In transmembrane and intracellular sites of neurom, calcium ion(Ca(++)) has been known to have an important role of signalling process. It is naw well accepted that calcium binding proteins, calbindin D-28K (calbindin) and parvalbumin, modulate and mediate above aclcium ionss action as a second messenger. Although it has been reported that calbindinergic and parvalbuminergic neurons comprise different subpopulations in the cat and rat spinal cords, the studies of their morphology, topographical distribution and ultrastructural features have not been done extensively in the mammalian spinal cords until now. This study was conducted to localize calbidinergic and parvalbuminergic neurons and to define their morphology, topographical distribution and ultrastructural features in the rabbit cervical cord by the preembedding immunocytochemical method using anti-calbindin and anti-parvalbumin antisera. In the rabbit cervical cord, calbindin immunoreactive neurons were mainly distributed in the dorsal horn, especially in lamina II, and a smaI1 number of labelled neurons were observed in the intermediate gray matter (IGS), but calbindin immunoreactivities were not observed in the intermediate gray substance(IGS), but calbindin immunoreactiveties were not observed in thr ventral horn. The somata of calbindin immunoreactive neurons received synaptic inputs from non-immunoreactive axon terminals in the dorsal horn and in the IGS. Parvalbumin immunoreactive neurons were mainly observed in the IGS and in the ventral horn, but only a few of parvalbumin immunoreactive neurons were distributed in the dorsal horn. In the ventral horn, two types of parvalbumin immunoreactive neurons were identified according to the sizes of the somata and labelled motor cells received synaptic inputs from labelled and unlabelled axon terminals. These results demonstrate that calbindinergic neurons are a number of neurons located in lamina II of dorsal horn and a few of neurons located in the intermediate gray and parvalbuminergic ne.urons are laocated in the intermediate gray substance and in the ventral horn, and these neurons comprise different subpopulations of neurons. It was suggest that calbindinergic neurons might play an important role in the process of pain modulation and parvalbumiergic neurons in the control of motor activity with their specific synaptic circuitry in the spinal cord.
Animals ; Calbindins ; Calcium ; Calcium-Binding Proteins ; Cats ; Horns ; Immune Sera ; Motor Activity ; Neurons* ; Presynaptic Terminals ; Rats ; Second Messenger Systems ; Spinal Cord

The authors collected 53 consecutive cases of chronic subdural hematoma which were diagnosed by carotid angiography and brain scanning. There were 39 males and 14 females. The mean age was 45.6 years old. 80% of all cases had a history of head injury and one of the clinical manifestations of increased intracranial pressure as well as contralateral hemiparesis. The most common site of hematoma was fronto-parietal region. 42 cases were treated with simple drainage and 11 cases with membranectomy. Post-op. course was excellent in all cases of simple drainage, but in 2 cases of membranectomy, recollection of hematoma developed after surgery.
Angiography ; Brain ; Craniocerebral Trauma ; Drainage ; Female ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Intracranial Pressure ; Male ; Paresis

This article report the case of a woman who developed an anterior spinal cord syndrome following epidural block. 10ml of 0.125% bupivacaine and 40mg of triamcinolone were injected epidurally for relief of back pain and radiating pain along the posterolateral aspect of right leg. Within 2 hours, the patient complained of weakness and severe pain in both lower extremities and rapidly became paraplegia. Myelography showed no obstruction and compression. Gd-enhanced sagittal and axial image of thoracic spine shows somewhat inhimogenous at the level of T9 on MRI. The paraplegia was permanent in the left leg and the right leg was slightly improved but grade I. We note a number of potential etiologies and analyze their possible mechanism of action.
Back Pain ; Bupivacaine ; Female ; Humans ; Leg ; Lower Extremity ; Magnetic Resonance Imaging ; Myelography ; Paraplegia ; Spinal Cord* ; Spine ; Triamcinolone

Infantile hypertrophic pyloric stenosis (IHPS) a common childhood disorders characterized by nonbilious projectile vomiting, an olive shaped mass in the right upper quadrant of the abdomen and visible gastric peristaltic wave in the upper abdomen. Its etiology and pathogenesis are not clear but abnormal nerve distribution of the pylorus has been postulated2-6. We performed immunocytochemical staning to the pyloric muscle from 10 IHPS and 3 controls patients, utilizing specific monoclonal antibody to NCAM(neural cell adhesion molecule). In IHPS patients, the number of NCAM protein immunoreactive nerve fibers were less than that in normal subjects. Auerbach myenteric plexuse was well developed and interbundle nerve plexuse was present but nerve fibers supplying individual muscle cells in smooth muscle bundles were poorly developed. These results indicate reduction of innervation in smooth muscles in IHPS patients that possibly contributes to the pathogenesis of IHPS.
Abdomen ; Cell Adhesion ; Humans ; Muscle Cells ; Muscle, Smooth ; Myenteric Plexus ; Nerve Fibers ; Neural Cell Adhesion Molecules ; Olea ; Pyloric Stenosis, Hypertrophic* ; Pylorus* ; Vomiting

