Of the many potential source of free radial generation, the enzyme xanthine oxidase has been shown to be important in ischemia in non-cerebral tissues. Oxygen-derived free radicals have been implicated in various pathological conditions including ischemia. Xanthine oxidase serve as a source of oxidizing agents such as superoxide radical and hydrogen peroxide. It is investigated that the effect of a specific xanthine oxidase inhibitor, allopurinol, on infarct size in a model of continuous partial cerebral ischemia in rats. Infarct volume was measured by triphenyl tetrazolium chloride staining of brains removed 24 hours after middle cerebral arterial occlusion. Cortical tissue was more effectively protected than basal tissue, especially in allopurinol pretreated group. On histological examinations, hemispheric swelling, PMN cell infiltration and endothelial damage were noted irrespective of allopurinol treatment. It was speculated that free radicals are important in infarction secondary to partial continuous cerebral ischemia and that xanthine oxidase may by the primary source of these radicals.
Allopurinol* ; Animals ; Brain Infarction* ; Brain Ischemia ; Brain* ; Free Radicals ; Hydrogen Peroxide ; Infarction ; Infarction, Middle Cerebral Artery* ; Ischemia ; Middle Cerebral Artery* ; Oxidants ; Rats ; Superoxides ; Xanthine Oxidase

In order to evaluate the effect of the lumbar epidural steroid injection in the low back pain and/or radicular pain. We studied 66 patients who were treated and followed for an average of 8.6 months. In the initial evaluation, main pain sites were as follows: low back pain in 41 patients, buttock pain in 7 patients, and leg pain. In 18 patients. Immediate response and delayed response in the patients were studied. Immediate response within 1 day after injection revealed the following : dramatic improvement in 3.0%;some improvement in 56.1%; no improvement in 27.3%; and more aggravated in 13.6%. Delayed response after 1 month revealed the following : 15.2% continuously maintained improvement; 9.1 showed progressive improvement;36.4% experienced recurring pain; 27.3% had no improvement; and 10.6% had aggravating pain. The effect of the lumbar epidural steroid injection was not affected by the severity of pain in the initial evaluation. Better improvements were noted in patients who suffered radicular pain than those who suffered low back or buttock pain. Good prognostic factors were young age and male. Complications that the patients suffered were transient injection pain(6), edema of the face or extremity(10), transient leg weakness(5) and dural puncture(1). The number of patients who wanted to recommend this procedure to others were 22(33.3%). In conclusion, epidural steroid injection was one of the methods in the management of the patients who suffered low back pain and/or radicular pain and had no effect by any other therapies.
Buttocks ; Edema ; Humans ; Leg ; Low Back Pain* ; Male

Pituitary adenomas are uncommon in childhood and adolescence. From a series of 94 patients with pituitary adenoma operated by microsurgical technique during the period of June. 1988 to March, 1994, the cases of nine young people whose symptoms had appeared between the ages of 8.3 and 17.3 years are selected and presented. Of these 9 patients, three(33.3%) had prolactin(PRL)-secreting tumors. 3(33.3%) had PRL and adrenocorticotropic hormone(ACTH)-secreting tumors, and among remaining three patients had a tumor secreting both growth hormone(GH) and PRL, one with clinically nonfunctioning tumor, and one with a craniopharyngioma. The average age of patients at the time of surgery was 14.8 years with the youngest patient being 8.5 years old. Presenting symptoms primarily reflected the increased intracranial pressure. All but one underwent operations by the transsphenoidal approach(TSA). There was no death in this patient group. Significant operative morbidity included one incidence of third nerve palsy in one case after transcranial approach and diabetes insipidus in another after TSA. Both incidences were transient and were resolved later. Plurihormonal tumors, broadly defined as tumors producing more than one hormone, were common in this study group. Follow-up study revealed good control of tumors in the majority of cases, however there were two cases of recurrences on 80% of initial remission rate. Based on the observed data, it is concluded that: 1) transsphenoidal surgery is feasible and safe in this age group: 2) plurihormonal tumors occur more frequently in the pediatric and adolescent age group than in adults: 3) Suprasellar extension is more frequent in this age group that in adults: 4) initial remission is high, but recurrence rate seems to be higher in this age group than in adults.
Adolescent* ; Adult ; Craniopharyngioma ; Diabetes Insipidus ; Follow-Up Studies ; Humans ; Incidence ; Intracranial Pressure ; Oculomotor Nerve Diseases ; Pituitary Neoplasms* ; Prolactinoma ; Recurrence

