The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.
Aged ; Humans ; Spine ; Vertebral Artery

No abstract available.
Brain Neoplasms* ; Brain* ; Tomography, Emission-Computed, Single-Photon*

Congenital radioulnar synostosis can be a disabling state, especially if it is bilateral or fixed hyperpronation. The purpose of this study is to introduce the surgical technique in proximal radioulnar synostosis who needs surgical intervention. Our procedures included excision of synostosis, interposition of muscle flap using brachioradialis, anconeus or extensor carpi ulnaris muscles with vascular pedicle for prevention of re-ankylosis and biceps transfer to improve supination. From July 1994 to July 1996, we evaluated 8 cases in 6 patients who underwent these procedures. The average age was 7 years and average duration of follow up was 24 months. The fixed forearms with hyperpronation have gained average 40 degrees of range of rotation. Improvement in holding and using small objects, sports activities and daily living activities was observed in all cases. There were no significant complications including re-ankylosis during the follow-up periods. In conclusion, surgical treatment of congenital radioulnar synostosis with these procedures is a reliable method that prevent re-ankylosis with providing forearm rotation.
Activities of Daily Living ; Follow-Up Studies ; Forearm ; Humans ; Muscles ; Sports ; Supination ; Synostosis* ; Tendon Transfer

At the beginning, researches on the biology of depression or affective illness have focused mainly on the receptor functions and neuroendocrine activities. And the studies of the past years did not break new theoretical background, but the recent advances in the research on the molecular mechanisms underlying neural communication and signal transduction do add some insights to many established ideas. This article will overview some of the more recent advances in the clinical researches of depression. Our major concerns to be presented here include the following : (1) alterations in the post-synaptic neural transduction ; (2) changes in the neurons of hypothalamic neuropeptides ; (3) decreased peptidase enzyme activities : (4) associations of hypothalamic-pituitary-adrenal axis abnormalities with serotonin neurotransmission ; (5) role of serotonin transporter ; (6) changes in the responsiveness of intracellular calcium ion levels ; (7) the inositol deficiency theory of lithium and depression ; (8) the transcription factors including immediate early genes ; (9) recent genetic studies in some families. This brief overview will suggest that changes in DNA occur during antidepressant therapy. These changes at the DNA level initiating a cascade of events underlying antidepressant modality will give us the insight on the molecular biological basis of the pathogenesis of depression and cues for a new class of antidepressants.
Antidepressive Agents ; Axis ; Biology ; Calcium ; Cues ; Depression* ; DNA ; Genes, Immediate-Early ; Humans ; Inositol ; Lithium ; Neurobiology* ; Neurons ; Neuropeptides ; Serotonin ; Serotonin Plasma Membrane Transport Proteins ; Signal Transduction ; Synaptic Transmission ; Transcription Factors

Meningiomas had long been considered radioresistant and therefore the role of radiation therapy in its treatment remains controversial. Lately, however, most of the retrospective analysis of meningiomas indicates that radiation therapy does show some degree of beneficial effects not only for malignant but also for benign meningiomas with the advanced technology and increased amount of radiation therapy, the rate of growth of tumor had been successfully slowed and local recurrence rate is also reduced following subtotal resection. We have performed conventional high dose radiation therapy on 7 cases of meningiomas(four cases of meningotheliomatous meningiomas, and three cases of malignant meningiomas). Of the 7 cases, the residual mass of 6 had decreased in size and neurological improvement was also evident. However, the 7th case resulted in complicated hydrocephalus. These cases are presented and the effect of conventional radiation therapy is discussed together with the review of literatures.
Hydrocephalus ; Meningioma* ; Recurrence ; Retrospective Studies

Tamoxifen and radiotherapy are used in breast cancer treatment worldwide. Radiation recall dermatitis (RRD), induced by tamoxifen, has been rarely reported. Herein, we report a RRD case induced by tamoxifen. A 47-year-old woman had a right quadrantectomy and an axillary lymph node dissection due to breast cancer. The tumor was staged pT2N0; it was hormone receptor positive, and human epidermal growth factor receptor 2 negative. The patient received adjuvant chemotherapy followed by tamoxifen and radiotherapy. After 22 months of tamoxifen, the patient developed a localized heating sensation, tenderness, edema, and redness at the irradiated area of the right breast. The symptoms improved within 1 week without treatment. Three weeks later, however, the patient developed similar symptoms in the same area of the breast. She continued tamoxifen before and during dermatitis, and symptoms resolved within 1 week.
Breast ; Breast Neoplasms* ; Chemotherapy, Adjuvant ; Dermatitis ; Edema ; Female ; Heating ; Hot Temperature ; Humans ; Lymph Node Excision ; Middle Aged ; Radiodermatitis* ; Radiotherapy ; Receptor, Epidermal Growth Factor ; Sensation ; Tamoxifen*

Lipopolysaccharide (LPS), a main constituent of Gram-negative bacterial membrane, specifically activates Toll-like receptor 4, leading to the production of pleiotropic cytokines/chemokines which in turn regulate inflammatory and innate and subsequent adaptive immune responses. Given that human gut harbors a large collection of commensal bacteria, LPS released by gut microbes is able to make the great impact on gut homeostasis through the intracellular signaling pathways engaged by host-microbial interaction. Emerging evidence indicates that LPS in the gut has a potency to elicit the pathogenesis of intestinal inflammatory diseases such as inflammatory bowel disease and necrotizing enterocolitis. In this review, we discuss the current understanding of the basic biochemistry of LPS, LPS-induced intracellular signaling, and physiological impacts of LPS in the intestine.
Bacteria ; Biochemistry* ; Enterocolitis, Necrotizing ; Homeostasis ; Humans ; Inflammatory Bowel Diseases ; Intestines ; Lipopolysaccharides ; Membranes ; Toll-Like Receptor 4 ; Toll-Like Receptors

