BACKGROUND: Intracellular calcium overload is a common final feature of the ischemic-reperfused heart and mediates the genesis of irreversible cell damage. Reactive oxygen medabolites have been known to play and important role as toxic mediators in myocardial injuries resulting from ischemia and reperfusion. In order to investigate the mechanism of intracellular calcium accumulation in the ischemic-reperfused myocardium, the present study observed the possible contribution of the reactive oxygen metabolite to the calcium transport of cardiac mitochondria. METHODS: Mitochondrial were isolated from rabbit hearts. The effects of a reactive oxygen metabolite, H2O2 on calcium uptake and release, redox states of endogenous pyridine nucleotides and glutathiones of mitochondria respiring with succinate were observed. Calcium uptake and release were monitored by dual-wave length spectrophotometer using a calcium indicator, arsenaze III. Contents and redox states of pyridine nucleotides and glutathiones were measured by enzymatic methods using spectrofluorometer and HPLC. RESULTS: Hydrogen peroxide(10-500microM) promoted calcium release dose-dependently from CA++-preloaded mitochondria, but did not affect the mitochondrial calcium uptake. The H2O2-induced calcium release was accompanied by simultaneous oxidation of the pyridine nucleotides and decrease in the content of the reduced form of glutathione(GSH). When mitochondria were treated with BCNU(N,N=bis(2-chloroethyl)-N-nitrosourea) to inhibit glutathione reductase and so as to reduce the GSH content, there were no increase in calcium release from the mitochondria. These results may indicate that H2O2 increases the permeability of cardiac mitochondrial membrane to calcium in association with the changes in redox state of endogenous pyridine nucleotides, but not with that of glutathiones. CONCLUSION: It is suggested that the reactive oxygen metabolites induce the release of calcium from mitochondria by altering the redox state of pyridine nucleotides, and it may partly be involved in the elevation of cytosolic calcium concentration in the ischemic-reperfused myocardial cells.
Calcium* ; Chromatography, High Pressure Liquid ; Cytosol ; Glutathione Reductase ; Heart ; Hydrogen ; Ischemia ; Mitochondria* ; Mitochondrial Membranes ; Myocardium ; Nucleotides ; Oxidation-Reduction ; Oxygen* ; Permeability ; Reperfusion ; Succinic Acid

No abstract available.
Biopsy* ; Lung Diseases* ; Lung*

No abstract available.
Empyema*

Herein we wish to report a case of pernicious anemia and myasthenia gravis occurred after treatment with removal of an invasive thymoma and irradiation. Nine years ago, the male patient was visited due to chest pain, and was found a mediastinal mass at his age of 55. He received open thoracotomy and was found stage III invasive thymoma which infiltrated phrenic nerve and pericardium. After removal of thymoma, he received 4,500cGy of radiation. Two years later, he complained of left eyelid drooping and diagnosed as myasthenia gravis with tensilon test. His myasthenic eye symptom was controled with Mestinon. After 9 years from thymectomy, he complained of dizziness and dyspnea on exertion. Bone marrow smear revealed megaloblastic anemia and serum vitamin B12 level was 42.24pg/ml. Gastric juice analysis revealed achlorhydria with positive anti-intrinsic factor antibody. 6 weeks after treatment with parenteral vitamin B12, hematologic findings were normalized.
Achlorhydria ; Anemia, Megaloblastic ; Anemia, Pernicious* ; Bone Marrow ; Chest Pain ; Dizziness ; Dyspnea ; Edrophonium ; Eyelids ; Gastric Juice ; Humans ; Male ; Myasthenia Gravis* ; Pericardium ; Phrenic Nerve ; Pyridostigmine Bromide ; Thoracotomy ; Thymectomy* ; Thymoma* ; Vitamin B 12

Herein, we report a case of multiple myeloma with multiple plasmacytomas of thyroid, lung, lymph nodes and adrenal gland, who presented as upper airway and esophageal obstruction with vocal cord palsy. An 80-year-old women complained of dysphagia, hoarseness and anterior neck mass. Ultrasonography of the neck showed huge inhomogeneous solid mass involving left thyroid lobe and isthmus with several lymphadenopathy along the both upper deep cervical chain. Chest CT scanning revealed 4x3 cm sized, low density mass in posterobasal segment of the right lower lobe with both lower paratracheal lymphadenopathy, and abdominal CT scanning revealed 4.5x4.5 cm sized round low density mass in left adrenal gland. Serum and urine electrophoresis was normal and immunofixation of serum and urine was negative. Bone marrow smear and a bone scintigram revealed no abnormality, but iliac bone marrow biopsy revealed infiltration of abnormal plasma cells. Histologic and immunohistochemical examinations of the thyroid and lung mass revealed monoclonal proliferation of plasma cells of kappa light chain. After local irradiation of the neck with parenteral dexamethasone injection, anterior neck mass was much diminished in size, but 2 weeks later she had a pneumonia with fatal outcome.
Adrenal Glands ; Aged, 80 and over ; Biopsy ; Bone Marrow ; Deglutition Disorders ; Dexamethasone ; Electrophoresis ; Fatal Outcome ; Female ; Hoarseness ; Humans ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Multiple Myeloma* ; Neck ; Plasma Cells ; Plasmacytoma* ; Pneumonia ; Thyroid Gland ; Tomography, X-Ray Computed ; Ultrasonography ; Vocal Cord Paralysis

