Inflammatory processes of vascular endothelial cells play a key role in the development ofatherosclerosis. We determined the anti-inflammatory effects and mechanisms of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on LPS-treated human umbilical vein endothelial cells (HUVECs) to evaluate their cardioprotective potential. Cells were pretreated with DHA, EPA, or troglitazone prior to activation with LPS. Expression of COX-2, prostaglandin E2 (PGE2) and IL-6 production, and NF-kappaB activity were measured by Western blot, ELISA, and luciferase activity, respectively. Results showed that EPA, DHA, or troglitazone significantly reduced COX-2 expression, NF-kappaB luciferase activity, and PGE2 and IL-6 production in a dose-dependent fashion. Interestingly, low doses (10 micrometer) of DHA and EPA, but not troglitozone, significantly increased the activity of NF-kappaB in resting HUVECs. Our study suggests that while DHA, EPA, and troglitazone may be protective on HUVECs under inflammatory conditions in a dose-dependent manner. However there may be some negative effects when the concentrations are abnormally low, even in normal endothelium.
Blotting, Western ; Chromans ; Cyclooxygenase 2 ; Dinoprostone ; Eicosapentaenoic Acid ; Endothelial Cells ; Endothelium ; Enzyme-Linked Immunosorbent Assay ; Human Umbilical Vein Endothelial Cells ; Humans ; Interleukin-6 ; Luciferases ; NF-kappa B ; Thiazolidinediones

PURPOSE: Bone marrow transplantation (BMT) involving high dose chemotherapy and irradiation can seriously affect the gonad and reproductive axis. We studied puberty and gonadal function in the subjects who underwent BMT during childhood for the treatment of acute leukemia. METHODS: 25 females (age at examination:15.7+/-3.1 years; age at BMT:10.3+/-3.0 years) and 22 males (age at examination:16.4+/-2.0 years; age at BMT:11.1+/-2.2 years) who underwent BMT for acute leukemia were included. We evaluated their pubertal status and gonadal function before and after BMT, and investigated the clinical factors influencing disturbances of gonadal function in these patients. RESULTS: Of the 13 females who were prepubertal before BMT, two had no breast development by 13 years of age, and the others entered puberty spontaneously. Of the 8 females who were older than 16 years at the last evaluation, 5 had primary amenorrhea, and 3 developed secondary amenorrhea. Sixteen (64.0%) out of 25 pubertal females had abnormally elevated serum concentrations of luteinizing hormone (LH), and 23 (92.0%) had abnormally elevated serum concentrations of follicle-stimulating hormone (FSH). Abnormal elevation of LH was more frequent in the females who had entered puberty at BMT compared with those before puberty (91.7% vs 45.5%, OR=13.2, P<0.05). Of the 19 males who were prepubertal before BMT, 3 did not enter puberty spontaneously by 14 years of age, and the others entered puberty spontaneously. Four (18.2%) out of 22 pubertal males had abnormally elevated plasma concentrations of LH, and 9 (42.9%) had abnormally elevated plasma concentrations of FSH. Abnormal elevation of FSH was more frequent in males who underwent BMT after relapse than those without relapse (87.5% vs 20.0%, OR=28.0; P<0.05). CONCLUSION: More than 40% of the girls who underwent BMT cannot retain adequate ovarian function to complete puberty and menstruate regularly. The ovaries of the pubertal girls seem to be more vulnerable to BMT. The majority of the boys experience normal pubertal development after BMT, but about 40% of the boys had abnormally elevated levels of FSH, which is indicative of germ cell dysfunction.
Adolescent ; Amenorrhea ; Axis, Cervical Vertebra ; Bone Marrow Transplantation* ; Bone Marrow* ; Breast ; Drug Therapy ; Female ; Follicle Stimulating Hormone ; Germ Cells ; Gonads* ; Humans ; Leukemia ; Luteinizing Hormone ; Male ; Ovary ; Plasma ; Puberty* ; Recurrence

PURPOSE: We investigated the epidemiological and clinical characteristics of diabetes mellitus developed in aplastic anemia patients who have had many blood transfusions. METHODS: We retrospectively reviewed medical records of 170 patients with aplastic anemia who were diagnosed before 15 years of age in Department of Pediatrics, The Catholic University of Korea from 1987 to 2001. We obtained their medical history, family history of diabetes mellitus, clinical onset of diabetes mellitus and the successive history, and coexistence of other disorders. RESULTS: Diabetes mellitus was diagnosed in 8 of 107 patients (7.5%) with severe aplastic anemia in childhood. The mean age of diagnosis of diabetes mellitus was 18.5+/-5.2 years, and the mean duration from the start of blood transfusion to the diagnosis of diabetes mellitus was 7.7+/-2.9 years. Duration of multiple blood transfusions was a major risk factor for the development of diabetes mellitus in severe aplastic anemia patients. There was a wide range of symptoms at clinical onset of diabetes mellitus from asymptomatic hyperglycemia to diabetic ketoacidosis. Incidence of other complications, such as hepatic impairment (88%) and cardiac dysfunction (75%), was high in patients who developed diabetes mellitus. CONCLUSION: Severe aplastic anemia patients treated with prolonged, multiple transfusions have a significant risk of developing insulin-deficient diabetes mellitus. These patients are at risk for other complications, such as hepatic, cardiac, or thyroid disorders. Early prevention of iron overload and screening for transfusion-related complications are very important in these patients.
Anemia, Aplastic* ; Blood Transfusion ; Diabetes Mellitus* ; Diabetic Ketoacidosis ; Diagnosis ; Humans ; Hyperglycemia ; Incidence* ; Iron Overload ; Korea ; Mass Screening ; Medical Records ; Pediatrics ; Retrospective Studies ; Risk Factors ; Thyroid Gland

No abstract available.

