ICAM-l(Intercellular adhesion molecule-1) is an important early marker of immune activation and response. ICAM-1 is expressed on varous cell types and observed in a variety of diseases, including patients with asthma, melanoma, prostatic cancer, ovarian and colon cancer. Some authors demonstrated the expression of ICAM-1 protein in high-grade intraepithelial squamous neoplasia of cervix by immunohistochemistry and suggested that the expression was related to human papillomavirus infection. The aim of this study was to determine the serum levels of soluble intercellular adhesion molecule-1(sICAM-1) in patients with squamous cell carcinoma of the cervix, Serum levels of sICAM-1 were measured by enzyme-linked immunosorbent assay(ELISA), We evaluate invasive squamous cell carcinoma of the cervix (40), carcinoma in situ (16) and control (15) patients. Serum levels of sICAM-1 in healthy volunteers, in parients with carcinoma in situ and invasive cervical cancer were 150.1+/-41.3, 182.7+/-105.9, 189.8+/-60.0 ng/ml, respectively. Although the serum levels of sICAM-1 in patients with carcinoma in situ did not increase, serum levels of ICAM-1 in patients with invasive cervical cancer were significantly increased (control vs invasive cervical cancer, p < 0,05). From the above results, sICAM-1 is shed from the cancerous tissue in patients with squamous cell carcinoma of the cervix.
Asthma ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri ; Colonic Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Female ; Healthy Volunteers ; Humans ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Melanoma ; Papillomavirus Infections ; Prostatic Neoplasms ; Uterine Cervical Neoplasms*

PURPOSE: To describe the CT and MR imaging features in patients with intracranial dolichoectasia. MATERIALS AND METHODS: The CT(n=21), MR(n=20) and MRA(n=11) imaging features seen in 28 patients (M:F=12:16 aged beetween 65 and 82 (mean, 65) years with intracranial dolichoectasia were retrospectively reviewed with regard to involved sites, arterial changes(maximum diameter, wall calcification, high signal intensity in the involved artery, as seen on T1-weighted MR images), infarction, hemorrhagic lesion, compression of brain parenchyma or cranial nerves, hydrocephalus and brain atrophy. Involved sites were classified as either type 1 (involvement of only the posterior circulation), type 2 (only the anterior circulation), or type 3 (both). RESULTS: In order of frequency, involved sites were type 1(43%), type 3(36%) and type 2(22%). Dolichoectasia was more frequently seen in the posterior circulation(79%) than in the anterior (57%). Arterial changes as seen on T1-weighted MR images, included dolichoectasia(mean maximum diameter 7.4mm in the distal internal carotid artery, and 6.7mm in the basilar artery), wall calcification(100% in involved arteries) and high signal intensity in involved. Cerebral infarction in the territory of the involved artery was found in all patients, and a moderate degree of infarct was 87%. Hemorrhagic lesions were found in 19 patients(68%); these were either l o b a r ( 53%), petechial(37%), or subarachnoid (16%), and three patients showed intracranial aneurysms, including one case of dissecting aneurysm. In 19 patients(68 %), lesions were compressed lesions by the dolichoectatic arteries, and were found -in order of descending frequency- in the medulla, pons, thalamus, and cerebellopontine angle cistern. Obstructive hydrocephalus was found in two patients (7 %), and 23 (82 % ) showed a moderate degree of brain atrophy. CONCLUSION: In patients with intracranial dolichoectasia, moderate degrees of cerebral infarction and brain atrophy in the territory of involved arteries, as well as hemorrhagic lesions and compression of the brain stem or cranial nerves, were not infrequently seen on CT and MR images. These changes were in addition to the basic arterial change(dolichoectasia, arterial wall calcification and intraluminal high signal intensity) seen on T1-weighted MR images.
Aneurysm, Dissecting ; Arteries ; Atrophy ; Brain ; Brain Stem ; Carotid Artery, Internal ; Cerebellopontine Angle ; Cerebral Infarction ; Cranial Nerves ; Humans ; Hydrocephalus ; Infarction ; Intracranial Aneurysm ; Magnetic Resonance Imaging* ; Pons ; Retrospective Studies ; Thalamus

PURPOSE: To determine the plain film findings of acute neuropathic joint in diabetic foot. MATERIALS AND METHODS: Acute neuropathic joint in diabetic foot was considered when fragmentation of the articular ends of bone and subluxation of the affected joint developed within eight weeks after clinical onset of diabetic gangrene. Eight toes of six diabetics were satisfactory to our criteria. We analyzed plain radiographic findings of the affected joint and soft tissue, interval changes in follow-up radiographs, and deformities after healing. RESULTS: The time interval between clinical onset of gangrene and bone destruction ranged from 2 weeks to 4 weeks(mean 2.6 weeks). Plain radiographs showed fragmentation of the articular ends, subluxation, and soft tissue swelling of the metatarsophalangeal joint or interphalangeal joint. The significant feature of these patients was rapid progression of the lesions. Clinically, all patients had diabetic gangrene in affected toes, however, there was no evidence of osteomyelitis in our series. Amputation was done in 2 cases, and lesions in 3 of the remaining 4 cases were repaired spontaneously with regression of gangrene, leaving radiological residua such as pointed-end, tapered-end, and ball and socket deformity. CONCLUSION: Rapid disorganization of the joint with associated evidence of soft tissue gangrene in plain radiograph is believed to be valuable for the diagnosis of diabetic osteoarthropathy.
Amputation ; Congenital Abnormalities ; Diabetic Foot* ; Diagnosis ; Follow-Up Studies ; Gangrene ; Humans ; Joints* ; Metatarsophalangeal Joint ; Osteomyelitis ; Toes

