The effects of clonidine that is an alpha2-adrenergic agonist are complex in that the intraocular responses are biphasic and dose dependent. The mechanisms of the ocular hypotensive responses to clonidine in the treated and the contralateral untreated eyes seemed to be dependent on the central activity of clonidine and the intact peripheral adrenergic system. Apraclonidine is a clonidine derivative which penetrates into the blood-brain barrier minimally and lowers the intraocular pressure significantly not accompanied by systemic side effects such as change in blood pressure and pulse rate. The main purpose of the present study is to use apraclonidine to elucidate the influence of the central and peripheral sympathetic activity in the change of the morphology of the ciliary nonpigmented epithelium in the pigmented rabbits 0.1 cc of 1% apraclonidine was injected into the vitreous cavity of pigmented rabbits after removal of 0.1 cc of aqueous humor from the anterior chamber and the eyes were enucleated on 1, 3, 5, 7 days after injection. The eyes were observed with light microscopic examination. 1. In the 1st day's specimen, swollen nonpigmented epithelium and increased pigments were noted in the treated eye. 2. In the treated eye on the 5th day, vacuole like appearances under the nucleus of the nonpigmented epithelium were noted. 3. Except for the appearance of slightly increased pigmented granules in the 3rd and 5th day's specimen, there were no significant changes in any of the nontreated eyes. 4. The mechanism of the hypotensive response of apraclonidine seemed to be dependent on the alpha2-adrenergic receptors which are located in the eye, not on the central nor on the peripheral adrenergic system.
Anterior Chamber ; Aqueous Humor ; Blood Pressure ; Blood-Brain Barrier ; Clonidine ; Epithelium* ; Heart Rate ; Intraocular Pressure ; Intravitreal Injections* ; Rabbits* ; Vacuoles

Coronary stent embolization is a rare event but may result in clinically relevant cardiac ischemia or peripheral embolization during the procedure. We report a case of systemic embolizations of two coil stents during the primary PTCA in acute myocardial infarction, who were treated successfully with a double wire helix technique and a gooseneck snare. Although in our experience this rare complication did not produce any clinical complications, care should be taken to prevent this possibility, especially in patients with significant vessel tortuosity, calcification, total occlusion, or mild stenosis proximal to the target lesion.
Constriction, Pathologic ; Humans ; Iliac Artery* ; Ischemia ; Myocardial Infarction ; SNARE Proteins ; Stents*

Surgical endarterectomy has been shown to be superior to medical treatment in the management of severe carotid stenosis. Endarterectomy, although effective, does have limitations, and percutaneous transluminal angioplasty with stent may offer an alternative modality of treatment. We report on a patient with severe coronary disease that femoral arterial cannulation was not possible due to aorto-femoral shunt operation and absent pulse. The transradial approach was used for aortography, bilateral carotid angiography and successful elective stent deployment in the left internal carotid artery. The transradial approach might be useful alternative in case of problems with femoral approach.
Angiography ; Angioplasty* ; Aortography ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Catheterization ; Coronary Disease ; Endarterectomy ; Humans ; Stents*

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis

PURPOSE: Traumatic brain injury is a multifaceted injury that involves direct mechanical damage, intraparenchymal and subarachnoid hemorrhage, breakdown of the blood- brain barrier, excitotoxicity, and ischemia. Despite the dozens of previous investigations, the information about its pathogenic mechanism is still limited. The aim of this study was to reveal the appearance of antigen presenting cells in the cerebral cortex of rats after cauterization. METHODS: A total of 18 male Sprague-Dawley rats weighing 300 g and 2 months old on the average were used throughout the experiment. The frontal bones were exposed by elevating the skin and craniectomies were performed adjacent to the central suture, midway between lambda and bregma. Cauterizing injury was then created by battery-operated small vessel cauterizers to the left frontal cortex. The rats were sacrificed on the 1st, 4th, 7th and 14th days after the surgery(n=3, each time), and three rats were sacrificed as normal controls. Serial brain cryosections were made by cryostat. For immunohistochemistry, brain tissue sections were allowed to react with mouse anti-rat MHC class II antibody(1:500) and mouse anti-rat ED2 antibody(1:200). Also, brain tissues were routinely stained by H-E, and then microscopic observation and cell counts were performed. RESULTS: 1) MHC class II positive dendritic cells were absent in normal cerebral cortex parenchyme, but were found 28 times more in number in injured rats on the 7th day after cauterization. 2) ED2 positive macrophages were absent in normal cerebral cortex parenchyme, and were found 16 times more in number in injured rats on the 7th day after cauterization. 3) The number of MHC class II positive dendritic cells were smaller in number than that of ED2 positive macrophages 6 hours and 1st day later after cauterization, but it was higher in number on the 4th, 7th and 14th days. 4) The number of MHC class II positive dendritic cells were higher in number than that of ED2 positive macrophages around blood vessels and peripheral regions in the injured brain. 5) MHC class II positive dendritic cells were usually aggregated. CONCLUSION: It can be suggested that the increase in number of two kinds of antigen- presenting cells affect cell-mediated immune responses and phagocytosis.
Animals ; Antigen-Presenting Cells ; Blood Vessels ; Brain ; Brain Injuries ; Cell Count ; Cerebral Cortex ; Dendritic Cells ; Frontal Bone ; Glycosaminoglycans ; Humans ; Immunohistochemistry ; Ischemia ; Macrophages ; Male ; Mice ; Rats ; Rats, Sprague-Dawley ; Skin ; Subarachnoid Hemorrhage ; Sutures

