No abstract available.

Insulin stimulates glucose transport in muscle cell and adipocyte via the rapid redistribution of GLUT4 glucose transporters from intracellular membrane compartments to the cell surface. The mechanism that insulin treggers the translocation of glucose transporters in not known yet whether it is due to the structural differences among glucose transporters or there is cell specific targetting/translocation apparatus insulin-sensitive cells.

This study was planned to examine this question by strdying insulin effect on the glucose transport rate at adipocyte and hepatocyte fused with GLUT1 vesicle, respecitively.

The results showed that treatment of 37nM insulin increased the transport rate of 3-0-methylglucose by 3.8-fold at adipocyte fused with GLUT1 but increased lnly by 1.2-fold at hepatocyte fused with GLUT1.

Therefore, it is suggested that insulin sensitive cell has a cell-specific targetting/translocation machinery which is triggered by insulin-insulin receptor interaction but insulin sensitivity may not dependent on isoform(structural)-specific manner.

Adenocarcinomas are uncommon tumors of the urinary bladder. accounting for 0.5% to 2.2% of all bladder malignancies over world.

Separating urachal tumors from non-urachal tumors are important in their prognosis. Authors report thirty-nine cases analyzed according to their clinical aspects at presentation and according to their gross and histopathologic features, such as location, size, shape, stage, d1fferentiation, cell types on microscopic examination. Twenty-one tumors were primary; 8 tumors were non-urachal, 11 tumors were urachal and others from colon, stomach, rectum and ovary. Urachal tumors. In histopathologic types fo primary adenocarcinoma in the urinary bladder, adenocarcinoma, NOS are most common. In urachal adenocarcinomas, enteric types cystitis cystica, cystitis glandularis, necrosis and calcification are also seen. But around urachal tumors, cystitis cystica and cystitis glandularis are not observed.

Sometimes, routine clinical and pathologic study cannot differentiate the histogenesis and the classification of adenocdarcinoma in the urinary bladder. Further studies are needed.

Benign prostatic hyperplasia and prostatic carcinoma are the most frequent and important two lesions of the prostate. Sometimes we encounter the situations to solve the problems for the differential of cancerous lesions form various histopathologic changes in the microscopic examination of the prostate tissue obtained by curettage or resection in the patients of benign prostatic Hyperplasia. This study was undertaken to make an accurate histopathologic diagnosis of the prostate through the recognition of various microscopic changes similar to those of prostatic cancer and to understand the possibility of percancerous lesion in the dysplasia of the prostate.

Authors reviewed total 1,023 cases of prostatic tissre obtained during the last ten years from 1981 to 1990 at Ewha Womans University Tongdaemun Hospital, Wonju Christian Hospital and Yong-Dong Severance Hospital.

The results are as follows:

1) Among total 1,023 cases, 922 cases were benign prostatic hyperplasia and 101 cases were prostatic carcinoma.

2) Dominant age groups are seventies and eighties decades.

3) Nonspecific inflammation is found in almost cases of benign prostatic hyperplasia and the incidence of granulomatous inflammation was 2.7%, that of nonspecific granulomatous inflammation was 1.8% and that of tuberculosis was 1.0%.

4) The incidence of stromal nodule in benign prostatic hyperplasia was 30.5%, basal cell hyperplasia, 29.7%, sclerosing adenosis, 2.1% and dysplasia, 3.5%.

5) Among total 983 cases of prostate, 54 cases(5.5%) were dysplasea. The incidence of dysplasia in benign prostatic hyperplasia was 3.9% and that in prostatic carcinoma was 29.5%. The incidence of grade III dyplasea was 0.3% in benign prostatic hyperplasia and 13.1% in prostatic carcinoma. Therefore, of presence and occurance of associated carcinoma in the grade III dysplasia is highly present.

It is very important to evaluate the pattern of predominant microorganisms and their antimicrobial susceptibility in new established hospitals. The recognition of changes in antimicrobial susceptibility pattern is reliable guide for selection proper antibiotics.

I evaluated the distribution of micreerganisms and the pattern of antemicrebial susceptibility on 3,583 clinical isolates at Ewha Womans University Mokdong Hospital from September 1993 to August 1994. The pattern of antibiotic susceptibility was also compared between two periods(Sep., 1993-Feb., 1994 and March 1994-Aug., 1994).

The results were as follows:

1) The total isolation rate was 20.3%(3,247 specimens were cultured from 15,979 specimens requested).

2) The most commonly isolated microorganisms were E. coli, Staphylococcus aureus, Pseudomonas aeruginoas, Staphyliciccus epidermidis, and Entercoccus faecalis in decreasion rate.

3) E.coli was highly resistant to ampicillin, piperacillin and revealed over 70% sensitivity to cephalothin. gentamicin and tobramycin.

4) Pseucimonas aeruginosa was highly resistant to ampicillin, cephalithin and revealed over 70% esnsivity to ceftazidime, amikacin, gentamicin, tobramycin, ciprofloxacin and piperacillin.

