OBJECTIVECheongseoikki-tang (CIT, Korean), also called Qingshu Yiqi decoction () and Seisho-ekki-to (Japanese), is well known as an effective traditional combination of herbs for treating cardiovascular diseases. This study was to research its effects on bone marrow-derived mast cell (BMMC)-mediated allergy and inflammation mechanisms.

METHODSIn this study, the biological effect of Cheongseoikki-tang ethanol extract (CITE) was evaluated, focusing on its effects on the production of allergic mediators by phorbol 12-myristate 13-acetate (PMA) plus calcium ionophore A23187 (A23187)-stimulated BMMCs. These allergic mediators included interleukin-6 (IL-6), prostaglandin D2 (PGD2), leukotriene C4 (LTC4), and β-hexosaminidase (β-hex).

RESULTSOur data revealed that CITE inhibited the production of IL-6, PGD2, LTC4, and β-hex induced by PMA plus A23187 (P<0.05).

CONCLUSIONThese findings indicate that CITE has the potential for use in the treatment of allergy.

Animals ; Anti-Inflammatory Agents ; pharmacology ; therapeutic use ; Bone Marrow Cells ; pathology ; Calcimycin ; pharmacology ; Cell Degranulation ; drug effects ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hypersensitivity ; drug therapy ; pathology ; Interleukin-6 ; secretion ; Leukotriene C4 ; pharmacology ; Male ; Mast Cells ; drug effects ; pathology ; physiology ; Mice ; Mice, Inbred BALB C ; Prostaglandin D2 ; biosynthesis ; Tetradecanoylphorbol Acetate ; pharmacology ; beta-N-Acetylhexosaminidases ; metabolism

BACKGROUND: A new technique resecting the hepatic parenchyma without inflow occlusion using a Cavitron Ultrasonic Surgical Aspirator (CUSA(R) ) reduces intraoperative blood loss and perioperative morbidity. This study was designed to identify the incidence and severity of venous air embolism (VAE) using transesophaseal echocardiography (TEE) in hepatic resection using CUSA(R) . METHODS: Forty patients undergoing hepatic resection using CUSA(R) of ASA class 1 and 2 were selected. After insertion of an epidural catheter for postoperative analgesia, all patients were anesthetized with sevoflurane in 50% air/O2. After the induction of anesthesia, A TEE probe was inserted into the esophagus. Blood pressure, heart rate, central venous pressure, end tidal CO2, and arterial carbon dioxide tension were recorded after induction, and during and after hepatic resection. During hepatic resection, an anesthesiologist evaluated the degree of VAE by transesophageal echocardiography in the 4-chamber view. RESULTS: The mean time of using CUSA(R) was 65.3 +/- 24.4 minutes. Of 40 patients, 9 had VAE grade I, 14 grade II, 14 grade III, and 3 grade IV. However, no significant difference was observed in hemodynamics or PaCO2 after induction, or during or after hepatic resection. The mean amount of blood loss was 887.0 ml +/- 598.8 ml and the mean transfused amount was 123.1 +/- 351.3 ml. CONCLUSIONS: All patients showed air embolism during hepatic resection with CUSA(R) . Serious complications associated with air embolism would occur in patients with an undiagnosed intracardiac right to left shunt. Therefore, meticulous monitoring by transesophageal echocardiography might be recommended in hepatic resection with CUSA(R) .
Analgesia ; Anesthesia ; Blood Pressure ; Carbon Dioxide ; Catheters ; Central Venous Pressure ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism, Air* ; Esophagus ; Heart Rate ; Hemodynamics ; Humans ; Incidence* ; Ultrasonics*

