To observe the role of oxygen free radical and enzymatic scavengers in cerebral ischemia, an infarction model was made using transorbital occlusion of the middle cerebral artery in cats. The changes of the superoxide radical production and the activities of superoxide dismutase and catalase were measured. The results were as follows ; 1) The infarction of the left middle cerebral artery(MCA) territory was identified with intracardiac perfusion of a TTC solution after transorbital occlusion. 2) The superoxide radical activities after occlusion of the left MCA were not changed in all groups except for the decrease in 6 hours group of the right side compared to the control group(p<0.05). 3) The Mn-superoxide dismutase activities of the left side in the 12 hours group were significantly higher than those of the right side(p<0.01) and those in the control group(p<0.05). 4) The Cu, Zn-superoxide dismutase activities of the left side in the 3 hours group after occlusion of the left MCA were significantly higher than those in the control group(p<0.05). 5) The catalase activities of the left side in the 3 hours, 6 hours and 12 hours groups after occlusion of the left MCA were significantly higher than those of the right side(p<0.05). 6) The catalase activities of the left side in the 12 hours group after occlusion of the left MCA were significantly higher than those in the control group(p<0.05). The authors suggest that the enzymatic scavangers such as Mn-SOD, Cu, Zn-SOD and catalase increased in the infarcted brain, which means an involvement of free radicals in cerebral infarction.
Animals ; Brain ; Brain Ischemia ; Catalase* ; Cats ; Cerebral Infarction* ; Free Radicals ; Infarction ; Middle Cerebral Artery ; Oxygen ; Perfusion ; Superoxide Dismutase* ; Superoxides*

An 11-year-old child presented with left hemiparesis and a seizure caused by fibromuscular dysplasia of the right internal carotid artery with cerebral infarction is presented. On conventional angiography, the authors found the classical `beaded' lesions. These pathognomic changes were most important to diagnosis. On brain single-photon emission computed tomography, we found the impaired vascular reserve of right basal ganglia, frontal and temporal area. We tried an antiplatelet agent and an encephaloduroarterio-synangiosis on the right hemisphere.
Angiography ; Basal Ganglia ; Brain ; Carotid Artery, Internal ; Cerebral Infarction* ; Child* ; Diagnosis ; Fibromuscular Dysplasia* ; Humans ; Paresis ; Seizures ; Tomography, Emission-Computed

OBJECTIVE: We present an evaluation of the safety and effectiveness of anterior reduction and stabilization of unilateral locked facet of the cervical spine. METHODS: Nine patients with unilateral locked facet of the cervical spine were treated with anterior decompression, reduction and stabilization from January 1997 through December 2000. There were six male and three female patients who ranged in age from 22 to 59 years (average 37.4 years). The level of facet dislocation was C4-5 in one, C5-6 in four, and C6-7 in four patients. One patient presented with complete spinal cord injury, two patients with incomplete spinal cord injury, four patients with radioculopathy, and two patients were neurologically intact. All patients underwent plain radiogram, computed tomogram scan, and magnetic resonance imaging. All patients underwent surgery for anterior open reduction, decompression and stabilization using bone graft and anterior cervical plate fixation systems. The mean follow-up periods was 11.9 months. RESULTS: All patients showed good decompression, reduction and stabilization without postoperative complications. Two patients showed vertebral artery thrombosis at facet locked side, but no cerebral ischemic symptoms. Follow-up neurological status was unchanged in two patients and improved in 7 patients. No patient experienced neurological deterioration or complications after this procedure. All patients showed good bony fusion without instability at follow-up period. CONCLUSION: Our results show that anterior decompression, reduction and stabilization procedure are safe and effective method in unilateral locked facet of the cervical spine without significant complications.
Decompression ; Dislocations ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Postoperative Complications ; Spinal Cord Injuries ; Spine* ; Thrombosis ; Transplants ; Vertebral Artery

