PURPOSE: Cerebral contusion is often associated with delayed edema, ischemia, demyelination, and secondary impairment in the neurological function. Early prediction of the outcome for patients with diverse critical illnesses has long been a concern of intensive care unit physicians. Recently, the systemic release of host-derived inflammatory mediators has been used for prognosis assessment in patients with multiple infections, burn injury, and systemic infection. Experimental investigations have revealed the importance of free radicals and calcium currents in cellular damage. Also experimental injuries have caused an early production of cytokines. This study was undertaken to analyze the production of interleukin-6 in the brain and in plasma following a brain contusion. METHODS: Sixty male Sprague-Dawley (SD) rats, each weighing 300-350 g were used in an experimental group following brain contusion, and 18 SD rats were used as a control group following a sham operation. Intracerebral IL-6 and plasma IL-6 were measured by using the ELISA method with a rat IL-6 kit at 3, 6, 24, 48, and 72 hours after the brain contusion. After contusion, the brains were fixed by perfusion via the carotid artery with 40% formaldehyde, glacial acetic acid, and 100% ethanol (1:1:8) at a flow rate of 25 ml/min and stained with hematoxylin and eosin for histologic examination. RESULTS: Brain IL-6 levels increased to reach a maximum of 160.23 pg/ml, at 6 hour after brain trauma. Plasma IL-6 levels increased to 70.02 pg/ml at 3 hour following brain contusion. CONCLUSION: The elevated brain IL-6 level in the injured rat does not seem to reflect a systemic inflammation. Although plasma IL-6 is detected in the sham-operated and the traumatized rats, the levels are too low to account for the increase observed in the brain cortex. This finding shows that the increase in brain IL-6 is related to the dynamics of brain contusion.
Acetic Acid ; Animals ; Brain Injuries* ; Brain* ; Burns ; Calcium ; Carotid Arteries ; Contusions ; Critical Illness ; Cytokines ; Demyelinating Diseases ; Edema ; Enzyme-Linked Immunosorbent Assay ; Eosine Yellowish-(YS) ; Ethanol ; Formaldehyde ; Free Radicals ; Hematoxylin ; Humans ; Inflammation ; Intensive Care Units ; Interleukin-6* ; Ischemia ; Male ; Perfusion ; Plasma ; Prognosis ; Rats* ; Rats, Sprague-Dawley

For many years chemonucleolysis has been proven effective in the curative treatment of lumbar disc herniation. However, this technique is seldom popular in the herniated cervical disc. For several years microsurgery of the cervical disc has been effective in the treatment of refractory cervicobrachial neuralgia. To compete with this method which has been familiar to neurosurgeons, cervical nucleolysis using chymopapain for 1 year. Twenty two pateints(75%) had excellent outcomes, 5 pateints(15%) considered good while 3 sustained their symptom, but showed decreased intensity. The decision to intervene is made when the radiculagia is recurrent or resistant to medical treatment of several weeks duration, without myelopathy or bony abnormalities such as spondylosis or canal stenosis. The principal advantages of this method are : short stay in the hospital(3 days to 5 days on average), absence of general anesthesia, prompt resumption of previous activities, and long-term preservation of an intervertebral space. As a result, cervical nucleolysis has been shown to be an effective alternative to surgery for cervical soft disc herniations with refractory radicualgia.
Anesthesia, General ; Brachial Plexus Neuritis ; Chymopapain ; Constriction, Pathologic ; Intervertebral Disc Chemolysis* ; Microsurgery ; Spinal Cord Diseases ; Spondylosis

No abstract available.
Animals ; Astrocytes* ; Interleukin-1* ; Interleukin-10* ; Interleukin-12* ; Interleukin-1beta* ; Interleukin-2* ; Interleukin-6* ; Melanoma* ; Mice* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma*

This study was conducted to figure out the prevalence of symptomatic peripheral arterial disease among teachers. The data used in the analysis were based on 831 questionnaires, filled out by elementary, middle and high school teachers in Taegu, between September 5, 1994 and October, 4 in 1994. The prevalence of symptomatic peripheral arterial disease was 1.7% among teachers, 1.2% for definite claudication, 0.5% for atypical claudication, 1.7% for serious illness grade I, and 0% for the walk pain grade II. The prevalence was 1.9% for the male and 1.4% for the female. The prevalence by age group was 1.3% for less than 39, 1.6% for the forties, and 2.9% for the over fifties. The results shows that the prevalence increases as the age. The prevalence was 1.8% for the smoking group, 1.6% for the non-smoking group, 2.0% for the alcohol drinking group, and 1.5% for the non-alcohol drinking group. The prevalence for the lean group based on Body Mass Index(BMI) was 1.3%, 1.8% for the normal group, 2.1% for the obese group, 2.2% for the behavior pattern A, and 1.4% for the behavior pattern B. This study shows that the peripheral arterial disease may be considered as an important health problem among teachers.
Alcohol Drinking ; Daegu ; Drinking ; Female ; Humans ; Male ; Peripheral Arterial Disease* ; Prevalence* ; Questionnaires ; Smoke ; Smoking

