No abstract available.
Stents

Osteoblasts are affected by TNF-alpha overproduction by immune cells during inflammation. It has been suggested that functional NF-kappaB sites are involved in TNF-alpha-induced bone resorption. Thus, we explored the effect of pyrrolidine dithiocarbamate (PDTC), which potently blocks the activation of nuclear factor (NF-kappaB), on the induction of TNF-alpha-induced activation of JNK/SAPK, AP-1, cytochrome c, caspase and apoptosis in MC3T3E1 osteoblasts. Pretreatment of the cells with PDTC blocked TNF-alpha-induced NF-kappaB activation. TNF-alpha-induced activation of AP-1, another nuclear transcription factor, was suppressed by PDTC. The activation of c-Jun N-terminal kinase, implicated in the regulation of AP-1, was also down regulated by PDTC. TNF-alpha-induced apoptosis, release of cytochrome c and subsequent activation of caspase-3 were abolished by PDTC. TNF-alpha-induced apoptosis was partially blocked by Ac-DEVD-CHO, a caspase-3 inhibitor, suggesting that caspase-3 is involved in TNF-alpha- mediated signaling through NF-kappaB in MC3T3E1 osteoblasts. Thus, these results demonstrate that PDTC, has an inhibitory effect on TNF-alpha-mediated activation of JNK/SAPK, AP-1, cytochrome c release and subsequent caspase-3, leading to the inhibition of apoptosis. Our study may contribute to the treatment of TNF-alpha-associated immune and inflammatory diseases such as rheumatoid arthritis and periodontal diseases.
Apoptosis* ; Arthritis, Rheumatoid ; Bone Resorption ; Caspase 3 ; Cytochromes c ; Inflammation ; JNK Mitogen-Activated Protein Kinases ; NF-kappa B ; Osteoblasts ; Periodontal Diseases ; Transcription Factor AP-1 ; Transcription Factors ; Tumor Necrosis Factor-alpha

Exercise-induced ischemic ST responses were analyzed in 36 patients who presented with chest pain and had exercise test and the results were compared with their coronary angiographic findings. Among 36 exercise test positives, the incidences of one-, two- and three vessel disease, and left main disease were 25%(9 cases), 30%(11 cases), 25%(9 cases) and 9%(3 cases), respectively. The incidence of multivessel disease(i.e., two-to three vessel disease or left main disease) in patients with ST depression > or =2.0mm was 72% and that in those with ST depression of 1.0-1.9mm was 45%. In patients with downsloping ST depression, the incidence of multivessel disease was significantly higher than that of one vessel disease(86% vs 14%, p<0.001). But both incidences of one vessel disease and multivessel disease were similar in patients with flat and slowly upsloping ST depression. More than two thirds of patients with ischemic ST depression appearing in the first 6 minutes of exercise or those lasting past 7 minutes in recovery were associated with multivessel disease. It is concluded that attention to depth, type, appearance time and duration of ST depression during exercise test is particularly helpful in detecting patients with advanced coronary disease.
Chest Pain ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Depression ; Electrocardiography* ; Exercise Test ; Humans ; Incidence

While there are reports regarding burns occurring to patients during the surgery, there are little reports concerning the incidents of the burns related to neurosurgical operations. Moreover, in Korea, even surveys and statistics on the incidents of burns in operating rooms are not known. This report explores burns occurring to a patient in an electrocautery scenario after disinfecting the surgical site with alcohol during the preparation of a neurosurgical operation in an operating room where there is much exposure to oxygen. The authors show a case of a 33-year-old male patient who undergoing evacuation of hematoma on occipital lesion, suffered second degree burns as a result of surgical fires.
Adult ; Burns* ; Electrocoagulation* ; Fires* ; Hematoma ; Humans ; Korea ; Male ; Neurosurgery* ; Operating Rooms ; Oxygen ; Skin*

Endolymphatic sac tumor is rare, locally aggressive hypervascular tumor of papillary structure, arising from the endolymphatic duct or sac in the posterior petrous bone. We present four cases with this tumor. Two patients were male and the other two were female. Age of each patient was 15, 52, 58, and 67 years. Three patients presented with progressive hearing loss and sustained vertigo for months to years and another one was referred for the tumor detected in routine medical check-up. Preoperative embolization was performed in 3 patients. Complete excision of the tumor was achieved in all patients using translabyrinthine or retrosigmoid approach. Herein, we describe the clinical and radiographic features, surgical treatment and pathologic findings with a review of the literature.
Endolymphatic Duct ; Endolymphatic Sac ; Female ; Hearing Loss ; Humans ; Male ; Petrous Bone ; Vertigo

