No abstract available.
Mediastinitis*

No abstract available.
Mediastinitis*

Isometric tension recording was performed in the transverse strips of porcine coronary arteries and rabbit aorta to observe the effects of the endothelium and endothelium-derived relaxing factor(EDRF) on vasomotor tone and to test the hypothesis that alcohol may have the deleterious effect on endothelium-dependent vasorelaxation. Tension-development by vasoconstrictor was markedly attenuated in the endothelium-intact strips compared to the endothelium denuded strips. Administration of hemoglobin(10-5M) to inhibit the action of EDRF increased tension selectively in the endothelium-infarct strips, which is suggestive of basal EDRF secretion. Nitro L-arginine(10-5M). an analogue of L-arginine(10-4M) partially reversed the inhibitory effect of nitro L-arginine. Ethyl alchol inhibited bradykinin-induced endothelium-dependent vasorelaxation of porcine coronary artery in dose dependent manner. These data suggest that the protective effect of vascular endothelium to the action of vasoconstirctor can be explained by exercise of basal EDRF release and damaged endothelium would be a great risk of induction of vasospasm. Also we believe that there is a relationship of competive inhibition between L-arginine. a precursor of EDRF, and its analogues on the action of EDRF and alcohol intake would be hazardous to the patients with coronary artey disease because its inhibitory action on endothelium-dependent vasorelaxation may evoke myocardial ischemia.
Aorta ; Arginine ; Coronary Vasospasm ; Coronary Vessels* ; Endothelium* ; Endothelium, Vascular ; Ethanol* ; Humans ; Myocardial Ischemia ; Spasm* ; Vasodilation

Cyclin D1, a cell cycle regulator essential for G1 phase progression, is a candidate proto-oncogene implicated in pathogenesis of several human carcinomas including breast carcinoma. We studied the cyclin D1 expression in 101 cases of primary breast carcinoma tissues. The overexpression of cyclin D1 was immunohistochemically demonstrated in 34 (37.8%) of 90 cases of invasive breast carcinoma. Positive cyclin D1 staining was seen in 32 of 79 invasive ductal carcinomas, and 2 of 3 mucinous carcinomas. All 5 medullary carcinomas, 2 invasive lobular carcinomas, and 1 metaplastic carcinoma were negative. Cyclin D1 overexpression was observed in 9 of 11 ductal carcinoma in situ (DCIS). Normal epithelial components, either ductal or lobular, were not immunoreactive for cyclin D1. No significant correlations were observed between cyclin D1 immunoreactivity and other parameters including tumor size, clinical stage, nuclear or histologic grades, lymphatic or angioinvasion, lymph node metastasis, and immunohistochemical status of progesterone receptor, p53 and c-erbB-2. The overexpression of cyclin D1 was positively correlated with estrogen receptor status (p=0.025). Based on our results, the cyclin D1 protein aberration may play a role in tumorigenesis of breast carcinoma, but does not seem to have prognostic value in invasive breast carcinoma without hormonal treatment.
Adenocarcinoma, Mucinous ; Breast Neoplasms* ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Carcinoma, Medullary ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Estrogens ; G1 Phase ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proto-Oncogenes ; Receptors, Progesterone

BACKGROUND: The long-term survival in patients with non-Hodgkin's lymphoma (NHL) after conventional chemotherapy is about 35% and the rest of the patients tend to have relapse. So, in relapsed or refractory NHL, the outcome of patients undergoing high-dose chemotherapy and autologous peripheral stem cell transplantation (APBSCT) was evaluated, and the main prognostic factors were determined. METHODS: 17 patients with relapsed or resistant NHL (5 complete response group, 7 partial response group, 4 primary refractory group, 1 resistant relapse) underwent BEAM (carmustine, etoposide, cytarabine, melphalan) chemotherapy and APBSCT between July 1997 and February 1999. RESULTS: The median follow-up duration was 17 months (range: 4-47). The response rate was 58.3% (complete response 33.3%, partial response 25.0%) in 12 patients in whom complete response group was not included. The 2-year, 3-year overall response rate were 41.2%, 27.5%, respectively. And 2-year progression free survival was 35.3%. The disease status before high-dose chemotherapy was the only significant prognostic factor in determining overall survival (univariate p=.024, multivariate p=.059) and progression free survival (univariate p=.013, multivariate p=.026). Patients with complete response to salvage regimen had better overall survival (p=.021) and progression free survival (p=.008) than patients with refractory response. WBC (> or = 1,000/uL) was recovered at the median 11 days (range; 8-24), and platelet (> or = 50,000/uL) was recovered at the median 18 days (range; 9-44). There was no treatment-related death and no grade 3 and 4 toxicity. Neutropenic infection was in 4 patients (1 Herpes zoster, 1 typhlitis, 1 perianal infection, 1 otitis externa). CONCLUSION: The pre-transplant disease status was the main prognostic factor. Patients with complete response to salvage regimen had the significant benefit in survival from high-dose chemotherapy and APBSCT, but patients with refractory or resistant relapsed NHL did not have any significant benefit.
Blood Platelets ; Cytarabine ; Disease-Free Survival ; Drug Therapy ; Etoposide ; Follow-Up Studies ; Herpes Zoster ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Otitis ; Peripheral Blood Stem Cell Transplantation* ; Recurrence ; Typhlitis

