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

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

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*

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: Phenylketonuria(PKU) is an inborn error of metabolism and a genetic disorder resulting from a deficiency of phenylalanine hydroxylase(PAH) and decreased activity of tetrahydrobiopterin(BH4).In this study the correlation between the DNA mutation and clinical manifestations was investigated and PAH DNA mutations were compared bewteen Asian and Caucasian populations. METHODS: DNA was isolated from peripheral leukocytes. The PAH gene was amplified by Polymerase Chain Reaction(PCR) and the sequence was analyzed with Multiplex Ligation-dependent Probe Amplification(MLPA). RESULTS: We characterized the PAH gene of 102 independent Korean patients with PKU. PAH nucleotide sequence analysis revealed 44 different mutations, including 10 novel mutations comprising 9 missense mutations(N207D, K95del, A447P, G344D, P69S, S391I, A202T, G103S, and I306L) and 1 novel splice-site variant mutation(IVS10-3C>G). R243Q was the most prevalent mutation in this study. A259T has not previously been reported in Asian populations, but we found that this mutation had a frequency of 10.1% in our study. Furthermore, the genotypes of BH4 responsive patients were analyzed and were divided into two groups: BH4 medication-only group and BH4 medication with diet therapy group. In the BH4 medication-only group and BH4 medication with diet therapy group, R241C was the most common mutation. CONCLUSION: Novel mutations in the PAH gene of PKU patients are still being discovered. Additional information as to the frequency of mutations in the tetrahydrobiopterine responsive gene is also accumulating. We anticipate that knowledge of these PKU gene mutations will assist the diagnosis, genetic counseling, and therapeutic treatment of PKU patients in future.
Asian Continental Ancestry Group ; Base Sequence ; DNA ; Genetic Counseling ; Genotype ; Humans ; Leukocytes ; Phenylalanine ; Phenylalanine Hydroxylase ; Phenylketonurias

No abstract available.
Pyoderma Gangrenosum* ; Pyoderma* ; Ulcer*

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

Type1 diabetes mellitus (DM) is generally known to be caused by destruction of insulin-producing pancreatic β cells or an immune-related problem. Polydipsia is a representative symptom of DM, and it has been reported that this condition is closely related to xerostomia and is considered that hyposalivation from the salivary gland results in this phenomenon. Although various studies have reported that induction of diabetes reduces endogenous stem cells in other organs (heart, brain etc.), diabetes-related changes in endogenous stem cells in the salivary gland have not yet been well established. Therefore, in this study, to verify the change in salivary gland stem cells after diabetes, salivary gland tissues in the control and diabetes-induced groups were processed by histochemistry (Masson's trichrome staining) for morphological analysis, TUNEL assay for cell death, and immunohistochemistry (Ki-67 and c-Kit) for cell proliferation and maturation. Diabetes induced by STZ leads to vacuolization, apoptosis, and reduction in proliferating cells/salivary gland stem cells in salivary glands of rats. This result suggests that diabetes may be associated with reduction in salivary gland function such as degeneration and inhibition of regeneration in the salivary gland.
Animals ; Apoptosis ; Brain ; Cell Death ; Cell Proliferation ; Diabetes Mellitus ; Immunohistochemistry ; In Situ Nick-End Labeling ; Polydipsia ; Rats* ; Regeneration ; Salivary Glands* ; Stem Cells* ; Xerostomia