Apodemus agrarius has been using for experimental purpose to identifying the route of infection and pathogenesis of korean hemorrhagic fever. However, despite the increasing amount of information being published at present about the physiologic and ecologic characteristics of Apodemus, few data are availalle about the morphologic findings in the brain. The NADPH-diaphorase[NADPH-d] positive neurons, uniquely resistant to toxic insults and neurodegenerative diseases, have been colocalized with neurons in the brain and peripheral tissue containing nitric oxide synthase, which generates nitric oxide, a recently identified neuronal messenger molecule. In this study we used NADPH-d histochemistry to evaluate the distribution of neuropeptide Y-immunoreactive[NPY-IR] cells within neurons which contain nitric oxide synthase. In the cerebral cortex of Apodemus agrarius, NADPH-d positive and NPY-IR neurons were observed in all cortical layers, but they were concentrated in two bands layer II/III and V/VI extending into the subcortical white matter. Double labeling for NADPH-d and NPY showed colocalization of NPY with NADPH-d in numerous neurons of the cerebral cortex. The data obtained showed that about 74-79% of NPY-IR neurons contained NADPH-d in the neocortex and that 77-89% in the allocortex. The number of NPY-IR/NADPH-d positive neurons was about 10-13 per unit area [2,500,000 micrometer] in the neocortex and about 11-25 in the allocortex except retrosplenial cortex. In the retrosplenial cortex, the number of double labeled neurons was about 5 per unit area. NPY-IR and NADPH-d positive neurons were predominantly medium-sized with extended, multipolar or bipolar dendritic branches which belong to fusiform or stellate cell types. A moderately dense network of fine, varicose NADPH-d positive fibers was present throughout all cortical layers.
Animals ; Brain ; Cerebral Cortex* ; Hemorrhagic Fever with Renal Syndrome ; Murinae* ; Neocortex ; Neurodegenerative Diseases ; Neurons* ; Neuropeptide Y* ; Neuropeptides* ; Nitric Oxide ; Nitric Oxide Synthase

Double outlet right ventricle, a complex of congenital cardiac anomalies in which both great arteries arise wholly or in large part from the morphologic right ventricle presents diverse clinical manifestations according to the morphological characteristics. Eighty cases with DORV were diagnosed and operated at Yonsei Cardiovascular Center from 1988 to 1992. The analysis of the morphological characteristics of this anomaly and comparative study of operative methods and mortality according to the morphological classification led to the following results: 1) The location of VSD varied to be subaortic in 40 cases, subpulmonic in 15, doubly committed in 6 and noncommitted in 19 cases. The great arteries were interrelated in D-malposition in 43 cases and L-malposition in 18 and 26 cases among above mentioned 61 cases revealed the side-by-side relationship. Ten of the cases showed normal position and the rest 9, A-malposition. 2) Pulmonary stenosis was found in 60 cases, and when associated with subpulmonic VSD, occurring less frequently. PDA and ASD secundum were associated in successional order and only 3 cases were verified to carry aortic arch anomalies such as coarctation and interruption, all with subpulmonic VSD. 3) Intraventricular tunnel repair was possible in every case associated with subaortic VSD and the postoperative prognosis was excellent. In comparison, most of the cases associated with other types of VSD in which only palliative surgery or various types of intraventricular repair were performed, the general outcome was poor. But total cavopulmonary connection, one of the physiological corrective methods, showing a better postoperative prognosis is being carefully considered for its broad adoptation in future. In conclusion, double outlet right ventricle, a pathophysiological complex of various anomalies, should be thoroughly evaluated for the morphological characteristics to decide the most appropriate types of operation and for consequent improvement of prognosis.
Aorta, Thoracic ; Arteries ; Classification ; Double Outlet Right Ventricle* ; Heart Ventricles ; Mortality ; Palliative Care ; Prognosis ; Pulmonary Valve Stenosis

One of the treatment options for edentulous state patients with residual ridge resorption is implant overdenture using milled bar and attachment. It not only provides improved retention and stability but can also reduce the coverage of palatal surface. In addition, when a small number of implants are used, milled bar has the effect of being splinted between implant fixtures, which makes it mechanically advantageous under functions such as mastication. The patient in this case was a maxillary edentulous state patient with a considerable amount of residual alveolar bone resorption after removing the existing failed implants. Three implants were planted on both sides and an implant overdenture was fabricated using milled bar and ADD-TOC attachment.

Excessive crown height space increases can cause crestal bone loss and screw loosening after prosthesis is placed. Milled bar and implant overdenture can be used as a treatment method for partially edentulous patients who have severe alveolar bone loss and excessive crown height space. Milled bar can provide primary splinting effect and stability between implants. Also, milled bar with additional retention device such as Advanced Dental Device-Treatment Of Choice (ADD-TOC) and magnet can provide additional retention force for implant overdenture. In this case, the patient has a partially edentulous mandible that has severe alveolar bone loss and multiple number of teeth loss after excision due to leiomyosarcoma. Because of the long-term loss of mandibular molars, the opposing teeth were extruded. Maxillary left molars were corrected to the occlusal plane through molar intrusion, and mandibular left molar region were treated with implant overdenture, using milled bar with ADD-TOC and magnet after implant placement. The clinical result was satisfactory on the aspect of esthetic and masticatory function.

