OBJECTIVES: lschemic acute renal failure(ARF) is characterized by an abrupt and sustained decline in GFR within minutes to days after renal ischemia and not immediately reversed on restoration of renal blood flow. The typical delay of a few days to a few weeks suggests reversible parenchymal damage awaiting cell regeneration for functional recovery. Many potentially cell damaging factors, such as ATP depletion, plasma membrane phospholipid degradatian and superoxide-induced membrane damage, play a central part in ischemic injury. More recently, much attention has been focused on the role of calcium, especially ischemic cell injury and the possible therapeutic role of calcium channel blockers emerged from studies conducted several years ago. In the past, it was thought that activation of renin-angiotensin system plays a role in the pathogenesis of ARF. Now the role of angiotensin in human renal ischemia also appears to be controversial. The following study was done in order to investigate the effect of a calcium channel blocker, nifedipine, on gene expression of renin during acute ischemic renal injury. METHODS: The Sprague-Dawley rats were divided into 4 groups, group I(n=3) as the control, group II (n=3) as the sham operation group, group III(n=15) as the ischemic renal injury group without nifedipine pretreatment, and group IV(n=15) as the ischemic renal injury model by right nephrectomy and left renal artery clamping for 40 minutes with systemic nifedipine pretreatment(10mg/kg), 1n ischemic renal injury model(group III and IV), rats were further divided into three subgroups according to reperfusion time of 1,24,72 hours. The non-ischemic right kidney removed at the time of initial procedure served as paired control. Total renal RNA was extracted by Chomczynskis method and electrophoresis was done in a 1% agarose gel containing 2,2M formaldehyde. Northern was performed at 42degrees C with isotope labeled renin probe for 18 hours, Autoradiographs were obtained and quantitated by a densitometer measured at 530nm. RESULTS: 1) The expression of renin gene was markedly decreased after renal ischemia and slowly recovered to one half of the control level after 72 hours of reperfusion. 2) Renin gene expression pattern of ischemic renal injury with prior nifedipine treatment was similar to the ischemic group without nifedipine pretreatment. CONCLUSION: These findings suggest that the renin gene expression was markedly decreased after renal ischemia and slowly recovered. Systemic nifedipine pretreatment does not have a significant effect on gene expression pattern of renin in ischemic renal injury.
Adenosine Triphosphate ; Angiotensins ; Animals ; Calcium Channel Blockers ; Calcium Channels* ; Calcium* ; Cell Membrane ; Constriction ; Electrophoresis ; Formaldehyde ; Gene Expression* ; Humans ; Ischemia ; Kidney ; Membranes ; Nephrectomy ; Nifedipine ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Renal Artery ; Renal Circulation ; Renin* ; Renin-Angiotensin System ; Reperfusion ; RNA ; Sepharose

No abstract available.
Aorta, Thoracic* ; Blood Flow Velocity* ; Female ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Umbilical Arteries*

HPV infection has been implicated strongly in the pathogenesis of human squamous cell carcinoma(SCC). We analysed a series of 28 surgically removed, invasive squamous cell carcinoma of the esophagus by polymerase chain reaction to detect HPV DNA using consensus primers and 8 type-specific primers of HPV (6, 11, 16, 18, 31, 33, 35, 51). HPV 6, 31, 35 or 51 DNA were detected in 20 out of 28 cases (71.4%) of the esophageal SCCs. HPV 51 was the most frequently detected type, occuring in 13 out of 28 cases (46.4%). p53 immunohistochemical staining was also performed to demonstrate any relationship to HPV DNA positivity. It showed positivity in 16 out of 28(57.1%) esophageal SCCs, and HPV DNA and p53 positivity were concurrently detected in 11 out of 28 cases of SCCs. There was no significant inverse relation between HPV DNA positivity and p53 expression(p>0.05). Our results supported HPV involvement in esophageal squamous cell carcinoma, and suggested there may be another pathway not related to the p53-binding pathway in the carcinogenesis of esophageal SCCs by HPV.
Humans

