No abstract available.
Doxycycline*

A 40-year-old man attended our hospital with presenting symptoms of an acutely swollen, tender testicle and bulging mass on the inguinal area. Considered it as urgent conditions no demonstrating blood flow to the involved testicle on Color Doppler ultrasonography, we underwent scrotal exploration right away. On operative finding the right testis was so enlarged and engorged secondarily to the irreversible ischemic damage, but torsion of spermatic cord was not found. Another inguinal approach revealed herniated mass protruding from internal inguinal ring and compressing the spermatic cord. For further evaluation abdominal ultrasonography and CT scan was done and huge mass occupying right lower quadrant of abdomen and pelvic cavity was noted. The resected tumor through surgical exploration was proved to be a retroperitoneal liposarcoma pathologically. Herein we report an uncommon case of testicular infarct, mimicking torsion of spermatic cord that is a urological emergency, caused by herniated retroperitoneal mass. So the present report suggest that, when adult men attend with symptoms of acutely swollen painful testicle, we pay a more careful attention to patient,s physical findings and recommend further diagnostic evaluation.
Abdomen ; Adult ; Emergencies ; Humans ; Inguinal Canal* ; Liposarcoma* ; Male ; Spermatic Cord ; Testis ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasonography, Doppler, Color

Buerger's disease was first identified in 1908 by Leo Buerger as a distinct clinicopathological entity, which causes severe pain and necrosis on distal parts of the extremities and occurs especially in young male adults. In spite of many treatment modalities, it is not completely cured but results in amputation in the long run. So, we studied a total of 120 cases of Buerger's disease, who were admitted at Yonsei University, Severance Hospital from Jan., 1975 to June, 1985 and we obtained the following results. 1. All the patients were male and majority of them were under 40 years of age (69.2%). 2. 118 cases were smokers and 2 cases were non-smokers. 3. The initial symptoms were resting pain, necrosis, and color change in descending order of frequency. 4. Diagnoses were made mainly by angiogram(75.8%) and most common site of obstruction was popliteal artery (49.4%). 5. After sympathectomy and angioplasty, there was temporary relief of symptoms, but none showed good results after long term follow up. As a result, amputations were performed after sympathectomy in 47 cases(39.2%), of which 36 cases(76.6%) received that surgery within 2 yeas after sympathectomy. 6. The pressure index not only helps diagnose the disease but also is a very useful method to objectively assess the severity of the initial symptoms and postoperative results.
Adult ; Amputation ; Angioplasty ; Clinical Study ; Diagnosis ; Extremities ; Follow-Up Studies ; Humans ; Male ; Methods ; Necrosis ; Popliteal Artery ; Sympathectomy ; Thromboangiitis Obliterans

This report describes rodents in a laboratory animal facility that was adversely affected by a noisy environment during construction work. There was much noise and vibration as well as dust caused by the drilling and hammering. The noise levels, frequencies, and length of time when occurring in the drilling and hammering, were all measured. The drilling showed noise levels ranging from 50-90 decibels (dB) (A-filter, A), and the hammering presented 60-70 dB (A). Some researchers raised problems regarding animal experiments, including skin injuries resulted from self-mutilation, and increase of mortality. This gives useful information to people who plan to renovate laboratory animal facilities as it is a very rare case.
Animal Experimentation ; Animal Welfare ; Animals ; Animals, Laboratory ; Dust ; Mandrillus ; Mice ; Noise ; Rats ; Rodentia ; Skin ; Vibration

We report distinctive diffusion-weighted magnetic resonance image (DWI) findings in a 65-year-old man with clinically diagnosed Creutzfeldt-Jakob disease (CJD). Four weeks before admission he developed general weakness and febrile sense which were followed by progressive dementia, ataxia, and choreo-athetoid movement of the right hand. T2-weighted magnetic resonance image (MRI) showed subtle high signal intensities only in the left basal ganglia, whereas DWI demonstrated marked hyperintensities in multiple regions including the left basal ganglia and left cerebral cortex. Five weeks after the onset of symptoms, he was noted to have myoclonus and characteristic electroencephalographic changes consisting of periodic triphasic sharp waves. In our patient, high signal changes on the DWI preceded myoclonus and typical EEG findings, a result suggesting that DWI may be useful in the early premortem diagnosis of CJD.
Aged ; Ataxia ; Basal Ganglia ; Cerebral Cortex ; Creutzfeldt-Jakob Syndrome* ; Dementia ; Diagnosis ; Electroencephalography ; Hand ; Humans ; Myoclonus

