The author analyzed the postoperative results in 96 patients who underwent temporary clipping during cerebral aneurysm surgery from July, 1990 to April, 1995. 1) The overall outcome were as follows:excellent(55.2%), good(21.9%), poor(16.7%), dead(6.3%) and its results were relatively similar to those of the patients who did not have the temporary clipping. 2) The patients were divided into 4 groups according to the site of the temporary clip application. The safe durations of temporary clipping were as follows:In the 1) anterior cerebral artery clipping group, 5 minutes for Hunt-Hess grade 1 & 2 patients and 2 minutes and 30 seconds for Hunt-Hess grade 3 & 4 patients, In the 2) middle cerebral artery clipping group, 5 minutes;In the 3) internal carotid artery clipping group, 5 minutes in Hunt-Hess grade 1 & 2 and 2 minutes for Hunt-Hess grade 3 & 4;The only one patient in the 4) basilar artery clipping group showed excellent outcome after 3 minutes of temporary clipping. Therefore, we concluded that the temporary clipping tecnique would be very useful to dissect the aneurysmal neck, to prevent and control the premature rupture without influencing the outcome. Furthermore, use of the cerebral protective agent, intraoperative cerebral blood flow monitoring and avoidance of excessive and prolonged hypotension during cerebral aneurysm surgery might be very helpful for preventing the cerebral ischemia and increasing the safety duration of the temporary clipping.
Aneurysm ; Anterior Cerebral Artery ; Basilar Artery ; Brain Ischemia ; Carotid Artery, Internal ; Humans ; Hypotension ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Neck ; Rupture

BACKGROUND: Puromycin aminonucleoside (PAN) is a known podocytotoxin. PAN-induced nephrosis is a widely used animal model for studying human idiopathic nephrotic syndrome. Abnormal protein accumulation associated with podocyte-specific endoplasmic reticulum (ER) stress damages cells structurally and functionally, which in turn induces apoptosis and severe proteinuria. In the present study, we investigated the effect of PAN on ER stress and apoptosis in podocytes in vitro. METHODS: Mouse podocytes were cultured and treated with various concentrations of PAN. ER stress markers were then evaluated by western blotting, and apoptosis was evaluated by fluorescence-activated cell sorting (FACS) and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays. RESULTS: PAN treatment increased ER stress markers such as activating transcription factor (ATF) 6α and caspase-12 in a dose-dependent manner at 12 and 24 hours, respectively. These markers were reduced by chemical chaperones, such as sodium 4-phenylbutyric acid and tauroursodeoxycholic acid. PAN treatment also increased 78 kD glucose-regulated protein (GRP78)/binding immunoglobulin protein (BiP) at the earlier stage of 12 hours. PAN significantly induced podocyte apoptosis in concentration- and time-dependent manners, as seen using FACS and TUNEL assays. This result was improved by Nox4 siRNA, ATF6 siRNA, and chemical chaperones. LY294002, a PI3-kinase inhibitor, significantly boosted ER stress and apoptosis. PAN-induced ER stress increased oxidative stress and subsequently induced apoptosis, and could be mitigated by inhibition of PI3-kinase signaling. CONCLUSION: Our findings suggest that PAN induces ER stress in podocytes mainly through the GRP78/BiP, ATF6α, and caspase-12 pathways, which trigger apoptosis via induction of oxidative stress. This stress is mitigated by inhibiting PI3-kinase signaling.
Animals ; Apoptosis* ; Blotting, Western ; Caspase 12 ; DNA Nucleotidylexotransferase ; Endoplasmic Reticulum Stress* ; Endoplasmic Reticulum* ; Flow Cytometry ; Humans ; Immunoglobulins ; In Situ Nick-End Labeling ; In Vitro Techniques ; Mice ; Models, Animal ; Nephrosis ; Nephrotic Syndrome ; Oxidative Stress ; Phosphatidylinositol 3-Kinases ; Podocytes* ; Proteinuria ; Puromycin Aminonucleoside* ; Puromycin* ; RNA, Small Interfering ; Sodium ; Transcription Factors

The authors would like to publish this corrigendum to correct the spells of an author's name in the above article.

