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

Localized fibrous tumor of the pleura is rare, slowly growing, benign tumor. Most of these tumors clinically behave asymptomatically, although tumor-associated hypoglycemia occurs in a few cases and lead to hypoglycemic coma. Laboratory investigations show elevation of IGF-II with a 2-3 times higher effect on the blood glucose level than insulin. Surgical resection of the tumor is recommended. We report on the case of a 81-year-old man, who complained of hypoglycemic episodes. Diagnostic evaluation showed a fibrous tumor of pleura attached to the right diaphragm.
Aged, 80 and over ; Blood Glucose ; Coma ; Diaphragm ; Humans ; Hypoglycemia* ; Insulin ; Insulin-Like Growth Factor II ; Pleura*

We are report a case of surgically treated a huge neurilemmoma in the lower thoracic and lumbosacral areas. A 57-year-old women presented with low back pain, motor weakness of the both lower extremities and urination difficulty. Magnetic resonance imaging revealed a huge enhancing lesion at the L3-S1 levels and isolated two small enhancing lesions at the T12 and L1 level respectively. This case was treated with extensive laminectomy from T12 through S1 level and total resection. The pathological findings were consistent with neurilemmoma. The patient's preoperative neurologic deficit has been recovered and no postoperative complications developed.
Cauda Equina* ; Female ; Humans ; Laminectomy ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Neurilemmoma* ; Neurologic Manifestations ; Postoperative Complications ; Urination

BACKGROUND: Aerobic training can be defined as any physical exercise that increases the heart rate and enhances the body's intake of oxygen long enough to benefit the condition of body. Running, cycling, and swimming are examples of aerobic activities. This type of exercise optimises immune functions. Recently several experimental findings suggested that the regular swimming training increase immune response, but there have been very few reports which compare warm water exercise with cold water exercise in spleen lymphocytes. METHODS: This study was designed to examine the effects of regular swimming training on Index, the number of lymphocytes, proliferative activity and production of reactive oxygen species (ROS) by splenocytes in BALB/c mice. Thirty six mice (6 week old) were performed 10 weeks of regular swimming training and they were divided into 6 groups according to the regular swimming training (CRG: control resting group, CEG: control exercise group, WRG: warm water trained resting group, WEG: warm water trained exercise group, CORG: cold water trained resting group, COEG: cold water exercise group). Analytical items were weight change, spleen index, the number of lymphocytes, proliferative activity and production of ROS. All data were expressed as mean and standard deviation by using SPSS package program (ver. 10.0). RESULTS: The swimming training significantly decreased body weight, and increased spleen index, the number of lymphocytes and proliferative activity in the presence or absence of Con A and LPS added conditions. For the WRG and CORG, the quantity of ROS from splenocytes was higher than CRG, whereas, ROS by spleen lymphocytes was lower following 90 min acute exercise stress. CONCLUSION: These results suggested that the swimming training not only increases the number of lymphocytes but also increases proliferative activity by splenocytes in vitro.
Animals ; Body Weight ; Exercise ; Heart Rate ; Lymphocytes* ; Mice* ; Oxygen ; Reactive Oxygen Species ; Running ; Spleen* ; Swimming* ; Water

OBJECTIVE: To evaluate the effects of electric cortical stimulation in the experimentally induced focal traumatic brain injury (TBI) rat model on motor recovery and plasticity of the injured brain. METHOD: Twenty male Sprague-Dawley rats were pre-trained on a single pellet reaching task (SPRT) and on a Rotarod task (RRT) for 14 days. Then, the TBI model was induced by a weight drop device (40 g in weight, 25 cm in height) on the dominant motor cortex, and the electrode was implanted over the perilesional cortical surface. All rats were divided into two groups as follows: Electrical stimulation (ES) group with anodal continuous stimulation (50 Hz and 194 micros duration) or Sham-operated control (SOC) group with no electrical stimulation. The rats were trained SPRT and RRT for 14 days for rehabilitation and measured Garcia's neurologic examination. Histopathological and immunostaining evaluations were performed after the experiment. RESULTS: There were no differences in the slice number in the histological analysis. Garcia's neurologic scores & SPRT were significantly increased in the ES group (p<0.05), yet, there was no difference in RRT in both groups. The ES group showed more expression of c-Fos around the brain injured area than the SOC group. CONCLUSION: Electric cortical stimulation with rehabilitation is considered to be one of the trial methods for motor recovery in TBI. However, more studies should be conducted for the TBI model in order to establish better stimulation methods.
Animals ; Brain ; Brain Injuries ; Electric Stimulation ; Electrodes ; Humans ; Male ; Motor Cortex ; Neurologic Examination ; Plastics ; Rats ; Rats, Sprague-Dawley

