We report a patient who had been initially diagnosed as a myelodysplastic syndrome in 1998 presenting purpuric patches on the left arm that started to develop about a year prior. The purpuric lesions were diagnosed as leukemia cutis by skin biopsy. Her subsequent bone marrow biopsy showed progression into an atypical chronic myeloid leukemia with increased numbers of leukocytes in the peripheral blood. Leukemia cutis typically is regarded as a sign of progression of disease or a manifestation of recurrent disease in treated patients with an established diagnosis of leukemia. We suggest that the skin lesion in this patient could have been a sign of con-version into atypical chronic myeloid leukemia.
Arm ; Biopsy ; Bone Marrow ; Diagnosis ; Humans ; Leukemia* ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative* ; Leukocytes ; Myelodysplastic Syndromes* ; Skin

PURPOSE: Extracorporeal shock wave lithotripsy(SWL) is currently prorposed for the first line treatment of most renal and ureteral stones. In general, SWL is very effective and non-invasive method than open surgery or endoscopic lithotripsy. We experienced 350 cases of SWL for 46 months and announced it. MATERIALS AND METHODS: We retrospectively reviewed the data of 324 patients(350 stones) who had been diagnosed as renal or ureteral stones and underwent SWL using Tripter Compact(R) lithotriptor from September 1994 to July 1998. Male to female ratio was 1.9:1 and patient`s ages ranged from 18 to 82 years(mean 43.7 years). We underwent SWL only with parenteral analgesics for pain control. RESULTS: In 350 stones, renal stones were 90 cases(25.7%) and ureteral stones were 260 cases(74.3%). In 90 renal stones, calyceal stones(include 1 staghorn stone) were 62 cases(68.9%) and renal pelvic stones were 28 cases(31.1%). In 260 ureteral stones, upper ureteral stones were 209 cases(80.4%), mid ureteral stones were 10 cases(3.8%), and lower ureteral stones were 41 cases(15.8%). The stones from 10 to 19mm in diameter were the majority of renal stones(53.3%), whereas in ureter, the stones smaller than 10mm in diameter were most common(41.5%). Less than 3 treatment sessions were needed for 147 cases(93.0%) of stones smaller than 10mm and for 146cases(76.0%) stones larger than 10mm. Less than 3 sessions were needed for 68 cases(75.6%) of renal stones and for 225 cases(86.5%) of ureteral stones. All renal stones were fragmented and the success rate for upper ureteral stones was 93.3%(195/209), for mid ureteral stones was 80.0%(8/10), and for lower ureteral stones was 80.5%(33/41). According to the size of stone, the success rate for the stones smaller than 10mm in diameter was 96.2%(152/158) and for the stones larger than 10mm was 90.6%(174/192). Total success rate was 93.1%(326/350). The complications after SWL were gross hematuria over 24hours(64 cases, 18.3%), flank pain(52 cases, 14.9%), gastrointestinal disturbances(7 cases, 2%), and Steinstrasse(31 cases, 8.9%). The causes of failure were incomplete fragmentation(21 cases, 87.5%) and mucosal impact(3 cases, 12.5%) of stones. Re-treatment rate was 59.7% and auxiliary procedure rate was 8.0%(efficiency quotient was 0.56). CONCLUSIONS: Our experiences shows extracorporeal shock wave lithotripsy is a safe and effective method for the treatment of renal and ureteral stones, and we expect the better outcome by development of techniques and equipments.
Analgesics ; Female ; Hematuria ; Humans ; Lithotripsy* ; Male ; Retrospective Studies ; Shock* ; Ureter ; Urinary Calculi

Maternal and fetal effects of anesthesis for 781 cases ceasarean sections, performed during the past 10 years (1965~1974) in Hanil Hospital have been evaluated clinically. It is emphasized that the selection of anesthetic agents and methods, should depend upon the physical status of the patients and the ability of both obstetricians and anesthesiologists. Optimal results require effective teamwork amongst obstetricians, anesthesiologists and nursing personnel. The anesthesiologist should be fully infermed of obstetric aspects. A variety of anesthetic techniques can be used for elective and emergency Caesarean sections. Each technique has its own advantages, disadvantages and limitations which must be thoroughly understood for proper application. The choice of anesthesia should be determined primarily by the experience of the operator, the degree of ugency, condition of the monther and the fetus, the physiopathology, the skill of the obstetrician and the desires and the emotional state of the monther.
Anesthesia ; Anesthetics ; Cesarean Section* ; Emergencies ; Female ; Fetus ; Humans ; Nursing ; Pregnancy

