The superior hypogastric plexus block (SHPB) is used for treating pelvic pain, especially in patients with gynecological malignancies. Various approaches to this procedure have been reported due to the anatomic obstacles of a high iliac crest or large transverse process of the 5th lumbar vertebra. Here, we report a new technique of superior hypogastric plexus block using a unilateral single-needle approach to block the bilateral superior hypogastric plexus with a Tuohy needle and epidural catheter. We have confidence that this new technique can be another option in performing the SHPB when the conventional bilateral approach is difficult to perform.
Catheters ; Humans ; Hypogastric Plexus ; Needles ; Nerve Block ; Pelvic Pain ; Spine

The leaner mouse carries a mutation in the gene encoding the alpha1A subunit of P/Q-type calcium channels. Leaner mice exhibit extensive cerebellar granule and Purkinje cell loss that results in cerebellar dysfunction. A previous study suggested that a small population of leaner Purkinje cells undergo apoptosis, however the cell death mode of the rest of degenerating Purkinje cells has not been identified. In order to investigate the mechanisms underlying leaner Purkinje cell death, gene arrays that contain 243 cell death related genes were carried out. To increase the chance of detecting Purkinje cell specific genes, laser capture microdissection was employed to obtain Purkinje cell enriched samples. The gene array analysis revealed several potential genes that are involved in autophagic cell death pathway including cathepsin D, a key lysosomal protease that triggers autophagic degradation. Further analysis on LC3, which is a hallmark for autophagic cell death showed that leaner Purkinje cells are degenerating via autophagic process. The present study provides evidence that calcium channel defects trigger different modes of neurodegeneration in the cerebellum.
Animals ; Apoptosis ; Autophagy ; Calcium Channels ; Cathepsin D ; Cell Death ; Cerebellar Diseases ; Cerebellum ; Laser Capture Microdissection ; Mice ; Purkinje Cells

The leaner mouse carries a mutation in the gene encoding the alpha1A subunit of P/Q-type calcium channels. Leaner mice exhibit extensive cerebellar granule and Purkinje cell loss that results in cerebellar dysfunction. A previous study suggested that a small population of leaner Purkinje cells undergo apoptosis, however the cell death mode of the rest of degenerating Purkinje cells has not been identified. In order to investigate the mechanisms underlying leaner Purkinje cell death, gene arrays that contain 243 cell death related genes were carried out. To increase the chance of detecting Purkinje cell specific genes, laser capture microdissection was employed to obtain Purkinje cell enriched samples. The gene array analysis revealed several potential genes that are involved in autophagic cell death pathway including cathepsin D, a key lysosomal protease that triggers autophagic degradation. Further analysis on LC3, which is a hallmark for autophagic cell death showed that leaner Purkinje cells are degenerating via autophagic process. The present study provides evidence that calcium channel defects trigger different modes of neurodegeneration in the cerebellum.
Animals ; Apoptosis ; Autophagy ; Calcium Channels ; Cathepsin D ; Cell Death ; Cerebellar Diseases ; Cerebellum ; Laser Capture Microdissection ; Mice ; Purkinje Cells

BACKGROUND: Various olfactory tests have already been proposed in order to clinically assess the olfactory function, for example, UPSIT, T & T olfactometer, CCCRC test, GITU, IV olfaction test. At recent, electro-olfactogram(EOG), olfactorhinometry, olfactory evoked potential, contingent negative variation was tried as the objective olfactory test. OBJECTIVES: We use the functional imaging of MRI which affords the potential for exploring regional pathophysiologic change in living brain as an olfactory function test. MATERIALS AND METHODS: Functional MRI scans of the brain were performed on 5 healthy subjects and 3 patients with olfactory dysfunction. 2 of the patients were diagnosed Parkinson's disease and the other one had basal skull fracture. Then, all subjects were performed CCCRC test. RESULT: 6 of 8 subjects showed significant region of activation in olfactory bulb and tract. Additional region of activation were also observed in amygdala and parahippocampus. Average activation ratio was 3.42+/-2.37%. CONCLUSION: These studies indicate that functional MRI have many limitations but it may be used to evaluate olfactory dysfunction and predict prognosis.
Amygdala ; Brain ; Contingent Negative Variation ; Echo-Planar Imaging* ; Evoked Potentials ; Humans ; Magnetic Resonance Imaging* ; Olfactory Bulb ; Parkinson Disease ; Prognosis ; Skull Fractures ; Smell

