No abstract available.
Obstetrics*

A 21-year-old man presented with a 7 days history of fever. Careful clinical examination led to the discovery of left supraclavicular lymphadenopathy without hepatosplenomegaly. Serologic tests for Ebstein-Barr virus, HIV, hepatitis type B & C, syphilis and typhoid fever were negative. Blood, urine, and stool cultures yielded no growth. Histologically, the process mainly involved the connective tissue framework of the lymph node, sharing the features of inflammatory pseudotmor(IPT) of other organs: a storiform growth pattern, increased vascularity with associated vascular lesions, and a polymorphous inflammatory infiltrate in a collagen-rich stroma. Immunohistochemical study for spindle cells showed positive reaction for actin and vimentin but not for desmin, and lymphoid cells revealed polyclonality. Characteristics of mass formation, and the inflammatory nautre of the process enabled us adopt the term IPT which should be differentiated from hematolymphoid proliferative disorder or mesenchymal neoplasia.
Male ; Humans

Authors experienced a rare adenocarcinoma arising in presacral sacrococcygeal teratoma in a adult and herein reported. The patient was a 52 year old female admitted because of lower abdominal pain for 5 to 6 months. Past and familial history were unremarkable. On rectal examination a mass was palpated 3 cm above the anal verge. The large bowel was displaced by an extrinsic mass but there was no evidence of intrinsic tumor lesion on barium enema, CT was done and showed a large presacral tumor attached to the sacrum. Clinical impression was sacrococcygeal teratoma. Resected tumor mass was a relatively well circumscribed cystic mass, measuring 11 x 11 cm and the cystic content was previously evacuated. Inner surface showed ragged appearance, and focal nodular solid area was noted. On microscopic examination, the tumor revealed the derivatives of three germ layers and main components were tissues of respiratory tract. Sections from the solid area showed a well differentiated adenocarcinoma and with stromal, capsular and perineural invasion. Borderline malignant epithelial lesions are also noted suggesting the pathogenesis and progression of this tumor. There was no recurrence for one year after surgery in the follow up.
Adult ; Male ; Female ; Humans ; Adenocarcinoma

Hydrops fetalis is diagnosed when abnormal fluid collections are manifest in two or more fetal compartments, including abdominal ascites, pleural effusions, pericardial effusions, skin edema, polyhydroamniosis and placental edema. Although fetal hydrops was hystorically most commonly associated with Rh blood group isoimmunization, the availability of Rh immunoglobulin has increased the proportion of fetuses affected due to nonimmune etiologies. We have experienced a case of nonimmune hydrops fetalis at 32 weeks of gestation in a 27-year-old woman and reported that with brief review of related literatures.
Adult ; Ascites ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Immunoglobulins ; Pericardial Effusion ; Pleural Effusion ; Pregnancy ; Skin