OBJECTIVE: To evaluate the clinical factors that contribute to femoral neuropathy subsequent to abdominal hysterectomy. METHODS: From March 1993 to March 2000, retrospective study on 17 cases of femoral neuropathy subsequent to abdominal hysterectomy was performed. Sixty eight patients who had normal neurologic finding on the lower extremities after the same operation were used as a control group. RESULTS: The incidence of femoral neuropathy subsequent to abdominal hysterectomy was 1.67%. Age, body weight, parity and type of skin incision were significantly different between study and control group. The mean age of the study group was 38.1+6.1 years and that of the control group was 43.2+/-8.9 years(p<0.05). The mean body weight of the study group was 52.9 6.4kg, while that of the control group was 57.8+/-7.4kg(p<0.05). The mean parity of the study group was 1.9+/-0.7 as opposed to 2.6+/-1.3 for the control group(p<0.05). Pfannenstiel`s incision was performed in 13 cases(76.5%) in the study group as opposed to 34 cases(50%) in the control group(p<0.05). There were no correlation between these two groups with respect to patient height, operative time, transfusion and change in hemoglobin level. In the study group, 13 cases(76.5%) with femoral neuropathy on the left side were found, 3 cases(17.6%) on the right side and 1 case(5.9%) on both side. Left side femoral neuropathy was more common than the right(p<0.05). Spontaneous recovery occurred in 16 cases of the study group within 4 months and, although residual symptoms were noted in the remaining 1 case, no serious sequelae have been observed. CONCLUSION: It was suggested that pelvic retractor compresses the femoral nerve during the abdominal hysterectomy. The patients age, body weight, parity and a type of skin incision could be contributing factors to femoral neuropathy.
Body Weight ; Female ; Femoral Nerve ; Femoral Neuropathy* ; Humans ; Hysterectomy* ; Incidence ; Lower Extremity ; Neurologic Manifestations ; Operative Time ; Parity ; Retrospective Studies ; Skin

Malignant fibrous histiocytoma(MFH) is a deep-seated pleomorphic sarcoma, which occurs principally as a mass of the extremities, abdominal cavity, or retroperitoneum in adults. However, it only rarely occurs in the chest wall. An 85-year-old man had undeergone excision of a small mass on the right posterior chest wall under local anesthesia 14 months age. However, the lesion did not heal and the mass recurred. He was referred to our hospital after the mass had grown to a size of 10.5x8x4cm with a 3x3cm skin defect. Intraoperative frozen biopsy revealed MFH. An en-bloc wide resection and thin-thickness skin graft from his thigh were performed. Although distant metastasis to the lund developed 14 months later and the patient died 2 months later, there was no local recurrence. Thin-thickness skin graft is a simple method for a wide range skin defect, especially in the old age. He recovered in good condition without any physical disabilities.
Abdominal Cavity ; Adult ; Aged, 80 and over ; Anesthesia, Local ; Biopsy ; Extremities ; Humans ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Skin ; Thigh ; Thoracic Wall* ; Thorax* ; Transplants

BACKGROUND: Esophageal perforation is an extremely lethal injury that requires careful management for survival. MATERIAL AND METHOD: We performed a retrospective clinical review of 14 patients treated for esophageal perforation at the Department of Thoracic and Cardiovascular Surgery hanyang University Hospital between July 1986 and August 1998. Cardiovascular Surgery Hanyang University Hospital between July 1986 and August 1998. RESULT: The ration between male and female patients was 12:2 and their ages ranged from 9 to 68 years( average: 446 years). Iatrogenic perforations were found in 6 patients(42.9%) spontaneous perforations in 3 patients(21.4%) traumatic perforations in 2 patients(14.3%) and caustic perforations foreign body origin and esophagel cancer in 1 patient (7.1%) each. Four of the patients(28.6%) had esophageal ruptures located cancer in 1 patient (7.1%) each. Four of the patients (28.6%) had esophageal ruptures located in the cervical esophagus and 10 patients (71.4%) in the thoracic esophagus, The most frequent location was in the mid third portion of the esophagus (35.7%) there were also 2 patients(14.3%) in the upper third portion and 3 patients(21.4%) in the lower third portion. Complications encountered included mediastinitis empyema or pleural effusion mediastinal or lung abscess sepsis and aspiration pneumonia. The most frequent complication that occurred was mediastinitis in 9 cases (57%) Three patients underwent conservative treatment. Among the patients who underwent surgical treatment 5 patients underwent primary closure 6 patients underwent open drainage and 2 patients underwent reconstrumction (1 patients had an initial primary closure and 1 patient had an initial open drainage procedure). The mortality rates for those with conservative and surgical treatment were 66.7% (2cases) and 9.1% (1 cases) respectively. CONCLUSIONS: Perforation of the esophagus although very rare has a high mortality rate and thus aggressive operative therapy is necessary.
Drainage ; Empyema ; Esophageal Perforation* ; Esophagus ; Female ; Foreign Bodies ; Humans ; Lung Abscess ; Male ; Mediastinitis ; Mortality ; Pleural Effusion ; Pneumonia, Aspiration ; Retrospective Studies ; Rupture ; Sepsis

