No abstract available.
Child* ; Encephalitis, Arbovirus* ; Humans

Nitric oxide has been considered to be an important modulator of the epileptic seizure response. Previous studies have mainly focused on the nitric oxide synthase (NOS) expressed in glial cells and vascular endothelial cells in the brain following seizures, while less data have been available reading the change of neuronal NOS (nNOS) produced in neurons. Polypeptide growth factors play a central role in a variety of environmentally induce structural changes in the cortex and hippocampus of adult brain. neuregulin is widely expressed in the central and peripheral nerve cells and Schwann cells, glia, oligodendrocytes and muscle cells, to control cellular proliferation, differentiation and migration. erbB family are the receptors of the neuregulin and consist of erbB2, erbB3 and erbB4. We have, therefore, investigated the change in the expression of nNOS and erbB4 in the rat hippocampus, one of the brain structures most vulnerable to seizures. Rats were injected with kainic acid (KA) and sacrificed 6 h, 1 d, 3 d and 6 d after KA administration. The expression pattern of nNOS and erbB4 was studied using reverse transcription-polymerase chain reaction analysis, NADPH-diaphorase (NADPH-d) histochemistry and immunohistochemistry. The increase in the level of nNOS reached maximal values in samples obtained 1 d after KA treatment. The optical densities of NADPH-d-positive neurons in the CA1 and dentate gyrus (DG) regions of the hippocampus were shown to have increased in samples obtained 1 d and 3 d after injection of KA. The number of NADPH-d-positive neurons in the CA1 regions of the hippocampus was shown to have decreased in samples obtained 3 d and 6 d after injection of KA. However, the number of NADPH-d-positive neurons in the DG region did not change significantly. We show that erbB4 immunoreactivity is increased in hippocampus, reaching maximal levels 3 d after KA treatment, some NOS neurons contain erbB4 protein. We propose that the survival of NOS neuron in the hippocampus after injection of KA is associated with expression of erbB4, neuregulin receptor.
Adult ; Animals ; Brain ; Cell Proliferation ; Dentate Gyrus ; Endothelial Cells ; Epilepsy ; Hippocampus* ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Kainic Acid ; Muscle Cells ; Neuroglia ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Oligodendroglia ; Peripheral Nerves ; Rats* ; Schwann Cells ; Seizures*

Pneumomediastinum, pneumothorax and subcutaneous emphysema are uncommon in pediatric practice, but they may be rarely ocured in association with respiratory distress and excessive ressusciation in the neonatal period, and as a complication of bronchial asthma, measles in childhood. And also, there was a report of a few cases that developed to pneumomediastinum and subcutaneous emphysema caused by vomiting in patient of diabetic coma. It is rare so far in this country that above events are complicated by miliary tuberculosis, but they may lead the patient to fatal and lifethreatening conditions, even though we perform a considerable medical treatment for that. We presnted 3 cases of 6 month 20 days old female infant, and each 10 year and 11 year old boys, developed to pneumomediastinu, pneumothorax and subcutaneous emphysema, and suddenly expired during hospital treatment of miliary tuberculosis. And, we reviewed the literatures, too.
Asthma ; Child ; Diabetic Coma ; Female ; Humans ; Infant ; Measles ; Mediastinal Emphysema* ; Pneumothorax* ; Subcutaneous Emphysema* ; Tuberculosis, Miliary* ; Vomiting

We experienced a case of cryptococcosis in a 13-year-old female who had been admitted to our hospital because of intermittent high fever and generalized lymphadenopathy accompanied by multiple nodular eruptions with erosions on the face, scalp, neck and back. The patient was treated under the impression of tuberculous lymphadenitis without any improvement. A surgical biopsy of the lymph node and the subcutaneous nodule, which was performed 14 days later, revealed chronic granulomatous tissue and Langhan's type giant cells which contained numerous cryptococci. A brief review of the literature was done.
Adolescent ; Amphotericin B ; Biopsy ; Cryptococcosis* ; Female ; Fever ; Flucytosine ; Giant Cells ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Neck ; Scalp ; Tuberculosis, Lymph Node

