Plasma pH can be altered during pregnancy and at labor. Membrane excitability of smooth muscle including uterine muscle is suppressed by the activation of K+ channels. Because contractility of uterine muscle is regulated by extracellular pH and humoral factors, K+ conductance could be connected to factors regulating uterine contractility during pregnancy. Here, we showed that TASK-2 inhibitors such as quinidine, lidocaine, and extracellular acidosis produced contraction in uterine circular muscle of mouse. Furthermore, contractility was significantly increased in pregnant uterine circular muscle than that of non-pregnant muscle. These patterns were not changed even in the presence of tetraetylammonium (TEA) and 4-aminopyridine (4-AP). Finally, TASK-2 inhibitors induced strong myometrial contraction even in the presence of L-methionine, a known inhibitor of stretchactivated channels in myometrium. When compared to non-pregnant myometrium, pregnant myometrium showed increased immunohistochemical expression of TASK-2. Therefore, TASK-2, seems to play a key role during regulation of myometrial contractility in the pregnancy and provides new insight into preventing preterm delivery.
4-Aminopyridine ; Acidosis ; Animals ; Contracts ; Female ; Hydrogen-Ion Concentration ; Lidocaine ; Membranes ; Methionine ; Mice ; Muscle, Smooth ; Muscles ; Myometrium ; Plasma ; Pregnancy ; Quinidine ; Relaxation ; Uterine Contraction ; Uterus

Infliximab, a tumor necrosis factor-alpha (TNF-alpha) inhibitor, has been approved for the treatment of a variety of inflammatory illnesses, including Crohn's disease. However, infliximab can increase the risk of reactivation of latent tuberculosis (Tbc) infection by affecting host immune responses. Therefore, a screening test should be performed before the initiation of infliximab therapy, and patients with evidence of latent infection should be treated with prophylactic anti-Tbc therapy. Here, we report a case of multifocal disseminated tuberculosis after treatment with infliximab in a patient diagnosed with Crohn's disease who had no past history of Tbc and showed a negative screening test.
Antibodies, Monoclonal ; Crohn Disease ; Humans ; Latent Tuberculosis ; Mass Screening ; Tuberculosis ; Tumor Necrosis Factor-alpha ; Infliximab

PURPOSE: This study was designed to investigate differences in ultrasonographic findings between malignant and benign mammary duct ectasia. METHODS: From January 2003 to June 2005, 54 surgically proven mammary duct ectasia lesions depicted on sonograms were included in this study. We evaluated the ultrasonographic (US) findings in terms of involved ductal location, size, margin, intraductal echogenicity, presence of an intraductal nodule, calcification, ductal wall thickening and echo changes of the surrounding breast parenchyma. The US findings were correlated with the pathological features. RESULTS: Of the 54 lesions, 46 lesions were benign and eight lesions were malignant. Benign lesions included an inflammatory change (n=7), ductal epithelial hyperplasia (n=7), fibrocystic change (n=18), intraductal papilloma (n=11), atypical ductal hyperplasia (n=2) and sclerosing adenosis (n=1). Malignant lesions included ductal carcinoma in situ (DCIS) (n=6), infiltrating ductal carcinoma (n=1) and mucinous carcinoma (n=1). On US images, the peripheral ductal location, an ill-defined margin, ductal wall thickening and a hypoechoic change of the surrounding parenchyma were features significantly associated with malignant duct ectasia. CONCLUSION: For ill-defined peripheral duct ectasia with ductal wall thickening and surrounding hypoechogenicity as depicted on US, the possibility of malignancy should be considered and radiologists should not hesitate to recommend a prompt biopsy.
Adenocarcinoma, Mucinous ; Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Dilatation, Pathologic ; Hyperplasia ; Papilloma, Intraductal ; Ultrasonography, Mammary

PURPOSE: Transforming growth factor (TGF)-beta is recognized as being associated with cataractogenesis. We quantitated the mRNA expression of TGF-beta isoforms in cataractous crystalline lens to determine the effect of the isoforms on cataractogenesis. METHODS: With lens epithelial cells from thirty eyes in thirty patients, the mRNA expressions of TGF-beta1, beta2 and beta3 were quantitated by real-time SYBR Green polymerase chain reaction and the results were compared according to cataract type and presence of diabetes mellitus. RESULTS: Each isoform mRNA of TGF-beta was expressed: TGF-beta3 in all 30 eyes, TGF-beta1 in 29 eyes (96.7%), with the exception being one diabetic senile cataract, and TGF-beta2 in 9 eyes. The amount of TGF-beta1 mRNA expression was significantly lower in the diabetic cataracts than in the non-diabetic cataracts (P=0.056). CONCLUSIONS: TGF-beta was associated with cataractogenesis. It is significant that the expression of TGF-beta2 mRNA was decreased in all cataracts. The decrease of TGF-beta1 mRNA expression was more meaningful in the diabetic cataracts than in the non-diabetic cataracts.
Cataract* ; Diabetes Mellitus ; Epithelial Cells* ; Humans ; Lens, Crystalline ; Polymerase Chain Reaction ; Protein Isoforms ; RNA, Messenger* ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1 ; Transforming Growth Factor beta2 ; Transforming Growth Factor beta3 ; Transforming Growth Factors

