No abstract available.
Acoustics* ; Ear, Inner ; Hearing* ; Neuroma, Acoustic* ; Semicircular Canals*

No abstract available.
Immunocompromised Host* ; Kluyvera* ; Sepsis*

The safety and efficacy of intravenous tissue plasminogen activator(tPA) on the condition of ruling out the significant risk were studied at 6 and 12 hours after cerebral artery embolization in rabbit model. The time selection was chosen to stimulate the analogous clinical situation. The safety and effectiveness of tPA in experimental and clinical treatment of acute coronary thrombosis have been established. Tissue plasminogen activator is an endogenous fibrin-specific serine protease with the potent thrombolytic activity that has been produced recently by recombinant DNA technology. The acute cerebral thromboembolic model was induced by injecting three 0.5X1.0mm fragments of autologous arterial thromi into internal carotid artery through the intra-arterial catheter. The autologous arterial thrombi was obtained from the traumatized arterial endothelium by scratching the lumen of auricular artery using modified spinal needle. The experimental group was divided into four groups : (1) group Ia : saline-treated(1 ml/kg) control group at 6 hours after embolization(n=10), (2) group Ib : tPA-treated(1 mg/kg) at 6 hours after embolization(n=10), (3) group IIa : saline-treated control group 12 hours after embolization(n=10), (4) group Iib : tPA-treated group 12 hours after embolization(n=13). The experimental rabbits were sacrificed at 24 hours after injection of tPA(1 mg/kg) or saline(1 ml/kg) in each group. Brain was cut into 0.5 cm thick coronal sections, which were stained with triphenyltetrazolium chloride to define the areas of infarction. The transparent plastic sheets were placed on the each section, and the total area of the brain slice and the area of infarction were measured by the plannimeter(as outlined by TTC staining). The percentage area of whole brain infarction was calculated as(the sum of infarcted area/the sum of brain slice areas)x100% for each rabbit. We also observed the pathologic findings with hematoxylin-eosin staining. The results were as follows : 1) Only 1 rabbit treated with tPA at 12 hours after occlusion exhibited the gross hemorrhage. 2) The infarcted area was limited to the basal ganglia and cortex in all group. 3) The mean percentage area of whole brain infarction averaged 18.6+/-1.94% in group Ia, 6.32+/-1.02% in group Ib, and 20.8+/-3.34% in group IIa, 6.78+/-1.40% in group IIb. One-way ANOVA test of infarction size showed the significant differences(p<0.05) between the tPA-treated group and the saline-treated control group, but no difference between the groups treated with same agent. 4) Under the study of microscope, infarcted area of saline-treated control group was more extended than that of tPA-treated group. Congulation necrosis and degeneration of neuronal cells could be seen. But the infarcted area of tPA-treated group was smaller than that of saline-treated control group. Only collection of foamy macrophages adjacent the necrotic area could be seen in tPA-treated group. These results suggest that tPA therapy may be safe and efficacious during the interval of 6 to 12 hours after embolization.
Arteries ; Basal Ganglia ; Brain ; Brain Infarction ; Carotid Artery, Internal ; Catheters ; Cerebral Arteries ; Coronary Thrombosis ; DNA, Recombinant ; Endothelium ; Hemorrhage ; Infarction ; Macrophages ; Necrosis ; Needles ; Neurons ; Plasminogen ; Plastics ; Rabbits ; Serine Proteases ; Tissue Plasminogen Activator*

BACKGROUND: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. METHODS: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. RESULTS: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were 156.7°, 152.2°, 61.1°, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. CONCLUSIONS: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.
California ; Elbow ; Follow-Up Studies ; Humans ; Humerus* ; Joint Capsule Release ; Methods ; Postoperative Complications ; Shoulder ; Surgeons ; Suture Anchors ; Sutures

