For the non-invasive evaluation of cardiac performance in hyperthyroidism, fractional systolic and diastolic time intervals were determined in 96 female patients with hyperthyroidism from the mechanocardiograms which included apexcardiograms together with electrocardiograms, phonocardiograms and carotid arterial pulse tracings. The observed values of the time intervals inversely related to heart rate, i.e., ejection period, mechanical systole, isovolumic relaxation time and active ventricular filling period, were significantly shortened in proportion to the severity of the disease in general, as determined by the rate of the radioactive iodine uptake of the thyroid glands. However, these values were not significantly different from those of the predicted for heart rate, except for one of mechanical systoles which is a time interval from the onset of the systolic upstroke in the apexcardiogram to the second aortic sound. This suggests that the shortening of these observed values is promarily due to tachycardia associated with hyperthyroidism. One the other hand, the observed values of the time intervals unrelated to heart rate, i.e., electromechanical delay, isovolumic contraction time together with one of its components, namely ventricular pressure elevation time, and rapid ventricular filling period, were significantly shorter than those in the controls, although the degree of the shortening was not related to the degree of the radioactive iodine uptake of the thyroid gland. It appears that the shortening of these time intervals is related to the altered cardiac function caused by hyperthyroidism and, in particular, that of the isovolumic contraction time and ventricular pressure elevation time reflects enhancemet by the thyrotoxic myocardial contractility.
Electrocardiography ; Female ; Hand ; Heart Rate ; Humans ; Hyperthyroidism* ; Iodine ; Relaxation ; Systole ; Tachycardia ; Thyroid Gland ; Ventricular Pressure

BACKGROUND: Propafenone is effective in the treatment of ventricular arrhythmias and paroxysmal supraventricular tachycardia. Propafenone has been shown to be also useful in preventing the recurrence of atrial fibrillation. But to date, date concerning the efficacy of propafenone for patients experiencing paroxysmal and chronic atrial fibrillation have not been examined in Korea. METHODS: In patients with paroxysmal atrial fibrillation propafenone was given at a dose of 450mg daily without dose titration and symptomatic recurrences were evaluated by patient interview during follow-up. In patients with chronic atrial fibrillation, who had no previously attempted cardioversion, propafenone was given at a dose of 450~675mg daily without dose titration, and after a minimum of 3 days pharmacological cardioversion was assessed. Those patients in whom sinus rhythm had been restored pharmacologically or by combined direct current cardioversion were followed with maintaining propafenone therapy also at a dose of 450~675mg daily. RESULTS: Of 7 patients with paroxysmal atrial fibrillation, 4 (57%) patients had marked symptomatic improvement and they were followed for 197 to 460 (mean 286) days Of 13 patients with chronic atrial fibrillation, 7 patients incuding 4 pharmacologically converted patients were initially controlled to sinus rhythm. In 5 (38%) patients maintenance of sinus rhythm was followed for 90 to 415 (mean 224) days. CONCLUSION: Although these observations were made in small number of patients and are so limited, the results are comparable to the previous studies which showed the potential role of propafenone in the management of atrial fibrillation.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Electric Countershock ; Follow-Up Studies ; Humans ; Korea ; Propafenone* ; Recurrence ; Tachycardia, Supraventricular