PURPOSE: Thallium behaves similarly to potassium in vivo. Potassium channel opener (K-opener) opens ATP-sensitive K+/-channel located at cell membrane, resulting in potassium efflux from cytosol. We have previously reported that K-opener can alter biokinetics of Tl-201 in cultured cells and in vivo. Malignant tumor cells have high Na-K ATPase activity due to increased metabolic activities and dedifferentiation, and differential delineation of malignant tumor can be possible with Tl-201 imaging. K-opener may affect tumoral uptake of Tl-201 in vivo. To investigate the effects of pinacidil (one of the potent K-openers) on the localization of the tumor with Tl-201 chloride, we evaluated the changes in biodistribution of Tl-201 with pinacidil treatment in tumor-bearing mice. MATERAL AND METHODS: Balb/c mice received subcutaneous implantation of murine breast cancer cells in the thigh and were used for biodistribution study 3 weeks later. 100 microgram of pinacidil dissolved in 200 microliter DMSO/PBS solution was injected intravenously via tail vein at 10 min after 185 KBq (5 microcurie) Tl-201 injection. Percentage organ uptake and whole body retention ratio of Tl-201 were measured at various periods after injection, and values were compared between control and pinacidil-treated mice. RESULTS: Pinacidil treatment resulted in mild decrease in blood levels of Tl-201, but renal uptakes were markedly decreased at 30-min, 1- and 2-hour, compared to control group. Hepatic, intestinal and muscular uptake were not different. Absolute percentage uptake and tumor to blood ratios of Tl-201 were lower in pinacidil treated mice than in the control group at all time points measured. Whole body retention ratio of Tl-201 was lower in pinacidil treated mice (58+/-4%), than in the control group (67+/-3%) at 24 hours after with injection of 100 microgram pinacidil. CONCLUSION: K-opener did not enhance, but rather decreased absolute tumoral uptake and tumor-to-blood ratios of Tl-201. Decreased whole body retention ratio and renal uptake were observed with pinacidil treatment in tumor-bearing mice.
Adenosine Triphosphatases ; Animals ; Breast Neoplasms ; Cell Membrane ; Cells, Cultured ; Cytosol ; Mice* ; Pinacidil* ; Potassium ; Potassium Channels ; Thallium ; Thigh ; Veins

BACKGROUND: There is considerable controversy about the exact molecular mechanisms of excitatory amino acid receptors in epileptogenesis. METHODS: We used in situ hybridization to examine the hybridization density (HD) of n-methyl- D-aspartic acid receptor type 1 (NMDAR-1) and alpha-amino-3-hydroxy -5-methyl-4-isoxazole-propionate (AMPA) receptor type 2 (GluR-2) mRNA, in the hippocampus obtained from the kainic acid (KA)-induced status epilep-ticus (SE) model. Some Sprague-Dawley rats were injected with KA (10 mg/Kg; I.p.), and others with MK-801 (4 mg/kg) 20 minutes prior to KA. The rats were allowed to have 4-hour SE and were killed at 8 hours or 4 weeks after KA or MK-801/KA injection. HD of NMDAR-1 and GluR-2 mRNA in subfields of the hippocampus was measured by an image analysis system. RESULTS: A typical neuropathological finding of hippocampal sclerosis and spontaneous repetitive seizures (SRS) were observed in the KA injected rats, but not in the MK-801 pretreated rats, killed at 4 weeks. Compared with controls, the rats killed at 8 hours after KA showed increased CA1, CA2, and CA3 NMDAR-1 HD, and stratum granulosum (SG) GluR-2 HD. The increase of NMDAR-1, not GluR-2, HD was blocked effectively by MK-801. The increase of SG GluR-2 HD remained until 4 weeks after the KA injection. CONCLUSIONS: Not only the NMDAR-1activa-tionbut also the GluR-2 activation is an important factor in delaying hippocampal neuronal loss and epileptogenesis. (J Korean Neurol Assoc 19(1):36~44, 2001
alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; D-Aspartic Acid ; Dizocilpine Maleate ; Epilepsy, Temporal Lobe ; Gene Expression* ; Glutamic Acid* ; Hippocampus ; In Situ Hybridization ; Kainic Acid ; N-Methylaspartate ; Neurons ; Rats ; Rats, Sprague-Dawley ; Receptors, Glutamate* ; RNA, Messenger ; Sclerosis ; Seizures ; Temporal Lobe*

