PURPOSE: Sleep deprivation may exert many negative effects on hippocampus-dependent cognitive function, such as learning and memory. The present study was conducted in order to investigate the effects of repetitive sleep deprivation on cognition, apoptotic neuronal cell death, and cell proliferation in the hippocampus, using mice. METHODS: To induce sleep deprivation, mice were placed in a water cage containing six platforms (3 cm in diameter), surrounded by water up to 1 cm beneath the surface of the platform for 24 h. Mice were randomly divided into four groups (n=20 in each group): control group, 24 h rest after 24 h sleep deprivation group, 48 h rest after 24 h sleep deprivation group, and 72 h rest after 24 h sleep deprivation group. This cycle was continued for 36 days. Novel objective recognition test and immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU), western blot for expression of Bax, Bcl-2, brain-derived neurotrophic factor (BDNF), and caspase-3 were performed. RESULTS: Results of the novel objective recognition test showed decreased cognition in the 24 h rest after 24 h sleep deprivation group, while a similar effect was observed in other groups, compared to the control group. Increased cell proliferation and enhanced expression of BDNF and Bax protein were observed in the 24 h rest after 24 h sleep deprivation group and the 48 h rest after 24 h sleep deprivation group, compared to the control group. Expression of Bcl-2 showed a decrease in the 24 h and 48 h rest groups, compared to the control group. Expression of caspase-3 in the dentate gyrus of the hippocampus showed a significant increase in the 24 h rest after 24 h sleep deprivation group and in the 48 h rest after 24 h sleep deprivation group, compared to the control group. CONCLUSION: Results of the present study indicate that insufficient rest after sleep deprivation may induce impairment of cognitive function. After sleep deprivation, at least 72 hr of rest time is needed for recovery.
Animals ; Apoptosis ; bcl-2-Associated X Protein ; Blotting, Western ; Brain-Derived Neurotrophic Factor ; Bromodeoxyuridine ; Caspase 3 ; Cell Death ; Cell Proliferation ; Cognition ; Dentate Gyrus ; Hippocampus ; Immunohistochemistry ; Learning ; Memory ; Memory, Short-Term ; Mice ; Neurons ; Sleep Deprivation ; Water

Bleeding and perforation are serious and commonly observed complications of colonofibroscopy. Pneumoretroperitoneum and pneumomediastinum are also infrequently reported as complications of colonofibroscopy. Clinical symptoms of pneumomediastinum are variable, with chest pain being the most common symptom, and a definitive diagnosis can be made by chest X-ray. Most cases can be successfully managed with only conservative treatment. Infrequently surgical managements are required. We report an unusual case of pneumoretroperitoneum and pneumomediastinum as a complication of colonofibroscopy. Pneumomediastinum was treated successfully and simply with only antibiotics and fasting.
Anti-Bacterial Agents ; Chest Pain ; Colon* ; Colonoscopy ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Fasting ; Hemorrhage ; Humans ; Intestinal Perforation ; Mediastinal Emphysema* ; Retropneumoperitoneum ; Thorax

Osteochondromas are common and typically arise from the metaphyseal ends of long bones. An osteochondral neoplasm of the soft tissue, which is a lesion of uncertain pathogenesis, is uncommon and usually arises from the synovial tissue in joints and tendon sheaths. Rarely, extraskeletal osteochondromas also arise outside of synovial compartments. Most of the reported cases were presented in the hands and feet, especially in the fingers. Here we describe a 44-yr-old female patient who presented with a pain in the left buttock. A well-defined osseous mass was detected in the buttock. It consisted of sharply demarcated, mature hyaline cartilage that was covered with a fibrous capsule, which changed gradually into cancellous bone, more pronouncedly at the center. The diagnosis of an extraskeletal osteochondroma should be considered when a discrete, ossified mass is localized in the soft tissues. A case of pathologically proven extraskeletal osteochondroma of the buttock is presented with a literature review, magnetic resonance imaging, and radiological findings.
Accidental Falls ; Adult ; Buttocks* ; Diagnosis, Differential ; Female ; Human ; Myositis Ossificans/diagnosis ; Osteochondroma/complications ; Osteochondroma/diagnosis* ; Osteochondroma/radiography ; Osteochondroma/surgery ; Pain/etiology ; Sarcoma/diagnosis ; Soft Tissue Neoplasms/complications ; Soft Tissue Neoplasms/diagnosis* ; Soft Tissue Neoplasms/radiography ; Soft Tissue Neoplasms/surgery

