The response of plasma renin activity and Na, K content to physiological stimuli; supine, standing after liberal salt intake and salt loading, was observed in the normal human and patients with essential hypertension. The results are as follow: 1) The substance obtained from sample that exert contractile activity to rat colon, had blood pressure raising activity. Method in this experiment was able to detect angiotensin-II for concentration of 1 ng. 2) In normal, plasma Na content of supine state with liberal salt intake showed 142.2+/-1.8 mEq/L, but it was increased to 151.0+/-5.9 mEq/L after salt loading. In standing, plasma Na content showed 141.5+/-2.5 mEq/L with liberal salt intake. 3) In normal, plasma Na content of liberal salt intake showed 142.2+/-1.8 mEq/L in supine and 141.5+/-2.5 mEq/L in standing. The pasma Na content in supine after salt loading was significantly reduced by standing (143.7+/-1.5 mEq/L). 4) In normal, plasam renin activity of supine showed 7.3+/-1.6 mg/ml with liberal salt intake and 4.8+/-1.1 ng/ml with salt loading. The plasma renin activity in standing showed 12.8+/-3.1 ng/ml witn liberal salt intake and 7.3+/-1.1 ng/ml with salt loading. In both cases the salt loading decreased the plasma renin activity significantly. 5) In normal, the plasma renin activity of liberal salt intake or salt loading was significantly increased by standing compared with that of supine state. 6) In hypertensive patients with subnormal plasma renin activity, the plasma Na content in supine state showed 144.5+/-0.7 mEq/L with diuretics and 145.5+/-3.3 mEq/L with salt loading. In hypertensive patients with normal or high plasma renin activity, the plasma Na content in supine state showed 129.5+/-7.3 mEq/L with diuretics and 136.5+/-3.0 mEq/L with salt loading. In standing, plasma Na content was 132.5+/-3.1 mEq/L with diuretics and 135.7+/-2.5 mEq/L with salt loading. In hypertensive patients, the lower renin activity cases showed higher plasam Na content. 7) In hypertensive patients with subnormal renin activity, the plasma Na content tend to decrease by standing compared with that of supine state. 8) In hypertensive cases of low renin activity, the plasma renin activity in supine was 3.6+/-1.5 ng/ml with diuretics and 2.4+/-1.1 ng/ml with salt loading, and in standing, it was 6.0+/-2.1 ng/ml. with diuretics and 3.7+/-1.9 ng/ml with salt loading. In cases of high renin activity, the plasma renin activity in supine was 9.3+/-2.3 ng/ml with diruetics and 6.0+/-1.2 ng/ml with salt loading and in standing, it was 18.0+/-3.5 ng/ml with diuretics and 9.7+/-0.5 ng/ml with salt loading. 9) In patients with essential hypertension, we found that the plasma renin activity was incrased or not. It is suggest that the increased renin activity is not the cause of essential hypertension but is caused by essential hypertension.
Animals ; Blood Pressure ; Colon ; Diuretics ; Humans ; Hypertension* ; Plasma* ; Rats ; Renin* ; Sodium*

No abstract available.
Child* ; Cytomegalovirus* ; Fluorescent Antibody Technique* ; Humans ; Prevalence*

In general, meningiomas are slowly growing benign neoplasms originating from specialized meningothelial cells in arachnoid granulation, but have a tendency to be locally invasive and recurrent. Meningiomas very rarely metastasize outside the nervous system, occurring in less than 0.1%. We report the CT and MR findings of a case of a solitary benign syncytial meningioma showing recurrent multiple tumors and malignant progression with eventual bone metastasis to rib after six surgical extirpations during six years.
Arachnoid ; Meningioma* ; Neoplasm Metastasis* ; Nervous System ; Ribs

