PURPOSE: The aquaporins (AQPs) are transmembrane water channel proteins. It is well known that AQP2, -3 and -4 contribute to the urinary concentration in collecting duct (CD) and also reported the presence of these three AQPs in the connecting tubule (CNT). Newborn rats are not capable of producing a concentrated urine. Rats develop the ability to concentrate urine after birth. The purpose of this study was to establish the time of the expression and the distribution of AQP2, -3 and -4 in the developing rat kidney. MATERIALS AND METHODS: Sprague-Dawley rats were used in all experiments. Kidneys were obtained from 16, 18 and 20-day-old fetuses and 1, 4, 7, 14 and 21-day-old pups and preserved and processed for immunohistochemical studies using a preembedding immunoperoxidase procedure. AQP2, -3 and -4 immunoreactivity was detected using rabbit polyclonal antibody and donkey anti-rabbit IgG. RESULTS: AQP2, -3 and -4 appeared first in 16-day-old fetuses in the CD and in 18-day-old fetuses in the CNT. Immunoreactivity for AQP2, -3 and -4 was markedly increased after birth and gradually increased during development. In CNT cells and principal cells, AQP2, -3 and -4 were not distinctly demonstrated on the apical, lateral and basal plasma membrane respectively until 21 days after birth. Distinct polarity of these AQPs both in CNTcells and principal cells were observed at 21 days after birth. CONCLUSIONS: AQP2 -3, and -4 were expressed not only in CD but also in CNT before developing of urine concentrating ability during development and it is concluded that their expression and distribution in CNT may play a role in the development of urine concentration abilities in rat kidney.
Animals ; Aquaporin 2* ; Aquaporins ; Attention ; Cell Membrane ; Equidae ; Fetus ; Humans ; Immunoglobulin G ; Infant, Newborn ; Kidney Concentrating Ability ; Kidney Tubules ; Kidney* ; Parturition ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Pericardium*

No abstract available.
Neurilemmoma* ; Neurofibromatoses* ; Neurofibromatosis 2*

OBJECTIVE: For the treatment of carotid cavernous fistula(CCF), transarterial detachable balloon occlusion(DBO) is the method of choice. When it has failed to occlude the fistula, various embolization methods are used to treat the fistula. Transvenous embolization through the superior ophthalmic vein(SOV) is another method of treatment. The venous approach through the SOV after surgical dissection and exposure of this vein has been recommended by some delete, but(here) delete delete(an) alternative treatment method by percutaneous puncture of the SOV without surgical dissection(is described). METHODS: A 19-year-old woman admitted to our hospital two months after accident, presented with proptosis, chemosis, occulomotor and abducens nerve palsies, and bruit of the right eye. The authors tried DBO via transarterial route in initial treatment and the fistula was occluded with subsequent disapearance of bruit. However, 2 weeks later, she complained of recurence of bruit. Transarterial approach was attempted again, but the fistula hole was too small for this approach. The venous approach via SOV by percutaneous puncture was then tried. Puncture was made at the medial one third of the superior orbital rim and the fistula was embolized with Guglielmi detachable coils (GDCs). RESULTS: The fistula was completely occluded and no early and late complications noted. The patient's clinical symptoms were improved within a few days. CONCLUSION: Treatment of CCF by percutaneous puncture of the SOV is an alternative and effective method when other approaches are not feasible.
Abducens Nerve Diseases ; Exophthalmos ; Female ; Fistula* ; Humans ; Orbit ; Punctures* ; Veins* ; Young Adult

