No abstract available.
Subclavian Artery* ; Thoracic Outlet Syndrome* ; Thromboembolism*

No abstract available.
Child* ; Humans ; Prone Position* ; Thoracotomy*

Five brains from established cases of Senile Dementia of Alzheimer Type (SDAT) and six branis from cases of no clinical or neuropathological evidences of SDAT were studied immunocytochemically using anti-somatostatin (SST) antibody. Fifty micrometer sections of immersion fixed brains (autopsy delay: 10-16 hours) were cut and then stored in 0.1 M tris-HCI buffer (pH7.4) until the immunocytochemical study. Lmmunostatinings were performed according to Sternberger's peroxidase-antiperoxidase (PAP) technique. The primary antiserum was rabbit antiserum to synthetic somatostatin (Cambridge Research Biochemicals). Diluted to 1: 1.000. The secondary antiserum was goat anti-rabbit IgG (Sternbeger-Meyer) in dilutions of 1: 400 to 500. Controls followed complete staining protocol. But without incubation in the specific antibody. SST-immunoreactive (IR) neurons in aged normal brains were distributed in all layers of cortices. These cells were multipolar, bitufted, or wramidal in shape. The changes of SST-IR neurons were profound in frontal, parietal, and temporal cortices of SDAT brains, but were absent in the Cal of hippocampus. Neuritic plaque-like structure formation was the most common changes seen in the cortices, especially in the temporal cortex. The morphology of altered SST-IR neuronal elements were similar to that of the neuritic plaques demonstrated by the Bielshowsky's silver impregnation method. Apparently intact SST-IR neurons were also found in SDAT brains, thus giving rise to the speculation that these neurons may have unusual survival and reorganization potential. Unexpectedly, there were no degenerative changes of SST-IR neurons in CA! region of SDAT hippocampus. These results strongly suggest that among SST-IR neurons only neocortical short association neurons are affected in the neuronal degenerative changes of SDAT.
Alzheimer Disease* ; Brain ; Goats ; Hippocampus ; Immersion ; Immunoglobulin G ; Neurons* ; Plaque, Amyloid ; Rabeprazole ; Silver ; Somatostatin

Since Maisonneuve mentioned osteomyelitis complicated by typhoid fever for the first time in 1835, numerous investigators had reported salmonella osteomyelitis. The authors recently experienced six cases of salmonella osteomylitis: four cases in lumbar spine and the remainders in bones adjacent to elbow. Four cases were in adult male ranging from 18 to 35 years old and the others were in a male, age of thirteen and female, age of seven in elbow respectively. The two among four spondylitic cases and two cases of long bone ostemyelitis were surgically treated, and the other two spondylitic cases were conservatively treated. Salmonella osteomylitis was confirmed in surgically treated group by culture of pus obtained from pathologic lesion, and conservatively treated group was diagnosed by history, clinical manifestation, laboratory data and especially characteristic progress of roentgenographic change. The causative organisms were paratyphoid group D in all cases. Review of literature was done with report of six cases of salmonella osteomyelitis.
Adult ; Elbow ; Female ; Humans ; Male ; Osteomyelitis ; Research Personnel ; Salmonella ; Spine ; Suppuration ; Typhoid Fever

Somatosensory evoked potentials(SSEP's) are commonly employed to monitor cerebral and spinal cord function in patients with various lesions in the nervous system. In this study, we evaluated SSEP's as a means of measuring not only neurophysiological function but also the alteration of blood folw in the territory of cerebral ischemia. We examined SSEP's and regional cerebral blood flow(rCBF) in the bilateral suprasy1vian gyri following unilateral middle cerebral artery(MCA) occlusion in 15 cats(Group II). The duration of arterial occlusion was 30 minutes followed by 1 hour of recirculation. Five additional cats served as sham-operated groups(Group I). The animals in Group II were divided into 2 subgroups according to the change of the observed rCBF in the ipsilateral hemisphere. Immediately after MCA occlusion, rCBF decreased from around 50 to 14mg/100g/min. Decreased rCBF was remained below 20ml/100g/min throughout the ischemic period in 6 cats(Group IIb), and in the remaining 9 cats, the decreased rCBF was increasing during ischemia although the blood flow was subnormal(Group IIa). The recovery of rCBF during recirculation was faster in Group IIa than in Group IIb. In Group IIa and IIb, there was a significant slowing of the interpeak latency between dorsal column nuclei(Fz) and the major negative deflection(MN) (P<0.05) in the ipsilateral hemisphere and a precipitous decrease in the amplitude of the ipsilateral P1-MN complex immediately after occlusion(P<0.05). In Group IIb the suppressed SSEP's did not show any recovery during ischemia, and recovered late during recirculation. In Group IIa the suppressed SSEP's tended to recover during recirculation. In Group IIa the suppressed SSEP's tended to recover during ischemia and recovered early during recirculation. SSEP's were not completely abolished throughout the experiment in any experimental grup. The relationship between the changes in rCBF and amplitude of SSEP's in the ipsilateral hemisphere was significant(r=0.943, P<0.05) during occlusion of the middle cerebral artery in Group IIa. However there was not any other relationship in the other groups or among other wave components. These results indicate that the suppression of SSEP's and their failure to recover during focal cerebral ischemia correlate with the lack of collateral circulation. Furthermore, SSEP's can be useful means to evaluate the reversibility of cerebral ischemia, which may be decided by existence of collateral circulation. And it appers that the time threshold for abolition of SSEP's is more than 30 minutes in focal cerebral ischemia in the cat.
Animals ; Brain Ischemia* ; Cats ; Cerebral Infarction* ; Collateral Circulation ; Evoked Potentials, Somatosensory* ; Humans ; Ischemia ; Middle Cerebral Artery ; Nervous System ; Spinal Cord