No abstract available.
Brain* ; Krukenberg Tumor* ; Neoplasm Metastasis*

We report a series of 19 consecutive patients with post-traumatic cerebral infarction. Post-traumatic cerebral infarction(PTCI) was diagnosed by CT within 24 hours of admission in 6 cases and up to 14 days after admission in 13 cases of 1092 patients who required cranial CT for trauma during the period. The frequency, vaascular territories, cause, and mortality rate of post traumatic cerebral infarction were discussed.
Cerebral Infarction* ; Humans ; Mortality

OBJECTIVES: DNA polymerase (pol) of Hepatitis B virus (HBV) includes 3 different domains such as terminal protein (TP), reverse transcriptase (RT) and RNase H. Humoral immune responses to each of these proteins have not been well documented previously, although antibody to pol was detected in serum of patients with chronic hepatitis B. We have constructed TP (amino acids 1-182), RT (amino acids 346-685) and RNase H (amino acids 690-832). METHODS: By ELISA using each protein expressed in E. coli as antigens, the corresponding antibodies were tested in serum from 40 patients with type B viral chronic liver diseases. (20 HBeAg-positive and 20 HBeAg-negative). As negative controls, sera from 3 healthy young men were used. With the mean values of the OD, which were tested 4 times per each test sample and 3 times per each control sample, we considered to be positive if the mean OD of each test sample is 2-fold or higher than that of controls. RESULTS: Five of 40 sera (12.5%) contained one or two different antibodies detectable by this method: 4 of 20 HbeAg-positive sera (20%) and 1 of 20 HbeAg-negative sera (5%). Anti-TP, anti-RT and anti-RNase H antibodies were detected in 2.5% (1/40), 10% (4/40) and 7.5% (3/40), respectively. Among 4/20 HbeAg-positive ELISA-positive sera, anti-TP, anti-RT and anti-RNase H were positive in 5% (1/20), 20% (4/20) and 10% (2/20), respectively, while 1 HBeAg-negative ELISA-positive sera were positive only for anti-RNase H. CONCLUSIONS: These results suggest that the corresponding antibody responses to individual recombinant peptides derived from 3 domains of DNA polymerase may tend to be detected more frequently in HBeAg-positive sera than in HBeAg-negative sera from various patients with type B viral chronic liver diseases.
Adult ; Antibodies, Antinuclear/analysis* ; Biological Markers/analysis ; DNA Polymerase II/immunology* ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis B Surface Antigens/analysis* ; Hepatitis B Virus/immunology* ; Hepatitis B, Chronic/immunology* ; Human ; Male ; Middle Age ; Odds Ratio ; Reference Values ; Substances: DNA Polymerase II ; Substances: Hepatitis B Surface Antigens ; Substances: Biological Markers ; Substances: Antibodies, Antinuclear

Neuroendocrine tumors are heterogeneous and potentially aggressive, and they must be distinguished from classic carcinoid tumors as the tumors share histologic features with their counterparts that occur in the lung, such as oat cell and intermediate cell carcinomas. Histopathologically, the oat cell neuroendocrine carcinoma displays itself in sheets, cord and rib-bons of small hyperchromatic, undifferentiated cells with very scanty cytoplasm. The intermediate cell is slightly larger than the oat cell and has more abundant cytoplasm. The authors report a case of a 52-year old patient with neuroendocrine carcinoma that occurred at the anterior cranial fossa extending into the nasal cavity. The patient presented with recurrent meningitis and seizure. Histological examination of the nasal biopsy tumor specimen confirmed neuroendocrine carcinoma, afterwhich the patient treated with a 4300 rad radiation therapy. Magnetic resonance imaging taken 2 years later showed an enlargement of the tumor mass at the anterior cranial fossa, and the patient was operated for removal of the intracranial tumor. The nasal cavity defect was reconstructed using rotation galeal flap technique.
Avena ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Cranial Fossa, Anterior* ; Cytoplasm ; Humans ; Lung ; Magnetic Resonance Imaging ; Meningitis ; Middle Aged ; Nasal Cavity ; Neuroendocrine Tumors ; Seizures

