No abstract available.
Humans

Aneurogenic pulmonary edema(NPE) following an aneurysmal subarachnoid hemorrhage(SAH) is a rare but devastating complication. The authors analyzed the clinical characteristics, therapeutic problems and management results from our cases in order to throughly evaluate for future therapeutic guide for such patients. There were seven patients diagnosed as NPE out of 546 patients who were admitted within one day following a SAH(1.3%) during the past 13 years. They were relatively young(average 51.3 years), had poor clinical grades on admission and had large amount of SAH. Hypotension and hypoxia on admission were also characteristics. Good results were obtained in 4 of the 7 patients by rapid correction of hypoxia and hypotension with intubation, mechanical ventilation and with positive end-expiratory pressure, diuretics and hypertensive drugs. We conclude that NPE following SAH may be triggered by an acute rise in intracranial pressure followed by a simultaneous decrease of the function of the heart and lungs. Although the patients had shown fulminant clinical state on admission, we recommend aggressive management of these patients because some of these patients can recover without neurological deficits by an aggressive treatment.
Aneurysm* ; Anoxia ; Diuretics ; Heart ; Humans ; Hypotension ; Intracranial Aneurysm ; Intracranial Pressure ; Intubation ; Lung ; Positive-Pressure Respiration ; Pulmonary Edema* ; Respiration, Artificial ; Subarachnoid Hemorrhage*

In order to find out the effect of blood glucose on the ischemic brain injury, the authors studied the relationship between the blood glucose level and the infarct volume in a focal cerebral ischemia-reperfusion model in a series of 60 adult rats. The experimental animals were divided into 4 groups of 15 rats: rats in group I were allowed free access to food until ischemic insults: rats in group II were fasted for 24 hours prior to ischemic insult: rats in group III were fed but received intraperitoneal injection of 1.7unit/kg of insulin 50 minutes before the onset of ischemia: and rats in group IV were fed and received intraperitoneal injection of 2g/kg of 50% glucose during ischemia. The ischemia was made through unilateral occlusion of the middle cerebral artery(MCA) by inserting a 16mm length of 4-0 nylon surgical thread through the internal carotid artery as well as occlusion of both common carotid arteries(CCA) using nontraumatic aneurysm clips. Reperfusion was induced by pulling the thread that occluded the MCA as well as removing the aneurysm clips from both of the CCAs. Each group was further divided into a(2 hour), b(4 hour), and c(6 hour) subgroups of 5 rats according to the duration of ischemia. All animal were killed 3 hours after reperfusion, and infarct volume determined by triphenyltetrazolium chloride was calculated by a computer image software. The results showed that rats of glucose loaded during ischemia(group IV) developed the highest blood glucose levels during ischemia and post-ischemia and the largest infarct volume among groups. The rats which were fed until ischemic insult(group I) developed higher blood glucose levels and larger infarct volume than those developed in group II and III. The rats of group III developed higher blood glucose levels and larger infarct volume than group II. According to our data, lowering the blood glucose level by fasting or intraperitoneal injection of insulin reduced the infarct volme in model of transient focal cerebral ischemia. These results suggest that maintenance of low level of blood glucose during early phase of cerebral infarction may reduce volume of infarction and neurological sequelae.
Adult ; Aneurysm ; Animals ; Blood Glucose* ; Brain Injuries ; Brain Ischemia ; Carotid Artery, Internal ; Cerebral Infarction ; Fasting ; Glucose ; Humans ; Infarction ; Injections, Intraperitoneal ; Insulin ; Ischemia ; Ischemic Attack, Transient* ; Nylons ; Rats* ; Reperfusion

No abstract available.
Craniocerebral Trauma* ; Head* ; Protons*

BACKGROUND AND OBJECTIVES: Coronary artery stenting actually shows a high efficacy in the treatment of coronary heart disease, but has the major limitation of restenosis. The ethylene-vinyl acetate copolymer (EVA), a biocompatible nondegradable copolymer, has been employed as a rate-controlling membrane in several drug delivery systems. Herein, the feasibility of an EVA-coated coronary stent was evaluated as a possible route for localized drug delivery. MATERIALS AND METHODS: A total of 15 rabbits were employed in this study. An uncoated stent was implanted into the non-diseased iliac artery in six rabbits, and an EVA-coated stent into a further nine. On the 30th day following the stent implantations, stented segments of the iliac arteries were removed for histological processing and morphometric analysis. RESULTS: The mean neointimal area of the uncoated and coated groups were 1.009 and 1.011 mm2 (p=0.56), respectively. No inflammatory cells were found in coated group. There were no apparent differences between the two groups. CONCLUSION: The results from this study have demonstrated that an EVA-coated coronary stent might be an appropriate method for the controlled-release of a drug.
Biological Availability* ; Coronary Disease ; Coronary Vessels ; Drug Delivery Systems ; Iliac Artery* ; Membranes ; Polyvinyls ; Rabbits ; Stents*

Objective: : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods: : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results: : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo- LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669–35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941–41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.