We have experienced 20 cases of the cerebral rete mirabile from 1969 to 1975. All were proved by bilateral carotid angiography, and clinical assessment and angiographical analysis were attempted. The results were summarized as follows: 1. Age distribution was ranged from 5 to 55. The majority of 20 cases were age over 20 as 15 cases who were distributed evenly in each decade and 5 cases were age below 20. 12 cases were male and 8 female. 2. Authors classified the cases as the group of subarachnoid hemorrhage and non-subarachnoid hemorrhage conveniently. All cases of age below 20 comprised in the group of non-subarachnoid hemorrhage while majority of subarachnoid hemorrhage group were age over 20. 3. There were no contributory factors to cerebral rete mirabile with regard to past history and family background. 4. There were considerable differences in the symptoms and signs between the groups of subarachnoid hemorrhage and non-subarachnoid hemorrhage. Clinical manifestations were mainly headache and impairment of consciousness with meningeal sign in the group of subarachnoid hemorrhage. On the other hand, motor disturbance such as hemiparesis or monoparesis was occurred in the majority of non-subarachnoid hemorrhage and the minority showed speech impairment, seizure and choreiform movement. 5. All cases showed the characteristic angiographic findings of cerebral rete mirabile, which are occlusion or stenosis at the supraclinoid portion of internal carotid artery with abnormal fine vascular network around the base of brain and poor or non-visualizing anterior cerebral and middle cerebral arteries. The interesting picture was rete formation of ophthalmic artery in the orbit of 2 cases. There were no abnormal angiographic findings on the vertebral angiogram except retrograde filling to anterior cerebral and middle cerebral arteries through collateral channel from the posterior cerebral artery. 6. The prognosis of the cerebral rete mirabile seem to be favorable with regard to mortality. There were no death in our 20 cases during the period of observation.
Age Distribution ; Angiography ; Brain ; Carotid Artery, Internal ; Chorea ; Consciousness ; Constriction, Pathologic ; Female ; Hand ; Headache ; Hemorrhage ; Humans ; Male ; Middle Cerebral Artery ; Mortality ; Ophthalmic Artery ; Orbit ; Paresis ; Posterior Cerebral Artery ; Prognosis ; Seizures ; Subarachnoid Hemorrhage

Simultaneous early repair of the myelomeningocele and ventriculoperitoneal shunt in patients with myelomenimgocele and hydrocephalus not only decreases further brain damage, but also eliminates dangers of wound break down, CSF leak, and secondary CSF infection. During the years 1975-1990, we have experienced 45 patients with neural tube dysraphism which consist of 32 lipomyelomenigocele, 8 myelomeningocele, 3 meningocele and 2 encephalocele. Among those, 7 patients underwent simultaneous repair of myelomeningocele and insertion of ventriculoperitoneal shunt. 2 Patients developed wound infection, but none of the patients developed myelomeningocele repair break down or shunt infection in the follow up period of 1 to 4 years. All patients underwent neuropsychological testing during their follow up period and 5 patients were found to have their normal growth and developments. 1 patient developed low intelligence and moderate degree gait disturbance and the other 1 patient developed voiding difficulty. The authors suggest that this technique may be safe and helpful in some infants born with a myelomeningocele and hydrocephalus overt at birth.
Brain ; Encephalocele ; Follow-Up Studies ; Gait ; Humans ; Hydrocephalus* ; Infant* ; Intelligence ; Meningocele ; Meningomyelocele* ; Neural Tube ; Neuropsychological Tests ; Parturition ; Ventriculoperitoneal Shunt* ; Wound Infection ; Wounds and Injuries

This study examined the responses of cultured adult rat trigeminal ganglion neurons to protons and to capsazepine and piperine, two substances known to produce pain and hyperalgesia in humans. Whole-cell patch clamp recordings were performed on cultured adult rat trigeminal ganglion(TG) neurons voltage-clamped near their resting membrane potential(-60mV). Piperine(10nM) caused a sustained inward current associated with either an increase or decrease in membrane conductance. When protons and piperine were coapplied, the membrane currents evoked in piperine-sensitive TG neurons far exceeded the algebraic sum of the responses to the two stimuli applied in isolation. Capsazepine blocked the response of TG neurons to piperine at both physiological and acidic pH. In the presence of capsazepine, responses to the mixture of piperine and protons resembled the response to a low pH stimulus applied alone. Capsazepine had no effect on sustained proton-induced current. These findings suggest that protons enhance piperine current by altering the vanilloid receptor/channel complex or by increasing the length constant of the space clamp. This study reveals that cultured trigeminal ganglion neurons show features of chemonociceptors and may provide a useful model for studying the mechanism of chemical pain production.
Adult ; Animals ; Humans ; Hydrogen-Ion Concentration ; Hyperalgesia ; Membranes ; Neurons* ; Protons ; Rats* ; Trigeminal Ganglion*

No abstract available.
Diarrhea* ; Follow-Up Studies* ; Milk Hypersensitivity* ; Milk*

