BACKGROUND: Ethyl crbmate(EC) has been identified at low microgram quantities in various fermented beverages, destiled products and tobacco smoke. EC has long been known as a carcinogen. Oxidation of the ethyl group of EC is followed by dehydration to yield the carcinogen vinyl carbamate (VC). This is further oxidized to vinyl carbamate epoxide(VCO). VC and VCO proved to be much more carcirogenic than EC. OBJECT: The objective of this study is to compare the potency of carcinogenic ability and histologic changes in skin tumors induced by EC, VC, or VCO. METHODS: In this exeriment, the tumor induction was performed by painting the mouse skin once a week for five weeks with EC, VC and VCO solution, and then 12-0-tetradecanoyl-phorbol-13-acetate(TP2) was treated in the same manner twice a week for 35 weeks. We biopsied the skin at B 0, 15, 25, 30 and 35 weeks and stained the specimens with hematoxylineosin. RESULTS: The time period for the first appearance of papilloma was 6 weeks in the VC-TPA and VCO-TPA group, but, 15 weeks in the EC TPA group. The average number of papilloma showed a statistically sign.ficant difference after 15 weeks between the EC-TPA, VC-TPA and VCO-TPA group. The occurrence of keratoacanthoma and squamous cell carcinoma was 16 and 21 weeks respectively. Histologic changes, such as epidermal layers, pseudohorncysts, degree of hyperkeratosis, hypergranulosis, dysplasia and dyskeratotic cells were more prominent in the papil loma than in the non-papilloma lesion. Dermal changes disclosed similiar findings, that is, increased dermal thicknes, proliferation of vessels and hair follicles, and fibrosis of the dermis. Squamous cell carcinomis and keratoacanthomas were produced only in the VCO-TPA group. CONCLUSION: From the above results it is concluded that VC and VCO have a more potent carcinogenic potential than EC. Various skin tumors, such as papilloma, keratoacanthoma or squamous cell carcinoma were prorduced by the above carcinogens.
Animals ; Beverages ; Carcinogens ; Carcinoma, Squamous Cell ; Dehydration ; Dermis ; Fibrosis ; Hair Follicle ; Keratoacanthoma ; Loma ; Mice ; Paint ; Paintings ; Papilloma ; Skin* ; Smoke ; Tobacco ; Urethane*

No abstract available.
Amniotic Fluid* ; Animals ; Embryonic Structures* ; Female ; Humans* ; Mice*

Neurofibromatosis, or von Recklinghausen's disease, is a hereditary, harmartomatous disorder that primarilyinvolves neuroectoderm and mesoderm. The estimated incidence is 1 in 2,500 to 3,000 births. The clinical featuresare skin manifestations such as cafe-au-lait spots, skeletal manifestations primarily in volving vertebrae,central and peripheral nervous manifestations, and other associated abnormalities with increased risk ofmalignancy. The authors analysed the radiologic findings of 18 cases of patients with neurofibromatosis whovisited Pusan Kosin Medical Center and Taegu Dongsan Medical Center during the last five years. All were proven bysurgery, biopsy and other diagnostic criteria. The results obtained were as follows: 1. The male ot female ratiowas 11:7 and the age ranged from 11 months to 51 years. 2. All the cases fulfilled the diagnotic criteria of Croweand associates. 3. Bone manifestations were present in 44% of the cases. The other radiologic findings wereintrathoracic meningocele, bilateral acoustic neurinomas, mediastinal or chest wall mass shadows, and peripheralsoft tissue masses. 4. One of the soft tissue masses was proved to be malignant.
Biopsy ; Busan ; Cafe-au-Lait Spots ; Daegu ; Female ; Humans ; Incidence ; Male ; Meningocele ; Mesoderm ; Neural Plate ; Neurofibromatoses ; Neurofibromatosis 1 ; Neurofibromatosis 2 ; Parturition ; Skin Manifestations ; Thoracic Wall

