BACKGROUND: Although the main features of psoriasis consist of abnormal epidermal proliferation and T cell infiltration, which of these is the initial abnormality has been a longstanding unresolved question. Recently there has been definite evidence that activated T cells produce the cytokines that induce keratinocyte abnormalities. OBJECTIVE: We investigated the distributions and relative numbers of T lymphocyte subpopulations, that is, CD4+ and CD8+ T cells, to verify the more important T cell subtype and its infiltrating site in the formation of psoriatic lesions. METHODS: Paired psoriatic lesional and non-lesional skin tissues were obtained from eight typical psoriatic patients. Immunohistochemical staining was done on the frozen sections using a labelled streptavidin-biotin peroxidase complex method with DAKO LSAB kit. The primary antibodies used in this study were monoclonal or polyclonal antibodies against CD3, CD4, CD8, HLA-DR, and ICAM-1. RESULTS: In lesional psoriatic skin, the epidermis was mainly infiltrated by CD8+ T cells. There were little or no T cells in non-lesional epidermis. In both lesional and non-lesional dermis, CD4+ T cells were the main ones. In lesional skin, anti-ICAM-1 antibody positively stained diffusely in the endothelial cells of papillary and subpapillary plexuses and focally in epidermal keratinocytes, but in non-lesional skin only the endothelial cells in the subpapillary plexus were stained. There were many HLA-DR+T lymphocytes in lesional and non-lesional dermis. In the epidermis, HLA DR was detected only in lesional keratinocytes and T lymphocytes. CONCLUSION: These results suggest (1) participation of activated epidermal CD8+ T lymphocytes in the formation of psoriatic plaques, and (2) a pathogenetic role of ICAM-1 expression on papillary microvessels.
Antibodies ; Cytokines ; Dermis ; Endothelial Cells ; Epidermis ; Frozen Sections ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Subsets* ; Lymphocytes* ; Microvessels ; Peroxidase ; Psoriasis ; Skin* ; T-Lymphocytes

A case of basilar impression surgically treated in a female patient aged 22 years is presented. A myriad of abnormal neurologic findings were present that were secondary to compression of neural tissue by anormalous bony structure at craniovertebral junction. Metrizamide computerized tomography with coronal and sagittal reconstruction identified bony abnomalities and displacement of the surrounding neural structures. The surgical intervention for the treatment of the basilar impression consisted of ventral decompression by transoral odontoidectomy and of dorsal decompression by an enlargement of foramen magnum and by laminectomy of C1, followed by occipito-atlanto-axial bony fusion.
Decompression ; Female ; Foramen Magnum ; Humans ; Laminectomy ; Metrizamide ; Neurologic Manifestations ; Platybasia*

Impact injuries to the surgically exposed dura overlying the lumbar cord at L2 were produced in cats. Cytochrome oxidase activities in frozen-dried sample of spinal cord gray matter were measured and analyzed as a step in the investingation of the possible effects of spinal cord trauma on mitochondria. As conservative index of mitochondria damage in gray matter resulting from inactivation on cytochrome oxidase activity, electron microscopic studies of mitochondrial ultrastructural changes in traumatized gray matter were performed. The effects of Naloxone on the alteration of the cytochrome oxidase activities and ultrastructures of the mitochondria in the gray matter were studied. A drop in cytochrome oxidase activities to approximately 50% of normal value was found as early as 15 minutes post-trauma, which greatest decrease at 1/2 hour and 1 hour post-trauma. Ultrastructural changes of the mitochondria continued to proceed with the lapse of time after the injury. Mitochondriae were slightly enlarged with decreased number of cristae at 15 minutes post-trauma. Enlargement of the mitochondria with disintegration of cristae and electron-lucent area in the matrices were observed at 1 hour and 4 hour post-trauma. As relatively less change to the mitochondrial ultrastructures was observed in the Naloxone-treated group than in the non-treated group, the results of this study suggest that Naloxone confers beneficial effects in enhancing the cytochrome-oxidase activity and preserving the mitochondrial ultrastructures from injury.
Animals ; Cats ; Cytochromes* ; Electron Transport Complex IV* ; Mitochondria ; Naloxone* ; Reference Values ; Spinal Cord Injuries* ; Spinal Cord*

PURPOSE: The purpose of this study was to compare the rehabilitation nursing services what nurses recognize to be important and what they do in practice of the industrial workers. METHOD: The subjects were 150 nurses who were working at the industrial hospital. The questionnaire was made up with 43 items about the perception on importance and performance of rehabilitation services. RESULT: The highest services in the perception on importance and performance subscale were physical and therapeutic services. The highest difference between perception on importance and performance was the social and occupational services. The perception on importance of rehabilitation services had positive correlation with performance. The group take care of general patients had a higher level of perception on importance than the other group, and level of performance had significant difference with age and position. CONCLUSION: We need to develop the strategy for promoting the performance of services that recognize it will be important services, but not to do. Further study on system for promoting the nurse practitioner who responsible for rehabilitation nursing.
Humans ; Nurse Practitioners ; Occupational Health ; Surveys and Questionnaires ; Rehabilitation Nursing

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

Tuberculous meningitis, which commonly causes thick granulations over the base of the brain, is a frequent cause of post-meningitic hydrocephalus. Raised intracranial tension affects the cause of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a V-A(V-P) shunt significally alters the course of the disease. The results in 5 cases have been detailed and discussed. Operation could be performed even in an active stage of the disease without much fear of milliary dissemination.
Brain ; Hydrocephalus* ; Intracranial Pressure ; Tuberculosis, Meningeal*

