No abstract available.
Autopsy* ; Endocarditis* ; Thromboembolism

PURPOSE: To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. MATERIALS AND METHODS: Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39months. RESULTS: Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. CONCLUSION: Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study.
Catheters* ; Deglutition Disorders ; Dilatation* ; Esophageal Achalasia* ; Esophageal Perforation ; Follow-Up Studies* ; Humans ; Male ; Recurrence

The Measurement of CSF glucose and CSF glucose-to-blood glucose ratio is a very useful laboratory test for the differential diagnosis of meningitis. We have observed the change of blood glucose & CSF glucose-to-blood glucose ratio according to the time of blood sampling in 84 patients with aseptic meningitis who had been admitted to the department of pediatrics, Dong Kang hospital from May 1993 to June 1993. The results obtained were as follows: 1) The blood glucose level examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 98.29+/-16.20mg/dl and 106.49+/-19.47mg/dl, respectively. 2) The blood glucose level examined with blood sample drawn just before lumbar puncture and one 30 min. after lumbar puncture was 96.47+/-21.52mg/dl and 117.00+/-22.12mg/dl, respectively. 3) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 67.70+/-12.40% and 62.83+/-12.62%, respectively. 4) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 70.10+/-21.77% and 56.35+/-13.75%, reskpectively. We concluded that a simultaneous blood glucose level should be taken just before lumbar puncture.
Blood Glucose ; Diagnosis, Differential ; Glucose* ; Humans ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Spinal Puncture

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

Transforming growth factor (TGF)-beta1 plays an important role in hepatocarcinogenesis and has been described as a useful tumor marker and one of the poor prognostic indicators in patients with hepatocellular carcinoma (HCC). To investigate the role and cellular localization of TGF-beta1 during multistep hepatocarcinogenesis we performed a quantitative analysis of TGF-beta1 mRNA and immunohistochemical expression of TGF-beta1 and TGF-beta receptor II (TGF-betarII) in female Sprague-Dawley rats. The experimental groups included neoplastic lesions produced by Solt-Farber's protocol, regenerating liver after partial hepatectomy, and normal control. Quantitative change of TGF-beta1 mRNA was analysed by competitive reverse-transcription polymerase chain reaction (RT-PCR). TGF-beta1 protein and TGF-betarII expression were evaluated by immunohistochemical stain. The discrete tumor nodules were detected on 14th day and then increased in number and size. Three HCCs were induced on 8th or 9th month. RT-PCR demonstrated TGF-beta1 mRNA band in all examples of the normal and regenerating liver, nodules and HCCs. Competitive RT-PCR displayed higher TGF-beta1 mRNA in nodules, HCCs and regenerating liver than in normal controls. Hepatocytes from control and regenerating livers showed weak immunoreactivity for TGF-beta1. In contrast, the cytoplasm of hepatocytes of nodules in 7th, 8th and 9th month and HCCs were intensely stained for TGF-beta1. Some sinusoidal cells showed immunoreactivity for TGF-beta1 in all experimental groups. In early phase of carcinogenesis, the cytoplasm of hepatocytes in liver of 12h, 1d and 3d showed transiently increased immunoreactivity for TGF-beta1 and The immunoreactivity decreased thereafter. TGF-beta1 mRNA was also detected in the neoplastic hepatocytes by in-situ hybridization. Although TGF-betarII expression was correlated with TGF-beta1 immunoreactivity during early phase of carcinogenesis, hepatocytes in most nodules in 7th, 8th, 9th month and carcinomas showed decreased or little immunoreactivity for TGF-betarII. Based on the above results, it is concluded that TGF-beta1 expression increases not only in precancerous nodules but also in HCCs and its increase seems to be correlated with decrease or loss of TGF-betarII expression although its mechanism remains unclear. Hepatocytes may be a major cellular source of TGF-beta1 during hepatocarcinogenesis.
Carcinogenesis ; Carcinoma, Hepatocellular ; Cytoplasm ; Diethylnitrosamine* ; Female ; Hepatectomy ; Hepatocytes ; Humans ; Liver ; Polymerase Chain Reaction ; Rats, Sprague-Dawley* ; Receptors, Transforming Growth Factor beta* ; RNA, Messenger* ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