Influenza virus infection is a zoonosis that has great socioeconomic effects worldwide. Influenza infection induces respiratory symptoms, while the influenza virus can infect brain and leave central nervous system sequelae. As children are more vulnerable to infection, they are at risk of long-term neurological effects once their brains are infected. We previously demonstrated that functional changes in hippocampal neurons were observed in mice recovered from neonatal influenza infection. In this study, we investigated changes in myelination properties that could affect neural dysfunction. Mice were infected with the influenza virus on postnatal day 5. Tissues were harvested from recovered mice 21-days post-infection. The expression levels for myelin basic protein (MBP) were determined, and immunohistochemical staining and transmission electron microscopy were performed. Real-time polymerase chain reaction and Western blot analyses showed that mRNA and protein expressions increased in the hippocampus and cerebellum of recovered mice. Increased MBP-staining signal was observed in the recovered mouse brain. By calculating the relative thickness of myelin sheath in relation to nerve fiber diameter (G-ratio) from electron photomicrographs, an increased G-ratio was observed in both the hippocampus and cerebellum of recovered mice. Influenza infection in oligodendrocyte-enriched primary brain cell cultures showed that proinflammatory cytokines may induce MBP upregulation. These results suggested that increased MBP expression could be a compensatory change related to hypomyelination, which may underlie neural dysfunction in recovered mice. In summary, the present results demonstrate that influenza infection during the neonatal period affects myelination and further induces functional changes in influenza-recovered mouse brain.
Animals ; Blotting, Western ; Brain ; Cell Culture Techniques ; Central Nervous System ; Cerebellum ; Child ; Cytokines ; Hippocampus ; Humans ; Influenza, Human ; Mice ; Microscopy, Electron, Transmission ; Myelin Basic Protein ; Myelin Sheath ; Nerve Fibers ; Neurons ; Oligodendroglia ; Orthomyxoviridae ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Up-Regulation

Background: /Aim: Transforming growth factor-beta (TGF-β) has a dichotomous role, functioning as a tumor suppressor and tumor promoter. TGF-β signatures, explored in mouse hepatocytes, have been reported to predict the clinical outcomes of hepatocellular carcinoma (HCC) patients; HCCs exhibiting early TGF-β signatures showed a better prognosis than those with late TGF-β signatures. The expression status of early and late TGF-β signatures remains unclear in defined lesions of human B-viral multistep hepatocarcinogenesis. Methods: The expression of TGF-β signatures, early and late responsive signatures of TGF-β were investigated and analyzed for their correlation in cirrhosis, low-grade dysplastic nodules (DNs), high-grade DNs, early HCCs and progressed HCCs (pHCCs) by real-time PCR and immunohistochemistry. Results: The expression levels of TGF-β signaling genes (TGFB1, TGFBR1, TGFBR2 and SMAD4) gradually increased with the progression of hepatocarcinogenesis, peaking in pHCCs. The expression of early responsive genes of TGF-β (GADD45B, FBP1, CYP1A2 and CYP3A4) gradually decreased, and that of the late TGF-β signatures (TWIST and SNAI1) significantly increased according to the progression of multistep hepatocarcinogenesis. Furthermore, mRNA levels of TWIST and SNAI1 were well correlated with those of stemness markers, with upregulation of TGF-β signaling, whereas FBP1 expression was inversely correlated with that of stemness markers. Conclusions The enrichment of the late responsive signatures of TGF-β with induction of stemness is considered to be involved in the progression of the late stage of multistep hepatocarcinogenesis, whereas the early responsive signatures of TGF-β are suggested to have tumor-suppressive roles in precancerous lesions of the early stage of multistep hepatocarcinogenesis.

