Aneurysm of the pulmonary artery is a rate entity. A neonate was seen with cyanosis and tachypnea. There was a grade 4/6 systolic murmur along the left sternal border. The chest X-ray showed a round mass shadow in the left parahilar region. Echocardiogram showed large Ventricular Septal Defect and mild Pulmonary Stenosis. The cardiac angiogram showed giant aneurysm of pulmonary artery. Surgical intervention was advised. However, the patient was discharged against operative plan. And the patient died two weeks later.
Aneurysm* ; Cyanosis ; Heart Septal Defects, Ventricular* ; Humans ; Infant, Newborn ; Pulmonary Artery ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Tachypnea ; Thorax

No abstract available.
Urinary Bladder Neoplasms* ; Urinary Bladder*

The authors retrospectively reviewed the operative cases of 28 patients with lower cervical spine injury from August 1991 to July 1996. Data from charts were reviewed the following clinical parameters, e.g.) etiologies, neurologic findings, degrees of recovery, managements including operative treatments, and complications. The lower cervical injury was most common in men in the third decade. The most common cause, mechanism and site of lower cervical injury were motor vehicle accidents, flexion type injury and C5-6 respectively. The head trauma was frequently combined. In most cases operation for stabilization was done around two weeks after the trauma, but for decompression purpose it was done before two weeks. Three patients who had complete neural injuries died due to pneumonia, adult respiratory distress syndrome, and upper gastrointestinal bleeding. A neurological recovery rate was high in incomplete neural injury group. In conclusion, early reduction and decompression of spinal canal in incomplete neural injury group is favorable for good recovery. Careful attention should be paid on the patient with complete injury for the development of serious complications such as upper gastrointestinal bleeding, ARDS and pneumonia.
Craniocerebral Trauma ; Decompression ; Hemorrhage ; Humans ; Male ; Motor Vehicles ; Neurologic Manifestations ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Spinal Canal ; Spine*

Teratogenic effects of a diphenylhydantoin on the neurulation of the explanted early chick embryos were studied using the punched-out filter paper explantation technique. The 6th to 9th Hamburger and Hamilton staged chick embryos were explanted and cultured in the Ham's F-10 media treated with 15 microgram/ml, 30 microgram/ml, 60 microgram/ml, 90 microgram/ml, 120 microgram/ml of diphenylhydantoin in the CO2 incubator for 6-9 hours. The morphological chracteristics and the ultrastructural changes of the neuroepithelium of early chick embryos were compared with the control and experimental group using the stereomicroscope and the electron microscope. Of th 40 chick embryos cultured in the Ham's F-10 media without drug, 37 embryos(92.5%) developed normally and 3 embryos(7.5%) developed abnormally in 94 embryos(61.4%). The frequent anomalous features of the embryos were deformities of the neural folds in the cranial regions, failure of neural tube closure, dispersion of somites and developmental arrest. The scanning electron microscopic findings of neuropithelial cells of abnormally developed embryos were diminished surface blebs and microvilli, flattened and smooth cellular surfaces, and irregular size of cells. The transmission electron microscopic findings of neuroepithelial cells of abnormally developed embryos showed no significant changes of the development of intracellular organelles except the smooth cellular surface and mild underdevelopment of microfilaments.
Actin Cytoskeleton ; Animals ; Blister ; Chick Embryo* ; Congenital Abnormalities ; Embryonic Structures ; Incubators ; Microvilli ; Neural Crest ; Neural Tube ; Neuroepithelial Cells ; Neurulation* ; Organelles ; Phenytoin* ; Somites

No abstract available.
Hemorrhage* ; Humans ; Movement Disorders*

Background/Aims: Extracellular vesicles (EVs) are secreted from various types of cells and have specific functions related to their origin. EVs are observed in the small intestinal lamina propria (lpEVs), but their function remains unclear. This study aimed to investigate the role of lpEVs. Methods: LpEVs were isolated from antigen (ovalbumin [OVA])-fed mice (lpEVs/OVA), and administrated to the naïve mice for 5 days before induction of lung inflammation. Afterwards, the mice were sensitized and challenged with OVA to evaluate the role of lpEVs/OVA in the regulation of immune tolerance. Results: The isolated lpEVs/OVA were sphere-shaped, bi-layered vesicles of approximately 50 to 100 nm in size. The vesicles expressed CD81, A33 antigen, and major histocompatibility complex (MHC) class II on the surface. When administrated to naïve mice, the lpEVs/OVA migrated to the spleen. Intraperitoneal lpEVs/OVA administration to naïve mice decreased the immune response against sensitized antigen in a CD4+FoxP3+T cell-dependent manner. Conclusions EVs are actively secreted from small intestinal epithelial cells to deliver information about orally administered antigens to immune cells, which will facilitate the modulation of the immune response by acting as an intercellular communicasome.