Nine typical cases of ossifying fibroma in the tibia or fibula were retrospectively reviewed for clinical and histopathological aspects of this disease. Along with the case analysis, light and polarized microscopic examinations were performed in each case. Differential points with monostotic fibrous dysplasia were as follows; 1) ossifying fibroma begins in the significantly younger age, which is in most cases below 10 years of age, 2) it is confined to diaphysis of tibia or fibula, 3) radiologically, multilocular osteolytic destructive change in eccentric pattern is usually combined with anterior or anterolateral bowing deformity, 4) microscopically, characteristic findings are presence of osteoblastic rimming, peripheral maturation, and zonal phenomenon. In the treatment of ossifying fibroma, definitive surgical treatment should be delayed until skeletal maturity, when segmental resection in wide margin including periosteum might be preferred.
Congenital Abnormalities ; Diagnosis ; Diaphyses ; Fibroma, Ossifying ; Fibrous Dysplasia, Monostotic ; Fibula ; Fluconazole ; Osteoblasts ; Periosteum ; Retrospective Studies ; Tibia

In man the epiglottis is a thin lamella of yellow elastic cartilage. The upper part is free and is known asleaf and lower part participates in the formation of the anterior wall of the vestibule of the larynx. Theipithelial covering extends forwards onto the base of the tongue over the medial glossoepiglottic folds. The sidesof epiglottis are connected with the cartilages of Wrisberg and arytenoid cartilage by the aryepiglottic fold. Inview of these anatomical complexities, the function and physiology of the epiglottis have been debated sinceMagendi(1815), who proposed the theory that the epiglottis acts as a flap valve to prevent food entering thewindpipe, and who found that he could remove the free part of the epiglottis in dog without spoiling the dog.Follwoing the introduction of laryngoscopy(Garcia, 1815; Liston, 1840; Czermark, 1861) and modern cineradiographicequipments in 1950's, the anatomy and physiology of epiglottis has become much clearrer. Age as it is seen on thelateral x-ray of the neck. In the present study we have made an attempt to systematically analyze aging changes ofthe epiglottis in the lateral x-ray of the neck in 245 healthy adults. The age ranged from 16 to 65 years old.Based on our observation the epiglottis was classified into type A, B, and C according to their curvatures. Thus,type A represented those with posterior curvature, type B those with straight epiglottis and type C anteriorcurvature. Type C was sudivided into I, II and III according to the degree of curvature. Thus, type C-I, C-II andC-III represented mild, moderated and marked anterior curvature, respectively. Type A epiglottis was found in thesecond, third and fourth decades and type C-III in the older age group. Type A was least comon and type C mostprevalent. It seems that the epiglottis inclines anteriorly with backward curvature with age (p<0.0001).
Adult ; Aging ; Animals ; Arytenoid Cartilage ; Cartilage ; Dogs ; Elastic Cartilage ; Epiglottis ; Humans ; Larynx ; Neck ; Physiology ; Tongue

A cases is reported of congenital atlanto-occipital fusion in a 12-years-old girl. The lesion was treated by occipito-cervical arthrodesis by iliac bone grafting with wiring. The congenital atlanto-occipital fusion has not progressed in this 2 years of observation. This is presented with a review of literature.
Arthrodesis ; Bone Transplantation ; Female ; Humans

PURPOSE: The Singh index which is based on a plain radiograph has commonly used in assessing the grade of osteoporosis. We studied value of the Singh index in assessing the grade of osteoporosis by obtaining reliability of the Singh index and correlation between the Singh index and bone mineral density. MATERIALS AND METHODS: Six observers assessed radiographs of 60 patients suspected osteoporosis. The interobserver and intraobserver agreement of the Singh index were obtained by using kappa statistics. The bone mineral density of proximal femur was measured by dual energy X-ray absorptiometry in all patients, and then the results of bone mineral density were compared with those of Singh index by using percentage of variance. RESULTS: The kappa values of interobserver agreement ranged from 0.28 to 0.76 (mean value: 0.45) and the strength of the agreement was moderate. The percentage of variance of BMD which was explained by Singh index was 7.1%. CONCLUSIONS: The results of this study suggest that the Singh index has low clinical value in assessing the grade of osteoporosis
Absorptiometry, Photon ; Bone Density ; Femur ; Humans ; Osteoporosis*