This paper describes the cloning and sequence analysis of the cDNAs encoding the canine homologues of interleukin-3 (IL-3) and interleukin-6 (IL-6). The coding sequences for canine IL-3 and IL-6 were obtained by using the reverse transcription polymerase chain reaction (RT-PCR) with RNA harvested from canine peripheral blood mononuclear cells (PBMCs). Canine IL-3 cDNA includes a single open reading frame of 432 nucleotides, which encodes a 143 amino acid polypeptide and has 44.7, 42.4, 37 and 23.7% homology with the cow, sheep, human and rat IL-3 sequences, respectively. Canine IL-6 cDNA (GenBank accession number; AF275796) encodes a putative 20-amino acid signal peptide followed by a 187-amino acid mature protein. The predicted amino acid sequence of canine IL-6 shares 60.4, 77.2, 71.0, 55.8 and 42.0% sequence identity with those of human, feline, porcine, sheep and rat IL-6, respectively.
Amino Acid Sequence ; Animals ; Base Sequence ; Cloning, Molecular ; Concanavalin A/pharmacology ; DNA, Complementary/*chemistry ; Dogs/blood/genetics/*immunology ; Interleukin-3/chemistry/*genetics ; Interleukin-6/chemistry/*genetics ; Leukocytes, Mononuclear/chemistry/drug effects ; Molecular Sequence Data ; Open Reading Frames/genetics ; Protein Sorting Signals/genetics ; RNA/blood/genetics ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Sequence Homology, Amino Acid ; Sequence Homology, Nucleic Acid

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*

Elevated plasma level of the sulfur amino acid homocysteine, termed hyperhomocysteinemia, is now recognized as a contributing factor to various pathological states of the brain including vascular, degenerative and other neurologic disorders. Endothelial dysfunction may be one of the underlying mechanisms leading to proatherogenic and neurotoxic effects associated hyperhomocysteinemia. We conducted electron microscopic studies to investigate microvascular changes in hyperhomocysteinemic rat brain due to folate deficiency. Dietary folate deprivation caused an increase in plasma Hcy by 317% from 6.15 +/- 0.9 micro mol/l to 19.5 +/- 3.2 micro mol/l with time up to 8 weeks of folate deprivation. In electron microscopic study, perivascular amorphous fibrosis, and pericytic and endothelial cell degenerative appearance were frequently found in hyperhomocysteinemic microvasculature. These findings are very similar with the typical cerebral microvascular pathology observed in neurodegenerative and aging processes. From these results, it can be suggested that hyperhomocysteinemia -induced blood -brain barrier disruption give rise to subsequent neuronal dysfunction in hyperhomocysteinemia.
Aging ; Animals ; Brain ; Endothelial Cells ; Fibrosis ; Folic Acid ; Homocysteine ; Hyperhomocysteinemia* ; Microscopy, Electron ; Microvessels* ; Nervous System Diseases ; Neurons ; Pathology ; Plasma ; Rats ; Sulfur

BACKGROUND/OBJECTIVES: The goal of this study was to examine the effect of Sargassum coreanum extract (SCE) on blood glucose concentration and insulin resistance in C57BL-KsJ-db/db mice. MATERIALS/METHODS: For 6 weeks, male C57BL/KsJ-db/db mice were administrated SCE (0.5%, w/w), and rosiglitazone (0.005%, w/w). RESULTS: A supplement of the SCE for 6 weeks induced a significant reduction in blood glucose and glycosylated hemoglobin concentrations, and it improved hyperinsulinemia compared to the diabetic control db/db mice. The glucokinase activity in the hepatic glucose metabolism increased in the SCE-supplemented db/db mice, while phosphoenolpyruvate carboxykinase and glucose-6-phosphatase activities in the SCE-supplemented db/db mice were significantly lower than those in the diabetic control db/db mice. The homeostatic index of insulin resistance was lower in the SCE-supplemented db/db mice than in the diabetic control db/db mice. CONCLUSIONS: These results suggest that a supplement of the SCE lowers the blood glucose concentration by altering the hepatic glucose metabolic enzyme activities and improves insulin resistance.
Animals ; Blood Glucose ; Glucokinase ; Glucose ; Glucose-6-Phosphatase ; Hemoglobin A, Glycosylated ; Humans ; Hyperglycemia* ; Hyperinsulinism ; Insulin Resistance* ; Insulin* ; Male ; Metabolism ; Mice* ; Phosphoenolpyruvate ; Sargassum*