The anterior communicating artery is one of common sites of intracranial aneurysms, and the anterior communicating artery aneurysms are operated by pterional approach most commonly. Anatomical variation around anterior communicating artery is one of the limiting factors in surgery. Pterional approach can be made from either left or right side according to many factors, such as, dominant feeding artery, shape, size and direction of aneurysm, vascular anomaly and variation around anterior communicating artery, existence of hematoma, and multiple aneurysms. Authors analyzed 62 cases of anterior communicating artery aneurysm and discussed optimal surgical direction in pterional approach and evaluated the usefulness of position of bilateral A1-A2 junction in lateral compression angiogram. The results were as follows: 1) In the existence of another aneurysm in the carotid or middle cerebral artery, optimal surgical direction is to the side of another aneurysm. 2) Significant amount of hematoma should be considered in selecting the surgical direction. 3) If the aneurysm is large, thrombosed, and fundus is broad, the approach should be made to the side which facilitate the exposure of the neck of aneurysm first. 4) Right side approach has advantages that nondominant hemisphere is retracted and surgical manipulation is convenient with small craniotomy. 5) Exposure of the neck of the aneurysm and temporary clip is easier when approach is made along the main feeding artery. 6) Approach to the side of posteriorly placed A1-A2 junction can be another useful option in selecting optimal surgical direction.
Aneurysm ; Arteries ; Craniotomy ; Hematoma ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Neck

No abstract available.
Hematoma, Subdural, Spinal* ; Spinal Puncture*

No abstract available.
Aneurysm* ; Bone Cysts* ; Spine*

No abstract available.
Animals* ; Brain* ; Hypothermia* ; Models, Animal*

After the publication of the modern Virchow's suture fusion hypothesis regarding craniosynostosis, various types of linear craniotomy have been developed. However, after the Moss's functional matrix hypothesis became known, extensive cranial remodeling surgical procedures have emerged. However, a recent view that the cause of craniosynostosis may be due to gene mutation has led to a tendency toward treating craniosynostosis with minimally invasive surgery including endoscopic surgery and distraction procedures that utilize springs or distractors. As nonsyndromic craniosynostoses are accompanied by unilateral coronal or lambdoid craniosynostosis, and syndromic craniosynostoses are accompanied by facial anomalies, it is presumed that cranial anomalies are accompanied by facial anomalies. However, the "back to sleep" campaign that was initiated in the 1990's in order to prevent infantile death syndrome led to research in the dramatic increase in the incidence of craniofacial anomalies, which resulted in the establishment of the positional plagiocephaly concept, which has also been ascertained in animal experiments. Despite these advances, the basic problem of whether craniosynostosis is simply a cosmetic anomaly or whether it is a neurological disease that is accompanied by complications such as increased intracranial pressure has not been resolved. The consequent confusion has prevented establishment of the optimal timing for surgery and the type of surgical procedure. The authors of this study review the history of craniosynostosis treatment and attempt to clarify the situation pertaining to the surgical treatment concepts and limitations.
Animal Experimentation ; Cosmetics ; Craniosynostoses ; Craniotomy ; Incidence ; Intracranial Pressure ; Osteogenesis, Distraction ; Plagiocephaly, Nonsynostotic ; Publications ; Sutures

No abstract available.
Animals* ; Brain* ; Hypothermia* ; In Situ Nick-End Labeling* ; Models, Animal*

The etiology of congenital dislocation of the hip is still the subject of much discussion. Genetic growth disturbance, intrauterine and postnatal mechanical influences are considered as possible factors. According to Hass, typical congenital dislocation of the hip is not primarily a congenital disease. The occurance rate of C.D.H in sister or brother has been reported higher than others. But there have been no report about this cases. Two cases of C.D.H. in sister have been treated at Kang-Nam St. Mary's Hospital. Both of them were treated by traction and closed reduction under arthrography. Pavlik harness was applied in younger case after removel of hip spica cast. Clinically and radiologically the results were good during the follow-up period.
Arthrography ; Dislocations ; Follow-Up Studies ; Hip Dislocation ; Hip ; Humans ; Siblings ; Traction