BACKGROUND: Aphasia is common in stroke patients. However, studies about characteristics and prog- nosis of aphasia by acute ischemic stroke were insufficient. The aim of this study is to disclose vascular lesions causing aphasia symptom and to evaluate and clarify types, severity and recovery patterns of vascular aphasia using quantitative aphasia test. METHODS: Twenty six patients were included in this study, who had aphasia symptoms due to acute ischemic lesions confirmed by MRI or CT. Standardized test of Korean version-the Western Aphasia Battery (K-WAB) was performed in all subjects in acute stagte of stroke and was repeated 3 month later. Based on neuroimaging findings and results of aphasia tests, we divided all subjects into two groups, cortical aphasia and subcortical aphasia, and classified further into 8 types. The severity of aphasia measured by aphasia quotient (AQ) was graded. Changes in aphasia types and AQ and prognosis between cortical and subcortical aphasia was analyzed. RESULTS: Various vascular lesions caused aphasia symptoms in cortical and subcortical areas with good clinico-anatomical correlations. Eighteen patients(69.2%) had cortical aphasia and 8(30.8%) had subcor- tical one. Among 8 types of aphasia, 7 types were detected in our patients, and the most frequent type is global aphasia(30.8%). The mean incremental score of AQ between initial and follow-up test was 21.1+/-14.0. The distribution of severity of aphasia was as follows; grade I, 3.8%; grade II, 19.2%; grade III, 42.3%; and grade IV, 34.6%. Twenty one patients(80.8%) were followed up 97.9+/-7.4 days after initial test. Subjects who showed improvement in aphasia were 13(61.9%). Nine out of 13 belonged to cortical aphasia group and 4 out of them belonged to subcortical aphasia group. There was no significant difference in prognosis between cortical and subcortical aphasia group(p=0.58). CONCLUSION: Our study discloses various acute vascular lesions cause aphasia. It also provides cha- racteristics of patients with aphasia by acute ischemic stroke, such as types, severities and recovery patterns, which may help to assess vascular aphasia and its prognosis.
Aphasia* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Neuropsychological Tests* ; Prognosis ; Stroke*

The influences of adrenal corticosteroid on the development and regression of neurons of dentate and hippocampus were studied by adrenalectomy and steroid overload in neonatal rats. The results obtained were as follows. 1. The cell death occurred naturally in numerous dentate granule cells and hippocampal pyramidal cells. 2. The number of dentate granule cells undergoing cell death decreased by injection of adrenal corticosteroid, but increased in adrenalectomized rat brains. The changes occurred prominently at postnatal day 6. 3. The number of hippocampal pyramidal cells undergoing cell death decreased in CA3 region by injection of adrenal corticosteroid, but was not changed in adrenalectomized rat brains. However, other regions exhibited no change by adrenal corticosteroid and adrenalectomy. 4. The cell death of pyramidal cells of CA3 region occurred in close relationship with the cell death of dentate granule cells, which was different from other CA regions. In summary, the cell death of dentate and hippocampal neurons occurred naturally but seemed to be influenced by other factors as well as adrenal corticosteroid.
Adrenalectomy ; Animals ; Brain ; Cell Death ; Hippocampus* ; Neurons* ; Pyramidal Cells ; Rats*

No abstract available.

No abstract available.
Ankle* ; Arthroplasty*

No abstract available.
Child* ; Humans ; Shigella* ; Vaginitis*

The 5 cases of human fetal liver aged from 11 to 23 weeks of gestation were investigated for the ultrastructure of sinusoidal wall by electron microscopy. The endothelial cells deficient in basement membrane formed almost all the part of sinusoidal wall. The cells were continued with neighboring cells by intercellular junction, and overlapped them and exhibited to maintain unfenestrated capillary wall, which was different from those with fenestra in adults. The cells were found to have coated pits on luminal side and several various vesicles in the cytoplasms. The cells were related with transcellular migration of reticulocytes and acidophilic erythroblastes, which penetrated into the endothelial cytoplasm to form transient migrating pore closing after the migration into sinusoidal lumen. The perivascular cells were present at perivascular space and surrounding the sinusoid discontinuously. The Kupffer cells were easily identified with filipodia and lamellipodia and with phagosome of nuclei enucleated from acidophilic erythroblasts.
Adult ; Basement Membrane ; Capillaries ; Cytoplasm ; Endothelial Cells* ; Erythroblasts ; Erythrocytes ; Humans* ; Intercellular Junctions ; Kupffer Cells* ; Liver* ; Microscopy, Electron ; Phagosomes ; Phenobarbital ; Pregnancy ; Pseudopodia ; Reticulocytes