In gliomas, the most frequently studied tumor suppressor gene is the p53 gene which has been found to be mutated in a considerable fraction of astrocytomas and glioblastomas. Mutations that alter the function of the p53 gene product are thought to play a critical role in glial tumorigenesis. The murine double minute 2(MDM2) gene has been shown to code for a cellular protein that forms a complex with the p53 tumor suppressor gene product and inhibits its function. The fact that MDM2 can negatively regulate p53 suggests MDM2 could function as an oncogene when overexpressed. We investigated the expression of p53, MDM2 and proliferative activity of the tumor cells in 71 cases of gliomas(17 cases of differentiated astrocytomas. 25 cases of anaplastic astrocytomas and 29 cases of glioblastomas). Their paraffin-embedded tissue sections were immunostained with monoclonal antibody(p53 and PCNA, proliferating cell nuclear antigen) and polyclonal antibody(MDM2) for detection of p53, MDM2 and PCNA respectively. The results were as follows: The p53 staining was positive in 28 cases(39.4%) and MDM2 staining in 5 cases(7.0%) of 71 gliomas. The p53 positive-staining was detected in 2 cases(11.8%) of 17 differentiated astrocytomas, 9 cases(36.0%) of 25 anaplastic astrocytomas and 17 cases(58.6%) of 29 glioblastomas. The p53 expression was associated with malignancy grade(p<0.005) and proliferative activity was strongly associated with malignancy grade(p=0.0001). The p53 expression was closely associated with proliferative activity : p53-positive tumors had significantly higher median PCNA-labeling index than p53-negative tumors(40.6+/-10.1% versus 19.6+/-15.0%)(p=0.0001). But, MDM2 expression was not associated with proliferative activity(p=0.4575). The proportion of p53 immunoreactivity had significant association with proliferaive activity: the more the proportion of p53 immunoreactivity increased, the higher PCNA-labeling index elevated(p=0.0001). None of the tumors with MDM2 expression showed immunoreactivity for p53. These results suggest that the mutation of p53 gene plays a critical role in malignant transformation in glioma and it could be the prognostic factor for histologically same grade gliomas and that a subset of human gliomas escapes from p53-regulated growth control by amplification and overexpression of MDM2. Therefore gene study targeting these genes may be useful for the management of human glioma as a diagnostic modality.
Astrocytoma ; Carcinogenesis ; Genes, p53 ; Genes, Tumor Suppressor ; Glioblastoma ; Glioma* ; Humans ; Oncogenes ; Proliferating Cell Nuclear Antigen ; Proto-Oncogene Proteins c-mdm2 ; United Nations

No Abstract Available.
Arthroplasty* ; Knee*

BACKGROUND: Although the superior reperfusion and improved clinical outcome following angioplasty for acute myocardial infarction (AMI) have been well known, 10 to 15% of reinfarction and recurrent ischemia in hospital are main limitation of primary percutaneous transluminal coronary angioplasty (PTCA). This study was undertaken to examine the safety and feasibility of stent-supported primary angioplasty in acute myocardial infarction. METHODS: Between July 1995 and Jun. 1997, 32 patients underwent direct or rescue PTCA, including patients with cardiogenic shock. After PTCA, stenting was attempted in patient with dissection or having more than 30% of residual stenosis. Result: In patient with direct PTCA, angiographic success rate was obtained in 91% (30/32). Stenting was attempted in 15 of 30 patients. These patients had suboptimal results (8 patients), non-occlusive dissection (3 patients) and acute occlusion (2 patient). Thrombolysis in myocardial infarction (TIMI) grade 3 flow was restored in 28 patients (93%). In one patient no-reflow phenomena was observed following stent insertion. Despite intra-aortic balloon pumping, there was one death during the hopitalization due to cardiogenic shock following PTCA. Subacute stent thrombosis developed in two patients. 27 patients (90%) were event-free and clinically improved through out the follow up period (11.5+/-5.2 month). Quantitative angiography showed excellent angiographic result after stenting compared with balloon PTCA (2.4+/-0.6 mm vs. 3.4+/-0.3 mm p<0.01). CONCLUSION: After failure of initial angioplasty, coronary stenting can be a supportive therapeutic strategy. Coronary stenting results in a high degree of angiographic success, a low incidence of subacute thrombosis.
Angiography ; Angioplasty* ; Angioplasty, Balloon* ; Angioplasty, Balloon, Coronary ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Intra-Aortic Balloon Pumping ; Ischemia ; Myocardial Infarction* ; Reperfusion ; Shock, Cardiogenic ; Stents ; Thrombosis

