A case of hypertrophic interstitial neuropathy in a 32 years old man developed in the median nerve is reported. This is a rare disease characterized by thickened peripheral nerves which may be palpable and visible. This case was treated by excision of transverse carpal ligament and external and internal neurolysis.
Hereditary Sensory and Motor Neuropathy ; Ligaments ; Median Nerve ; Peripheral Nerves ; Rare Diseases

PURPOSE: Nitric oxide(NO) is a highly reactive messenger molecule that is synthesized by nitric oxide synthase(NOS) in a number of tissues including the brain. Our aim was to examine the possible role of NO on pentylenetetrazole(PTZ)-induced seizure in rats as a proconvulsant or an anticonvulsant. METHODS: Male Sprague-Dawley rats weighing 200-300g were used. PTZ(40mg/kg) was used to induce seizure. In order to examine the role of NO in seizures, the neuronal nitric oxide synthase (nNOS) was blocked by a specific inhibitor, 50mg/kg 7-nitroindazole(7-NI), and a non-specific inhibitor, 50mg/kg L-nitroarginine(L-NA). Both 7-NI and L-NA were administered 30 min before the administration of PTZ. We evaluated the onset time of the first myoclonic jerk and the nature of seizures, such as the types and severity of the seizures in each group. Western blot and RT-PCR were used to examine the expression of nNOS mRNA and proteins in the hippocampus of each group. RESULTS: The onset time of the first rnyoclonic jerk was markedly delayed in the 7-NI and L-NA pretreated groups in comparison to the PTZ group. In addition, 7-NI and L-NA markedly sup- pressed the severity of PTZ-induced seizure. The expression of nNOS mRNA was higher in the PTZ and 7-NI pretreated groups than in the control group. The expression of nNOS protein was more suppressed in the 7-NI and L-NA pretreated groups than in the PTZ group. CONCLUSION: The expression of nNOS protein appears to increase in PTZ-induced seizures. Both specific and non-specific NOS inhibitors produce a reduction in seizure activity and nNOS protein expression. These results suggest that nNOS may be in a close relationship with seizures, and NO may play an important role as a proconvulsant in the PTZ-induced seizure in rats.
Animals ; Blotting, Western ; Brain ; Hippocampus ; Humans ; Male ; Myoclonus ; Nitric Oxide Synthase Type I ; Nitric Oxide* ; Pentylenetetrazole* ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Seizures*

Atrial septal defect is one of the most common congenital heart diseases in adult, of which absolute causes is not confirmed, but explained by multifactorial inheritance. In Korea, there has been no case report of atrial septal defect in identical twins in spite of some reports of atrial septal defect in relatives and twins in other countries. We present a first case of atrial septal defect in identical twins whose mother had no infection or medication history during pregnancy.
Adult ; Heart Diseases ; Heart Septal Defects, Atrial* ; Humans ; Korea ; Mothers ; Multifactorial Inheritance ; Pregnancy ; Twins ; Twins, Monozygotic*

A clinical trial was done to evaluate the antihypertensive efficacy and side effects of manidipine, a new calcium antagonist, in 30 patients with mild to moderate essential hypertension. 1) The study patients consisted of 19 men and 11 women, and the mean age was 51.8 years. 2) Blood pressure dropped significantly in 2 weeks and in 4 weeks, and well maintained throughout the study period. The mean-pressure drop was 26.2/14.9mmHg after 10 weeks. 3) Heart rate did not change significantly with manidipine therpy. 4) Optimal dose for effective pressure-drop was between 10 and 20 mg in 86% of patients. Overall good antihypertensive effect was achieved in 83% of patients. 5) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change, but serum calcium increased from 9.2% mg/dl (p=0.001) in 10 weeks. 6) Side effects were mild in nature(palpitation in 3, dry mouth in 1, weakness in 1 and impotence in 1 patient). In conclusion, manidipine monotherapy with 10 to 20 mg once a day regimen is effective and well tolerated in the patients with mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Chemistry ; Electrolytes ; Erectile Dysfunction ; Female ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth

Tension pneumocephalus is rare complication is neurosurgical operation. But it should be treated promptly because of sudden neurological deterioration. Computed tomography permitted rapid diagnosis including localization of the air, thus facilitating prompt treatment. A case of subdural tension pneumocephalus after cranial operation under the impression of bifrontal subdural hygroma is presented.
Diagnosis ; Pneumocephalus* ; Subdural Effusion

Oligodendroglioma constitutes about 4% of all gliomas. The usual symptoms of oligodendrogliomas are seizures, focal neurologic deficits, and increased intracranial pressure. They usually present with a gradual onset of symptoms and slow progression. The apopletic symptom due to sudden tumor bleeding is rare. The author review literatures and present a case of oligodendroglioma initially manifested as ventricular hemorrhage after head injury.
Craniocerebral Trauma* ; Glioma ; Head* ; Hemorrhage* ; Intracranial Pressure ; Neurologic Manifestations ; Oligodendroglioma* ; Seizures

Recent studies suggest that coronary endothelial dysfunction in atherosclerosis may contribute to the predisposition both for coronary spasm as well as for thrombus formation. The integrity of at least one aspect of endothelial function can be assessed by the intracoronary administration of acetylcholine. Eleven(13.4%, mean age 48+13, male 11) out of 82 consecutive patients with acute myocardial infarction showed angiographically normal or near normal coronary arteries at 7~10 in-hospital days. Ten(91%) had history of heavy smoking and 7 patients(64%) had no history of previous angina. Anterior myocardial infarction was in 8 and inferior in 3 patients. After intracoronary administration of acetylcholine(incremental dose of 20, 50ug for the right and 20, 50, 100ug for the left), 9(82) of 11 infarct related arteries showed total or subtotal occlusion, but only in 3(17%) out of 18 non-infarct related arteries of 10 patients. Multivessel spasm was noticed in 3. Ergonovine test(graded doses of 0.05, 0.1 and 0.2 mg intravenously) was performed 30 minutes after completion of acetylcholine test in 5 patients. In 1 patients, acetylcholine test was positive and but ergonovine test was negative. Conclusion : 1) Eleven(13.4%) out of 82 patients with acute myocardial infarction had angiographically normal coronary arteries. 2) Ach positive responses of infarct-related arteries are more frequent(82%) than that of non-infarct related arteries(17%), suggesting that the infarction might be related to coronary artery spasm. 3) Positive Ach responses of non-infarct related arteries occurred in 30% of Patients. 4) Ach and Erg induced vasospasm developed at the same site in 5, which suggests that local hyperreactivity might be related to spasm.
Acetylcholine* ; Arteries ; Atherosclerosis ; Coronary Vessels* ; Ergonovine ; Humans ; Infarction ; Male ; Myocardial Infarction* ; Smoke ; Smoking ; Spasm* ; Thrombosis

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is a major endothelium dependent vasomediator and growth inhibitor. NO synthesis is catalyzed by endothelial nitric oxide synthase (eNOS), and NO can also produce peroxynitrite, which activates matrix metalloproteinases (MMPs). The purpose of this study was to determine the gene expression of eNOS and MMP-2 in the lungs of a rat model of pulmonary hypertension after bosentan treatment. MATERIALS AND METHODS: Six-week-old male Sprague-Dawley rats were treated as follows: control group, subcutaneous (sc) injection of saline; monocrotaline (MCT) group, sc injection of MCT (60 mg/kg); and bosentan group, sc injection of MCT (60 mg/kg) plus 20 mg/day bosentan orally. The rats were sacrificed after 1, 5, 7, 14 and 28 days. RESULTS: The right ventricle/(left ventricle+septum) ratio significantly increased in the MCT group compared to the control group on day 14 and 28. The expression of eNOS messenger ribonucleic acid was significantly increased in the MCT group compared to the control group on day 28. MMP-2 gene expression was significantly increased in the MCT-treated rats compared to the control group on day 5 and 28. Following bosentan treatment to reduce pulmonary hypertension, the expression levels of MMP-2 gene were significantly decreased on day 7 and 28. eNOS and tissue inhibitor of MMPs genes were also significantly decreased on day 28 after bosentan treatment. CONCLUSION: These results suggest that elevated eNOS expression may be responsible for MMP-2 activation. The causal relationship between eNOS and MMP-2 and their role in pulmonary hypertension require further investigations.
Animals ; Endothelium ; Gene Expression ; Humans ; Hypertension, Pulmonary ; Lung ; Male ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinases ; Monocrotaline ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type III ; Peroxynitrous Acid ; Rats ; Rats, Sprague-Dawley ; RNA ; Sulfonamides