OBJECTIVE: Hirabayashi's open-door laminoplasty is a good procedure to use to treat patients with myelopathy of the cervical spine; however, the authors have experienced problems in maintaining an open-window in cervical spines after the surgery. The authors developed a modified method of the expanded open-door laminoplasty and compared the radiological and clinical results with those of the classical method. METHODS: In the modified method, wiring fixation with lateral mass screws on the contra lateral-side instead of fixing the paraspinal muscle or facet joint, as in the classical methods, was used in the open window of the cervical spine. Fifteen patients with cervical myelopathy were treated using the classical method and 12 patients were treated using the modified method. Preoperative and postoperative clinical conditions were assessed according to the Japanese Orthopedic Association (JOA) score. The radiological results were compared with the preoperative and postoperative computed tomography (CT) findings. RESULTS: In both methods, the clinical results revealed a significant improvement in neurological function (p<0.001). Image analysis revealed that the cervical canals were continuously expanded in patients treated using the modified methods. However, authors have observed restenosis during the follow-up periods in 4 patients treated using the original method. Progression to deformity and spinal instability were not observed in any of the patients in the radiological results. CONCLUSION: Although analysis with a larger population and a longer follow-up period needs to be undertaken, our modified open-door laminoplasty has shown an advantage in better maintaining an open window in comparison with the Hirabayashi's open-door laminoplasty.
Asian Continental Ancestry Group ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Orthopedics ; Paraspinal Muscles ; Spinal Cord Diseases ; Spine ; Spondylosis ; Zygapophyseal Joint

OBJECTIVE: Hirabayashi's open-door laminoplasty is a good procedure to use to treat patients with myelopathy of the cervical spine; however, the authors have experienced problems in maintaining an open-window in cervical spines after the surgery. The authors developed a modified method of the expanded open-door laminoplasty and compared the radiological and clinical results with those of the classical method. METHODS: In the modified method, wiring fixation with lateral mass screws on the contra lateral-side instead of fixing the paraspinal muscle or facet joint, as in the classical methods, was used in the open window of the cervical spine. Fifteen patients with cervical myelopathy were treated using the classical method and 12 patients were treated using the modified method. Preoperative and postoperative clinical conditions were assessed according to the Japanese Orthopedic Association (JOA) score. The radiological results were compared with the preoperative and postoperative computed tomography (CT) findings. RESULTS: In both methods, the clinical results revealed a significant improvement in neurological function (p<0.001). Image analysis revealed that the cervical canals were continuously expanded in patients treated using the modified methods. However, authors have observed restenosis during the follow-up periods in 4 patients treated using the original method. Progression to deformity and spinal instability were not observed in any of the patients in the radiological results. CONCLUSION: Although analysis with a larger population and a longer follow-up period needs to be undertaken, our modified open-door laminoplasty has shown an advantage in better maintaining an open window in comparison with the Hirabayashi's open-door laminoplasty.
Asian Continental Ancestry Group ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Orthopedics ; Paraspinal Muscles ; Spinal Cord Diseases ; Spine ; Spondylosis ; Zygapophyseal Joint

Microcystic adenoma, also known a glycogen rich or serous cystadenoma is very rare and usually presents grossly a large multiloculated mass, and the individual cystic cavities being small and filled with a clear(serous) fluid. The cut surface is spongy in appearance. Microscopically, cysts are composed of multiple small cysts lined by small, flat or cuboidal cells containing abundant glycogen but only an insignificant amount of mucin. The microcystic cystadenoma is benign, but mucinous cystadenoma is potentially malignant,so the two cysts should be differentiated, and should never be treated by-pass sugery in the case of mucinous cystadenoma. A 43-year-old female was admitted to this hospital with the palpable epigastric mass, postprandial nausea and weight loss for the preceeding 2 years, and increase in size in the past recent 8 months. Upper G.I series and ultrasonographic studies revealed a huge mass in the pancreatic head portion. Exploratory laparotomy was performed, which disclosed a round adult fist sized multicystic mass in the pancreatic head. Pancreaticoduodenectomy was performed. In gross specimen examination, the mass was 9x7.5x7 cm in size, the outer surface was smooth and grayish white, the cut surface was sponge- like with multiple small cysts. The content of cysts was serous fluid. Microscopically, the cystic mass was composed of small cysts, in which the lining of the cell shows flat and mild secretory activity. There was no malignant evidence. The patient was discharged uneventfully on the 22nd postoperative days.
Adenoma* ; Adult ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Female ; Glycogen ; Head ; Humans ; Laparotomy ; Mucins ; Nausea ; Pancreas* ; Pancreaticoduodenectomy ; Weight Loss

