Effects of various peripheral vasoconstrictors on isolated porcine basilar and posterior communicating arteries(BA and PCA) were investingated and effected of flunarizine on the contractile responses were compared with those of a vasodilator, nitroglycerin. KCl elicited dose-dependent contractions in BA and PCA. 50mM KCl-induced contraction was not affected by nitroglycerin but dose-dependently inhibited by nimodipin and flunarizine in both rings. Epinephrine produced contractile response of BA and PCA in a dose-dependent fashion, but norepinephrine or phenylephrine did not cause obvious contraction by itself. Norepinephrine and phenylephrine elicited dose-dependent contractions in both rings treated with 10 -6M propranolol and the epinephrine-induced contractions were potentiated by pretreatment with propranolol, 5-hydroxytryptamine and histamine contracted BA and PCA in a dose-dependent manner and the contraction of PCA was more prominent than that of BA. In PCA rings, 10(-6)M 5-hydroxytryptamine and 10 -6M orepinephrine-induced contractions were not changed by nitroglycerin but inhibited by flunarizine in a dose-dependent manner. Small doses of flunarizine inhibited gradually both drug-induced contractions and large doses(3.5 x 10(-6) and 10(-6)M) steeply inhibit ed the contractions. Then the slopes of inhibitory curves in both cases were biphasic. Above results suggest that responsibility of catecholamine in porcine brain artery is more prominent in alpha-adrenoceptors than in beta-adrenoceptors, and inhibitory effect of flunarizine on brain artery results from inhibition of calcium influx through stimulated receptor-operated calcium channel(ROC) and potential-operated calcium channel(POC) .
Arteries* ; Brain* ; Calcium ; Epinephrine ; Flunarizine* ; Histamine ; Nitroglycerin ; Norepinephrine ; Passive Cutaneous Anaphylaxis ; Phenylephrine ; Propranolol ; Serotonin ; Vasoconstrictor Agents

A case of mucocele of the sphenoid sinus with blurred vision and headache is presented. Mucocele of the sphenoid sinus is relatively rare and benign. Accurate diagnosis is possible through Brain CT scan and MRI. But it should be included in the differential diagnosis of malignancy or pituitary tumor, and unnecessary treatment such as radiotherapy or craniotomy should not be performed. In this case, mucocele is extended into sella turcica which is markedly destroyed and eroded. We removed it by sublabial transseptal sphenoidal sinusotomy and drainage without difficulties and postoperative complications.
Brain ; Craniotomy ; Cytochrome P-450 CYP1A1 ; Diagnosis ; Diagnosis, Differential ; Drainage ; Headache ; Magnetic Resonance Imaging ; Mucocele* ; Pituitary Neoplasms ; Postoperative Complications ; Radiotherapy ; Sella Turcica ; Sphenoid Sinus* ; Tomography, X-Ray Computed

Meningioma has been considered to be rare as multiple growths. More often than not, they are associated with neurofibromatosis, bilateral acoustic tumors and multiple angiomata. Less frequently multiple meningiomas may be present without these associated problems. Cushing and Eisenhardt called the former "meningiomatosis" and the latter multiple meningiomas. The incidence of multiple meningiomas has been reported 1-8.9% of all intracranial meningiomas. The availability of CT has increased the incidence of the diagnosis of multiple meningiomas by visualizing smaller meningiomas which would have remained undetected and it seems to be reasonable that some elderly patients with multiple lesions diagnosed by CT should be followed and not operated on. We report a patient with multiple meningiomas without evidence of von Recklinghausen's disease and explore its various theories of the etiology.
Aged ; Diagnosis ; Humans ; Incidence ; Meningioma* ; Neurofibromatosis 1 ; Neurofibromatosis 2

OBJECTIVE: The ovine fetus responds to hemorrhage with a 10-20 fold increase in plasma erythropoietin (EPO) concentration at 24 hr and a return toward normal at 48 hr after the hemorrhage. The objective of the present study was more accurately to compare the magnitude and time course of the plasma EPO response after fetal hemorrhage. METHODS: Chronically catheterized, 12 of late gestation ovine fetus were gradually hemorrhaged 40% of their blood volume over 2 hr (1ml/min). Plasma was sampled for EPO concentration at 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, 24, 30, 36 hr after initiating the hemorrhage were collected at these times. Radioimmunoassay was used to measure plasma EPO concentrations. Analysis of variance was used for statistical analysis. RESULT: After a slow hemorrhage in the ovine fetus (1ml/min over 2hr), plasma EPO concentration increased significantly at 4hr (2.3 times basal values), reached a maximum at 16 hr (33.3 times basal values), and declined thereafter. CONCLUSION: We studied change in time course of the fetal plasma EPO after slow hemorrhage and recent studies have shown that the fetal kidney, liver and placenta express EPO mRNA. These observation suggest that plasma EPO increase may be mediated by a tissue specific up-regulation of EPO transcription in the fetal kidney, liver and placenta. We have studied change in Epo mRNA expression in various fetal tissue after slow haemorrhage.
Blood Volume ; Catheters ; Erythropoietin* ; Fetus ; Hemorrhage* ; Kidney ; Liver ; Placenta ; Plasma* ; Pregnancy ; Radioimmunoassay ; RNA, Messenger ; Sheep ; Up-Regulation