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is a major endothelium dependent vasomediator and growth inhibitor. NO synthesis is catalyzed by endothelial nitric oxide synthase (eNOS), and NO can also produce peroxynitrite, which activates matrix metalloproteinases (MMPs). The purpose of this study was to determine the gene expression of eNOS and MMP-2 in the lungs of a rat model of pulmonary hypertension after bosentan treatment. MATERIALS AND METHODS: Six-week-old male Sprague-Dawley rats were treated as follows: control group, subcutaneous (sc) injection of saline; monocrotaline (MCT) group, sc injection of MCT (60 mg/kg); and bosentan group, sc injection of MCT (60 mg/kg) plus 20 mg/day bosentan orally. The rats were sacrificed after 1, 5, 7, 14 and 28 days. RESULTS: The right ventricle/(left ventricle+septum) ratio significantly increased in the MCT group compared to the control group on day 14 and 28. The expression of eNOS messenger ribonucleic acid was significantly increased in the MCT group compared to the control group on day 28. MMP-2 gene expression was significantly increased in the MCT-treated rats compared to the control group on day 5 and 28. Following bosentan treatment to reduce pulmonary hypertension, the expression levels of MMP-2 gene were significantly decreased on day 7 and 28. eNOS and tissue inhibitor of MMPs genes were also significantly decreased on day 28 after bosentan treatment. CONCLUSION: These results suggest that elevated eNOS expression may be responsible for MMP-2 activation. The causal relationship between eNOS and MMP-2 and their role in pulmonary hypertension require further investigations.
Animals ; Endothelium ; Gene Expression ; Humans ; Hypertension, Pulmonary ; Lung ; Male ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinases ; Monocrotaline ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type III ; Peroxynitrous Acid ; Rats ; Rats, Sprague-Dawley ; RNA ; Sulfonamides

Percutenous transluminal coronary angioplasty(PTCA) for total coronary occlusion was performed in 20 patients(mean age 51+11years, male 16, female 4) including 12 patients with recent myocardial infaction. Primary success rate of procedure was 71%(15 out of 21 lesions). The success rate with occlusion<3 months duration was 11 out of 13(85%) lesions vs 4 out of 8(50%) with occlusion>3 months duration(P=NS). There was no difference in success rate according to vessel dilated(left anterior descending and intermediate branch 70%, right coronary artery 83%, left circumflex 67%). All patients had well developled(>grade 2 in 15 patients) collateral flow to the occluded vessel. The leng of occluded lesion more than 1.5cm was in 4 out of 21, and 3 of them had procedural failure because of inability to cross with a guide wire. Six procedsural failures included inability to cross the lesion with a guide wire in 5 and one in inability to dilate the lesion due to recoiling. Complications included intimal dissection in 3(1.5%), prolonged chest pain in 1 1 and one death due to cardiogenic shock. Although the primary success rate is relatively lower than that associated with conventional stenotic lesions, coronary angioplasty could be performed safely and successfully in the majority of patients with coronary occlusion.
Angioplasty* ; Chest Pain ; Coronary Occlusion ; Coronary Vessels* ; Female ; Humans ; Male ; Shock, Cardiogenic