No abstract available.
Peptic Ulcer Perforation* ; Peptic Ulcer*

No abstract available.
Humans

No abstract available.
Appendicitis* ; Child* ; Humans

Peroxisome proliferator-activated receptor-gamma (PPARgamma) has been implicated in the growth inhibition of a number of cancer cells. In the present study, we investigated the antitumor effect of the PPARgamma agonist rosiglitazone in U87MG human glioma cells. Rosiglitazone treatment in vitro reduced cell proliferation without induction of cell death in a dose- and time-dependent manner. Rosiglitazone decreased cell migration and mRNA level of MMP-9. Rosiglitazone treatment also induced marked changes in glioma cell morphology. Oral administration of rosiglitazone in animals with subcutaneous U87MG glioma cells reduced tumor volume. Subsequent tumor tissue analysis showed that rosiglitazone decreased the number of PCNA-positive staining cells and MMP-9 expression and induced apoptosis of tumor cells. These data suggest that rosiglitazone exerts antineoplastic effect in U87MG cells and may serve as potential therapeutic agent for malignant human gliomas.
Administration, Oral ; Animals ; Apoptosis ; Cell Death ; Cell Movement ; Cell Proliferation ; Glioma ; Humans ; Peroxisomes ; PPAR gamma ; RNA, Messenger ; Thiazolidinediones ; Tumor Burden

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

There were many methods to treat spondylolisthesis since the past but completely satisfiable method was not developed until now. Recently, many spinal instruments were introduced and used worldwidely to treat spondylolisthesis. The author reports the experience of nine patients of transpedicular screw instrumentation of obtain reduction and fixation of the spondylolisthesis. Follow-up period was between 7 to 33 months after operation with average 19 months. The result was as follows: The age of the patients was 46 years in average ranging from 29 to 61 years. 2) Types of spondylolisthesis were isthmic type in 6 cases and degenerative type in 3 cases. The level of lesion were L4-5 in 5 cases. L5-S1 in 3 cases and L3-4 in 1 case. 3) Preoperative clinical feature include low back pain(100%), sensory disturbance(78%), radiating pain(67%), neurologic claudication(56%). 4) The amount of displacement measured by Boxall was 22.6% preoperatively to 7.3% postoperatively and the amount of angle by Meschan was from 12.7 degree preoperatively to 4 degree postoperatively. 5) Postoperative complications were urinary tract infection(3 cases), screw loosening(1 case), superficial wound infection(1 case), deep wound infection(1 case), and meralgia paresthetica(1 case). 6) The overall result was satisfactory except 1 case due to screw loosening, and satisfiable bony fusion was obtained except 1 case.
Follow-Up Studies ; Humans ; Postoperative Complications ; Spondylolisthesis* ; Urinary Tract ; Wounds and Injuries

Aneurysms of the vertebrobasilar trunk pose a most difficult anatomic problem to access because these lesions are located in a small restricted area encased with thick dense bone, with a limited subarachnoid space, and are filled with the most dense collection of vital cranial nerves and vascular structures. So, "exposure is everything" is very appropriate for these lesion. Furthermore, while achieving maximum exposure, there must be a minimum of brain retraction to protect the patient from the injury. For achieve these purpose, several techniques that maximize lateral skull removal to provide a relatively short and flat route of access to the front of the brain stem and basilar artery, were introduced but full satisfaction was not achieved. Recently, transpetrosal approaches were applied to access into the anterior brain stem and clival region through the petrosal bone removal without brain or brain stem retraction and excellent results were reported. In this paper, detailed summary of steps of each petrosal approaches and illustrations form Fukushima's manual of skull base dissection will be presented after reviewing some articles about petrosal approaches.
Aneurysm ; Basilar Artery ; Brain ; Brain Stem ; Cranial Nerves ; Humans ; Intracranial Aneurysm* ; Skull ; Skull Base ; Subarachnoid Space