Administration of kainic acid (KA) results in induction of epileptiform activity and motor seizures. Nitric oxide (NO) mediates the increase in cerebral blood flow during seizure activity. However, the production site of NO has not been clearly defined. Recent studies showed that constitutive nitric oxide synthase may be induced under certain conditions. Therefore, this study was aimed to investigate the change in endothelial nitric oxide synthase (eNOS), neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP) since these are involved in cerebral blood flow. Rats were treated with KA and killed at 6 hours, 1, 3, 6 and 12 days after seizure. Expressional changes were assessed by immunohisto-chemistry and RT-PCR. eNOS was detected in the blood vessels of the cerebral cortex of the control group, but was not detected in neurons. eNOS-positive neurons were induced in the cerebral cortex at 1 and 3 days after seizure and found in specific cortical areas, such as primary motor cortex, secondary motor cortex, primary somatosensory cortex, secondary somatosensory cortex, insular cortex, ectorhinal cortex, parietal association cortex, temporal association cortex, auditory cortex and visual cortex. The levels of eNOS mRNA increased at 1 and 3 days after seizure compared to controls. The staining intensity of eNOS-positive microvessels was elevated in samples obtained 1, 3, and 6 days after seizure compared to the control group. However, NPY- and VIP-positive neurons, and glial fibrillary acidic protein-positive astrocytes were not induced in the cerebral cortex after seizure. Therefore, specific neuroactive substances may be induced in the cerebral cortex after seizure. Nitric oxide, a free radical synthesized in the brain by NOS, is a messenger molecule that mediates vascular dilatation and neural transmission. Therefore, neurons showing induced eNOS-positivity and upregulated eNOS-positive microvessels may affect the cerebral blood flow and neuronal activity in the cerebral cortex after seizure.
Animals ; Astrocytes ; Auditory Cortex ; Blood Vessels ; Brain ; Cerebral Cortex* ; Dilatation ; Kainic Acid ; Microvessels ; Motor Cortex ; Neurons ; Neuropeptide Y ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type III* ; Rabeprazole ; Rats* ; RNA, Messenger ; Seizures* ; Somatosensory Cortex ; Synaptic Transmission ; Vasoactive Intestinal Peptide ; Visual Cortex

PURPOSE: The objective of this study was to investigate the relationships between primary implant stability as measured by impact response frequency and the structural parameters of trabecular bone using cone-beam computed tomography(CBCT), excluding the effect of cortical bone thickness. METHODS: We measured the impact response of a dental implant placed into swine bone specimens composed of only trabecular bone without the cortical bone layer using an inductive sensor. The peak frequency of the impact response spectrum was determined as an implant stability criterion (SPF). The 3D microstructural parameters were calculated from CT images of the bone specimens obtained using both micro-CT and CBCT. RESULTS: SPF had significant positive correlations with trabecular bone structural parameters (BV/TV, BV, BS, BSD, Tb.Th, Tb.N, FD, and BS/BV) (P<0.01) while SPF demonstrated significant negative correlations with other microstructural parameters (Tb.Sp, Tb.Pf, and SMI) using micro-CT and CBCT (P<0.01). CONCLUSIONS: There was an increase in implant stability prediction by combining BV/TV and SMI in the stepwise forward regression analysis. Bone with high volume density and low surface density shows high implant stability. Well-connected thick bone with small marrow spaces also shows high implant stability. The combination of bone density and architectural parameters measured using CBCT can predict the implant stability more accurately than the density alone in clinical diagnoses.
Bone and Bones ; Bone Density ; Bone Marrow ; Cone-Beam Computed Tomography* ; Dental Implants* ; Diagnosis ; Swine ; X-Ray Microtomography

Nitric oxide (NO) is a gaseous messenger that plays a role in neurotransmission, long term potentiation, depression and cerebral blood flow. Increases in intracellular calcium levels activate the enzyme NOS, and the NO released then diffuse to adjacent cells and activate guanylate cyclase. NO mediates the increase in cerebral blood flow during seizure activity. Therefore, the present study was aimed to investigate the change of NOS and calcium binding proteins in the rat cerebral cortex following seizure. Rats were injected with kainate (KA) and killed at 6 hours, 1, 3, 5 and 10 days after seizure. Expressional change of nNOS, calbindin D28k and parvalbumin was assessed by histochemistry, immunohistochemistry and microdensitometry in the rat brain. The intensity of the NADPH -d staining in rat cortical neurons showed a marked susceptibility to KA administration. At 6 hours and 3 days after seizure, the optical density of the NADPH -d staining was increased relative to the signal in saline treated control rats. At 5 and 10 days after seizure, the optical density of NADPH -d staining was not significantly different in most cortical regions compared to controls. In the hippocampus, the optical density of NADPH -d staining was highest at 5 days after seizure. The optical densities of calbindin D28k and parvalbumin positive neurons were various in the cerebral cortex, hippocampus and caudatoputamen during postseizure period. These results indicate that the calcium binding proteins investigated here are not essential for determining the activation of nNOS/NADPH -d positive neurons in the cerebral cortex and striatum.
Animals ; Brain* ; Calbindin 1 ; Calbindins ; Calcium* ; Calcium-Binding Proteins ; Carrier Proteins* ; Cerebral Cortex ; Depression ; Guanylate Cyclase ; Hippocampus ; Immunohistochemistry ; Kainic Acid ; Long-Term Potentiation ; NADP* ; Neurons* ; Nitric Oxide ; Rats* ; Seizures* ; Synaptic Transmission

