OBJECTIVE: To evaluat the effects of a culture medium with glucose in the presence of glutamine on the development of mouse embryos. METHODS: Two-cell embryos recovered from ICR mice at 48 hrs after hCG injection (mated just after hCG injection) were cultured in DMEM (with 20% hFF) supplemented with or without glucose on the presence of glutamine. Embryos were cultured under three different glucose regimens: (1) 0 mM (control); (2) 0.5 mM (group I); or (3) 3.15 mM (group II), and were analyzed at 24, 48, 72 and 96 hours intervals. Chi-square test (x2-test) was used to compare values of groups. RESULTS: No differences were found in the number of embryos showing morula (control: 37.5%; group I: 51.0%; group II: 48.4%), blastocyst (control: 21.5%; group I: 33.3%; group II: 34.4%) and blastocyst and hatching or hatched blastocyst (control: 81.9%; group I: 83.3%; group II: 82.8%) between groups at 24 hrs, 48 hrs or 72 hrs respectively. However at 96 hrs, the number of hatched and attached blastocyst was significantly higher in group I (82.3%) and II (78.5%) than control (63.2%; P<0.05). CONCLUSION: The addition of glucose (0.5 mM) to the DMEM, as energy source, improved the rate of development of late stage embryos in mice.
Animals ; Blastocyst ; Eagles* ; Embryonic Development* ; Embryonic Structures* ; Female ; Glucose* ; Glutamine* ; Mice* ; Mice, Inbred ICR ; Morula ; Pregnancy

Anterior clinoid process is a small bony structure but it is very important regarding its location and relationships with neighboring neurovascular, dural, and bony structures. Removal of this process has been used in various modification of standard pterional approach. The authors have speculated how much expansion of operative window could be obtained with anterior clinoidectomy, so we measured the lengths of optic nerve, internal carotid artery, and the length and width of optico-carotid triangle(OCT) before and after extradural anterior clinoidectomy 17 times in 10 cadaveric heads. This procedure provided about two fold increase in the length of optic nerve and OCT, and over three fold expansion in the width of OCT. The results indicate that the addition of this relatively simple and easy procedure to standard approach makes the operative field more comfortable and safe than expected. We believe this procedure can be used routinely with or without combination of wide skull base exposure in cases of such lesions as belows: 1) lesions causing optic nerve or chiasmatic compression, 2) lesions encircling/covering the optic nerve and internal carotid artery, 3) lesions arising from or extending into the optic canal, orbital apex, and paraclinoid region, 4) suprasellar/parasellar lesions with limited operative windows(e.g. prefixed chiasm, infra-optic or subchiasmatic locations or adherence).
Cadaver* ; Carotid Artery, Internal* ; Head ; Optic Nerve* ; Orbit ; Skull Base

Compliance of epileptic patients is one of the most important factors for adequate therapy. Recently, it had been shown that the variability of three serial measurement of the serum levels of antiepileptic drug(AED) may be used as an indication of the degree of compliance. Coefficient variation(CV) of serum drug levels calculated by only one AED had been used to determine the compliance in epileptic patients who took multiple AEDs. We attempted to evaluate the CV of AEDs and then find the objective clue of compliance and the compatible therapeutic planing according to CV. Ninety seven epileptic patients of outpatients department of the Gyengsang National University Hospital were entered to this study. All patients were taking medication at least for 6 months without any changes of drug regimen. Patient's information was acquired by reviewing the chart and interview with questionnaire. With these informations, we determined the compliance of the patients. Antiepileptic serum levels were measured three times at intervals of at least two to four weeks apart, and their CV was calculated. We compared the CV between the compliant and non-compliant group in each AED(phenytoin, carbamazepine , valproic acid) and three drugs in the compliant group. The mean CVs of phenytoin, carbamazepine and valproic acid in the compliant group were 18.3+/-13.0, 15.2+/-10.2 and 23.8+/-8.9, respectively(mean+/-SD). The mean of CV in the compliant and the non-compliant group were 17.9+/-10.9 and 38.8+/-27.2, respectively. The CVs of the compliant group were significantly lower than those of the non-compliant group(p<0.05). However, CVs had no significant difference between three antiepileptic drugs. This study showed that CVs of AEDs were not different between each AEDs, even though they possess different pharmacokinetic properties. Therefore, the CV of one AED can be used in determining the compliance of the epileptics who are taking multiple AEDs.
Anticonvulsants ; Carbamazepine* ; Compliance ; Humans ; Outpatients ; Phenytoin* ; Surveys and Questionnaires ; Valproic Acid*