This study was undertaken to identify acute changes and mechanism of traumatic brain edema in the rabit by measuring the regional specific gravities and water content with Evans blue dye staining. After delivery of brain injury on the frontal area, animals were sacrificed at 30 minutes, 2, 4 and 6 hours. Specific gravity data collection of regional brain tissue was taken in the serial copper sulfate gravity solution. The regions tested included frontal lobe, occipital lobe, basal ganglia, cerebellum, pons and medulla. Specific gravity data and Evans blue dye staining with spread were compared with those from similar areas in the uninjured anesthetized rabbits to test for brain edema. The results obtained were as follows: 1) Immediately following brain impact, almost all animals in this study demonstrated temporary respiratory arrest. The mean duration of respiratory arrest in experimental animals was 15+/-3 seconds. There was no correlation between length of respiratory arrest and either gross intracranial pathology or brain edema data. 2) The specific gravities in both hemispheres were same in control animals and were not affected by the duration of anesthesia. 3) Significant decrease of specific gravity was identified in the both supratentorial regions at 30 minutes, 2 and 4 hours after trauma. This finding was more prominent in the contused side. No significant changes occurred in the cerebellum but significant decrease of specific gravity occurred in medulla at 6 hours. 4) Almost brain water content was increased as the time course and arrived on peak value at 4 hours and decreased at 6 hours after trauma in the supratentorial regions. 5) Evans blue dye staining occurred in the contusion area at 30 minutes after trauma and spread to surrounding cortex and subcortex but dye density was decreased with time. These results suggest that traumatic brain edema may originate from vasogenic mechanism due to dysfunction of blood-brain barrier and this edema may spread to both cerebral hemispheres and brain stem.
Anesthesia ; Animals ; Basal Ganglia ; Blood-Brain Barrier ; Brain Edema* ; Brain Injuries* ; Brain Stem ; Brain* ; Cerebellum ; Cerebrum ; Contusions ; Copper Sulfate ; Data Collection ; Edema ; Evans Blue ; Frontal Lobe ; Gravitation ; Occipital Lobe ; Pathology ; Pons ; Rabbits ; Specific Gravity

Nimodipine, a potent, central active, calcium channel blocker, is known to relieve vasospasm, increase cerebral blood flow(CBF) and affect positively on clinical outcome in patients with subarachnoid hemorrhage. Experimentally, the potent effects on both vascular dilatation and increasing CBF were proven. However, there are still controversies and many debates at present about the actual clinical effects of nimodipine on subarachnoid hemorrhage. To evaluate the clinical effectiveness of nimodipine on aneurysmal subarachnoid hemorrhage in our series, we analyzed 122 consecutive patients with ruptured aneurysms who underwent operations between October, 1993 and June, 1995. These patients were grouped as follow: Group I consisted of 63 cases(52%) in which the patients were treated with nimodipine and Group II consisted of 59 cases(48%) in which the patients were treated conventionally. Administration of nimodipine was started immediately after the radiological diagnosis of ruptured aneurysm. The dose of nimodipine was 0.5microg/kg/min via continuous intravenous infusion for 7 to 10 days after the subarachnoid hemorrhage. After a course of intravenous treatment, oral administration of nimodipine was then continued for up to 21 days after subarachnoid hemorrhage in a dose of 60mg every four hours. We analyzed two groups based on patient's age, sex, aneurysmal location and size, timing of surgery, presence of hypertension, Hunt-Hess grade, presence of vasospasm on preoperative angiography and Fisher's CT classification. We also analyzed the incidence of delayed ischemic deficits(DID) and outcome(GOS) in each group. There were no significant differences in any of these parameters between nimodipine-treated group and the control group(p>0.05) and also, no significant differences in the distribution of DID or outcome between two groups (p>0.05). Based on these results, we conclude that nimodipine does not provide any significant beneficial effects on the prevention of DID and outcome in the patients with aneurysmal subarachnoid hemorrhage.
Administration, Oral ; Aneurysm* ; Aneurysm, Ruptured ; Angiography ; Calcium Channels ; Classification ; Diagnosis ; Dilatation ; Humans ; Hypertension ; Incidence ; Infusions, Intravenous ; Nimodipine* ; Subarachnoid Hemorrhage*

Intracranial subdural empyema is a neurosurgical emergency and an unusual condition which carries a serious incidence of mortality and morbidity if untreated. The subdural empyema developes from varied sources, but paranasal sinus, the ear and the mastoid process are predominantly affected and subtentorial empyema usually originates from otogenic intracranial complication. Its manifestations are variable such as impaired consciousness, headache, hemiparesis, acute fits, pyrexia, meningism, vomiting, papilledema. ophthalmoplegia, hemianopsia and dysphasia. Subtentorial empyema has additional cerebellar dysfunction syndromes. Early accurate diagnosis and surgical drainage are the most important factors affecting the prognosis. Recently, we experienced two cases of subtentorial empyema which were very rare otogenic intracranial complications. These patients were treated with suboccipital craniectomy, but reaccumulations of empyema and subsequent cerebellar abscess in one case occurred. Finally these patients were recovered without neurologic deficits. Reviewing our two cases and the literature, we are going to describe about causes, symptoms and signs, method of diagnosis, treatment and prognosis of subtentorial empyema.
Abscess ; Aphasia ; Cerebellar Diseases ; Consciousness ; Diagnosis ; Drainage ; Ear ; Emergencies ; Empyema* ; Empyema, Subdural ; Fever ; Headache ; Hemianopsia ; Humans ; Incidence ; Mastoid ; Meningism ; Mortality ; Neurologic Manifestations ; Ophthalmoplegia ; Papilledema ; Paresis ; Prognosis ; Vomiting