This study was undertaken to observe the effects of centrally administred antihistamines on the blood pressure. Diphenhydramine(DPH), a H1-receptor antagonist, and ranitidine(RAN), a H2-receptor antagonist were administered intracerebroventricularly(icv) on urethane-anesthetized rabbits. 1) Both DPH and RAN administered intraccebroventricularly increased blood pressure, however the intravenous(iv) adminstration of them did not affect blood pressure. The pressor response to icv DPH was dose-dependent, but that to icv RAN was not. 2) The pressor response to icv DPH(1mg) was either markedly attenuated or reversed to depressor response by the pretreatment with icv phentolamine(250,500ug), and iv chlorisondamine(0.1, 1mg/Kg) and iv phenoxybenzamine(1mg/Kg). In cord-sectioned rabbtis, icv RAN) 1mg) did not produce pressor response. 3) The pressor responsr to icv RAN(1mg) was not affected by the pretreatment with icv phentolamine(500ug), iv chlorisondamin(1mg/Kg) and iv phenoxybenzamine(1mg/Kg), and iv phenoxybenzamine(1mg/Kg). RAN also producted pressor response in cordsectioned rabbits. These results suggest that the pressor response to icv DPH is elecited by increasing peripheral sympathetic tone via the stimulation of central alpha-adrenoreceptors and the pressor response to icv RAN is produced by releasing some humoral facotr which can increase blood pressure.
Blood Pressure ; Diphenhydramine* ; Histamine Antagonists ; Rabbits* ; Ranitidine*

Moyamoya is a chronic cerebrovascular disease characterized by progressive stenosis or occlusion of the terminal parts of both intermal carotid arteries with telangiectatic vascular network of collateral circulation at the base of the brain and leptomeningeal arteries. The etiology and pathophysiology of this disease are still unknown. Although the idiopathic presentattion is the commonest, moyamoya disease has also been reported in several hereditary or acquired clinical conditions including neurofibromatosis, sickle cell anemia, tuberculous meningitis, atherosclerosis, and following radiation therapy to the head. The term moyamoya disease should be reserved for those cases in which the characteristic angiogrphic pattern is idiopathic; moyamoya syndrome is used when the underlying condition is known. We have experienced a case of coexistence of moyamoya syndrome and hereditary spherocytosis in a 6-year-8-month-old girl who presented with right-sided hemiparesis and pallor. A cerebral angiogram revealed occlusion of proximal portion of left middle cerebral artery and abnormal collateral network. The peripheral blood smear and osmotic fragility test disclosed hereditary spherocytosis. To our knowledge, the coexistence of moyamoya syndrome and hereditary spherocytosis has not been documented. We report here the case and the brief review of related literatures. Further studies are needed to clarify the intimate relationship between the two diseases.
Anemia, Sickle Cell ; Arteries ; Atherosclerosis ; Brain ; Carotid Arteries ; Collateral Circulation ; Constriction, Pathologic ; Female ; Head ; Humans ; Middle Cerebral Artery ; Moyamoya Disease* ; Neurofibromatoses ; Osmotic Fragility ; Pallor ; Paresis ; Tuberculosis, Meningeal

OBJECTIVES: There have been several studies documenting the changing level of the conus throughout infancy and childhood, but there is only a little detailed study that documents the range of conus positions in a living adult population, especially in Korean, without spinal deformity. METHODS: we made a sequential study of magnetic resonance images of the lumbar spine to determine the variation in position of the conus medullaris in 650 living korean adults population without spinal deformity who checked MRI to identify the cause of low back pain. The study population consisted of patients over the age of 16 years. A T1-weighted, midline, sagittal image was reviewed for identifying the postion of conus. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disc. RESULTS: The study group consisted of 305 men(47%) and 345 women(53%) with a mean age 45.9 years(range, 16-79 years). The conus existed commonly at the middle third of L1(131cases, 20.2%), at the L1-2 intervertebral space(129cases, 19.8%), and the lower third of L1(123cases, 18.9%). The mean position of conus was the lower third of L1(range, middle third of T12 to middle third of L3). Conclusions:The mean position of conus was at the lower third of L1(range, middle third of T12 to middle third of L3). This results was same as that of foreign study. Our results of living korean adult population could allow for safe clinical procedures such as lumbar puncture, spinal anesthesia, and help to explain the differences among observed neurologic injuries from fracture-dislocation at the thoracolumbar junction.
Adult* ; Anesthesia, Spinal ; Congenital Abnormalities ; Conus Snail* ; Humans ; Intervertebral Disc ; Low Back Pain ; Magnetic Resonance Imaging* ; Spinal Puncture ; Spine

