This study was designed to identify the ultrastructural changes of mouse endometrum during peri-implantation period and obtain the fundamental information for the establishment of 3-dimensional culture system of mouse endometrial cells in vitro. The used female ICR mice (6~8 wks) were conducted on pregnant. The biopsies were obtained from whole uterus at cycle day 1 (D1) and day 5 (D5) after hCG injection and mating. The biopsies materials were fixed 2.5% glutaraldehyde and 1% osmium tetroxide. Subsequently, for observation using light and transmission electron microscopy (LM and TEM), they were dehydrated and embedded in Epon and the embedded biopsies were sectioned and stained. For scanning electron microscypy (SEM), the fixed specimens were dehydrated, dried and coated with gold. 1)For LM, the biopsied materials at D5 (late secretory phase) were appeared the extended stromal layer by increased connective tissues and the fully developed endometrial glands and vessels compared with D1 (early secretory phase). 2) For TEM, the mouse endometrium was consisted of 3-layers, a simple polarized columnar epithelial cells, basement membrane and stromal cells. At D5, the distribution of microvilli, endoplasmic reticulum, Golgi body, lipid and glycogen deposits, secretory granules and surface area of basement membrane were increased. 3) For SEM, the degree of folding and microvilli of surface of mouse epithelial cells was became more and more according to the process of secretory phase, and at D5, implantation time of mouse, the appearance of pinopodes as a specific marker of uterine receptivity was found. The uterine pinopodes of mouse were found in narrow sites at the luminal surface, irregularity and appeared the different stages in the same sample. Therefore, these results indicated that the mouse endometrium was experienced dramatic morphological changes during peri-implantation period.
Animals ; Basement Membrane ; Biopsy ; Connective Tissue ; Endometrium* ; Endoplasmic Reticulum ; Epithelial Cells ; Female ; Glutaral ; Glycogen ; Humans ; Mice* ; Mice, Inbred ICR ; Microscopy, Electron, Transmission ; Microvilli ; Osmium Tetroxide ; Phenobarbital ; Secretory Vesicles ; Stromal Cells ; Uterus

We describe here a 57-year-old woman with a chronic-contained rupture of an internal iliac arterial aneurysm, and this was eroding the sacral neural foramen. Although an isolated internal iliac arterial aneurysm is known to be rare, the ruptured internal iliac arterial aneurysm was diagnosed based on the characteristic radiolgic findings with performing color Doppler ultrasound, MRI and multi-slice computed tomography. The ruptured aneurysm was successfully treated by coil embolization. Color Doppler US, MRI and multi-slice CT are useful for evaluating a mass of a vascular origin that involves the neural foramen.
Aneurysm ; Aneurysm, Ruptured ; Cytochrome P-450 CYP1A1 ; Embolization, Therapeutic ; Female ; Humans ; Middle Aged ; Rupture ; Spine

Ictal spitting is an unusual manifestation that originates from the non-dominant hemisphere, but rarely from the dominant hemisphere. In the latter case, it has not been well defined as to whether symptomatogenic area for ictal spitting originates from the dominant hemisphere. We present a patient with ictal spitting. Intracranial EEG demonstrated a left hippocampal onset with propagation to the right hemisphere, and subsequent ictal spitting development. Even in dominant hemispheric seizures, the non-dominant hemisphere is a symptomatogenic area for ictal spitting.
Automatism* ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Humans ; Seizures ; Temporal Lobe*

