This study was carried out to investigate the direct neurotoxicity of alcohol on CNS and the effects of piracetam or vitamins on ultrastructural changes of the rat cerebellar and hippocampal neurons during long-term alcohol treatment. To evaluate the results, quantitative analysis were done for light and electronic microscopic findings. On the light microscopy, red degeneration of pyramidal cells and Purkinje cells was found more apparently in the alcohol only treated group than in the control group. On the electron microscopy, increased lipofuscin pigments wee found in cerebellum and hippocampus. In quantitative analysis, vitamins significantly reduced red degeneration in both hippocampus and cerebellum. However, piracetam significantly reduced red degeneration in cerebellum but not in hippocampus. Lipofuscin pigments in Purkinje cells and pyramidal cells were significantly reduced in the alcohol with piracetam treated group than the alcohol only treated group. However, vitamin had no significant reducing effect of lipofuscin pigments in Purkinje cells and pyramidal cells. According to the results, it is concluded that vitamins deficiency might cause red degeneration of pyramidal cell after long-term alcohol treatment, but increment of lipofuscin pigments in pyramidal and Purkinje cell may be caused by alcohol itself or its metabolite rather than vitamins deficiency. Piracetam seems to improve cognitive function impairment caused by alcohol consumption.
Alcohol Drinking ; Animals ; Cerebellum ; Hippocampus ; Lipofuscin ; Microscopy ; Microscopy, Electron ; Neurons* ; Piracetam* ; Purkinje Cells ; Pyramidal Cells ; Rats* ; Vitamins*

The two most common causes of acute arterial occlusion are embolism and thrombosis in sity. They are mainly originated from the cardiovascular sources. About 70-80 per cent of occlusions occur in the axial limb vessels. Therapeutic options include supportive measures, pharmacologic treatment, surgery, and non-operative interventions. There have been several successful case reports using percutaneous aspiration thromboembolectomy with the advent of new instruments and technical imprevement. We report a case of 70-year-old male with acute anterior wall myocardial infaction who experienced acute embolic arterial occlusion of the left popliteal artery from mural thrombus in the left ventricular apex. It wan managed successfully by percutaneous aspiration thromboembolectomy.
Aged ; Embolism ; Embolism and Thrombosis ; Extremities ; Humans ; Male ; Popliteal Artery ; Thrombosis

Objective: We studied the efficacy of the power spectral and nonspectral analysis and its diurnal variations for the early detection of the diabetic autonomic neuropathy. METHOD: The spectral and nonspectral analysis of 24hour-Holter monitoring were done for both diabetic neuropathy patients and controls. We also made a comparative analysis of the diurnal variations between the patient and control groups by means of hourly power spectral analysis. RESULT: 1) The power spectral density of the diabetic neuropathy patients was below than that of the normal controls (P<0.05) (Table 2, Fig. 1). 2) The nonspectral analysis of the diabetic neuropathy patients was below than that of the normal controls except for the mean RR intervals (P<0.05) (Table 3). 3) Every hour-power spectral analysis showed a diurnal variation of day time (06:00 to 16:00) decrease in high frequency area of the normal controls. On the contrary, there was a disappearance of the diurnal variation in patient group. CONCLUSION: The power spectral and nonspectral analyses after 24hour-Holter monitoring and its diurnal variation in the diabetic patients are considered as good means of the early detection of autonomic neuropathy, but further study of its diagnostic value will be needed.
Diabetic Neuropathies* ; Electrocardiography, Ambulatory* ; Humans

