Both direct and indirect environmental stress to brain were increase the expression of transcription factor c-fos in various populations of neurons. In this study, we examined whether the intraperitoneal injections of lidocaine at doses inducing convulsion within 10 min increased the level of c-fos mRNA and protein in forebrain areas. In situ hybridization using (35S)UTP-labeled antisense c-fos, cRNA increased c-fos mRNA levels though hippocampal formation, piriform cortex, septum, caudate-putamen, neostriatum, and amygdala within 2 hr. In parallel with the mRNA expression, c-FOS protein immunoreactivity was also observed in the same forebrain areas. In contrast to the seizure activity and widespread neuronal degeneration following a kainate treatment, injections of lidocaine did not produce neuronal death within 3 days. The present study indicates that lidocaine induces convulsion and c-fos expression without causing neuro-toxicity.
Adult* ; Amygdala ; Animals ; Brain* ; Hippocampus ; Humans ; In Situ Hybridization ; Injections, Intraperitoneal ; Kainic Acid ; Lidocaine* ; Neostriatum ; Neurons ; Prosencephalon ; Rats* ; RNA, Complementary ; RNA, Messenger* ; Seizures ; Transcription Factors

BACKGROUND: The nasal mucosa is degenerated by inflammations, physical stimulations such as cessation of air flow, and other chemical stimulations. And it is regenerated regularly by newly differentiated cells. OBJECTIVES: In order to investigate the morphologic changes of the nasal mucosa and regenerating activities in sinusitis. MATERIALS AND METHODS: The authors made animal models of acute maxillary sinusitis by obstructing the natural ostium of maxillary sinus of rabbit and inoculating Staphylococcus aureus colonies. Each contralateral side was used as control. The rabbits were sacrificed after 1, 2, and 3 weeks. Morphologic changes of the nasal mucosa and regenerating activities of the olfactory mucosa were observed with Hematoxylin-eosin staining and immunohistochemistry using BrdU. RESULTS: Purulent sinusitis was developed in all rabbits. Light microscopy showed that nasal mucosa revealed inflammatory changes such as edema, inflammatory cell infiltration, goblet cell metaplasia, polypoid change, epithelial ulceration, and submucosal connective tissue proliferation. BrdU-labelled cells were observed mainly in the basal cell layer of the olfactory mucosa, and their numbers in the control sides were significantly higher than in the experimental sides. CONCLUSION: These results indicate that acute infection of the maxillary sinus induces inflammatory changes of both respiratory and olfactory mucosa of the nose and decreases the regenerating activity of olfactory mucosa.
Bromodeoxyuridine ; Connective Tissue ; Edema ; Goblet Cells ; Immunohistochemistry ; Inflammation ; Maxillary Sinus* ; Maxillary Sinusitis* ; Metaplasia ; Microscopy ; Models, Animal ; Nasal Mucosa* ; Nose ; Olfactory Mucosa ; Physical Stimulation ; Rabbits* ; Sinusitis ; Staphylococcus aureus ; Stimulation, Chemical ; Ulcer

Adult ; Anesthesia ; Colloids ; Dizziness ; Equidae ; Fluid Therapy ; Headache ; Humans ; Orthognathic Surgery ; Postoperative Period ; Pulmonary Edema ; Surveys and Questionnaires ; Sleep Stages ; Surgery, Oral ; Thirst