In this study, the distribution and reisolation of Mycoplasma pneumoniae(Mp) were observed from the various tissues of BALB/c mice which were intraperitoneally pre-inoculated with Mp. In addition, the effect of Mp on the growth, phagocytic activities and nitric oxide production of microglial cells were also examined. The results were as follows; 1) Mp was reisolated from the various tissues such as lymph node, spleen, liver, kidney, brain and blood from one hour through 48 hours after intra-peritoneal inoculation of Mp in mice by the cultural method. Furthermore, it could also be confirmed from those tissues up to 72 hours by the indirect immunofluorescent antibody method. 2) There was no difference in the phagocytic activities between the control microglial cells and Mp stimulated microglial cells. 3) The growth of microglial cells in the medium was significantly increased by the stimulation with Mp compared with that of the control. 4) Nitric oxide production of mouse microglial cells was increased by the combined treatment if IFN-r and LPS or IFN-r and Mp or IFN-r, LPS and Mp, whereas, no increase was observed by either LPS or Mp alone. 5) Nitric oxide production of microglial cells primed with IFN-r was closely related with the dose of LPS and Mp in the dose dependent manner rather than that of the IFN-r. These results suggest that; i) Mp spreads to the various tissues of mice within one hour after intraperitoneal inoculation, ii) the growth of microglial cells increases by the infection of Mp, iii) microglial cells have phagocytic activities to C.albicans and iv) nitric oxide production of microglial cells was augmented by the infection of Mp. Increased nitric oxide production of microglial cells is regarded as an increase of the intracellular bactericidal activiteis of microglial cells. It is suggested, nonetheless, that the inflammatory response of the Mp infected tissues is augmented by the increase of nitric oxide.
Animals ; Brain ; Kidney ; Liver ; Lymph Nodes ; Mice* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Nitric Oxide* ; Pneumonia, Mycoplasma* ; Spleen

The authors report a case of giant-cell tumor of the right middle cranial fossa floor a 43-year-old man. His presentation, characteristic magnetic resonance image findings, treatment, and 2-year follow-up result are described. The patient about this rare neoplasm of the skull base are also reviewed.
Adult ; Cranial Fossa, Middle* ; Follow-Up Studies ; Humans ; Skull Base

Subarachnoid hemorrhage (SAH) induces an inflammatory reaction and may lead to ischemic brain damage. The pathogenesis of brain dysfunction and delayed ischemic symptoms remain difficult to understand despite extensive surveys of such reactions. Cytokine production in the central nervous system following SAH and its relation with clinical outcome have hardly been studied. This study was aimed to determine whether the levels of IL-1 beta, IL-6 and TNF-alpha in the initial cerebrospinal fluid would increase following aneurysmal SAH, and be related with development of delayed ischemic deficit and clinical outcome. Nineteen patients suffering from aneurysmal SAH and 12 control volunteers were the subjects in this study. Cerebrospinal fluid samples were obtained on admission and the levels of each cytokine were determined with enzyme-linked immunosorbent assay. Patients with aneurysmal subarachnoid hemorrhage showed elevated levels of IL-1 beta, and TNF-alpha on admission. The patients with poor neurological status showed high levels of IL-1 beta, and IL-6. The patients who developed delayed ischemic deficit had high level of IL-6. We suggest that elevated level of IL-6 in cerebrospinal fluid of patients with aneurysmal SAH on admission can predict the high risk of delayed ischemic deficit.
Adult ; Aged ; Brain Ischemia/*cerebrospinal fluid/*diagnosis/immunology ; Cytokines/*cerebrospinal fluid ; Female ; Glasgow Outcome Scale ; Human ; Interleukin-1/cerebrospinal fluid ; Interleukin-6/cerebrospinal fluid ; Male ; Middle Age ; Predictive Value of Tests ; Subarachnoid Hemorrhage/*cerebrospinal fluid/*diagnosis/immunology ; Tumor Necrosis Factor/cerebrospinal fluid

