Morphometry of nuclei of the benign and malignant prostatic lesions was performed to study the relationship between nuclear size and shape and the prognosis of prostatic adenocarcinoma. Fifty one cases of prostatic adenocarcinoma and 13 cases of benign prostatic hyperplasia were included to evaluate area, perimeter, Dmax, Dmin, and 5 form factors of the nuclei by image analyzer (Zeiss Ibas 2000) using hematoxylin-eosin stained slides. All analytic factors of nuclear size and shape were significantly different between benign lesions and adenocarcinomas. Increased nuclear size was associated with nu- clear irregularity, presence of metastasis, advanced clinical stage, and high Gleason's grade and score of prostatic adenocarcinoma. On Kaplan-Meier method, survival was decreased with older age, no hormonal treatment, stage D, high Gleason's grade and stage as well as with larger size and irregular shape of the nuclei. In conclusion, morphometry of nuclei of the prostate can be a helpful tool to differentiate between benign and malignant lesions. Nuclear morphology is thought to be associated with prognosis of prostatic adenocarcinoma.
Adenocarcinoma ; Breast ; Fibroadenoma ; Hepatitis B e Antigens* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Neoplasm Metastasis ; Prognosis ; Prostate ; Prostatic Hyperplasia

BACKGROUND/AIMS: We examined the effects of cilostazol on mitogen-activated protein kinase (MAPK) activity and its relationship with cilostazol-mediated protection against apoptosis in lipopolysaccharide (LPS)-treated endothelial cells. METHODS: Human umbilical vein endothelial cells (HUVECs) were exposed to LPS and cilostazol with and without specific inhibitors of MAPKs; changes in MAPK activity in association with cell viability and apoptotic signaling were investigated. RESULTS: Cilostazol protected HUVECs against LPS-induced apoptosis by suppressing the mitochondrial permeability transition, cytosolic release of cytochrome c, and subsequent activation of caspases, stimulating extracellullar signal-regulated kinase (ERK1/2) and p38 MAPK signaling, and increasing phosphorylated cAMPresponsive element-binding protein (CREB) and Bcl-2 expression, while suppressing Bax expression. These cilostazol-mediated cellular events were effectively blocked by MAPK/ERK kinase (MEK1/2) and p38 MAPK inhibitors. CONCLUSIONS: Cilostazol protects HUVECs against LPS-induced apoptosis by suppressing mitochondriadependent apoptotic signaling. Activation of ERK1/2 and p38 MAPKs, and subsequent stimulation of CREB phosphorylation and Bcl-2 expression, may be responsible for the cellular signaling mechanism of cilostazolmediated protection.
Apoptosis/*drug effects ; Caspases/metabolism ; Cell Line ; Cell Survival/drug effects ; Cyclic AMP Response Element-Binding Protein/metabolism ; Cytochromes c/metabolism ; Dose-Response Relationship, Drug ; Endothelial Cells/*drug effects/enzymology/pathology ; Humans ; Lipopolysaccharides/*toxicity ; Mitochondrial Membrane Transport Proteins/drug effects/metabolism ; Mitogen-Activated Protein Kinase 1/antagonists & inhibitors/*metabolism ; Mitogen-Activated Protein Kinase 3/antagonists & inhibitors/*metabolism ; Phosphodiesterase Inhibitors/*pharmacology ; Phosphorylation ; Protein Kinase Inhibitors/pharmacology ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Signal Transduction/*drug effects ; Tetrazoles/*pharmacology ; Time Factors ; bcl-2-Associated X Protein/metabolism ; p38 Mitogen-Activated Protein Kinases/antagonists & inhibitors/*metabolism

Retroperitoneal cystic lymphangioma is a rare benign tumor which had previously been difficult to diagnose preoperatively by conventional radiographic technique(1). Recent reports describe the computed tomographic and ultrasonographic findings in cystic lymphangioma(1,2). We report a case of retroperitoneal cystic lymphangioma, accurately diagnosed by lymphography, with computed tomographic findings and percutaneous drainage findings. To the best of out knowledge, this is the most aged case of retroperitoneal cystic lymphangioma of preoperatively diagnosed.
Drainage ; Lymphangioma, Cystic* ; Lymphography

Bee stings can cause severe adverse reactions. There have been no cases of acute lung injury induced by bee sting acupuncture. We report a case of a 52-year-old male who required high flow oxygen therapy because of acute lung injury by bee sting acupuncture. The patient had been treated with live bee sting acupuncture by himself for knee pain. After self-injections of live bee sting, he immediately presented with generalized urticaria that remitted within 3 hours after taking an oral antihistamine. Ten days later, he visited our emergency department due to dyspnea and dizziness. He was diagnosed with acute lung injury by bee sting acupuncture based upon a history of symptom onset after exposure to the allergen and clinical test results. This case emphasizes that practitioners should consider potential risks of delayed-onset adverse reactions induced by bee sting acupuncture.
Acupuncture* ; Acute Lung Injury* ; Bee Venoms ; Bees* ; Bites and Stings* ; Dizziness ; Dyspnea ; Emergency Service, Hospital ; Humans ; Knee ; Male ; Middle Aged ; Oxygen ; Urticaria