Toxic megacolon is a devastating complication of colitis, which is commonly caused by inflammatory bowel disease. Frequently reported complications of toxic megacolon are bleeding, sepsis, colon perforation, and shock. Herein, we report a rare case of cardiac arrest that was likely caused by toxic megacolon in a 49-year-old male, who experienced 3 months of intermittent dyspnea and abdominal distension that abruptly worsened before presentation. Our case suggests that severe colon dilation complicated by toxic megacolon, especially accompanied by cardiopulmonary symptoms and signs, has the potential to progress to an abdominal compartment syndrome, which is a rare but life-threatening complication.
Colitis ; Colon* ; Critical Care ; Dyspnea ; Heart Arrest* ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Intra-Abdominal Hypertension ; Male ; Megacolon ; Megacolon, Toxic ; Middle Aged ; Sepsis ; Shock

To evaluate effect of coronary collateral circulation on left ventricular function in patients with acute myocardial infarction, global ejection fraction(EF), left ventricular end distolic pressure(LVEDP), peak creatine kinase(CK) level and regional wall motion were analysed and compared in 30 patients with acute myocardial infarction according to grade of coronary collateral circulation. Patients with total or near total(above 95% of diameter) occlsion of left anterior descending coronary artery without significant lesion in right coronary artery or left circumflex artery were selected and divided into 3 groups according to the degree of collateral circulation on coronary angiography, to be compared by the index of ejection fraction, peak creatine kinase level, left ventricular and diastolic pressure and regional wall motion. The result are as following : 1) There were no statistically significant differences in ejection fraction, peak creatine kinase level, left ventricualr and diastolic pressure among the groups. 2) Regional wall motion of infarct related area of G2+3 group(adequate collateral) were better than that of G0(no collateral) group(p<0.05). Therefore, adequate coronary collateral circulation in acute myocardial infarction is thought to have beneficial effect on left ventricular function especially in regional wall motion of infarct related area.
Arteries ; Blood Pressure ; Collateral Circulation* ; Coronary Angiography ; Coronary Vessels ; Creatine ; Creatine Kinase ; Humans ; Myocardial Infarction* ; Ventricular Function, Left*

Isometric tension recording was performed in the transverse strips of porcine coronary arteries and rabbit aorta to observe the effects of the endothelium and endothelium-derived relaxing factor(EDRF) on vasomotor tone and to test the hypothesis that alcohol may have the deleterious effect on endothelium-dependent vasorelaxation. Tension-development by vasoconstrictor was markedly attenuated in the endothelium-intact strips compared to the endothelium denuded strips. Administration of hemoglobin(10-5M) to inhibit the action of EDRF increased tension selectively in the endothelium-infarct strips, which is suggestive of basal EDRF secretion. Nitro L-arginine(10-5M). an analogue of L-arginine(10-4M) partially reversed the inhibitory effect of nitro L-arginine. Ethyl alchol inhibited bradykinin-induced endothelium-dependent vasorelaxation of porcine coronary artery in dose dependent manner. These data suggest that the protective effect of vascular endothelium to the action of vasoconstirctor can be explained by exercise of basal EDRF release and damaged endothelium would be a great risk of induction of vasospasm. Also we believe that there is a relationship of competive inhibition between L-arginine. a precursor of EDRF, and its analogues on the action of EDRF and alcohol intake would be hazardous to the patients with coronary artey disease because its inhibitory action on endothelium-dependent vasorelaxation may evoke myocardial ischemia.
Aorta ; Arginine ; Coronary Vasospasm ; Coronary Vessels* ; Endothelium* ; Endothelium, Vascular ; Ethanol* ; Humans ; Myocardial Ischemia ; Spasm* ; Vasodilation

