No abstract available.
Humans ; Microcomputers* ; Survival Analysis*

DNase I footprinting assay using liver nuclear extracts revealed six protected regions between nucleotide -600 and +110 and hence named Box I-VI. Upstream promoter element (UPE), a DNA element playing crucial role in transcriptional control of the tissue specific expression of pancreatic beta-cell, has been detected within the proximal region of rat GLUT2 promoter. This region is included in Box VI. The protein-DNA interaction in this region (Box VI) was confirmed by mobility shift assay using liver nuclear extracts. Deletion of the region between -585 bp and -146 bp resulted in dramatic changes in promoter activity when they were expressed in liver and beta-cell derived cell line. When -585/-146 construct was expressed in liver, the activity was decreased to 46%, whereas the activity in beta-cell line, HIT-T15 cell, was increased by 84% when compared to -146/+190 construct. These opposing phenomena can be explained by the fact that beta-cell specifically expresses the UPE binding protein. Assuming that there may be Box VI-binding protein playing negative roles both in hepatocyte and beta-cell, and that the protein acts as a negative regulator of GLUT2 gene, the UPE binding protein in the beta-cell may overcome the inhibition by binding to the protein.
Animal ; Binding Sites ; Cell Line ; Comparative Study ; DNA Footprinting ; Deoxyribonuclease I ; Gene Expression Regulation ; Islets of Langerhans/metabolism* ; Islets of Langerhans/cytology ; Liver/metabolism* ; Liver/cytology ; Monosaccharide Transport Proteins/genetics ; Monosaccharide Transport Proteins/biosynthesis* ; Promoter Regions (Genetics)* ; Protein Binding ; Rats ; Transcription Factor AP-1

Accessory renal artery (ARA) is a kind of developmental anomaly in renal artery. It is important in respect to clinical medicine, for example primary hypertension, renovascular disease, inferior vena caval obstruction, ureteral obstruction, occurrence of other vascular anomalies such as accessory renal veins, surgical importance and renal transplantation. However, up to few research of ARA was reported in dissection of cadavers. In our dissecting theater, 12 accessory renal arteries for 10 cadavers were found during dissection the 22 cadavers from 1995 to 1996. 1. Two cases were bilateral and 8 cases were unilateral accessory renal arteries. 2. Seven cases were left and 5 cases were right accessory renal arteries. 3. Two cases originated at the abdominal aorta between celiac trunk and superior mesenteric artery, 7 cases originated between superior mesenteric artery and inferior mesenteric artery, and 3 cases originated below inferior mesenteric artery. 4. Seven cases have no branches during their courses, 4 cases have 3 branches, and a case has 2 branches. 5. Seven cases entered into renal parenchyma through renal hilum, 5 cases entered into apical and arterosuperior segments, and 6 cases entered into inferior segment.
Aorta, Abdominal ; Cadaver ; Clinical Medicine ; Hypertension, Renovascular ; Kidney Transplantation ; Mesenteric Arteries ; Mesenteric Artery, Inferior ; Mesenteric Artery, Superior ; Renal Artery* ; Renal Veins ; Ureteral Obstruction

BACKGROUND: we have evaluated the association of age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases with postoperative pulmonary complications and identified which parameter of preoperative spirometry was a predictor of postoperative pulmonary complications. METHOD: In 270 patients older than 60 years, the postoperative pulmonary complications were evaluated according to age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases and the parameters of preoperative spirometry were analyzed. RESULTS: The postoperative pulmonary complications rates were significant higher among patients older than 70 years, and among those with previous chronic pulmonary diseases or their smoking history. The pulmonary complications were increased among patients with general anesthesia or duration of surgery more than 2 hours. The pulmonary complications rates did not differ according to sex, type of operation. The patients with hypercarbia(PaCO2> 45mmHg) have more increased postoperative complications. The preoperative FEVl less than 1 liter, FVC, MMEFR & MVV less than 50% of predicted respectively were predictive of complications. CONCLUSION: Age 70, history of smoking,duration of operation more than 2 hours, general anesthesia, previous chronic pulmonary disease and hypercarbia (> or=45mmHg) on preoperative arterial blood gas analysis were predictivd of pulmonary complications. Among the parameters of spirometry, FEV1, FVC, MMEFR and MVV were indicator of predicting postoperative pulmonary complications.
Aged* ; Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Humans ; Lung Diseases ; Postoperative Complications ; Smoke ; Smoking ; Spirometry