Inflammatory myofibroblastic tumor (IMT) of the urinary bladder is an uncommon disease in young patients that presents with gross hematuria. However, IMT should be cautiously diagnosed because of its similarities with malignant spindle cell sarcoma. In this case, the tumor was successfully removed by transurethral resection of the bladder tumor and a final diagnosis of IMT was established conclusively.

BACKGROUND: The conventional management of the symptomatic stenosis of intracranial artery is the administration of antithrombotic agents while controlling the vascular risk factors. Despite medical therapy, the stroke risk for patients with intracranial artery stenosis remains high. Recently, balloon angioplasty with or without stent placement has emerged as a potential therapeutic option. This study was aimed to assess the efficacy, safety and clinical outcome of balloon angioplasty without stent placement for patients with symptomatic middle cerebral artery (MCA) stenosis. METHODS: Between February 1996 and December 2004, 41 cases (40 consecutive patients) with symptomatic MCA stenosis greater than 50% were treated with balloon angioplasty. Patient records were retrospectively reviewed for angiographic findings, periprocedural complications, and long-term outcome. RESULTS: Mean stenosis rate (75.4%) was significantly reduced after the procedure (26.6%). The procedure revealed that 4 of the 41 (9.7%) patients developed major related complications (one death and 3 minor strokes). Other minor related complications were also observed in 7 patients, which included 3 transient neurological deficits, 3 asymptomatic dissections and 1 asymptomatic petechial hemorrhage. During the follow-up period (2-108 months), none of the patients developed ischemic stroke in the territory of treated MCA, however one patient developed TIA at the 12 month after angioplasty. CONCLUSIONS: Angioplasty without stent placement is technically feasible, safe and effective in the patients with symptomatic MCA stenosis.
Angioplasty ; Angioplasty, Balloon* ; Arteries ; Constriction, Pathologic* ; Fibrinolytic Agents ; Follow-Up Studies ; Hemorrhage ; Humans ; Middle Cerebral Artery* ; Retrospective Studies ; Risk Factors ; Stents ; Stroke

BACKGROUND AND PURPOSE: Percutaneous transluminal angioplasty (PTA) is being increasingly used in the treatment of symptomatic middle cerebral artery (MCA) stenosis. We evaluated the long-term durability after PTA for symptomatic MCA stenosis. METHODS: We analyzed consecutive patients included in our stroke database who were treated with angioplasty alone. The subjects without major periprocedural complications were followed up for at least 42 months. Recurrent ischemic symptoms were defined as newly developed episodes of transient ischemic attack or ischemic stroke in the territory of the treated vessel. Stroke was defined as ischemic stroke in any vessel. RESULTS: PTA was technically successful in 37 of the 40 included patients. Thirty-two of the 37 patients were followed up at regular intervals of 1 to 6 months in the outpatient clinic of our institution for at least 42 months. Restenosis occurred in 3 of the 32 patients (9.4%) within 2 years of PTA, and no restenosis was identified thereafter. Two of the three patients with restenosis had asymptomatic complications such as dissection and vasospasm during the intervention. The ischemic area was in the treated vessel in 1 of the 32 patients and in other vessels in 3 of the 32 patients (9.4%). CONCLUSIONS: Successful PTA can result in a low rate of recurrent ischemic symptoms, and restenosis during a long-term follow-up appears to be more frequent in the early period.
Ambulatory Care Facilities ; Angioplasty ; Constriction, Pathologic ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Ischemic Attack, Transient ; Middle Cerebral Artery ; Stroke