The primitive erythroblasts in 21 cases of embryonic hearts from 4 to 9 weeks of gestation were studied with a light microscope. The nuclear diameter, the motosis, and the loss of nuclei of the primitive erythoblasts were analyzed quantitatively. The results obtained were as follows. 1. At 4 weeks of gestation, the blood cells consisted of proerythroblasts, along with basophilic polychromatophilic primitive erythroblasts. The nuclear diameter ranged from 3.20 µm to 9.20 µm, but the main range was from 4.20 µm to 6.00 µm. It was revealed that 9.50% had diameter of more than 6 µm. 2. At the fist half of the 7 week gestation when hepatic hemopoiesis developed, the blood cells consisted of basophilic, polychromatophilic, and eosinophilic erythroblasts. Cells of more than 6 µm in nuclear diameter were about 1.10% and thereafter gradually disappeared. The range of the nuclear diameters was from 2.60 µm to 7.00 µm, while a range from 3.40 µm to 5.20 µm wqs the main. The proportion of cells less than 4 µm in nuclear diameter was 39.58% and thereafter rapidly increased. 3. From the second half of 7 weeks to 9 weeks of gestation, the erythrocytes originating from hepatic hemopoiesis increasingly replaced the circulating primitive erythroblasts, which became mature during this time. The erythrocytes showed 72.88% at 9 weeks of gestation. The proportions of cells less than 4 µm in nuclear diameter in the first and second haIves of 8 weeks and 9 weeks were 52.73%, 80.02%, and 89.09%, which represented the rapid destruction of nuclei. 4. Mitosis in the primitive erythroblasts occurred principally up to the early 6th weeks, and very weakly at 8 weeks. 5. As the crown-rump length increased, the average nuclear diameter decreased very significantly (P<0.01, y=-0.2811X + 0.3171). The results suggest that distrilbution of the nuclear diameter, the maturity, the rate of nuclear loss, and the mitotic figure offer credible data for estimating embryonic age.
Basophils ; Blood Cells ; Crown-Rump Length ; Embryonic Structures* ; Eosinophils ; Erythroblasts* ; Erythrocytes ; Heart ; Humans* ; Mitosis ; Pregnancy

Callus is a nonpenetrating circumscribed hyperkeratosis produced by repeated friction or pressure. It occurs on parts subjected to intermittent pressure, particularly on the palms and soles, and particularly over the bony prominences of the joints. In painful callosities of the feet, ill-fitting shoes and orthopedic problems of the foot (bunions, exostoses) are some of the etiological factors to be considered. Gout is a condition of inborn metabolic and/or acquired form of the disease characterized by hyperuricemia, tophaceous deposits of sodium urate and recurrent attacks of arthritis. We present a case of callus caused by tophi. The patient was a 45-year-old man who had complained of a painful, well-demarcated, hyperkeratotic plaque on the heel of the left foot for 18 months. After the tophi beneath overlying whitish thickened skin had been removed, the skin lesion disappeared and to date has not recurred.
Arthritis ; Bony Callus* ; Callosities ; Foot ; Friction ; Gout ; Heel ; Humans ; Hyperuricemia ; Joints ; Middle Aged ; Orthopedics ; Shoes ; Skin ; Uric Acid

Two women were referred for evaluation of new-onset urinary retention of unclear etiology. The results of the urodynamic study confirmed bladder outlet obstruction. The evaluations revealed a bladder neck mass with bilateral hydronephrosis on radiologic studies. Cystoscopy verified a urethral mass and transurethral biopsy was conducted. The pathology report showed a urethral adenocarcinoma. One patient underwent pelvic exenteration and ileal conduit, but another patient refused the operation
Adenocarcinoma ; Biopsy ; Cystoscopy ; Female ; Humans ; Hydronephrosis ; Neck ; Pelvic Exenteration ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Diversion ; Urinary Retention ; Urodynamics

No abstract available.