OBJECTIVE: Percutaneous vertebroplasty is often complicated by the presence of multiple fractures or non-localizing pain in the patients with osteoporotic vertebral fractures. The purpose of this study is to estimate the value of preoperative radiologic studies in the localization of symptomatic vertebrae and to determine the factors which can influence on the clinical results. MATERIALS AND METHODS: We retrospectively reviewed the clinical and radiologic data of 57 vertebrae in 30 patients underwent percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Inclusion criteria was severe pain(McGill-Melzack score 3, 4 or 5) associated with the acute vertebral fractures and absence of spinal nerve root or cord compression sign. Acute symptomatic vertebral fracture was determined by the presence of signal change on MR images or increased uptake on whole body bone scan. RESULTS: Pain improvement was obtained immediately in all patients and favorable result was sustained in 26 patients(86.7%) during the mean follow-up duration of 4.7 months(5 complete pain relief, 21 marked pain relief). Those who underwent vertebroplasty for all acute symptomatic vertebrae had significantly better clinical result than those who did not. Further vertebral collapse and eventual bursting fracture occurred in 1 vertebra which showed intradiskal leakage of bone cement and disruption of cortical endplate on postoperative CT scan. CONCLUSION: Preoperative MR imaging and whole body bone scan are very useful in determining the symptomatic vertebrae, especially in the patients with multiple osteoporotic vertebral fractures. To obtain favorable clinical result, the careful radiologic evaluation as well as clinical assessment is required. Control of PMMA volume seems to be the most critical point for avoiding complications.
Follow-Up Studies ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging* ; Polymethyl Methacrylate ; Retrospective Studies ; Spinal Nerve Roots ; Spine ; Tomography, X-Ray Computed ; Vertebroplasty*

Lamivudine is widely used for the treatment of chronic hepatitis B infection because of it's remarkable antiviral efficacy and safety. We report a case of severe skin eruption caused by lamivudine. A 47-year-old female was admitted because of jaundice and itching sensation. She was diagnosed as chronic hepatitis B infection a few years ago but did not receive any specific treatment. Laboratory data showed acute deterioration of chronic hepatitis B infection. We prescribed lamivudine as a rescue therapy. Her general condition improved and lab data showed improvement in liver function test thereafter. However, she complained of severe skin eruption and itching sensation a few days after the discharge. We stopped lamivudine because the symptoms did not improve despite the use of anti-histamine. Skin biopsy showed interface dermatitis. After stopping lamivudine, her symptoms improved. However, the skin eruption developed again after lamivudine was restarted. Adefovir was used instead, and the patient did not experience any further skin problems since then.
Aged ; Colon, Transverse ; Female ; Hernia, Abdominal/*diagnosis/radiography ; Humans ; Imaging, Three-Dimensional ; *Mesocolon ; Tomography, Spiral Computed

OBJECTIVE: The purpose of study was to assess in a longitudinal study of maternal plasma concentrations of Tumor necrosis factor-alpha(TNF-alpha), Vascular cell adhesion molecule-1(VCAM-1), Lipid peroxide (malonaldehyde, MDA) in uncomplicated pregnancy. METHODS: Blood was collected from healthy women at 4 to 41 weeks' gestation and non-pregnant women. Plasma samples were measured by immunoassay for TNF-alpha, VACM-1 and by colorimetric assay for lipid peroxide, and data were statistically analyzed. RESULTS: Plasma concentration of TNF-alpha was not significantly elevated during first trimester compared with non-pregnant women, but significantly elevated during second and third trimester compared with non-pregnant women. Plasma concentration of VCAM-1 was significantly elevated during first trimester compared with non-pregnant women. Plasma concentration of lipid peroxide was not significantly elevated during pregnancy compared with non-pregnant women. CONCLUSION: The plasma concentration of TNF-alpha and VCAM-1 were significantly higher than that of non-pregnant state during second and third trimester in case of TNF-alpha, and during first trimester in case of VCAM-1. But the plasma concentration of lipid peroxide during pregnancy was not significantly different from that of non-pregnant, and the plasma concentration was kept up constant levels during gestation. These were seems to be meant that abnormal pregnancy would be happened if the level is above or below the measured level.
Cell Adhesion ; Female ; Humans ; Immunoassay ; Longitudinal Studies ; Necrosis ; Plasma* ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Pregnancy* ; Tumor Necrosis Factor-alpha* ; Vascular Cell Adhesion Molecule-1*