Yellow nail syndrome is characterized by yellow discoloration of nails, chrnnic lymphedema and respiratory dieorders such as chronic bronehitis, bronchiectasis, pleural effusion and chronic sinusitis. Other changes of nail in this syndrome are the exaggerated lateral curvature and disappearance of lunula and cuticle. These nail changes are caused by greatly slow nail growth than in normal due to the defective lymphatic drainage. We report a case of yellow nail syndrome in a 55 year-old woman who has pulmanary edema, congestive heart failure for 3 years, and yellow naiIs of all fingers and toes for 1 year.
Bronchiectasis ; Drainage ; Edema ; Female ; Fingers ; Heart Failure ; Humans ; Lymphedema ; Middle Aged ; Pleural Effusion ; Sinusitis ; Toes ; Yellow Nail Syndrome*

The mechanism of cytolysis by complement attack of nucleated cells(NC) is of special interest in comparison to that of red blood cells. It is known that NC death by membrane attack comples, C5b-9, is caused by many factors, i.e., efficiency of complex assembly, activation of intrinsic metabolic pathway by signal transduction, cytotoxic effect of the channel itself and natural repair ability. These factors suggest that colloid osmotic lysis, known in red blood cells, does not fully explain the complement-mediated cell death of NC. In this study, the authors investigated correlation between biochemical and morphological changes to prove "Ca2+-mediated metabolic death"8~13) representing a mechanism of NC death caused by C5b-9 attack. The L1210 cells, mouse leukemic cell line carrying small complement channel(TAC5b-91) were used in the experiments. The amounts of intracellular adenine nucleotides to extracellular Ca2+, ouabain, KC1 and dextran were analyzed by bioluminescence method using luminometer. Cell viability was checked by 0.4% trypan blue dye and LDH release. Morphological observation of TAC5b-91 was done by immunocytochemical staining and electron microscope. The results were as follows: 1) The release of ATP, ADP and AMP followed by cell death was rapid and progressive along the incubation time at 37 degrees C and it was accelerated in 1.5 mM of [Ca2+]0. 2) There was no evidence of ATP repairment in the TAC5b-91. 3) Extracellular KC1(150 mM), dextran(0.66 mM) and ATP supplement(0.2 microM) could not effectively inhibit ATP depletion and cell death. Ouabain(27 and 100 microM) enhanced cell death and could not completely prevent ATP loss. 4) Most of the mitochondria showed swelling, loss of cristae and Ca2+ deposit in matrix in the electron microscopic observation. Rapid, sustained and irreversible depletion of adenine nucleotides was due to Ca2+ deposit with destruction of mitochondria and also the leakage through transmembrane channels. Moreover this energy depletion was accelerated by high extracellular Ca2+ concentration. These results indicate that Ca2+-mediated, energy exhaustion is one of the mechanisms of the metabolic cell death by C5b-9 attack of NC.
Mice ; Animals

No abstract available.
Diazepam* ; Humans ; Hypnotics and Sedatives* ; Midazolam* ; Surgery, Plastic*

Developmental surface ultrastructure of Macroorchis spinulosus was studied by scanning electron microscopy. One-day-old juvenile fluke was leaf-shaped and bent ventrally. Body surface was covered densely with peg-like spines and with cobblestone-like cytoplasmic processes. Ciliated sensory papillae were concentrated around oral sucker. Several unciliated sensory papillae occurred equidistantly on oral sucker and acetabulum. The ciliated papillae appeared in two longitudinal lines symmetric bilaterally on dorsal surface. On adult flukes, tegumantal spines became wider in middle of the body surface. The cytoplasmic processes differentiated into more fine velvety form. It is likely that the differentiated fine cytoplasmic processes are an increased absorptive surface to adult M. spinulosus. It is suggested that single pointed tegumental spines on anterior half of the body may be supportive for this fluke to migration.
Animals ; Microscopy, Electron, Scanning ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't ; Trematoda/*anatomy & histology/*ultrastructure