5) Staphylococcus aureus was highly resistant to ampicillin, penicillin and revealed about 50% sensitivity to oxacillin, cephalothin and clindamycin. The susceptibility pattern of Staphlococcus epidermis was slightly different.

6) The sensitivityto penicillin of Enteococcus faecalis is 60% and that of Streptococcus pneumoniae was 71%.

7) The antimicrobial susceptibility of Pseudomonas aeruginosa, Staphlococcus aureus and Streptococcus pneumoniae were slightly decreased during last 6 months.

There were some differences of the distribution distribution of microorganisms and their antimicrobial susceptovolity pattern on isolates of ther study with comparison of other reports in Korea. Antimicrobial susceptibility pattern showed slightly increase of resistant strains. This study suggested that the periodic evaulation of antimicrobial suceptibility pattern was desirable.

To evaluate the long term results of sequential neoadjuvant chemotherapy followed by radiotherapy in locally advanced non small ciell lung cancer(NSCLC), 32 patients with stage III NSCLC were studied.

Neoadjuvanjt chemotherapy was performed with 2-3 cycles of cisplatin containing combination at the interval of 3-4 weeks, and then radiotherapy to and primary tumor, mediastinum and both supaclavicular lymph nodes was followed.

The results were as follows:

1) After neoadjuvant chemotherapy, partial remission(PR) rate was 59.4% without complete remission(CR). At completion of radiotherapy, CR rate was 28.1%, PR rate 50.0% and overall response rate was 78.1%.

2) The median survival of all patients was 14.4 months, for stage III A NSCLC patients was 22 months compared to 11.4 month in stage III B NSCLC patients without significance. For responder of neoadjuvant chemotherapy, median survival was 16.6 months, and 9.3 months for the non responder(p<0,05). Median survival of responders at completion of chemotherapy was 26.8 months at the rangd of 4-48 months. Overall survival rate at 2 year was 27.1% and continued plateau till 50 months without late relapse.

3) The acute toxicities were tolerable in all patients and not fatal, but late complications of three restricitive pneumonitis and one cough induced syncopal attack compromise the quality of life among the 8 long term survivors who lived over 2 years.

4) The relapse rate was 58.1%(18 out of 31 cases) and the pattern of relapse was local in 14 cases(45.2%), systemic in 3 cases(9.7%) and local plus systemic in 1 case(3.2%). The sites of systemic relapse were brain in 3 cases and brain combined with bone in 1 case.

In conclusion, sequential neoadjuvant chemotherapy and radiotherapy can prolong the survival and diminish the systemic relapse in locally advanced non small cell lung cancer patients but local failure was the main problem in these patients.

To enhance the local control, other trials such as concurrent chemoradiotherapy, hyperfractionated radiotherapy combined with developing more effective new chemotherapeutic agents and combined regimens should be further investigated.

The present study was conducted to evaluate ego defense mecahnisms of 78 forensic schizophrenia patients selected on the basis DSM-III-R criteria who were admitted to the Forensic Psychiatric Institution from March to June of 1992. 47 Normal controls were matched for sex, age and education level with the forensic schizophrenia partients. EDMT(Ewha Diagnostic Test of Diagnostic Mechanism), consisted of 200 items and 20 scales, was administered to the subject group and the normal control group. No significant differnce was found between the two groups in sex ratio, age and educational level.

Results of the present study were as follows:

1) The forensic schizophrenia group presented a statistically significant higher score on denial, supression, rationalization and anticipation scales than normal control group.

2) The normal group gave had a higher score on denial and anticipation scales than the normal control group.

3) The male patient group had a higher score on denial and anticipation scales than the normal control group.

4) On the basis of the factor analysis, the forensic schizophrenia group had a higher score on behavior inhibted scales and the normal group on the self-expansive scale.

5) It was suggested that the forensic schizophrenia group had the overcontorlled personality trait and more severe ego distubance.

Late two-cell mouse embryos from ICR(Swiss albino) mice were cultured to the blastocyst stage in New MHBS media.

In order to invertigate the effect protein macromolecule and glutamine on the development of preimplantation embumin(BSA), polyvinylpyrolidone (PVP) and glutamine and the rate of blastocyst developnent was observed.

The results were as following:

1) There were a signigicant difference in blastocyst development of early and late 2-cell mouse embryos(p<0.05).

2) The development of late 2-cell mouse embryo to blastocyst in the BSA-free but containing glutamine was higher than those of 0.4% BSA, 0.4% PVP group.

3) The development of late 2 cell mouse embryo in the MHBS containing glutamine was higher than MHBS with BSA but glutamine-free media group(p<0.05).

4) Blastocyst development is higher in media supplemented with glutamine than in media containing no glutamine.

5) These study suggests that the addition of glutamine to the culture media may be a required for energy substrate for in-vitro development of late 2-cell mouse embryo.

