BACKGROUND: Besides prostacyclin and nitric oxide, the endothelium-derived hyperpolarizing factor (EDHF), which is another distinct endothelium-dependent vasodilator, is involved in relaxing the vascular smooth muscle cells. The myoendothelial gap junction (MEGJ) and female sex hormone play important roles in the EDHF-mediated responses. Therefore, this study was designed to determine the influence of gender on the gap junctional distribution and endothelium-dependent vasodilation in the rat mesenteric arteries. METHODS: Male and female Sprague-Dawley rat were euthanized and the tertiary branch of the mesenteric artery was harvested. Immunohistochemistry and confocal microscopic examination of the arterial wall were performed after treating them with specific antibodies to delineate the distribution of connexin 43, a gap junctional protein. Segments of the mesenteric artery, 5 mm in length, were connected to two tungsten wires under isometric tension. The arterial segments were suspended in a modified Krebs solution (37 degrees C) aerated with 95% O2 and 5% CO2 in a vertical water-jacketed temperature-controlled tissue bath. The standard dose-response curve for acetylcholine (10(-9)-10(-5) M) was drawn in the presence of the NO synthase inhibitor, N(omega)-nitro-L-arginine methyl ester (L-NAME; 10(-4) M) plus indomethacin (10(-5) M) and/or gap junctional inhibitor, carbenoxolone (10(-4) M). RESULTS: In the female rat mesenteric artery, the gap junctional plagues were more prevalent particularly along the endothelial layer. The inhibition of the relaxation response to acetylcholine was depressed in the presence of L-NAME plus indomethacin and augmented in the presence of carbenoxolone when compared with the male rat mesenteric arteries (P < 0.05). CONCLUSIONS: Gender differences in the rat mensenteric arteries have an effect on the expression of connexin 43 and the release of EDHF through MEGJ may play a key role in controlling the female arterial tone.
Acetylcholine ; Animals ; Antibodies ; Arteries ; Baths ; Carbenoxolone ; Connexin 43 ; Dilatation* ; Epoprostenol ; Female ; Gap Junctions ; Humans ; Immunohistochemistry ; Indomethacin ; Male ; Mesenteric Arteries* ; Muscle, Smooth, Vascular ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Tungsten ; Vasodilation

No abstract available.
Leukemia ; Mucormycosis*

Desmoplastic cerebral astrocytoma of infancy is a massive cystic tumor, typically occurring in the cerebral hemisphere and a rare intracranial tumor that arises in subjects usually below the age of 18 months and shows a favorable prognosis. A 5.5-month-old boy was presented with a rapidly increasing head circumference and lethargy. A computerized tomography scan revealed a large, multicystic, partially enhancing right parieto-occipital mass with hydrocephalus. This patient was treated with a surgery and a firm plaque-like tumor along withmulticystic component was gross totally removed. The tumor mass was firmly attached to the dura and extended in fingerlike projections onto the cortical surface. The infant underwent no further therapy and has developed normally during 6 months after surgery. Desmoplastic cerebral astrocytoma of infancy is a rare intracranial tumor but recognition of this tumor should be appreciated because, despite its massive size and rapidly growing characterstics, this tumor often has a relatively benign clinical course.
Astrocytoma* ; Cerebrum ; Head ; Humans ; Hydrocephalus ; Infant ; Lethargy ; Male ; Prognosis

BACKGROUND: Airwayscope (AWS), which has been used successfully for difficult airway in general anesthesia, has been anticipated that hemodynamic response to tracheal intubation in the difficult airway may be attenuated. Also, there is a series of reports demonstrating the successful use of lightwand to open the difficult airway. Thus, we decided to conduct a survey to compare AWS to lightwand and to direct laryngoscopy of cardiovascular response to tracheal intubation. METHODS: Of 64 healthy patients without cardiovascular disease, 22, 21, 21 patients were randomly assigned to AWS group, lightwand group and direct laryngoscope group. After induction of general anesthesia, intubation was performed with manual in-line neck stabilization. During laryngoscopy, a modified Cormack-Lehane grade was assessed and time to intubation was measured. Systolic arterial pressure (SAP) and heart rate (HR) were recorded at the following timepoints: baseline, just before intubation, 1 min, 2 min, 3 min, 4 min and 5 min after intubation. RESULTS: There were no significant differences between the 3 groups in SAP, HR (P > 0.05). However modified Cormack-Lehane grade of all patients in the AWS group was I, while that in direct laryngoscope group was IIB or III. In addition, the mean time to intubation of the direct laryngoscope group was significantly longer than that of the AWS and lightwand (P < 0.05). CONCLUSIONS: In the difficult airway, AWS was very effective in improving laryngeal view and decreasing time to intubation compared to direct laryngoscopey. In addition, lightwand reduced the time to intubation. However we could not find any significant difference in hemodynamic response to tracheal intubation among the 3 groups.
Anesthesia, General ; Arterial Pressure ; Cardiovascular Diseases ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Laryngoscopes ; Laryngoscopy ; Neck