OBJECTIVE: Surgically removed herniated lumbar disc specimen are immunostained to evaluate the production of MMPs(Matrix metalloproteinases) -1, 2, 3 for the investigation of the possible correlation of MMPs in lumbar disc herniation depending on the types of disc herniation. METHODS: The study population consists of 30 patients with lumbar disc herniation. There were 18 men and 12 women with patient age averaging 43.4 years(19-68years). The types of disc herniation identified at the time of surgery were classified as follow ; protruded type(Group 1, 10cases), extruded type(Group 2, 10cases), sequestrated type(Group 3, 10cases). Immunohistochemical study for the MMPs of the herniated disc tissue was performed and results of staining were graded to examine differences in histology among three types of disc herniation . RESULTS: The MMPs immunopositive cells were increased in old patients but statistically it was not significant(p=0.074). A significantly increased incidence of positive cells for MMP-1, 2 was found in the herniated lumbar disc tissue than the control group(p=0.02) but there were no significant differences among the three types of disc herniation. The MMP-3 positive cells were predominantly detected in the sequestrated disc tissue group(p=0.037) more than other groups. CONCLUSION: These results suggest that the MMP-1, 2, 3 may play important roles in the process of degeneration, herniation, and resorption of the lumbar intervertebral discs and that the MMP-3 may express the severity of lumbar disc herniation and play a role in resorption of the sequestrated disc tissue.
Female ; Humans ; Immunohistochemistry ; Incidence ; Intervertebral Disc ; Intervertebral Disc Displacement ; Male ; Matrix Metalloproteinases*

The authors report 3 cases of intracranial cysticercosis simulating brain tumor. The 2 cases of them had parenchymatous huge cysts in the cerebral hemisphere and the other one had large cyst in the 4th ventricle. In one case of parenchymatous cysticercosis, angiographic finding was less significant though C-T scan revealed huge cystic shadow in the frontal lobe bilaterally and multiple small cystic shadow in occipital lobe and cerebellum. The 4th ventricular cysticercosis was well delineated with Conray ventriculography. All cases were proved as cerebral cysticercosis by operation and the patients were uneventful postoperatively.
Brain Neoplasms ; Cerebellum ; Cerebrum ; Cysticercosis* ; Frontal Lobe ; Humans ; Occipital Lobe

The ruptured aneurysms are frequently complicated with cerebral infarction, rebleeding, hydrocephalus and severe medical complications which add secondary injury to the brain surviving initial hemorrhage. Early diagnosis and judicious medical management for the complications as they occur will improve patient outcome. This paper will review current opinion about prevention and management of secondary complications associated with aneurysmal subarachnoid hemorrhage.
Aneurysm* ; Aneurysm, Ruptured ; Brain ; Cerebral Infarction ; Early Diagnosis ; Hemorrhage ; Humans ; Hydrocephalus ; Subarachnoid Hemorrhage*

