To elucidate the significance of the nesidiodysplasia of pancreas, histological re-evaluation and immunohistochemical studies for insulin, glucagon and somatostatin were done on 16 consecutive cases (5 premature babies, 2 stillborns, 5 infants and 3 adults) in which paraffin blocks of the pancreas were available. Only one infant was hypoglycemic. All 16 pancreases showed changes of nesidiodysplasia which appeared immunohistochemically to have isulin, glucagon and /or somatostatin. The histologic patterns of nesidiodysplasia included ductoendocrine proliferation, endocrine cell dysplasia, adenomatosis, septal islet, islket cell hypertrophy and islet hypertrophy. All the patterns of nesidiodysplasia except for the adenomatosis were seen in premature babies, infants, stillborns and adults with or without hypoglycemia. The adenomatosis was found only in the hypoglycemic infant. The result suggests that all patterns of nesidiodysplasia of other than the adenomatosis does not imply the pathologic basis of hypoglycemia.
Infant ; Adult ; Male ; Female ; Humans

No abstract available.
Animals ; Endometriosis* ; Female ; Horns* ; Kidney*

No abstract available.
Animals ; Endometriosis* ; Female ; Horns* ; Kidney*

No abstract available.
Oocytes* ; Pregnancy* ; Spermatozoa*

We performed tendon transfer with a microvascular free flap for recovery of handicapped function and reconstruction for the skin and soft tissue loss. We review the clinical data of 11 children who underwent these operation due to injured foot by pedestrian car accident from January, 1986 to June, l994. The mean age of patients was 5.6 years old (3-8). Five cases underwent tendon transfer and microvascular free flap simultaneously. Another 6 cases underwent operations separately. The time interval between tendon trasnfer and microvascular free flap was average 5.8 months (2-15 months). The duration between initial trauma and tendon transfer was average 9.6 months (2-21 months). The anterior tibial tendon was used in 6 cases. Among these, the technique of splitting the anterior tibial tendon was used in 5 cases. The posterior tibial tendon was used in 3 cases and the extensor digitorum longus tendon of the foot in 2 cases. Insertion sites of tendon transfer were the cuboid bone in 3 cases, the 3rd cuneiform bone in 3 cases, the 2nd cuneiform bone in I case, the base of 4th metatarsal bone in I case, and the remnant of the extensor hallucis longus in 3 cases. The duration of follow-up was average 29.9 months (12-102 months). The clinical results were analyzed by Srinivasan criteria. Nine cases were excellent and 2 cases were good. The postoperative complications were loosening of the tranferred tendon in 2 cases, plantar flexion contracture in l case, mild flat foot deformity in I case and hypertrophic scar in 2 cases. So we recommend the tendon transfer with a microvascular free flap in the case of injured foot of children combined with nerve injury and extensive loss of skin, soft tissue and tendon.
Child* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Disabled Persons ; Flatfoot ; Follow-Up Studies ; Foot* ; Free Tissue Flaps* ; Humans ; Metatarsal Bones ; Postoperative Complications ; Skin ; Tarsal Bones ; Tendon Transfer* ; Tendons*

