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

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

Clinical experience with a rare case of sparganosis invading the spinal epidural space was reported with review of the literatures. A 58-year-old man who had food hakit of eating raw snakes was hospitalized with chief complaint of low back and left leg pain.
Eating ; Epidural Space* ; Humans ; Leg ; Middle Aged ; Snakes ; Sparganosis ; Sparganum*

The authors has investigated the effect of intracisternal urokinase on the multihemorrhage canine model of chronic post-subarachnoid hemorrhage(SAH) hydrocephalus. Each of 16 adult mongrel dogs was assigned to one of two experimental groups. All animals received a total of 13ml of fresh unheparinized autologous blood via three cisternal injections. Eight animals were treated by intracisternal injection of 20,000 IU of Urokinase every 12 hours for 3 days, and the remaining were not treated. The changes in ventricular volumes were measured by computed tomography(CT) before and 3 months after the initial subarachnoid blood injection. To compare the changes of hydrodynamic properties in chronic phases of post-SAH hydrocephalus, the pressure-volume index(PVI) technique of bolus manipulation of cerebrospinal fluid(CSF) was used to measure the volume-buffering capacity of neural axis and the resistance to the absorption of CSF(before SAH, post-SAH 1 month, 3 months). The final ventricular volume at 3 months of control group was 4 times greater than the initial volume, but Urokinase group less than two times. The mean measured PVI values of control group and Urokinase group were 3.98+/-0.76ml(+/- standard deviation(SD)) and 4.01+/-0.82ml in baseline study, 3.09+/-0.96ml and 3.70+/-0.84ml in post-SAH 3 months. The mean resistance of CSF outflow of control group and Urokinase group were 10.30+/-2.24mm Hg/ml/min), and 10.34+/-1.98mm Hg/ml/min in baseline study. At 1 month and 3 months after SAH control group maintained high absorptive resistance(29.54+/-11.50mm Hg/ml/min, 22.43+/-3.82mm Hg/ml/min), whereas the resistances of Urokinase group were slightly increased and then returned to the original levels(16.04+/-4.87mm Hg/ml/min, 12.87+/-3.06mm Hg/ml/min). The results described in this experimental study indicated that if fibrinolysis of the subarachnoid blood clot can be achieved rapidly after SAH, the complicating chronic hydrocephalus might be prevented.
Absorption ; Adult ; Animals ; Axis, Cervical Vertebra ; Dogs ; Fibrinolysis ; Humans ; Hydrocephalus* ; Hydrodynamics ; Subarachnoid Hemorrhage* ; Urokinase-Type Plasminogen Activator*

Hyperglycemia has been reported to worsen the tolerance of the brain to ischemia, and it has therefore been recommended that patient undergoing neurosurgical procedures not receive glucose-containing solutions. Since ischemic events lead to increased lactate production and accumulation and hence neuronal damage, the present study was designed to test the effect of insulin-induced hypoglycemia and decreased lactate by 2-Deoxyglucose and Dichloroacetate on focal cerebral ischemia in rats. Although the pre and post-ischemic blood glucose levels of control group and Dichloroacetate group showed no change, the blood glucose level of 2-Deoxyglucose group showed a significant increase(p=0.001), and insulim group a significant decrease(p=0.004). The reducing effects on the infarct zone in these three treated groups were found with statistical significance. As compared with control group, the tissue lactate levels of treated groups were decreased in both infarct zone and border zone but these data did not show statistical significance. From these observations, it is suggested that reduction of lactate production and accumulation could be beneficial by affording neuronal protection in ischemic tissues.
Animals ; Blood Glucose ; Brain ; Brain Ischemia* ; Cerebral Infarction ; Deoxyglucose* ; Dichloroacetic Acid* ; Humans ; Hyperglycemia ; Hypoglycemia ; Insulin* ; Ischemia ; Lactic Acid ; Neurons ; Neurosurgical Procedures ; Rats*

Collagen-induced arthritis (CIA) is mediated by self-reactive CD4+ T cells that produce inflammatory cytokines. TGF-beta2-treated tolerogenic antigen-presenting cells (Tol-APCs) are known to induce tolerance in various autoimmune diseases. In this study, we investigated whether collagen-specific Tol-APCs could induce suppression of CIA. We observed that Tol-APCs could suppress the development and severity of CIA and delay the onset of CIA. Treatment of Tol-APCs reduced the number of IFN-gamma- and IL-17-producing CD4+ T cells and increased IL-4- and IL-5-producing CD4+ T cells upon collagen antigen stimulation in vitro. The suppression of CIA conferred by Tol-APCs correlated with their ability to selectively induce IL-10 production. We also observed that treatment of Tol-APCs inhibited not only cellular immune responses but also humoral immune responses in the process of CIA. Our results suggest that in vitro-generated Tol-APCs have potential therapeutic value for the treatment of rheumatoid arthritis as well as other autoimmune diseases.
Animals ; Antigen-Presenting Cells/*drug effects/*immunology ; Arthritis, Experimental/*immunology ; Chickens ; Collagen Type II/immunology ; Immune Tolerance/drug effects ; Mice ; Mice, Inbred BALB C ; Ovalbumin/immunology ; Th1 Cells/drug effects/immunology ; Th2 Cells/*drug effects/*immunology ; Transforming Growth Factor beta2/*pharmacology

Hypopharyngeal perforation associated with traffic accident is a rare occurrence, which can cause serious morbidity and mortality if not diagnosed and treated early. We report an autopsy case of hypopharyngeal perforation following a traffic accident. A 32-year-old man hits his chin when his car hits highway guardrail. He complained continuous neck pain and died 5 days after the accident. Autopsy was performed, and death was due to undiagnosed retropharyngeal abscess with sepsis.
Accidents, Traffic ; Adult ; Autopsy ; Chin ; Humans ; Hypopharynx ; Neck Pain ; Retropharyngeal Abscess ; Sepsis