Alveolar macrophages participate in the host defense against P. carinii, but the mechanisms in degradation and clearance of the organism from lung has not been well established. We observed the transmission and scanning electron microscopic features and evaluated the expression of TNF-alpha and Surfactant-D in the interaction of P. carinii with alveolar macrophages. Expression of TNF-alpha and Surfactant-D in the experimentally induced P. carinii pneumonia in rat was examined by immunohistochemistry and immunoelectron microscopy. Electron microscopically, the alveolar macrophages phagocytized trophozoites and cysts of P. carinii micro-organisms. Immunohistochemically TNF-alpha was strongly expressed in the cytoplasms of alveolar macrophages. Postembedding immunogold labeling for Surfactant-D protein was expressed on the pellicles of trophozoites and cysts, P. carinii micro-organisms in the cytoplasms of macrophages, free floating surfactant materials and multilamellar bodies of type II epithelial cells. We conclude that alveolar macrophages interacted with P. carinii micro-organisms respond with increased expression of TNF-alpha. TNF-alpha may bind to P. carinii and exert a direct toxic effect upon the micro-organisms. Surfactant-D protein may augment binding of P. carinii to the alveolar macrophages and enhance the clearance of the micro-organisms.
Animals ; Cytoplasm ; Epithelial Cells ; Immunohistochemistry ; Lung ; Macrophages ; Macrophages, Alveolar* ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Rats ; Trophozoites ; Tumor Necrosis Factor-alpha*

p21 is a universal inhibitor of cyclin-dependent kinase (cdk) and of cell-cycle progression. p21 expression is variable according to the type of tissue and the pathologic condition. To study the role of p21 in the multistep hepatocarcinogenesis, the expression of p21, p53 and Ki-67 was investigated in 53 cases of inactive liver cirrhosis, 4 cases of low grade dysplastic nodules, 3 cases of high grade dysplastic nodules, 7 cases of early hepatocellular carcinomas (HCCs), 27 cases of small HCCs (< or =3 cm), and 52 cases of advanced HCCs (>3 cm). p21 expression was not detected in liver cirrhosis, low grade dysplastic nodules, high grade dysplastic nodules and early HCCs which were mitotically inactive. p21 expression was significantly increased in small HCCs and advanced HCCs which were mitotically active. p21 expression was significantly correlated with Ki-67 labelling indices. p53 protein was not expressed in liver cirrhosis, dysplastic nodules, and early HCCs. The expression of p53 protein was, however, significantly increased in small and advanced HCCs. The p21 expression was not correlated with p53 expression. Therefore, p21 is suggested to play a role in the mitotically active small and advanced HCCs, but not in the mitotically inactive lesion of dysplastic nodules and early HCC in multistep hepatocarcinogenesis. These findings suggest that homeostatic mechanism of growth control is not totally destroyed in HCC.
Carcinoma, Hepatocellular ; Cell Proliferation* ; Humans* ; Liver Cirrhosis ; Phosphotransferases

This study was undertaken to investigate the morphologic changes following flushing, preservation and reperfusion procedures in a canine lung allotransplantation model. Donor lungs were flushed with modified Euro-Collins (MEC) solution, low potassium dextran glucose (LPDG) solution or University of Wisconsin (UW) solution, then stored at 10oC for 20 hours. Light microscopic and electron microscopic features of the lungs were examined after flushing, preservation and 2 hours after reperfusion. After flushing light microscopy showed focal mild alveolar collapse and interstitial edema. After preservation the lung tissue showed multiple foci of alveolar collapse, consolidation, and alveolar epithelial cell damage. After reperfusion the lung tissue showed diffuse alveolar collapse, consolidation and many destroyed cellular debris in the alveolar lumina. After flushing electron microscopy showed focal alveolar collapse and mild swelling of type I epithelial cells. After preservation both type I epithelial cells and endothelial cells were swollen and destroyed focally. Some type I epithelial cells were detached from the basal lamina. The endothelial cells showed luminal protrusion of tactile-like structure and vacuoles of the cytoplasm. After reperfusion the lung tissue showed fibrin material in the alveoli, prominent type I epithelial cell swelling with fragmented cytoplasmic debris and marked endothelial cell swelling with vacuoles or tactile-like projections. The alveolar macrophages showed active phagocytosis. After preservation scanning electron microscopic examination of the pulmonary arteries showed multiple patchy areas of swelling or conglomerated lesions in the inner surface of the pulmonary arteries. In conclusion, the ultrastructural changes associated with flushing were mild in severity, the donor lungs were injured during the preservation, and further damage occurred during the reperfusion.
Basement Membrane ; Cytoplasm ; Dextrans ; Edema ; Endothelial Cells ; Epithelial Cells ; Fibrin ; Flushing ; Glucose ; Humans ; Lung Transplantation* ; Lung* ; Macrophages, Alveolar ; Microscopy ; Microscopy, Electron ; Perfusion* ; Phagocytosis ; Phenobarbital ; Potassium ; Pulmonary Artery ; Reperfusion* ; Tissue Donors ; Vacuoles ; Wisconsin