The Bentall-DeBono operation is the technique of choice for aortic root replacement. When the patients have contraindications for lifelong anticoagulation, the biologic Bentall operation may be a good option. However, complex reoperation may be required when bioprosthetic degeneration occurs. For this reason, a new technique for simple reoperation after the Bentall operation has recently been performed by some surgeons. We performed a similar technique in two patients with aortic root dilation and for whom aortic valve sparing techniques could not be performed because of an unrepairable valve contour, we think this modification seems to be simple and reproducible for reoperation.
Aneurysm ; Aorta ; Aortic Valve ; Bioprosthesis ; Cardiovascular Diseases ; Humans ; Reoperation

An abnormal course of carotid artery may surprise surgeons during surgery and result in an transient ischemic attack or other ischemic symptoms. We report an unusual case of kinking in the common carotid artery located below the right thyroid lobe, which was found during a total thyroidectomy in a 74-years old patient. We emphasize in this case how important it is to palpate the neck before surgeries such as tracheostomy, thyroid surgery and so on.
Carotid Arteries ; Carotid Artery, Common ; Humans ; Ischemic Attack, Transient ; Neck ; Thyroid Gland ; Thyroidectomy ; Tracheostomy

BACKGROUND AND OBJECTIVES: Electrical stimulation is one of various methods of treatment for patients suffering from tinnitus. However, the effect or mechanism of electrical stimulation is still unclear. Also, although the success rate of electrical stimulation ranged from 13% to 80% in other studies, the best condition of electrical stimulation is unknown yet. The purpose of this study is to elucidate the effect of alternate current electrical stimulation at tympanic membrane on tinnitus suppression and to seek the best condition that yield maximum tinnitus reduction. SUBJECTS AND METHOD: Forty-five patients who suffered from tinnitus with moderately severe hearing loss above 56 dB and 20 patients with limited frequency hearing loss above 56 dB were selected for this study. The study was performed in 4 phases. Fourty-five patients who passed the screening phase received 10 min duration of electrical stimulation twice a week for 6 weeks. RESULTS: The results were as follows. 1) Among the 65 patients, alternate current stimulation suppressed tinnitus in 45 patients (69%) in the screening phase. So 45 patients were selected for the electrical stimulation group. 2) Tinnitus suppression was most effective in patients with sudden deafness in the screening phase. 3) Effective tinnitogram for electrical stimulation was white noise and 8 kHz (pure tone) in the screening phase. 4) The most common optimal stimulation was the low frequency square wave. 5) The mean intensity of the current was 47.5 microliterA. 6) Suppression of tinnitus was achieved in 30 patients (67%) among 45 patients who received electrical stimulation therapy. 7) Long term treatment was more effective than short term, but adaptation phenomenon was noted during the treatment phase in 15 patients (33%). CONCLUSION: These results showed that alternate current stimulation for patients with tinnitus is effective and that the optimal condition to use is the low frequency square wave. We found good response to electrical stimulation in patients with sudden deafness and moderate to severe hearing loss. Therefore, we think electrical stimulation is a good treatment for patients with tinnitus for whom it is difficult to apply TRT (tinnitus retraining therapy).
Electric Stimulation Therapy ; Electric Stimulation* ; Hearing Loss ; Hearing Loss, Sudden ; Humans ; Mass Screening ; Noise ; Tinnitus* ; Tympanic Membrane*

No abstract available.
Humans ; Peritonitis*

BACKGROUND: Intraperitoneal(IP) vancomycin has been widely used for the treatment of peritonitis or exit-site infection associated with continuous ambulatory peritoneal dialysis(CAPD). However, some previous reports in the literature have suggested that IP administration of certain vancomycin may be associated with chemical peritonitis in CAPD patients. METHODS: Between 1 February 1994 and 1 February 1997, 35 consecutive CAPD patients requiring treatment with intraperitoneal vancomycin for either exit-site infection or peritonitis in the Yeungnam University Hospital were recruited retrospectively into the study. We compared retrospectively the incidence of chemical peritonitis after using two different preparations of vancomycin from different pharmaceutical companies, namely vancocin CP(R) and vancomycin(R). RESULTS: Thirty-three cases(all 26 cases given vancocin CP(R) and 7 out of the 9 cases given vancomycin(R)) showed improvement. None of them developed fever, abdominal pain or cloudy dialysate. Out of the 9 cases given IP vancomycin(R), two who currently did not have abdominal pain and cloudy dialysis effluent develolped these symptom and sign at 5 and 6 hours after administration of IP vancomycin. The chemical peritonitis may be secondary to prolonged contact of the peritoneal membrane with one or more of the impurities present in vancomycin preparation. CONCLUSION: In summary, it is necessary for the nephrologists to be aware of the possible chemical peritonitis which can be caused by the impurities of certain brand of vancomycin.
Abdominal Pain ; Dialysis ; Fever ; Humans ; Incidence ; Membranes ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Retrospective Studies ; Vancomycin*

BACKGROUND: Many types of tricuspid annuloplasty are used in surgical correction of functional tricuspid regurgitation (FTR). We evaluated the mid-term and long-term outcomes in patients treated with a posterior annular plication technique (a modified Davila technique) for FTR. MATERIAL AND METHOD: Between January 1991 and August 2006, 58 adult patients (male, 22; female, 36) with FTR of grade 2/4 or more or with tricuspid annular dilatation of more than 5.0 cm in diameter, even with an FTR of less than grade 2, had received a posterior annular placation. Preoperatively, 26 patients (44.8%) had a grade 3 or more FTR. All patients had received a mitral valve replacement, and 20 (34.5%) had concomitant aortic valve replacement. RESULT: During the mean follow-up period of 101.4+/-51.6 months, FTR disappeared or remained trivial in 28 patients (49.1%), was grade 2~3 (> or =grade 2 and Adult ; Aortic Valve ; Dilatation ; Female ; Follow-Up Studies ; Humans ; Mitral Valve ; Tricuspid Valve ; Tricuspid Valve Insufficiency