PURPOSE: The effects of pain on brain is not well known. Also, differences between somatic and visceral pains have not been fully elucidated. This study was conducted to investigate changes in the expression of c-Fos protein after somatic and visceral pains were induced by formalin. METHODS: Male rats(n=65) were underwent one of three procedures : (i) Control group, rats were left undisturbed in their cages; (ii) Somatic pain group, rats were injected subcutaneously with 0.1 ml of 10% formalin in the plantar surface of right hindpaw; (iii) Visceral pain group, rats were administered with same amount of formalin, as described above, in the rectum. Rats were sacrificed at increasing times(30 minutes, 1 hour, 2 hours, 6 hours, 1 day, 3 days and 7 days) after noxious formalin stimuli to hindpaws and rectums. Rat brains were removed and sliced in rat brain matrix. Brain slices were coronal sectioned at interaural 5.70-6.70mm. Serial sections were immunohistochemically reacted with polyclonal c-Fos antibody. The numbers of c-Fos protein immunoreactive neurons in cingulate cortex, primary somatosensory area, and hippocampus were examined and analyzed statistically with Mann-Whitney U test. RESULTS: 1) The numbers of c-For protein immunoreactive neurons in cingulate cortex, primary somatosensory area and hippocampus peaked at 2 hours after somatic pain stimuli and reached almost normal conditions at 7 days. 2) The numbers of c-Fos protein immunoreactive neurons in cingulate cortex, primary somatosensory area and hippocampus peaked at 1 day after visceral pain stimuli and reached almost normal conditions at 7 days. 3) The numbers of c-Fos protein immunoreactive neurons of somatic pain groups were higher than that of visceral groups at all times and the difference of numbers peaked at 2 hours after pain stimuli. CONCLUSION: Reactions of somatic pain stimuli influenced more changable than visceral pain stimuli to brain. Conduction velocities of somatic pain were more faster than those of visceral pain. Higher numbers of c-Fos protein immunoreactive neurons were found in specific regions. These results provide some basic knowledge in understanding the mechanism and control of pain.
Animals ; Brain* ; Formaldehyde* ; Gyrus Cinguli ; Hippocampus ; Humans ; Male ; Neurons* ; Nociceptive Pain ; Rats* ; Rectum ; Visceral Pain

Behcet's disease was originally described as a triple symptom complex of oral aphthous ulceration, genital ulceration, and hypopyon iritis. It is now known to have a wide systemic manifestations. Among them, the central nervous system involvement should be diagnosed earlier because of it's lethal potential. Recently the authors experienced a case of Behcet's disease with CNS involvement. A 51-year-old female patient was admitted due to deterioration of mentality and generalized ache since 2 years prior to admission. The findings on physical examination were compatible with Behcet's disease, but without cerebrospinal pleocytosis. The manifestations were improved with medications of prednisolone, chlorambucil, colchicines, but relapsed relapsed 2 months later during subsequent tapering of prednisolone and chlorambucil. The patient is now on medication again. A case of Behcet's disease with CNS manifestations is reported with review of literature.
Behcet Syndrome ; Central Nervous System ; Chlorambucil ; Female ; Humans ; Iritis ; Leukocytosis ; Middle Aged ; Physical Examination ; Prednisolone ; Stomatitis, Aphthous ; Ulcer

Transrectal ultrasonography provides an accurate assessment of the prostate, ejaculatory ducts and seminal vesicles, which can be helpful in the evaluation of the patients with variable genitourinary symptoms. We studied 65 symptomatic patients and 20 age-matched controls who underwent transrectal ultrasonography from Feb. 1993 to Jul. 1993. The broad spectrum of genitourinary signs and symptoms was segregated into 4 groups. Group 1 was hematospermia. Group 2 was pains including ejaculatory pain, pain on erection. perineal pain, scrotal pain, tenderness on prostate grand, suprapubic pain, lower back pain, inguinal pain, and penile pain. Group 3 was bladder outlet obstructive symptoms including hesitancy, intermittancy, terminal dribbling, weak stream, and residual urine sensation. Group 4 was bladder irritative symptoms including frequency, nocturia, urgency, and dysuria. The major abnormal findings on the transrectal ultrasonography were cysts in seminal vesicle, cysts in ejaculatory duct, prostatic calculi, ejaculatory duct calculi, and seminal vesicle dilation. Compared with age-matched controls, symptomatic patients had significantly increased prevalence of the abnormal findings on the transrectal ultrasonography (p <0.01 ). Ejaculatory duct calculi were significantly associated with bladder outlet obstructive symptoms and bladder irritative symptoms (p <0.05), and seminal vesicle dilation was also significantly associated with pain (p <0.05). Prostatic calculi and ejaculatory duct calculi were closely associated with voiding dysfunction, however, cyst in seminal vesicle and ejaculatory duct were closely associated with pain. Transrectal ultrasonography offers clinical insights into the causes of distressing genitourinary symptoms, and may be helpful in their management.
Calculi ; Dysuria ; Ejaculatory Ducts* ; Hemospermia ; Humans ; Low Back Pain ; Male ; Nocturia ; Prevalence ; Prostate ; Rivers ; Seminal Vesicles* ; Sensation ; Ultrasonography ; Urinary Bladder

