The Analysis of Tumor Aggressiveness accord- ing to Tumor Size in Occult Papillary Thyroid Carcinoma

PURPOSE: Occult papillary thyroid carcinomas (OPC) are defined as tumors measuring 0.5 cm. A near-total or total thyroidectomy with a central lymph node dissection is the preferred treatment. The early detection and treatment of OPC might be warranted through the routine use of thyroid USG and USG-guided FNA.

The Abundance and Nuclear Distribution of TonEBP in Response to Changes of Tonicity in Hyperglycemic Cells / 대한내분비학회지

BACKGROUND: TonEBP (Tonicity-responsive enhancer binding protein) regulates the transcription of tonicity responsive genes, such as sodium-myo-inositol and the sodium- chloride-betaine co- transporters (SMIT & BGT1), heat shock protein 70 (HSP70) and aldose reductase (AR). To characterize the signals that activate TonEBP in hyperglycemic human retinal pigment epithelial (hRPE) cells, the abundance and nuclear distribution of TonEBP were studied in response to changes of tonicity in culture media. METHODS: After the cultures reached confluence, the hRPE cells were exposed for 3 days to 25 mM glucose and 100 mM NaCl, both with and without 20 M tolrestat. The expressions of AR, SMIT and HSP 70 were determined by northern blot, and the abundances of TonEBP by western blot. The nuclear distributions of TonEBP were observed by fluorescence microscopy, after immuno staining. RESULTS: The AR and SMIT mRNA levels in hyperglycemic and hypertonic media were decreased compared to those in hypertonic media alone. These decreased AR and SMIT mRNA expressions were also observed to be significantly prevented in those cells incubated with tolrestat. Stimulation of TonEBP in hypertonic medium occurs due to a combination of an increased abundance of TonEBP and an increased distribution into the nucleus from the cytoplasm. However, the expressions and nuclear distributions of TonEBP in hyperglycemic and hypertonic media were not different from those in hypertonic media alone. CONCLUSION: The expressions of AR and SMIT genes that may influence the development of diabetic complication were down-regulated by the intracellular accumulation of sorbitol in sustained hyperglycemia. TonEBP does not play a key role in the hypertonicity-induced transcriptional regulation of AR and SMIT in hyperglycemic cells, due to the intracellular accumulation of sorbitol and depletion of myo-inositol

Cardiac response to head-out water immersion in man

Head-out water immersion induces marked increase in the cardiac stroke volume. The present study was undertaken to characterize the stroke volume change by analyzing the aortic blood flow and left ventricular systolic time intervals. Ten men rested on a siting position in the air and in the water at 34.5degreeC for 30 min each. Their stroke volume, heart rate, ventricular systolic time intervals, and aortic blood flow indices were assessed by impedance cardiography. During immersion, the stroke volume increased 56%, with a slight (4%) decrease in heart rate, thus cardiac output increased ~50%. The slight increase in R-R interval was due to an equivalent increase in the systolic and diastolic time intervals. The ventricular ejection time was 20% increased, and this was mainly due to a decrease in pre-ejection period (28%). The mean arterial pressure increased 5 mmHg, indicating that the cardiac afterload was slightly elevated by immersion. The left ventricular end-diastolic volume index increased 24%, indicating that the cardiac preload was markedly elevated during immersion. The mean velocity and the indices of peak velocity and peak acceleration of aortic blood flow were all increased by ~30%, indicating that the left ventricular contractile force was enhanced by immersion. These results suggest that the increase in stroke volume during immersion is characterized by an increase in ventricular ejection time and aortic blood flow velocity, which may be primarily attributed to the increased cardiac preload and the muscle length-dependent increase in myocardial contractile force.

Clinical Study on Mitral Valve Prolapse

During 1 year and 9 month period, from September, 1980 to June, 1983, retrospective study was performed on 35 patients with Mitral Valve Prolapse at Kyung Hee University Medical Center. And the following results were obtained; 1) The mitral valve prolapse syndrome presents with various cardiovascular symptoms including dyspnea(63%), palpitation(49%), chest pain(34%), syncope and dizziness(11%). 2) Of 35 patients with MVP, 17 cases were isolated MVP, 13 cases were associated with cardiovascular disorders and 5 cases were associated with non-cardiovascular disorders. 3) Electrocardiographic abnormalities were found in 20 patients with MVP. The most common abnormality was ST-T change and atrial fibrillation, VPB, RBBB, first degree A-V block and W-P-W syndrome were also noted. 4) QTc interval prolongation was more common in serverely symptomatic patients with MVP. 5) 18 cases in 35 patients showed systolic click or murmur on phonocardiography. 6) Of 35 patients with MVP, 19 patients demonstrated prolapse of the anterior leaflet, 11 patients demonstrated prolapse of posterior leaflet and 5 patients demonstrated prolapse of the both leaflets. 7) There were severe derangement on echocardiography in severely symptomatic patients were MVP.

Pheochromocytoma Arising from the Organ of Zuckerkandl Associated with Intracerebral Hemorrhage: 1 case report

Pheochromocytoma is a hazardous and dramatic cause of hypertension. This potentially lethal neoplasm originates in most cases in the adrenal medulla and less frequently in the cells of the extraadrenal paraganglion system which are disseminated along the paravertebral axis from the pelvis to the base of the skull. The organ of Zuckerkandl is paraganglia lying the abdominal aorta with highest incidence in the region of the inferior mesenteric artery and usually degenerate shortly after birth. In the literature, and additional one case of pheochromocytoma arising from the organ of Zuckerkandl associated with intracerebral hemorrhage which was treated recently in the Kyung Hee University Hospital is presented in this report.