No Abstract Available.

OBJECTIVE: To determine, using proton magnetic resonance spectroscopy (1H MRS) whether thalamotomy in patients with Parkinson's disease gives rise to significant changes in regional brain metabolism. MATERIALS AND METHODS: Fifteen patients each underwent stereotactic thalamotomy for the control of medically refractory parkinsonian tremor. Single-voxel 1H MRS was performed on a 1.5T unit using a STEAM sequence (TR/TM/TE, 2000/14/20 msec), and spectra were obtained from substantia nigra, thalamus and putamen areas, with volumes of interest of 7-8ml, before and after thalamotomy. NAA/Cho, NAA/Cr and Cho/Cr metabolite ratios were calculated from relative peak area measurements, and any changes were recorded and assessed. RESULTS: In the substantia nigra and thalamus, NAA/Cho ratios were generally low. In the substantia nigra of 80% of patients (12/15) who showed clinical improvement, decreased NAA/Cho ratios were observed in selected voxels after thalamic surgery (p < 0.05). In the thalamus of 67% of such patients (10/15), significant decreases were also noted (p < 0.05). CONCLUSION: Our results suggest that the NAA/Cho ratio may be a valuable criterion for the evaluation of Parkinson's disease patients who show clinical improvement following surgery. By highlighting variations in this ratio, 1H MRS may help lead to a better understanding of the pathophysiologic processes occurring in those with Parkinson's disease.
Adult ; Aged ; Aspartic Acid/*analogs & derivatives/metabolism ; Brain/*metabolism/pathology ; Choline/metabolism ; Female ; Human ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Male ; Middle Age ; Parkinson Disease/*metabolism/pathology/*surgery ; Protons ; Putamen/metabolism/pathology ; Substantia Nigra/metabolism/pathology ; Thalamus/*metabolism/pathology/*surgery

BACKGROUND/AIMS: We evaluated whether colonic transit time (CTT) can predict the degree of bowel preparation in patients with chronic constipation undergoing scheduled colonoscopy in order to assist in the development of better bowel preparation strategies for these patients. METHODS: We analyzed the records of 160 patients with chronic constipation from March 2007 to November 2012. We enrolled patients who had undergone a CTT test followed by colonoscopy. We defined patients with a CTT > or =30 hours as the slow transit time (STT) group, and patients with a CTT <30 hours as the normal transit time (NTT) group. Boston Bowel Preparation Scale (BBPS) scores were compared between the STT and NTT groups. RESULTS: Of 160 patients with chronic constipation, 82 (51%) were included in the STT group and 78 (49%) were included in the NTT group. Patients with a BBPS score of <6 were more prevalent in the STT group than in the NTT group (31.7% vs. 10.3%, P=0.001). Multivariate analysis showed that slow CTT was an independent predictor of inadequate bowel preparation (odds ratio, 0.261; 95% confidence interval, 0.107-0.634; P=0.003). The best CTT cut-off value for predicting inadequate bowel preparation in patients with chronic constipation was 37 hours, as determined by receiver operator characteristic (ROC) curve analysis (area under the ROC curve: 0.676, specificity: 0.735, sensitivity: 0.643). CONCLUSIONS: Patients with chronic constipation and a CTT >30 hours were at risk for inadequate bowel preparation. CTT measured prior to colonoscopy could be useful for developing individualized strategies for bowel preparation in patients with slow CTT, as these patients are likely to have inadequate bowel preparation.
Colon* ; Colonoscopy ; Constipation* ; Humans ; Multivariate Analysis ; ROC Curve ; Sensitivity and Specificity

This study was conducted to investigate the metabolic changes in the motor and motor association cortices following axonal injury in the internal capsule that was caused by deep intracerebral hematoma. Using proton magnetic resonance spectroscopy (1H MRS), the authors studied the primary motor cortices (M-1) and sup-plementary motor areas (SMA) of 9 hemiparetic patients with documentable hemi-paresis of varying severity, and we studied 10 normal volunteers as controls. To measure the M-1 and SMA biochemical changes, 4 separate single volumes of inter-est(VOIs) were located bilaterally in the affected and unaffected hemisphere (AH and UH).1H MRS provided a neuronal and axonal viability index by measuring levels of N-acetylaspartate (NAA) and creatine/phosphocreatine (Cr). The M-1/SMA NAA/Cr ratios of the AH and UH in patients, and the AH and normal volunteers were com-pared. The NAA/Cr ratios of the M-1 and SMA in AH, and the SMA in UH were sig-nificantly lower than those of normal volunteers. These 1H MRS findings indicate that axonal injury in the descending motor pathway at the level of internal capsule could induce metabolic changes in the higher centers of the motor pathway.
Adult ; Aged ; Aged, 80 and over ; Aspartic Acid/*analogs & derivatives/metabolism ; Basal Ganglia Hemorrhage/metabolism/*pathology ; Creatine/metabolism ; Female ; Humans ; *Magnetic Resonance Spectroscopy ; Male ; Middle Aged ; Motor Cortex/metabolism/*pathology ; Paresis/metabolism/*pathology ; Phosphocreatine/metabolism ; Protons ; Pyramidal Tracts/metabolism/*pathology