The serum level of immunoglobulin E (IgE) in 28 atopic patients and 41 healthy, normal, non-allergic subjects were measured by standard radial immunodiffusion method (RIDT). The correlation between IgE level and clinical manifestations are studied. The results are as follows. 1) IgE value was higher in atopic dermatitis than normal subjects. 2) IgE value in atopie dermatitis revealed no sigaificant difference between in male and in female. 3) IgE value was increased parallel with the severity of the disease. 4) IgE value was not correlated with the extent of disease. 5) IgE value was not correlated with the duration of disease. 6) IgE value was not correlated with the age of onset. 7) IgE value was not correlated with the eosinophil count of peripheral blood.
Age of Onset ; Dermatitis ; Dermatitis, Atopic* ; Eosinophils ; Female ; Humans ; Immunodiffusion ; Immunoglobulin E* ; Immunoglobulins ; Male

This study was performed to investigate the stimulating effect on oocyte maturation and cumulus cell expansion in TC199 media by human cord serum (HCS) supplementation. Immature mouse oocyte cumulus complexes (OCCs) were cultured in TC199 media supplemented with bovine serum albumin (BSA), HCS and human chorionic gonadotropin (hCG) instead of luteinizing hormone (LH) respectively, and the expression of cumulus expansion and oocyte maturation were observed. After 4hr and 24hr culture with or without OCCs, media containing 0.4% BSA, 10% HCS and 10 lU hCG respectively were collected and analyzed for changing concentrations of estradiol (E2), progesterone(P4), testosterone(T), and PGF2. There were no elevation of E2, T, and PGF2 by OCCs culture, but minute elevation of P4 level by 24hr OCCs culture in hCG supplementation (p=0.048). The stimulating pattern of cumulus expansion of OCCs by HCS and hCG supplementation was similar to our previously report using Ham's F-10 media, however oocyte maturation rates after 24hr OCCs culture in all media were increased by 20~30% compared to Ham's F-10 media. These results suggest that LH in HCS induce cumulus expansion probably by P4 secretion of OCCs, and TC199 is efficient media for immature mouse oocyte maturation.
Animals ; Chorionic Gonadotropin ; Cumulus Cells* ; Dinoprost ; Estradiol ; Humans* ; Luteinizing Hormone ; Mice ; Oocytes* ; Serum Albumin, Bovine

Melanoma is relatvely uncommon malignant tumor arising in the skin from epidermal melanocytes, from the junctional component of a cellular nevus or, rarely within a blue nevus and frequently metastasizes to regional lymph nodes first, followed by hematogenous spread to lungs, liver, gastrointestinal tract, pancreas, adrenal, heart and brain. All melanoma patients are carefully evaluated according to several parameters. A complete history and physical examination are carried out, with particular attention being devoted to other pigmented tumors that the patient may have. The patient should be further evaluated to determine the presence or absence of metastases by chest X-ray examination, metastatic series or bone scan, liver function studies, liver scan, EKG, etc. Special factors such as age, sex, and race, as well as site, size, and growth rate of lesions are also evaluated. We had a case of 59 year-old male patient with disseminated malignant melanoma. Upon his first visit, we did not find any abnormality in his physical examination and routine laboratory findings except skin tumors on left heel and left leg.
Brain ; Continental Population Groups ; Electrocardiography ; Gastrointestinal Tract ; Heart ; Heel ; Humans ; Leg ; Liver ; Lung ; Lymph Nodes ; Male ; Melanocytes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Nevus ; Nevus, Blue ; Pancreas ; Physical Examination ; Skin ; Thorax