PURPOSE: Anatomical change of the prostatic stroma, that is benign prostatic hyperplasia, results in a functional change which manifests as lower urinary tract symptoms (LUTS). We observed/investigated whether there are structural changes in the three-dimensional arrangement of muscle, collagen and elastin fibers of the prostatic urethra which can be another possible mechanism of LUTS. MATERIALS AND METHODS: Hyperplastic nodules, which were surgically en bloc resected, and normal prostate from radical cystectomy specimens were examined. Surgical specimens were fixed in formalin and sectioned serially in a transverse plane along the lumen of the upper segment of the prostatic urethra. Additional sagittal sections were also made serially. All tissue blocks were 2mm thick. All slides were prepared with hematoxylin-eosin, Masson-trichrome and Verhoeff's elastin stain. RESULTS: Muscle and collagen fibers surrounding prostatic acini seemed poorly oriented and blended with the outermost fibers of the urethra. Muscle and stromal fibers surrounding the prostatic urethra seemed to be stretched and oriented mainly in the longitudinal direction with small fibroblastic nodules in the periurethral stroma. A periurethral gland structure was observed between the urethral wall in which the fiber was arranged longitudinally. Circular muscle fibers were not observed in the periurethral area, indicating that the surgical capsule resulted from urethral muscle fibers. CONCLUSIONS: Apparent changes to the 3-dimensional arrangement of collagen, elastin and muscle fibers surrounding the acini and prostatic urethra were not observed in the proximal prostatic urethra or the bladder neck, except that the fibers surrounding the urethra were stretched.
Collagen* ; Cystectomy ; Elastin* ; Fibroblasts ; Formaldehyde ; Lower Urinary Tract Symptoms ; Neck ; Prostate ; Prostatectomy ; Prostatic Hyperplasia* ; Urethra* ; Urinary Bladder

Hemangioendotheliomas are vascular neoplasms characterized by histologic appearance that are intermediate between hemangiomas and angiosarcomas first described by Weiss and Enzinger in 1982. They are classified into at least 3 subgroups, including epithelioid hemangioendothelioma, spindle cell hemangioendothelioma, and malignant endovascular angioendothelioma, and have been reported principally in soft tissues of the extremities, lung, liver, and bone. The cases involving the central nervous system reported are very rare. We report an intraspinal epithelioid hemangioendothelioma occurring in a 52-year-old man. To our knowledge, it is first case of spinal hemangioendothelioma in Korea.
Central Nervous System ; Extremities ; Hemangioendothelioma ; Hemangioendothelioma, Epithelioid* ; Hemangioma ; Hemangiosarcoma ; Humans ; Korea ; Liver ; Lung ; Middle Aged ; Spinal Cord* ; Vascular Neoplasms

PURPOSE: We prospectively studied to evaluate the therapeutic effect of combination therapy of imipramine and desmopressin on the monosymptomatic nocturnal enuresis. MATERIALS AND METHODS: From April 1997 to July 2000, all of 129 monosymptomatic enuretic patients were randomized to three groups: combination therapy group of imipramine and desmopressin (I+D, 46 cases), imipramine group (I, 43 cases) and desmopressin group (D, 40 cases). We performed motivational counselling, reduction of fluid intake prior to bed time and voiding diary in addition to drug thrapy. Therapeutic response was classified as excellent (0-1 wet night/week), good (over 50% reduction of night) and poor responder (less than 50% reduction of night). RESULTS: Therapeutic response in group I+D, I and D were excellent in 84.8%, 81.4% and 60.0%, good in 10.9%, 11.6% and 35.0% and poor in 4.3%, 7.0% and 5.0%, respectively. As compared with group I and D, average response duration in group I+D was significantly shorter (p<0.05). There was no significant difference of relapse rate at 3 months after cessation of medication in excellent responders among each groups. There were no significant side effects in all of three groups. CONCLUSIONS: These data suggest that combination therapy of imipramine and desmopressin has no better therapeutic effect than impramine or demopressin monotherapy on the monosymptomatic nocturnal enuresis, except shorter average response duration.
Child* ; Deamino Arginine Vasopressin* ; Humans ; Imipramine* ; Nocturnal Enuresis* ; Prospective Studies ; Recurrence