In order to elucidate the existence and locality of DARP in the human brain, immunohistochemical identification was done in the brain tissues. This glycoprotein was distributed in paraventricular nucleus and thalamic reticular nucleus of diencephalon, substantia nigra and inferior colliculus of mesencephalon, medial vestibular nucleus, medial longitudinal nucleus, lateral reticular nucleus of medulla oblongata. And they follows a close distribution to that of catecholamine (CA) rich in either CA fiber or CA neuronal cell groups as previously reported by others using tyrosine hydroxylase (TH) as a marker. This striking similarities in the topographic arrangement of the DARP-positive reaction product and the TH-positive reaction product is another argument favoring the view that DARP is involved in the regulation of catecholaminergic neurons.
Brain* ; Diencephalon ; Dopamine* ; Glycoproteins ; Humans* ; Inferior Colliculi ; Medulla Oblongata ; Mesencephalon ; Neurons ; Paraventricular Hypothalamic Nucleus ; Strikes, Employee ; Substantia Nigra ; Tyrosine 3-Monooxygenase ; Vestibular Nuclei

No abstract available.
Biopsy* ; Brain* ; Protons*

The purpose of this extension study was to assess the long-term efficacy and safety of gemigliptin 50 mg in patients with type 2 diabetes mellitus (T2DM). Patients with T2DM who had completed the initial 24-week study comparing gemigliptin monotherapy with placebo were eligible to enrol. In the open-label, 28-week extension study, all enrolled patients received gemigliptin, regardless of the treatment received during the initial 24-week study period. The mean reduction±standard deviation (SD) in glycosylated hemoglobin (HbA1c) observed after 24 weeks of treatment (–0.6%±1.1%) was further decreased for the gemi-gemi group and the mean change in HbA1c at week 52 from baseline was –0.9%±1.2% (P<0.0001). For the pbo-gemi group, HbA1c decreased after they were switched to gemigliptin, and the mean change in HbA1c at week 52 from baseline was –0.7%±1.2% (P<0.0001). Furthermore, the overall incidence of adverse events demonstrated that gemigliptin was safe and well tolerated up to 52 weeks.

The purpose of this extension study was to assess the long-term efficacy and safety of gemigliptin 50 mg in patients with type 2 diabetes mellitus (T2DM). Patients with T2DM who had completed the initial 24-week study comparing gemigliptin monotherapy with placebo were eligible to enrol. In the open-label, 28-week extension study, all enrolled patients received gemigliptin, regardless of the treatment received during the initial 24-week study period. The mean reduction±standard deviation (SD) in glycosylated hemoglobin (HbA1c) observed after 24 weeks of treatment (–0.6%±1.1%) was further decreased for the gemi-gemi group and the mean change in HbA1c at week 52 from baseline was –0.9%±1.2% (P<0.0001). For the pbo-gemi group, HbA1c decreased after they were switched to gemigliptin, and the mean change in HbA1c at week 52 from baseline was –0.7%±1.2% (P<0.0001). Furthermore, the overall incidence of adverse events demonstrated that gemigliptin was safe and well tolerated up to 52 weeks.

No abstract available.

BACKGROUND: The pathogenesis of primary non function or delayed graft function after liver transplantation is not yet clearly defined. However it is presumed that these unhappy events most likely attributes to the Kupffer cell-mediated, reperfusion injury aggravating the sinusoidal endothelial cell damage following preformed ischemic insults. Prostaglandin (PG) I2 and its analogues were reported to protect the liver against ischemic injury thereby be efficacious for the use during the preservation of harvested liver. Prevention of platelet aggregation, vasodilation, stabilization of lysosomal membranes, and inhibition of thromboxane generated by platelets may be the attributable biological activities of PGI2. PURPOSES: We designed this experimental study to assess the effect of continuous PGI2 infusion during in situ liver splitting on the bile flow from liver segment during resection and after reimplantation, and to establish our unique autotransplantation model in mongrel dogs before warming-up of living donor partial liver transplantation in the clinic. METHODS: Mongrel dogs weighing 15-25 kg were used after fasting for 12 hours. After endotracheal intubation under monitoring, abdomen was opened through the Chevron incision extending to xiphoid process. Initially, the right hepatic duct was ligated and divided. The common bile duct was divided, the end being cannulated proximally and drained. Basal bile flow was measured for 1 hour as a reference value. The left partial graft including the right medial, quadrate, left medial, left lateral lobe, and the papillary process of caudate lobe was resected en bloc. After cold flushing ex vivo, the harvested segment was immediately reimplanted orthotopically. In PGI2 group, PGI2 50 microgram was slowly infused through splenic venous cannulation. After closing the abdomen, the bile flow was measured continuously. RESULTS: Eleven out of 24 dogs were alive 12 hours after surgery; 5 in PGI2 and 6 in control group. Basal mean bile flow (BF) rate were 2.9 ml/hr/100 gm of liver tissue in control vs. 2.5 ml/hr/100 gm in PGI2 group. This difference did not reach the statistical significance. However, postoperative BF increased significantly in PGI2 group; 0.45 ml/hr/100 gm in contro vs. 1.71 ml/hr/100 gm in PGI2 group (p=0.04). CONCLUSION: Continuous infusion of PGI2 through the splenic vein during the harvest of the liver could mitigate the manipulation injury. The BF reflecting the quality of resected liver segment was relatively well preserved in PGI2 group after canine autotransplantation model. This model is not complicated, and will be useful for the mastery of surgical techniques for the living donor partial liver transplantation in the clinic.
Abdomen ; Animals ; Autografts* ; Bile ; Catheterization ; Common Bile Duct ; Delayed Graft Function ; Dogs ; Endothelial Cells ; Epoprostenol* ; Fasting ; Flushing ; Hepatic Duct, Common ; Humans ; Intubation, Intratracheal ; Liver Transplantation ; Liver* ; Living Donors ; Membranes ; Platelet Aggregation ; Reference Values ; Reperfusion Injury* ; Replantation ; Splenic Vein ; Transplants ; Vasodilation