Purpose: The purpose of this study was to compare the concurrent validity and test-retest reliability of ‘KPIMT Torticollis Protractor’, a smart phone and I-pad application for convenient range of motion measurement, and ‘Image J’, an analysis software with high reliability and validity, according to head tilt and active cervical rotation angle. This was done to determine the clinical utility of ‘KPIMT Torticollis Protractor’. Methods: Head tilt and active cervical spine rotation angles of 40 children with congenital muscular torticollis were measured using Image J and KPIMT Torticollis Protractor, respectively. The level of concurrent validity and inter-rater and intra-rater reliability between the two measurement methods were analyzed. Results: For forty participants, the concurrent validity between Image J and KPIMT Torticollis Protractor showed very high validity with ICC of ICC 0.977 (0.995-0.999), 0.994 (0.994-0.998), CVME% 0.71-0.72%, SEM% 0.31-0.34%, MDC% 0.86-0.94%. The test-retest intra-rater reliability showed very high reliability ICC 0.911 (0.911-0.966), CVME% 0.71%, SEM% 0.34-0.36%, MDC% 0.81-0.94%. The test-retest inter-rater showed very high reliability ICC 0.936 (0.933-0.957), CVME% 0.70%, SEM% 0.34-0.35%, MDC% 0.81-0.83%. Conclusion The KPIMT Torticollis Protractor, a smart phone and IPD application, is a highly reliable and valid device for angle measurement in children with congenital myotonia and can be easily used in clinical practice.

PURPOSE: Dendritic cells (DCs) are the most potent antigen presenting cells and should be differentiated to mature form to induce primary T cell response. In this study, we intended to generate mature DCs from peripheral blood mononuclear cells (PBMCs), so that develope the basis for immunotherapy using DCs. METHODS: PBMCs were isolated from 25 mL of normal adults' peripheral blood and evenly distributed in 5 wells of a 6-well plate. Nonadherent cells were gently aspirated after 2 hour-incubation under humidified 5% CO2 at 37degrees C. Adherent monocytes were cultured in 3 mL of 10% fetal bovine serum plus RPMI-1640 media containing granulocyte/macrophage-colony stimulating factor (GM-CSF) 200 ng/mL and interleukin (IL)-4 20 ng/mL. To assess the effect of tumor necrosis factor (TNF)-alpha and interferon (IFN)-alpha on DC maturation, either or both were added on day 4 of culture. Cells were harvested on day 4 and 7 to calculate the cell counts, CD83 /HLA-DR cells, and CD86 /HLA-DR cells. RESULTS: On day 4, large amounts of DCs were observed. CD83 /HLA-DR cells and CD86 / HLA-DR cells were 11.6% and 16.6% of total cells counted and yields were 1.3% and 2.0%, respectively. On day 7, DCs were more frequently observed in all instances and purity ranged from 24.0% to 31.0% as a mean value. The final yields of matue DCs were 2.9~3.4% of PBMCs inoculated. Adding TNF-alpha plus IFN-alpha led to the best yield. But, IFN-alpha alone did not increase the mature DCs compared to the control. CONCLUSION: We successfully cultured large quantities of mature DCs from PBMCs using GM-CSF and IL-4. IFN-alpha seems to have a synergistic effect when added with TNF-alpha, but further studies are required to prove the clinical significance.
Antigen-Presenting Cells ; Cell Count ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; HLA-DR Antigens ; Immunotherapy ; Interferon-alpha ; Interferons ; Interleukin-4 ; Interleukins ; Monocytes ; Tumor Necrosis Factor-alpha