OBJECTIVE: Two-staged endoscopic endonasal transsphenoidal approach(TSA) has not been reported for the satisfactory removal of large pituitary adenomas with suprasellar extension. This study is aimed to determine whether deliberate two-staged endoscopic endonasal TSA would be effective for the treatment of large pituitary adenomas with suprasellar extensions. METHODS: Since 1998, we have started endonasal endoscopic TSA, so encountered 12 patients of large pituitary adenomas with suprasellar extension in which deliberate two-staged removal was carried out. The extent of tumor removal, improvement of eye symptoms and endocrine functions after staged operation were analyzed retrospectively. RESULTS: Among the 12 patients with large pituitary adenomas, five had prolactinomas; four growth hormone secreting adenomas; three nonfunctioning tumors. The interval between the two surgical procedures ranged from three weeks to 14 weeks(mean 8.4 weeks). Of 12 patients treated by deliberate two-staged endonasal endoscopic TSA, 38.8%(7/18 eyes) recovered normal visual acuity; improvement was noted in another 55.6%(10/18 eyes). The visual fields were corrected in 88%(15/17 eyes). In these large tumors, 58.3%(7/12 patients) was removed totally, 25%(3/12 patients) subtotally, 16.7%(2/12 patients) partially. Endocrine outcome of 9 hypersecretory adenomas was relatively good. There were no significant complications. CONCLUSION: The authors conclude that the patients who have large pituitary adenomas with suprasellar extension are good candidates for deliberate two-staged endoscopic endonasal transsphenoidal surgery, which maximize tumor removal and improvement of eye symptoms, minimize complication and morbidity.
Adenoma ; Growth Hormone ; Humans ; Pituitary Neoplasms* ; Prolactinoma ; Retrospective Studies ; Visual Acuity ; Visual Fields

OBJECTIVE: This study is aimed to evaluate the effect of chondroitinase ABC on normal rabbit lumbar discs. MATERIALS AND METHODS: A series of intradiscal injections of chondroitinase ABC was performed in 9 young adult rabbits. A control series of intradiscal injections of iodine contrast medium was performed in 6 young adult rabbits. Roentgenograms were taken preoperatively and were repeated at one, three, five, seven days after injection of chondroitinase ABC. Roentgenograms also were taken preoperatiely and at seven days after injection of contrast dye. Magnetic resonance imagings(MRI) scan was performed pre-operatively and at seven days after injection. Light microscopic examination of both groups was done at 7 days postinjection. RESULTS: Roentgenographic evidence of disc space narrowing showed significant correlation with time course in the series of intradiscal injections of chondroitinase ABC compared with the control series. T2 weighted MRI of disc space demonstrated significantly decreased signal intensity in the series of intradiscal injections of chondroitinase ABC at seven days after injection, as compared with the control series. Histologic evaluation revealed the stainability of nucleus pulposus and annulus to toluidine blue which was quite decreased. The cytoplasm of notochordal cells of nucleus pulposus appeared to be shrunken, and the large cytoplasmic vacuoles in hematoxylin-eosin stain were decreased in the series of intradiscal injections of chondroitinase ABC, which were not evident in the control series. CONCLUSION: Intradiscal injections of chondroitinase ABC on normal rabbit lumbar disc proven to have chemonucleolytic effects.
Chondroitin ABC Lyase* ; Cytoplasm ; Humans ; Intervertebral Disc Chemolysis* ; Iodine ; Magnetic Resonance Imaging ; Notochord ; Rabbits ; Tolonium Chloride ; Vacuoles ; Young Adult

OBJECTIVE: This study is aimed to evaluate the chemonucleolytic effect of medical ozone by investigating the change of the signal intensity on magnetic resonance imaging (MRI) scan after injection of medical ozone into the lumbar intervertebral disc of the rabbit. METHODS: A series of 21 intradiscal injections of 1ml of medical ozone(30microgram of ozone per ml of oxygen) was performed in 7 young adult rabbits. Two control series, which 20 intradiscal injections of 0.1ml of iodine contrast medium in 7 young adult rabbits and 21 intradiscal injections of 0.05ml of chymopapain in 7 young adult rabbits, were performed. T2 weighted MRI scan was performed pre-operatively and at 4 weeks after injection. RESULTS: T2-weighted MRI scan of intervertebral disc spaces demonstrated significantly decreased signal intensities in the series (n=21) of intradiscal injections of medical ozone at 4 weeks after injection, as compared with the control series of intradiscal injections of 0.1ml of iodine contrast medium. T2-weighted MRI scan of intervertebral disc spaces demonstrated significantly decreased signal intensities in the series(n=21) of intradiscal injections of chymopapain at 4 weeks after injection. Any neurologic deficit or complication was not found in all groups. CONCLUSION: Intradiscal injections of medical ozone into the lumbar intervertebral disc of the rabbits are proven to have chemonucleolytic effects.
Chymopapain ; Humans ; Intervertebral Disc Chemolysis* ; Intervertebral Disc* ; Iodine ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Ozone* ; Rabbits ; Young Adult