BACKGROUND: To pass through the microcirculation, erythrocytes need to undergo considerable deformation. We performed an experiment to investigate the erythrocyte deformability in healthy adults and in patients with uncontrolled hypertension and controlled hypertension. METHODS: 5ml of whole blood is anticoagulated with 2mg ethylenediaminotetra-acetic acid(EDTA). 1ml graduated plastic syringe, without its plunger, is filled with anticoagulated whole blood to the 1ml mark, And the syringe is put into the assembled membrane holder. Under standard condition, whole blood is passed through a 5micro polycarbonate membrane filter under negative pressure of 20cm H2O. The studies are performed at roon temperature and within two hours of venipuncture. RESULTS: Erythrocyte deformability was observed in 91 normal healthy adults and 25 patients with uncontrolled hypertension and 18 patients with controlled hypertension. Following results were obtained. 1) In male control age group I, II, III, the erythrocyte deformability indices were 0.776+/-0.125, 0.792+/-0.189, and 0.714+/-0.172 respectively and in female the indices were 0.880+/-0.138, 0.865+/-0.182 and 0.796+/-0.170 accordingly. 2) THe RBC deformability indices in female control troup were significantly higher than the male group in statistics(p<0.05). 3) No significant differences were observed among each age group in control. 4) In patients with uncontrolled hypertension, each age group I, II and III, the erythrocyte deformability indices were 0.785+/-0.050, 0.775+/-0.122, and 0.692+/-0.133 respectively and in control group, the indices were 0.8365+/-0.140, 0.8252+/-0.186 and 0.7534+/-0.173 accordingly. And in patients with controlled hypertension, the indices were 0.820+/-0.00, 0.788+/-0.135 and 0.716+/-0.141 accordingly. 5) The erythrocyte deformability inddex in patients with uncontrolled hypertension were significantly lower than the control group(p<0.05), and no significant differences were observed among each age group between male and female in patients with uncontrolled hypertension. 6) There was no significant statistical difference of deformability indices between uncontrolled group and controlled group(p>0.05). CONCLUSION: This study reveals that the erythrocyte deformability in patients with essential hypertension is significantly lower than the healthy adults.
Adult ; Erythrocyte Deformability* ; Erythrocytes* ; Female ; Humans ; Hypertension* ; Male ; Membranes ; Microcirculation ; Phlebotomy ; Plastics ; Syringes

BACKGROUND: Despite improvement of mortality in acute myocardial infarcrtion, high mortality rate associated with cardiogenic shock remains essentially unchanged. We have reviewed our result of coronary intervention in 15 patients and found relative survival advantage. METHODS: Between Sep. 1992 and Aug. 1995, 15 consecutive patients(M. 10, F. 5) with cardiogenic shock in acute myocardial infarction were treated with coronary intervention using ballon PTCA. IABP was inserted in all patients prior to PTCA. RESULTS: 1) Most commonly found infarct related artery was left anterior descending artery(11) followed by right coronary artery(3) and left main coronary artery(1). 2) Successful reperfusion rate was 86.7%(13/15), and in-hospital mortality rate was 26.7%(4/15). 3) In-hospital mortality was higher in elderly patients compared with less than 70yaer old patients(0%(0/11)vs. 75.0%(3/4)(P < 0.05). 4) Mortality rate was lower in single vessel disease than multivessel disease(11.1%(1/9) vs. 50%(3/6) p<0.05). CONCLUSION: Although this study is uncontrolled, the date suggest that urgent coronary intervention for improving coronary perfusion may reduce mortality of acute myocardial infarction complicated by cardiogenic shock, particularly with single vessel disease and young age group.
Aged ; Arteries ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Shock, Cardiogenic*

A study on changes of serum HDL-cholesterol level in various diseased states was performed. Diseased groups were nephrotic syndrome, liver cirrhosis, hyperthyroidism, hypothyroidism and chronic alcoholism. Following results were obtained. 1) Compared to normal control group, levels of HDL-cholesterol in nephrotic syndrome were lower but the difference was significant statistically. 2) In liver cirrhosis, the result showed much lower levels than normal control group with high significance. 3) In both hyper-and hypothyroidism group, the levels of HDL-cholesterol were significantly lower than normal control group. 4) In chronic alcoholism, the levels were significantly higher than normal control group. 5) Except for the group of chronic alcoholism, the levels of HDL- cholesterol were higher in female groups than male groups, but was of no significance statistically.
Alcoholism ; Cholesterol ; Female ; Humans ; Hyperthyroidism ; Hypothyroidism ; Liver Cirrhosis ; Male ; Nephrotic Syndrome