BACKGROUNDS: In adult, the clinical seizure characteristics of complex partial seizure(CPS) originated from temporal lobe are pretty stereotypic, and could be used as one of the important guidelines for the preoperative localization of the epileptogenic zone. Recently, surgical treatment for the intractable childhood temporal lobe seizure is frequently performed. However, most of the clinical studies to describe the seizure patterns of CPS in childhood included CPS of extratemporal lobe origin. There is still controversy about the typical pattern of temporal lobe seizure(TLS) in childhood. Therefore, we intend to investigate the clinical seizure patterns of CPS originated from temporal lobe, and the difference of seizure characteristics in different age group. SUBJECTS AND METHODS: On June 1996, 33 patients among 172 patients who presented CPS had CPS of temporal lobe origin, and were treated with antiepileptic drugs at the Pediatric Epilepsy Clinic of Ajou University Medical Center. We classified 33 patients according to age group; Group A(1-6 yr, 16 cases) and Group B(7-15 yr, 17 cases). We selected following criterias to determine CPS of temporal origin; focal spike in the temporal area with interictal or ictal EEG, mesial temporal sclerosis(MTS) or other epileptogenic lesion in the temporal area on brain MRI, and/or decreased rCBF in the temporal area on brain SPECT. We have analyzed the clinical seizure patterns with 24-48 hr Video-EEG monitoring in 3 patients, ictal EEG in 4 patients, and questionnaire or medical record in 26 patients. RESULTS: 1) Commonly observed ictal symptoms of TLS in children are versive movement(46%), motor phenomenon(42%), simple automatism(42%), complex automatism(24%), secondary generalization(21%), and dystonic posture(12%). If we analyzed the ictal symptoms of TLS according to age group, school age children showed relatively similar ictal symptom to those of adult. However, ictal symptoms in the preschool age group disclosed a significant differences to those of school age children as follows; frequent motor phenomenon(63%) and simple automatism(48%), but rarity of secondary generalization(6%) and complex automatism(0%). 2) Motor phenomenon of extremity, tonic posture, showed pretty different pattern; highly symmetric presentation in the preschool age group(78%) but always unilateral presentation in the school age group. 3) Commonly observed initial symptoms of TLS are aura(46%), behavioral arrest(30%), versive movement(12%), arousal response(9%), and motor phenomenon(3%). School age children always presented aura(70%) or behavioral arrest(24%) as an initial symptom. However, preschool age children showed variable initial symptoms as follows; behavioral arrest(37%), versive movement(19%), aura(19%), and arousal response(19%). 4) Aura was presented as initial symptom in 15 patients with TLS; visceral sensation in 7 cases, psychic symptoms in 5 cases, and cephalic symptoms in 3 cases. CONCLUSION: The clinical seizure characteristics of CPS originated from temporal lobe was similar to those of adult in the school age group, but quietly different in preschool age group. Preschool age children frequently showed behavioral arrest, versive movement, and arousal response as an initial symptom of TLS. Most frequent clinical characteristics of TLS in the preschool age group is symmetric tonic posture which we frequently observed in the frontal lobe epilepsy. Therefore, clinical seizure characteristics of CPS of temporal lobe origin could not be used as an important guideline for the preoperative localization of the epileptogenic zone in the young children.
Academic Medical Centers ; Adult ; Anticonvulsants ; Arousal ; Brain ; Child* ; Electroencephalography ; Epilepsy ; Epilepsy, Frontal Lobe ; Extremities ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Posture ; Surveys and Questionnaires ; Seizures* ; Sensation ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: Nucleolar organizer regions(NORs) are loops of DNA that transcribe ribosomal RNA; they can be easily identified in paraffin section using silver method. Recently, the application of NORs to the study of various types of benign and malignant proliferation has suggested that the number of NORs per nucleus can provide an indication of degree of cellur maligriancy. Many authors indicated a significant overlapping of NORs counts between benign and malignant proliferation. OBJECTIVE: The purpose of this study is to discriminate benign m laocytic nevi from malignant melanoma effectively, thus we use simple enumeration and computerized image analysis of AgNORs in melanocytic skin lesions. METHOD: NORs were investigated on silver stained histologicec ion of 18 malignant melanoma (MM), 19 acquired nevi(AN), 21 congenital nevi(CN). For each case, 100 nucleus sample were cuantified using image analysis system(AIC Inc., Roswell, GA). There is no consensus at present as to the best criterion for quantifying AgNORs proteins in melanocytic skin lesion. We prefer to quantify a large number of parameters. The mean value or standard deviation(SD), each calculated for a batch of 100 cells, are average again(mean+SD), over the 58 cases for six morphological criteria mean number of AgNORs per nucleu, mean ratio of AgNORs area per ruc eus area, mean area of largest AgNORs, mean ratio of largest AgNORs area per nucleus area, mean nucleus area per a AgNOR, and coefficient of variation of nucleus area. RESULTS: 1. All of the six parameters show significant difference between benign melanocytic nevi and malignant melanoma. But., there is no significant difference between acquired nevi and congenital nevi. 2. In stepwise discriminate analysis, we discriminate benign melanoctic nevi from malignant melanoma effectively using combined two parameters(number of AgNORs and mean ratio of AgNORs area per nucleus area). But there is some overlapping between malignant melanoma and ber ign melanocytic nevi using each six parameters. 3. In metastatic and non-metastatic malignant melanoma, six param ters have not shown significant difference. CONCLUSION: Study of AgNORs in the image analysis system is a very useful tool to differentiate malignant melanoma from benign melanocytic nevi.
Consensus ; DNA ; Melanoma ; Nevus ; Nevus, Pigmented ; Nucleolus Organizer Region ; Paraffin ; RNA, Ribosomal ; Silver ; Skin*