Parkinson's disease most consistently involves pathologic changes in the substantia nigra, which is the major source of dopamine to the striatum. It has been shown that either fetal substantia nigra or adrenal medulla tissue implanted to the rat brain survives, produces dopamine, and improves behavioral abnormalities induced by deprivaion of the caudate nucleus of its dopaminergic innervation. Thus, grafts containing dopamine could be potential replacement for destroyed or damaged dopaminergic neurons in patients with Parkinson's disease. In the present study, authors administrated 6-hydroxydopamine into the right substantia nigra, and produced unilateral dopamine denervated Parkinson's experimental model using solid graft method and cell suspension implant, the results of these grafts were examined behaviorally, biochemically, immunohistochemically 3 months after grafting. In this study, a total of forty-five young(4 to 5 week old) rats were used and divided into three experimental groups-control group which underwent dopamine denervation without any grafting(15), solid graft group which was grafted fetal mesencephalon to the caudate-putamien(n=15) and cell suspension implant group which was grafted cell suspension fetal mesencephalon to the caudate-putamen(n=15). The apomorphine induced rotation test was performed at four weeks, eight weeks, twelve weeks after grafting. The dopamine concentration in the caudate-putamen was biochemically measured by High Performance Liquid Chromatography(HPLC) and immunohistochemically these grafts containing dopamine granules were stained by Avidin-Biotin immunoperoxidase staining with dopamine monoclonal antibody. The results were as follows ; 1) Behavioral testing was performed by apomorphine induced rotational test. A mean rotation number during the first five minutes following apomorphine injection was 40.0+/-.5 in control and 18.3+/-.9 in cell suspension implanted group at one month after grafting and these was more reduction of turning than that in solid graft group. The both graft groups demonstrated explicit reduction of turning by 58% and 55.3% when compared to the control group respectively 3 months after grafting. However the difference in reduction of turning between the two grafted groups was statistically not significant. 2) Biochemical measurements of dopamine concentration was done in pathologic and normal caudate-putamen. The concentration of dopamine was 13.5+/-3.1ng/mg of protein in normal subject and 0.6+/-0.2ng/mg of protein in the dopamine denervated caudate-putamen of the control group which was markedly reduced by 4.4% of dopamine concentration in the normal caudate-putamen. The concentration of dopamine in the cell suspension implant group was 3.2+/-1.2ng/mg of protein at three months after grafting and 3.0+/-1.1ng/mg of protein in the solid group and these values were increased in the concentration give 5 times more than those of pregrafting state. 3) In the results of immunohistochemical examination cells containing granules of dopamine were exclusively found in the grafted groups. In experimental Parkinson's disease model of Sprague-Dawley rats, it was found that the grafts of fetal mesencephalon to the caudate nucleus induced an elevation of dopamine concentration and symptomatic improvement. In the method of graft, cell suspension implant method brings faster effect, leaves less amount of damage to the host brain, and can be used in any area of the brain for the transplantation. Therefore graft of fetal mesencephalon using cell suspension grafting method might be effective treatment of patients with Parkinson's disease.
Adrenal Medulla ; Animals ; Apomorphine ; Brain ; Caudate Nucleus ; Denervation ; Dopamine ; Dopaminergic Neurons ; Humans ; Mesencephalon* ; Models, Theoretical ; Oxidopamine* ; Parkinson Disease ; Rats* ; Rats, Sprague-Dawley ; Substantia Nigra ; Transplantation ; Transplants

In order to study the effects of stereotaxic destruction of distinct epileptogenic focus, the amygdala was destroyed with radiofrequency coagulator. A total of twenty Sprague-Dawley rats were divided into two group : the control group which underwent craniectomy on the biparietal area and was instilled crytal penicillin solution into the right amygdala on the basis of stereotaxic coordinates(n=10), and the amygdalectomy group which was performed selective amygdalectomy with radiofrequency coagulator after confirmation of clinical and electroencephalographic epileptic features after proceeding same methods of control group(n=10). The experimental epileptic models in rats were obtained by selective instillation of crystal penicillin solution into the right amygdala. The effects of amygdalectomy were investigated by observation of the changes in behavior and electroencephalographic recordings. The results were as follows ; 1) A typical behavioral seizure was shown in the control group and epilepticform discharge was prominent in crystal penicillin soultion instilled side, but there was no bilateral synchronous epileptic discharges during ictal stages. 2) In comparision to two groups, the severity and the frequency of behavioral seizure were more decreased in the stereotaxic amygdalectomy group. 3) The amygdalectomy group was shwon a significant decrease in amplitude and frequency of spikes, especially during interictal stages, compared to the control group. From the results of electroencephalographic and behavioral analysis, selective amygdalectomy with radiofrequency coagulator seemed to be an effective method to treat the crystal penicillin soulution induced epileptic rats.
Amygdala ; Animals ; Penicillins ; Rats* ; Rats, Sprague-Dawley ; Seizures