Congenital esophageal stenosis due to tracheobronchial remnants is one of main forms of congenital esophageal stenosis, and it was first described by Frey and Duschel in l936. An 18-month-old male presented with underdevelopment and dehydration state due to persistent vomiting several times per day since 3 months after his birth. Esophagogram revealed an elongated and diiated esophagus with marked stenosis at distal portion. Partial distal esophagectomy was performed. Histologically, the thickened esophageal wall is composed of tracheobronchial remnants including hyaline cartilages, mucous glands, and ductal structures lined by ciliated respiratory epithelium under stratified squamous mucosa.
Male ; Humans

Congenital esophageal stenosis due to tracheobronchial remnants is one of main forms of congenital esophageal stenosis, and it was first described by Frey and Duschel in l936. An 18-month-old male presented with underdevelopment and dehydration state due to persistent vomiting several times per day since 3 months after his birth. Esophagogram revealed an elongated and diiated esophagus with marked stenosis at distal portion. Partial distal esophagectomy was performed. Histologically, the thickened esophageal wall is composed of tracheobronchial remnants including hyaline cartilages, mucous glands, and ductal structures lined by ciliated respiratory epithelium under stratified squamous mucosa.
Male ; Humans

The clinicopathologic features and the comparative analysis of diagnostic methods in 42 patients having intestinal tuberculosis were studied. In all the cases, clinical and colonoscopic diagnosis was confirmed by histological examination. Abdominal pain was the most common symptom (54%). Twenty nine patients had active pulmonary tuberculosis which was confirmed by a chest X-ray, or an AFB smear and a culture of sputum. A transverse ulcer with surrounding hypertrophic mucosa and multiple erosion was the usual colonoscopic findings. The granulomas were usually located in the just upper and lower portion of muscularis mucosa. The direct smear and culture of the fresh biopsy material showed AFB in 11 (32.4%) and 12 cases (36.4%) respectively. Ziehl-Neelsen staining in serially sectioned slides from formalin-fixed, paraffin- embedded tissue revealed AFB in 15 cases (35.7%). An immunohistochemical stain for Mycobacterium bovis was done in all cases and 13 cases were positive (31%). A polymerase chain reaction (PCR) was done and showed positivity in 4 out of 20 cases of fresh biospy material and 12 out of 40 cases in paraffin embedded tissue. For the conclusive diagnosis of intestinal tuberculosis, a Ziehl-Neelsen stain is the most sensitive, fast, and cost-effective method. The diagnostic accuracy will be increased when other diagnostic methods such as tissue culture and PCR are coupled with this simple staining method.
Abdominal Pain ; Biopsy ; Diagnosis* ; Granuloma ; Humans ; Intestines ; Mucous Membrane ; Mycobacterium bovis ; Paraffin ; Polymerase Chain Reaction ; Sputum ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

Proliferating cell nuclear antigen (PCNA, PC10), an auxillary protein of DNA polymerase, plays a main role in the early stage of DNA Synthesis and is synthesized from Gl phase to s phase of the cell cycle. Nucleolar organizer region (NORs) are DNA loops encoding RNA proteins(AgNORs). To evaluate correlation with PCNA labelling index (LI)and AgNORs according to histological grades and clinical stages of transitional cell carcinoma of the urinary bladder, the authors analysed 54 transitional cell carcinoma using immunohistochemical stain for PCNA and silver stain for AgNORs in paraffin sections. The comparison of PCNA (PC10) LI and clinical stage showed a significant correlation (p<0.05), where as PCNA (PC10) LI according to histologic grade showed no significant correlation. High grade tumors showed increase PCNA LI. Superficial tumors (Ta-Tl) showed significantly lower PCNA LI than muscle invasive tumors (T2-T4)(p<0.05). There was no significant correlation between AgNORs and clinical stage, bur higher stage and higher grade tumors showed increased noubers of AgNORs. These results suggest that PCNA LI has a significant correlation with clinical stages of transitional cell carcinoma of the urinary bladder.

The pulmonary cytology has reached a high level of accuracy. By the examination of the sputum and/or bronchial brushings, it is now possible to make a diagnosis in 70% to 90% of patients with cancer. Primary melanoma of the lung is very rare and there have been reported about 20 cases in the world literature. We present a case of primary malignant melanoma of the lung in a 61-year-old male diagnosed by cytologic examination of sputum, bronchial brushing and aspirated pleural fluid. Histologic examination of bronchoscopic biopsy and examination of the skin and other primary sites confirmed the diagnosis.
Male ; Humans ; Biopsy