The purpose of this study was, first, to devise a new model for topical application of excitatory amino acids(EAAs) to rat cerebral cortex that successfully and repeatdly initiate the cortical spreading depression(CSD). Then, by using this model, six major EAAs that are known to act on single or multiple subtypes of EAA receptor were examined; glutamate, kainate, aspartate, N-methyl-D-aspartate(NMDA), quisqualate, and alpha-amino-3-hydroxy-5-methyl-4-isoxazoie-proprite(AMPA). Through the model, with a cone-shaped well buried in 1.5mm depth of the cerebral cortex, these chemical agents were topically applied to the cortical gray matter. A total of 50 Sprague-Dawley rats were used and divided into seven groups including the sham group. Doses of each EAA between 10(-7) and 10(-4)M concentrations were escalated for triggering the CSD and its rate of consistency in triggering was also evaluated. In the overall results. CSDs were repeatedly initiated in all experimental groups with relatively consistent rates. Duration of CSDs were 1-4 minutes(mean 2.2+/-1.4) and amplitudes were 20-40mV. Effective dose(50)(ED(50)), that trigger over 50% of CSD was 10(-5)M(n=8) for glutamate, 10(-7)M(n=8) for aspartate, 10(-5)M(n=7) for AMPA, 10(-5)M(n=7) for quisqualate, and 10(-4)M(n=7) for NMDA and kainate group. Among those acting on the single receptor, AMPA was shown to be the most effective in triggering CSD, and NMDA, and kainate were in descending orders. Aspartate that was known to act on multiple EAA receptors, showed the highest rate of triggering CSD among all groups, but glutamate, known to act on all receptors of its subtypes, showed the most consistent rate of triggering CSD at dose escalation. These results revealed that those EAA acting on multiple receptors, namely aspartate and glutamate, showed the highest and most consistent rate of triggering CSD. Among those acting on single channel of receptors. AMPA was the most effective, although its consistency and rate of triggering of CSD was somewhat lower than.
alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; Aspartic Acid ; Cerebral Cortex ; Cortical Spreading Depression* ; Excitatory Amino Acids* ; Glutamic Acid ; Kainic Acid ; N-Methylaspartate ; Quisqualic Acid ; Rats ; Rats, Sprague-Dawley ; Receptors, AMPA

OBJECTIVE: Although surgical clipping of intracranial aneurysm is the definite method of treatment, there remains a small number of patients in whom surgical clipping is not technically possible. In such difficult cases, surgeon has to consider other therapeutic alternatives. In this report, we analyze our aneurysmal cases treated by wrapping and coating method and evaluate their surgical outcome and follow-up results. METHOD: Among the total of 877 patients operated from 1990 to 1999 for intracranial aneurysms at our hospital, 40 cases(4.6%) were treated by wrapping and coating method. They included 24 cases of single ruptured aneurysms and 16 with unruptured ones in multiple aneurysms. Wrapping with temporalis muscle and/or muslin gauze and coating with bioadhesive agent such as fibrin glue were performed. RESULT: Wrapping and coating method was performed mostly to the anterior communicating artery aneurysm (35%), and mostly because of the broad-based neck of an aneurysm(43%). At the time of discharge, 30 out of 40 patients(80%) showed favourable outcome and three cases died. The patients were monitored for average of 37 months(3-75 months). Among 24 cases with single ruptured aneurysm, 4 cases(17%) had early rebleeding within 6 months from the initial hemorrhage, and such rebleeding occurred within the first postoperative month in 3 cases. However, there was no rebleeding after the 6 months. Among 16 patients whose aneurysms were unruptured ones, none of them showed bleeding episode. CONCLUSION: It seems likely that the wrapping and coating method would be some help to prevent the rebleeding of an intracranial aneurysm. In order to obtain more accurate results regarding the efficacy of such method, it will be necessary to perform a multi-center study for longer follow-up periods and various wrapping and coating materials.
Aneurysm ; Aneurysm, Ruptured ; Fibrin Tissue Adhesive ; Follow-Up Studies ; Hemorrhage ; Humans ; Intracranial Aneurysm* ; Neck ; Surgical Instruments

Spinal Cord contusions in cats were produced experimentally by impact injuries to the surgically exposed cord at the second lumbar vertebral level. As a step in the investigation of the possible effect of spinal cord trauma on biochemical and ultrastructural changes in the injured cord, activities of lipid peroxidation were measured in the frozen-dried sample of the spinal cord and the fine structure of the myelinated nerve fiber in the white matter were observed before and after the cord injury. An increase of lipid peroxidation level was found as early as 30 minutes after the injury and the highest concentration was reached at 4 hours of injury. Fine structures of the myelinated nerve fibers were changed progressively with the lapse of time after the injury. By 1 hour after the contusion the myelinated nerve fibers showed moderately enlarged periaxonal space, attenuation and disarray of the myelin sheaths. By 4 hour after the contusion, there appeared disarray of the myelin sheaths, greatly enlarged periaxonal space and irregulary contoured axons. The effect of naloxone of the lipid peroxidation and fine ultrastructure of the myelinated nerve fibers were studied, and the results of this study suggested that naloxone have a beneficial effect on the change in lipid peroxidation and the preservation of the myelinated nerve fibers after injury.
Animals ; Axons ; Cats ; Contusions ; Lipid Peroxidation* ; Myelin Sheath* ; Naloxone* ; Nerve Fibers, Myelinated ; Spinal Cord Injuries ; Spinal Cord*