BACKGROUND: Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. METHOD: We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. RESULTS: The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. CONCLUSION: Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.
Biomarkers ; Blood Pressure ; Diagnosis* ; Dilatation ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension, Pulmonary* ; Hypertrophy, Right Ventricular ; Immunoassay ; Plasma*

We describe a 27-year-old man who developed gait disturbance and dysarthria 2 years after the onset of cardinal symptoms of Behcet's disease. Positron emission tomography with 18F-fluorodeoxyglucose revealed severe hypometabolism in the cerebellum, in accordance wih cerebellar symptoms and sign of the patient. However, single-photon emission tomography with Tc-99m-HMPAO and Tc-99m-ECD did not disclose significant perfusion abnormalities in the brain. Routine brain magnetic resonance imaging did not show signal abnormalities. The findings of imaging studies compared with neurological manifestations of the patient are discussed.
Adult ; Brain ; Cerebellum ; Dysarthria ; Gait ; Humans ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Perfusion ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon*

Asphyxiating thoracic dysplasia(ATD;Jeunes's syndrome) is a rare variety of short limb dwarfism. It is characterized by an extremely small thorax when compared to the ab-dominal circumference, which frequently results in respiratory distress. Other anomalies as-sociated with Jeune's syndrome are pelvic bone malformations and renal dysplasia. It was first described and namely by Jeune et al. in 1954. Jeune's syndrome is an autosomal rece-ssive trait and has a 25% recurrence risk. These patients died at early age due to respirat-ory insufficiency. Death due to uremia has occurred in number of children surviving infan-cy, following progressive renal failure, hypertension and hepatic failure. About 50 cases have been reported in the world literature. We experienced a case of small thorax with short limb dwarfism on antenatal ultraso- und examination and then the baby was delivered by cesarean section. The diagnosis was confirmed to Asphyxiating thoracic dysplasia by clinical features, radiological findings and pathological findings. We reported a case of Asphyxiating thoracic dysplasia with review of literatures.
Cesarean Section ; Child ; Diagnosis ; Dwarfism ; Extremities ; Female ; Humans ; Hypertension ; Liver Failure ; Pelvic Bones ; Pregnancy ; Recurrence ; Renal Insufficiency ; Thorax ; Uremia

We reviewed 86 thymic epithelial tumors and reclassified them according to the Kirchner and Muller- Hermelink classification. They were subtyped as medullary, mixed, predominantly cortical (organoid), cortical, well differentiated thymic carcinoma, and poorly differentiated thymic carcinoma. The frequency of each subtype was determined and histologic findings were related to stage and myasthenia gravis. Immunohistochemical stains for bcl-2 protein as a marker for medullary thymocytes and MIC-2 protein as a marker for cortical thymocytes were performed in each case. The stages and association of myasthenia gravis was significantly different in each subtypes. The results of this study demonstrate that this histogenetic classification is clinically applicable. The bcl-2 protein was specifically demonstrated in lymphocytes within areas of medullary differentiation and MIC-2 protein in cortical differentiation. The expression of bcl-2 and MIC-2 proteins lend histogenetic support for this new classification of thymoma. Bcl-2 protein is strongly expressed in tumor epithelial cells of every case of poorly differentiated thymic carcinoma whereas the other types of thymic epithelial tumors do not show epithelial expression of this protein. The strong expression of bcl-2 protein in tumor epithelium may be considered as a predictor of aggressive behavior in thymic epithelial tumors.
Classification ; Coloring Agents ; Epithelial Cells ; Epithelium ; Lymphocytes ; Myasthenia Gravis ; Staphylococcal Protein A ; Thymocytes ; Thymoma*

A case of cervical chordoma diagnosed by fine needle aspiration is discussed. A 41year-old male was admitted due to dyspnea on neck flexion. Radiologic image revealed a retrotracheal superior mediastinal solid mass. Aspiration cytology showed many clusters of oval or large polygonal cells having abundant eosinophilic or bubbly cytoplasm in an amorphous blue-gray mucoid background. The nuclei were round and showed size variation, coarse granular chromatin, and indistinct nucleoli. Some cells contained brown granular pigments in the cytoplasm. Mitoses were rarely found. The cytoplasm was strongly positive for PAS stain. Immunohistochemical stains using cell block revealed positive reaction for cytokerain, EMA, vimentin, and S-100 protein. The confirmative diagnosis was made by following excisional biopsy. Electron microscopic study revealed large pools of intracytoplasmic glycogen and microfilaments. This is the first case of cervical chordoma diagnosed by aspiration cytology to our knowledge in Korean literature.
Actin Cytoskeleton ; Biopsy ; Biopsy, Fine-Needle* ; Chordoma* ; Chromatin ; Coloring Agents ; Cytoplasm ; Diagnosis ; Dyspnea ; Eosinophils ; Glycogen ; Humans ; Male ; Mitosis ; Neck ; S100 Proteins ; Vimentin