PURPOSE: The purpose of this study is to evaluate the radiologic findings of the extraosseous Ewing's sarcoma. MATERIALS AND METHODS: Six patients with pathologically confirmed extraosseous Ewing's sarcoma were retrospectively reviewed. Patients included two men and four women with an average age of 21.5 years (age range 9-48 years). Plain radiographs (six patients), magnetic resonance (MR) images (five patients), computed tomographic (CT) scans (three patients) and whole body scintigraphy (two patients) were reviewed and analyzed. Images were evaluated with regard to lesion location, size, margin, muscle or bone involvement and intrinsic imaging characteristics on CT and MRI. RESULTS:The tumors were located in the thigh (three patients), back (two patients) and upper arm (one patient). The tumors ranged in size from 2.3 cm to 7.5 cm (mean, 5.2 cm), were mainly well circumscribed and showed no evidence of calcification prior to treatment. Margins were well defined in four out of the six patients. Four patients had subcutaneous lesions and the other two patients had intramuscular lesions. Muscle (two patients) and bone invasion (one patient) were present. The masses were heterogenous low signal intensity on T1 weighted images and heterogeneous high signal intensity on T2 weighted images compared with muscle. Heterogeneous enhancement within the lesion was observed in all patients on CT and MRI. Whole body scintigraphy using Tc-99 m MIBI showed increased uptake in the masses of two patients. CONCLUSION: Extraosseous Ewing's sarcomas were frequently seen as a well-circumscribed ovoid mass with nonspecific findings on CT and MRI. Despite being a relative rare tumor, it should be included in the differential diagnosis of a non-calcified soft-tissue mass, especially in subcutaneous tissue.
Arm ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Radionuclide Imaging ; Retrospective Studies ; Sarcoma, Ewing* ; Subcutaneous Tissue ; Thigh

PURPOSE: To compare CT features of gastrointestinal stromal tumors (GIST) with those of lymphomas in the small intestine. MATERIALS AND METHODS: CT findings of 11 pathologically confirmed GIST patients and 10 lymphoma patients were retrospectively reviewed. CT findings were analyzed with regard to location, size, margin, growth patterns, internal character, enhancement, invasion, vascular encasement, lymphadenopathy, intestinal obstruction and ascites. RESULTS:An extraluminal mass was present in 82% (9/11) of the GIST patients versus 30% (3/10) of the lymphoma patients. Circumferential wall thickening was observed in 80% (8/10) of the lymphoma patients (p<.05). Internal necrosis or gas was present in 73% (8/11) of the GIST patients versus 10% (1/10) of the lymphoma patients (p<.05). Inhomogeneous enhancement was observed in 63% (7/11) of the GIST patients compared to homogeneous enhancement in 90% (9/10) of the lymphoma patients (p<.05). Lymphadenopathy was only observed in 80% (8/10) of the lymphoma patients (p<.05). In other findings such as fatty infiltration, ascites and intestinal obstruction there were no statistically significant differences (p>.05). CONCLUSION: Features revealed by CT scans are highly useful in differentiating GIST from lymphoma of the small intestine. Extraluminal growth and internal necrosis or gas are more common in patients with GIST compared with lymphoma. CT features of circumferential wall thickening and associated lymphadenopathy are more common in patients with lymphoma.
Ascites ; Gastrointestinal Stromal Tumors* ; Humans ; Intestinal Obstruction ; Intestine, Small* ; Lymphatic Diseases ; Lymphoma* ; Necrosis ; Retrospective Studies ; Tomography, X-Ray Computed

Hyperhomocyst(e)inemia is an established risk factor for atherosclerosis. We performed this study to identify the correlating variables and risk factors for atherosclerosis, as measured by the atherosclerotic score (AS), and to determine the relative risk for cardiovascular disease in relation to plasma homocyst(e)ine levels in patients on chronic hemodialysis. We evaluated and measured 61 patients on chronic hemodialysis for clinical and biochemical parameters including atherosclerotic score (AS) and plasma homocyst(e)ine. We divided patients into high and low groups, first, by the mean AS, and second, by the median value of plasma total homocyst(e)ine levels. Then we compared the variables between the two groups. Out of the 61 patients, the median plasma total homocyst(e)ine level was 24.4 micromol/L (mean+/-SD, 27.7+/-17.4; range, 9.8-127.4 micromol/L), and the median AS was 5 (mean+/-SD, 6.2+/-2.8; range, 3-13) out of a possible 20 points. AS was significantly correlated with plasma total homocyst(e)ine levels (r=0.37) and age (r=0.67). Through multivariate analysis, plasma total homocyst(e)ine level and age were determined as significant risk factors for the high-AS group (p<0.05). However, plasma total homocyst(e)ine level did not correlate with age (p>0.05). Eighteen of the 61 patients, presented with cardiovascular disease until the present study, had an AS>6. Cardiovascular disease was found more often in the high-homocyst(e)ine group (>24.4 micromol/L) than in the low-homocyst(e)ine group (odds ratio, 9.3; 95% confidence interval, 2.3-37.4). Regardless of age, hyperhomocyst(e)inemia (especially homocyst(e)ine levels >24.4 micromol/L) is a risk factor that can be modified for the development of cardiovascular disease in patients on chronic hemodialysis.
Adolescence ; Adult ; Aged ; Arteriosclerosis/etiology* ; Chronic Disease ; Female ; Homocysteine/blood* ; Homocystine/blood* ; Human ; Hyperhomocysteinemia/physiopathology* ; Male ; Middle Age ; Renal Dialysis* ; Risk Factors