No abstract available.
Embolism, Air*

Loss of pain and temperature sensation due to lateral medullary infarction are well known and classically involve the ipsilateral side of the face and the lower part of the body on the controlateral side. This pattern of sensory loss below a certain level on the trunk, usually a sign of spinal cord disease, may also appear following a lesion in the lateral medullar, due to damage to the spinothalamic tract. A 72-year-old hypertensive man developed sudden dizziness, headache, and gait ataxia. On neurologic examination, he had left limb and gait ataxia. Five days later he noted loss of pain and temperature sensation on the right leg and trunk with a sensory level at T4 with preservation of touch, vibration, and joint position sense in all limbs. Brain MRI showed a small infarct in the left lower lateral medulla. Brain MR angiography showed stenosis of the right proximal carotid artery, left distal vertebral artery, and mid-basilar artery. We report a case of sensory defects with a sensory level on the trunk that occured as the result of lesion of the lower lateral medulla.
Aged ; Angiography ; Arteries ; Brain ; Carotid Arteries ; Constriction, Pathologic ; Dizziness ; Extremities ; Gait Ataxia ; Headache ; Humans ; Infarction ; Joints ; Leg ; Magnetic Resonance Imaging ; Medulla Oblongata ; Neurologic Examination ; Proprioception ; Sensation ; Spinal Cord Diseases ; Spinothalamic Tracts ; Vertebral Artery ; Vibration

A pancreatic arteriovenous malformation (AVM) is a very rare disease entity that is usually asymptomatic; however, it may present with a massive gastrointestinal hemorrhage. Recent advances in cross-sectional imaging and the widespread availability of angiography have contributed to the diagnosis of this condition. A patient was transferred to our clinic due to unknown origin gastrointestinal bleeding and upper abdominal pain. Double balloon enteroscopy and duodenoscopy revealed a bleeding pancreatico-cholangio-duodenal fistula. We were able to diagnose an arteriovnous malformation with a pancreatico-cholangio-duodenal fistula by the use of angiography and from the post-operative pathological findings.
Abdominal Pain ; Angiography ; Arteriovenous Malformations* ; Diagnosis ; Double-Balloon Enteroscopy ; Duodenoscopy ; Fistula ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Pancreas ; Rare Diseases

BACKGROUND: Type 2 diabetes develops because of defects in both insulin secretion and action. The half-life of insulin in uremia is prolonged because the metabolic clearance rate of insulin in diabetic end stage renal disease (ESRD) patients is reduced with consequence that the dose of insulin and/or oral hypoglycemic agent (OHA) administered in normal renal function make them increase the risk of hypoglycemia. Therefore, we should usually reduce the dose of insulin and/or OHA, or stop administration of insulin and/or OHA if type 2 diabetic patients are progressed to ESRD. But in some patients, that is not true. The aim of this study was to test the hypothesis that insulin resistance plays an important role in (re)evaluation of optimal insulin and/or OHA dose for glycemic control after type 2 diabetic patients are progressed to ESRD. METHODS: Insulin resistance was examined in 23 type 2 diabetic ESRD patients with tight control of glycemia using the K index of the insulin tolerance test (Kitt). We divided 23 patients into three groups. Group 1 (n=10) was defined as patients who were administered neither insulin nor OHA after ESRD. Group 2 (n=9) was defined as patients who were changed from insulin to OHA as drug for glycemic control after ESRD. Group 3 (n=4) was defined as patients in whom insulin or OHA was continuously administered after ESRD without a change of them for glycemic control. We compared the degree of insulin resistance among these three groups. RESULTS: Insulin resistance determined by Kitt was significantly different between group 1 (Kitt, 2.1422/0.94-4.01%/min), group 2 (Kitt, 1.3811/0.79- 3.90%/min) and group 3 (Kitt, 0.8550/0.44-1.81%/min) by using Kruskal-Wallis test (p=0.048). Kitt in group 3 was significantly lower than in group 1 by using Mann-Whitney test (p=0.016). CONCLUSION: Although metabolic clearance of insulin is reduced by renal failure, demand of insulin/ OHA for optimal glycemic control is not reduced in higher insulin-resistant type 2 diabetic ESRD patients on hemodialysis. Insulin resistance plays an important role in determination of optimal insulin/ OHA dose for glycemic control after type 2 diabetic patients are progressed to ESRD.
Half-Life ; Humans ; Hypoglycemia ; Insulin Resistance* ; Insulin* ; Kidney Failure, Chronic* ; Metabolic Clearance Rate ; Renal Dialysis* ; Renal Insufficiency ; Uremia