Objective: : Spontaneous intracranial hemorrhage is a life-threatening disease, and non-lesional spontaneous intraparenchymal hemorrhage (nIPH) and aneurysmal subarachnoid hemorrhage (aSAH) are the leading causes of spontaneous intracranial hemorrhage. Only a few studies have assessed the association between prior physical activity or triggering events and the occurrence of nIPH or aSAH. The purpose of this study is to investigate the role of specific physical activities and triggering events in the occurrence of nIPH and aSAH. Methods: : We retrospectively reviewed 824 consecutive patients with spontaneous intracranial hemorrhage between January 2010 and December 2018. Among the 824 patients, 132 patients were excluded due to insufficient clinical data and other etiologies of spontaneous intracranial hemorrhage. The medical records of 692 patients were reviewed, and the following parameters were assessed : age, sex, history of hypertension, smoking, history of stroke, use of antiplatelet or anticoagulation agents, season and time of onset, physical activities performed according to the metabolic equivalents, and triggering event at onset. Events that suddenly raised the blood pressure such as sudden postural changes, defecation or urination, sexual intercourse, unexpected emotional stress, sauna bath, and medical examination were defined as triggering events. These clinical data were compared between the nIPH and aSAH groups. Results: : Both nIPH and aSAH most commonly occurred during non-strenuous physical activity, and there was no significant difference between the two groups (p=0.524). Thirty-two patients (6.6%) in the nIPH group and 39 patients (8.1%) in the aSAH group experienced triggering events at onset, and there was a significant difference between the two groups (p=0.034). The most common triggering events were defecation or urination in both groups. Conclusion : Specific physical activity dose no affect the incidence of nIPH and aSAH. The relationship between the occurrence of intracranial hemorrhage and triggering events is higher in aSAH than nIPH.

The enamel matrix derivative (EMD) has been recently used in the periodontal regenerative techniques. The present study was established to investigate the influence of EMD on human periodontal ligament cells using expression of mRNA of periodontal ligament specific gene (PDLs)17, PDLs22, type I collagen when EMD applied to periodontal ligament cells. Periodontal ligament cells were obtained from a healthy periodontium and cultured in Dulbecco's modified Eagle's medium (DMEM) plus 10% fetal bovine serum and beta-glycerophosphate with ascorbic acid. Test groups were two; One adds EMD in culture media and another added EMD and Dexamethasone (DEX) in culture media. Positive control group added DEX in culture media, and negative control group adds niether of EMD nor DEX. Emdogain(R) (Biora, Sweden, 30 mg/ml) was diluted by 75 microgram/ml concentration to culture media. For reverse transcription-polymerase chain reaction (RT-PCR), total RNA isolated on days 0, 7, 14 and 21. mRNA of PDLs17 was expressed on days 14 and 21 in EMD or DEX group, and expressed on days 7, 14 and 21 in EMD plus DEX group, the other side, expressed on days 21 in negative control group. mRNA of PDLs22 expressed on days 7, 14 and 21 in EMD group, and expressed on days 14 and 21 in DEX group, and expressed on days 7, 14 and 21 in EMD plus DEX group. Negative control group expressed on days 14 and 21. Type I collagen was expressed on all days and all groups. These results indicate that EMD promotes differentiation of periodontal ligament cells, and this is considered to offer basis that can apply EMD to periodontal tissue regeneration technique.
Ascorbic Acid ; Collagen Type I ; Culture Media ; Dental Enamel* ; Dexamethasone ; Humans* ; Periodontal Ligament* ; Periodontium ; Regeneration ; RNA ; RNA, Messenger ; Sweden