PURPOSE: The aim of this study is to demonstrate the feasibility of 2-[fluorine-18] fluoro-2-deoxy-D-glucose (F-18-FDG) whole body scan (FDG W/B Scan) using dual-head gamma camera equipped with ultra high energy collimator in patients with various cancers, and compare the RESULTS with those of coincidence imaging. MATERIALS AND METHODS: Phantom studies of planar imaging with ultra high energy and coincidence tomography (FDG CoDe PET) were performed. Fourteen patients with known or suspected maligancy were examined. F-18-FDG whole body scan was performed using dual-head gamma camera with high energy (511 keV) collimators and regional FDG CoDe PET immediately followed it. Radiological, clinical follow up and histologic RESULTS were correlated with F-18-FDG finding. RESULTS: Planar phantom study showed 13.1 mm spatial resolution at 10 cm with a sensitivity of 2638 cpm/MBq/ml. In coincidence PET, spatial resolution was 7.49 mm and sensitivity was 5351 cpm/MBq/ml. Eight out of 14 patients showed hypermetabolic sites in primary or metastatic tumors in FDG CoDe PET. The lesions showing no hypermetabolic uptake of FDG in both methods were all less than 1 cm except one lesion of 2 cm sized metastatic lymph node. The metastatic lymph nodes of positive FDG uptake were more than 1.5 cm in size or conglomerated lesions of lymph nodes less than 1 cm in size. FDG W/B scan showed similar RESULTS but had additional false positive and false negative cases. FDG W/B scan not visualize liver metastasis in one case that showed multiple metastatic sites in FDG CoDe PET. CONCLUSION:S: FDG W/B scan with specially designed collimators depicted some cancers and their metastatic sites, although it had a limitation in image quality compared to that of FDG CoDe PET. This study suggests that F-18-FDG positron imaging using dual-head gamma camera is feasible in oncology and helpful if it should be more available by regional distribution of FDG.
Electrons ; Follow-Up Studies ; Gamma Cameras* ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Positron-Emission Tomography ; Whole Body Imaging*

Recently, motor evoked potential(MEP) using cortical surface of transcranial stimulation have been used to monitor the integrity of motor pathways and map motor cortex in human and animal. The primary concept using motor evoked potentials(MEPs) for test of motor pathways was based on the assumtion that pyramidal neurons in the motor cortex are activated by electrical stimulation applied on the cerebral cortex and synchronized compound action potentials are conducted mainly along the corticospinal tracts in the spinal cord. However, the origins and the descending pathways of these MEPs in small animals may be different from those of potentials evoked by intracortical microstimulation because of current spread. Our previous study revealed that the origns of the MEPs in rats differed from those previously believed and may be reticular nuclei. To further clarify those results and localize the intraspinal pathways conduction MEPs, consecutive vertical and/or horizontal sections of the spinal cord were performed at T9 cord level in twelve rats. MEPs were recorded at T2/3 and L2/3 before and after each section and sequential alterations of MEPs were observed. In six rats, the stimulation was alternated between the right and left cortex and the lateralities of conduction pathways were compared. All six cases showed no differences of MEPs and pattern of wave abolition after each section between right and left brain stimulation. The alteration of MEPs after each consecutive section was categorized by analyzing latency shift, amplitude change, and disappearance of waves. We divided a cross section of T9 spinal cord into forty-six squares. If one of the categorized changes occurrd after cutting an area, the appropriate score was given for the area since more change of waves meant more significant contribution of the cut area to conduction of MEPs. The score of twelev rats were summed in each forty-six spots and map showing the distribution of MEPs was constructed. The map revealed that MEPs were conducted along the wide area of ventral and lateral funiculus of the spinal cord but mainly along the medial portion of the ventral funiculus of the spinal cord but mainly along the medial portion of the ventral funiculus and ventral portion of the larteral funiculus through which reticulospinal and vestibulospinal tracts pass. No conduction of MEPs along the corticospinal tracts was confirmed. This finding supports the result of our previous study. However, this extrapyramidal MEP conducted along ventral spinal cord in addition to somatosensory evoked potential(SSEP) which is conducted along posterior funiculus can be useful to monitor the integrity of the whole spinal cord. Moreover, the extrapyramidal MEP can be more useful than pyramidal MEP in rats because the reticular formation plays a more important role in motor function and pyramidal tract is located in posterior funiculus.
Action Potentials ; Animals ; Brain ; Cerebral Cortex ; Efferent Pathways ; Electric Stimulation ; Evoked Potentials, Motor* ; Extrapyramidal Tracts ; Humans ; Motor Cortex ; Neurons ; Pyramidal Tracts ; Rats* ; Reticular Formation ; Spinal Cord