PURPOSE: To compare of quantitative measurement of the total cerebral blood flow using two-dimensional phase-contrast MR imaging and Doppler ultrasound. MATERIALS AND METHODS: In 16 volunteers (mean age, 26 years; mean body weight, 66 kg) without abnormal medical histories, two-dimensional phase-contrast MR imaging was performed at the level of the C2-3 intervertebral disc for flow measurement of the internal carotid arteries and the vertebral arteries. Volume flow measurements using Doppler ultrasound were also performed at the internal carotid arteries 2 cm above the carotid bifurcation, and at the vertebral arteries at the level of the upper pole of the thyroid gland. Flows in the four vessels measured by the two methods were compared using Wilcoxon's correlation analysis and the median score. Total cerebral blood flows were calculated by summing these four vessel flows, and mean values for the 16 volunteers were calculated. RESULTS: Cerebral blood flows measured by 2-D phase-contrast MR imaging and Doppler ultrasounds were 233 and 239 ml/min in the right internal carotid artery, 250 and 248 ml/min in the left internal carotid artery, 62 and 56 ml/min in the right vertebral artery, and 83 and 68 ml/min in the left vertebral artery. Correlation coefficients of the blood flows determined by the two methods were 0.48, 0.54, 0.49, and 0.62 in each vessel, while total cerebral blood flows were 628+/-68 (range, 517 to 779) ml/min and 612+/-79 (range, 482 to 804)ml/min, respectively. CONCLUSION: Total cerebral blood flow was easily measured using 2-D phase-contrast MR imaging and Doppler ultrasound, and the two noninvasive methods can therefore be used clinically for the measurement of total cerebral blood flow.
Body Weight ; Carotid Artery, Internal ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Thyroid Gland ; Ultrasonography* ; Vertebral Artery ; Volunteers

OBJECTIVES: The objective of this study is to evaluate the efficacy of conization of the cervix in patients with cervical intraepithelial neoplasia. STUDY DESIGN: Cold-Knife conization was performed in total 436 patients from June 1994 to May 2000. Indications and complications of conization were studied. And the results of cervical cytology, cervical histology, colposcopic findings and pathologic diagnosis of conization specimens were evaluated in comparison with the pathologic diagnosis of hysterectomy specimens and follow-up check of the patients. RESULTS: Followings are results summarized. 1. Patients distribution according to cone biopsy results was 31.0% for CIS, 43.3% for CIN III, 14.7% for CIN II, 7.6% of CIN I, 3.4% for CNI, respectively. 2. The rate of agreement between colposcopy-directed biopsy and conization was 63.1%. 3. The positive rate of resection margin was 15.1%. 4. The recurrence rate in clear resection margin group was 7.0%. But there was no recurrence after hysterectomy in cases with positive resection margin of conization specimen, and the recurrence rate of positive resection margin without hysterectomy group was 10.5%. 5. The incidence of delayed hemorrhage (bleeding after 2 weeks) in hemostatic suture group and electric cauterization only group was 4.7% (13/279) and 15.6% (23/157), respectively. CONCLUSION: We conclude that conization of the cervix as the surgical treatment was effective in CIN patients with careful patient selection.
Biopsy ; Cautery ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Conization* ; Diagnosis ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Patient Selection ; Recurrence ; Sutures

Epithelioid hemangioendothelioma(EH) is a rare vascular tumor of low-grade malignancy. It was previously described as intravascular bronchioloalveolar tumor (IVBAT). But electron microscopic study and immunohistochemical staining results have proved endothelial origin. Patients are usually asymptomatic and the tumors are found incidentally on routine chest X-rays. Most patients show a slowly progressive clinical course, even though some patients occasionally die as results of respiratory failure or extrathoracic complications. Confirmative diagnosis is made through thoracoscopic or open-lung biopsy. There is still no effective therapeutic modality for pulmonary EH. We have experienced a 55-year-old woman whose simple chest x-ray film revealed bilateral multiple small nodules. The nodules were histopathologically and immunohistochemically diagnosed as primary epithelioid hemangioendothelioma of the lung. The possibility of metastatic disease was excluded thorough clinical, laboratory and radiological studies. Comparison of radiographic chest film taken 3 years ago showed no significant progression of the pulmonary nodular lesions. Conservative management was instituted and careful 4 months follow-up showed no significant changes.
Biopsy ; Diagnosis ; Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid* ; Humans ; Lung ; Middle Aged ; Respiratory Insufficiency ; Thorax ; X-Ray Film