The purpose of this study is to evaluate the effects of bioresorbable membranes in guided bone regeneration of streptozotocin induced diabetic rats. 50 Sprague-Dawley rats were randomly categorized into 4 groups: Group 1 & 2 had 10 normal rats each and group 3 & 4 included 15 streptozotocin induced diabetic rats each. Defect measuring 7mm in diameter was formed on every rat calvarium. No membrane was used in groups 1 & 3 and membranes were used in groups 2 & 4. The rates were sacrificed at 2 and 4 weeks after defect formation. Routine histological specimens were prepared. Masson-trichrome and HE stain were done before light microscopy. Guided regenerative potential was evaluated by measuring the amount of new bone formation in the calvarial defect by histomorphometry. Following results were obtained. 1.New bone formation in the diabetic groups was significantly less that than in the normal groups regardless of membrane use(p <0.05). 2.In the comparison of new bone formation in the normal groups, membrane group showed significantly more bone formation(p <0.1). 3.When the amount of new bone formation was compared in the diabetic groups, more bone was formed in the membrane groups but the difference was not statistically significant. 4.In the normal groups the amount of new bone formation was significantly greater at 4 weeks compared to that at 2 weeks(p <0.05) but amount of bone regeneration at 4 weeks was not significantly greater than that at 2 weeks in both diabetic groups.
Animals ; Bone Regeneration* ; Diabetes Mellitus ; Membranes* ; Microscopy ; Osteogenesis ; Rats* ; Rats, Sprague-Dawley ; Skull ; Streptozocin*

A persistent left superior vena cava draining into the coronary sinus is the most benign and widely encountered abnormality and can easily be explained embryologically as the persistence of the usual pattern of vnous circulation in the embryo,. However a persistent left superior vena cava draining into the left atrium with absent right superior vena cava is an extremely rare anomaly. We report this situation in an infant with tetralogy of Fallot. The most common approach has traditionally been intraatrial baffle repair to create a tunnel to the right atrium or rerouting of the left superior vena cava flow by directly anastomosing the left superior vena cava to the right atrium In the present study the left superior vena cava was transposed to the left pulmonary artery after the correction of tetralogy of Fallot. The most common approach has traditionally been intraatrial baffle repair to create a tunnel to the right atrium or rerouting of the left superior vena cava flow by directly anastomosing the left superior vena cava to the right atrium. In the present study the left superior vena cava was transposed to the left pulmonary artery after the correction of tetralogy of Fallot.
Coronary Sinus ; Embryonic Structures ; Heart Atria* ; Humans ; Infant ; Pulmonary Artery ; Tetralogy of Fallot* ; Vena Cava, Superior*

The purpose of this 6-months study was to compare the clinical and radiographic outcomes following guided tissue regeneration treating human mandibular Class II furcation defects with a bioabsorbable BioMesh barrier(test treatment) or a non-absorbable ePTFE barrier(control treatment). Fourteen defects in 14 patients(mean age 44 years) were treated with BioMesh barriers and ten defects in 10 patients(mean age 48 years) with ePTFE barriers. After initial therapy, a GTR procedure was done. Following flap elevation, root planing, and removal of granulation tissue, each device was adjusted to cover the furcation defect. The flaps were repositioned and sutured to complete coverage of the barriers. A second surgical procedure was performed at control sites after 4 to 6 weeks to remove the nonresorbable barrier. Radiographic and clinical examinations(plaque index, gingival index, tooth mobility, gingival margin position, pocket depth, clinical attachment level) were carried out under standardized conditions immediately before and 6 months after surgery. Furthermore, digital subtraction radiography was carried out. All areas healed uneventfully. Surgical treatment resulted in clinically and statistically equivalent changes when comparisons were made between test and control treatments. Changes in plaque index were 0.7 for test and 0.4 for control treatments; changes in gingival index were 0.9 and 0.5. In both group gingival margin position and pocket depth reduction was 1.0mm and 3.0mm; clinical attachment level gain was 1.9mm. There were no changes in tooth mobility and the bone in radiographic evaluation. No significant(p< or =0.05) difference between the two membranes could be detected with regard to plaque index, gingival index, gingival margin position, pocket depth, and clinical attachment level. In conclusion, a bioabsorbable BioMesh membrane is effective in human mandibular Class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Furcation Defects ; Granulation Tissue ; Guided Tissue Regeneration* ; Humans* ; Membranes ; Periodontal Index ; Radiography ; Root Planing ; Tooth Mobility