PURPOSE: We report a case of pyogenic arthritis of the shoulder secondary to infective endocarditis. MATERIALS AND METHODS: A 70 year-old male who had suffered from pyogenic arthritis of the left shoulder secondary to infective endocarditis was treated with artificial valvuloplasty, arthroscopic synovectomy and drainage. RESULTS: Infection was cured and the patient achieved a good functional outcome. CONCLUSION: Pyogenic arthritis of the shoulder is rarely associated with infective endocarditis. However, if the symptoms are misdiagnosed as musculoskeletal symptoms associated with infective endocarditis, serious complications may arise. As such, musculoskeletal symptoms associated with infective endocarditis should be paid careful attention.
Arthritis ; Arthritis, Infectious ; Drainage ; Endocarditis ; Humans ; Male ; Shoulder

BACKGROUND: There is experimental evidence that overexpression of cyclin D1 accelerates the entry of cells into the S-phase, but that p16 inhibits the CDK4 and CDK6 by binding in competition with the cyclin D1. Previous attempts to correlate cyclin D1 amplification with prognoses have frequently drawn associations with adverse outcome or a more aggressive phenotype. Recently, overexpression of cyclin D1 has been associated with improved relapse-free survival and overall survival rates. To elucidate whether the expressions of the cyclin D1 and the p16 protein might be of clinical value as prognostic factors, we used the chi-square test to compare the immunoreactivities of the cyclin D1 and the p16 proteins with the histopathologic findings and with such known prognostic factors as the estrogen receptor, progesteron receptor, c-erbB-2, p53 and Ki-67. METHODS: The expressions of the cyclin D1 and the p16 proteins were analysed using immunohistochemical methods in formalin-fixed and paraffin-embedded tissue samples of 340 invasive breast carcinomas accumulated between 1990 to 1997 at Yeungnam University Hospital. Disease-free survival and overall survival were compared to cyclin D1 and p16 status by using the Kaplan-Meier method. RESULTS: Nuclear immunoreactivities of the cyclin D1 and the p16 proteins were detected in 75.6% (257/340) and 70.5% (208/295) cases, respectively. Cyclin D1 was found to have a strong correlation with lower histologic grade, lower nuclear grade, lower mitotic index, and lower Scarff-Bloom-Richardson (SBR) and Modified-Scarff-Bloom-Richardson (MSBR) grade (p<0.05). Cyclin D1 was more common in non-ductal carcinomas than ductal carcinomas, though this difference did not reach statistical significance. Cyclin D1 was also correlated with positive estrogen receptor, negative c-erbB-2, and positive p16 protein. P16 protein expression was found to have a correlation with positive estrogen receptor and progesterone receptor. The expressions of the cyclin D1 and the p16 proteins were not significantly correlated with overall survival and disease-free survival. CONCLUSIONS: These results show that the expressions of the cyclin D1 and the p16 proteins can not be used as prognostic indicators in primary breast carcinomas.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cyclin D1* ; Cyclins* ; Disease-Free Survival ; Estrogens ; Mitotic Index ; Phenotype ; Prognosis ; Receptors, Progesterone ; Survival Rate

BACKGROUND: Facial laceration is the most common injury encountered in the emergency room in the plastic surgery field, and optimal treatment is important. However, few authors have investigated this injury in all age groups or performed follow-up visit after repair. In the present study, the medical records of patients with lacerations in the facial area and underwent primary repair in an emergency room over a 2-year period were reviewed and analyzed. METHODS: Medical records of 3,234 patients with lacerations in facial area and underwent primary repair in an emergency room between March 2011 and February 2013 were reviewed and identified. RESULTS: All the 3,234 patients were evaluated, whose ratio of men to women was 2.65 to 1. The forehead was the most common region affected and a slip down was the most common mechanism of injury. In terms of monthly distribution, May had the highest percentage. 1,566 patients received follow-up managements, and 58 patients experienced complications. The average days of follow-up were 9.8. CONCLUSIONS: Proportion of male adolescents was significantly higher than in the other groups. Facial lacerations exhibit a 'T-shaped' facial distribution centered about the forehead. Careful management is necessary if a laceration involves or is located in the oral cavity. We were unable to long term follow-up most patients. Thus, it is necessary to encourage patients and give them proper education for follow-up in enough period.
Adolescent ; Education ; Emergency Service, Hospital* ; Facial Injuries ; Female ; Follow-Up Studies ; Forehead ; Humans ; Lacerations* ; Male ; Medical Records ; Mouth ; Surgery, Plastic