No abstract available.
Melanoma* ; Proliferating Cell Nuclear Antigen*

Vascular injury is a serious but rare complication of hip procedures. Most of vascular complications reported in articles occured in vessels around hip joint and femoral artery. To date, report of popliteal artery occlusion during or after total hip arthroplasty was absent. The authors have experienced one case of popliteal artery occlusion after total hip arthroplasty. It was suspected that the cause of occlusion of this particular case was a excessive maneuvering of limb during operation and then, artheromatous plaque fracture or thrombosis made occulusion in popliteal artery. Angiographic embolectomy using a catheter was performed and circulation of limb was recovered. To reduce the risk of vascular complications after total hip arthroplasty procedure, we recommend a thorough evaluation of lower extremity circulation in risky patient. And if a vascular insult is suspected either during or soon after the procedure, then a vascular consultation with arteriography including popliteal artery should be obtained urgently. Delay in treatment could result in a deleterious outcome.
Angiography ; Arthroplasty, Replacement, Hip* ; Catheters ; Embolectomy ; Extremities ; Femoral Artery ; Hip ; Hip Joint ; Humans ; Lower Extremity ; Popliteal Artery* ; Thrombosis ; Vascular System Injuries

Todays, remnant split-thickness skin graft is stored for graft failure or for delayed grafting. Refrigerated skin is usually stored for 3 weeks, after which, cellular respiration ceaces. Even though the refrigerated skin can be used before 3 weeks after harvest, the success rate of the skin graft is usually lower than in case of fresh skin. One of the most reliable explanations is multiplication of microorganisms on the stored skin, that is, the more microorganisms on the refrigerated skin, the less the success rate of grafts. For this reasons, some kind of antibiotics have been used for storage of the split-thickness skin piece. But there is no report about the effect of antibiotics on stored skin. We want to know the effect of the antibiotics on stored skin. For this purpose, we did three experiments for qualititative bacteriology of refrigerated skin. Experiment 1 was qualititative identification of microorganisms colonizing split-thickness skin after 2 weeks storage in low temperature, and sensitivity tests for identified microorganisms. On the basis of experiment 1, the proper antibiotics were selected and samples of split-thickness skin were stored using this antibiotics. At 2 weeks after storage in low temperature, samples of split-thickness skin were cultured for identification of bacterial growth. This is experiment 2. Experiment 3 is histologic examination of the split-thickness skin involved in experiment 1 and 2.In the experiment 1, we found five kinds of microorganisms in 9 out of 30 split-thickness skin samples. The most common microorganism was coagulase negative Staphylococcus which was found in 4 samples. Through the antibiotics sensitivity test, teicoplanin was selected as the most proper antibiotics. In experiment 2, we could not find any microorganisms in 30 split-thickness skin samples. In experiment 3, there were no histologic differences in the split-thickness skin samples whether antibiotics were used or not. Through these results, we have confirms that split-thickness skin pieces are more safely stored using proper antibiotics.
Anti-Bacterial Agents* ; Bacteriology ; Cell Respiration ; Coagulase ; Colon ; Skin* ; Staphylococcus ; Teicoplanin ; Transplants

We report our case of laparoscopy-assisted distal gastrectomy with D1 + beta lymph node dissection for a patient with early gastric cancer and laparoscopic cholecystectomy for gallstone with situs inversus totalis. A superficial elevated lesion was found on the lesser curvature of the antrum. The preoperative diagnosis was cStage IA (cT1, cN0, cH0, cP0, cM0). A 1 cm-sized gallstone was found in the fundus through upper abdominal ultrasound. A laparoscopy-assisted distal gastrectomy with standard D2 lymph node dissection for early gastric cancer and laparoscopic cholecystectomy was successfully performed by not shifting the monitor to the left and right and not changing operator's position without additional blood loss and time. The number of retrieved lymph nodes was 36. We have not found any abnormal course of blood vessels except for the right/left inversion. Billroth I reconstruction was performed through end-to-side anastomosis. Based on a histopathological examination, a 1.5 x 1.5 cm, submucosal (sm3), moderately differentiated adenocarcinoma (pT1, pN0, sH0, sP0, sM0, stage IA) was diagnosed. The postoperative course was favorable and the patient was discharged on postoperative day 7.
Adenocarcinoma ; Blood Vessels ; Cholecystectomy, Laparoscopic ; Gallstones ; Gastrectomy ; Gastroenterostomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Organothiophosphorus Compounds ; Situs Inversus ; Stomach Neoplasms