The technique of large loop excision of the transformation zone(LLETZ) as an alternative to destructive/ablative methods of treatment of CIN(cervical intraepihelial neoplasia) such as cryotherapy, laser vaporization and cone biopsy was assessed. In 63 women with suspected CIN attending the colposcopy clinic, the histologic diagnoses made from excision biopsies taken by LLETZ were compaired with those from colposcopically directed punch biopsies. This microinvasive tumors were found by LLETZ and the diagnosis made by LLETZ was worse than that made by punch biopsy in 17 cases(26.9%). That is to say, LLETZ improves the accuracy of diagnosis of CIN. And in offers a cheap and accurate alternative to laser vaporization or cone biopsy, and also combines the benifits of the gold standard cone biopsy with that of local ablative metholds. LLETZ is considered as a fairly new and good method of treatment of CIN, and the olng-term complications or effects should by yet fully evaluated in future.

Retinal changes were evaluated after vitreous replacement with perfluorodecalin. Tolerance to this liqued in rabbit eyes was investigated for peiod of 1 month.

Histologic examination revealed degeneration the loss of the outer segment of the photoreceptors, decreased thickness of the outer retinal layers and in the vitreous These changes were progressed with the longer duration of the intravitreal replacement of perfluorodecalin. From the above resulgts, perfluorodecalin is thought to be unsuttable for the long-term witreous substitute and should be removed from the wyw before the vompletion of surgery.

Clinically, the diagnostic method of dry eye and adaptation of contact lens wearing have been the slit lamp examination, tear film break up time(BUT) measurement and Schirmer test. There have been many reports that Schirmer test and BUT measurement can be influenced by may factors, especially the mothods of measuring it. So the question of their repeatability and reproducibility has not yet been solved.

We studied the influence of contact lens wearing on the tear film phenol red thread test between contact lens wearers and non-wearers.

The results as follows:

1) The mean value measured by the PRT method was 13.92±7.68mm in right eye, 15.03±7.68mm in right eye, 21.48±6.30mm in left eye among the contact lens-non wearing group.

2) There was statistically significant decreased value of PRT in the contact lens wearing group.

3) There was not statistically significant difference between contact lens type, duration of contact lens wearing, duration of exchanging of contact lens, contact lens wearing time perone day.

Moyamoya diseases is an unusual vascular disorder highlighted by progressive bilateral internal carotid artery occlusion and collateralization of intracranial blood flow. To minimize the ischemic deficit, various surgical methods have been tried.

Among the 11 cases, 10 cases were associated with intracerebral and intraventricular hemorrhage and other one with cerebral infarction.

7cases with the surgical intervention were performed, 3 cases with EMS and 4 cases with EDAS. Outcome was exellent excepting 2 cases.

9 cases was survived and 2 cases was dead due to brain swelling and rebleeding.

In children, the cause of angular deformity after the treatment of distal humeral fracture is mainly not dew to the growth problem but the alignment of initial reduction state. The alignment of reduction status can be measured by numerous methods for anatomical reduction. The Baumann angle and lateral humero-capitellar angle are the most useful radiologic measuring methods for the evaluation of the anatomical configuration of distal humerus. But the determination of the straight line along the capitellar growth plate has some difficulties because the curved rounded capitellar shape may overlap the distal humeral metaphysis. So, 4 types classfication suggested by Williamson et. is used for determination of the line eith easy.

The Baumann angle is a valuable measurement method of distal humerus alignment, but as we know, there is no normal range data in Korean children. We measured the normal Baumann angle and lateral humero-capitellar angle using 112 cases normal elbow X-ray films and analysed its significanses.

The results are as follows:

1) The mean baumann angle is 69.2° with 6.2° standard deviation.

2) The mean lateral humero-capitellar angle is 45.3° with 8.2° standard deviation.

3) The Baumann angle and lateral humero-capitellar angle have no differences between ages, sexes, sidedness and types.

4) The 4 types classification by the shape of the capitellar growth plate is a realtively objective and useful method for the measurement of Baumann angle.

5) The Baumann angle has negative value coefficiency with lateral humero-capitellar angle.

Primary depression with cognitive impairment, referred to as depressive pseudodementia, may be mistaken for a progressive degenerative dementia. Recognition of primary depression is clinically important because of its treatability.

To differentiate depression from degenerative dementia, author rsed brain Tc 99m-HMPAO SPECT. By the result the regionar cerebral blood flew(rCBF) in elderly depressed patient was decreased in the left temporoparietal cortex. The pattern of rCBF was different from that of dementia which shows decreased rCBF in bilateral cortex.

By using brain SPECT in depressed elderly patient with cognitive impairment, the discrimination from dementia will be more effective and accurate.

Xeroderma pigmentosum is a rare autosomal recessive disorder characterized by extreme photosensitivity and defect in repair of damage to DNA Lentigenes, freckles, telangiectasia and the hyperpigmented cutaneous macules in the sun-exposed area and early development of cutaneous malignancies are observed. In addition to cutaneous symptoms, ophthalmologic changes and neurologic abnormalities can be associated.

We report a case of xeroderma pigmentosum associated with squamous cell carcinoma in a 4-year-old girl. This case is thought to be more earlier development of malignancies than ever reported.