Objective: : Although several commercialized bone cements are used during percutaneous vertebroplasty (PVP) for patients with osteoporotic vertebral compression fracture (OVCF), there are no reports using domestic products from South Korea. In this study, we investigated the safety and efficacy of Spinofill® (Injecta Inc., Gunpo, Korea), a new polymethyl methacrylate product. Methods: : A prospective, single-center, and single-arm clinical trial of 30 participants who underwent PVP using Spinofill® for painful thoracolumbar OVCF was performed with 6-months follow-up. Clinical and surgical outcomes included the Visual analog scale (VAS), Korean-Oswestry disability index (K-ODI), and Odom’s criteria, complication rate, and recurrence rate. Radiological outcomes were evaluated by measuring the findings of postoperative computed tomography and simple radiograph. Results: : The pain of VAS (from 8.95±1.05 to 4.65±2.06, p<0.001) and the life quality based on K-ODI (from 33.95±5.84 to 25.65±4.79, p<0.001) improved significantly, and successful patient satisfaction were achieved in 20 patients (66.7%) 1 day after surgery. These immediate improvements were maintained or more improved during the follow-up. There was no surgery- or product-related complications, but OVCF recurred in two patients (6.7%). Favorable cement interdigitation was reported in 24 patients (80.0%), and extra-vertebral cement leakage was reported in 13 patients (43.0%). The mean vertebral height ratio (from 60.49%±21.97% to 80.07%±13.16%, p<0.001) and segmental kyphotic angle (from 11.46°±8.50° to 7.79°±6.08°, p=0.002) improved one day after surgery. However, these short-term radiological findings somewhat regressed at the end. Conclusion : The overall outcomes of PVP using Spinofill® were as favorable as those of other conventionally used products.

No abstract available.
Biopsy* ; Brain* ; Protons*

BACKGROUND: Propofol decreases arterial blood pressure. This has been ascribed to vasodilation and decreased cardiac output occurring separately or in combination. This study investigated the relaxant effects of propofol and the effects of L-arginine and L-NAME on the vasodilation of propofol in rat thoracic aortic rings. METHODS: Isolated aortic rings were precontracted with phenylephrine (0.01 micrometer -10 micrometer) cumulatively and 10 minutes before the precontracted phenylephrine treatment, propofol was added cumulatively (1 micrometer-10 micrometer). The effects of L-NAME and L-arginine were evaluated by applying L-NAME (10 micrometer) and L-arginine (10 micrometer) after added propofol and before precontracted phenylephrine. RESULTS: A low concentration of propofol (1 micrometer) did not reduce phenylephrine-induced contraction but a high concentration of propofol (over 10 micrometer) reduced it significantly. Propofol also relaxed rat thoracic aortic rings in an endothelium independent manner. The L-NAME and L-arginine treatment did not affect the propofol-induced relaxation. CONCLUSIONS: Propofol was shown to have a biphasic vasoactive effect on rat thoracic aorta rings. The vasodilation effect of propofol was not related to the production of nitric oxide.
Animals ; Aorta, Thoracic ; Arginine* ; Arterial Pressure ; Cardiac Output ; Endothelium ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Phenylephrine ; Propofol* ; Rats* ; Relaxation ; Vasodilation*

The elevated level of circulating estradiol increases the risk of breast tumor development. To gain further insight into mechanisms involved in their actions, we investigated the molecular mechanisms of 4-hydroxyestradiol (4-OHE2) to initiate and/or promote abnormal cell growth, and of alpha- or gamma-tocopherol to inhibit this process. MCF-10A, human breast epithelial cells were incubated with 0.1 microM 4-OHE2, either with or without 30 microM tocopherols for 96 h. 4-OHE2 caused the accumulation of intracellular ROS, while cellular GSH/GSSG ratio and MnSOD protein levels were decreased, indicating that there was an oxidative burden. 4-OHE2 treatment also changed the levels of DNA repair proteins, BRCA1 and PARP-1. gamma-Tocopherol suppressed the 4-OHE2-induced increases in ROS, GSH/GSSG ratio, and MnSOD protein expression, while alpha-tocopherol up-regulated BRCA1 and PARP-1 protein expression. In conclusion, 4-OHE2 increases oxidative stress reducing the level of proteins related to DNA repair. Tocopherols suppressed oxidative stress by scavenging ROS or up-regulating DNA repair elements.
alpha-Tocopherol ; Breast ; Breast Neoplasms ; DNA Damage ; DNA Repair ; Epithelial Cells ; Estradiol ; Estrogens, Catechol ; gamma-Tocopherol ; Humans ; Oxidative Stress ; Proteins ; Tocopherols