BACKGROUND: The intrathecal (IT) administration of glycine or GABAA receptor antagonist result in a touch evoked allodynia through disinhibition in the spinal cord. Glycine is an inhibitory neurotransmitter that appears to be important in sensory processing in the spinal cord. This study was aimed to evaluate the effect of glycine-related amino acids on antagonizing the effects of IT strychnine (STR) or bicuculline (BIC) when each amino acid was administered in combination with STR or BIC. METHODS: A total of 174 male ICR mice were randomized to receive an IT injection of equimolar dose of glycine, betaine, beta-alanine, or taurine in combination with STR or BIC. Agitation in response to innocuous stimulation with a von Frey filament after IT injection was assessed. The pain index in hot-plate test were observed after it injection. The effect of it muscimol in combination with str or bic were also observed. RESULTS: The allodynia induced by STR was relieved by high dose of glycine or betaine. But, allodynia induced by BIC was not relieved by any amino acid. Whereas the STR-induced thermal hyperalgesia was only relieved by high dose of taurine at 120 min after IT injection, the BIC-induced one was relieved by not only high dose of taurine at 120 min but also low dose of glycine or betaine at 60 min after IT injection. The BIC-induced allodynia and thermal hyperalgesia was relieved by IT muscimol. CONCLUSIONS: This study suggests that IT glycine and related amino acids can reduce the allodynic and hyperalgesic action of STR or BIC in mice.
Amino Acids ; Animals ; beta-Alanine ; Betaine ; Bicuculline ; Dihydroergotamine ; Glycine ; Humans ; Hyperalgesia ; Male ; Mice ; Mice, Inbred ICR ; Muscimol ; Neurotransmitter Agents ; Nitrogen Mustard Compounds ; Spinal Cord ; Strychnine ; Taurine

PURPOSE: To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). MATERIALS AND METHODS: We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. RESULTS: The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or > or =1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). CONCLUSION: Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Estrogens ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome*

PURPOSE: To find the rebleeding factors in bronchial arterial embolization for treatment of hemoptysis, a retrospective study was performed. MATERIALS AND METHODS:Medical records, anglographic findings and embolic materials of 35 patients who had undertaken arterial embolization for control of hemoptysis were reviewed. The period of follow-up for rebleeding was from 3 to 32 months after arterial embolization. We investigated the anglographic findings of extravasation, neovascularity, intervascular shunt, aneurysm and periarterial diffusion. Neovascularity was classified as mild(numerable neovascularity) and severe(innumerable). RESULTS: Rebleeding occured in 15(43%) among 35 cases. Only two of 11 cases with no past episode of hemoptysis showed recurrence, while 9 of 15 cases who had more than three episodes did. Severe neovascularity were seen in 11 of 15 recurred cases, but seven of 20 non-recurred cases showed severe neovascularity. More than three anglographic findings representing hemoptysis were seen on 11(73%) among recurred 15 cases and seven(35%) among non-recurred 20 cases. The lesion was supplied by more than two different arteries on 8(54%) of the recurred cases, but only three(15%) of the non-recurred cases. Six of seven cases persistent neovascularity after arterial embolization were recurred. CONCLUSION: The history of repeated hemoptysis, severe neovascularity, variable anglographic findings, and post-embolization persistency of neovascularity were the factors related with the rebleeding after arterial embolization for hemoptysis. Careful and active arterial embolization are required on these conditions.
Aneurysm ; Arteries ; Diffusion ; Follow-Up Studies ; Hemoptysis* ; Humans ; Recurrence ; Retrospective Studies

