The transient acute severe hypertensions with arrhrthmia after intramrometrial injection of Img PGF2 alpha during cesarean section by means of spinal as well as general anestheaia are returned to normal limit of vital sings without special treatment. Ne specific complications were experienced following the episode until discharge.
Cesarean Section ; Dinoprost* ; Female ; Hypertension* ; Pregnancy

Osteosarcoma is one of the most common malignant bone tumors except for multiple myeloma. The current managements of the osteosarcoma patients include preoperative chemotherapy, definitive operation and postoperative chemotherapy with tremendous improved oncologic results by lots of Orthopedic Oncologists. The definitive operations are either limb-salvage operations or amputation. Limb-salvage operations include autograft, allograft, tumor prosthesis, or its combination. However, we have a difficulty to use allograft due to Korean traditonal customs. Authors managed the 6 year-old female patient with the osteosarcoma on the proximal metaphysis of the right humerus by wide-margin resection and reconstruction with a clavicula pro humero procedure with an excellent result, which technique was devised and developed by W. Winkelmann in Germany.
Allografts ; Amputation ; Autografts ; Child ; Drug Therapy ; Female ; Germany ; Humans ; Humerus* ; Multiple Myeloma ; Orthopedics ; Osteosarcoma* ; Prostheses and Implants

PURPOSE: To evaluate the low attenuation of mosaic pattern in pulmonary embolism, as observed on HRCT, and to correlate the findings with the pathologic features of resected lung. MATERIALS AND METHODS: Using permanent embolic materials, pulmonary embolism was induced in eight Yorkshire pigs. Pre-and post-embolic pulmonary angiography was performed and after 6 weeks, the incidence and pattern of parenchymal change in low attenuation (mosaic pattern), as seen on HRCT, was evaluated. The animals were then sacrified and contact radiography of the lung was performed. Thirty-eight segments of pathology were taken from the area in which the presence of embolism had been suggested. Pathologic and HRCT findings were then correlated. RESULTS: On HRCT, low attenuation was seen in 23 of 36 segments (64%) and showed variable patterns : crescent peripheral hyperlucency (61%, n=14), heterogeneous mottled hyperlucency (17%, n=4), lobular hyperlucency (13%, n=3), and homogeneous segmental hyperlucency (9%, n=2). Parenchymal low attenuation was seen on HRCT in 10 of 11 segments (91%) in which large segmental arterial occlusion occurred, and in 3 of 16 segments (19%) in which there was small segmental arterial occlusion. Abnormal pathologic findings were pulmonary congestion, dilatation of pulmonary arteries, interlobular septal thickening, and thrombus formation. Among the 38 pathologic segmental specimens, 29 were from the area in which HRCT findings were positive, and in which pulmonary embolism subsequently occurred. In only four of nine segments (44%) in the area in which HRCT fingings were negative was pulmonary embolism subsequently. CONCLUSION: HRCT findings of pulmonary embolism at six weeks after embolization showed variable patterns of low attenuation, diminished diameter of pulmonary arteries, and normal diameter of bronchi. In cases with large segmental arterial occlusion, the finding of low attenuation was more common ; this may be due to reduced blood flow to the embolic area, in combination with bronchiolar spasm. For the early diagnosis of pulmonary embolism, these findings may be useful.
Angiography ; Animals ; Bronchi ; Dilatation ; Early Diagnosis ; Embolism ; Estrogens, Conjugated (USP) ; Incidence ; Lung ; Pathology ; Pulmonary Artery ; Pulmonary Embolism* ; Radiography ; Spasm ; Swine ; Thrombosis

Natural orifice translumenal endoscopic surgery (NOTES) involves the intentional perforation of the viscera with an endoscope to access the abdominal cavity and perform an intraabdominal operation. In a brief time period, NOTES has been shown to be feasible in laboratory animal and human studies. Easy access to the peritoneal cavity and complete gastric closure should be secured before NOTES can be recommended as an acceptable alternative in clinical practice. The concept of submucosal endoscopy has been introduced as a solution to overcome these two primary barriers to human NOTES application. Its offset entry/exit access method effectively prevents contamination and allows the rapid closure of the entry site with a simple mucosal apposition. In addition, it could be used as an endoscopic working space for various submucosal conditions. Herein, the detailed procedures, laboratory results and human application of the submucosal endoscopy will be reviewed.
Abdominal Cavity ; Animals, Laboratory ; Endoscopes ; Endoscopy ; Humans ; Peritoneal Cavity ; Viscera

