BACKGROUND AND OBJECTIVES: Neointimal ingrowth rather than stent recoil is thought to be important for coronary in-stent restenosis. However only limited pathologic data are available to adress the mechanisms of in-stent restenosis. With the specific aim of measuring cell replication and of assessing cellularity and extracellular matrix (ECM) composition, we analyzed atherectomized coronary arterial in-stent restenotic specimens. METHODS AND RESULTS: In the present study, we analyzed 29 atherectomized coronary arterial in-stent restenotic tissue samples (14 LAD, 10 RCA, and 5 LCX) retrieved from 25 patients (m/f:18/7: age 59+/-13 yr) at 0.5-23 (mean 5.7) months after deployment of Palmaz-Schatz stent. Histopathological analysis of cellular components and ECM was performed using H & E, modified Movat pentachrome, and immunocytochemical staining. Cellular proliferation rate, as estimated by use of antibodies to Ki-67 nuclear antigen showed low proliferation rate with the range of 0-4%, and no positive cells were found in 62% of cases. Myxoid tissue having ECM enriched with versican and hyaluronan was found in 69% of cases, and decreased over time after stenting. Foci of cell poor area were found in 57% of cases, and could be classified into as: (1) containing collagen-rich ECM and (2) containing a proteoglycan-rich ECM. Versican, biglycan, perlecan, and hyaluronan were identified with varying individual distributions in the proteoglycan rich area. Specimens with foci of cell poor area tended to increase over time after stenting (31% in & 4 mo vs. 81% in > or =4 mo after stenting, p<0.01). alpha-smooth muscle actin staining identified the majority of cells as smooth muscle cells (SMC) and occasional macrophages (< or =12 cells per section) were detected by CD68 antibody. CONCLUSIONS: These data suggest that enhanced ECM accumulation rather than cell proliferation may be important mechanisms for stent restenosis. Angioplasty of stent restenosis may therefore fail due to transient compression of this hygroscopic matrix.
Actins ; Angioplasty ; Antibodies ; Biglycan ; Cell Proliferation ; Extracellular Matrix ; Humans* ; Hyaluronic Acid ; Macrophages ; Myocytes, Smooth Muscle ; Proteoglycans ; Stents* ; Versicans

No abstract available.
Korea* ; Vaccination*

Platelet-derived growth factor (PDGF), a potent chemotactic and mitogenic factor, is involved in the regulation of hematopoiesis and platelet production. Our studies demonstrate the presence of functional PDGF receptors (PDGFR) on human megakaryocytes/platelets and CD34(+) cells, and their ability to mediate a mitogenic response. PDGF promotes the ex vivo expansion of human hematopoietic stem (CD34(+)) and progenitor (CD41(+)) cells. More significantly, PDGF enhances the engraftment of human CD45(+) cells and their myeloid subsets (CD33(+), CD14(+) cells) in NOD/SCID mice. PDGF also stimulates in vitro megakaryocytopoiesis via PDGFR and/or the indirect effect on bone marrow microenvironment to produce TPO and other cytokines. It also shows a direct stimulatory effect of PDGF on c-Fos, GATA-1 and NF-E2 expressions in megakaryocytes. We speculate that these transcription factors may be involved in the signal transduction of PDGF on the regulation of megakaryocytopoiesis. PDGF also enhances platelet recovery in mouse model with radiation-induced thrombocytopenia. This radioprotective effect is likely to be mediated via PDGFR with subsequent activation of the PI3K/Akt pathway. It provides a possible explanation that blockage of PDGFR may reduce thrombopoiesis and play a role in imatinib mesylate-induced thrombocytopenia.
Animals ; Hematopoietic Stem Cells ; cytology ; Humans ; Megakaryocytes ; cytology ; Mice ; Platelet-Derived Growth Factor ; metabolism ; Receptors, Platelet-Derived Growth Factor ; metabolism ; Thrombopoiesis

Congenital absence of the lower sternum, defect of the abdominal wall, defects of the anterior diaphragm, pericardial defects and cardiac anomalies had been described as a syndrome by Cantrell et al. Developing mechanism of the syndrome was embryologically defined. These defects arise apparently from combined anomalies of developing of the dorsal mesoderm. The authors present two cases of Cantrell's syndrome developed in one day old and eight months old female patient in which angiocardiography was done at the Department of Radiology, Seoul National University Hospital.
Abdominal Wall ; Angiocardiography ; Diaphragm ; Female ; Humans ; Mesoderm ; Seoul ; Sternum

Leukemia is the commonest malignancy in childhood, accounting for about one-third of all malignancies in thosebelow the age of 15 years. Authors analysed the chest PA findings of 177 cases of leukemia in childhood below theage of 15 years, diagnosed at Seoul National University Hospital in recent 5 years since 1978. The summaries ofthe analysis are as follows; 1. Among 177 cases, 121 cases were male and 56 cases were female. The malepredominant than the female with the ratio of 2.2:1. In 177 cases, 77% of the patients were under the 10 years ofage. 2. The incidence of subtype of leukemia was as follows; The acute form was 158 cases (89%), acute lymphocyticleukemia, 55%, acut myelocytic group, 31.6%, chronic myelocytic type, 10%. And acute lymphocytic leukemia was61.4% of acute form. 3. The incidence of abnormality in chest PA was 32.2%(57 cases) . Among these 57 cases,abnormality in lung field was 35 cases (19.8% of total patients) hilar and mediastinal lymph nodes enlargement was19 cases(10.7%). Pleural effusion was 13 cases (7.3%) and cardiac shadow enlargement in chest PA was 3 cases.
Child ; Female ; Humans ; Incidence ; Leukemia ; Lung ; Lymph Nodes ; Male ; Pleural Effusion ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Seoul ; Thorax