The back pain is increasingly becoming a major problem in the elderly people. The cause of back pain in the elderly patient is quite different from in the young subject. And relationship of the occurrence of osteoporosis with the incidence of fractures in general is currently regarded as a major factor. The authors performed clinical observation on 194 elderly patients who were treated for back pain during 5 years period from April, 1983 to April, 1988 at the Department of Orthopaedic Surgery, Severance Hospital and relationship between osteoporosis and compression fracture of spine was reviewed. The results were as follows : l. Among the 194 cases of back pain(28.3% of total admission cases), whose age were over 50: 142 cases were female and 52 cases were male, being more common in female. 2. Most common cause of back pain was the compression fracture of spine : 86 cases(44.3 %). Osteoporosis was associated with 66 cases(76.7%) out of 86 cases. 3. The number of compression fracture in same patient was more frequent in osteoporotic patient and thoracolumber junction (T12, Ll) was the major site of fracture (45.6%). Compression fracture of spine caused by osteoporosis occured at multiple level in 60.6%. 4. Twenty three cases(34.8%) of compression fracture of spine with osteoporosis were found to have previous history of fractures of spine and/or extremities by radiological examination. Regarding this results, compression fractures of spine was not infrequent cause of back pain in the elderly. It was thought that re-fracture of spine should be prevented by vigorous approach against osteoporosis along with the treatment of presenting fracture in these patients.
Aged ; Back Pain ; Clinical Study ; Extremities ; Female ; Fractures, Compression ; Humans ; Incidence ; Male ; Osteoporosis ; Spine

Since 1952, Ilizarov external fixator has been developed and used for more than 30 years in Russia and world-wide interest on it has been prevalent during last 2-3 years. The fixation of the tension applied thin wires to the metal frame resist flexional and translational deformity just like other extenal fixators. But, it allows cyclic axial micro-motion at the fracture site without loss of reduction so that it can provide good environment for the fracture healing biologically and biomechanically. Another advantage of Ilizarov external fixator is that it permits mobilization of the adjacent joints and weight bearing of the fractured limb during the application of it and shortens the duration of administration. Since 1988, We applied the Ilizarov external fixator for the treatment of diffcult tibial fractures (open comminuted, segmented and comminuted fractures, nonunion, maunion) and obtained good results in 7 cases. So we report our results even if we had limited cases and experiences.
Congenital Abnormalities ; External Fixators ; Extremities ; Fracture Healing ; Fractures, Comminuted ; Joints ; Russia ; Tibia ; Tibial Fractures ; Weight-Bearing

Cysticercosis is the most common parasitic infection affecting the central nervous system. Spinal neurocysticercosis (NCC) is very rare compared with intracranial NCC and requires more aggressive management because these lesions are poorly tolerated. The authors report a case of intradural extramedullary cysticercosis of the entire level of spine with review of the literature.
Central Nervous System ; Cysticercosis ; Neurocysticercosis ; Spine

Acute vertebrobasilar artery occlusion is a fatal event, even after intra-arterial thrombectomy and thrombolysis. We are reporting a case of acute vertebral artery (VA) occlusion. A 37-year-old man was admitted with mild dizziness, but cardiopulmonary arrest suddenly developed after eleven hours. We performed cardiopulmonary resuscitation immediately and his mental and vital state was recovered. Thus we performed intra-arterial thrombectomy, thrombolysis and balloon angioplasty for left vertebral artery occlusion. But pre-existing stenosis of VA was revealed during intervention so we inserted a stent to the stenotic area. Conclusively, we obtained the good angiographical and clinical outcomes.
Adult ; Angioplasty ; Angioplasty, Balloon ; Arteries ; Cardiopulmonary Resuscitation ; Constriction, Pathologic ; Dizziness ; Emergencies ; Heart Arrest ; Humans ; Stents ; Thrombectomy ; Vertebral Artery