Motor evoked potential(MEP) produced by cortical surface or transcranial stimulation has evolved as a new clinical and experimental tool to monitor the integrity of motor pathways and to map motor cortex. Clinical assessment of motor system using MEP has further advanced with recent development of the magnetic stimulator. The primary concept using MEPs for test of motor pathways was based on the assumption that pyramidal neurons in the motor cortex are activated by electrical stimulation applied on the cerebral cortex and synchronized compound action potentials are conducted mainly along the corticospinal tracts in the spinal cord. However,recent studies indicated that the origins of the Meps in non primates may differ from those previously believed. In order to use MEPs as a clinical or experimental tool, it is essential to clarify the origin of MEPs. Therefore, goals of this study were : (1) to investigate the origin of MEPs, and (2) to design the most reliable but simple method to evoke and monitor MEPs. In a total of fifteen rats, MEPs were produced by cortex to cortex stimulation and were monitored using a pair of epidural electrodes. Using varying stimulus intensities, the amplitudes and latencies of MEPs were statistically analyzed. The latencies and amplitudes of the MEPs in these animals showed surprisingly large standard deviations, which were partially resulted in these animals showed surprisingly large standard deviations, which were partially resulted from convergence of neighboring waves during high stimulation intensities. Wave forms of MEPs were also varied greatly depending on the position of recording electordes. At low stimulus intensities, most consisten MEPs were obtained when the stimulating electrodes were placed on the hard palate and the temporal muscle, not on the motor cortex. This observation indicates that the primary source of MEPs is not the motor cortex in the rat. When the potentials generated by direct stimulation of motor cortex and those generated by reticular nuclei were monitored epidurally in the same preparation using the same electrodes, these potentials generated by different sources actually identical in their latencies and wave forms. However, the threshold stimulus intensities evoking these potentials were quite different in the two metholds. The threshold was much lower to evoke potentails by reticular nuclei stimulation. It suggests that MEPs are geneated by the reticular nuclei or brain structure located in the brain stem. The observation that the motor cortex play no major roles in generating MEPs was confirmed by sequential sections of neural axis from the motor cortex to brain stem in three rats. All these findings suggested that neither direct motor cortex stimulation not transcranial stimulation did evoke MEPs originating from the motor cortex in rat. These stimulating methods activate reticular nuclei by stimulus current spread to the brain stem. Since the reticular formation plays an important role in motor function in rats, MEP originated from reticular nucleus can be an important testing of the motor function in rats. Moreover, transcranial stimulation of the brain is technically easy. This technique producing MEPs originated from reticular nucleus can be useful to monitor the integrity of motor pathways.
Action Potentials ; Animals ; Axis, Cervical Vertebra ; Brain ; Brain Stem ; Cerebral Cortex ; Efferent Pathways ; Electric Stimulation ; Electrodes ; Evoked Potentials, Motor* ; Extrapyramidal Tracts ; Motor Cortex ; Neurons ; Palate, Hard ; Primates ; Pyramidal Tracts ; Rats* ; Reticular Formation ; Spinal Cord ; Temporal Muscle

Purpose: The purpose of this study is to evaluate the usefulness of individualized metabolic surgery score for Korean patients in determining bariatric surgical procedures. Materials and Methods: A total of 135 patients with type 2 diabetes mellitus who underwent sleeve gastrectomy (n=19) or Roux-en-Y gastric bypass (n=116) at our institute with a 1-year follow up were analyzed for the predictive power of diabetes remission using the individualized metabolic surgery scoring system. Results: At the postoperative follow-up of 1 year, the remission of type 2 diabetes mellitus (HbA1C＜6.5%, off medications) was achieved in 88 (65.2%) patients. The remission rates showed no significant differences between patients who underwent sleeve gastrectomy and Roux-en-Y gastric bypass (63.2% versus 65.5%; P=0.84), regardless of the severity of type 2 diabetes mellitus. Although there was no statistically significant difference in the remission rate according to the bariatric surgery procedures (P＞0.99 in mild, P=0.11 in moderate, P＞0.99 in severe IMS score), remission rates were higher in moderate severity patients who underwent Roux-en-Y gastric bypass than in those who underwent sleeve gastrectomy (69.7% versus 37.5%). Conclusion The remission rates after bariatric surgery procedures were similar to that of the previously reported study. Despite the limitations of our data, the individualized metabolic surgery score can be used as a complement to other scoring systems in Korean patients.