BACKGROUND: In patients with mitral stenosis, the degree of pulmonary hypertension is expected to be related to the severity of mitral valve obstruction. However, some patients with severe mitral stenosis do not develop reactive pulmonary hypertension. MATERIALS AND METHODS: We evaluated 34 patients with symptomatic mitral stenosis undergoing percutaneous mitral valvuloplasty by clinical, echocardiographic, and invasive hemodynamic(cardiac cathrterization) data. Prevalvuloplasty data were available in 34 subjects[mean age 38+/-9 year ; women 74% ; NYHA class 1 (6 patients), class 2 (17 patients), class 3 (7 patients), class 4 (4 patients) ; in electrocardiography, NSR(23 patients), Atrial fibrillation(11 patients)]. RESULTS: 1) The pulmonary vascular bed gradient was significantly correlated with pulmonary vascular resistance(r=0.91), mean pulmonary artery pressure(r=0.82), transmitral mean pressure gradient(r=0.64) and mitral valve area(r=-0.48). The pulmonary vascular resistance was significantly correlated with mena pulmonary artery pressure(r=0.77), transmiral mean pressure gradient(r=0.61) and mitral valve area(r=-0.54), NYHA functional classification(r=0.36). However, the pulmonary vascular bed gradient and pulmonary vascular resistance was not significantly correlated with age, sex, cardiac output, the severity of mitral regurgitation and mean left atrial pressure. 2) The mean pulmonary artery pressure was significantly correlated with mean left atrial pressure(r=0.80), transmitral mean pressure gradient(r=0.72) and mitral valve area(r=-0.47). 3) When patients were divided into those with a pulmonary vascular bed gradient > 12mmHg and Atrial Pressure ; Cardiac Output ; Echocardiography ; Electrocardiography ; Female ; Heart Diseases ; Humans ; Hypertension, Pulmonary* ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pulmonary Artery ; Vascular Resistance

Acute pulmonary edema associated with intense laryngospasm during or after anesthesia seems to be a rare complication. Although emergency reestablishment of the airway may avert fatal hypoxia, subsequent morbidity may follow from the delayed effects of the obstruction. We recently observed a 16-year-old, 5kg boy, with inguinal hernia who developed laryngospasm and pulmonary edema following a herniorrhaphy and he had no evidence of cardiac enlargement or cardiovascular disease.
Adolescent ; Anesthesia ; Anoxia ; Cardiovascular Diseases ; Emergencies ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Laryngismus* ; Male ; Pulmonary Edema*

Primary hemangioma of the heart is very rare and is difficult to be diagnosed during life. We present a case of pericardial hemangioma with spontaneous hemopericardium, which was diagnosed by operation and confirmed histologically by excisional biopsy. This 58-yr old patients had pericardial effusion on echodardiography. After evacuation of bloody pericardial effusion by pericardiocentesis, his symptoms were subsided. After then, he uneventfully convalesced. On the 32th day, sudden dyspnea developed with narrow pulse pressure. So exploratory pericardiotomy was done under the impression of cardiac tamponade. At operation, we noticed diffuse hemangiomatous lesion at epicardium and large amount of bloody pericardial effusion. We performed only diagnostic excisional biopsy because the lesion was too extensive and location was not suitable for total excision. The lesion was confirmed to be pericardial hemangioma histologically.
Biopsy ; Blood Pressure ; Cardiac Tamponade ; Dyspnea ; Heart ; Hemangioma* ; Humans ; Pericardial Effusion* ; Pericardiectomy ; Pericardiocentesis ; Pericardium

BACKGROUND AND OBJECTIVES: Many diabetic patients suffer from cardiomyopathy, even in the absence of vascular disease. The aim of this study was to see if dietary antioxidant supplementation has an inhibitory effect on the progression of cardiac tissue damage in streptozotocin (STZ)-induced diabetic rats. MATERIALS AND METHODS: Sprague-Dawley male rats (n=60) were used as experimental animals; they were divided into the normal control group and the diabetic group. Eight weeks after STZ injection (65 mg/kg of body weight), the products of lipid peroxidation (malondialdehydes, MDA), and the antioxidant enzyme superoxide dismutase (SOD), and catalase activities were determined in the cardiac tissue homogenates. The cardiac tissues were studied by light microscopy (LM) and electron microscopy (EM), and the tissue lesions were graded by a semiquantitative score. RESULTS: The histologic scores for perivascular fibrosis, interstitial fibrosis and myocardial necrosis according to LM were significantly lower in the combined vitamin C & E treated rats than in the diabetic control rats. The ultrastructural scores for the overall cardiac morphology, mitochondria and myofilaments, according to EM, were significantly lower in the vitamin E treated rats and the combined vitamin C & E treated rats than in the diabetic control rats, even though this was of less magnitude than that in the insulin-treated diabetic rats. CONCLUSION: These results suggest that antioxidants such as vitamin C & E might have a beneficial effect on diabetes as an adjunct therapy against lipid peroxidation and diabetic cardiomyopathy, in addition to the effects of instituting strict measures for controlling the blood glucose.
Animals ; Antioxidants* ; Ascorbic Acid ; Blood Glucose ; Cardiomyopathies ; Catalase ; Diabetes Mellitus, Experimental ; Diabetic Cardiomyopathies ; Fibrosis ; Humans ; Lipid Peroxidation ; Male ; Microscopy ; Microscopy, Electron ; Mitochondria ; Myofibrils ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Streptozocin ; Superoxide Dismutase ; Vascular Diseases ; Vitamin E ; Vitamins