PURPOSE: To evaluate the usefulness of whole body bone mineral densitometry in the diagnosis of frequent osteopenia of preterm infants by comparison with the wrist radiographs and biochemical parameters. MATERIALS AND METHODS: From January 1995 to January 1996, we obtained whole body bone mineral density(BMD) studies using dual energy X-ray absorptiometry(DXA) and wrist radiographs of 39 preterm infants. They were divided into three groups according to birth weight, under 1500g, 1501g to 2000g and above 2000g, and four grades of skeletal change, as seen on wrist radiography, according to the scoring method of Koo et al. Groups of birth weight and grades of skeletal change were then correlated with whole body BMD and biochemical parameters. For comparison, normal data were obtained from 13 infants born at full term. Data were analyzed by one way analysis of variation(ANOVA) and correlation and regression analysis. A p-value of less than 0.05 was considered significant. RESUTLS: Whole body BMDs were significantly lower in the more premature and smaller birth weight infants(r=0.77, p=0.0000), and in the higher grade of skeletal change (r=-0.5276, p=0.0000). Aggravated skeletal changes were found in infants with lower birth weight(r=-0.3822, p=0.01). Interobserver variation in grading skeletal change was 42.9%, and intraobserver variation was 18.4%. Biochemical parameters such as serum calcium, phosphate, alkaline phosphatase, parathromone, calcitonin and 25-hydroxy-vitamine D did not vary significantly according to either birth weight or skeletal change (p>0.05). CONCLUSION: Premature osteopenia is more effectively diagnosed by measuring whole body BMD using DXA than by grading radiographical skeletal change or by biochemical parameters.
Alkaline Phosphatase ; Birth Weight ; Bone Diseases, Metabolic* ; Calcitonin ; Calcium ; Densitometry* ; Diagnosis ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Observer Variation ; Parturition ; Radiography* ; Research Design ; Rickets ; Wrist*

BACKGROUND: Inactivation of the retinoblastoma protein (pRb) is a mechanism by which tumor cells can subdue normal growth control. Among the molecules involved in control of pRb phosphorylation, cyclin D1 and cyclin E have been found to be deregulated and overexpressed in various types of cancers. METHODS: Immunohistochemical stains for pRb, p16, cyclin D1 and cyclin E were performed in 73 cases of infiltrating duct carcinomas of the breast. In addition to analysis of their expression rates, the relationships between their expressions and the clinicopathologic parameters were evaluated. RESULTS: pRb, p16, cyclin D1 and cyclin E were positive in 64.7% (44 out of 68 cases), 24.6% (15 out of 61 cases), 43.8% (32 out of 73 cases) and 61.6% (45 out of 73 cases), respectively. Their expression rates were not significantly associated with clinicopathologic prognostic factors. 33 out of 38 cases with p16-negative reactions were pRb positive, while 10 out of 15 cases with pRb-negative reactions were p16 positive. There was a significant inverse relationship between pRb and p16 expressions (P<0.005). 25 out of 32 cases with cyclin E-positive reactions were cyclin D1-positive, and 25 out of 45 cases with cyclin D1-positive reactions were cyclin E-positive. A statistically significant association was observed between cyclin D1 and cyclin E expressions (P<0.05). CONCLUSIONS: The main mechanism during tumorigenesis of breast carcinoma depends on the cyclin D1/p16/pRb pathway, but cyclin E might play a role in the absence of cyclin D1. The inverse correlation between the pRb and p16 expressions may represent one of the important mechanisms in tumorigenesis, as well.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Coloring Agents ; Cyclin D1* ; Cyclin E* ; Cyclins* ; Phosphorylation ; Retinoblastoma ; Retinoblastoma Protein