BACKGROUND: The purpose of this study was to determine the clinical effective dose of alfentanil required for successful tracheal intubation during inhalation induction using 5% sevoflurane without neuromuscular blockade in children sedated with ketamine. METHODS: Twenty-one children, aged 3-10 years, undergoing surgeries under general anesthesia were enrolled into the study. All patients were premedicated with 0.004 mg/kg glycopyrrolate intramuscularly 30 min before anesthesia.To facilitate separation of the child from the parents, intravenous 1 mg/kg ketamine was given prior to transfer into the operating room.After inhalation induction with 5% sevoflurane and 100% oxygen, pre-determined dose of alfentanil was injected over 20 sec. The dose of alfentanil was determined by modified Dixon's up-and-down method (2microgramkg as a step size starting from 12microgramkg).The study ended when six independent pairs of patients, who manifested cross over from 'failure' to 'success' for tracheal intubation, were recruited. RESULTS: In 50% of children, the effective bolus dose (ED50) (95% confidence intervals) of alfentanil for successful tracheal intubation was 7.2microgram/kg (6.3-8.1microgram/kg) during sevoflurane inhalation induction.From isotonic regression, 95% effective dose (ED95) (95% confidence intervals) of alfentanil was 9.9microgram/kg (2.2-16.0microgram/kg). CONCLUSIONS: During inhalation induction using 5% sevoflurane without neuromuscular blockade after ketamine sedation, the ED50 and ED95 of alfentanil for successful tracheal intubation were 7.2 microgram/kg and 9.9microgram/kg in children, respectively.
Aged ; Alfentanil ; Anesthesia, General ; Child ; Glycopyrrolate ; Humans ; Inhalation ; Intubation ; Ketamine ; Methyl Ethers ; Neuromuscular Blockade ; Oxygen ; Parents

No abstract available.
Animals ; Fibronectins* ; Macrophages* ; Mycobacterium bovis* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Rats* ; Urinary Bladder*

PURPOSE: In this study, we evaluated in vitro whether the anti-sense transfection that was targeted against Bcl-xL would induce cytotoxicity via apoptosis in prostate cancer cells. MATERIALS AND METHODS: cDNA of the human Bcl-xL gene was obtained by RT-PCR amplification, and the anti-sense Bcl-xL mRNA plasmid was generated using the pCR 3.1 TOPO plasmid vector. The function of the cloned anti-sense Bcl-xL plasmid vector (pCR3.1-AS-Bcl-xL) was evaluated by the Western blot analysis. Using the MTT assay, the efficacy of growth inhibition by transfection with pCR3.1-AS-Bcl-xL was tested in vitro on PC-3 and DU145 human prostate cancer cell lines. Immunoblot analyses of Bax and caspase-9 were also performed. To evaluate the apoptosis, DNA fragmentation and caspase-3 assay were performed. RESULTS: Bcl-xL expression after transfection with pCR3.1-AS-Bcl-xL was gradually decreased in PC-3 cells and was continuously decreased in DU145 cells, compared to the parent cells. Bax protein was not expressed in DU145 cells, and the levels of Bax protein expression was not altered in the transfected PC-3 cells compared to the parent cells. The cytotoxicity of pCR3.1-AS-Bcl-xL on PC-3 and DU145 cells increased significantly compared to the empty vector, pCR3.1. This increased cytotoxicity was associated with enhanced apoptosis as assessed by the DNA fragmentation assay and the caspase-3 assay. The expression of the active caspase-9 was increased in the PC-3 cells but not in the DU145 cells after transfection with pCR3.1-AS-Bcl-xL. CONCLUSIONS: Our results showed that the suppression of Bcl-xL by anti-sense transfection efficiently inhibited the growth of PC-3 and DU145 human prostate cancer cell lines. The inhibition of Bcl-xL expression can possibly be a novel therapeutic alternative in the treatment of hormone refractory prostate carcinoma.
Apoptosis* ; bcl-2-Associated X Protein ; bcl-X Protein ; Blotting, Western ; Caspase 3 ; Caspase 9 ; Cell Line ; Clone Cells ; DNA Fragmentation ; DNA, Antisense ; DNA, Complementary ; Humans ; Parents ; Plasmids ; Polymerase Chain Reaction ; Prostate* ; Prostatic Neoplasms* ; RNA, Messenger ; Transfection