To elucidate the role of CNS GABA ergic system in the regulation of cardiovascular function, the effects of intracerebroventricular(icv) bicuculline(BIC), a selective GABAA antagonist, on blood pressure and heart rate were investigated in urethane anesthetized rabbits. 1) Icv BIC produced dose-dependent pressor and bradycardiac effect, while intravenous(iv) BIC had no effect on blood pressure and heart rate. 2) The pressor effect of BIC(10(g) was significantly attenuated by pretreatments with icv ketamine(5 mg) or icv diazepam(0.1 mg, 1 mg). Bilateral vagotomy and pretreatment with icv mecamylamine(0.2 mg), iv chlorisondamine(1 mg/kg), in phentolamine(1 mg/kg) did not affect the pressor action. 3) The bradycardiac effect of BIC(10(g) was abolished or reversed to slight tachycardia by bilateral vagotomy and pretreatment with icv ketamine(2.5 mg, 5 mg), icv diazepam(0.1 mg, 1 mg) and iv chlorisondamine(1 mg/kg). Neither icv mecamylamine(0.2 mg) nor iv phentolamine(1 mg/kg) affected the bradycardia. These results suggest that blockade of GABAA receptor produce pressor action which is associated with central excitatory amino acid system and produce reflex bradycardia induced by the pressor effect, and that sympathetic nervous system might not be involved in the pressor effect.
Bicuculline* ; Blood Pressure* ; Bradycardia ; Excitatory Amino Acids ; gamma-Aminobutyric Acid ; Heart Rate* ; Heart* ; Rabbits* ; Reflex ; Sympathetic Nervous System ; Tachycardia ; Urethane ; Vagotomy

Effects of a M1 receptor antagonist, pirenzepine, a M2 receptor antagonist, AF-DX116, and a nicotinic receptor antagonist, mecamylamine on the pressor responses to preganglionic sympathetic nerve stimulation(PNS) and McN-A-343 and DMPP in spinal(pithed) rabbits were investigated in order to elucidate a functional role of M1, M2 and nicotinic receptors in ganglionic transmission. Pirenzepine and AF-DX116 selectively inhibited the McN-A-343-induced pressor reponse in chlorisondamine-treated rabbit and the BCh-induced bradycardia, respectively. Electrical stimulations of preganglionic sympathetic outflow at T8 level produced increases in blood pressure. Pirenzepine(3 microgram/kg) significantly inhibited the PNS-induced pressor response and the degree of inhibition was not changed by increasing the doses to 100 microgram/kg. AF-DX116(100 microgram/kg) had no effect on the PNS-induced pressor response. Mecamylamine inhibited the PNS-induced pressor response in a dose-dependent manner. The inhibitory action of mecamylamine was significantly augmented by combined-treatment with pirenzepine(30 microgram/kg) but AF-DX116(100 microgram/kg) did not affect the inhibitory action of mecamylamine. McN-A-343 and DMPP elicited pressor response in the spinal rabbit. Pirenzepine and AF-DX116 dose-dependently inhibited the McN-A-343-induced pressor response but they did not affect DMPP-induced pressor response. Mecamylamine inhibited both pressor responses induced by Mc-N-343- and DMPP. These results suggest that not only nicotinic receptors but also M1 receptors play a facilitatory role in ganglionic transmission but M2 receptors do not contribute the transmission in spinal(pithed) rabbits.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; Blood Pressure ; Bradycardia ; Dimethylphenylpiperazinium Iodide ; Electric Stimulation ; Ganglia, Sympathetic* ; Ganglion Cysts ; Mecamylamine ; Pirenzepine ; Rabbits ; Receptors, Nicotinic*

Two cases of glioblastoma multiforme in children are reported. In one case, 2-year and 11 month-old female with the complaints of vomiting and the left hemiparesis for one month, the huge supra-Sylvian cystic tumor was associated with arteriovenous malformation originating from tumor and draining into the superior sagittal sinus. In the other case, 14-year-old male presenting seizure for 6 months, headache and the right hemiparesis for one month, the cystic frontal soft tumor infiltrated to the wall of the lateral ventricle. Wide internal decompression was performed as possible and pathologic reports were proved glioblastoma multiforme.
Adolescent ; Arteriovenous Malformations ; Child* ; Decompression ; Female ; Glioblastoma* ; Headache ; Humans ; Infant ; Lateral Ventricles ; Male ; Paresis ; Seizures ; Superior Sagittal Sinus ; Vomiting

No abstract available.
Meningioma* ; Skull Base* ; Skull*