No abstract available.
Decompression* ; Facial Nerve* ; Recovery of Function*

The exercise ECG gives a valuable indirect evidence of insufficient myocardial perfusion during stress, but it has been impossible with ECG data alone to localize the site or sites of partial or complete arterial occlusion. The coronary angiography has proved to be valvuable as a technique for identifying anatomical lesions. However, arteriography alone dose not provide evaluation of the underlying myocardium. The two tests are complementary, one supplying indirect physiologic data and the other providing anatomical licalization of obstruction. The author reviewd 58 patients out of 86 patients who performed treadmill test and coronary angiography at the cardiac laboratory of Yonsei University Severance Hospital from January, 1981 through December, 1983. The following results were obtained. 1) Among the 58 patients in this study, 33 had negative exercise test and 25 had positive test. 2) Among the 14 patients who ended exercise test due to chest pain,2patients had negative exercise test. Coronary angiography on all the 14 patients showed significalt coronary artery stenosis. 3) With this multigraded treadmill test, the sensitivity was 68.8% and spedccificity was 88.7%. 4) The appreance of ischemic change during the early stage of exercise, the deeper ST segment depression and the downsloping ST segment have the higest specificity as indicators of coronary artery disease. 5) Four patients showed ST segment elevation in the exercise ECG, and their coronary angiogram showed 1-vessel disease in 1 patientts, 2-vessel dosease in 2 and 3-vessel disease in 3. All of them had multiple stenosis or complete obstruction of the left anterior descending artery on coronary angiogram and ventricualar dyskinesia on the left ventriculogram.
Angiography ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Dyskinesias ; Electrocardiography ; Exercise Test* ; Humans ; Myocardium ; Perfusion ; Sensitivity and Specificity ; Thorax

A case of a 39-year-old woman with corrected transposition of the great vessels without significant intracardiac anomaly or coronary disease is reported. The clinical diagnosis of coronary arterial disese was supported in this patient by electrocardiographic changes of probable old anteroseptal myocardial infarction. Coronary arteriographic study showed the morphologic left coronary artery supplied the right-sided ventricle, and the right coronary artery supplied the left-sided ventricle, and the right coronary artery supplied the left-sided ventricle. Although the condition is theoretically compatible with a normal life span, few patient with this lesion survive past 40 years of age because of the subsequent heart block or functioning as a systemic ventricle.
Adult* ; Anterior Wall Myocardial Infarction ; Coronary Angiography* ; Coronary Disease ; Coronary Vessels ; Diagnosis ; Electrocardiography ; Female ; Heart Block ; Humans

BACKGROUND: Various studies on the prediction of common bile duct (CBD) stones through preoperative or operative cholangiography have been reported. When CBD stones were suspected due to preoperative screening factors, endoscopic retrograde cholangiopancreatography was done as a first choice and operative cholangiography could be omitted. We want to know the indications of selective cholangiography and the significance of routine operative cholangiography during a simple cholecystectomy. METHODS: The cases of 134 patients who received on open cholecystectomy between Jan. 1995 and Sept. 1997 were reviewed. Twenty-even (27) cases of a choledocholithotomy without cholangiography were discarded from this study. Our cases were divided into two groups: group I included 9 patients who had CBD Stones, which was pathologicaly confirmed by operative cholangiography, and group II included 98 patients who had no CBD Stones, which pathologicaly confirme by operative cholangiography. The predictability of pathologic CBD. was calculated by the factors as the total bilirubin, alkaline phosphatase, AST, ALT, GGT, CBD. diameter by sonography. According to the number of positive screening factors, 3 grades of scoring were imposed in each case. Grade I was the case where 0- screening factor was positive, grade II was the case where 2 screening factors were positive, and grade III was the case where 3 or more screening factors were positive. RESULTS: Eighty-ive (85) cases were grade I, 6 cases were grade II, and 16 cases were grade III. In grade I, only one case had asymptomatic CBD stones, and the negative predictability was 98.8%. In grade II, there were no CBD lesions, and the negative predictability was 100%. In grade III, there were 8 cases of pathologic CBD lesions, and the negative predictability was 50%. CONCLUSIONS: Precise prediction of CBD lesions before a cholecystectomy is of value in deciding whether or not to perform an operative cholangiography. In our study, we graded the patients according to 5 non-nvasive screening factors. In grade I cases, the negative predictability of 98.8% was acceptable for omitting the operative cholangiography. In grade II cases, the negative predictability was 100%, but in these cases, there was the possibility of pathologic CBD Stones. Hence, in these cases, an operative cholangiography may be done, depending on the surgeon's decision. In grade III cases, an operative cholangiography or a preoperative ERCP. is mandatory.
Alkaline Phosphatase ; Bilirubin ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Common Bile Duct ; Humans ; Mass Screening

