The purpose of this study was to identify the branching patterns and the distribution of the cortical branches of the middle cerebral artery (MCA) in 100 cerebral hemispheres of Korean adults. The intracranial arteries were perfused with red latex compounds. The territory of the MCA was divided into 12 areas: orbitofrontal, prefrontal, precentral, central, anterior parietal, posterior parietal, angular, temporo -occipital, posterior temporal, middle temporal, anterior temporal and temporopolar. Branching pattern of the main trunk of the MCA was divided into five types: Type I: a single -trunk type of MCA in 34% of cases; Type II: bifurcation (57%); Type III: trifurcation (5%); Type IV: quadrifurcation (1%); Type V: two MCAs originated from the internal carotid artery (3%). The MCA of the bifurcation type was classified into equal bifurcation (20%), superior trunk dominant (11%) and inferior trunk dominant (26%) according to the cortical area. The superior trunk of the equal bifurcation supplied from the orbitofrontal to posterior parietal area. The outer diameter of the main trunk of the MCA was 3.15 +/-0.52 mm on average. The anatomical types of the MCA were discussed with the related symptoms in disease of the MCA.
Adult ; Arteries ; Carotid Artery, Internal ; Cerebrum ; Humans ; Latex ; Middle Cerebral Artery* ; Rabeprazole

In the present study, the effect of primary infection to reinfection with Ascaris suum larvae was experimented in mouse model. Mice were challenged with l,000 infective stage eggs of Ascaris suum. The embryonated eggs were directly introduced into stomach of mice. Reinfection was performed at 50 days after the primary infection with same method as primary infection. Mice were sacrificed 3, 5, 7, 10, 15 and 20 days after infection in both groups respectively. Larvae collected from livers and lungs with Baermann's apparatus were enumerated and measured after sacrifice. Sera of mice were also collected at same time. The results of the experiment were as follows: With antigen prepared from coelomic fluid of adult Ascaris suum and sera collected from mice before reinfection, the production of antibody in experimental mice was confirmed by the gel-diffusion technique. In the livers of reinfected mice, the larvae were recovered up to 10 days after challenge, otherwhile in the primary infected mice, the larvae were observed up to 7 days. The maximum number of larvae were observed in the lungs of primary infected mice on 10 days after inoculation. In the lungs of reinfected mice, maximum number of larvae were recovered on 7 days after, only few larvae were recovered on 10 days after reinfection. As regards the growth of the larvae, the third stage larvae, over 500 micrometer in length, appeared in livers at 5 days after reinfection, but it couldn't be found on 7 days and 10 days after challenge. The third stage larvae continuously developed were observed in lungs of mice from 5 days after reinfection. In conclusion, it was found that development of larvae in livers of immune mice were probably repressed by the immune mechanisms being rised in livers and defence mechanism is also acting by interfering with the process of larval penetration into the lung from the liver.
parasitology-helminth-nematoda ; immunology ; Ascaris lumbricoides ; mouse

No abstract available.
Child ; Femoral Fractures ; Humans

Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein- 2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann–Whitney U-test, P <0.05). Conclusion Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.

6months); were analyzed by linear measurement to evaluate changes in position (hard tissue B, Pogonion point)and compare relapse between both groups.]]>
Chin ; Follow-Up Studies ; Genioplasty ; Osteotomy ; Recurrence

PURPOSE: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. MATERIALS AND METHODS: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. RESULTS: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. CONCLUSION: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.
Critical Pathways ; Early Ambulation ; Enteral Nutrition ; Humans ; Ileus ; Incidence ; Length of Stay ; Postoperative Complications ; Preoperative Care ; Prospective Studies ; Starvation ; Stomach ; Stomach Neoplasms

This study was designed to evaluate the contractile and relaxing responses of abdominal aorta in renovascular hypertension accompanied with essential hyper- tension and to examine the effect of angiotensin II receptor blocker(losartan). An experimental renovascular hypertension accompanied with essential hypertension model was established by clipping the left renal artery of spontaneously hypertensive rats(SHR). These rats were then divided into two groups of which one was given losartan during the one week postopertion before being terminated. Ring preparations of the abdominal aorta were obtained one week after the operation. The contraction of abdominal aorta strips were induced by high potassium or norepinephrine, and relaxation produced by acetylcholine or sodium nitroprusside. The contractile and relaxing responses were recorded and compared with data obtained from the control group. In the second experiment, the rats received angiotensin Il blocker(LRAO group), losartan in the drinking water for 7 days after the induction of the renal artery stenosis operation. Then, the contractile and relaxing responses were evaluated by the same method. The following results were obtained; 1) The contractile responses to the high level potassium solution and norepinephrine in renal artery occlusion(RAO) group were significantly increased compared with SHR group(p<0.05). 2) The contractile reponses to the high level norepinephrine in LRAO group were similar to that of SHR control group. However, there was no remarkable differences for high potassium. 3) The relaxing responses to the acetylcholine were significantly reduced in the RAO group compared with the SHR group. However, there was no remarkable differences for sodium nitroprusside. 4) There were no significant differences in the acetylcholine or sodium nitroprusside induced vasodilation response between the LRAO group and SHR group. From the above result, it is suggested that re- novascular hypertension in spontaneously hypertensive rats might induce changes of vascular responses and this effects may be concerned with endothelium-dependant mechanism. And angiotensin II receptor blocker rnay prevent the development of abnormal endothelium-dependent relaxation in renovascular hypertension accompanied with essential hypertension by maintaining endothelial function.
Acetylcholine ; Angiotensin II* ; Angiotensins* ; Animals ; Aorta, Abdominal* ; Drinking Water ; Hypertension ; Hypertension, Renovascular* ; Losartan ; Nitroprusside ; Norepinephrine ; Potassium ; Rats ; Rats, Inbred SHR* ; Receptors, Angiotensin ; Relaxation ; Renal Artery ; Renal Artery Obstruction ; Vasodilation