BACKGROUND: C677T single nucleotide polymorphism (SNP) of Methylentetrahydrofolate reductase (MTHFR) has been known to be associated with plasma homocysteine (Hcy) levels, which is an independent risk factor for stroke. However, recent large clinical trials did not show any benefits of Hcy lowering therapy with vitamins on the prevention of stroke. We hypothesized that the Hcy lowering effect by vitamins would be different according to the MTHFR C677T SNP types (CC, CT or TT), which may influence the benefits of vitamins by Hcy lowering on stroke prevention. METHODS: The authors retrospectively studied acute stroke patients with information of the genotype of MTHFR and serial levels of Hcy during a recent 4 year period (July 2002 - Dec 2005). Vitamins (folic acid 1 mg, and/or cobalamin 750 microgram and pyridoxine 75 mg) were prescribed to the patients whose basal plasma Hcy levels were above 12 umol/L. RESULTS: Among 172 patients, 68 patients took vitamins. The mean basal Hcy level was significantly higher in the TT type than the others, and was decreased by vitamin therapy. Distribution of homocysteine grading (normal, intermediate or high) in follow up was not significantly different according to these SNP types. CONCLUSIONS: The Hcy lowering effect by vitamins was not different by MTHFR genetic polymorphism. Considering the higher prevalence of certain gene types in stroke and our study results, genetic factors such as MTHFR polymorphism may play an important role on the development of stroke rather than the plasma Hcy levels.
Follow-Up Studies ; Genotype ; Homocysteine* ; Humans ; Oxidoreductases ; Plasma* ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide* ; Prevalence ; Pyridoxine ; Retrospective Studies ; Risk Factors ; Stroke* ; Vitamin B 12 ; Vitamins*

We report herein a case of subclavian steal syndrome due to occlusive disease in multiple branches of the aortic arch, which was successfully treated by axilloaxillary bypass and subclavian stent insertion. The hemodynamic changes were evaluated using duplex sonography and transcranial Doppler before and after each procedure. The waveform and parameters of blood flow revealed an objective improvement in cerebral perfusion. These findings correlated well with clinical outcome. Neurosonologic evaluation can provide objective evidence for improved hemodynamic status after treatment.
Aorta, Thoracic ; Hemodynamics ; Perfusion ; Stents ; Subclavian Steal Syndrome

BACKGROUND/AIMS: Statins act as antineoplastic agents through the inhibition of cell proliferation. This study sought to demonstrate the effects of statins on extrahepatic bile duct cancer cell apoptosis and to document the changes in protein expression involved in tumor growth and suppression. METHODS: Human extrahepatic bile duct cancer cells were cultured. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays were performed to determine the effect of statins on cell proliferation. Apoptosis was measured by a cell death detection enzyme-linked immunosorbent assay and caspase-3 activity assay, and flow cytometry was used to determine the percentage of cells in each phase of the cell cycle. The protein expression of Bax, Bcl-2, insulin-like growth factor 1 (IGF-1) receptor, extracellular signal-regulated kinase 1/2 (ERK1/2), and Akt was measured by Western blot analysis. RESULTS: Simvastatin suppressed cell proliferation by inducing G1 phase cell cycle arrest in bile duct cancer cells. Furthermore, it induced apoptosis via caspase-3 activation, downregulated the expression of the Bcl-2 protein, and enhanced the expression of the Bax protein. Moreover, simvastatin suppressed the expression of the IGF-1 receptor and IGF-1-induced ERK/Akt activation. CONCLUSIONS: Simvastatin induces apoptosis in bile duct cancer cells, which suggests that it could be an antineoplastic agent for bile duct cancer.
Antineoplastic Agents/pharmacology ; Apoptosis/*drug effects ; Bile Duct Neoplasms/*drug therapy ; Cell Cycle/drug effects ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Hypolipidemic Agents/*pharmacology ; Receptor, IGF Type 1/*drug effects ; Simvastatin/*pharmacology