No abstract available.
Skull Base* ; Skull*

Two isotypes of nm23 gene have been reported as multifunctional genes as well as CD44 gene. In tumor, both of genes, one isotype of human nm23, nm23-H1 and splice variants of surface glycoprotein CD44[CD44 v8-10], are correlated with tumor growth and metatastic potential[Keim et al., 1992 ; Dall et al., 1995]. However, the correlation of expression between these genes in tumor was not reported. In this immunohistochemical study on skin cancers, basal cell carcinoma, squamous cell carcinoma, and malignant melanoma, we intended to clarify the differences of expression on the basis of origins of skin tumors, basal cell, prickle cell, melanin producing cell, and compare the alterations of expressions between two genes in each tumor, respectively. The conclusion of this comparison is that relative parallel alteration in expressions between nm23-H1/NDP kinase and CD44 v8-10 was observed in basal cell carcinoma and malignant melanoma with inverse relation in differentiation. In squamous carcinoma, the expressions of two genes were much associated with differentiation. On the periphery of tumor, very low level of nm23-H1 protein and high level of CD44 v8-10 protein were detected.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans* ; Melanins ; Melanoma ; Membrane Glycoproteins ; Phosphotransferases* ; Skin Neoplasms* ; Skin*

No abstract available.
Aspergillosis* ; Mastoid*

Hereditary nonpolyposis colorectal cancer(HNPCC) is an autosomal dominantly inherited disease associated with a marked increase in cancer susceptibility, especially cancer of the colorectum. The frequency of HNPCC in the general population is yet to be determined, but HNPCC may account for as much as 2% to 5% of colorectal cancer, Colorectal cancer in HNPCC differs from sporadic colorectal cancer by an early age of cancer onset, proximal predominance of colorectal cancer, an excess of synchronous and metachronous colorectal cancer, and excess extra-colonic cancers. We have found 5 HNPCC families since 1992 when we reported first HNPCC family (KHU-Hl) In order to register the patients of HNPCC and to review the clinicopathologic feature and appropriate management, we have analysed 5 HNPCC families. Five HNPCC families included 16 colorectal cancer patients(14 males and 2 females). The average age of first diagnosis was 39. Among 16 patients, 8 patient were operated at the KyungHee University hospital and their operative and pathologic records were available. Two synchronous and seven metachronous cancers were founded, so that eight patients had 15 colorectal cancer lesions. Ten cancers were located proximal to splenic flexure and five were distal. Partial resection of colon was performed in seven cases except one when the first diagnosis was made and recurrence was founded in 5 patients. Recurrence was treated by total colectomy in 3 cases and subtotal colectomy in two. In conclusion, we re-confirmed that HNPCC patient should be treated by no less than a subtotal colectomy because of high multiplicity and high recurrence rate of partial resection.
Colectomy ; Colon ; Colon, Transverse ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis* ; Diagnosis ; Humans ; Male ; Recurrence

BACKGROUND: This study was conducted to compare the clinical and radiological outcomes of the locking hook plate fixation (HP) technique and the single tight rope (TR) technique applied for acute high-grade acromioclavicular (AC) joint separations. METHODS: Between 2009 and 2014, 135 consecutive patients with acute AC joint separation Rockwood types III, IV, and V were subjected to surgical reconstruction. One hundred fourteen patients (84.4%) were available for retrospective evaluation. Of them, 62 and 52 were treated using the single TR group and clavicular HP group techniques, respectively. The visual analogue scale, Constant, American Shoulder and Elbow Surgeons (ASES), and Taft scores were used for clinical assessment. Postoperative shoulder range of motion was also assessed. An anteroposterior radiograph of the coracoclavicular distance (CCD) was obtained to evaluate the radiographic signs of recurrence. RESULTS: The TR group patients had better Constant, ASES, and Taft scores than the HP group patients. The loss of reduction in terms of the CCD did not differ between groups. Subacromial osteolysis was observed in 34.6% of the cases in the HP group. However, there were no significant differences in the clinical outcomes between the patients with and without osteolysis in the HP group. Subcoracoid osteolysis, drill tunnel widening, and metal displacement were observed in 3.2%, 22.6%, and 4.8% of the cases in the TR group, respectively. CONCLUSIONS: The single TR technique was relatively more effective at treating acute high-grade AC joint injuries than the HP fixation technique (level of evidence: therapeutic; retrospective comparative study, Level III).
Acromioclavicular Joint* ; Dislocations* ; Elbow ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Surgeons