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip*

BACKGROUND: Extracellular ATP, released from platelets and nerve endings, plays significant roles in the regulation of circulation. The effects of ATP depend on the location of the vessels and the species of experimental animals. Until now, studies were limited to arteries, so we compared the effects of ATP in rat vena cava with those in the aorta and attempted to identify the characteristics of their receptors. METHODS: Vascular rings were isolated from the rat inferior vena cava and descending thoracic aorta. Endothelial cells were preserved or removed by gentle rubbing. The isometric contractions were recorded on polygraph using a force transducer. RESULTS: In the vena cava ring precontracted by 100 nM norepinephrine (NE), ATP elicited relaxations in a dose-dependent manner. These effects were abolished by removal of the endothelium or pretreatment with a nitric oxide synthase inhibitor. Relaxations to ATP in the vena cava (EC50 :9.9 microM) were less potent than those in the aorta (1.7 microM). The relative order of potencies was ADP>ATP>AMP>adenosine, but the maximal relaxation to ADP was smaller than to ATP. ATP-induced vasorelaxation was blocked by suramin, a nonselective antagonist for P2 purinoceptor and reactive blue-2, a P2Y blocker. At basal tension, ATP contracted the vena cava dose-dependently and these effects were potentiated by endothelium-removal. Contractions in the vena cava were also less potent than in the aorta, and the order of potencies was alpha, beta-MeATP>UTP>ATP>ADP>AMP=adenosine. ATP-induced vasoconstriction was blocked by suramin and alpha, beta-MeATP, a desensitizing antagonist of P2X purinoceptor, and potentiated by pretreatment with UTP. CONCLUSION: These results suggest that ADP and ATP acts on P2Y1- and P2Y2-purinoceptor in the endothelium, respectively and induces vasorelaxation of the vena cava, which is mediated by nitric oxide. Since ATP and UTP induced vasoconstriction in endothelium-denuded condition, it may be mediated by the activation of the P2X and P2Y4, 6 purinoceptor on smooth muscles, respectively.
Adenosine Diphosphate ; Adenosine Triphosphate ; Animals ; Aorta ; Aorta, Thoracic ; Arteries ; Endothelial Cells ; Endothelium ; Isometric Contraction ; Muscle, Smooth ; Nerve Endings ; Nitric Oxide ; Nitric Oxide Synthase ; Norepinephrine ; Rats* ; Receptors, Purinergic P2 ; Receptors, Purinergic P2X ; Receptors, Purinergic* ; Relaxation ; Suramin ; Transducers ; Uridine Triphosphate ; Vasoconstriction ; Vasodilation ; Vena Cava, Inferior*

PURPOSE: To obtain magnetization transfer ratio(MTR) of the annulus fibrosus and nucleus pulposus and to assess the feasibility of utilizing the changes of these MTRs as an early indicator of disk degeneration. MATERIALS AND METHODS: MR images of lumbar spine with magnetization transfer(MT) technique in 42 patients were obtained. spin echo techniques (600/14) with same TR/TE with 1KHz off-resonance saturation were employed in 1.0T MR system. MTRs were calculated in two regions, anterior annulus fibrosus and nucleus pulposus, and the results were compared between the normal and degenerative disks, from grade I to IV, on T2-weighted images. RESULTS: MTRs of the nucleus pulposus were 17.6% in the normal disks, and 26.7%, 28.4%, 29.1%, 29.7% in degenerative disks, from grade I to IV, respectively, with a significant difference(P<0.05). On the other hand, MTRs in the annulus fibrosus were 30.2% in the normal disks and 31.5%, 33.2%, 32.1% and 35.6% in degenerative disks, from grade I to IV, respectively, without significant difference. CONCLUSION: Since MTRs are significantly higher in degenerative nucleus pulposus than those of the normal disks, increased MTRs in the nucleus pulposus can be used as an early sign of the degeneration of the nucleus pulposus.
Hand ; Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging* ; Spine

Computed tomography (CT) seems to be the best imaging modality to diagnose an enterovesical fistula, but is not always able to demonstrate enterovesical fistula itself. In this case report, we present Tc-99m HMPAO white blood cell (WBC) scintigraphic findings of an enterovesical fistula complicating Crohn's disease. A 22 year-old male presented with a one-month history of urinary symptoms such as dysuria, hematuria, and frequency. The patient had intermittent right lower quadrant pain, diarrhea and hematochezia. Enterovesical fistula was highly suggestive in pelvic CT which showed air density in the urinary bladder, but cystoscopy failed to find an opening of the fistula. Tc-99m HMPAO WBC scintigraphy for evaluation of inflammatory bowel disease incidentally demonstrated enterovesical fistular tract. Crohn's disease was later confirmed by histologic examination of the surgical specimen. In our patient, Tc-99m HMPAO WBC imaging was helpful in determining the location of the fistula as well as assessing the disease activity and extent of the Crohn's disease.
Crohn Disease* ; Cystoscopy ; Diarrhea ; Dysuria ; Fistula* ; Gastrointestinal Hemorrhage ; Hematuria ; Humans ; Inflammatory Bowel Diseases ; Leukocytes* ; Male ; Radionuclide Imaging* ; Technetium Tc 99m Exametazime* ; Urinary Bladder ; Young Adult

BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*