Cardiac electromechanical dissociation is a cause of cardiac arrest and this is characterized by regularly recurring QRS complexes and T waves- P waves may even be present. without an obtainable blood pressure and pulse. Such findings in man are almost invariably associated with a fatal outcome although one can observe this phenomenon in potentially treatable disorders. Recognition of these disorders on the basis of certain clinical and electrocardiographic findings may be of clinical importance. This experimental study on rabbits was performed to observe electromechanical dissociation (E.M.D.) and to recognize its clinical importance, in exsanguinating hemorrhage with the cutting of the right femoral artery. The results were as follows: 1) The incidence of E.M.D. was 100 percent. 2) In the all cases except two cardiac rhythm showed sinus rhythm but in two cases it was difficult to distinguish it from nodal rhythm. 3) Heart rate at the time of E.M.D showed a significant increase of 13,8 percent as compared with the control. 4) The voltage of the P wave and QRS complex at the time of E.M.D. showed a significant decreases of the former, 34.7%, and the latter, 30%, as compared with the control. and the QRS complex at the time of E.M.D showed severe axis deviation. 5) In seven cases in all, the voltage of the T wave at the time of E.M.D, showed a significant decrease of 61. 3 percent (one case showed T wave inversion) and the others showed. conversely a significant increase of 271 percent. 6) Regarding change of interval, the QRS interval showed no changes and P-R and Q-T intervals showed shortening of 14, 7% and 2.4%. 7) We consider that devices for heart sound, pulse or blood pressure monitoring should be: combined with ECG monitoring.
Blood Pressure ; Blood Pressure Monitors ; Electrocardiography ; Exsanguination* ; Fatal Outcome ; Femoral Artery ; Heart Arrest ; Heart Rate ; Heart Sounds ; Incidence ; Rabbits*

BACKGROUNG AND OBJECTIVES: Diet is the basic and principal therapeutic modality for hyperlipidemia. However, diet therapy alone showed variable responses in lowering lipid levels in different studies. This research is to prove the effect of diet and Apo E polymorphism on the variation of serum lipid profile in Korean males. MATERIALS AND METHODS: To evaluate the gene-diet interation, serum total cholesterol (Chol), triglycerides (TG), HDL-cholesterol and LDL-cholesterol (HDLc, LDLc), lipoprotein (a) (Lp (a)), and fasting blood glucose (FBS) were measured with Apo E genotyping in vegeterians (group A, n=154) and in healthy Korean male adults (group B, n=150) of similar mean age (50.1 vs. 49.3). RESULTS: Lipid profiles showed significantly lower levels in group A compared to group B (Chol 168.3+/-30.5 mg/dL vs. 181.3+/-33.4 mg/dL, p<0.001;TG 131.0+/-62.9 mg/dL vs. 149.4+/-76.7 mg/dL, p=0.023;HDLc 56.0+/-11.0 mg/dL vs. 56.9+/-11.5 mg/dL, p=0.509;LDLc 92.5+/-28.1 mg/dL vs 100.6+/-29.9 mg/dL, p=0.016;Lp (a) 22.1+/-14.6 mg/dL vs. 26.9+/-13.8 mg/dL, p=0.004;FBS 85.1+/-14.1 mg/dL vs. 102.7+/-16.6 mg/dL, p<0.001). The Apo E genotyping showed Epsilon3/3, 64.1%; Epsilon3/4, 20.7%;Epsilon2/3, 11.8%;Epsilon2/2, 1.3%;Epsilon4/4, 0.6% in the combined groups. The distribution was similar in both groups. Chol and LDLc were significantly (p<0.05) higher in Epsilon3/4 allele group compared to other allele groups among non-vegetarians. On the other hand, Chol and LDLc were significantly (p<0.01) lower in vegetarians compared to non-vegetarians only in Epsilon3/4 allele group. CONCLUSION: Vegetarian diet significantly lowered Chol, TG, LDLc, Lp (a) and FBS levels. Significant lipid lowering effect of vegetarian diet was noted in Apo E allele Epsilon3/4 group which had significantly higher Chol and LDLc levels without diet intervention. These data suggest that the influence of diet on serum lipid profiles differ according to apo E genotypes.
Adult ; Alleles ; Apolipoproteins E ; Blood Glucose ; Cholesterol ; Diet Therapy ; Diet* ; Diet, Vegetarian ; Fasting ; Genotype ; Hand ; Humans ; Hyperlipidemias ; Lipoprotein(a) ; Male* ; Triglycerides

