A case of primary empty sella syndrome combined with Cushing's disease / 대한내과학회지

Empty sella is defined as a sella which, regardless of its size, is completely or partly filled with cerebrospinal fluid (CSF), and is divided into two groups, primary or secondary. Secondary empty sella syndrome is associated with a prior surgery, radiation therapy or medical treatment of pituitary gland, and otherwise primary. The endocrine function of primary empty sella syndrome is usually normal, but sometimes, this syndrome is associated with complete or partial pituitary insufficiency and rarely pituitary hypersecretion. In the cases of hypersecretion of pituitary hormones, hyperprolactinemia, acromegaly and hypersecretion of adrenocorticotrophin (ACTH) has been reported. but, hypersecretion of ACTH is rarely reported. We describe a patient of primary empty sella syndrome combined with Cushing's disease. So we present this case with a review of the literature.

Effects of Ischemic Preconditioning, Adenosine and Pinacidil on Expression of Apoptosis in the Rectus Femoris Muscles of the Rats after Ischemia and Timely Reperfusion / 체질인류학회지

The ischemia and reperfusion injury of skeletal muscle is caused by generation of reactive oxygen species. Recently, apoptosis has been associated with oxidative stress in a number of cell systems. The effects of ischemic preconditoining in cardiac muscle have been established as rendering muscle tolerance to ischemic reperfusion damage via opening of KAPT channel and activation of adenosine A1 receptor. The effects and mechanisms of ischemic preconditioning are not known clearly. The present study was performed to investigate the effect and the mechanisms of ischemic preconditioning by measuring the incidences of apoptosis on timely reperfused ischemic muscles. The healthy Sprague -Dawley rats weighing from 200 g to 250 g were used as experimental animals. Under pentobarbital (50 mg/kg) anesthesia, lower abdominal incision was done and left common iliac artery was ligated by using vascular clamp for 2 hours. Rectus femoris muscles were obtained at 0 hour, 1 hour, 2 hours, 6 hours, 12 hours and 24 hours of reperfusion. The group of ischemic preconditioning underwent three episodes of 5 minutes occlusion and 5 minutes reperfusion of common iliac artery followed by 2 hours of ischemia and timely reperfusion. Adenosine (50 microgram/kg) or pinacidil (1 mg/kg) were administered intravenously before ischemia and 2 hours of ischemia and timely reperfusion was done. 6 microM of paraffin sections were obtained. The incidencies of apoptosis were observed by use of in situ apoptosis detection kit. The results obtained were as follows. 1. The reactivities to apoptosis in the rectus femoris muscle increased after 2 hours of ischemia and timely reperfusion. 2. After 2 hours of ischemia and timely reperfusion with ischemic preconditioning and the treatment of pinacidil, the reactivities to apoptosis in all groups decreased markedly. 3. After 2 hours of ischemia and timely reperfusion with the treatment of adenosine, the reactivities to apoptosis in all groups were similar to those in the group of 2 hours of ischemia and reperfusion. Consequently, these results suggest that the reactivities to apoptosis decrease after 2 hours of ischemia and timely reperfusion with ischemic preconditioning. The effect of ischemic preconditioning is related to opening of KATP channel partly.

A Case of Primary Pulmonary Sarcoma with Morphologic Features of Biphasic Synovial Sarcoma / 결핵

Synovial sarcoma is a malignant soft tissue neoplasm that occurs frequently in the extremities of young adults, near large joints. The lung is a common site of metastasis but an extremely unusual primary site for synovial sarcoma. We report an unusual case of primary synovial sarcoma that arose in the lung of a 59-year-old woman. The tumor had histologic and immunophenotypic features consistent with biphasic synovial sarcoma. These features included of an intimate admixture of cytokeratin and epithelial membrane antigen(EMA)-positive neoplastic epithelial cells and vimentin-positive fibroblast-like spindle cells. The patient had a closed thoracomy drainage and doxycycline pleurodesis for malignant loculated effusion and showed tumor extension in the left whole lung 4 months after pleurodesis. This case is an usual addition to the small number of published reports on primary pulmonary synovial sarcoma. The distinctive features of this neoplasm allow it to be distinguished from a variety of primary and metastatic malignancies in the lung.