OBJECTIVE: The incidence of spinal metastases continues to increase, likely a result of increasing survival times for patients with cancer. This retrospective study was undertaken to analyze the results of surgery and the outcome of patients with extradural metastases in the cervical spine. METHODS: Thirty-three patients with cervical spine metastases who underwent spinal surgery by two surgeon at a single center in a 14-year period(1993-2007) were analyzed. Indications for surgery include intractable pain, neurological deficits, spinal cord compression, and the need for stabilization of impending pathological fractures. Numerous factors affect outcome including the nature of the primary cancer, the presence of fracture or dislocation, approach of surgery, and the severity of spinal cord compression. The change of predominant symptoms and survival time were evaluated after surgery. RESULTS: There were 17 male and 16 female patients aged from 29 to 78 years old(mean age, 59.9 years). Among the metastatic tumors, colon, breast, and liver were the most common primary sites of origin, and lung, kidney, stomach and thyroid were also common. All patients had bony invasion and 24 patients had pathologic vertebral fracture and 6 patients had dislocation. Based on the tumor location, approaches included 12 anterior, 6 posterior and 15 combined. Epidural spinal cord compression on the axial T2-weighted magnetic resonance(MR) image was noted in 31 patients(93.9%). The American Spinal Injury Association(ASIA) impairment scale scores in preoperative state were stable in 29 patients(87.9%) who presented with ASIA Score D and E. The most common predominant symptoms of patients were cervical and/or radiating pain(26 patients) and 23 patients had neurological deficits. At Follow-up, predominant preoperative symptoms improved in 28(84.8%) patients who had pain or neurological deficits. The overall mean survival duration for patients with cervical metastatic tumors after diagnosis was 7.4 months in 28 expired patients and 17.4 months in 5 survived patients. There were four major early and late complications in this study. One patient suffered from the immediate postoperative epidural hematoma and improved after evacuation of hematoma. There were three cases of instrumentation failure. One of them was symptomatic and underwent second-look surgery. CONCLUSION: Surgery for the treatment of cervical spine metastases is effective for improvement of the neurological deficits and relief the local pain in a significant proportion of patients with acceptable complication rates. The tech- nical evolution of cervical implants has improved our ability to achieve long-term rigid fixation, particularly over the cervicothoracic junction.
Aged ; Asia ; Breast ; Cervical Vertebrae ; Colon ; Dislocations ; Female ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Incidence ; Kidney ; Liver ; Lung ; Magnetics ; Magnets ; Male ; Neoplasm Metastasis ; Pain, Intractable ; Retrospective Studies ; Spinal Cord Compression ; Spinal Injuries ; Spine ; Stomach ; Thyroid Gland

The increased use of magnetic resonance imaging (MRI) has increased the frequency of diagnosis of cavernous hemangioma, but its presentation of an epidural lesion with foraminal extension without intramedullary involvement is very rare. We describe a 31-year-old woman admitted to our department with pain in the left side of her neck and shoulder. Gadolinium enhanced cervical MRI revealed a brightly enhanced, extradural mass (112 cm sized) with widened neural foramen; after surgical excision, it was histologically confirmed as a cavernous hemangioma. Postoperatively, the patient has no neurological deficit or specific complication. Although this lesion mimicked an epidural- neurogenic tumor, its enhancement pattern indicated a cavernous hemangioma. Accurate preoperative diagnosis is necessary for treatment planning. Cavernous hemangioma must be included in the differential diagnosis of a brightly enhanced, extradural tumors.
Adult ; Caves ; Diagnosis, Differential ; Female ; Gadolinium ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Imaging ; Neck ; Shoulder

A case of nutcracker syndrome which was initially diagnosed by magnetic resonance angiography (MRA) is reported. On preoperative MRA in an 18-year-old male patient with gross hematuria, left renal vein was obliterated at the level of superior mesenteric artery and there was no connection with inferior vena cava. The follow-up MRA after surgical correction with external prosthesis demonstrated entire course of left renal vein without evidence of obstruction which might suggest a possible usage of MRA for a non-invasive diagnosis of nutcracker syndrome.
Adolescent ; Angiography* ; Diagnosis* ; Follow-Up Studies* ; Hematuria ; Humans ; Magnetic Resonance Angiography ; Male ; Mesenteric Artery, Superior ; Prostheses and Implants ; Renal Veins ; Vena Cava, Inferior

A case of nutcracker syndrome which was initially diagnosed by magnetic resonance angiography (MRA) is reported. On preoperative MRA in an 18-year-old male patient with gross hematuria, left renal vein was obliterated at the level of superior mesenteric artery and there was no connection with inferior vena cava. The follow-up MRA after surgical correction with external prosthesis demonstrated entire course of left renal vein without evidence of obstruction which might suggest a possible usage of MRA for a non-invasive diagnosis of nutcracker syndrome.
Adolescent ; Angiography* ; Diagnosis* ; Follow-Up Studies* ; Hematuria ; Humans ; Magnetic Resonance Angiography ; Male ; Mesenteric Artery, Superior ; Prostheses and Implants ; Renal Veins ; Vena Cava, Inferior

We present a rare case of an intradural ventral arteriovenous fistula (AVF) mimicking an intramedullary ependymoma. A 46-year-old woman presented with sudden onset of right leg weakness, which she had been experiencing for two weeks. Whole-spine magnetic resonance imaging (MRI) scan revealed a 0.5-cm-sized intramedullary lesion of high signal with a dark signal rim on a T2-weighted image at the T9 level. The T1-weighted MRI after contrast enhancement revealed a nodular and rim-like enhancement. However, a signal void, likely to be seen in the case of an engorged vein, was not obvious, thus giving the impression of an intramedullary ependymoma. Surgery was planned, but was aborted due to the observation of a large engorged vein as soon as the dura was opened.
Arteriovenous Fistula ; Ependymoma ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Veins