BACKGROUND: Patients with non-Hodgkin's lymphoma who do not respond to first-line chemotherapy or those who relapse after obtaining a complete response have a poor prognosis and are rarely cured with usual salvage chemotherapy. We investigated the treatment responses, toxicities, prognostic factors and mobilization efficacy of peripheral blood stem cells (PBSC) used as salvage chemotherapy. METHODS: 55 patients with refractory (36) or relapsed (19) NHL were treated from Novembr 1997 to October 1999 with IVAM (ifosfamide, etoposide, cytarabine, methotrexate) regimen. Each patients was scheduled to receive one to three cycles of chemotherapy. When the leukocyte count reached 5x109/L after chemotherapy, PBSC collection was performed. The treatment was repeated every 4 weeks. RESULTS: The median age was 48 years (range, 19-76). Median 2.1 cycles of chemotherapy were administered. 15 patients (27.3%) achieved complete response and 29 (52.7%) partial response, with an overall response rate of 80.0%. Myelosuppression was the major toxicity, with 98.2% of grade 3, 4 neutropenia and thrombocytopenia, but there was no serious hemorragic event. Neutropenic fever occurred in 25.5% of the patients with one treatment-related death due to sepsis. Non-hematologic toxicity was modest. PBSC was collected in 36 patients for high dose chemotherapy and autologous stem cell transplantation. The median number of mononuclear cells collected was 9.9x108/kg and the median number of CD34(+) cells collected was 11.9x106/kg. After a median follow-up of 13 months (range, 3-26), median progression free survival were 12 months and median overall survival has not been reached yet. 1-year overall survival and progression free survival were 61.9% and 46.1%, respectively. In univariate analyses, unfavorable prognosis was associated with poor performance status (p=0.001), high LDH (p=0.041), stage III,IV (p=0.04), extralymphatic lesion (p=0.027), B sx (p=0.034), bone marrow involvement (p=0.039) and performing high dose chemotherapy (p=0.005). Multivariate analysis showed that performance status(p=0.0042), B sx(p=0.049) was a significant independent risk factors for death. CONCLUSION: These results suggest that IVAM is an effective salvage chemotherapy for refractory or relapsed NHL and allow effective PBSC collection for high dose chemotherapy and autologous PBSCT.
Bone Marrow ; Cytarabine ; Disease-Free Survival ; Drug Therapy* ; Etoposide ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Lymphoma, Non-Hodgkin* ; Multivariate Analysis ; Neutropenia ; Prognosis ; Recurrence ; Risk Factors ; Sepsis ; Stem Cell Transplantation ; Stem Cells ; Thrombocytopenia

BACKGROUND: Long term athletic training is associated with an increase in left ventricular diastolic cavity dimension, wall thickness, and mass. These changes in left ventricular morphology represent an adaptation to increased ventricular load and are generally described as the “athlete's heart”. In the present study, we used echocardiography to evaluate the left ventricular structure and function in track athletes. METHODS: We studies 48 males(average age 22 years)by Doppler and echocardiography, which consisted of 12 normal controls, 36 track athletes(12 long distance track, 12 sprint, 12 jump). These athletes were trained regularly for 3-19 years(average 9±4 years). RESULTS: 1) At rest, left ventricular diastolic and systolic diameter, systolic interventricular septal wall thickness, diastolic and systolic posterior wall thickness, and left ventricular end diastolic and systolic dimension were larger in long distance track athletes than in the controls. 2) Left ventricular mass was larger in long distance track athltes and sprinter than controls. 3) After maximum exercise, left ventricular diastolic and systolic diameter, systolic interventricular septal wall thickness, diastolic and systolic posterior wall thickness, and left ventricular end diastolic and systolic dimension increased more significantly in long distance track athletes than in the controls. But, in sprinters, the left end systolic diameter, diastolic and systolic interventricular septal thickness, and left end diastolic and systolic dimensions were increased. 4) At rest, the E/A and Ei/Ai of the mitral flow in long distance track athletes increased more than in the controls. But there were no differences of parameters of mitral and aortic flow between long distance track athletes and controls after maximum exercise. CONCLUSIONS: The left ventricular mass of long distance and sprint track athletes were lager Than controls. In the long distance track athletes, the left ventricular structural and functional changes before and after maximum exercise were prominent. In the sprinters, after maximum exercise, the left ventricular structural and functional changes were prominent.
Athletes ; Echocardiography ; Echocardiography, Stress ; Heart Ventricles ; Humans ; Sports