BACKGROUNDS AND OBJECTIVES: C-Reactive protein (CRP) levels are powerful predictors of cardiac complications and death in patients with unstable angina unrelated with myocardial cell damage or myocardial ischemia. This study was performed to determine the optimal timing to measure CRP to predict cardiac events in patients with unstable angina. MATERIALS AND METHOD: The study was comprised 50 patients with unstable angina (Braunwald Class IIIb). We randomized the study subjects by the time of CRP elevation (> 8mg/L): Group A (on admission, 15 patients), Group B (during hospitalization, 19 patients), and Group C (at discharge, 19 patients). RESULTS: 1) CRP levels (median and range) of Group A, B, and C were 10.6 (8.2-24.2), 12.8 (8.1-33.7), and 10.3 (8.1-18.7) mg/L, respectively (p=S). 2) During clinical follow-up at a mean duration of 12 months, there were 1 death, 1 myocardial infarction, 6 revascularization therapy (PTCA or CABG) and 11 recurrent angina. 3) In Group A, 10 cardiac events (1 myocardial infarction, 4 revascularization therapy, and 5 recurrent angina) occurred. The elevated levels of CRP predicted cardiac events during clinical follow-up with sensitivity of 53%(10/19), positive predictive value of 67%(10/15), and negative predictive value of 74%(26/35). In Group C, 13 cardiac events were occurred. Sensitivity, positive and negative predictive value to predict cardiac events of elevated levels of CRP were 68%(13/19), 68%(13/19) and 81%(25/31), respectively. 4) Elevated levels of CRP (>8mg/L) were predictors for cardiac events in patients with unstable angina (Group A; p<0.05, Group B; p<0.05, Group C; p<0.001). However, by logistic regression analysis, CRP values > 8mg/L at discharge were only predictive of cardiac events with odd ratio of 6.01 (95% CI 1.50-44.3, p<0.05). CONCLUSIONS: CRP (> 8mg/L) was elevated in 38% of patients at discharge and elevated levels of CRP at discharge were only predictive of cardiac events in patients with unstable angina.
Angina, Unstable* ; C-Reactive Protein* ; Follow-Up Studies ; Hospitalization ; Humans ; Logistic Models ; Myocardial Infarction ; Myocardial Ischemia

OBJECTIVES: There are many interesting reports suggesting that magnesium(Mg) deficiency is deleterious in patients with congestive heart failure (CHF). It is paradoxical that the most important cause of Mg deficiency in these persons is maybe use of therapeutics including diuretics. Authors investigated the trend of serum and 24 hour urine Mg with other relating electrolytes in Mg homeostasis prospectively, in the management of CHF. And we assessd the effects of medications and many variables in .CHF on serum Mg, and the usefulness of serum Mg representing the body content. METHODS: Fifty three patients who were diagnosed as CHF by clinical finding and echocardiogaphy were prescribed conventional doses of diuretics as furosemide 40mg and spironolactone 50mg daily, with or without angiotensin converting enzyme(ACE) inhibitor and digitalis. And then, serial serum and 24 hour urine Mg, sodium, potassium and calcium were obtained at admission, 2nd day, 5th day, and discharge. RESULTS: The patients group with chronic CHF, which was defined as long-term use of diuretics over 6 months, showed higher prevalence of low level of serum Mg concentration than the group with acute one(11 of 28, 39% vs. 2 of 25. 8%, P< 0.01). Of those two groups, the latter showed upward trend of serum Mg from admission to discharge, but the former showed no change. In 24 hour urine Mg excretion, the amount of the patients with CHF was larger than that of control group. In the chronic CHF group, the effect of digitalis on decreasing serum Mg was evident. Serum Mg of acute CHF group correlated with serum BUN(r=0.5609). Whereas, that of chronic group with ejection fraction(r=-0.4742) and plasma renin activity(r=-0.3791), with serum potassium(r=0.4673) and creatinine(0.5846). Serum Mg may be useful indicator of Mg homeostasis, especially in chronic CHF patients. CONCLUSION: Because patients with chronic CHF were prone to deficiency of Mg in the management, maintaining the adequate serum Mg through long- term replacement seems very important in decreasing the morbidity and mortality of these persons.
Angiotensins ; Calcium ; Digitalis ; Diuretics ; Electrolytes ; Estrogens, Conjugated (USP)* ; Furosemide ; Heart Failure* ; Homeostasis ; Humans ; Magnesium Deficiency ; Magnesium* ; Mortality ; Plasma ; Potassium ; Prevalence ; Prospective Studies ; Renin ; Sodium ; Spironolactone