PURPOSE: The events of cell stress and cell death are linked, with the heat shock proteins (Hsps) induced in response to stress appearing to function at key regulatory points in the control of apoptosis. The purpose of this study was to investigate the effect of arisostatins A on the Hsp70 expression and signal mechanism of its transcription. MATERIALS AND METHODS: We used natural arisostatins A produced by Actinomycete, in Caki cells. We measured the growth rate of cell using trypan blue staining, and the induction of the transcriptional levels of Hsp70 with arisostatins, which was quantified by reverse transcript-polymerase chain reaction (RT-PCR) and transiently transfecting cells with a Hsp70. The induction of the transcriptional levels of Hsp70 with arisostatins A was quantified by RT-PCR and transiently transfecting cells with a Hsp70 promoter-luciferase reporter plasmid. RESULTS: Arisostatins A-induced Hsp70 up-regulation was not prevented by the overexpression of peroxiredoxinI (PrxI), PrxII or treatment of superoxide dismutase and catalase. However, the arisostatins A-mediated expression of Hsp70 was reduced significantly in Caki cells treated by the antioxidant, N-acetylcystein. Inhibition of the Janus tyrosine kinase (JAK) activity with AG490 did not inhibit the arisostatins A-induced Hsp70 up-regulation, suggesting that JAK is not associated with the arisostatins A-mediated Hsp70 expression. The mechanism of Hsp70 induction depends on the activation of heat shock factor-1. However, arisostatins A did not effect the change in the expression levels of heat shock factor-1. CONCLUSIONS: These findings suggested that Hsp directly regulates specific stress-responsive signaling pathways, which may antagonize the signaling cascades that result in apoptosis.
Apoptosis ; Carcinoma, Renal Cell* ; Catalase ; Cell Death ; Cell Line* ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Plasmids ; Protein-Tyrosine Kinases ; Shock ; Superoxide Dismutase ; Trypan Blue ; Up-Regulation

PURPOSE: To report a case of choroidal neovascularization after successful macular hole surgery in an eye with macular drusen. CASE SUMMARY: A 66-year-old woman visited our clinic complaining of decreased visual acuity in her right eye. Fundoscopy showed a full thickness macular hole in the right eye and bilateral scattered drusen. The patient underwent uncomplicated pars plana vitrectomy, internal limiting membrane peeling using triamcinolone, and perfluoropropane (C3F8) gas tamponade. One month after vitrectomy, the macular hole was closed. Twenty-four months following the macular hole surgery, the patient presented with defective vision in the right eye. Fluorescein angiography showed classic subfoveal choroidal neovascularization. Intravitreal bevacizumab was administrated three times in the right eye; however, visual improvement was not observed. CONCLUSIONS: In eyes with macular hole and drusen, the possibility of choroidal neovascularization developing after macular hole surgery should be considered.
Aged ; Antibodies, Monoclonal, Humanized ; Choroid ; Choroidal Neovascularization ; Eye ; Female ; Fluorescein Angiography ; Fluorocarbons ; Humans ; Membranes ; Retinal Perforations ; Triamcinolone ; Vision, Ocular ; Visual Acuity ; Vitrectomy ; Bevacizumab

For better understanding and management of intracranial arteriovenous malformation(AVM), a retrospective clinical study was performed on 87 patients with intracranial AVM during the period from February 1980 to August 1986. The 54 patients managed conservatively and the 33 patients treated surgically were followed for an average of 13.7 months. Followings are the results : 1) The age range of presentation of intracranial AVM was 10 months to 52 years, with peak incidence from second to third decade. 2) The presenting symptoms were hemorrhage (51.7%), seizure (31%), and headache (6.9%) in order of frequency. In hemorrhage, intracerebral hematoma was most frequent and in seizure, generalized seizure was most frequent. 3) The location of intracranial AVM was hemispheric (71.3%), deep seated (17.2%), posterior fossa (8%), and dural location (3.5%) in order of frequency. 4) Concomitant aneurysm was found in 5 cases (5.7%). 5) In small intracranial AVM, 85% was presented with hemorrhage, and in large intracranial AVM, 59% with seizure. 6) The clinical outcome according to age was not different statistically between children and adults. 7) The incidence of rebleeding was 20% (9 of 45), and the mortality due to rebleeding was 22.2% (2of 9). 8) The clinical outcome for patients presenting with hemorrhage is worse than that for patients presenting with seizure. 9) The clinical outcome for patients managed surgical was more favorable than that for patients managed conservatively.
Adult ; Aneurysm ; Arteriovenous Malformations ; Cerebral Hemorrhage ; Child ; Headache ; Hematoma ; Hemorrhage ; Humans ; Incidence ; Intracranial Arteriovenous Malformations* ; Intracranial Hemorrhages ; Mortality ; Retrospective Studies ; Seizures