BACKGROUND: Heat shock proteins (HSP), especially the HSP 70 family, may play certain roles in the immunophysiology of some skin diseases such as psoriasis, pemphigus, and lichen planus. HSPs generally induce down-regulation of the process of apoptosis that is considered to be one of the acantholysis-producing pathways in pemphigus. OBJECTIVE: We planned to examine possible roles of HSPs 70/105 in the blistering process in pemphigus vulgaris (PV) and pemphigus foliaceus (PF), in connection with the detection results of apoptosis in local tissue specimens. METHODS: Immunohistochemical stainings and Western blot analysis were performed for the detection and semiquantitation of HSPs 70/105 in skin specimens from lesional, nonlesional, and normal control sites. Hoechst 33342 staining was simultaneously carried out to examine features of apoptosis in lesional skin specimens. RESULTS: The findings on expression of HSP were as follows. In PV, the expression of HSP 70 was minimum or negative; however, in PF, the expression was obvious and recognizable in lesional and perilesional normal skin. In contrast, HSP 105 was not detected in all cases of PV and PF. The features of apoptosis were evident at the lesional skin of all cases of pemphigus with acantholytic changes. CONCLUSION: PV and PF had different relative intensities of HSPs in lesional tissue stainings, especially in cases with HSP 70. This suggests that there may be subtle differences in the mechanisms causing acantholysis between PV and PF.
Acantholysis ; Apoptosis ; Benzimidazoles ; Blister ; Blotting, Western ; Down-Regulation ; Heat-Shock Proteins ; Hot Temperature ; HSP70 Heat-Shock Proteins ; Humans ; Lichen Planus ; Pemphigus ; Psoriasis ; Skin ; Skin Diseases

BACKGROUND: The p53 and retinoblastoma(Rb) tumor suppressor genes are associated with the pathogenesis of several types of human cancer. Substantial. proportion of the primary lung cancers or cell lines have been reported to have the p53 and/or the Rb gene mutations. But so far there is no report on the analysis of the Rb gene polymorphism as one of the genetic susceptibility marker. This study was undertaken to establish the gene frequencies of the polymorphic genotypes of the p53 and Rb genes in Koreans to evaluate the possible involvement of these genotypes as a risk factor of lung cancer. METHODS: In this study 145 controls without previous and present tumor history and 128 lung cancer patients were subjected to analysis The two intragenic polymorphisms of the p53 gene(exon 4/AccII, intron 6/MspI) and one intron 17/XbaI polymorphism of the Rb gene were analysed by the method of polymersae chain react lion-restriction fragment length polymorphisms(PCR-RFLPS). The genotype of the intron 3/16 bp repeat polymorphism of p53 was determined by PCR and direct gel electrophoresis. RESULTS: There were no significant differences in the genotype distributions of the p53 gene between lung cart cert patients and controls. But heterozygotes(Arg/Pro) of the exon 4/AcclII polymorphisms were slightly over-represented than controls, especially in the Kreyberg type I cancer, which was known 13 be associated with smoking. The intron 3/16 bp duplication and the intron 6/MspI polymorphisms were in complete linkage disequilibrium. About 95% of the individuals were homozygotes of the common alleles both in the 16 duplication and MspI polymorphisms, and no differences were deteced in the genotype distributions between lung cancer patients and controls. Overall genotype distributions of the Rb gene polymorphisms between lung cancer patients and controls were not significantly different However, the genotype distributions in the Kreyberg type I cancer were significantly different from those of controls(p=0.0297) or adenocarcinomas(p=0.0008). It was noticeable that 73.4% of the patients with adenocarcinomas were heterozygotes(r1/r2) whereas 39.2% of the Kreyberg type I cancer were heterozygous at this polymorphisms. In the lung cancer patients, significant differences were a]so noted between the high dose smokers and low dose smokers including non-smokers(p=0.0258). The relative risk to Kreyberg type I cancer was significantly reduced in the individuals with the genotype of r1/r2(odds ratio=0.46, 95%C.I.=0.25-0.86, p=0.0124). The combined genotype distribution of the exon 4/AccII of the p53 and the intron 17 Rb gene polymorphisms in Kreyberg type I cancers were significantly different from dose of controls or adenocarcinomas. The highest odds ratio were observed in the individuals with the genotypes of Arg/pro and r2/r2(odds ratio=1.97, 95%C.I.=0.84-4.59) and lowest one was in the patients with Arg/Arg, r1/r2 genotype(odds ratio=0.54, 95%C.I.=0.25-1.14). CONCLUSION: The p53 and the Rb gene polymorphisms modulate the risk of smoking induced lung cancer development in Koreans. However, the exact mechanism of risk modulation by these polymorphism remains to be determined. For more discrete clarification of associations between specific genotypes and lung cancer risk, the evaluations of these polymorphisms in other ethnics and more number of patients will be needed.
Adenocarcinoma ; Alleles ; Cell Line ; Electrophoresis ; Exons ; Gene Frequency ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Genetic Predisposition to Disease ; Genotype ; Homozygote ; Humans ; Introns ; Linkage Disequilibrium ; Lung Neoplasms* ; Lung* ; Odds Ratio ; Polymerase Chain Reaction ; Risk Factors ; Smoke ; Smoking