The author performed radiosurgery with linear accelerator(LINAC) on two patients who were unable to receive surgical treatment. A 75-year-old-male patient(case 1) whose main complaints were gait disturbance and headache had undergone total resection of cerebellar hemangioblastoma five years before the admission and the lesion recurred. Because the patient's general condition was poor, radiosurgery with LINAC was performed and at 1 month after the radiosurgery, obstructive hydrocephalus developed, and ventriculoperitoneal shunt was done. After 11 months, follow-up brain magnetic resonance image findings showed the decrease of the size of the tumor, and the patient's consciousness returned to alertness. He could also walk using a cane. A 28-year-old male paient(case 2) whose main complaints were vertigo, ataxia refused to receive surgical resection due to his religious beliefs, and radiosurgery was performed, after cyst aspiration with ommaya reservoir insertion as an alternative. Eighteen months later, the tumor size has decreased and there were no radiosurgical complications. The patient has been followed-up at the outpatient without any notable symptoms. Through these two cases, the authors experienced tumor control by LINAC radiosurgery when surgical treatment is not acceptable. Radiosurgery seems safe and effective in the treatment of hemangioblastoma, but there is the need for further evaluation.
Adult ; Ataxia ; Brain ; Canes ; Consciousness ; Follow-Up Studies ; Gait ; Headache ; Hemangioblastoma* ; Humans ; Hydrocephalus ; Male ; Outpatients ; Radiosurgery* ; Religion ; Ventriculoperitoneal Shunt ; Vertigo

OBJECTIVE: Adenoid cystic carcinoma is a relatively slowly growing malignant tumor. Probably at least 40-50% of patients eventually develop distant metastases. We present the natural history and treatment modality of this malignancy from our experience and review of literature. METHODS: We report a case of a 30-year-old man who complained of a headache, facial pain and hearing disturbance in the right ear. Physical examination revealed soft, protruded mass and narrowed external auditory canal. The cranial MRI showed a well defined mass in the extradural middle cranial fossa. RESULTS: The patient underwent subtotal resection of the lesion after tumor embolization was performed. The pathological diagnosis was adenoid cystic carcinoma. The patient received postoperative radiation therapy(56Gy) resulting in a complete neurological recovery. Fifteen months later, the patient was readmitted for severe back pain. Bone scan disclosed hot uptakes at the upper cervical spine, the 4th lumbar vertebra, and the pelvic area. These areas were irradiated(40Gy) and the presenting symptoms were relieved. Twenty months later, he complained of respiratory difficulty and was found to have a multiple nodule(s) in the lung. He was given 10 cycles of chemotherapy but discharged because of unresponsivencess and development of new lesions. Brain MRI and bone scan were checked 10 months after his discharge due to more aggravated lung metastasis although local tumor was controlled. Adjuvant radiation therapy(18Gy) was performed and he continued to be functional independently, although he was no longer working as a registered nurse. Two months later, dyspnea and hemoptysis were more improved and chest X-ray showed decreased mass. During the follow up period, he complained of intercostal pain, chest X-ray showed more aggregated lung mass. Chest CT scan showed multiple lung metastases and liver metastasis. In spite of adjuvant radiotherapy, the patient died of multiple systemic metastases 47 months after the first operation. CONCLUSION: Surgery is essential in the treatment of adenoid cystic carcinoma. Radiotherapy has gained acceptance as a palliative therapy, as it reduces tumor bulk and relieves symptoms. The combined treatment do not, however, prevent further recurrence and distance metastasis.
Adenoids* ; Adult ; Back Pain ; Brain ; Carcinoma, Adenoid Cystic* ; Chest Pain ; Cranial Fossa, Middle ; Diagnosis ; Drug Therapy ; Dyspnea ; Ear ; Ear Canal ; Facial Pain ; Follow-Up Studies ; Headache ; Hearing ; Hemoptysis ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; Natural History ; Neoplasm Metastasis* ; Palliative Care ; Physical Examination ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Spine ; Thorax ; Tomography, X-Ray Computed