This is the report of our clinical experience of 1365 cases of aneethesia for eelectroconvu lsive therapy at the Department of Anesthsiology, Maryknoll Hospital, during the period of March, 1989 to February, 1986. To prevent complications, suck as compressed fracture of the spine, and to improve doctor-patient relationship, softening electroconvulsive therapy is the preferred treatment for indicated cases.The results were as follows: 1) Diagnostic distribution of the patients treated by E.C,T. were schizophrenia 74.3%, affective disorder 15.0%, other psychosis 10.7$. 2) Average number of treatments given to a patient were average 6.7 times, for the entire group,7.8times for schizophrenia, 8.2 times for the patients with mania,5.5 times for the Patients with major depression, 5.6 times for the patients with the other psychosises. 3) Medication required was sufficient with half the dosage of uaual surgical procedu res ; ie, atropine sulfate 0.008 mg/kg, thiopental sodium 2.5 mg/kg, and succinylcholine 0.5 mg /kg. 4) Duration of apnea averaged 2 minutes 30 seconds, awakening averaged 10 minutes, and average duration per treatment was 15 min. 5) Few patients complained of discomfort or phobia, and less personnel and less effort were required. Complications and side effecta due to anesthesia were minimal.
Anesthesia ; Anesthesia, General* ; Apnea ; Atropine ; Depression ; Electroconvulsive Therapy* ; Humans ; Mood Disorders ; Phobic Disorders ; Psychotic Disorders ; Schizophrenia ; Spine ; Succinylcholine ; Thiopental

PURPOSE: Periodic lateralized epileptiform discharges (PLEDs), initially described by Chatrian et al in 1964, are an EEG phenomenon characterized by lateralized or focal spike-and-wave complexes with moderate to high voltage which occur in a periodic or semiperiodic pattern. This study was performed to assess the clinical significance of PLEDs and its relation to an imaging study of the brain. MEHTODS: Twenty children (10 males and 10 females), from 2 days to 14 years of age, who had been hospitalized at Hanyang University Hospital were studied retrospectively. Their medical records, EEG results and brain imaging study were reviewed. RESULTS: Of the 20 patients studied, 15 patients showed unilateral PLEDs and 5 had bilateral PLEDs in EEG. Brain imaging studies were done for 18 of the patients, revealing abnormalities in 15 patients in this order of frequency: intracranial hemorrhage, diffuse cerebral atrophy, leukomalacia, cerebral infarctions, cerebral edema and hydrocephalus. PLED sites were not significantly correlated with the results of the imaging study. Finally, 3 patients died and 17 patients survived, and among the surviving 17 patients, 5 had recurrent seizures, 1 had recurrent seizures with mental regression, 3 had neurologic sequelae without seizures and 8 had no neurologic sequelae. CONCLUSION: We conclude that children who show PLEDs in EEG are more commonly associated with acute cerebral lesions and there is a high incidence of subsequent seizures and/or other neurological sequelae in surviving children with PLEDs.
Atrophy ; Brain Edema ; Brain* ; Cerebral Infarction ; Child* ; Electroencephalography ; Humans ; Hydrocephalus ; Incidence ; Intracranial Hemorrhages ; Male ; Medical Records ; Neuroimaging* ; Retrospective Studies ; Seizures

PURPOSE: Periodic lateralized epileptiform discharges (PLEDs), initially described by Chatrian et al in 1964, are an EEG phenomenon characterized by lateralized or focal spike-and-wave complexes with moderate to high voltage which occur in a periodic or semiperiodic pattern. This study was performed to assess the clinical significance of PLEDs and its relation to an imaging study of the brain. MEHTODS: Twenty children (10 males and 10 females), from 2 days to 14 years of age, who had been hospitalized at Hanyang University Hospital were studied retrospectively. Their medical records, EEG results and brain imaging study were reviewed. RESULTS: Of the 20 patients studied, 15 patients showed unilateral PLEDs and 5 had bilateral PLEDs in EEG. Brain imaging studies were done for 18 of the patients, revealing abnormalities in 15 patients in this order of frequency: intracranial hemorrhage, diffuse cerebral atrophy, leukomalacia, cerebral infarctions, cerebral edema and hydrocephalus. PLED sites were not significantly correlated with the results of the imaging study. Finally, 3 patients died and 17 patients survived, and among the surviving 17 patients, 5 had recurrent seizures, 1 had recurrent seizures with mental regression, 3 had neurologic sequelae without seizures and 8 had no neurologic sequelae. CONCLUSION: We conclude that children who show PLEDs in EEG are more commonly associated with acute cerebral lesions and there is a high incidence of subsequent seizures and/or other neurological sequelae in surviving children with PLEDs.
Atrophy ; Brain Edema ; Brain* ; Cerebral Infarction ; Child* ; Electroencephalography ; Humans ; Hydrocephalus ; Incidence ; Intracranial Hemorrhages ; Male ; Medical Records ; Neuroimaging* ; Retrospective Studies ; Seizures