PURPOSE: To evaluate the value of dacryoscintigraphy in the assessment of patients with a clinical diagnosis of functional nasolacrimal duct obstruction. MATERIALS AND METHODS: Dacryoscintigraphy was performed in symptomatic 35 lacrimal drainage systems in 18 patients (age range: 37~76, 8 males, 10 females) that were patent on syringing. RESULTS: Abnormalities were detected with dacryoscintigraphy in 75.8% of systems. The positive scintigrams were subdivided into those demonstrating prelacrimal sac delay (31.8%), delay at the lacrimal sac/junction (40.9%), or delay within the duct (27%). CONCLUSION: Dacryoscintigraphy is noninvasive useful technique in the assessment of the functional nasolacrimal duct obstruction and very sensitive at detecting abnormalities in patients with lid laxity caused by senile change and facial nerve palsy.
Diagnosis* ; Drainage ; Facial Nerve ; Humans ; Male ; Nasolacrimal Duct* ; Paralysis

Myelodysplastic syndrome (MDS) is a relatively uncommon hematological disorder, charactedzed by cytopenia in the peripheral blood and normo-or hypercellularity in the bone marrow with morphological dysplastic change. Ineffective hematopoiesis leads to hematological failures in this syndrome. MDS is largeIy affected in older individuaIs with a median age of 60-75. It's association with pregnancy is even rarer. Although the exact incidence of MDS in pregancy is unknown, it is likely to be less than 1 per 100,000 pregnancies annually. Recently, we experienced a case of MDS presented initially during pregnancy in a 34-year-old primipara and managed with intensive hematologic support. Uerine rupture occurred in pregnancy complicated with MDS at 34 gestation weeks and a healthy infant was successfully delivered by Cesarean section. We report this case with a brief review of the literature.
Adult ; Bone Marrow ; Cesarean Section ; Female ; Hematopoiesis ; Humans ; Incidence ; Infant ; Myelodysplastic Syndromes* ; Pregnancy* ; Rupture ; Uterine Rupture*

Myelodysplastic syndrome (MDS) is a relatively uncommon hematological disorder, charactedzed by cytopenia in the peripheral blood and normo-or hypercellularity in the bone marrow with morphological dysplastic change. Ineffective hematopoiesis leads to hematological failures in this syndrome. MDS is largeIy affected in older individuaIs with a median age of 60-75. It's association with pregnancy is even rarer. Although the exact incidence of MDS in pregancy is unknown, it is likely to be less than 1 per 100,000 pregnancies annually. Recently, we experienced a case of MDS presented initially during pregnancy in a 34-year-old primipara and managed with intensive hematologic support. Uerine rupture occurred in pregnancy complicated with MDS at 34 gestation weeks and a healthy infant was successfully delivered by Cesarean section. We report this case with a brief review of the literature.
Adult ; Bone Marrow ; Cesarean Section ; Female ; Hematopoiesis ; Humans ; Incidence ; Infant ; Myelodysplastic Syndromes* ; Pregnancy* ; Rupture ; Uterine Rupture*

Basal cell carcinoma (BCC) is the most common dermatologic cancer characterized by slow growing, less invasive and highly curable clinical course. But occasionally, BCC behaves aggressively with deep invasion and potential regional and distant metastasis. Several risk factors, including tumor size, duration, histologic type, and perineural invasion have been postulated as markers of the aggressive BCC phenotype. Tumors occuring along the nasolabial fold or the retroauricular area may be aggressive but that is still debated. Aggressive cases of BCC involving the parotid gland, the emporal bone and the facial nerve have been rarely reported. We report a case of aggressive basal cell carcinoma involving the parotid gland, the temporal bone, and the facial nerve with a review of the literature.
Carcinoma, Basal Cell ; Facial Nerve ; Nasolabial Fold ; Neoplasm Metastasis ; Parotid Gland ; Phenotype ; Risk Factors ; Temporal Bone