PURPOSE: In most cases, xanthogranulomatous pyelonephritis (XGP) is diffusely or focally enlarged, mimicking a neoplastic process. The purpose of this study was to improve the preoperative diagnosis of this disease. MATERIALS AND METHODS: The clinical characteristics, laboratory and radiological findings, preoperative diagnoses and operative methods of 13 patients with XGP, who underwent an operation between 1979 and 2004, were retrospectively reviewed. All patients had undergone intravenous pyelography(IVP) and ultrasonography. Their mean age was 51+/-3.3 years (range 30 to 71), with a male to female ratio of 4 to 9. RESULTS: All 13 patients had flank pain, 8(61.5%) had a urinary tract infection and 9(69.2%) with benign renal disease preoperatively underwent a simple nephrectomy. Four patients preoperatively diagnosed with a renal cell carcinoma(RCC) underwent a radical nephrectomy. 3 patients had extended to the psoas muscle. On the basis of the ultrasonographic features: (1) 6(46.1%) were diffuse hydronephrotic; (2) 4(30.8%) were diffuse parenchymal; (3) 2(15.4%) were diffuse contracted, and (4) 1(7.7%) was segmental or focal. On the basis of the computed tomography(CT) features, the diffuse or global forms(88.9%) were more common than the localized or focal forms(11.1%). Diffuse XGP may be staged as follows: Stage I(25%), involvement is limited to the kidney; Stage II(50%), involvement extends to the perirenal fat within Gerota's fascia; Stage II(25%), involvement extends beyond the Gerota's fascia into another organ. CONCLUSIONS: Preoperative diagnosis of XGP will be raised through a better understanding of the characteristics and radiological findings of this disease.
Diagnosis ; Fascia ; Female ; Flank Pain ; Humans ; Kidney ; Male ; Nephrectomy ; Psoas Muscles ; Pyelonephritis, Xanthogranulomatous* ; Retrospective Studies ; Ultrasonography ; Urinary Tract Infections

Cyanide intoxication results in severe metabolic acidosis and catastrophic prognosis with conventional treatment. Indications of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are expanding to poisoning cases. A 50-year-old male patient arrived in the emergency room due to mental change after ingestion of cyanide as a suicide attempt 30 minutes prior. He was comatose, and brain stem reflexes were absent. Initial laboratory analysis demonstrated severe metabolic acidosis with increased lactic acid of 25 mM/L. Shock and acidosis were not corrected despite a large amount of fluid resuscitation with highdose norepinephrine and continuous renal replacement therapy. We decided to apply ECMO and CRRT to allow time for stabilization of hemodynamic status. After administration of antidote infusion, although the patient had the potential to progress to brain death status, vital signs were improved with correction of acidosis. We considered the evaluation for organ donation. We report a male patient who showed typical cyanide intoxication as lethal metabolic acidosis and cardiac impairment, and the patient recovered after antidote administration during vital organ support through ECMO and CRRT.
Acidosis ; Brain Death ; Brain Stem ; Coma ; Cyanides ; Eating ; Emergency Service, Hospital ; Extracorporeal Membrane Oxygenation* ; Hemodynamics ; Humans ; Lactic Acid ; Male ; Middle Aged ; Norepinephrine ; Organ Transplantation ; Poisoning ; Prognosis ; Reflex ; Renal Replacement Therapy* ; Resuscitation ; Shock ; Suicide ; Tissue and Organ Procurement ; Vital Signs

No abstract available.
Cell Cycle* ; Endothelial Cells*

Recently, morbidity and mortality are reduced in elderly trochanteric fracture patients, which is best accomplished with multiple flexible intramedullary nail fixation under image intensifier control. Condylocephalic nailing of the trochanteric fractures offers four advantages; Minimally traumatic, short operation time, little blood loss, and very early weight bearing on the injured limb after surgery. The authors treated 15 cases of intertrochanteric fractures from June 1981 to March 1983 with multiple flexible intramedullary nails (Ender or P.G.P.). The results obtained were as follows; l. Among 15 cases, two patients were ages between 41 and 50, there between 51 and 60, one between 61 and 70, seven between 71 and 80, and two patients above 81 years, Nine were men and six women. 2. The average operation time was 60 minutes (range, 30 to 150 minutes) and average blood loss was 140ml (range, 50 to 400ml). After operation, Bucks extension traction was applied for 3 weeks in three cases. 3. Partial weight bearing ambulation was recommended one day after operation in eleven cases, and at 21th days in the other three cases. Full weight bearing ambulation, using appropriate assistive devices, was recommended as early as possible. 4. The clinical union was obtained as early as 5 weeks after operation in 7 cases, 9 weeks in two cases and 12 weeks in one case. 5. Among the complications, downward migration of the nail occured in two patients. With early weight-bearing, varus deformity due to collapse of the reduced fracture resulting secondary leg shortening (less than 3 cm) occured in 8 cases and mild external rotation deformity of lower leg in 3 cases (less than 15), but did not present any clinical problem in elderly patients, Irritation by the nail tip caused pain around the knee and also developed the partial stiffness of the joints temporarily after surgery. No nails migrated into the oits. It was felt that most difficult thing to manage was the maintenance of reduced fracture till clinical union to prevent varus deformity and distal nail migration, and the method was technically simple and could be employed succesfully.
Aged ; Congenital Abnormalities ; Extremities ; Female ; Femur ; Hip Fractures ; Humans ; Joints ; Knee ; Leg ; Male ; Methods ; Mortality ; Self-Help Devices ; Traction ; Walking ; Weight-Bearing