Vascular malformations are known by several names, such as angiodysplasia, vascular ectasia, arteriovenous malformation, and telangictasia. Arteriovenous malformations may occur anywhere in the gastrointestinal tract. The large intestine is the most commonly involved location, usually on the right side. Arteriovenous malformations, which consist of enlarged, tortuous and dilated, often thin-walled blood vessels, usually occur in the submucosa or mucosa. Occasionally, they can cause recurrent and even massive hemorrhage. The authors treated a case of angiodysplasia in the upper jejunum, which caused massive bleeding. A 67-year-old female patient was admitted because of massive lower gastrointestinal bleeding. The bleeding point was found by angiography, injection of methylene-blue dye, and intraoperative endoscopy. The bleeding lesion in jejunal segment was resected, and end-to-end anastomosis was performed. The postoperative course was uneventful, and the patient was discharged on the 10th postoperative day.
Aged ; Angiodysplasia ; Angiography ; Arteriovenous Malformations ; Blood Vessels ; Dilatation, Pathologic ; Endoscopy ; Female ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Intestine, Large ; Jejunum* ; Mucous Membrane ; Vascular Malformations*

BACKGROUND : There are plenty of documented observations of gastric cancer patients having suppressed cellular immunity, and this immunity may be correlated to recurrence. We studied the changes in the peripheral T-lymphocyte subpopulations in gastric cancer patients and their predictive roles for recurrence. METHODS : Lymphocyte subpopulations in peripheral blood from thirty-eight gastric cancer patients who were operated on at Taegu Catholic Medical Center from September 1995 to February 1997 were measured by 3-color direct immunofluorescence analysis with a Coulter S-plus IV automatic counter. RESULTS : CD4 significantly increased with tumor size and depth of invasion although other immune parameters, such as CD8, CD19, the CD4/CD8 ratio, and total lymphocyte count did not changed. In the patients with lymph-node metastasis, increases in CD3 and CD4 and a decrease in CD19 were observed. CD19 and the B lymphocyte count also decreased in advanced gastric cancer patients. However, T-lymphocytes subpopulations did not significantly change with stage. There were significant decreases in CD8 and in the T- & B-lymphocyte counts, without changes in CD4 and the CD4/CD8 ratio in the postoperative immune parameters.The preoperative values of the T- & B-lymphocyte counts and CD8 and CD19 were lower in patients who had recurrences during six months to two years of follow up, compared to recurrence-free patients. CONCLUSIONS : On the basis of these results, we found changes of T-lymphocyte subpopulations with size, depth of invasion, and regional lymph node metastasis, but not with stage. Postoperatively, there were significant decreases in the T- & B-lymphocyte counts. Suppressed immunity correlated with recurrence, and preoperative evaluation of peripheral T-cell subpopulations may be helpful for predict recurrence and for postoperative prognosis.
B-Lymphocytes ; Daegu ; Fluorescent Antibody Technique, Direct ; Follow-Up Studies ; Humans ; Immunity, Cellular ; Lymph Nodes ; Lymphocyte Count ; Lymphocyte Subsets* ; Lymphocytes* ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Stomach Neoplasms* ; T-Lymphocytes

Proton magnetic rcsonance spectroscopy (1H MRS) has demontrated its abilities to detect an increase of choline containing compounds (Cho) in various brain tumors and prostatic cancer tissues. Based on preclinical works done by other authors using multinuclei MRS, it is reasonable to assume malignant breast tumors will have elevated level of Cho compared to that of normal tissues and benign breast lesions. Several challenges must be met to obtain clinically useful 1H breast spectrum. Good water and fat suppression, Bo homogeneity are required to detect low level metabolic signals like choline if any. In this study, we investigated the clinical utility of 1H MRS with simultaneous suppression of water and fat signals, using breast imaging surface coil for evaluating breast cancer with small lesions. All studies were performed using a GE signa MRI unit (1.5 T, Ver 5.5) and 2-channel breast coil (GE). Water suppression was achieved by chemical selective saturation, and fat signal was attenuated using inversion recovery sequence. Spectroscopic data were acquired with PRESS sequence. Twenty-three patients, age 14-75, were examined. Eleven of these patients presented with invasive ductal carcinoma. The remaining patients presented with benign processes including fibroadenoma, fibrocystic change, galactocele, adenosis, ductal ectasia and dystrophic calcification. The size of lesions were variable (8-90 mm in diameter). Choline at 3.25 ppm was visible in the spectra of all cancer patients, while invisible in the spectra of all benign lesions except a lesion of dystrophic calcification. We concluded that in vivo detection of choline containing compounds in breast carcinomas using proton magnetic resonance spectroscopy demonstrated its potential as a noninvasive tool for differential diagnosis of malignant and benign breast lesions larger than 7 mm in diameter.
Brain Neoplasms ; Breast Diseases* ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Choline ; Diagnosis, Differential* ; Dilatation, Pathologic ; Fibroadenoma ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Prostatic Neoplasms ; Protons* ; Spectrum Analysis ; Water