Vecuronium induced intense neuromuscular blockade was evaluated in 40 USA class l, ll adult patients using the post tetanic count (PTC) and train-of-four(TOF) methods. All patients were anesthetized with thiopental sodium, nitrous oxide(50%), and enflurane(1~2%). Neuromuscular monitoring commended immediately after administration of thiopental sodium. The ulnar nerve was stimulated using surface electrodes and the mechanical response of the adductor policis muscle recorded using the Acclograph, neuromuscular transmission monitor. TOF nerve stimulation was used every 15s. After supramaximal stimulation was achieved a bolus of vecuronium 0.1mg/kg was injected intravenously. The traches was intubated when TOF response was depressed to 95% or above to control twitch height and the lungs ventilated with a tidal volume of 10ml/kg and a rate of 14 b.p.m. The patients were allocated randomly to two groups of 20 patients each. Patients in control group were allowed to recover TOF response spontaneously, and in PTC group were applied tetanic stimulation(50Hz for 5s) at 7 minutes intervals during no TOF response. In PTC group, the tetanic stimulation was preceded by a 30s period of 1Hz stimulation on each occasion, which was continued after the 3s pause. Duration of no TOF response in each group, and relationship between first post tetanic twitch height of PTC and time to first reaction to TOF nerve stimulation in PTC group were measured. In the results, duration of no TOF response was shortened by tetanic stimulation(p<0.01). There was a close inverse correlation between first post tetanic twitch height or PTC and time to first reaction to TOF nerve stimulation (p<0.01). It was concluded that PTC method appeared to be a valuable supplement to TOF nerve stimulation in assessment and trend for vecuronium induced intense neuromusclular blockade.
Adult ; Electrodes ; Humans ; Lung ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Thiopental ; Tidal Volume ; Ulnar Nerve ; Vecuronium Bromide*

Fibrolipoma is an uncommon variant of lipomas which shows a distinct pathologic findings with both component of mature adipose cells and broad bands of dense fibrous connective tissue. A 30-year-old woman developed an 5×7cm sized, indurated, ill-defined, subcutaneous mass on the right axilla. Microscopically, the tumor contained broad bands of dense connective tissue with mature adipose tissue scattered throughout the mass, but it did not show encapsulation. The lesion was excised and she showed no evidence of recurrence after 6 months of follow-up.
Adipose Tissue ; Adult ; Axilla ; Connective Tissue ; Female ; Follow-Up Studies ; Humans ; Lipoma ; Recurrence

No abstract available.
Gastrectomy* ; Stomach Neoplasms*

From July, 1992 to June, 1993, 32 patients with BPH were treated with transurethral radio frequency thermotherapy(TURT) and 54 patients with transurethral microwave thermotherapy (TUMT). Of the patients 15 and 19 were followed for 3 month(range 2-6 months) and analysed to compare the effectiveness of TURT and TUMT respectively. Mean age was 70.3(range 55-88) and 68.7( 54-82) and mean prostatic weight was 30.3gm ( 14-52gm) and 33.8gm(11 -60gm). These patients were treated by one session for 1 hour. The improved response rate with TURT versus TUMT in residual urine volume and maximal flow rate were 40%, 57% and 47%, 32%. The improved response rate more than 6 points in modified Boyarsky symptom score were 73% and 63%. The side effects were urinary retention, dysuria, hematuria and perineal discomfort in both types. We conclude there were no differences in the effectiveness according to electromagnetic wave types and these transurethral thermotherapies are safe and simple method for patients who are not candidates for surgery because of medical illness or personal favorites.
Dysuria ; Electromagnetic Radiation ; Hematuria ; Humans ; Hyperthermia, Induced* ; Microwaves* ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Urinary Retention

No abstract available.
Cardiomyopathy, Hypertrophic* ; Humans ; Infant* ; Mothers*

No abstract available.
Cardiomyopathy, Dilated*