Inadvertent application of ionizing radiation, a valuable tool in diagnostic radiology and radiotherapy, results in injury and death of adjacent normal cells, inducing gene mutations or even producing latent cancers. Captopril, an angiotensin I converting enzyme (ACE) inhibitor, has been reported to prevent the structural and functional changes in variable organs, such as lung and kidney, from radiation injury in different experimental animal models. An experiment was carried out to elucidate the radiation-induced histomorphologic changes of small intestine, especially jejunum, and to determine whether captopril can reduce or prevent the radiation-induced injuries in jejunum. Twenty-six healthy Sprague-Dawley rats were used. Experimental group (n=24) was divided into two large groups: the first one (n=16) was treated with two different single dose (9 Gy, 17 Gy) irradiation only and was sacrificed at 12 hours and at 8 weeks following irradiation; the second one (n=8) received captopril 500 mg/l per oral continuously after same doses of irradiation and was sacrificed at 8 weeks. The control group (n=2) was maintained on a stock diet in a same period of experimental group and sacrificed coincidentally. On light and electron microscopy, the 9 Gy and 17 Gy 12 hours groups revealed frequent apoptosis and necrosis but extremely decreased mitotic figures of the crypt cells. However, the 9 Gy and 17 Gy 8 weeks groups and the combined irradiation with captopril groups showed extremely reduced apoptosis and necrosis with increased mitotic figures. There was good correlation between experimental groups in apoptotic count and mitotic count (p<0.05). In the 9 Gy and 17 Gy 12 hours groups, the mucosal surface was focally or diffusely fragmented and the villi were slightly to moderately distorted. Collagen deposition was very mild and confined to the lower portion of the lamina propria. The 9 Gy and 17 Gy 8 weeks groups showed more severe mucosal surface fragmentation even with foci of erosion, short and distorted villi, and more intense collagen deposition. In contrast, the combined irradiation with captopril groups revealed complete regeneration of the mucosal surface epithelium and absent collagen deposition. These findings suggest that the acute radiation injuries to small intestine occur principally in the mucosal crypt cells. Captopril, the ACE inhibitor, might provide a useful intervention in the radiation injuries of intestinal mucosa.
Animals ; Apoptosis ; Captopril ; Collagen ; Diet ; Epithelium ; Intestinal Mucosa* ; Intestine, Small ; Jejunum ; Kidney ; Lung ; Microscopy, Electron ; Models, Animal ; Mucous Membrane ; Necrosis ; Peptidyl-Dipeptidase A ; Radiation Injuries ; Radiation, Ionizing ; Radiotherapy ; Rats* ; Rats, Sprague-Dawley ; Regeneration

No abstract available.
Peristalsis*

No abstract available.
Pregnancy*

The most common site of posterior urethral valve is that in which there is an exaggeration of the normal ridges which extend from the midline dorsal urethral ridge and from the verumontanum to surround the urethra just before the membranous region. Obstruction to urine flow may be complete or partial. In patients with partial obstruction, failure to thrive, systemic acidosis with renal failure and continuous over-flow dribbling rather than a good urinary stream may be seen. Apart from the problem of renal damage consequent to the obstruction, these children are subject to recurrent urinary infections. Excretory urography and retrograde cystourethrography are needed to establish the diagnosis. The characteristic proximal ballooning of the urethra is best seen during micturition or attempts to express urine from the bladder. Early surgical decompression is warranted. A temporary diversionary procedure is recommended, with a definitive operation at a later age to correct the valvular obstruction. We experienced a case of posterior urethral valve which was developed in a 4 years old boy, treated this case by destruction of posterior urethral valve and report it with brief review of literatures.
Acidosis ; Child ; Child, Preschool ; Decompression, Surgical ; Diagnosis ; Failure to Thrive ; Humans ; Male ; Renal Insufficiency ; Rivers ; Urethra ; Urinary Bladder ; Urination ; Urography

Pericardial cysts have been recognized as infrequent benign intrathoracic lesions, and are mainly found by accident. Recently, we experienced 3 cases of pericardial cysts. We report these case with the brief review of literature.
Mediastinal Cyst*

Synaptic plasticity has been thought to be a mechanism of synaptic maturation, learning and memory. In this study, the possible involvement of Rac, RhoA, proline-rich tyrosine kinase 2 (PYK2) and focal adhesion kinase (FAK) in the synaptic plasticity was investigated using PC12 cells and rat brains. The followings are the results. 1. Depolarization induced extracellular signal-regulated kinase (ERK) activation but did not activate Rac and RhoA in PC12 cells. 2. ERK activation and c-fos expression were observed after electroconvulsive shock (ECS) but the activity of Rac and RhoA was not changed following ECS. 3. PYK2 not FAK activation was observed after ECS. 4. The activity of PYK2 was increased with postnatal development but that of FAK was decreased with ages. 5. The expression of Rac and PYK2 was clearly observed in the postsynaptic density but that of RhoA and FAK was not. These findings indicate that PYK2 seems to play an important role in activity-dependent synaptic plasticity in vivo brain.
Animals ; Brain ; Electroshock ; Focal Adhesion Kinase 2 ; Focal Adhesion Protein-Tyrosine Kinases ; GTP Phosphohydrolases* ; Learning ; Memory ; Nervous System* ; PC12 Cells ; Phosphotransferases ; Plastics ; Post-Synaptic Density ; Rats ; Signal Transduction*