Primary mediastinal nonseminomatous germ cell tumor is extremely rare. Apart from rarity and large size, mediastinal germ cell tumors show striking similarity to testicular tumors in age, incidence, and tumor type. The symptoms associated with these tumors are related mainly to size, invasion of neighboring structures, and distant metastases. Tissue diagnosis is obtained by biopsy of the primary lesion or by biopsy of metastatic sites. Tumors often present with advanced bulky disease, which are unresectable. So these tumors require an aggressive multidisciplinary approach to management. Optimal management includes aggressive surgical debulking and early use of cisplatin-bleomycin-based combination chemotherapy. Serial biomarker measurements permit early recognition of recurrence and improved timing of surgical intervention. The prognosis for mediastinal germ cell tumors is poor, not only because they are far advanced at the time of diagnosis but also because some of the tumors-such as embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors-are very aggressive. In these cases, we present three young male patients with large mass on anterior mediastinum. Tissue diagnosis was obtained by primary lesion biopsy. All patients received surgical debulking and combination chemotherapy and experienced a brief response and eventually had relapses. We report these cases with a review of literatures.
Biopsy ; Carcinoma, Embryonal ; Choriocarcinoma ; Diagnosis ; Drug Therapy, Combination ; Endoderm ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Incidence ; Male ; Mediastinum ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal* ; Pregnancy ; Prognosis ; Recurrence ; Strikes, Employee ; Testicular Neoplasms

This study was carried out to reveal the epidemiologic characteristics of psoriasis in Korea. Seventeen university hospitals were engaged in this study, and the results were as follows : 1. The number of psoriasis patients during the 10 years from January 1977 to March 1987 was 1.05% of all the outpatients; the male to female-ratio was 1.08:1. 2. In the prospective study, the number of psoriasis patients was 2.3% of all the outpatients in 1987, 2.8% of all the outpatients in 1988 and the male to female ratio was 1.26:1. 3. The most prevalent age of onset was 20-29 years ; 81.1% were living in urban areas; and a family history was obtainable in 19.8% with parents holding the highest rank of 7.8%. 4. The most frequent duration of disease activity was under 5 years in 63.3%; the most common age for the worst condition was 20-29 yrs. The most common area size of skin involvement at the peak of the worst condition was less than 10%. 5. The most common initiating skin lesion began on the scalp in 20.2%, on the nail in 17.2%, pruritus in 63.0% with joint symptoms in 10.8%, and Koebner phenomena in 50.6%. 6. Emotional stress was the most common aggravating factor in 34.4%. The method of treatment that attained the best result was the combination therapy of oral medication and a topical agent. The best treatment modality was said to be the application of ointment with p.o.medication by as many as 28.4% of patients who took the leading rank. Photo-chemotherapy, effective with few complications, was not used much as it was not well-known in Korea until after 1980. Most people had an accurate knowledge of psoriasis.
Age of Onset ; Epidemiologic Studies* ; Epidemiology ; Female ; Hospitals, University ; Humans ; Joints ; Korea ; Male ; Methods ; Outpatients ; Parents ; Prospective Studies ; Pruritus ; Psoriasis* ; Scalp ; Skin ; Stress, Psychological

The skin concentrations of 8-methoxypsoralen (8-MOP), 5-methoxypsoralen (5-MOP), and 4, 5', 8-trimethylpsoralen (TMP) were studied in the guinea pig following oral administration and bathing. The skin concentration of phototoxic drugs after oral administration peaked at 1.5 hours, and the concentration of 8-MOP was 3.5 times greater than that of 5-MOP. The skin concentration of TMP was not detected in our study (limit of sensitivity 5ng/ml). The skin concentrations of phototoxic drug after bathing decreased in the order of 5-MOP, TMP, and 8-MOP
Administration, Cutaneous ; Administration, Oral ; Animal ; Guinea Pigs ; Methoxsalen/administration & dosage/*analysis ; PUVA Therapy ; Skin/*chemistry ; Support, Non-U.S. Gov't ; Trioxsalen/administration & dosage/*analysis

No abstract available.
Skin*

One hundred sixteen C57 BL mice were painted with either 8-MOP, 5-MOP or TMP solution in concentrations of 0.02%, 0.1%, and 0.5% each and UVA irradiated. Skin biopsies were performed at 1, 3, 5 and 7 weeks after LJVA irradiation. The results measuring the number, area, and perimeter of the melanocytes after topical PLJVA were higher in the TMP-painted group than in the 8-MOP or 5-MOP painted groups. In all groups, the weekly changes showed an increasing value through five weeks. In comparing the drug concentrations used, 0.1% of chemicals produced the same or higher values than 0.5%. There have been few studies on the effects of 5-MOP in photochemotherapy. In tho study 5-MOP produced a pigment-producing effect similar to 8-MOP. Therefore, if topical PIJVA with 5-MOP is used in clinical practice, we could expect a significant therapeutic effect in vitiligo.
Animals ; Biopsy ; Melanocytes* ; Methoxsalen ; Mice* ; Paint ; Photochemotherapy ; Skin ; Thymidine Monophosphate ; Vitiligo