Abnormal attachment of the placenta (Placenta accreta, increta, and percreta) is an uncommon but potentially lethal cause of maternal mortality from massive postpartum hemorrhage. A 33-yr-old woman, who had been diagnosed with a placenta previa, was referred at 30 weeks gestation. On ultrasound, a complete type of placenta previa and multiple intraplacental lacunae, suggestive of placenta accreta, were noted. For further evaluation of the placenta, pelvis MRI was performed and revealed findings suspicious of a placenta increta. An elective cesarean delivery and subsequent hysterectomy were planned for the patient at 38 weeks gestation. On the day of delivery, endovascular catheters for balloon occlusion were placed within the hypogastric arteries, prior to the cesarean section. In the operating room, immediately after the delivery of the baby, bilateral hypogastric arteries were occluded by inflation of the balloons in the catheters previously placed within. With the placenta retained within the uterus, a total hysterectomy was performed in the usual fashion. The occluding balloons were deflated after closure of the vaginal cuff with hemostasis. The patient had stable vital signs and normal laboratory findings during the recovery period; she was discharged six days after delivery without complications. The final pathology confirmed a placenta increta.
Adult ; Arteries/*surgery ; *Catheterization ; Cesarean Section ; Female ; Gestational Age ; Humans ; Hysterectomy/*methods ; Placenta/*blood supply/ultrasonography ; Placenta Accreta/*surgery/ultrasonography ; Placenta Previa/*surgery/ultrasonography ; Postpartum Hemorrhage/*prevention & control ; Pregnancy ; Treatment Outcome

No abstract available.
Pneumonectomy*

Vertebral, anal, cardiac, tracheo-esophageal, renal, and limb(VACTERL) association is defined as the presence of at least three of the above-mentioned six manifestations. An estimated incidence of the VACTERL association is 1 in 20,000 to 35,000 live births although the diagnostic criteria vary. The VACTERL association is highly heterogeneous in clinical presentation. It may represent a spectrum from the less severely affected to the more severely affected. Diagnosis is difficult because of the number of disorders that have overlapping features with trisomy 13 syndrome, trisomy 18 syndrome, trisomy 21 syndrome, Feingold syndrome, and so on. The incidence of trisomy 18 syndrome, a type of a chromosomal disorder, is estimated to be 1 in 6,000-8,000 live births. It includes characteristic craniofacial anomalies, clenched hand with overlapping of index finger over third, fifth finger over fourth, underdeveloped thumbs, short sternum, cardiac anomalies such as ventricular septal defect, and renal anomalies such as horseshoe kidney. Approximately over 50% of infants with trisomy 18 syndrome live less than one week. In 1983, Khoury et al. reported VACTERL association combined with trisomy 18 syndrome. Here, we report a case of a low birth weight female infant with VACTERL association, whose second diagnosis is Edward syndrome, and that she also has another combined anomaly, meningomyelocele. To the best of our knowledge, this is the first reported case of VACTERL association with meningomyelocele combined with trisomy 18 syndrome in Korea.
Chromosome Disorders ; Diagnosis ; Down Syndrome ; Female ; Fingers ; Hand ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Kidney ; Korea ; Live Birth ; Meningomyelocele* ; Sternum ; Thumb ; Trisomy*

PURPOSE: We aimed to investigate the clinical characteristics and associated diseases in children with a horseshoe kidney and compared these data between children and adults. METHODS: We performed a retrospective analysis of the medical records and radiological findings of 43 patients diagnosed with a horseshoe kidney in the Busan Paik Hospital. The subjects were divided into the children's group (14 cases, age <18 years) and the adult group (29 cases, age > or =18 years). RESULTS: The study group consisted of 17 males and 26 females with a median age of 34 years. In the children's group (14 cases), 5 subjects were male and 9 were female, with a mean age of 6.7+/-6.2 years. Most of the subjects were asymptomatic and were incidentally diagnosed with horseshoe kidney during their evaluation for another disease. Among the associated diseases in the children's group, Turner syndrome was the most common (5 cases), whereas ureteropelvic junction (UPJ) stricture was observed in 2 cases (14.2%). None of the children exhibited abnormal renal function during the follow-up period. In the adult group (29 cases), 12 subjects were male and 17 were female, with a mean age of 48 years. Eighteen patients were incidentally diagnosed with horseshoe kidney during their evaluation for another disease, and 11 patients had hematuria or abdominal pain due to renal stones. Among the associated diseases in the adult group, Turner syndrome was the most common (5 cases), and UPJ stricture was observed in 5 cases; the other accompanying diseases included hydronephrosis and overactive bladder. Six patients exhibited decreased renal function (serum creatinine level >1.5) during the follow-up period. CONCLUSION: Horseshoe kidney is usually diagnosed incidentally in both children and adults. In the present study, we noted that Turner syndrome was the most common associated disease in children. In addition, most children were asymptomatic but had a high risk of urologic complications after the transition to adulthood. Therefore, children with horseshoe kidney require continuous follow-up.
Abdominal Pain ; Adult ; Child ; Constriction, Pathologic ; Creatinine ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Hydronephrosis ; Kidney* ; Male ; Medical Records ; Retrospective Studies ; Turner Syndrome ; Urinary Bladder, Overactive ; Urinary Calculi ; Urogenital Abnormalities

BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.
B-Lymphocytes* ; Cough ; Dyspnea ; Fever ; Glass ; Humans ; Lymphoid Tissue* ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Pneumonia* ; Radiography, Thoracic ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed

BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.
B-Lymphocytes* ; Cough ; Dyspnea ; Fever ; Glass ; Humans ; Lymphoid Tissue* ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Pneumonia* ; Radiography, Thoracic ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed