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

PURPOSE: MRI is known to be an effective imaging modality of the aorta and its role is steadily increasing in the evaluation of acquired aortic diseases including aortic dissections and aortic aneurysms. However, differentiation of the aortic dissections with thrombosed false lumen from the aortic aneurysm with mural thrombus in MRI has not been easy. Therefore, the authors tried to find the characteristic MR featrses which would to differentiate the two diseases. MATERIALS AND METHODS: MR images of 6 patients with thrombosed aortic dissection and 7 patients with thrombosed aortic aneurysms were reviewed retrospectively and compared in regand to shape and extent of thrombus, dimension of aorta, and luminal flow signal. RESULTS: Thrombosed aortic dissections showed sharply demarcated crescent shaped aortic wall thickening of even thickness involving long segment of the aorta, whereas thrombosed aortic aneurysms showed irregular aortic wall thickening of uneven thickness localized in the short dilated segment of the aorta. Characteristically aortic aneurysm with mural thrombus showed eccentric intraluminal slow flow signal. In contrast to the signal void of the true lumen in aortic dissections, the residual lumen of the aortic aneurysm with mural thrombus revealed intraluminal signal due to slow flow. CONCLUSION: Familiarity to these MRI findings of thrombosed aortic dissections and aortic aneurysms may lead to the accurate differential diagnosis in majority of cases.
Aorta ; Aortic Aneurysm* ; Aortic Diseases ; Diagnosis, Differential* ; Humans ; Magnetic Resonance Imaging* ; Phenobarbital ; Recognition (Psychology) ; Retrospective Studies ; Thrombosis

PURPOSE: To evaluate the usefulness of Gd-DTPA enhanced MR imaging in determining the metastatic lymph nodes in uterine cervical carcinoma. MATERIALS AND METHODS: Sixty nine patients with histologically proven cervical carcinoma underwent Gd-DTPA enhanced MR imaging. One hundred and thirty-eight pelvic regions(69 right,69 left) in 69 patients were analyzed for lymph node metastases. Pelvic lymph nodes were considered to be abnormal if they were greater than lcm in diameter and were enhanced on postcontrast T1 weighted images. RESULTS: Metastatic lymph nodes were found in 22 pelvic regions by surgicopathologic examinations. On MR imaging there were 14 true positives, 106 true negatives, 10 false positives and 8 false negatives. Gd-DTPA enhanced MR image had an accuracy of 86.9%, a sensitivity of 58.3%, a specificity of 91.4%, a positive predictive value of 58.3% and negative predictive value of 92.9% in evaluation of pelvic lymph node metastases. CONCLUSION: MR imaging with contrast enhancement may be useful in the evaluation of pelvic lymph node metastases in patients with uterine cervical carcinoma.
Gadolinium DTPA ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pelvis ; Sensitivity and Specificity

A 7-year-old girl had a 7 × 6cm sized dark red colored tumor on the left elbow and several erythematous macules on the face, right upper arm, and both thighs. Her general health was good and all laboratory findings were within normal limit. Histopathologic examination revealed an infiltration of atypical mononuclear cells in the dermis and subcutis. L26 and leukocyte common antigen were positively stained in an immunohistochemical study. According to clinical, histological and immunohistochemical findings, we diagnosed the disease as primary cutaneous B cell lymphoma. The patient's skin lesions markedly improved after a surgical excision and chemotherapy.
Antigens, CD45 ; Arm ; Child ; Dermis ; Drug Therapy ; Elbow ; Female ; Humans ; Lymphoma, B-Cell* ; Skin ; Thigh

Backgroud : The number of proliferating cell populations in the hair is follicles is closely related to the regulation of hair growth. Destruction of hair germ cells and the loss of proliferating cells have been suggested to be of major pathogenetic significance in alopecia areata OBJECTIVE: The purpose of this study is to compare the growth frrections in proliferating cells of normal hair follicles with those in alopecia. METHODS: An immunohiatochemical study was done to detect the proliferating cells in hair follicles using a monoclonal antibody against proliferating cell nuclear antigen(PCNA) in the scalp biopsy of an alopecia patient on the peraffin embedded sections. RESULTS: A significant decrease of the labelling indeces of PCNA were observed in the hair follicles of alopecia compared with normal condition. But we could not find significant differences of labelling index in the clinical types of alopecia, responses to treatment, anc systemic immunologic state. CONCLUSIONS : Whole the above results confirmed that significant decreases of proliferating cells in the hair follicle could explain the part of the pathogenetic mechanism in alopecia, its direct cause which inhibit the proliferation of cells is not clear.
Alopecia Areata ; Alopecia* ; Biopsy ; Germ Cells ; Hair ; Hair Follicle ; Humans ; Proliferating Cell Nuclear Antigen* ; Scalp