PURPOSE: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TRI) and normal brain MRI findings. MATERIALS AND METHODS: Thirty TBI patients and 19 healthy volunteers underwen1 rest/acerazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM97), RESULTS: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities, In patients with lower performance scale scores. CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a port of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal Iobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. CONCLUSION: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.
Adult ; Brain ; Brain Injuries* ; Frontal Lobe ; Healthy Volunteers ; Humans ; Intelligence* ; Magnetic Resonance Imaging ; Occipital Lobe ; Rabeprazole ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon

The breakage of component is rare in TKA and usually restricted to hinges and linked design. Occasionally fracture of metal tibial component has been noted, but fracture of the femoral component has been rarely reported and occurred to be a significaot problem in TKA. This study reports 2 cases of femoral component fracture using Whiteside Ortholoc total knee system and analyzes the cause of this phenomenon. One pahent, a 67 years old female who weighed 74kg, was performed 1ke left TKA using Whiteside Ortholoc g system with cement. The size of feraoral component was small plus, and small tibial component, 14mm tibial insert and 28mm pateBa were used, The medial site of femoeal component fractured at 38 months postoperatively. A second female patient, who weighed 68kg and was 64 years old at the time of surgery, had also the left TKA using a medium sized femoral component of Whiteside Ortholoc modular system with cement. The small-Ex large tibial component, 8rrun tibial insert were used, but did not replace the pateBa. Also at 37 mainths postaperatively the medial site of femoral compcnent fractured, Ail cases were revised with using a cemented P,F.C. Modular Total Knee System (Johnson k Johnson). All two cases were kactured at the junction between the posterior bevel md distal surface of the medial femoral condyle. The thickness and length of Whiteside Ortholoc femoral component are thinner and shorter at posterior bevel surface compared with other TKA systems. So it is encouraging that a minor design modification of Whiteside Ortholoe femoral component and also should be edueated for the prohibihon of excessive flexion of the knee joint after TKA.
Aged ; Female ; Humans ; Knee Joint ; Knee* ; Middle Aged

No abstract available.

The toxicity and adrenostatic effect of o,p'-DDD, a derivative of the insecticidal DDT, on the adrenal cortex were well known. It known that the toxicity was based on the blocking of steroid biopsynthesis when cholesterol was converted to pregnenolone. Lysodren(R) was also known to be capable of producing a regression of adrenocortical carcinoma and its metastases, and this drug became one of useful choice for the treatment of unoperable adrenocortical carcinomas. Recently, fine structural effect of o,p'-DDD on the adrenocortical carcinoma show that the mitochondria is the primary target organelle. o,p'-DDD was dissolved in corn oil and it was orally administered for 28 days to investigate the ultrastructural effects of zona fasciculata of rat adrenal cortex. The results obtained were as follow: 1) The body weight was decreased after feeding o,p'-DDD. 2) Light microscopic examination showed no remarkable change except increased fine lipid droplets of zona fasciculata in group I (o,p'-DDD 75 mg/kg feeding). Moderately increased intracytoplasmic lipid droplets and pyknotic nuclei bearing membrane indentations were seen in group II (o,p'-DDD 150 mg/kg feeding). Large sized lipid droplet aggregates, pyknotic nuclei with severe nuclear membrane indentations and karyorrhexis in focal area were evident in group III. 3) Immunohistochemical staining for ACTH in pituitary gland showed increasing number of ACTH secretory cell and increasing intensity of staining property according to the dosage of o,p'-DDD. 4) Ultrastructural examination showed increased intracytoplasmic lipid droplets and mild increased peroxisome. There was no remarkable ultrastructural changes in mitochondria in group I. Moderately increased lipid droplets and clusters formation, compressed mitochondria, partial disappearance of mitochondrial cristae, increased peroxisome and nuclear membrane indentations were seen in group II. In group III, nuclear membrane showed prominent indentation. Numberous cytoplasmic vacuolation, double membrane ring in mitochondria, disappearance of mitochondrial cristae, myelin figure formation in mitochondrial matrix, and fatty changes in mitochondrial matrix were seen. These findings showed that the primary target organelle of attack by o,p'-DDD on zona fasciculata of adrenal gland in rat is mitochondria and it was developed from double ring formation in mitochondrial matrix.
Rats ; Animals