BACKGROUNDS/AIMS: Identifying pancreatic cancer patients at high risk of early mortality following surgical resection for pancreatic cancer is important to make optimal treatment decisions in multidisciplinary setting. The purpose of this study was to identify the factors related to early mortality in patients who underwent pancreatic resection for pancreatic adenocarcinoma. METHODS: We reviewed our institution's experience with all consecutive patients who underwent pancreatectomy for pancreatic adenocarcinoma from January 2000 to December 2010. One thousand patients were eligible for our study. Fifty-three patients who did not meet the study criteria were excluded. Based on 12 months after surgery, patients were divided into early mortality group or the remaining group. We performed logistic regression analysis to identify predictors of early mortality. RESULTS: Among 947 patients who met our study criteria, 302 (31.9%) early mortality (defined as experiencing death within 12 months after surgery) occurred. Multivariate analysis revealed that patient age and surgery time period were statistically significant predictors of early mortality within six months after surgery. Poorly differentiated tumor and adjuvant chemotherapy were statistically significant predictors of early mortality within 12 months after surgery. Total pancreatectomy and lymphovascular invasion were significant (p<0.05) prognostic factors of early mortality within 6 or 12 months after surgery. CONCLUSIONS: We suggest followings to avoid early mortality after pancreatic resection: patients with multiple risk factors related to early mortality after pancreatectomy should be considered for alternative treatment; patient's general condition and surgical technique improvement are important; and adjuvant therapy should be taken into consideration.
Adenocarcinoma* ; Chemotherapy, Adjuvant ; Humans ; Logistic Models ; Mortality* ; Multivariate Analysis ; Pancreas ; Pancreatectomy ; Pancreatic Neoplasms ; Prognosis ; Risk Factors

PURPOSE: Vascular access failure is the most common reason for hospitalization among hemodialysis (HD) patients. Cilostazol, which has antiplatelet action and vasodialtory effects, significantly reduces the risk of restenosis after percutaneous coronary intervention in many patients. We conducted this study to evaluate the relationship between the use of antiplatelet agents, especially cilostazol, and arteriovenous fistula (AVF) patency in HD patients. METHODS: A total of 241 patients underwent native AVF creation from January 2001 to December 2008. Among these patients, we selected 86 patients excluding 38 patients (15.8%) with primary technical failure, 49 patients without complete data and 68 patients used cilostazol less than 1 month. Demographic characteristics, medication history and fistula failure rate were collected and analyzed to elucidate the effect of cilostazol to native AVF. RESULTS: From all groups, AVF failure occurred in 24 patients (27.9%). 28 patients received cilostazol (62.3 %) and mean duration of cilostazol therapy was 229.5+/-115.7 days. All patients were classified into two groups according to cilostazol (Cilostazol [n=28, 32.6%] vs. non-Cilostazol [n=58, 67.4%]. There was no statisticallly significant difference in failure rate between the two groups (32.1% vs. 25.9%, p=0.543). In diabetes group, patients who received statin have much lower AVF failure rate (0% vs. 32.4%, p=0.024). Logistic regression analysis showed that female was independent risk factor for access failure (HR 5.549, CI 1.104-27.877, p=0.037). CONCLUSION: Cilostazol and other antiplatelet agent had a no significant association with AVF patency. Female was an independent risk factor for access failure.
Arteriovenous Fistula ; Female ; Fistula ; Hospitalization ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Logistic Models ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors ; Renal Dialysis ; Risk Factors ; Tetrazoles ; Vascular Patency

The effect of lidocaine on the neuromuscular junction and the interaction between lidocaine and the muscle relaxant, succinylcholine(SCC) or vecuronium(VEC), were investigated in 12 cats of either sex using the sciatic nerve-anterior tibialis muscle preparation. The degree of twitch depression with lidocaine itself was 16.43+/-14.94%, and the ED from dose-response curves of SCC and VEC(8.35+/-4.62 and 6.36+/-8.03 ug/kg, respectively) in group II (under lidocaine infusion) were smaller than those(20.57+/-15.80 and 8.98+/-7.31 ug/kg) in group I (without lidocaine). There was no difference in the duration of action of SCC and VEC between the two groups, but the onset of VEC in group II was longer than in group I(p<0.05), The mean arterial pressure(MAP) after lidocaine infusion was reduced 149.17 to 130.83mmHg and MAPs at the same dose of each agent were also lower in group II than in group L The authors conclude that lidocaine itself produces the twitch depression and potentiates the SCC-or VEC-induced neuromuscular block. However, there is no influence on the duration of SCC or VEC.
Animals ; Cats* ; Depression ; Drug Interactions ; Lidocaine* ; Neuromuscular Blockade* ; Neuromuscular Junction ; Succinylcholine* ; Vecuronium Bromide*

No abstract available.
Adult* ; Fistula* ; Humans

In the present study, we evaluated the effect of CGM on osteogenic differentiation of cultured osteoblasts, and determined whether combination treatment with LLLT had synergistic effects on osteogenic differentiation. The results indicated that CGM promoted proliferation, differentiation, and mineralization of osteoblasts at the threshold concentration of 10 µg/ml; whereas, CGM showed cytotoxic properties at concentrations above 100 µg/ml. ALP activity and mineralization were increased at concentrations above 10 µg/ml. CGM in concentrations up to 10 µg/ml also increased the expression of osteoblast-activated factors including type I collagen, BMP-2, RUNX2, and Osterix. The CGM (50 µg/ml) and LLLT (80 mW for 15 sec) combination treatment group showed the highest proliferation levels, ALP activity, and mineralization ratios. The combination treatment also increased the levels of phosphorylated forms of p38, ATF2, PKD, ERK, and JNK. In addition, the osteoblast differentiation factors including type I collagen, BMP-2, RUNX2, and Osterix protein levels were clearly increased in the combination treatment group. These results suggested that the combination treatment of CGM and LLLT has synergistic effects on the differentiation and mineralization of osteoblastic cells.
Collagen Type I ; Gingiva* ; Low-Level Light Therapy* ; Miners ; Osteoblasts*