The adult trematodes, Fasciola hepatica, Eurytrema pancreaticum and Paramphistomum cervi, employed in this experiment were obtained from the cattle slaughtered at the local abbatoir. The worms selected and washed several times in normal sterilized saline solution. Each about ten of intact F. hepatica, fourty of E. pancreaticum, and twenty of P. cervi were incubated in 50 cc volume of special incubation flasks with incubation medium consisting of 10 cc. of Krebs-Ringer phosphate buffer(pH 7.4) The incubation medium was added C(14)-1-acetate and non-radioactive carrier Na-acetate so as to contain acetate concentration of 50 mg per cent . The worms were allowed to incubate for 5 hours in the Dubnoff metabolic shaking incubator at 38 C. After incubation period, respiratory CO(2) samples from central well of incubation flask were analysed for total CO(2) production rate and their specific activity of respiratory CO(2). The lactate and pyruvate appearance rates were determined by analyzing the lactate and pyruvate concentration in a medium after incubation. The glycogen samples isolated from worms were analyzed for the tissue concentration and their radioactivities in order to determine the turnover rate of glycogen pool. Radioactivities of these series of experiments were counted by an endwindow Geiger-Muller counter as an infinitely thin samples. The quantitative analysis of C(14)-acetate utilized by F. hepatica, E. pancreaticum and P. cervi were compared and discussed in this report. According to these data of the experiment, it is suggested that the fatty acid such as acetate may play a part of their oxidative process into the respiratory CO2 and the synthetic process into glycogen in the above species of trematodes.
parasitology ; helminth ; trematoda ; Fasciola hepatica ; Eurytrema pancreaticum ; Paramphistomum cervi ; acetate ; metabolism ; biochemistry ; CO(2) ; glycogen ; Krebs-Ringer phosphate buffer

Microbial recognition by multicellular organisms is initially accomplished by a group of pattern recognition receptors which are specialized to recognize microbe-associated molecular patterns (MAMPs) such as lipopolysaccharide, bacterial lipoprotein, CpG DNA motif, double strand RNA and flagellin. Toll-like receptors (TLRs) are the representative pattern recognition receptors, and microbial recognition by TLRs elicits innate and inflammatory responses. Ten TLR family members have been presently identified in human genome, and numerous studies discovered that intracellular responses from MAMPs-TLR engagements are mediated by a participation of at least 4 immediate adaptor molecules such as myeloid differentiation primary response gene-88 (MyD88), MyD88 adaptor-like (Mal) (also known as Toll/IL-1 receptor domain-containing adaptor protein [TIRAP]), Toll/IL-1 receptor domain-containing adaptor-inducing interferon-beta (TRIF) and TRIF-related adaptor molecule (TRAM) leading to activate transcription factors including nuclear factor kappaB, activator protein-1 and interferon-regulatory factors. Given that large amounts of commensal microbiota constantly reside in the intestinal lumen, enteric microbial recognition by TLRs at the intestinal epithelium provides a critical impact on regulating intestinal homeostasis. Indeed, aberrant TLR4 and TLR5 activations are etiologically associated with the development and progress of intestinal inflammatory diseases including inflammatory bowel disease and necrotizing enterocolitis. In this review article, we present the molecular mechanism by which TLRs elicit intracellular signal transduction, and summarize the physiological relevance of TLRs related to the gastrointestinal tract.
Enterocolitis, Necrotizing ; Flagellin ; Gastrointestinal Tract ; Genome, Human ; Homeostasis ; Humans ; Immunity, Innate ; Inflammatory Bowel Diseases ; Interferon-beta ; Intestinal Mucosa ; Intestines ; Lipoproteins ; Metagenome ; Nucleotide Motifs ; Receptors, Pattern Recognition ; RNA ; Signal Transduction ; Toll-Like Receptors ; Transcription Factor AP-1 ; Transcription Factors

BACKGROUND AND OBJECTIVES: The efficiency of second harmonic generation at 532 nm is high when a pulsed Nd : YAG laseris used as a pump source of fundamental waves. The pulse durations of 532 nm-irradiation can be varied from 10 ns to 1000 ns by changing the pumping method. The purpose of this study was to compare the macroscopic and micropscopic changes in the muscle and skin after irradiation by 532 nm Flash lamp pumped solid state (FPSS) laser and Diode pumped solid state (DPSS) laser, whose pulse durations are 600 ns and 100 ns, respectively. MATERIALS AND METHOD: Two experiments were conducted on the muscle and skin of guinea pig. First, the guinea pig muscle and skin were irradiated by the 532 nm FPSS and DPSS lasers with various intensities and time duration. Macroscopic examinations were performed on the muscle lesions and immediate histopathologic examinations on the skin were carried out. RESULTS: The volume of vaporization and necrosis of the guinea pig muscle by the FPSS laser was larger than that by the DPSS laser. The vaporization and necrosis reaction of skin by the FPSS was significantly stronger than that by the DPSS laser. CONCLUSION: It appears that the DPSS laser system would be superior over the FPSS laser system in providing more accurate and precise surgery with less intense injury on the surrounding tissue.
Animals ; Guinea Pigs* ; Guinea* ; Necrosis ; Skin* ; Volatilization