BACKGROUND: Patients with a prior myocardial infarction who undergo noncardiac surgery have a higher risk of perioperative morbidity and mortality. Therefore, this study was designed to assess the outcomes after non-cardiac surgery in patients who had a previous myocardial infarction. METHODS: Ninety three patients who had a prior myocardial infarction and underwent noncardiac surgery were included in this study. The patients were divided as follows: the Complication group versus the Non-Complication group. A retrospective analysis was performed to determine if age, gender, ejection fraction, prior coronary revascularization, ASA physical status, operation time and type, perioperative vital signs, cardiac risk factor, preoperative medications and coronary multivessel disease influence the perioperative morbidity and mortality. RESULTS: Fourteen of the 93 patients (15.1%) had perioperative complications, of which 3 (3.2%) were fatal. All fatal patients had undergone noncardiac surgery within 3 months after the previous coronary revascularization. The incidence of intraoperative tachycardia and oliguria, operation time and the ASA physical status were longer and greater in the Complication group (P<0.05). Otherwise there were no significant differences between the two groups. CONCLUSIONS: The incidence of intraoperative tachycardia and oliguria, the operation time and ASA physical status influence the outcomes after noncardiac surgery of patients with a prior myocardial infarction. In addition, the interval between the coronary revascularization procedure and the noncardiac surgery has a major impact on postoperative mortality. However, prospective multi-center studies will be needed to determine the effects of several variables.
Humans ; Incidence ; Mortality* ; Myocardial Infarction* ; Oliguria ; Retrospective Studies ; Risk Factors ; Tachycardia ; Vital Signs

We present an extremely rare case of the atypical choroid plexus papilloma in an adult which developed at the trigone of right lateral ventricle. A 62-year-old woman presented with the history of intermittent and gradually progressive headache and left side hemiparesis for 6 months. The brain magnetic resonance image showed highly enhanced and well demarcated mass at the trigone of lateral ventricle attached to the choroid plexus. Gross total resection was performed by transcortical approach via the middle temporal gyrus. The tumor was diagnosed as an atypical choroid plexus papilloma. She had no neurologic deficit after the surgery. We report a case of atypical choroid plexus papilloma in adult and introduce newly classified pathologic characteristics of this tumor.
Adult ; Brain ; Choroid ; Choroid Plexus ; Diffusion Tensor Imaging ; Female ; Headache ; Humans ; Lateral Ventricles ; Magnetic Resonance Spectroscopy ; Middle Aged ; Neurologic Manifestations ; Neuronavigation ; Papilloma, Choroid Plexus ; Paresis

Glycine and gamma-aminobutyric acid (GABA) are localized and released by the same interneurons in the spinal cord. Although the effects of glycine and GABA on analgesia are well known, little is known about the effect of GABA in strychnine-induced hyperalgesia. To investigate the effect of GABA and the role of the glycine receptor in thermal hyperalgesia, we designed an experiment involving the injection of muscimol (a GABAA receptor agonist), baclofen (a GABAB receptor agonist) or glycine with strychnine (strychnine sensitive glycine receptor antagonist). Glycine, muscimol, or baclofen with strychnine was injected into the cisterna magna or lumbar subarachnoidal spaces of mice. The effects of treatment on strychnine-induced heat hyperalgesia were observed using the pain threshold index via the hot plate test. The dosages of experimental drugs and strychnine we chose had no effects on motor behavior in conscious mice. Intracisternal or intrathecal administration of strychnine produced thermal hyperalgesia in mice. Glycine antagonize the effects of strychnine, whereas, muscimol or baclofen does not. Our results indicate that glycine has anti-thermal hyperalgesic properties in vivo; and GABA receptor agonists may lack the binding abilities of glycine receptor antagonists with their sites in the central nervous system.
Animals ; Baclofen/*administration & dosage/pharmacology ; Drug Delivery Systems ; GABA Agonists/administration & dosage/pharmacology ; GABA Antagonists/administration & dosage/pharmacology ; Glycine/*administration & dosage/pharmacology ; Hot Temperature ; Hyperalgesia/chemically induced/*drug therapy ; Injections, Spinal ; Male ; Mice ; Mice, Inbred ICR ; Muscimol/*administration & dosage/pharmacology ; Pain Threshold ; Random Allocation ; Strychnine ; gamma-Aminobutyric Acid/metabolism