BACKGROUND: Aortic valve stenosis induces left ventricular hypertrophy as an adaptive response to the chronic overload caused by the valve disease. Despite the fact that aortic valve replacement may lead to regression of the left ventricular hypertrophy, there is a controversy on the change of the left ventricular muscle after use of small prostheses. MATERIAL AND METHOD: We reviewed 20 patients who had undergone aortic valve replacement for aortic stenosis. There were 13 males and 7 females with a mean age of 61+/-13.8 years. A retrospective analysis of Doppler echocardiography was undertaken in preoperatively, early postoperatively(mean 10.4days), and late postoperatively(mean 29.9 months). They were divided into two groups according to the size of prosthesis used(group 1; 21 mm or smaller, group 2; 23 mm or larger). RESULT: Significant improvement of NYHA Functional class was detected in all groups. Ejection fraction was not significantly different in the group 1 between preoperative and postoperative period, however it increased significantly in the group 2 over time. But preoperative ejection fraction of the group 2 was significantly lower than that in the group 1(p=0.044). Left ventricular muscle mass index(g/m2) was not reduced significantly in the group 1 at the early postoperative period, but it was reduced significantly at the late postoperative period. In the group 2 it was reduced significantly over time. CONCLUSION: Both groups showed clinical improvement. However, the number of patients in whom 19 mm size prosthesis was used was only two. Thus, we suggest that more attention to age, BSA, and exercise should be paid in patients who will undergo aortic valve.
Aortic Valve Stenosis ; Aortic Valve* ; Echocardiography, Doppler ; Female ; Humans ; Hypertrophy, Left Ventricular* ; Male ; Postoperative Period ; Prostheses and Implants* ; Retrospective Studies

Inflammation appears to have a major role in the development of atherosclerosis. Cyclooxygenase-2 (COX-2) is involved in the inflammatory response via the generation of prostanoids that, in turn, are involved in the production of matrix metalloproteinases (MMPs). This study aimed to investigate atherosclerosis in human aortas for in situ tissue distribution of COX-2, MMPs including MMP-9 and membrane type 1 MMP (MT1-MMP), and tissue inhibitor of metalloproteinase-2 (TIMP-2). Immunohistochemical studies were performed on atherosclerotic lesions of aortas from patients with aortic aneurysms (n = 4) and dissections (n = 3) by using antibodies to COX-2, MMP-9, MT1-MMP, and TIMP-2. Control tissues were obtained from traumatically dissected aortas (n = 2). All specimens from diseased aortas had atherosclerotic lesions ranging from fatty streak to atheromatous plaques. In control, there was no expression of COX-2, MMP-9, and MT1-MMP in all aortic layers. Immunoreactivity for COX-2 was predominantly noted in macrophages and smooth muscle cells (SMCs) of the intima including atherosclerotic plaque itself and the medial layer of the plaque base, as well as in SMCs and endothelial lining of the vasa vasorum in the adventitia. Immunoreactivity for MMP-9 and MT1-MMP was found in the same distribution as that of COX-2. Additionally, the expression of TIMP-2 increased in relation to MMP-9 expression. This study demonstrates that COX-2 is coexpressed with MMP-9 and MT1-MMP, not only by macrophages and SMCs in atherosclerotic lesions, but also in endothelial lining of the vasa vasorum of human aortas. Thus, vascular inflammatory reactions may influence extracellular matrix remodeling by coactivation of MMPs in the development of atherosclerosis and, in turn, the progression of disease.
Animal ; Aorta/enzymology* ; Aortic Diseases/pathology ; Aortic Diseases/enzymology* ; Arteriosclerosis/pathology ; Arteriosclerosis/enzymology* ; Female ; Guinea Pigs ; Human ; Immunochemistry ; Isoenzymes/metabolism* ; Male ; Matrix Metalloproteinases/metabolism* ; Middle Age ; Prostaglandin-Endoperoxide Synthase/metabolism*