PURPOSE: To describe radiologic differences between tuberculous pleural effusion and empyema on the basis of computed tomography(CT). MATERIALS AND METHODS: We reviewed retrosepectively CT findings of 50 patients with pathologically and grossly proved empyema. Twenty-two patients had empyema, and 28 patients had tuberculous pleurisy. RESULTS: CT findings known to be useful in differentiating tuberculous pleural effusion from empyema (1) contour and extent of pleural thickening, (2) mediastinal pleural involvement, (3)accumulation of extrapleural tissue and (4) change of ipsilateral thoraic volume of empyema. However, none of the above findings were helpful in the differential diagnosis of empyema. CONCLUSION: The differentation of tubrculous pleurisy from pyogenic empyema may be not possible with CT findings only.
Diagnosis, Differential ; Empyema* ; Humans ; Pleural Effusion* ; Pleurisy ; Tuberculosis, Pleural

No abstract available.
Endoscopy ; Humans ; Midazolam ; Propofol

Patients with symptomatic stenosis of the basilar artery have a poor prognosis and the treatment options are limited. Surgical bypasses are technically difficult and there is no proven benefit. Percutaneous angioplasty shows significant complications because of dissection, restenosis secondary to elastic recoil and embolic phenomena. The medical treatment with aspirin and wafarin showed the annual risk of 20% for symptomatic basilar artery stenosis as repoted in WASID(Warfarin-Aspirin Symptomatic Intracranial Disease)study. We report a patient with symptomatic high grade stenosis of the basilar artery refractory to appropriate maximal medical therapy, in whom endovascular stenting was performed successfully without preliminary balloon angioplasty. Excellent angiographic result was achieved and there were no procedural and periprocedural complications. The patient was asymptomatic except preprocedural mild dysarthria and had no neurological symptoms during clinical follow-up of 2 months at outpatient department. Primary stenting of basilar artery stenosis may be an alternative to balloon angioplasty for patient with symptomatic lesions refractory to medical therapy or in whom anticoagulation is contraindicated.
Angioplasty ; Angioplasty, Balloon ; Aspirin ; Basilar Artery* ; Constriction, Pathologic ; Dysarthria ; Follow-Up Studies ; Humans ; Outpatients ; Prognosis ; Stents* ; Vertebrobasilar Insufficiency*

Three hundred ninety potentially curative resections for an adenocarcinoma of the stomach were performed in the Surgical Department of Chonbuk National University Hospital between 1991 and 1995. Eighty-nine patients were over 65 years of age, and three hundred-one patients were under 65 years of age. Pre-operative risk factors were statistically common in the over 65-years-old group(p<0.0044). Among the risk factors, pulmonary dysfunction was the most common pre-operative risk factor in both age groups, but diabetes mellitus was statistically significant factor in the under 65-years-old group. The incidence of post-operative complications revealed no statistical difference between two groups, and diarrhea was the most common complication in both groups. The incidence of complications increased when the disease was in an advanced stage and we did an extended operation, including a gastrectomy and a lymphadenectomy, but there was no statistical difference between the two age groups. The 3-year survival rate was higher when we did a curative resection with a subtotal or a total gastrectomy with a D2 lymphadenectomy than when we did non-curative resection, but there was no statistical difference between the two age groups. Hence, a curative resection including a radical gastrectomy with a D2 lymphadenectomy, if it is indicated, is reasonable approach for improving the survival rate in patients with an adenocarcinoma of the stomach, even elderly patients over 65 years of age.
Adenocarcinoma ; Aged* ; Diabetes Mellitus ; Diarrhea ; Gastrectomy ; Humans ; Incidence ; Jeollabuk-do ; Lymph Node Excision ; Risk Factors ; Stomach ; Stomach Neoplasms* ; Survival Rate*

In many cases where failure to remove the stone during mechanical lithotripsy occur, an emergency mechanical lithotriptor enabled the stone to be removed. Stones captured within an impacted basket are either crushed or the wires of the Dormia basket are broken to release the trapped basket. However, occasionally, emergent mechanical lithotripsy may be complicated by the impaction of a basket wire due to fracture of the traction wire during crushing of the stone. We report a novel method for retrieval of an entrapped Dormia basket fractured just outside the oral cavity during an attempt to use the emergent lithotriptor. This was done by introducing a second Dormia basket into the bile duct. After catching the knob of the impacted basket, the basket was then disengaged from the stone. The simplicity of this maneuver makes it a first line salvage technique to be used before subjecting the patient to more invasive techniques.
Bile Ducts ; Emergencies* ; Humans ; Lithotripsy* ; Mouth ; Traction