No abstract available.
Urinary Tract Infections* ; Urinary Tract*

Solitary osseous plasmacytoma accounts for 3-5% of plasma cell tumor and are assumed to have a fairly good prognosis, with long duration of relapse free survival after local irradiation. A 64 year old woman with a lytic lesion involving left iliac bone was diagnosed as a solitary plasmacytoma, with a negative work-up for coexisting plasma cell disorders. Three months after irradiation of 5,400 cGy, the patient was readmitted with hypercalcemia and mass in left forehead and left gingiva. New multiple osteolytic lesions were developed. A aspiration cytology of forehead mass and curetted specimen of right femur due to pathologic fracture revealed plasmacytoma. MRI of thoracolumbar spine revealed abnormal high signal intensity in the L2 body, T8 and T9 vertebrae. Serum protein electropheresis revealed monoclonal gammopathy of IgG-kappa type. This aggressive case of solitary plasmacytoma, evolving into multiple myeloma after brief duration of remission, is in sharp contrast with the natural course of a solitary plasmacytoma.
Female ; Femur ; Forehead ; Fractures, Spontaneous ; Gingiva ; Humans ; Hypercalcemia ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Myeloma* ; Paraproteinemias ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Radiotherapy ; Recurrence ; Spine

PURPOSE: The purpose of this study was to evaluate the differences in survival rates between primary gastric and intestinal gastrointestinal non-Hodgkin's lymphoma (NHL) and to investigate risk factors for survival. MATERIALS AND METHODS: We reviewed survival rates and risk factors in 60 cases with stage I and II primary gastrointestinal lymphomas treated at Keimyung University Hospital between January 1972 and August 1999. RESULTS: No differences in sex, age, histology, stage, or percentage of curative resection were observed between primary gastric and intestinal lymphoma. The overall 10-year survival rates of gastric and intestinal NHL were 68.1% and 39.6%, respectively (p<0.05). The overall 10-year survival rates in stage I gastric and intestinal NHL were 66.7% and 70.0%, respectively, while those in stageII were 65.1% and 23.7%, respectively (p<0.001). A multivariate analysis of risk factors for survival revealed that the site of origin (5.68, CI=1.8-17.5) and stage (4.22, CI= 1.19-14.85) were significantly correlated with prognosis (p<0.05). There was no significant difference in the expression of bcl-2 and p53 between gastric and intestinal NHL. Furthermore bcl-2 and p53 expressions were not correlated with the prognosis. CONCLUSION: This study indicates that stage II primary intestinal lymphoma has lower survival rate than gastric lymphoma.
Lymphoma* ; Lymphoma, Non-Hodgkin* ; Multivariate Analysis ; Prognosis ; Risk Factors ; Survival Rate*

No abstract available.
Thoracic Outlet Syndrome*

BACKGROUND: Although surgical angioplasty for isolated coronary ostial stenosis is assumend as an alternative approach to CABG, the clinical features of isolated coronary ostial stenosis, postoperative complications and follow-up angiographic results would have not been well studied. METHODS: We retrospectively studied 24 patients (female : male = 20 : 4, mean age 50.0 +/- 12.3 yr) who underwent surgical angioplasty for isolated coronary ostial stenosis using patch ( 22 fresh autologous pericardium, 2 saphenous vein) during the period of March 1990 through February 1998. Repeat coronary angiography (16 patients) and echocardiography (24 patients) were performed. Aortic regurgitation was evaluated semiquantitatively (Grade I - Grade IV). RESULTS: There were 3 deaths after surgical angioplasty. One death was due to acute coronary dissection perioperatively, the second due to low cardiac output syndrome 2 weeks post-surgery, and the third due to traumatic panperitonitis 10 months post-procedure. Angina recurred in 4 patients and the remaning 18 patients were symptom-free. Repeat angiography (19.3 +/- 20.7 Mo) showed widely patent ostium with excellent run-off except 2 patients (1 distal patch stenosis, 1 ostial restenosis in Takayasu's arteritis). The third symptomatic patient was proven to have coronary spasm by ergonovine test. AR increased in the fourth patient (Grade II -> III) with patent ostium. CONCLUSION: Surgical angioplasty may be feasible and alternative operative method to CABG for isolated coronary ostial stenosis. It should however be noted that postop AR can develop and/or increase. Further investigation is needed to evaluate the clinical significance of the AR.
Angiography ; Angioplasty* ; Aortic Valve Insufficiency ; Cardiac Output, Low ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Male ; Pericardium ; Postoperative Complications ; Retrospective Studies ; Spasm