OBJECTIVE: Infection and bone resorption are major complications of cranioplasty and have been well recognized. However, there are few clinical series describing the epidural fluid collection (EFC) as complication of cranioplasty. This study was planned to identify the predictive factors and fate of EFC after cranioplasty. METHODS: We reviewed retrospectively the demographic, clinical, and radiographic data in 59 patients who underwent a first cranioplsty following decompressive craniectomy during a period of 6 years, from January 2004 to December 2009. We compared demographic, clinical, and radiographic factors between EFC group and no EFC group. The predictive factors associated with the development of EFC were assessed by logistic regression analysis. RESULTS: Overall, 22 of 59 patients (37.3%) suffered from EFC following cranioplasty. EFC had disappeared (n=6, 31.8%) or regressed (n=6, 31.8%) over time on follow up brain computed tomographic (CT) scans. However, 5 patients (22.7%) required reoperation due to symptomatic and persistent EFC. Predictive factors for EFC were male [odds ratio (OR), 5.48; 95% CI, 1.26-23.79], air bubbles in the epidural space (OR, 12.52; 95% CI, 2.26-69.28), and dural calcification on postoperative brain CT scan (OR, 4.21; 95% CI, 1.12-15.84). CONCLUSION: The most of EFCs could be treated by conservative therapy. Air bubble in the epidural space and dural calcification are proposed to be the predictive factors in the formation of EFC after cranioplasty.
Bone Resorption ; Brain ; Decompressive Craniectomy ; Epidural Space ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Reoperation ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: It is known that both hypercholesterolemia and aging cause endothelial dysfunction, but which has the greater effect is less well known. A useful, non-invasive method for the evaluation of endothelial function is flow-mediated dilation (FMD) of the brachial artery (BA) employing high-resolution ultrasound. This study was performed to evaluate the effect of serum cholesterol and age on endothelial function in women utilising the above method. SUBJECTS AND METHODS: 21 of the 37 women in this study (mean age 46+/-15 years, range 24-72), had hypercholesterolemia (>or=200 mg/dL) and 16 had normocholesterolemia (<200 mg/dL). None of the subjects suffered classic risk factors associated with atherosclerosis other than hypercholesterolemia. The inner diameter of the right BA was measured at the peak of ECG R wave, from a longitudinal section taken by an 8.0-MHz B-mode linear-array ultrasonic transducer. Scans were taken at rest, during reactive hyperaemia (endothelium-dependent dilation;EDD), again at rest, and following sublingual nitroglycerin (endothelium-independent dilation;EID). RESULTS: From simple linear regression analyses, the serum cholesterol levels were found to be negatively related to the EDD of the BA at an age <50 years (r=-0.63, p<0.01), and also >or=50 years (r=-0.54, p<0.05). Serum cholesterol levels were not significantly related to the EID, regardless of age. In contrast, age was not related to EDD or EID in either normocholesterolemic or hypercholesterolemic subjects. CONCLUSION: These results suggest hypercholesterolemia has a greater effect than age in impairing the endothelial function in women.
Age Factors ; Aging ; Atherosclerosis ; Brachial Artery ; Cholesterol ; Electrocardiography ; Endothelium ; Female ; Humans ; Hypercholesterolemia* ; Linear Models ; Nitroglycerin ; Risk Factors ; Transducers ; Ultrasonics ; Ultrasonography ; Vasodilation

PURPOSE: It is increasingly being recognized that the lymph node ratio (LNR) is an important prognostic factor for gallbladder carcinoma patients. The present study evaluated predictors of tumor recurrence and survival in a large, mono-institutional cohort of patients who underwent surgical resection for gallbladder carcinoma, focusing specifically on the prognostic value of lymph node (LN) status and of LNR in stage IIIB patients. METHODS: Between 2004 and 2011, 123 patients who underwent R0 radical resection for gallbladder carcinoma at the Chonnam National University Hwasun Hospital were reviewed retrospectively. Patients were staged according to the American Joint Committee on Cancer 7th edition, and prognostic factors affecting disease free survival, such as age, sex, comorbidity, body mass index, presence of preoperative symptoms, perioperative blood transfusion, postoperative complications, LN dissection, tumor size, differentiation, lymph-vascular invasion, perineural invasion, T stage, presence of LN involvement, N stage, numbers of positive LNs, LNR and implementation of adjuvant chemotherapy, were statistically analyzed. RESULTS: LN status was an important prognostic factor in patients undergoing curative resection for gallbladder carcinoma. The total number of LNs examined was implicated with prognosis, especially in N0 patients. LNR was a powerful predictor of disease free survival even after controlling for competing risk factors, in curative resected gallbladder cancer patients, and especially in stage IIIB patients. CONCLUSION: LNR is confirmed as an independent prognostic factor in curative resected gallbladder cancer patients, especially in stage IIIB gallbladder carcinoma.
Blood Transfusion ; Body Mass Index ; Chemotherapy, Adjuvant ; Cohort Studies ; Comorbidity ; Disease-Free Survival ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Joints ; Lymph Nodes ; Postoperative Complications ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors

Leptomeningeal carcinomatosis (LMC) is rare metastatic form of gastric cancer. Most cases are diagnosed in the final stage after multiple distant metastasis. An 84-year-old woman was admitted with melena, headache and vomiting. Esophagogastro-duodenoscopy showed an ulceroinfiltrating lesion at the stomach (Borrmann class III), and biopsy revealed a signet ring cell carcinoma. The abdominal-pelvic CT showed no evidence of metastasis. A sudden decrease of consciousness was noted, but the brain CT showed no active lesion while the brain MRI revealed enhancement of leptomeninges. A lumbar puncture was performed and the cerebrospinal fluid study revealed malignant neoplastic cells. With family consent, no further evaluation and treatment were administered and she died six weeks after the diagnosis of gastric cancer. We report an extremely rare case of a patient who initially presented with neurologic symptoms, and was diagnosed LMC from advanced gastric cancer without any evidence of metastasis in abdomen and pelvis.
Abdomen ; Aged, 80 and over ; Biopsy ; Brain ; Carcinoma, Signet Ring Cell ; Cerebrospinal Fluid ; Consciousness ; Diagnosis ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Melena ; Meningeal Carcinomatosis* ; Neoplasm Metastasis ; Neurologic Manifestations ; Pelvis ; Spinal Puncture ; Stomach ; Stomach Neoplasms* ; Vomiting

BACKGROUND AND OBJECTIVES: The protective effect of angiotensin converting enzyme (ACE) inhibitor against ischemia/reperfusion injury has been demonstrated in animal models, however the effect of AT1 receptor antagonist is contradictory. The present study was designed to investigate the myocardial protective effects of the AT1 receptor antagonist irbesartan during myocardial ischemia/reperfusion in vivo. MATERIALS AND METHODS: Sprague-Dawley rats were subjected to a 45-minute left coronary artery ligation followed by a 2-hour re-perfusion. An inert vehicle (group I:n=14) or irbesartan (50 mg/kg/day:group II, n=12) was administered for 3 days before coronary occlusion. The ratio of the myocardial infarct area to the ischemic area at risk was assessed through triphenyltetrazolium chloride staining. Apoptosis was evaluated by analyzing DNA fragmentation and TdT-mediated dUDP nick end labeling staining. Western blot analysis was performed for MAP Kinases (ERK1/2 and p38) and Bcl-2 and Bax. RESULTS: The ratio of the infarct area to the ischemic area at risk of group II was smaller than that of group I (42.6+/-2.7% vs. 64.1+/-4.6%;p<0.005). Agarose gel electrophoresis revealed discrete DNA laddering in the ischemic zone of group I, however DNA ladder formation was attenuated in group II. The expressions of ERK1 MAPK and Bcl-2 were increased in the ischemic area of group II compared to that of group I. CONCLUSION: AT1 receptor antagonist was effective in reducing myocardial reperfusion injury in vivo. This effect can at least be partially attributed to the attenuation of cardiomyocyte apoptosis, and this anti-apoptotic effect appears to be related to the increased expression of Bcl-2 and alterations in MAP kinase signaling.
Angiotensin II* ; Angiotensins* ; Animals ; Apoptosis ; Blotting, Western ; Coronary Occlusion ; Coronary Vessels ; DNA ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Ligation ; MAP Kinase Signaling System ; Models, Animal ; Myocardial Infarction ; Myocardial Ischemia* ; Myocardial Reperfusion Injury ; Myocytes, Cardiac ; Peptidyl-Dipeptidase A ; Phosphotransferases ; Rats* ; Rats, Sprague-Dawley ; Receptors, Angiotensin ; Reperfusion Injury* ; Reperfusion*