Malignant mesenchymoma is a rare soft tissue neoplasm showing two or more separate and distinct types of malignant mesenchymal differentiation in addition to an undifferentiated sarcomatous component. Occasional cases of malignant mesenchymoma have been reported in the spermatic cord and paratesticular area. However, documented reports have been seldom found in Korea. We report a case in which there was evidence of lipo-, rhabdomyo-, osteosarcomatous differentiation in the same neoplasm with brief review of the literatures.
Korea ; Liposarcoma ; Mesenchymoma* ; Osteosarcoma ; Rhabdomyosarcoma ; Soft Tissue Neoplasms ; Spermatic Cord

By definition, PSAD is the serum PSA concentration divided volume of the gland, as determined from transrectal ultrasonography. If prostatic volume were the sole determinant of the serum PSA concentration, there would be no correlation between PSAD and age. We examined the relationships between serum PSA concentration, rostatic volume and age. Entry included 318 men over 40 years who have no clinical evidence of prostate cancer. The mean age of this study population was 65.2(range 40-89). The mean PSA was 3.94ng/ml and the mean prostate volume 36.4cc(range 11-120). 85 men(26.7 %) had volumes >20cc and levels >4ng/ml. When all entry included, the serum PSA concentration correlates directly with age (r=0.2, p<0.01). Based on linear regression analysis, the serum PSA concentration would increase approximately 2.7% per year. The prostatic volume correlates directly with age(r=0.3, p<0.01). Based on linear regression analysis, the prostatic volume would increase approximately 2.2% per year. Correlation between the prostatic volume and PSA was also significant(r=0.1, p<0.01). Based on linear regression analysis, an increase in prostatic volume of 1mL will, on the average, produce a corresponding increase of 3.2% in PSA. There was an increasing tendency of PSAD with age but statistically insignificant. The mean PSAD was 0.11 but 47men of 59 had >0.15 in levels 4-10ng/ml. In conclusion, the application of PSAD in clinical field should be taken into consideration seriously and interpretation of PSA should be include the corresponding variables such as age and prostate volume. The PSA velocity or age specific reference range for PSA can aid in the application of PSA.
Aging* ; Humans ; Linear Models ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Reference Values ; Ultrasonography

The aims of this study were to describe a reproducible method for the isolation, purification and primary culture of rat Kupffer cells, and were to develop in vitro system which could provide a tool for the study of ischemia-reperfusion injury. Kupffer cells were isolated following sequential collagenase digestion of the liver by perfusion and enrichment of a nonparenchymal cell fraction by a double-densities gradient centrifugation step using Percoll and were selected by allowing them to adhere to culture vessel for 2 h at 37 degrees C under 5% CO2. The purity of obtained Kupffer cell was about 90% assessed by the phagocytosis of 3 micrometer latex beads. This method for Kupffer cell isolation resulted in yields of 1~5 x10(7) Kupffer cells per liver and Kupffer cells were preserved in maintenance cultures for 10 days. The phagocytic capacity of cultured Kupffer cells was measured according to the amount of latex beads incorporated into the cytoplasm. Larger round Kupffer cells in the culture had higher phagocytic capacity compared with smaller round or irregular shaped Kupffer cells. The different phagocytic capacity of Kupffer cells which was dependent on size and shape in vivo was well preserved during culture. The experimental group of Kupffer cells in culture were sequentially treated with ischemia and reperfusion at 1h and 30 min. The ratio of Kupffer cells having latex beads in their cytoplasm was significantly increased compared with control (p<0.01). This result was able to explain the Kupffer cells' activation after ischemia-reperfusion injury in vivo. In conclusion, Kupffer cells in this culture well resembled the cells in vivo and this in vitro model could provide a valuable tool for the study of Kupffer cells with a key role in pathophysiology of ischemia-reperfusion injury.
Animals ; Cell Separation ; Centrifugation ; Collagenases ; Cytoplasm ; Digestion ; Ischemia ; Kupffer Cells* ; Liver ; Microspheres ; Perfusion ; Phagocytosis ; Rats ; Reperfusion ; Reperfusion Injury*