BACKGROUND AND OBJECTIVES: Practical concerns about transradial approach are increasing in consideration of high procedural success rate, low local complications, and patient's convenience. There was no available data about repeated-use of radial artery for coronary procedures. We evaluate the changes of radial arterial diameter and procedural outcomes of repeated transradial procedure. MATERIALS AND METHOD: Of consecutive 1771 transradial coronary procedures, 117 patients received repeated transradial procedures through the same radial artery. Radial arterial diameter, vascular access time and procedural outcomes were evaluated in between the group of first-use and repeated-use of radial artery. RESULTS: Among 117 patients of second transradial coronary procedure in the repeated-use group, 47 patients (41.6%) underwent coronary intervention and 66 patients (58.4%) underwent coronary angiography. The right radial approach was used in 82.9% of the cases. There was no significant difference in radial artery mean diameter between pre-procedure and 1 day after procedure in patients with first-use and repeated-use group. There was no significant change of radial arterial diameter after first-use depending on the SAR (the ratio of sheath outer diameter to radial artery inner diameter). However, after repeated-use of radial artery, there was significant reduction of radial arterial diameter 1 day after procedure in the patients with SAR more than 0.9 (p<0.05). In repeated-use group, the mean radial arterial diameter was 2.63 +/- 0.35mm mm before the procedure and 2.51 +/- 0.29mm during follow-up (136 +/- 123 days) (p<0.05). There was no significant difference of the vascular access time between the first-use and repeated-use procedures (2.9+/-3.1 vs 3.3+/-3.6 minutes, p<0.05). The procedural success and vascular complication rate of repeated-use of radial artery were as similar to those of the first-use, but total occlusion of radial artery was higher in the repeated-use group (2.6% vs 0.7%, p<0.05). CONCLUSION: The diameter of radial artery after transradial procedures was significantly reduced during follow-up and the incidence of asymptomatic radial artery occlusion was more frequent after repeated-use. However, repeated-use of radial artery was feasible in most patients with high procedural success rate and low vascular complications.
Coronary Angiography ; Follow-Up Studies ; Humans ; Incidence ; Radial Artery*

Transforming growth factor-B1 (TGF-B1) is well known to be one of the most potent Immunosuppressive cytokines. To determine whether TGF-B1 secreted in the latent form can be immunoregulatory, TGF-B1 cDNA driven by the human -actin promotor was transfected into a murine thymoma cell line, EL4 cells. The transfectants (ELJ4) secreted a latent torm of TGF-B1 at a concentration of 5 ng/ml under the influence of TPA. Transfected TGF-b1 transcripts was readily detected by RT-PCR in ELJ4 cells regardless of the presence of TPA, but not in EL4 cells. In addition, we found the degree of Thy-B1 expression, IL-2 secretion and the proliferation rate are not altered by the transfection. Finally, EL4 and ELJ4 cells were injected into C57BU6 mice (syngenic strain), subcutaneously. Tumor cell masses derived from both cell populations survived longer than 1 wk, and the size of tumor derived from ELJ4 was three times larger (2.5 cm of diameter) than that from EL4. Virtually, there was no histopathological difference between two tumors. Taken together, the results from the present study indicates that EL4 thymomas transfected with TGF-1 secretes a latent form of TGF-B1 which may suppress host immune defence system.
Humans ; Mice ; Animals

An open trial was carried out to investigate the efficacy and tolerance of isosorbide 5-mononitrate(Elantan(R)) in 30 patients diagnosed as angina pectoris at Pusan national university hospital. Drugs were given 20mg two times daily for 2 to 3 weeks and the results were assessed in terms of effects on anginal pain and untoward side effects experienced during administration of medication. Treament resulted in an overall improvement in 25 patients(83.4%), complete abolition of anginal attacks in 17 patients(56.7%) and reduction in frequency of attacks in 8 patients(26.7%). So called "Nitrated headache" was observed in 5 patients(16.6%) but improved with proceeding of administration in 3 patients. This trial indicates that isosorbide 5-mononitrate should be efficacious as well as tolerated in patients with coronary heart disease.
Angina Pectoris* ; Busan ; Coronary Disease ; Humans ; Isosorbide*