BACKGROUND: Left atrial thrombus(LAT) has long been recognized as a complication of mitral stenosis(MS).The transesophageal echocardiographic approach readily visualize LAT. We evaluated the risk factors for left atrial thrombus in patients with MS using transthoracic(TTE) and transesophageal echocardiography(TEE). METHODS AND RESULTS: One hundred and forty-three(patients) who had moderate to severe MS were consecutively studied with TTE and TEE. They were 43 males(30%) and 100 females(70%).The mean age was 44+/-11 years(range 21-70). Twenty-five patients had at least one episode of embolic events. Ninety-six patients were in atrial fibrillation(AF). LAT was detected in 30 pts(21%) : 16 had thrombus confined to the LA appenge(LAA), 14 to true LA cavity and/or LAA. TTE variables were compared between LAT group and non-LAT group. Univariate predictors of LAT were mitral valve area(MVA)(0.78+/-0.22cm2 vs 1.05+/-0.32cm2, p=0.001), pressure half time(353+/-88ms vs 258+/-118ms, p=0.002). LV ejection fraction(EF)(55+/-11% vs 62+/-8%,p=0.008), LA size (58+/-11mm vs 52+/-7mm, p=0.033) and AF(p=0.001). Stepwise logistic regression analysis revealed significant independent predictors of LAT to be AF(p=0.02), MVA(p=0.02) and EF(p=0.03). CONCLUSION: Left atrial thrombus was not uncommon in patients with rheumatic mitral stenosis. Small mitral valve area and reduced ejection fraction of left ventricle appear to be significant predictors of LAT in mitral stenosis with atrial fibrillation.
Atrial Fibrillation ; Echocardiography* ; Heart Ventricles ; Humans ; Logistic Models ; Mitral Valve ; Mitral Valve Stenosis* ; Risk Factors ; Thrombosis*

We evaluated the hypolipidemic effect and adverse reaction of Lovastatin, HMG-CoA reductase inhibitor 20 to 40mg once-daily in the evening, in 20 patients with primary hypercholesterolemia for 12 weeks and the following results were obtained. 1) Lovastatin significantly reduced the total cholesterol(from 264.8+/-12.9mg/dl to 195.3+/-31.3mg/dl) by 26.3%, TG(from 191.1+/-41.5mg/dl to 156.2+/-52.9mg/dl) by 18.3%, LDL-C(from 177.0+/-12.4mg/dl to 121.3+/-19.6mg/dl) by 31.5% and increased th HDL-C (from 39.8+/-4.2mg/dl to 41.6+/-5.0mg/dl) by 4.5% at the end of 12th week. 2) The adverse reaction during the period of study were limited to diarrhea and nausea in one patient, dryness of skin and itching in one patient, and no patients was withdrawn form therapy. In this study, Lovastatin was well toterated and effective agent for the treatment of hypercholesterolemia without serious side effects.
Diarrhea ; Humans ; Hypercholesterolemia* ; Lovastatin ; Nausea ; Oxidoreductases ; Pruritus ; Skin

One hundred premature infants with birth weight less than 2000 gm or with gestational ages less than 37 weeks who admitted to Ewha Womans University from January 1991 to May 1993 were examined by indirect ophthalmoscope. We analysed the incidence and the risk factors of retinopathy. The results were as follows: 1. Twenty one infants(21.0%) were diagnosed as retinopathy of prematurity. Among them, six infants(28.6%) presented stage 1, three infants(14.3%) at stage 2, twelve infants(57.1%) at stage 3. 2. Male patients were 11(52.4%) and female patients were 10(47.6%). There was no significant difference in incidence between male and female. 3. The incidence of retinopathy of prematurity increased with low birth weight(<1500 gm), small gestational age(33 weeks) and oxygen administration. 4. The risk factors associated with oxygen therapy besides the duration of oxygen exposure were hyperoxia, hypoxia, hypercarbia, hypocarbia and acidosis. 5. The retinopathy of prematurity was initially diagnosed at 5.6 weeks in average(36.3 weeks by postconceptional age). The onset of retinopathy of prematurity was timed according to postconceptional age rather than chronologie age since birth. 6. Other possible associated risk factors were spontaneous premature rupture of membrane, sepsis, hyaline membrane disease, neonatal hyperbilirubinemia, transfusion and low 5-minute Apgar scores.
Acidosis ; Anoxia ; Birth Weight ; Female ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Hyperbilirubinemia, Neonatal ; Hyperoxia ; Incidence ; Infant, Newborn ; Infant, Premature ; Male ; Membranes ; Ophthalmoscopes ; Oxygen ; Parturition ; Retinopathy of Prematurity* ; Risk Factors ; Rupture ; Sepsis