BACKGROUND AND OBJECTIVES: The voice rehabilitation following total laryngectomy is very important for the quality of life of patients who are cured by cancer treatment. The purpose of this study is to investigate the success rate and complications of various procedures used in our clinics and to evaluate various factors that can affect the success rate of the voice rehabilitation. SUBJECTS AND METHOD: From March 1993 to November 2002, 77 medical charts of the patients who underwent total laryngectomy were reviewed retrospectively to determine the immediate and long-term success rates of voice rehabilitation. The statistic correlation between the variables (age, tumor stage, tumor site, radiotherapy) and the success rate was analysed. RESULTS: Good vocalization was achieved in 90.5% of patients after Provox insertion, 81% after Amatsu procedure, while esophageal voice was acquired by 11.1%. The long-term success rate in 39 patients was 75% in Provox group, 81.8% in Amatsu group and 30.5% in esophageal voice group. There were no statistically significant correlation between the variables and the success rate of vocie rehabilitation. CONCLUSION: The result of this study suggested that tracheoesophageal puncture with Provox prosthesis and Amatsu operation are very effective procedures for the long term voice rehabilitation following total laryngectomy.
Humans ; Laryngectomy* ; Prostheses and Implants ; Punctures ; Quality of Life ; Rehabilitation* ; Retrospective Studies ; Voice*

Recent reports have suggested that ergonovine stress echocardiography is a safe and accurate procedure for the diagnosis of coronary vasospasm. We experienced a case of heart arrest caused by ergonovine stress echocardiography. A 44 year-old female patient was referred to our emergency room for evaluation of chest pain. She had been admitted to another hospital complaining of chest pain and syncope. The finding of a coronary angiogram was normal and an ergonovine stress echocardiography was performed in order to diagnose the coronary vasospasm, which may be an etiologic mechanism in an unstable angina. After 250 microgram of ergonovine was administered intravenously, we suspected segmental wall motion abnormality (hypokinesia of the inferior wall). An additional dose (100 microgram) was administered to confirm the diagnosis. The patient complained of severe chest pain and dizziness. Segmental wall motion abnormalities progressed and heart arrest finally developed. She recovered following cardiopulmonary resuscitation and was discharged without complication.
Adult ; Angina, Unstable ; Cardiopulmonary Resuscitation ; Chest Pain ; Coronary Vasospasm ; Diagnosis ; Dizziness ; Echocardiography, Stress* ; Emergency Service, Hospital ; Ergonovine* ; Female ; Heart Arrest* ; Heart* ; Humans ; Syncope

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

No abtract available.

OBJECTIVES: The authors present three cases of brain tumors in which epidural hematomas(EDHs) were developed postoperatively in the remote areas from craniotomy sites. The preventive tactics as well as possible mechanisms of development of remote EDH are discussed. MATERIAL AND METHODS: The magnetic resonance imagings of three patients revealed a left lateral ventricular mass located just aside of foramen Monro in a 27-year-old male, a large cystic mass in the temporal lobe in a 35-year-old male, and a partially calcified pineal mass in a 27-year-old male patient. The surgical removals of these tumors were performed without any noticeable events during surgery via left frontal transcortical transventricular approach for lateral ventricular tumor, left temporal craniotomy for cystic temporal tumor, and right occipital transtentorial approach for pineal tumor. RESULTS: Postoperative EDHs remote from the sites of craniotomy were detected by the immediate postoperative computerized tomographic scans. We obtained good outcomes without any morbidity in all three patients with emergent evacuation of the hematoma. The pathologic diagnoses were lateral ventricular ependymoastrocytoma, temporal craniopharyngioma and mixed germinoma of the pineal region. CONCLUSION: It is postulated that a sudden reduction of intracranial pressure(ICP) at the time of tumor removal may strip the dura from the inner table of the skull to cause EDH from the remote site of craniotomy. Gradual reduction of ICP with slow drainage of cerebrospinal fluid before tumor removal as well as lowering the head position of patient during surgery might be helpful for preventing this unusual complication.
Adult ; Brain Neoplasms* ; Brain* ; Cerebrospinal Fluid ; Craniopharyngioma ; Craniotomy ; Diagnosis ; Drainage ; Germinoma ; Head ; Hematoma* ; Humans ; Male ; Neoplasms, Neuroepithelial ; Pinealoma ; Skull ; Temporal Lobe