PURPOSE: The separation of prescription and dispensation of drugs starting from July 2000 has led to a reduced exposure to drugs for the general population. Therefore, we hypothesize that the policy of separation the prescribing and the dispensing of drugs has decreased the actual incidence of drug intoxication from drug abuse. METHODS: Patients with acute intentional drug intoxication who were admitted to emergency centers in Seoul were retrospectively studied. The study period was subdivided into three: before, during, and after the launch of the policy of separation of prescription and dispensation, corresponding to the periods January to June, 2000; January to June 2001; and January to June 2002, respectively. RESULTS: Acute drug intoxication was associated with 0.2% of all prescriptions during the studied period. There was no significant difference in the types of intoxicating drugs whereas the most commonly abused drug was Doxylamine succinate. Prescribed medications accounted for 37.0%, 29.2%, and 32.3% of the acute drug intoxication cases in 2000, 2001, and 2002, respectively. There was no significant difference in the treatment outcomes between the three study groups although three patients died of paraquat intoxications in 2001. CONCLUSION: The launch of the policy of separation of prescription and dispension of drugs did not significantly reduce the rate of acute drug intoxication from drug abuse which questions the effectiveness of the policy in decreasing drug abuse. We suggest reassessment of sedatives, in particular, those prescribed medications, in order to decrease the incidence of acute intoxications.
Doxylamine ; Emergencies* ; Humans ; Hypnotics and Sedatives ; Incidence ; Paraquat ; Poisoning* ; Prescriptions* ; Retrospective Studies ; Seoul ; Substance-Related Disorders ; Succinic Acid

PURPOSE: The accurate plain radiography interpretation was essential skill in emergency residency. We researched the accuracy and clinical significance of the interpretation of plain radiography by emergency medical residents, and so, it help our development the education program of emergency residency. METHODS: From 15, Dec 2000 to 15, Feb 2001 and during 1 month at Feb 2003, each two period all plain radiographs were interpreted by two EM resident who were trained for one year and by radiologists. The each results of interpretation were compared with the result of formal results which decided by EM staffs and radiology staffs. Misinterpreted groups were assigned based on the following criteria. According to Nature of discrepancy, Group M (underreaded); Subgroup M0 (not significant), M1 (minor effect on treatment), M2 (potential for injury or bad outcome), M3 (severe potential for injury or bad outcome) and Group Q (overread); Subgroup Q0 (not significant), Q1 (significant unsuitable additional modality and management). Then CSDR (clinically significant discrepancy rate) was defined as (M1+M2+M3 +Q1) / No. of Sudies. RESULTS: Total 889 radiographic studies were enrolled in 372 patients. Total EM residency misinterpretation rate was 3.9% and total CSDR was 2.3%. Total radiologist misinterpretation rate was 1.1%. In total 35 error cases, M1 were most frequent (14 studies). The CSDR were highest for KUB (5.2%), Head (3.9%), Shoulder (3.7%), Chest (3.6%), Rib (3.4%). CONCLUSION: Low overall misinterpretation rate and CSDR have implications for the medical practice and reimbursement of emergency residency for radiologic interpretation. But need for efforting reduce error rate then we propose establishment of interpretation radiography education program.
Diagnostic Errors ; Education ; Emergencies ; Head ; Humans ; Internship and Residency ; Radiography ; Ribs ; Shoulder ; Thorax

PURPOSE: We performed this study to determine the diagnostic significance and useful cut-off value of reticulated platelet, which can be used for discriminating the destructive thrombocytopenia from underproductive thrombocytopenia. METHODS: We evaluated 37 patients with thrombocytopenia who were admitted to the Wonju christian hospital from March to July, 1995. All patients were evaluated with bone marrow megakaryocyte count. We divided them into two groups, group 1 was consisted of underproductive thrombocytopenic patients and group 2 was consisted of destructive thrombocytopenic patients. We measured the peripheral blood reticulated platelet count by FACScan flowcytometry after thiazole orange staining. RESULTS: 1) Among 37 patients, underproductive group consisted of 21 patients and destructive group consisted of 16 patients. 2) There was no significant difference in platelet count between two groups (41.7 31.8x109/L vs. 41.0 29.1x109/L). 3) Destructive group showed higher reticulated platelet count than underproductive group (7.7 3.7% vs. 19.1 11.1% : p<0.01). 4) Ideal cut-off value of reticulated platelet count for the discrimination of two groups was 11%. Its sensitivity and specificity were 88% and 95%, respectively. CONCLUSIONS: We suggest that reticulated platelet count is closely correlated with thrombopoiesis of bone marrow. The measurement of reticulated platelet can be a simple and useful diagnostic tool to discriminate destructive thrombocytopenia from underproductive thrombocytopenia.
Blood Platelets* ; Bone Marrow ; Citrus sinensis ; Discrimination (Psychology) ; Gangwon-do ; Humans ; Megakaryocytes ; Platelet Count ; Sensitivity and Specificity ; Thrombocytopenia* ; Thrombopoiesis