BACKGROUND: The pathophysiological and neurochemical changes following spinal injury are not yet elucidated. This study was designed to evaluate the morphological changes of the dorsal horn of the spinal cord and profiles of pain behaviors following intraspinal injection of NMDA in rats. METHODS: Rats were randomized into three groups: a sham-operated control group and groups where the rats received 10 mM or 100 mM N-methyl-D-aspatate (NMDA) injected into their spinal dorsal horn. Following injection, hypersensitivity to cold and mechanical stimuli and excessive grooming behaviors were assessed serially for four weeks. Morphological changes of the spinal cord were evaluated four weeks after intraspinal injection. RESULTS: Few animals in the NMDA groups developed hypersensitivity to cold and mechanical stimuli. The number of groomers and the severity of excessive grooming were significantly higher in the 100 mM NMDA group than those values of the control and 10 mM NMDA groups. The size of the neck region (lamina III-IV) was significantly smaller in the 100 mM NMDA group than in the control and 10 mM NMDA groups. CONCLUSIONS: In conclusion, intraspinal injection of NMDA in rats leads to the pathological sequela in the spinal cord and to excessive grooming behavior. These results support the use of NMDA and excessive grooming behavior after excitotoxic SCI as a model to study chronic pain after SCI.
Animals ; Chronic Pain ; Cold Temperature ; Grooming ; Horns ; Hypersensitivity ; Injections, Spinal ; N-Methylaspartate ; Neck ; Pilot Projects ; Rats ; Spinal Cord ; Spinal Cord Injuries ; Spinal Injuries

Chronic subdural hematoma is a relatively common disease which is practically always secondary to severe or minor injury to the head but may occur in connection with blood dyscrasias or cachexia in the absence of trauma. Early diagnosis and proper operative treatment result in complete recovery in most cases, but the outcome without operative treatment is almost invariably fatal. During 1972 to 1975, 28 patients with chronic subdural hematoma were examined and operated in the Department of Neurosurgery, Korea University, and clinical observation and analysis were made particularly of the relationship of age to clinical and pathological findings. Incidence of hematoma was predominated by men and estimated as 71.4% of total cases over the age group of 31 to 40 years and In the group of under 10 years were found in 3 cases A history of craniocerebral trauma in varying degrees was obtained in 23 cases(82%), and remainings had no history of it or any other illness. The average time interval from trauma to operation was 31.7 days and it was shorter in the young patients who had more evidence of increased intracranial pressure. The prevalence of the most commonly encountered symptoms and signs, especially in different age groups were analyzed. Headache was by far the commonest symptom in this series, being present in 20(71.4%) vomiting in 15(53,6%), hemiparesis in 13(16.43%) speech disturbance in 5(18%), papilledema in 16(57.2%), and convulsion in 2(7.14%). There was a tendency that young patients had headache more frequent and severe than the older patients, while mental symptoms, such as somnolence, confusion, and memory less were significantly more frequent in the older age group. Hemiparesis and other pyramidal tract signs were more frequent in the older age group. Leukocytosis in peripheral blood was investigated in 75% of cases and roentgenograms of the skull showed evidence of a linear fracture in 10 of the total cases. Carotid angiograms were of diagnostic value in that they demonstrated a lentiform shaped avascular zone by in 28% and a crescent shaped-one in the remainders by an inward displacement of the terminal branches of the middle cerebral artery. The hematomas were most frequently found in the parietotemporal region. The thickness of the hematomas as measured from angiograms increased with the age of the patient. Only 1 of 28 cases died of reaccumulation of blood in the subdural space and bleeding in the gastrointestinal tract following the operation. Excellent recovery following operation is obtained in 82% of the cases at the time of discharge from hospital.
Cachexia ; Craniocerebral Trauma ; Early Diagnosis ; Gastrointestinal Tract ; Head ; Headache ; Hematoma ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Incidence ; Intracranial Pressure ; Korea ; Leukocytosis ; Male ; Memory ; Middle Cerebral Artery ; Neurosurgery ; Papilledema ; Paresis ; Prevalence ; Pyramidal Tracts ; Seizures ; Skull ; Subdural Space ; Vomiting

A man with bilateral primitive persistent trigeminal artery combined with cerebral rete mirabile is reported. Direct both common carotid artery angiogram is described with a brief discussion of the embryogenesis of carotid-basilar anastomosis and cerebral rete mirabile. Associated findings of previously reported cases of persistent trigeminal artery and cerebral rete mirabile are briefly reviewed. Persistent of the bilateral trigeminal artery associated with hemorrhage from cerebral rete mirabile seems worthy of notation. The angiographic findings were as follows; 1) The characteristic angiographic findings are bilateral occlusion at the cavernous portion of internal carotid artery. 2) Retrograde filling of middle cerebral artery from the collateral anastomotic channel was showed. 3) Anterior and posterior cerebral arteries are filled from leptomeningeal anastomotic channel and cerebral rete anastomosis. Authors suggested that the persistent trigeminal artery is congenital origin and cerebral rete mirabile may suspect to the secondary change.
Arteries* ; Carotid Artery, Common ; Carotid Artery, Internal ; Embryonic Development ; Female ; Hemorrhage ; Middle Cerebral Artery ; Posterior Cerebral Artery ; Pregnancy

A case of the tuberous sclerosis, 14-years old boy, was observed. In his father and sister, the cerebral tubers were noted by brain computerized tomography. This disease has been reported occasionally in dermatologic and psychiatric department because of adenoma sebaceum, mental retardation and epilepsy respectively, but it has not been reported at neurosurgical department in Korea. The histopathology of the brain lesion showed atypical cell(tuberous sclerosis cell), gliosis and nonspecific calcification which confirmed the diagnosis of tuberous sclerosis.
Adolescent ; Brain ; Diagnosis ; Epilepsy ; Fathers ; Gliosis ; Humans ; Intellectual Disability ; Korea ; Male ; Sclerosis ; Siblings ; Tuberous Sclerosis*