BACKGROUND: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients. METHODS: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon's (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one. RESULTS: Mean patient age was 55 years (range, 48–61 years), and mean follow-up period was 20 months (range, 12.0–27.2 months). Mean VAS score significantly improved from 6.6 ± 2.6 preoperatively to 1.8 ± 2.5 postoperatively (p=0.009), mean ASES score increased from 67.6 ± 9.2 to 84.6 ± 15.1, and mean UCLA score from 18.0 ± 1.4 to 28.8 ± 8.5 (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome. CONCLUSIONS: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.
California ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Rotator Cuff ; Rupture ; Shoulder ; Shoulder Pain ; Superficial Back Muscles ; Tears ; Tendon Transfer ; Tendons ; Ultrasonography

BACKGROUND: Dizziness due to brain lesions manifests mainly in infratentorial lesions, with few cases related to supratentorial lesions having been reported. This study aimed to elucidate the clinical characteristics and demographic factors of patients with dizziness caused by cerebral infarction and to determine the site of the brain where supratentorial lesions are most prevalent. METHODS: Patients with prominent dizziness who visited the emergency room of Gachon University Gil Hospital between July 2006 and July 2007 were included. Among them, 101 patients with acute cerebral infarction were categorized into supratentorial (n=51) and infratentorial (n=50) groups based on brain MRI. Demographics and clinical characteristics of dizziness in each group were compared, and common brain sites of the supratentorial group were assessed. RESULTS: The nature of the dizziness differed between the supratentorial group (vertigo, 27.4%; presyncope, 5.9%; disequilibrium, 29.4%; ocular, 11.8%; and nonspecific, 25.5%) and the infratentorial group (vertigo, 50.0%; presyncope, 6.0%; disequilibrium, 32.0%; ocular, 0%; and nonspecific, 12.0%; p=0.02). The duration of dizziness was shorter in the supratentorial than the infratentorial group (p<0.01). In the supratentorial group, common sites of the lesion were the thalamus (19.6%) and frontoparietal lobe (15.7%). The lesion usually appeared in the left hemisphere (60.8%). CONCLUSIONS: Dizziness from supratentorial lesions manifests in different ways, and its duration is shorter than that from infratentorial lesions. The central vestibular pathway may be located in the thalamus and frontoparietal lobe.
Brain ; Cerebral Infarction ; Demography ; Dizziness ; Emergencies ; Humans ; Infarction ; Syncope ; Thalamus

The coexistence of craniofacial cleft and bilateral choanal atresia has only been reported in three cases in the literature, and only one of those cases involved a Tessier number 3 facial cleft. It is also rare for bilateral choanal atresia to be found in adulthood, with 10 previous cases reported in the literature. This report presents the case of a 19-year-old woman with a Tessier number 3 facial cleft who was diagnosed with bilateral choanal atresia in adulthood. At first, the diagnosis of bilateral choanal atresia was missed and septoplasty was performed. After septoplasty, the patient’s symptoms did not improve, and an endoscopic examination revealed previously unnoticed bilateral choanal atresia. Computed tomography showed left membranous atresia and right bony atresia. The patient underwent an operation for opening and widening of the left choana with an image-guided navigation system (IGNS), which enabled accurate localization of the lesion while ensuring patient safety. Postoperatively, the patient became able to engage in nasal breathing and reported that it was easier for her to breathe, and there were no signs of restenosis at a 26-month follow-up. The patient was successfully treated with an IGNS.

PURPOSE: We analyzed the complications of femoral peritrochanteric fractures treated with the Gamma nail to reduce its complications. MATERIALS AND METHODS: We evaluated the complications among the 96 patients who were treated with the Gamma nail from January 2000 to May 2005. Mean follow-up period was 17.8 months and mean age was 75.2 years. We analysed the relationship between the complication and the fracture pattern, postoperative reduction status, position of the lag screw, bone density, displacement and tip-apex index (TAD). RESULTS: The complications were presented in 12 cases (12.5%). Cut-out of lag screw were in 5 cases, varus deformity with short lag screw in 2 cases, metal breakage of distal screw in 1 case, breakage of drill bit intraoperatively in 1 case, superficial infection in 2 cases and deep infection in 1 case. 5 cases (4.2%) were required reoperation. All of the cut-out of lag screw showed increased TAD (tip apex distance) above 25 mm. CONCLUSION: To reduce the complications of the Gamma nail, we need exact surgical technique, good positioning of the lag screw and choice of appropriate length for the lag screw.
Bone Screws ; Congenital Abnormalities ; Displacement (Psychology) ; Follow-Up Studies ; Humans ; Isothiocyanates ; Mandrillus ; Nails ; Reoperation