PURPOSE: To demonstrate the incidence and variation of the meniscofemoral ligament in Koreans. MATERIALS AND METHODS: A total of 100 MR studies of 95 patients were reviewed with special attention to the appearance and incidence of the meniscofemoral ligaments. The ligament of Wrisberg was classified according to proximal insertion: type I, insertion at the posterofemoral condyle ; type II, insertion at the distal portion of the posteriorcruciate ligament ; type III, insertion at the distal portion of the posterior cruciate ligament. On T2-weighted images, the high signal at the meniscal insertion of the meniscofemoral ligament was classified according to itsshape. RESULTS: The ligament o Humprey was observed in 17 cases and the ligament of Wrisberg was in 90:type I in41 cases;type II, 19 cases;type III, in 28 cases; unclassified, in 2 cases. In 77 cases, the cleft with high signal intensity was seen between the meniscofemoral ligament and the posterior cruciate ligament. CONCLUSION: From our results, the incidence of the ligament of Wrisberg on MRI was moe prevelant than the ligament of Humprey. An exact knowledge of the meniscofemoral ligament could be helpful in distinguishing it from pathologic lesions.
Classification* ; Humans ; Incidence* ; Knee ; Ligaments* ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament

Approximately 1% of all the meningiomas arise from the extradural space. Intradiploic meningiomas constitutes only a very small percentage of this figure. Because of its rarity, it is often confused preoperatively with primary bone tumors of the skull. The intradiploic meningioma of the orbital wall may be considered as a subgroup of intradiploic ectopic meningioma. The following is our report of a recently observed case of intradiploic meningioma of the orbital wall without intracranial or intraorbital involvement. The preoperative tentative diagnosis was osteoma of the orbital wall. Nomenclature and histogenesis of this type of meningioma are discussed.
Diagnosis ; Meningioma* ; Orbit* ; Osteoma* ; Skull

Approximately 1% of all the meningiomas arise from the extradural space. Intradiploic meningiomas constitutes only a very small percentage of this figure. Because of its rarity, it is often confused preoperatively with primary bone tumors of the skull. The intradiploic meningioma of the orbital wall may be considered as a subgroup of intradiploic ectopic meningioma. The following is our report of a recently observed case of intradiploic meningioma of the orbital wall without intracranial or intraorbital involvement. The preoperative tentative diagnosis was osteoma of the orbital wall. Nomenclature and histogenesis of this type of meningioma are discussed.
Diagnosis ; Meningioma* ; Orbit* ; Osteoma* ; Skull

BACKGROUND: Losartan potassium, one of an orally active, selective type 1 angiotensin II receptor blocker, has been introduced recently as an antihypertensive agent. METHOD: Losartan, angiotensin II receptor blocker, was administrated as an initial antihypertensive agent over 12 weeks in 30 patients (11 male, 19 female, 60.1+/-7.2 years) with stage 1 to 3 hypertension in order to observe the clinical effects. Changes in quality of life, side effects, electrocardiogram and left ventricular function were also evaluated before and after losartan therapy. RESULTS: 1) After 12 weeks treatment with 50 to 100 mg of losartan, blood pressure was lowered markedly in 18 (60%), moderately in 9 (30%) and mildly in 1 (3%) out of 30 patients studied. The average of blood pressures of the 30 subjects were systolic 159.0+/-13.2 mmHg and diastolic 100.7+/-9.4 mmHg before treatment, which were lowered to 130.7+/-15.6 and 85.9+/-9.1 mmHg respectively after 12 weeks (p<0.005). 2) Heart rates were not changed with losartan. 3) Quality of life including general well-being, physical symptom, sleep and sexual dysfunction improved markedly in 2 (7%) and slightly in 17 (57%) out of 30 subjects. 4) Laboratory findings revealed no significant changes. 5) In electrocardiographic and echocardiographic follow-up 1 patient with ST-T abnormality and 2 patients with mild LV systolic dysfunction improved to normal. 6) Undesirable side effects were observed in 2 cases with dizziness, 1 dry cough, 1 skin rash, 1 leg edema and 1 epigastric discomfort, among whom one with dizziness stopped losartan. 7) In the final clinical assessment according to the scores of hypotensive effect, quality of life, LV function and side effect, losartan was very useful in 3 (10%), useful in 18 (60%) and slightly useful in 3 (10%) out of 30 hypertensive patients. CONCLUSION: Losartan can be used as an effective initial agent for the treatment of hypertension of various severities with the improvement of quality of life and low side effects.
Blood Pressure ; Cough ; Dizziness ; Echocardiography ; Edema ; Electrocardiography ; Exanthema ; Female ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension ; Leg ; Losartan* ; Male ; Quality of Life ; Receptors, Angiotensin ; Ventricular Function, Left