Objective To investigate the changes of serum leptin levels and the influential factors in maintenance peritoneal dialysis patients.Methods Seventy-six peritoneal dialysis patients were chosen at the time before,and 3 months,6 months,12 months,18 months and 24 months after they began the peritoneal dialysis therapy,to examine body mass index (BMI),triceps skinfold thickness (TSF),abdominal circumference,homeostasis model assessment of insulin resistance (HOMA-IR),the plasma lipid profile,and leptin in the same situation.Results For 24 months,these patients showed higher serum leptin level than the values before commencing peritoneal dialysis treatment (P ＜ 0.01).The level of leptin was positively correlated with the BMI(r =0.412,P ＜ 0.01),TSF(r =0.308,P ＜ 0.01),abdominal circumference(r =0.284,P ＜ 0.01),HOMA-IR(r =0.184,P ＜ 0.01) and TG(r =0.288,P ＜ 0.01),negatively corelated with the high-density lipoprotein cholesterol(HDL-C)(r =-0.285,P ＜ 0.01).Multiple logistic regression analysis showed that BMI (β =0.339,P ＜ 0.01),TGβ =0.157,P ＜ 0.01) and HDL (β =-0.126,P ＜ 0.05)were significant predictive factors for the changes of serum leptin levels.Conclusion Leptin maybe involve in the occurrence and the development of cardiovascular events like other metabolic parameters in peritoneal dialysis therapy.

Pulmonary alveolar proteinosis (PAP) is a rare disease clinically, and at present no western medicine can effectively cure the disease. After the analysis of literatures related to Traditional Chinese Medicine (TCM) for treatment of the disease in the China National Knowledge Internet Database, it was discovered that the syndrome differentiation showed the disease closely associated with phlegm, blood stasis and yin deficiency. In this study, from view point of pulmonary gangrene TCM theory and treatment combined with PAP pathophysiological characteristics, it is emphasized that phlegm accumulation, blood stasis and yang deficiency are the key pathological manifestations of PAP, thus Yanghe decoction, Tounong powder, Kongxian pellet were used for treatment of one such case, the rational thinking in diagnosis and treatment of this patient being consistent with the idea learning western medicine for China use.

Fractures of the proximal humerus occur more frequently in older patients but are seen in all ages and emerge epiphyseal separations. The objectives of treatment are restoration of all involved structures to normal anatomical state and a completely functional limb in the shortest time possible. One part and two part fractures were indicated in conservative treatment and surgical treatment in most of three, four part fractures. The results of treatment of forty four cases according to Neer's classification were analysed at the Department of Orthopedic Surgery, Chonbuk National University Hospital from Mar. 1978 to Dec.1985. The results were as follows. 1. The prevalent age distribution was third and fifth decade(48%) . 2. The most common cause of injury was slip down(14 cases, 32%). 3. The most frequent cases of the fractures in Neer's classification were two part fractures(22 cases, 50%). 4. Thirty one cases(71%) were treated by conservative treatment, twelve cases(27%) by open reduction and 1 case(2%) by prosthesis. 5. Good results were in 23 cases(52%) of one and two part fractures, fair in 17 cases(39%) and poor in 4 cases(9%) of two, three and four part fractures.
Age Distribution ; Classification ; Clinical Study ; Extremities ; Humans ; Humerus ; Jeollabuk-do ; Orthopedics ; Prostheses and Implants ; Shoulder Fractures

No abstract available.
Aneurysm* ; Heart Septal Defects, Ventricular*

This study was conducted to find out an appropriate means for preventing the juvenile delinquency (JD), which is supposed to be greatly realted to family environment. The data were collected through a questionnaire survey with a means of writing by themself, to 257 middle and high school students and 309 juvenile delinquents who were in confinement. The questionnaire was consisted of 27 items of juvenile delinquencies, 15 questions about personal environment in their period of childhood, 36 questions on their home atmosphere, 25 items with regard to their parental behavior to their children in the rearing of them. The extent of delinquency was calculated by summing the numbers of experienced delinquencies of the listed items. The study subjects were divided into two groups; student group (SG) and juvenile delinquent group (JDG) and the collected data were analyzed with the extent of delinquency in each group by SPSS/PC+statistical package. The extent of JD was increased as the study subjects grew older, defective families were more common, total family income was more poor, parents' educational level was lower, personal expenses were higher and the conflicts between parents were more high in JDG as compared with of SG. The differences were statistically significant. As long as the extent of delinquency is concerned, delimquent points of JDG were significantly higher as compared with that of SG in all items except one item, below the primary school item in fathers' educational level. (In order to prevent JD in our country, it is recommended that educational level and the living standared of the lower class people should be raised, the sound families which do have less conflictsshould be established as much as possible, the present educational system which is making much conflicts between parents and their offsprings should be changed so that their given temperament would be brought up to the highest level, defective families should be reduced as much as possible and adults should not do actions that are considered not to be done by youngsters and must set a good example.)
Adult ; Atmosphere ; Child ; Humans ; Juvenile Delinquency* ; Parents ; Surveys and Questionnaires ; Temperament ; Writing