The role of amino acids in culture media for IVF-ET was examined in a total of 76 cycles. Patients received clomiphene citrate (CC) followed by hMG or GnRH-a combined with gonadotropins (FSH/hMG) for controlled ovarian hyperstimulation. Severe male (<4 x10(6) motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. No significant differences were found in age, duration of infertility, follicle size, the level of E2 on the day of hCG injection, the mean number of oocytes retrieved, total motile sperm count, fertilization rate and the mean number of embryos transferred between bHTF (without amino acids) and mHTF (with amino acids) groups. However, total ampules of gonadotropins were higher (p<0.01) in mHTF group than bHTF group. Significantly (p<0.05) more clinical pregnancies were recorded in mHTF group (13/30) compared with bHTF group (9/46). The multiple pregnancy rates were 11.1% in bHTF group and 77% in mHTF group. There were one ectopic pregnancy in mHTF group and one heterotopic pregnancy in bHTF group. Abortion rates were 22.2% in bHTF group and 7.7% in mHTF, respectively The ongoing pregnancy or livebirth .ate was significantly (p<0.05) higher in mHTF group (12/30) than bHTF group (7/46). These results suggest that the addition of amino acids in culture media is essential for culture of zygotes in vitro and adjustment of energy substrates in phosphate-free culture media appears to be beneficial for human IVF-ET procedure.
Abortion, Induced ; Age Factors ; Amino Acids* ; Clomiphene ; Culture Media ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Gestational Sac ; Gonadotropins ; Humans* ; Infertility ; Male ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Multiple ; Sperm Count ; Ultrasonography ; Zygote

Volume replacement is a vital therapy in patient with circulatory shock, but the type of fluid that should be infused remains in controversy. This study is designed to compare the cardiopulmonary effects of a colloid solution and a crystalloid solution in dogs subjected to severe hemorrhagic shock. Twelve dogs were bled into shock and mean arterial pressure(MAP) were maintained at 60 mmHg for 1 hour followed by further hemorrhage to 40 mmHg for additional one hour, Animals were randomized to fluid challenge with 10% pentastarch(group P) or 0.9% normal saline(group S) to restore MAP. Complete hemodynamic and blood gas parameters and plasma lactate concentration were measured at pre-shock, during shock and after resuscitation for 2 hours. Cardiac function and hemodynamic stability were restored to higher level than the control level on the completion of fluid challenge with each type of solution, but hemodynamic parameters decreased as time goes after resuscitation. Especially in group S, hemodynamic parameters decreased more significantly and rapidly than group P. Considering the relation of left ventricular stroke work index(LVSWI) and pulmonary capillary wedge pressure(PCWP), the cardiac performance was well maintained to normal level in group P during post-resuscitation period, but rapidly deteriorated in group S. There was a significant increase in intrapulmonary shunt fraction with pentastarch that was maximal on the completion of fluid challenge but which normalized over the next 1 hour. Assessment of tissue perfusion was measured by mixed venous oxygen tension(PVO2) and plasma lactate concentration. In group P, PVO. was restored to higher than the control level and maintained to the cantrol level during post-resuscitation period, but in group S, it was not restored to control level at the completion of fluid challenge, moreover after then, it decreased progressively. Plssma lactate concentration was recovered to control level in group P at the completion of fluid challenge, but in group S, it was recovered lately. It means that tissue perfusion was more rapidly and effectively restored in group P than group S. In conclusion, infusion of pentastarch at severe hemorrhagic shock restored the hemodynamic parameter more rapidly and maintained cardiac performance more effectively during post-resuscitation period than normal saline. Infusion of pentastarch also maintained tissue perfusion more effectively but it increased intrapulmonary shunt fraction transiently.
Animals ; Capillaries ; Colloids ; Dogs ; Hemodynamics ; Hemorrhage ; Humans ; Hydroxyethyl Starch Derivatives* ; Lactic Acid ; Oxygen ; Perfusion ; Plasma ; Resuscitation* ; Shock* ; Shock, Hemorrhagic ; Stroke

Gastrointestinal (GI) hemangiomas are relatively rare benign vascular tumors. The choice of an appropriate diagnostic method depends on patient age, anatomic location, and presenting symptoms. However, GI hemangiomas are not a common suspected cause of GI bleeding in children because of their rarity. Based on medical history, laboratory results, and imaging study findings, the patient could be treated with either medication or surgery. Herein, we report 3 cases of GI hemangioma found in the small bowel, rectum, and GI tract (multiple hemangiomas). Better knowledge and understanding of GI hemangioma could help reduce the delayed diagnosis rate and prevent inappropriate management. Although rare, GI hemangiomas should be considered in the differential diagnosis of GI bleeding.
Child ; Delayed Diagnosis ; Diagnosis, Differential ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Hemangioma* ; Hemangioma, Cavernous ; Hemorrhage* ; Humans ; Rectum ; Vascular Neoplasms

The precise role of radiotherapy for low grade gliomas including the optimal radiation dose and timing of treatment remains unclear. The information given by a retrosepctive analysis may be useful in the design of prospective randomized studies looking at radiation dose and time of surgical and radiotherapeutic treatment. The records of 56 patients (M:F=29:27) with histologically verified cerebral low grade gliomas(47 cases of grade 1 or 2 astrocytomas and 9 oligodendrogliomas) diagnosed between 1979 and 1989 were retrospectively reviewed. The extent of surgical tumor removal was gross total or radical subtotal in 38 patients(68%) and partial or biopsy only in the remaining 18 patients(32%). Postooperative radiation therapy was given to 36 patients(64%) of the total 56 patients with minimum dose of 5000 cGy (range=1250 to 7220 cGy). The 5-and 10-year survival rates for the total 56 patients were 44% and 32% respectively with a median survival of 4.1 years. According to the histologic grade the 5- and 10-year survivals were 52% and 35% for the 24 patients respectively with grade I astrocytomas compared to 20% and 10% for the 23 patients with grade II astrocytomas. Survival of oligodendroglioma patients was greater than those with astrocytoma (65% vs 36% at 5 years), and the difference was also remarkable in the long term period of follow up (54% vs 23% at 10 years). Those who received high-dose radiation therapy (> or =5400 cGy) had significant better survival than those who received low-dose radiation(< 5400 cGy) or surgery alone (p<0.05). The 5-and 10-year survival rates were, respectively 59% and 46% for the 23 patients receiving high-dose radiation, 36% and 24% for the 13 patients receiving low-dose radiation, and 35% and 26% for the 20 patients with surgery alone. Survival rates by the extent of surgical resection were similar at 5 years (46% vs 41%), but long term survival was quite different (p<0.01) between total/subtotal resection and partial esection/biopsy (41% and 12%, resepctively). Previously published studies have identified important prognostic factors in these tumor : age, extent of surgery, grade, performance status, and duration of symptoms. But in our cases statistical analysis revealed that grade I histology (p<0.025) and young age (p<0.001) were the most significant good prognostic variables.
Astrocytoma ; Biopsy ; Brain Neoplasms ; Follow-Up Studies ; Glioma ; Humans ; Oligodendroglioma ; Radiotherapy* ; Retrospective Studies ; Survival Rate

BACKGROUND: Psoriasis is a common, scaly erythematous disease of unknown etiology, marked by remissions and exacerbations of unpredictable onset and duration. Among many etiologic factors, psoriatic keratinocyte is found to play the most important role. OBJECTIVE: The purpose of this study is to evaluate the hypothesis that the mechanism(s) responsible for the abnormal proliferation of psoriatic keratinocytes may be located within the cell themselves. METHODS: Human epidermal keratinocytes were isolated from lesion(PL) and from uninvolved skin (PN) with chronic plaque-like psoriasis and from the normal skin(NN). Keratinocytes were passaged onto culture vessels without the feeder layer and maintained with serum free medium. Growth rates were measured in secondary cultures by MTT assay and ultrastructural findings of cell differentiation were evaluated with a transmission electron microscope. Results : 1 Keratinocytes from PL reached 50% confluency in one week compared to two weeks of PN and NN in primary cultures. 2. By the MTT assay, keratinocyte proliferation from PL showed a significantly faster rate than those from PN and NN(p<0.01). But there was no significant difference of keratinocyte proliferation rate between PN and NN(p>0.05). 3. All of the three cell populations(PL, PN, NN) showed variable degrees of cell differentiation during secondary culturing in a serum-free medium. In the PL, however, small, compact basal cells were more prevalent than PN and NN. 4. When keratinocytes underwent differentiation by culturing in DMEM with serum, keratinocytes from PL formed more cell layers with incomplete formation of cornified envelopes suggests the presence of some unknown factors that induce or promote psoriasis. While keratinocytes from PN and NN were characterized by a complete codified layer as in normal skin. Conclusion : These results indicated that the characteristic hyperproliferation and the defective terminal differentiation of keratinocytes of PL were maintained throughout the culture period.
Cell Differentiation ; Feeder Cells ; Humans ; Keratinocytes* ; Psoriasis ; Skin

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.
Chest Pain ; Contrast Media* ; Coronary Angiography* ; Diatrizoate Meglumine ; Electrocardiography* ; Humans ; Ioxaglic Acid ; Osmolar Concentration

PURPOSE: Although it is well recognized that SCLC is a chemo and radiosensitive tumor, only fraction of treated patients have a complete remission, fewer still have durable remissions. This study was performed to evaluate the clinical effects of IEP chemotherapy in patients with SCLC. MATERIALS AND METHODS: Patients with histologically proven SCLC who has measurable disease and previously untreated, were eligible. Treatment consisted of ifosfamide 1000 mg/m2 iv infusion for 1 hour on days 1~5 with mesna uroprotection; epirubicin 60 mg/m2 iv on day 1; and cisplatin 20 mg/m2 iv infusion on days 1~5 with hydration; repeated treatment every 4 weeks RESULTS: Twenty four patients(20 males, 4 females) were eligible for response to IEP chemotherapy. The two patients were excluded because one died before evaluating response to chemotherapy and the other had brain metastasis. The median age was 61(range 34-74). Fifteen patients had a limited disease(LD), nine patients had a extensive disease(ED). The overall response rate was 86.4%(CR 36.4%, PR 50%). In LD, response rate was 86.7%(CR 46.7%) and in ED, response rate was 85.7%(CR 14.3%). The median overall survival time was 43.5 weeks. The median survival time of LD and ED was 46.5 weeks and 43.5 weeks respectively. The median time to progression was 20 weeks in responders. The toxicity was moderate. One toxic death was observed. Grade 1 or 2 non-hematologic toxicities consisted of alopecia, nausea and vomiting in all cases, peripheral neuropathy in 3, hematuria in 2, mucositis in 11, and fever/infection in 6. Hematologic toxic effects included leukopenia(> or =grade.3, 16.5%), anemia(> or =grade 3, 1%), and thrombocytopenia(> or =grade 3, 6.8%). CONCLUSIONS: These results suggest that IEP chemotherapy may be useful as a treatment strategy in small cell lung cancer, but its efficacy is equivalent. The phase III study should be needed.
Alopecia ; Brain ; Cisplatin ; Drug Therapy ; Epirubicin* ; Hematuria ; Humans ; Ifosfamide* ; Male ; Mesna ; Mucositis ; Nausea ; Neoplasm Metastasis ; Peripheral Nervous System Diseases ; Small Cell Lung Carcinoma* ; Vomiting