OBJECTIVES: To investigate the correlation of the initial Computerized Tomography(CT) findings of the brain and the functional outcome, and to suggest the initial CT findings as a functional outcome predictor in the traumatic brain injured(TBI) patients. METHODS: Thirty-nine TBI patients were included in this study. Subjects were divided into groups of non-focal or focal TBI, and with or without a depressed skull fracture according to their initial brain CT findings. RESULTS: The non-focal TBI patients were not significantly different from focal TBI patients in the days from onset to rehabilitation, rehabilitation stay, and initial FIM score. However their outcome in FIM gain and FIM efficiency significantly worse than focal TBI patients. The TBI patients with a depressed skull fracture were not significantly different from the patients without a depressed skull fracture in the days from onset to rehabilitation, rehabilitation stay, and intial FIM score. However their outcomes were significantly worse than patients without a depressed skull fractrue in FIM efficiency. CONCLUSION: The initial brain CT findings were generally useful for the prediction of functional outcomes in TBI patients.
Brain Injuries ; Brain* ; Humans ; Rehabilitation ; Skull ; Skull Fracture, Depressed

No abstract available.
Durapatite* ; Radionuclide Imaging*

PURPOSE: Purpose of this study is to synthesize 99mTc-labeled transferrin for infection imaging and to compare it with 67Ga-citrate for the detection of infectious foci. MATERIALS AND METHODS: Succinimidyl 6-hydrazino-nicotinate hydrochloride-chitosan-transferrin (Transferrin) was synthesized and radiolabeled with 99mTc. Labeling efficiencies of 99mTc-Transferrin were determined at 10 min, 30 min, 1 hr, 2 hr, 4 hr and 8 hr. Biodistribution and imaging studies with 99mTc-Transferrin and 67Ga-citrate were performed in a rat abscess model induced with approximately 2 x 10(8) colony forming unit of Staphylococcus aureus ATCC 25923. RESULTS: Successful synthesis of Transferrin was confirmed by mass spectrometry. Labeling efficiency of 99mTc-Transferrin was 96.2+/-0.7%, 96.4+/-0.5%, 96.6+/-1.0%, 96.9+/-0.5%, 97.0+/-0.7% and 95.5+/-0.7% at 10 min, 30 min, 1 hr, 2 hr, 4 hr and 8 hr, respectively. The injected dose per tissue gram of 99mTc-Transferrin was 0.18+/-0.01 and 0.18+/-0.01 in the lesion and 0.05+/-0.01 and 0.04+/-0.01 in the normal muscle, and lesion-to-normal muscle uptake ratio was 3.7+/-0.6 and 4.7+/-0.4 at 30 min and 3 hr, respectively. On image, lesion-to-background ratio of 99mTc-Transferrin was 2.18+/-0.03, 2.56+/-0.11, 3.08+/-0.18, 3.77+/-0.17, 4.70+/-0.45 and 5.59+/-0.40 at 10 min, 30 min, 1 hr, 2 hr, 4 hr and 10 hr and those of 67Ga-citrate was 3.06+/-0.84, 4.12+/-0.54 and 4.55+/-0.74 at 2 hr, 24 hr and 48 hr, respectively. CONCLUSION: Transferrin is successfully labeled with 99mTc, and its labeling efficiency was higher than 95% and stable for 8 hours. 99mTc-Transferrin scintigraphy showed higher image quality in shorter time compared to 67Ga-citrate image. 99mTc-transferrin is supposed to be useful in the detection of the infectious foci.
Abscess ; Animals ; Mass Spectrometry ; Models, Animal ; Radionuclide Imaging ; Rats ; Staphylococcus aureus ; Stem Cells ; Transferrin