No abstract available.
Peripheral Nerves*

Xenotransplantation using pigs as the transplant source holds great promise to resolve the severe shortage of human organ donors. Although stem-cell-derived organ and tissue regeneration have a potential to solve this as well for the future, it still remains as very early experimental phase. Likewise, artificial organs and mechanical devices have been simply used for bridge therapy to transplant. Therefore, xenotransplantation might provide the most imminent solution to the scarcity of human organ donors. In the last two decades, major progress has been made in understanding the mechanisms of xenografts rejection, zoonotic infections including porcine endogenous retrovirus (PERV) and production of genetically engineered pigs including alpha1,3-galactosyltransferase-deficient pigs. With these elaborations, it is now on the threshold of first clinical application. Particularly promising first target is porcine pancreatic islet xenotransplantation. Graft survival has been prolonged to almost one year in the non-human primate study and is waiting for the development of relatively non-toxic or clinically applicable immunosuppressive or tolerance-inducing regimens. This review highlights the currently known obstacles to translate xenotransplantation into clinical therapies and the possible strategies to overcome these hurdles, as well as current status and future perspective for clinical xenotransplantaion.
Artificial Organs ; Endogenous Retroviruses ; Graft Rejection ; Graft Survival ; Humans ; Immune Tolerance ; Islets of Langerhans ; Islets of Langerhans Transplantation ; Primates ; Regeneration ; Rejection (Psychology) ; Swine ; Tissue Donors ; Transplantation, Heterologous ; Transplants

Stenosis or occlusion of large arteries after radiation are rare. The authors report a case of internal carotid arterial occlusion after radiation therapy. The patient was 45 year-old female. She received postoperative radiation therapy, a total dose of 4940cGy, to treat the remnant tumor after transsphenoidal surgery for the asymptomatic nonfunctioning pituitary adenoma. She suffered intermittant ischemic symptoms from 18 month after radiation therapy, and died with global infarction due to stenotic occlusion of the internal carotid artery at 30 month after surgery. Endocrine or vascular complications occasionally follow radiation therapy of pituitary tumor. But with improved therapies for pituitary tumors and hypopituitarism, patients are expect to live longer. Yet we must consider another delayed complication of radiation induced carotid arterial disease. As a whole, hemispheric transient ischemic attacks, amaurosis fugax, and seizure are the major presenting symptoms and signs. In such a case, it is important to consider the possibility of radiation induced arterial stenosis, and prompt cerebral angiography and proper management are mandatory.
Amaurosis Fugax ; Arteries ; Carotid Artery Diseases ; Carotid Artery, Internal ; Carotid Stenosis ; Cerebral Angiography ; Constriction, Pathologic ; Female ; Humans ; Hypopituitarism ; Infarction ; Ischemic Attack, Transient ; Middle Aged ; Pituitary Neoplasms* ; Seizures

OBJECTIVE: The purpose of this study was to analyze the clinical presentation and available therapeutic modalities for treating dural arteriovenous fistulas (DAVFs), according to the angiographic features. (Ed note : "...fistulas (DAVFs), and we wanted to determine their correlation with the angiographic features?") METHODS: We retrospectively reviewed the records of 10 DAVFs patients who were treated at our institution from June 2001 to January 2008. The nature and cause of the clinical presentation was reviewed. The angiographic findings were categorized according the patterns of venous drainage, which were based on the classification system described by Cognard et al.7 The goals (eradication of the AV fistulas vs. interruption of the cortical venous reflux) and the modalities of treatment (endovascular treatment, surgery or radiation therapy) were analyzed according to the angiographic classifications. The angiographic results and clinical outcomes were also assessed. RESULTS: According to Cognard's classification, 2 cases were type I, 3 were type II b, 1 was type II a+b, 2 were type III and 2 were type V, respectively. The initial presenting symptoms included headache (5 cases), pulsatile tinnitus (1 case), visual disturbance (1 case), seizure (1 case), mental change (3 cases) and progressive quadriplegia (1 case). Trans-arterial embolization was adapted as an initial treatment method in 6 cases (1 type I, 1 type II b, 1 type II a+b, 1 type III and 2 type V) with the goal of fistula obliteration or limited interruption of the cortical venous reflux. The procedure was successful in 5 cases (83.3%) and additional craniotomy was necessary in 1 case. Surgery was performed in 4 cases (40%) as the primary treatment modality because of the lack of endovascular accessibility or the complexity of the anatomical relationships. The surgical results were successful in all cases and no further endovascular treatment was required. Among the 9 patients who experienced the angiographically determined disappearance of DAVFs, 6 patients were rated as 5 for the Glasgow outcome scale (GOS) score, 2 patients were rated as 4 and 1 patient was rated as 3. One patient with angiographically determined incomplete obliteration showed a GOS of 3. CONCLUSIONS: The venous drainage pattern is a single most important factor for determining the clinical presentation, the treatment planning and the outcome. An endovascular procedure can be chosen as an initial treatment modality when feasible. Surgery is required for more complex and aggressive lesions with cortical venous reflux.
Central Nervous System Vascular Malformations ; Craniotomy ; Drainage ; Endovascular Procedures ; Fistula ; Glasgow Outcome Scale ; Headache ; Humans ; Quadriplegia ; Retrospective Studies ; Seizures ; Tinnitus