We report a case of primary transitional cell carcinoma developed in bladder vdiverticulum with brief review of literatures. Patient was a 71 year-old man who had painless gross hematuria for 10 days. Excretory urogram showe a large diverticulum in the bladder. At cystoscopy a 0.5 x 0.5cm sized papillary mass was seen on diverticular mucosa. Urine cytology revealed class V transitional cell carcinoma. At pelvic CT, metastatic evidence was not seen. We carried out partial cystectomy involving diverticulum under the diagnosis of primary transitional cell carcinoma developed in vesical diverticulum. The histopathologic diagnosis was grade III, stage A transitional cell carcinoma combining with carcinoma in situ.
Aged ; Carcinoma in Situ ; Carcinoma, Transitional Cell* ; Cystectomy ; Cystoscopy ; Diagnosis ; Diverticulum* ; Hematuria ; Humans ; Mucous Membrane ; Urinary Bladder*

BACKGROUND: Recently involvenment of apoptosis, or programmed cell death, has been suggested in myocardial reperfusion injury. Free radicals are one of the inducers of apoptosis, and superoxide dismutase(SOD), a oxygen free radical scavenger, inhibits apoptotic cell death of neurons. Reperfusion of ischemic myocardium results in a burst of oxygen free radical production, however, it has not been defined that oxygen free radicals mediate apoptosis in myocardial reperfusion injury. This study was undertaken to investigate the role of oxygen free radicals by examining the inhibition of apoptosis by SOD. METHOD: New Zealand white rabbits (n=16) weighing 1.8-20kg underwent 30 minutes of left anterior descending coronary artery occlusion followed by reperfusion for 1 or 4 hours. In control group, bovine serum albumin(5mg/kg) was administered continuously via the left atrial appendage starting 10 minutes before reperfusion and ending simultaneously with reperfusion for 1 hour(n=4) or 4 hours(n=4). In SOD group, bovine erythrocyte SOD(15,000u/kg) was administered starting 10 minutes before reprefusion and ending simultaneously with reperfusion for 1 hour(n=5) or 4 hours(n=3). Ventricles were excised immediately after intervention. Tissues were fixed in 10% buffered formalin and 2.5% glutaraldehyde. Apoptosis was examined by hematoxylin and eosin(H&E) staining, in situ nick end labeling, and transmission electron microscopy. Number of apoptotic cells was evaluated semi-quantitatively on H&E stained section. RESULTS: Evidence of apoptosis was detected in every ischmia-reperfused myocardium, and apoptotic cells were found in the non-necrotic myocardium near areas of contraction band necrosis. In control group, the average number of apoptotic cells was 1.7(range 1.5-2.0)for 1 hour reperfused myocardium and 1.4(range 0.3-2.5) for 4 hours reperfused myocardium per high power field(x400). In SOD group, the average number of apoptotic cells was 0.2(range 0.2 -0.3) for 1 hour reperfused myocardium and 0.3(range 0.2-0.4) for 4 hours reperfused myocardium. There was a significant difference in the number of apoptotic cells between conrol and SOD groups (as a whole group 1.5 +/- 0.2 vs 0.3 +/- 0.1,p<0.01). CONCLUSION: SOD partially, however, singificantly inhibits apoptosis, which suggests that oxygen free radicals may induce apoptosis in ischemia-reperfused myocardium of rabbit.
Apoptosis* ; Atrial Appendage ; Cell Death ; Coronary Vessels ; Erythrocytes ; Formaldehyde ; Free Radicals ; Glutaral ; Hematoxylin ; In Situ Nick-End Labeling ; Microscopy, Electron, Transmission ; Myocardial Reperfusion Injury ; Myocardium* ; Necrosis ; Neurons ; Oxygen ; Rabbits ; Reperfusion ; Superoxide Dismutase* ; Superoxides*