A 56 year old female was admitted because of the right upper quadrant mass for 4 days. She complained of intermittent colicky RUQ pain, fever and chills. So diagnostic procedures was performed: Blood chemistry testings. Ultrasonography. Barium enema, Liver scan, Hepatobiliary scan, ERCP and Abdomen CT, which diagnosed as gall bladder carcinoma. So explolaparotomy was performed and gross operative finding was gall bladder carcinoma with metastatic lymph node and cystic duct stone. So cholecystectomy, hemigastrectomy and anterior segmentectomy of right liver was done. But the biopsy result was cystic duct stone, cholecystitis and gall bladder empyema.
Abdomen ; Barium ; Biopsy ; Chemistry ; Chills ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis* ; Cystic Duct* ; Enema ; Female ; Fever ; Humans ; Liver ; Lymph Nodes ; Mastectomy, Segmental ; Middle Aged ; Ultrasonography ; Urinary Bladder

In order to determine the electrophysiologic properties of aberrant ventricular conduction we analyzed the electrophysiologic studies done for various reasons in SNUH(1983.3 -1987.8). All patients did not have underlying heart disease and were in sinus rhythm with normal PR intervals & no intraventricular conduction delay at the time of study. The patients of preexcitation syndrome were excluded. Only aberrant ventricular conduction induced by premature atrial stimulation at the high right atrium or(HRA) during sinus rhythm or HRA pacing was analyzed. 1) Aberrant ventricular conuction was induced by premature atrial extrastimulation in 34 subjects of 156 cases reviewed(21.8%). The patients were 16 to 70 years old(sixteen males and eighteen females). 2) The longest atrial coupling(A1S2) interval resulting in aberrant ventricular conduction approximated 45%(600-280) of the basic cycle length(450-1550 msec). 3) As a prerequisite for aberrant ventricular conduction, the functional refractory period(FRP) of the AV node should be less than the relative refractory period(RRP) of the His Purkinje System and the most important determinant of aberrant ventricular conduction by atrial extreastimulation was resultant H1H2 interval, which should be between RRP and effective refractory period(ERP) of HPS. 4) There was good linear correlation between the basic cycle length(BCL) and RRP of the HPS(RRP=0.247xBCL+247.048, r=0.885, p-value<0.001). 5) 155 different configurations of aberrant ventricular conduction were recorded during atrial extrastimulation till atrial ERP. The pattern frequencies were as follows : left anterior hemiblock, 6(3.9%) ; right bundle brach block, 92(59.4%) ; left bundle branch block, 28(18.0%) ; left anterior hemiblock combined with right bundle branch block, 14(9.0%) ; left posterior hemiblock combined with right bundle branch block, 9(5.8%) ; unclassified intraventricular conduction disturbances, 6(3.9%). 6) As the atrial coupling intervals were further shortened, aberrant conduction persisted up to the point of atrial ERP at 19/41 BCL's(46.3%). Other patterns of atrioventricular conduction were as follows : atrio-His block, 7(17.1%) ; His-ventricular block, 6(14.6%) ; normal conduction due to prolonged A2H2, 9(22.0%). But there was no statistical significance between the pattern of A-V conduction and the longest S2H2 & H2V2 intervals during VAB (p-value=0.235>0.050). In conclusion, atrial extrastimulation which is routinely done during clinical EPS is an effective method to induce aberrant ventricular conduction and to study the electrophysiologic characteristics of atrioventricular conduction. Further study with recording of bundle branch electrogram, after infusion of cardioactive drugs and pacing of HRA at fixed rate should be done to determine the electrophysiologic properties of VAB more completely.
Atrioventricular Node ; Bundle-Branch Block ; Heart Atria ; Heart Diseases ; Humans ; Male ; Pre-Excitation Syndromes

No abstract available.
Glomerulonephritis, Membranous* ; Small Cell Lung Carcinoma*

We report a case of testicular tunica albuginea cyst with psammoma body which was treated with excision and testicular preservation. The presumptive diagnosis of a simple intratesticular cyst was made by ultrasound. The intraoperative pathological diagnosis was benign serous cyst and then simple excision of the lesion with testicular masses, and it may permit identification of lesions that can be excised locally with testicular preservation. To our knowledge tunica albuginea cyst with psammoma body, a characteristic histological finding, has not been reported. Its histogenesis was also discussed.
Diagnosis ; Testis ; Ultrasonography