Patients with NIDDM are at increased risk for the development of coronary atherosclerosis and experience more silent myocardial infarction than non-diabetic subjects. The screening tools for early detection of coronary artery disease without significant narrowing has been requested in diabetic patients. Coronary artery calcification (CAC) score, quantified by electron beam computed tomography (EBT), have been reported to correlate with the amount of atherosclerotic plaque and vascular luminal narrowing. We investigated the distribution of CAC score and associated risk factors in asymptomatic NIDDM patients and patients with ischemic heart disease to estimate the usefulness of CAC as a screenig tool for ischemic heart disease in asymptomatic diabetes. METHOD: 136 NIDDM patients without any symptom of coronary artery disease and 37 patients with significant coronary artery stenosis were included. CAC were measured by electron bean tomography (ultrafast CT). Forty contiguous 3-mm thickness transverse two-dimensional sections were obtained through root of aorta and heart. Coronary calcification were defined as the presense of at least two adjacent pixel within the border of visualized coronary artery with CT number of at least 130 HU. Body mass index, waist-hip ratio were measured and body fat components were counted by impedence method. Visceral fat versus subcutaneous fat ratio were calculated by abdominal computed tomography. Plasma lipid profile, fasting insulin, C-peptide level, HbA1c concentration were measured. Correlations between natural log of CAC score and clinical parameters were evaluated and multiple regression analysis with natural log of CAC score as a independent variable was performed. Coronary angiography were performed in 17 asymptomatic NIDDM patients.. RESULT: CAC score was significantly higher in male than female subjects and increased significantly with aging (p<0.01). In patients with hypertension, previous history of cerebrovascular or peripheral vascular disease (p<0.05), CAC score was significantly increased. The CAC score showed significant positive correlations with smoking amount, duration of diabetes and a negative correlation with HDL-cholesterol (p<0.05). There were no association between CAC score and total cholesterol, LDL-cholesterol, waist to hip circumference ratio, or fasting insulin levels. After adjustment of compounding variables (age, sex), duration of diabetes, amount of smoking and previous history of atherosclerotic vascular disease were shown to be associated with CAC score. In multiple logistic regression analysis with natural log of CAC score as dependent variable, age, HDL-cholesterol, duration of diabetes, male gender were found to be significant independent variables. Seventeen diabetic patients with high CAC score, were taken coronary angiography and significant luminal narrowings (more than 50%) of coronary artery were documented in 16 patients. But, In 7 out of 17 patients with coronary one-vessel disease, coronary calcification were not detected by EBT. CONCLUSION: coronary artery calcium score quantified by electron beam computed tomography may be useful for screening of preclinical or asymptomatic coronary artery disease in asymptomatic NIDDM patients.
Adipose Tissue ; Aging ; Aorta ; Body Mass Index ; C-Peptide ; Calcium ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels* ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Fasting ; Female ; Heart ; Hip ; Humans ; Hypertension ; Insulin ; Intra-Abdominal Fat ; Logistic Models ; Male ; Mass Screening* ; Myocardial Infarction ; Myocardial Ischemia ; Peripheral Vascular Diseases ; Phenobarbital ; Plaque, Atherosclerotic ; Plasma ; Risk Factors ; Smoke ; Smoking ; Subcutaneous Fat ; Tomography, X-Ray Computed* ; Vascular Diseases ; Waist-Hip Ratio

Immunoglobulin deficiency with increased IgM, as defined by World Health Organization classification of primary immunodeficiency, is characterized by normal or increased concentrations of serum IgM and, in some cases, IgD, but decreased or absent IgG, IgA, and IgE. Patients with these disorders have a high incidence of recurrent pyogenic infections, including otitis media, pneumonia, and septisemia. We recently experienced a case of immunoglobulin deficiency with increased IgM in a 25-year old man. He had been suffered from recurrent pyogenic infections-pneumonia, otitis media-since about 6 months of his age. He was admitted due to pneumonia, and Haemophilus influenza was isolated from the sputum culture. Also chest X-ray showed bronchiectasis. His serum immunoglobulin levels revealed increased concentration of IgM and decreased IgG and IgA. He was successfully treated with antibiotics, and now he is being followed-up. So we present this case with the review of literature.
Adult ; Anti-Bacterial Agents ; Bronchiectasis ; Classification ; Haemophilus ; Humans ; Immunoglobulin A ; Immunoglobulin D ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M* ; Immunoglobulins* ; Incidence ; Influenza, Human ; Otitis ; Otitis Media ; Pneumonia ; Sputum ; Thorax ; World Health Organization

Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis

Paragonimiasis caused by Paragonimus westermani is essentially a pulmonary disorder, but it is also known to cause ectopic parasitism at various sites in human host such as the brain, muscle, liver, spinal cord and spleen. Ectopic parasitism of the female genital tract, especially the ovary is relatively rare. We have experienced a case of a 62-year-old Korean woman with asymptomatic ectopic paragonimiasis in the salpinx , ovary, and cul de sac.
Female ; Humans

Adrenal cysts are rare lesion that usually present themselves as an incidental finding during surgery, or at the time of autopsy. The cysts are usually small, seldom exceeding 10cm in diameter, and are generally asymptomatic. However, they present a difficult problem in differentiation between benign and malignant lesions of the adrenal gland. In the differential diagnosis, other cystic lesions of the upper abdomen must also be considered, including hepatic, splenic, renal and pancreatic cysts. Herein we report a case of endothelial cyst of lymphangiomatous type of the adrenal gland which was detected in a 44-year-old male patient during a routine health examination by ultrasonography as a pancreatic pseudocyst. Gross examination revealed multiple separate but continuous cysts, measuring 10.6x8x7cm in dimension. Within the wall, compressed adrenal cortex was noted. Microscopically, fibrous wall containing hypertrophied smooth muscle lined by endothelial cells was also noted. We reviewed literatures of the adrenal cyst and report a case.
Male ; Humans ; Cysts