Balloon pulnounary valvuloplasty is an established method in the treatment of congenital valvular pulmonary stenosis. Balloon valvuloplasty was performed by using one or two balloons in a total of 19 mongrel dogs. Cross sectional area ratio ranging 145-406% was used to compare the relative sizes of the pulmonary annulus the balloon Hemodynamic changes and cardiac damages in single and double balloon groups were analyzed. Survival time of double balloon group was longer than that of single balloon group(P<0.05). Increment of the right ven?dular systolic pressure in single balloon group (mean 38 mmHg) was greater than that in double balloon group (mean 18 mmHg) (p<0.05). Decrement of the femoral arterial pressure in single balloon group (mean 87 mmHg) was greater than in double balloon group (mean 41 mmHg) (p<0.05). The locations of trauma were mainly the right ventricular free wall, the main pulmonary artery, the anterior leaflet of the pulmonary valve and in a less degree, anterior wall of the right atrium, the right ventricular outflow tract and the left pulmonary artery in the order of frequency. There were no significant differences in cardiac damages between single and double balloon groups (P>0.05). Major microscopic findings were sloughing of the endotheliu, fibrin deposition, hemorrhage, localized myocardial infarction and so on. In conclusion, double balloon pulmonary valvuloplasty is superior to single balloon technique in survival time and hemodynamics. Therefore, double, balloon technique is recommended for the pulmonary valvuloplasty.
Animals ; Arterial Pressure ; Balloon Valvuloplasty ; Blood Pressure ; Catheters* ; Dogs ; Fibrin ; Heart Atria ; Hemodynamics ; Hemorrhage ; Methods ; Myocardial Infarction ; Pulmonary Artery ; Pulmonary Valve ; Pulmonary Valve Stenosis

Balloon pulnounary valvuloplasty is an established method in the treatment of congenital valvular pulmonary stenosis. Balloon valvuloplasty was performed by using one or two balloons in a total of 19 mongrel dogs. Cross sectional area ratio ranging 145-406% was used to compare the relative sizes of the pulmonary annulus the balloon Hemodynamic changes and cardiac damages in single and double balloon groups were analyzed. Survival time of double balloon group was longer than that of single balloon group(P<0.05). Increment of the right ven?dular systolic pressure in single balloon group (mean 38 mmHg) was greater than that in double balloon group (mean 18 mmHg) (p<0.05). Decrement of the femoral arterial pressure in single balloon group (mean 87 mmHg) was greater than in double balloon group (mean 41 mmHg) (p<0.05). The locations of trauma were mainly the right ventricular free wall, the main pulmonary artery, the anterior leaflet of the pulmonary valve and in a less degree, anterior wall of the right atrium, the right ventricular outflow tract and the left pulmonary artery in the order of frequency. There were no significant differences in cardiac damages between single and double balloon groups (P>0.05). Major microscopic findings were sloughing of the endotheliu, fibrin deposition, hemorrhage, localized myocardial infarction and so on. In conclusion, double balloon pulmonary valvuloplasty is superior to single balloon technique in survival time and hemodynamics. Therefore, double, balloon technique is recommended for the pulmonary valvuloplasty.
Animals ; Arterial Pressure ; Balloon Valvuloplasty ; Blood Pressure ; Catheters* ; Dogs ; Fibrin ; Heart Atria ; Hemodynamics ; Hemorrhage ; Methods ; Myocardial Infarction ; Pulmonary Artery ; Pulmonary Valve ; Pulmonary Valve Stenosis

PURPOSE: To establish the optimal inclusion criteria for the patients with gallbladder stones to extracorporeal shock wave lithotripsy(ESWL) by retrospectively analyzing our current results. MATERIALS AND METHODS: Data obtained from 201 patients with gallbladder stones treated with ESWL and oral chemolytic agent from November 1989 to July 1992 were restroepectively analyzed. Ninety-six had radiolucent stones and 105 had radiopaque stones. We used piezoelectric lithotriptor(EDAP LT. 01) and there were no limitation in number of sessions or total number of shock waves. ESWL was repeated until the size of the largest fragment is smaller than 4 mm. Follow up ultrasound was done in every three months after the successful fragmentation. Average length of the follow up was 205 days. We analyzed the rate of successful fragmentation, number of shock waves needed to achieve successful fragmentation according to the size, number of stones as well as the presence of the calcification. Stone-free rate after 6 months was also calculated from all subgroups and compared to each other. RESULTS: The rate of successful fragmentation was 76.2% for radiolucent stones and 66.6% for radiopaque stones(p > 0.05) after 46,731 and 56,111 shock waves respectively(p > 0.05). The rate of successful fragmentation was highest in patients with single, radiolucent stone smaller than 2cm(91.7%) followed by single radiolucent stone larger than 2cm(83.3%), multiple calcified stones smaller than 2cm(77.4%) and single calcified stone smaller than 2cm(72.1%). The rate of complete stone clearance after 6 month follow-up was highest in patients with single radiolucent stone smaller than 2cm(63.3%) and followed by multiple calcified stones smaller than 2cm(37.3%), single calcified stone smaller than 2cm(33.9%)(p <0.05). CONCLUSION: To obtain better results with ESWL in patients with gallbladder stone, the authors propose a more strict inclusion criteria, which is the patient with a single, radiolucent stone smaller than 2cm.
Follow-Up Studies ; Gallbladder* ; Humans ; Lithotripsy* ; Retrospective Studies ; Shock ; Ultrasonography