Currently, no vaccine or established therapeutic agents are available for coronavirus disease 2019. The sharp increase in demand for personal protective equipment (PPE) necessitates an improvement in the protective efficacy of PPE. We evaluated the potential antimicrobial and antiviral effects of a surface-coating disinfectant (3-(trimethoxysilyl)propyldimethyl octadecyl ammonium chloride, Si-QAC) when applied onto PPE. Si-QAC-pre-coated PPE was artificially contaminated with either influenza virus or Salmonella. The results showed significantly reduced influenza and Salmonella titers in Si-QAC-coated PPE; these antimicrobial effects lasted 7 days. This suggests that this surface-coating disinfectant effectively reduces pathogen contamination of PPE, enabling their safe and long-term use.

Purpose: The favorable clinical efficacies of intramuscular injection of autologous blood in patients with atopic dermatitis (AD) and intramuscular injection of autologous serum in patients with chronic urticaria have been demonstrated by randomized clinical trials. In this study, we assessed the clinical effectiveness and safety of the intramuscular injection of autologous serum in patients with AD. Materials and Methods: In this randomized, placebo-controlled, and double-blind trial, 23 adolescent and adult patients with moderate-to-severe AD were enrolled. The patients were randomized to receive eight intramuscular injections of 5 mL of autologous serum (n=11) or saline (n=12) over 4 weeks, and were followed up until week 8. Changes in the clinical severity scores of AD assessed by SCORing Atopic Dermatitis (SCORAD), patient-reported Dermatology Life Quality Index (DLQI) score, and incidence of adverse events were assessed from baseline to week 8. Results: One patient in the treatment group and two patients in the placebo group were lost to follow-up before week 8. The intramuscular administration of autologous serum, compared with saline, decreased the SCORAD clinical severity score (-14.8% vs. 10.7%, p=0.006) and improved the DLQI score (-32.6% vs. 19.5%, p=0.01) from baseline to week 8. Serious adverse events were not observed. Conclusion Intramuscular injection of autologous serum may be effective in treating AD. Further studies are needed to evaluate the clinical usefulness of this intervention for AD (KCT0001969).

Currently, no vaccine or established therapeutic agents are available for coronavirus disease 2019. The sharp increase in demand for personal protective equipment (PPE) necessitates an improvement in the protective efficacy of PPE. We evaluated the potential antimicrobial and antiviral effects of a surface-coating disinfectant (3-(trimethoxysilyl)propyldimethyl octadecyl ammonium chloride, Si-QAC) when applied onto PPE. Si-QAC-pre-coated PPE was artificially contaminated with either influenza virus or Salmonella. The results showed significantly reduced influenza and Salmonella titers in Si-QAC-coated PPE; these antimicrobial effects lasted 7 days. This suggests that this surface-coating disinfectant effectively reduces pathogen contamination of PPE, enabling their safe and long-term use.

PURPOSE: We aimed to evaluate the histologic and radiologic findings of vascular lesions after stereotactic radiosurgery (SRS) categorized as radiation-induced cavernous hemangioma (RICH). MATERIALS AND METHODS: Among 89 patients who underwent neurosurgery for cavernous hemangioma, eight RICHs from 7 patients and 10 de novo CHs from 10 patients were selected for histopathological and radiological comparison. RESULTS: Histologically, RICHs showed hematoma-like gross appearance. Microscopically, RICH exhibited a hematoma-like area accompanied by proliferation of thin-walled vasculature with fibrin deposits and infiltrating foamy macrophages. In contrast, CHs demonstrated localized malformed vasculature containing fresh and old clotted blood on gross examination. Typically, CHs consisted of thick, ectatic hyalinized vessels lined by endothelium under a light microscope. Magnetic resonance imaging of RICHs revealed some overlapping but distinct features with CHs, including enhancing cystic and solid components with absence or incomplete popcorn-like appearance and partial hemosiderin rims. CONCLUSION: Together with histologic and radiologic findings, RICH may result from blood-filled space after tissue destruction by SRS, accompanied with radiation-induced reactive changes rather than vascular malformation. Thus, the term "RICH" would be inappropriate, because it is more likely to be an inactive organizing hematoma rather than proliferation of malformed vasculature.
Adult ; Aged ; Brain/*pathology ; Brain Neoplasms/*pathology ; Female ; Hemangioma, Cavernous/complications/*pathology/surgery ; Hematoma/surgery ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiosurgery/adverse effects ; Treatment Outcome