Cesarean hysterectomy is associated with high risks of severe blood loss, postoperative complication, and maternal morbidity. This study was undertaken to identify the risk factors of cesarean hysterectomy and to reduce the postoperative complications and maternal morbidity. There were 6,362 deliveries between January 1992 and December 1996 at department of obstetrics and gynecology, Inchon Christian Hospital. 1'he results of this study were as follows, 15 cases of cesarean hysterectomy were performed during this period. Cesarean hysterectomy was performed in 10 cases (0.32 %) among 3178 cesarean deliveries and in 5 cases (0.16 %) among 3184 vaginal deliveries. The incidence of cesarean hysterectomy was 0.24 % (15/6,362). The age of patients ranged from 24 to 38 years old. The maternal mortality and morbidity were 0 % (0/15) and 86.7% (13/15), respectively. Indications for cesarean hysterectomy were uterine atony (53.3 %), uterine myoma with pregnancy (20.0 %), placenta accreta and/or increta(20.0 %), and placenta previa (6.7 %) in orders. The associated risk factors of cesarean hysterectomy were prior cesarean delivery (46.7 %) and placenta previa (6.7 %). The postoperative complications were anemia (60.0%), febrile morbidity (13.3 %), paralytic ileus (6.7 %), and wound disruption (6.7 %). We concluded that risk factors of cesarean hysterectomy were cesarean delivery, prior cesarean delivery, uterine myoma with pregnancy, placenta accreta and/or increta, and placenta previa and that sufficient fresh blood and careful prenatal care were needed in risk group of postpartum bleeding.
Adult ; Anemia ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Incheon ; Incidence ; Intestinal Pseudo-Obstruction ; Leiomyoma ; Maternal Mortality ; Obstetrics ; Placenta Accreta ; Placenta Previa ; Postoperative Complications ; Postoperative Hemorrhage ; Postpartum Period ; Pregnancy ; Prenatal Care ; Risk Factors ; Uterine Inertia ; Wounds and Injuries

PURPOSE: The in vitro dissolution of intrahepatic stones was evaluated using the various solvent mixtures. MATERIALS AND METHODS: Sixty four intrahepatic stones from 16 patients were used. Four kinds of solvent mixtures(No. 1 = basic buffer + EDTA, No. 2=1 + Sulfobetain-12, No. 3=2 + N-acetylcysteine, No. 4=3 + urea) were used. Dissolution rates were determined by measuring the weight loss of stones after 6, 12, 24, 48 hours incubation periods, respectively. RESULTS: The highest dissolution rates in dissolving intrahepatic stones were achieved with No. 4 solvent mixture(1% W/V EDTA/80mM, Sulfobetain-12/1 M, urea, pH 9.5). CONCLUSION: lntrahepatic stones could be largely dissolved up to about 70% of their initial weight after 48 hours incubation period in vitro.
Acetylcysteine ; Edetic Acid ; Humans ; Hydrogen-Ion Concentration ; Urea ; Weight Loss

Voltage dependent calcium channel (VDCC), one of the most important regulator of Ca2+ concentration in neuron, play an essential role in the central processing of nociceptive information. The present study investigated the antinociceptive effects of L, T or N type VDCC blockers on the formalin-induced orofacial inflammatory pain. Experiments were carried out on adult male Sprague-Dawley rats weighing 220-280 g. Anesthetized rats were individually fixed on a stereotaxic frame and a polyethylene (PE) tube was implanted for intracisternal injection. After 72 hours, 5% formalin (50 microL) was applied subcutaneously to the vibrissa pad and nociceptive scratching behavior was recorded for nine successive 5 min intervals. VDCC blockers were administered intracisternally 20 minutes prior to subcutaneous injection of formalin into the orofacial area. The intracisternal administration of 350 or 700 microg of verapamil, a blocker of L type VDCC, significantly decreased the number of scratches and duration in the behavioral responses produced by formalin injection. Intracisternal administration of 75 or 150 microg of mibefradil, a T type VDCC blocker, or 11 or 22 microg of cilnidipine, a N type VDCC blocker, also produced significant suppression of the number of scratches and duration of scratching in the first and second phase. Neither intracisternal administration of all VDCC blockers nor vehicle did not affect in motor dysfunction. The present results suggest that central VDCCs play an important role in orofacial nociceptive transmission and a targeted inhibition of the VDCCs is a potentially important treatment approach for inflammatory pain originating in the orofacial area.
Adult ; Animals ; Calcium ; Calcium Channel Blockers ; Calcium Channels ; Calcium Channels, L-Type ; Calcium Channels, N-Type ; Calcium Channels, T-Type ; Dihydropyridines ; Facial Pain ; Formaldehyde ; Humans ; Injections, Subcutaneous ; Male ; Mibefradil ; Neurons ; Pain Measurement ; Polyethylene ; Rats ; Rats, Sprague-Dawley ; Verapamil