Transient ischemic attack (TIA) often precede cerebral infarcts as a warning symptom. But the studies revealing the frequency and the correlation between preceding TIAs and following infarcts are rare. According to the western data, about one-quarter of the patients with cerebral infarct have been supposed to have the previous history of TIAs. We prospectively studied the exact frequency, clinical presentation, and presumed causes of TIAs preceding cerebral infarct. Ninety five patients diagnosed as acute cerebral infarction were interviewed whether they had had previous episodes of TIA. 4 check-list using ordinary language was used, and NINDS diagnostic criteria was applied on the consensus between several neurologists. Seventeen patients (18%) had history of preceding TIAs. Carotid territory was affected in 11 patients (65%), while vertebrobasilar in 4(24%) and undetermined in 2. Duration was less than an hour in 10 patients(59%), and attacks were multiple in about half. Time interval between the last attack and infarction was less than one week in 10 cases(59%). Incidence of recent TIA ((1 month) was 22% in large artery disease(LAD), 11% In cardioembolism(CE), 9% in small-artery disease(SAD), and 7% in mixed etiology. Conclusion, TIAs preceding cerebral infarcts are not rare, but seems to be less common in Koreans than in Caucasians. As expected, atherothrombosis of large artery is supposed to be the leading cause of TIAs.
Arteries ; Cerebral Infarction ; Consensus ; Humans ; Incidence ; Infarction ; Ischemic Attack, Transient* ; National Institute of Neurological Disorders and Stroke ; Prospective Studies

Although there had been many studies for evaluating an usefulness of expanded polytetrafluoroethylene(Gore-Tex(R)) as a temporary treatment of corneal perforation and a supporting skirt of keratoprosthesis, complications and instability of graft had limited the clinical applications. To find histopathologic factors that can contribute to the instability of graft and to try to modify the surgical methods with models of graft, serial examinations including biomicroscopy and histopathology were performed. According to the results, we were able to divide the causes of instability into two categories as a function of time. Epithelial down growth into the interface between graft and cornea with absence of epithelial coverage over the graft may cause leakage from anterior chamber in early period. Absence of fibrovascular invasion into Gore-Tex(R) resulting no cohesion between graft and cornea might be a factor of instability in late period. Based on these results, modification of surgical techniique and models of graft are needed. Several methods of modificiation are suggested in this report.
Anterior Chamber ; Cornea ; Corneal Perforation* ; Keratoplasty, Penetrating* ; Rabbits* ; Transplants

No abstract available.
Leg* ; Myocutaneous Flap* ; Superficial Back Muscles*

BACKGROUND: Epidermolysis bullosa is a group of inherited disorcier characterized by blistering of the skin as a result of minor trauma. OBJECTIVE: There exist very little epidemiologic data for most of the major and minor subsets of inherited epidermolysis bullosa in Korea. We look forward to obtaining basic data for the pathogenesis and treatment of epidermolysis bullosa. METHOD: We performed 1st and 2nd trial of survey with the help of 28 dermatologic Departments snd 28 pediatric departments of medical colleges and 14 dermatologic dipartments of general hospitals. RESULTS: 68 cases were collected and classified by disease type, sex distribution, age distribution, and regional distribution. In disease type, 42 cases of EB simplex(62%), 8 cases of junctional type(12%), 10 cases of dominant dystrophic type(15%), 8 cases of recessive dytrcphic type(12%) were reported. In most cases males predominnted, but in dominant dystrophic type both sexes were equivalent. EB simplex, junctional type, RDEB were mostly developed in the 1st decade of life, dominant dystrophic type in the 2nd decade of life. In regional distribution, the number of pi tients was outstanding in large cities such as Seoul, Pusan, Taegu, Kwanju. CONCLUSION: Due to many limitations and shortage of techniques, this epidemiologic study may be notgood enough for the total estimated number of epidermolysis bullos. patients, prevalence rate, and therapeutic modalities. Furthe evaluation should be necessary next time.
Age Distribution ; Blister ; Busan ; Daegu ; Epidemiologic Studies* ; Epidermolysis Bullosa* ; Gwangju ; Hospitals, General ; Humans ; Korea* ; Male ; Prevalence ; Seoul ; Sex Distribution ; Skin