Coronary artery disease is a leading cause of morbidity and mortality across the world. Percutaneous coronary intervention has become the major technique of revascularization. However, restenosis remains a major limitation of this procedure. Recently the need for repeat intervention due to restenosis, the most vexing long-term failure of percutaneous coronary intervention, has been significantly reduced owing to the introduction of two major advances, intracoronary brachytherapy and the drug-eluting stents. Intracoronary brachytherapy has been employed in recent years to prevent restenosis lesions with effective results, principally in in-stent restenosis. Restenosis is generally considered as an excessive form of normal wound healing divided up in processes: elastic recoil, neointimal hyperplasia, and negative vascular remodeling. Restenosis has previously been regarded as a proliferative process in which neointimal thickening, mediated by a cascade of inflammatory mediators and other factors, is the key factor. Ionizing radiation has been shown to decrease the proliferative response to injury in animal models of restenosis. Subsequently, several randomized, double-blind trials have demonstrated that intracoronary brachytherapy can reduce the rates of both angiographic restenosis and clinical event rates in patients undergoing percutaneous coronary intervention for in-stent restenosis. Some problems, such as late thrombosis and edge restenosis, have been identified as limiting factors of this technique. Brachytherapy is a promising method of preventing and treating coronary artery restenosis.
Brachytherapy* ; Coronary Artery Disease* ; Coronary Vessels* ; Drug-Eluting Stents ; Humans ; Hyperplasia ; Models, Animal ; Mortality ; Percutaneous Coronary Intervention ; Radiation, Ionizing ; Thrombosis ; Wound Healing

Lipid cell tumors of the ovary are among the rarest of the functional ovarian neoplasms. Recently, authors experienced a case of lipid cell tumor of the left ovary in a 19 year old female, who presented with amenorrhea and hirsutism for 4 years. Grossly, the ovary was well encapsulated, and measured 6.5x6x4.5 cm. Cut surface show homogenous yellowish bulging neoplastic tissue and peritheral displaced normal ovarian tissue. Microscopically, neoplastic cells were composed of rounded and polyhedral cells, arranged in nests seperated by rich vascular networks. On the basis of the author's findings and the evidence available in the literature, we determined this case as ovarian lipid cell tumor.
Female ; Humans

A 55 year old male complain right shoulder pain and right upper quadrant pain about three months. He was a heavy alcoholism. Highly selective angiography, CT scan and operation findings suggest primary malignant neoplasm of the liver. Right hepatic lobectomy and partial diaphragmectomy was done under impression of heaptocellular carcinoma. The specimen measured 15x11x9 cm and disclose relatively hard and nodular mass devoid of cirrhotic changes. Cut surface show unilobar large mass measuring 11x8x6 cm and bearing brightly yellow discoloration and multifocal hemorrhagic necrosis. Histological characteristics were diffuse proliferation of large neoplastic cells with ample cytoplasm, containing granular materials, erythrophagocytosis, neutrophagocytosis and hemosiderin pigments. Atypical and bizarre mitosis and multinucleated giant cells bearing abundant erythro and neutrophagocytosis were frequently seen. The large or vesicular nuclei were irregular, with occasional deep indentations and revealed sharply defined nuclear membrane, coarse chromatin and conspicious nucleoli. Ultrastructurally the cytoplasm of neoplasltic cells had lysosomal granule, phagolysosome, phagocytized material and residual bodies. Immunohistochemical stains for alpha 1-antitrypsin, alpha 1-antichymotrypsin, vimentin and lysozyme showed positive reactions, but, alpha fetoprotein, cytokeratin, S-100 protein, factor VIII, complement 3 receptor and carcinoembryonic antigen were negative. Alpha-naphtyl acetate esterase activity in paraffin embedded tissue ribbon showed negative reaction. These findings show compatible with primary malignant lymphoma, true histiocytic type, (histiocytic sarcoma, Kupffer cell carcinoma) of the liver.
Male ; Humans