This report describes a case of a serpentine fusiform aneurysm of the internal carotid artery in a patient who presented with visual disturbances. The serpentine aneurysm was treated successfully by coil trapping and occlusion of the parent artery, accompanied by balloon dilation. Nine months post-operatively, the patient's visual acuity had improved considerably.
Aneurysm* ; Arteries ; Carotid Artery, Internal ; Humans ; Parents ; Visual Acuity

Gastroduodenal intussusception is an rare condition usually caused by prolapse of a gastric tumor with subsequent invagination of a portion of the stomach wall into the duodenum. Symptoms are protean, but classically patients have presented with episodic epigastric abdominal distress, a history of intermittent vomiting and gastroduodenal bleeding, either as melena, hematochezia, or stools positive for occult blood. Examination generally discloses a fullness or mass in the epigastrium. Its typical radiologic presentation includes luminal narrowing, distally converging gastric folds, infolding and outpouching of the gastric wall, a filling defect, and a coil-spring pattern. A 71-year-old man was admitted for epigastric pain and melena which required blood transfusions. Endoscopy showed an unexplained pulling-down of part of the gastric body and the pylorus couldn't be identified. An upper GI barium examination demonstrated a huge lobulated mass from the distal antrum of stomach to the duodenal cap. On abdominal sonography, double contour of stomach wall was seen at the proximal portion of narrowing stomach. At surgery, a large, intraluminally exophyting gastric mass prolapsed into duodenum was excised and diagnosed as leiomyoma of stomach.
Aged ; Barium ; Blood Transfusion ; Duodenum ; Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intussusception* ; Leiomyoma* ; Melena ; Occult Blood ; Phenobarbital ; Prolapse ; Pylorus ; Stomach ; Vomiting

PURPOSE: To compare the effectiveness of embolization of the bronchial artery embolization for the management of hemoptysis in pulmonary tuberculosis cases with the severity of lung parenchymal injury and pleural infiltration, as seen on plain chest radiographs, and with the findings of angiography of the bronchial artery. MATERIALS AND METHODS: Among 265 patients with hemoptysis due to pulmonary tuberculosis, the findings of plain chest radiography and angiography of the bronchial artery were comparatively analyzed in the 206 for whom the results of follow up were available. The chest radiographic findings were lassified as follows: Type I refers to simple pulmonary tuberculosis; Type II includes cases in which pulmonary tuberculosis is complicated by bronchiectasis, aspergillosis, or cavitation; Type III is either Types I or II accompanied by pleural infiltrates limited to the lung apex, and Type IV includes cases in which pleural infiltrates have extended beyond the apex in the whole of the lung. Bronchial angiographic findings were divided into four groups : Group I consists of cases which show abnormalities of only the bronchial artery; Group II includes those in which abnormalities are seen in the bronchial artery and either the internal mammary or an ntercostal artery; Group III comprises cases which belong to Group I or II and in which a branch of the subclavian artery is abnormal, and Group IV includes those in which abnormalities occur in at least two branches of the subclavian artery, or there is direct visualization of hypervascularity of this vessel. The initial post-embolic hemostatic effect and the results of follow up were studied over a six-month period. RESULTS: As compared with simple pulmonary tuberculosis (Type I), we found that as the severity of pleural infiltration and complications revealed by plain chest radiographs increased (Type II, III, IV), so did the severity of the manifestation of systemic collateral arteries other than the bronchial artery, as depicted by increase on bronchial angiography. Early post-embolic hemostasis occurred in 96% of Type-I cases (47/49), 82% of Type II (36/44), 70% of Type III (28/40), and 55% of Type IV (40/73). The average success rate was 74% (151/205). During the six month follow-up period, continued hemostasis was found in 80% of Type-I patients (36/45), 75% of Type II (30/40), 59% of Type III (20/34), and 48% of Type IV (20/42). The average long-term hemostasis rate was 66% (106/161). CONCLUSION: Bronchial angiography shows that in systemic collateral arteries circulation increases very substantially, and in cases in which plain chest radiographs depict extensive pleural infiltration or complications associated with pulmonary tuberculosis, it is therefore difficult to expect good hemostatic results after embolization. In such instances we thus recommend aggressive treatment such as surgical intervention.
Angiography* ; Arteries ; Aspergillosis ; Bronchial Arteries ; Bronchiectasis ; Follow-Up Studies ; Hemoptysis* ; Hemostasis ; Humans ; Lung ; Radiography ; Radiography, Thoracic* ; Subclavian Artery ; Thorax* ; Tuberculosis, Pulmonary*

Polycythemia is a condition in which the red blood cell count is increased due to an inherited or acquired mutation, a physiologic response to hypoxia, autonomous erythropoietin production, or deliberate erythropoietin administration. Higher testosterone levels appear to act as a stimulus for erythropoiesis and testosterone replacement therapies have rarely been reported as causes of polycythemia. We report here a case of a 51-year-old man with polycythemia that was caused by long-acting testosterone undecanoate (Nebido(R)).
Anoxia ; Erythrocyte Count ; Erythropoiesis ; Erythropoietin ; Humans ; Middle Aged ; Polycythemia ; Testosterone