Transformation and progression of breast cancer are thought to be caused by an accumulation of complex genetic alterations, but little is known about specific changes. In this study, the author has undertaken a genome-wide screening to detect genetic changes in 20 cases of breast cancer among Koreans, including 16 infiltrating ductal carcinomas, 2 medullary carcinomas, 1 invasive lobular carcinoma, and 1 borderline phyllodes tumor. Comparative genomic hybridization (CGH) was used to screen for DNA sequence gains and losses across all human chromosomes. Simultaneous immunohistochemical staining for c-erbB-2 (Her-2/neu), c-myc, cyclin D1, and p53 protein was done to make comparisons with nuclear grade and that with CGH results. Biotin-labeled tumor DNA and digoxigenin-labeled normal DNA were hybridized to normal metaphase cells. The fluorescence signals were captured by fluorescence microscope after detection by avidin-FITC and anti-digoxigenin rhodamine. Then, the ratio of fluorescence was calculated by an image analyzer. The immunohistochemical staining was done in paraffin-embedded tissue with an LSAB kit and avidin-biotin complex (ABC) method. The CGH results showed gains on chromosomes 8q (40%), 1q (30%), 17q (15%), 20q (15%), 18q (15%), 5p (15%), and 13q (15%). Deletions were on chromosomes 17p (45%) and 22q (20%). High-level amplifications (green/red ratio >1.5) were noted on chromosomes 1p31, 1q, 3q25-qter, 5p, 7q31-qter, 8q, 9p22-qter, 10p, 11p, 11q22-qter, 12p, 12q24, 14q21-qter, 15q23-qter, 17q, 18p, 18q12-qter, 20p, and 20q. By comparison with infiltrating ductal carcinoma, the two medullary carcinomas showed high-level amplification on chromosomes 1p31, 1q, 8q, 10p, 11p and 12p. c-erbB-2, c-myc, cyclin D1, and p53 protein expression was immunohistochemically detected in 9 of 20 (45%), 8 of 20 (40%), 10 of 20 (50%), and 13 of 20 (65%), respectively. The results indicate that the amplification on chromosome 8q, 1q and the deletions on chromosomes 17p and 22q are the most frequent genetic alterations in breast cancers among Koreans. The results reveal a different pattern of genetic alteration from previous studies. The CGH results were not correlated with the immunohistochemical profiles. The amplification pattern of medullary carcinomas was quite different from the pattern of infiltrating ductal carcinomas. The CGH was thought to be very useful in the screening of genetic alterations of solid tumors.
Base Sequence ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Lobular ; Carcinoma, Medullary ; Chromosomes, Human ; Comparative Genomic Hybridization* ; Cyclin D1 ; DNA ; Fluorescence ; Humans ; Mass Screening ; Metaphase ; Phyllodes Tumor ; Rhodamines

Carcinosarcoma of the female genital tract, also called malignant mixed mullerian tumor (MMMT), is a rare and relatively aggressive tumor with various homologous and heterologous components. There have been various studies to find prognostic factors and to investigate the histogenesis, including tissue culture, electron microscopy, and immunohistochemical studies. We investigated carcinomatous, sarcomatous, and transitional areas of 6 cases of carcinosarcoma of the uterus and ovary by using epithelial and mesenchymal markers. Immunohistochemical profiles of the transitional areas were significantly different from those of carcinomatous and sarcomatous areas. Immunoreactivities for cytokeratin and epithelial membrane antigen (50% and 22.2%) were weaker than those of carcinomatous areas (95.2% and 100%), but stronger than those of sarcomatous areas (11.1% and 5.6%)(p<0.01). In transitional areas, vimentin, smooth muscle actin and S-100 protein were more strongly expressed than in carcinomatous areas, but more weakly expressed than in sarcomatous areas (p<0.01, p<0.01, and p=0.018, respectively). Myoglobin was entirely negative in carcinomatous areas and immunoreactive in minor portions of transitional and sarcomatous areas (22.2% and 16.7%, respectively). These results suggest that the transitional areas are between the carcinomatous and sarcomatous nature in differentiation, further supporting that the carcinosarcomas of the female genital tract may arise, through metaplastic change, from a type of carcinoma.
Actins ; Carcinosarcoma* ; Female* ; Humans ; Immunohistochemistry ; Keratins ; Metaplasia ; Microscopy, Electron ; Mucin-1 ; Muscle, Smooth ; Myoglobin ; Ovary ; S100 Proteins ; Uterus ; Vimentin