OBJECTIVE: Primary intraventricular hemorrhage(PIVH) is uncommon and accounts for only 3.1 % of all non-traumatic intracerebral hemorrhage. The aim of this study is to analyze clinical characteristics, image features, etiology and prognostic factors of outcome in patients with PIVH. METHODS: We identified 25 patients with PIVH during 9-year period between 1994 and 2002 at our institute. The clinical data, complimentary examination, outcome and computed tomographic blood amounts were reviewed. RESULTS: Major symptoms included sudden decreased level of consciousness, headache, nausea/vomiting and neck stiffness. Cerebral angiography was performed in 12 patients(48%) and revealed vascular malformation in 6 patients(24%). The positive result of angiography was more common in young patients and among vascular malformation the incidence of Moyamoya disease was relatively high(4 patients). Other causative factors were coagulation disorder, arterial hypertension, tumor bleeding. Outcome were death in 9 patients(36%): 7 patients(28%) died by direct consequence of bleeding and 2 patients died after other adverse events(sepsis, hepatic failure) but prognosis of survivor was good. Factors correlating with the outcome were the presence of coagulopathy, initial Glasgow Coma Scale(GCS), obstruction of 4th ventricle and ventricular blood amount including hemorrhagic dilatation of temporal horn of lateral ventricle, 3rd and 4th ventricle. CONCLUSION: The poor prognosis factors of PIVH are the presence of coagulopathy, low initial GCS, obstruction of 4th ventricle and large ventricular blood amount. Additionally patients whose initial clinical condition is not serious need an appropriate work up including cerebral angiography, because cause of bleeding is vascular malformation especially in young patients.
Angiography ; Animals ; Cerebral Angiography ; Cerebral Hemorrhage ; Coma ; Consciousness ; Dilatation ; Headache ; Hemorrhage* ; Horns ; Humans ; Hypertension ; Incidence ; Lateral Ventricles ; Moyamoya Disease ; Neck ; Prognosis ; Survivors ; Vascular Malformations

Spinal cord compression associated with plasma cell neoplasm is observed always in the patients suffering from the multiple myeloma or solitary plasmacytoma that occur in the marrow of the spine. Authors report a rare case of extramedullary plasmacytoma forming a mass in the epidural space of the thoracic spine. In 70 year old woman with paraplegia, MRI of the thoracic spine indicated a presence of epidural mass at the 2nd to 8th thoracic vertebrae. There was no abnormal bony changes in the spine on plain X-ray and MRI. Total removal of the epidural mass was performed by posterior approach. Histopathologic examination including immunohistochemical stain showed the plasma cell neoplasm producing IgM and kappa light chain. Cancer workup after operation including bone marrow study and whole body simple radiologic studies supported the diagnosis of extramedullary plasmacytoma.
Aged ; Bone Marrow ; Diagnosis ; Epidural Space* ; Female ; Humans ; Immunoglobulin M ; Magnetic Resonance Imaging ; Multiple Myeloma ; Neoplasms, Plasma Cell ; Paraplegia ; Plasmacytoma ; Spinal Cord Compression ; Spine ; Thoracic Vertebrae

PURPOSE: Angiostatin, a 38 kDa internal fragment of plasminogen, is a potent inhibitor of angiogenesis. It blocks neovascularization and growth of primary and metastatic tumors in mice. To produce recombinant angiostatin protem comprising kringle 1-4 of plasminogen, we cloned the angiostatin cDNA from human liver tissue mRNA and expressed it in E. coli. MATERIALS AND METHODS: We cloned angiostatin cDNA from human liver tissue mRNA using reverse transcriptase polymerase chain reaction (RT-PCR) method. Cloned cDNA was ligated to pET22b (+) expression vector, transformed into E. coli stram BL21 (DE3) and expressed by IPTG induction. Recombinant human angiostatin protein was purified from the inclusion bodies of lysated bacterial pellet with 8 M urea solubilization, refolding, single step Lysine-Sepharose 4B affinity chromatography and 0.2 M E-aminocarproic acid elution. The anti-angiogenic activity of purified recombinant angiostatin was assayed with endothelial cell proliferation assay and chorioallantoic membrane assay (CAM). RESULTS: The identification of cloned angiostatin cDNA was confirmed by Southern hybridization and Pst I restriction enzyme digestion pattern. Angiostatin cDNA was expressed in E. coli, refolded in vitro and purified by Lysine Sepharose 4B affinity chromatography. The molecular weight of purified recombinant angiostatin was about 55 kDa on the SDS-PAGE. It inhibited the proliferation of bovine capillary endothelial (BCE) cells in vitro with a half-maximal inhibition concentration (ED50) of approximately 500 ng/mL. It also suppressed neovasculrization on the CAM assay. CONCLUSION: These results demonstrated that recombinant human angiostatin has similar function and biological activity compared with human angiostatin which is purified from porcine elastase digested human plasminogen fragment.
Angiostatins* ; Animals ; Capillaries ; Chorioallantoic Membrane ; Chromatography, Affinity ; Clone Cells* ; Cloning, Organism* ; Digestion ; DNA, Complementary* ; Electrophoresis, Polyacrylamide Gel ; Endothelial Cells ; Humans* ; Inclusion Bodies ; Isopropyl Thiogalactoside ; Kringles ; Liver* ; Lysine ; Mice ; Molecular Weight ; Pancreatic Elastase ; Plasminogen ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger* ; Sepharose ; Urea