No abstract available.
Nitric Oxide* ; Paclitaxel* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: The outcome of adjuvant systemic chemotherapy, in patients with a locally advanced transitional cell carcinoma of the upper urinary tract, was analyzed. MATERIALS AND METHODS: Between January 1990 and June 2001, a total of 97 patients underwent surgery for a transitional cell carcinoma of the upper urinary tract at our institute. Forty-five had a locally advanced disease (T3, N1, N2, lymphovascular invasion). Of these, 33 patients (chemotherapy group) underwent a median of four courses of cisplatin-based adjuvant systemic chemotherapy (M-VAC in 23, gemcitabine plus cisplatin in seven, CISCA in three), whereas 12 (Observation group) refused chemotherapy. To define possible prognostic factors in these patients, various factors, including age, sex, location, surgical method, pT stage and number of involved lymph nodes, were analyzed using the Cox's regression model. RESULTS: The mean follow-up was 39 months, ranging from 8 to 98 months; the median survival time in the chemotherapy and observation groups were 65 and 31 months, respectively. Five-year disease-specific survival rates in the chemotherapy and control groups were 71.1 and 40.9%, respectively. Of the several factors, adjuvant chemotherapy (p=0.016) and lymph node metastasis (p=0.017) both had prognostic significance. In the chemotherapy group, 21 (63.6%) were given a reduced dose for at least one cycle due to a reduced renal function. However, there was no fatal febrile neutropenia, while cellulitis or grade 3 neutropenia occurred in six patients during the chemotherapy. CONCLUSIONS: Our findings suggest that adjuvant systemic chemotherapy, for a locally advanced transitional cell carcinoma of the upper urinary tract, may lead to a significant prolongation in the survival time.
Carcinoma, Transitional Cell* ; Cellulitis ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Febrile Neutropenia ; Follow-Up Studies ; Humans ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Neutropenia ; Survival Rate ; Ureteral Neoplasms ; Urinary Tract*

PURPOSE: We reviewed our experiences, at a single-center, of patients with upper tract urothelial cancer in order to assess treatment outcomes and to determine the prognostic factors of the condition. MATERIALS AND METHODS: We retrospectively reviewed 115 patients, with urothelial tumors of the renal pelvis and ureter, treated at Seoul National University Hospital. The mean age of the patients was 61.1 years, with a mean follow-up of 35.5 months. Traditional prognostic factors, including age, sex, and tumor stage, grade, location, and type of surgical treatment, were analyzed with respect to disease recurrence and survival. RESULTS: Ninety six patients (83.4%) were treated surgically. A nephroureterectomy was performed in 88 patients (91.8%); 74 with bladder cuffing and 14 without. Actuarial 5-year survival rates, by tumor stage, were 100% for Ta, 90% for T1, 76.3% for T2 and 55.6% for T3. From the multivariate analysis, the T (p=0.008), N (p=0.017) and M (p=0.002) stages were significant prognostic factors for survival. A recurrence occurred in 46 (47.9%) patients at a mean of 13.1 months. Recurrent bladder tumors developed in 36.5 and 33.3% of patients treated with conventional nephroureterectomy, with bladder cuffing and other treatments, respectively. CONCLUSIONS: Tumor stage was a unique significant prognostic factor for survival on multivariate analysis and there is no significant difference in recurrence rate of bladder tumor regardless of surgical method. Bladder tumor surveillance should be carefully performed due to the high rates of recurrence in the bladder within 2 years postoperatively.
Follow-Up Studies ; Humans ; Kidney ; Kidney Pelvis ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Ureter ; Ureteral Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract*

PURPOSE: We reviewed our experiences, at a single-center, of patients with upper tract urothelial cancer in order to assess treatment outcomes and to determine the prognostic factors of the condition. MATERIALS AND METHODS: We retrospectively reviewed 115 patients, with urothelial tumors of the renal pelvis and ureter, treated at Seoul National University Hospital. The mean age of the patients was 61.1 years, with a mean follow-up of 35.5 months. Traditional prognostic factors, including age, sex, and tumor stage, grade, location, and type of surgical treatment, were analyzed with respect to disease recurrence and survival. RESULTS: Ninety six patients (83.4%) were treated surgically. A nephroureterectomy was performed in 88 patients (91.8%); 74 with bladder cuffing and 14 without. Actuarial 5-year survival rates, by tumor stage, were 100% for Ta, 90% for T1, 76.3% for T2 and 55.6% for T3. From the multivariate analysis, the T (p=0.008), N (p=0.017) and M (p=0.002) stages were significant prognostic factors for survival. A recurrence occurred in 46 (47.9%) patients at a mean of 13.1 months. Recurrent bladder tumors developed in 36.5 and 33.3% of patients treated with conventional nephroureterectomy, with bladder cuffing and other treatments, respectively. CONCLUSIONS: Tumor stage was a unique significant prognostic factor for survival on multivariate analysis and there is no significant difference in recurrence rate of bladder tumor regardless of surgical method. Bladder tumor surveillance should be carefully performed due to the high rates of recurrence in the bladder within 2 years postoperatively.
Follow-Up Studies ; Humans ; Kidney ; Kidney Pelvis ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Ureter ; Ureteral Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract*