There are much evidences to indicate that muscles and its tendon are inserted during the reperfusion phase of ischemia-reperfusion insults. However, until now the alterations of neurotransmitter induced by ischemia- reperfusion have not been examined in peripheral nervous system. This study reports the alterations of calcitonin gene-related peptide(CGRP) and substance P(SP) in the hindlimb ischemic model by immunohistochemical methods. In the control group, the CGRP and SP immunoreactivity was observed in nerve terminals of gastrocnemius muscle and its tendon. In the dorsal root ganglia, CGRP immunoreactivity was shown in the large A cell and small B cell. On the other hand, SP immunoreactvity was predominantly detected in small B cells. The CGRP immunoreactivity in the gastrocnemius muscle increased significantly in 2 hour ischemic group, but decreased in its tendon. The SP immunoreactivity, however, was declined in the gastrocnemius muscle as well as its tendon in 2 hour ischemic group. The CGRP immunoreactivity in the dorsal root ganglia was significantly decreased, particularly in large A cell, compared to the control group. The SP immunoreactivity in the dorsal root ganglia, on the other hand, was markedly increased. In conclusion, these results suggest that the ischemia may evoke the alteration of neurotransmitter expressions as well as the muscle degeneration, and that the changes of neuropeptide distribution induced by ischemia show the difference from the kind of neuropeptides.
Animals ; B-Lymphocytes ; Calcitonin ; Calcitonin Gene-Related Peptide ; Ganglia, Spinal* ; Hand ; Hindlimb ; Ischemia* ; Muscle, Skeletal* ; Muscles ; Neuropeptides* ; Neurotransmitter Agents ; Peripheral Nervous System ; Rats* ; Reperfusion ; Spinal Nerve Roots* ; Substance P ; Tendons

Pro-oxidant properties of ascorbate have been studied with uses of brain tissues and neuronal cells. Here we address potential mechanism of ascorbate coupling with glutamate to generate oxidative stress, and the role which oxidized ascorbate (dehydroascorbate) transport plays in oxidative neuronal injury. Ascorbate in neurones can be depleted by adding glutamate in culture medium since endogenous ascorbate can be exchanged with glutamate, which enhances ascorbate/ dehydroascorbate transport by depleting ascorbate in the neurons with the glutamate-heteroexchange. However, ascorbate is known readily being oxidized to dehydroascorbate in the medium. Glutamate enhanced the dehydroascorbate uptake by cells via a glucose transporter (GLUT) from extracellular region, and cytosolic dehydroascorbate enhanced lipid peroxide production and reduced glutathione (GSH) concentrations. Iso-ascorbate, the epimer of ascorbate was ineffective in generating the oxidative stress. These observations support the current concept that the high rates of dehydroascorbate transport via a GLUT after the release of ascorbate by glutamate leads to peroxidation, the role of glutamate on ascorbate/ dehydroascorbate recycling being critical to induce neuronal death via an oxidative stress in the brain injury.
Animals ; Ascorbic Acid/analogs & derivatives/pharmacology ; Biological Transport/drug effects ; Cerebral Cortex/*drug effects/*metabolism ; Cytochalasin B/pharmacology ; Dehydroascorbic Acid/*metabolism ; Glutamic Acid/*pharmacology ; Glutathione/metabolism ; In Vitro ; Lipid Peroxidation/*drug effects ; Male ; Oxidation-Reduction/drug effects ; Oxidative Stress/drug effects ; Rats ; Rats, Sprague-Dawley ; Thiobarbituric Acid Reactive Substances/metabolism

BACKGROUND: It is well known that intracoronary thrombolysis during the early period of acute myocardial infarction leads to the limitation of myocardial necrosis, preserves left ventricular function, and improves survivals. The recanalization rate of intracoronary rrokinase infusion into infarct-related coronary artery was known as 62-94 percents in previos studies. The various factors influence the outcome of intracoronary thrombolysis, including total dose of urokinase, time from onsrt of chest pain to thrombolysis. The purpose of this study was to evaluate whether the occlusion site morphology influences recanalization rates of intracoronary thrombolysis. METHODS: We evaluated infarct-related coronary artery morphology of 56 acute mycardial infarction patients who performed intracoronary thrombolytic therapy within 6-12 hours after the onset of acute myocardial infarction. Intracoronary urokinase infusion was performed at a rate of 25000 IU/minute. The presence of calcification, collaterals, side branches and the stump site morphologies(thrombus type, pencil type, cutting type) were identified on magnified 35mm cine frames. RESULTS: Reperfusion was successed in 34 patients and failed in 22 patients. There were no statistically significant difference in the pressure of calcification, collaterals, and side branches between success and failure groups. Intracoronary thrombus was identified in 21 percent of success group, but not in failure group. The reperfusion rates according to stump site morphology were 76% in thrombus type, 58% in cutting type, and 42% in pencil type(p<0.05). CONCLUSION: Our study indicates the presence of intracoronary thrombus and the morphology of thrombus type is more effective in intracoronary thrombolysis in acute myocardial infarction. The identification of types of the coronary obstruction will be helpful for the selection of intracoronary thrombolysis in acute myocardial infarction patients. And the results suggest that the difference of stump composition show different stump morphologies.
Chest Pain ; Coronary Vessels* ; Humans ; Infarction ; Myocardial Infarction* ; Necrosis ; Reperfusion ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Ventricular Function, Left

No abstract available.
Dyspnea* ; Humans

BACKGROUND AND OBJECTIVES: The myocardial protective effect of ischemic preconditioning is well known. However, the mechanism is remains unclear. The purpose of this study is to determine the role of adenosine, protein kinase C, KATP channel and the change of monophasic action potential duration on cardioprotective effect of ischemic preconditioning in cat. Materials AND METHODS: In this experiment, 66 cats were allocated into 7 groups:control (n=10), ischemic preconditioning (n=10), adenosine pre-treated (n=10), SPT (8-p-sulfophenyl theophylline) pre-treated (n=9), polymyxin B pre-treated (n=9), glibenclamide pre-treated (n=9) and nicorandil pre-treated (n=9) groups. Ischemic preconditioning was performed in ischemic preconditioning, SPT pre-treated, polymyxin B pre-treated and glibenclamide pre-treated groups by 3 episodes of 5 minutes ischemia and 10 minutes reperfusion. All animals were subjected to 40 minutes of ischemia and 40 minutes reperfusion. Monophasic action potential duration at 50% repolarization (MAP50) was measured in the ischemic and non-ischemic area respectively by epicardial probe throughout the experiment. The effect of ischemic preconditioning was determined by infarct size (% area at risk). RESULTS: Ischemic preconditioning, adenosine pre-treatment and nicorandil pre-treatment groups demonstrated a significant reduction in infarct size (26+/-4%, 25+/-4% and 34+/-8% infarction of the risk zone, respectively, p<0.01, p<0.01 and p<0.05 vs. control) with respect to control (41+/-8% infarction of the risk zone). However, pretreatment with SPT, polymyxin B or glibenclamide abolished the effect of ischemic preconditioning. Ischemic preconditioning group exhibited a significant reduction of MAP50 duration in the ischemic area during preconditioning;at the first preconditioning 128+/-11 msec vs. 144+/-10 msec control, at the second preconditioning 110+/-10 msec vs.147+/-10 msec control (p<0.01), at the third preconditioning 114+/-10 msec vs. 145+/-11 msec control (p<0.05). But, pretreatment with SPT, polymyxin B and glibenclamide prevented the reduction of MAP50 in the ischemic area during ischemic preconditioning. During 40 minutes ischemia, the shortening of MAP50 was more pronounced in the preconditioned group than in control group;at 5 minutes 112+/-13 msec vs. 124+/-10 msec control, at 10 minutes 89+/-12 msec vs. 133+/-11 msec control (p<0.05 ), at 20 minutes 93+/-12 msec vs. 136+/-11 msec control (p<0.05), and at 30 minutes 107+/-19 msec vs. 144+/-14 msec control (p<0.05). In adenosine pre-treated group, the MAP50 was significantly shortened than control group throughout 40 minutes occlusion period;at 5 minutes 90+/-8 msec (p<0.05), at 10 minutes 77+/-9 msec (p<0.05), at 20 minutes 92+/-8 msec (p<0.05), and at 30 minutes 103+/-8 msec (p<0.05). Nicorandil pretreatment pronounced the ischemic shortening of MAP50 in ischemic area and the effect was significant during early ischemic period;at 10 minutes 98+/-22 msec (p<0.05 vs. control). In pretreatment groups with SPT, polymyxin B or glibenclamide, the ischemic preconditioning of MAP50 measured in non-ischemic area was not significantly different compared with control group. MAP50 measured in ischemic area during reperfusion was not significantly different between groups. CONCLUSION: Based on this study, adenosine receptor-protein kinase C-KATP channel activation and monophasic action potential duration shortening during ischemia play an important role in myocardial protection during ischemic injury.
Action Potentials* ; Adenosine* ; Animals ; Cats* ; Glyburide ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Nicorandil ; Phosphotransferases ; Polymyxin B ; Protein Kinase C* ; Protein Kinases* ; Receptors, Purinergic P1* ; Reperfusion

Patients with acute coronary syndromes (ACS) who are accompanied by atypical symptoms are frequently misdiagnosed and under-treated. This study was conducted to examine and compare the factors associated with atypical symptoms other than chest pain in younger (<70 yr) and older (> or =70 yr) patients with first-time ACS. Data were obtained from the electronic medical records of the patients (n=931) who were newly diagnosed as ACS and hospitalized from 2005 to 2006. The 7.8% (n=49) of the younger patients and 13.4% (n=41) of the older patients were found to have atypical symptoms. Older patients were more likely to complain of indigestion or abdominal discomfort (P=0.019), nausea and/or vomiting (P=0.040), and dyspnea (P<0.001), and less likely to have chest pain (P=0.007) and pains in the arm and shoulder (P=0.018). A logistic regression analysis showed that after adjustment made for the gender and ACS type, diabetes and hyperlipidemia significantly predicted atypical symptoms in the younger patients. In the older patients, the co-morbid conditions such as stroke or chronic obstructive pulmonary disease were positive predictors. Health care providers need to have an increased awareness of possible presence of ACS in younger persons with diabetes and older persons with chronic concomitant diseases when evaluating patients with no chest pain.
Abdominal Pain/etiology ; Acute Coronary Syndrome/complications/*diagnosis ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Diabetes Mellitus/etiology ; Dyspnea/etiology ; Female ; Humans ; Hyperlipidemias/etiology ; Male ; Middle Aged ; Nausea/etiology ; Odds Ratio ; Predictive Value of Tests ; Pulmonary Disease, Chronic Obstructive/etiology ; Regression Analysis ; Risk Factors ; Stroke/etiology ; Vomiting/etiology

BACKGROUND: Smoking-related chronic obstructive pulmonary disease and chronic asthmatic bronchitis, which are the most important causes of chronic airflow obstruction (CAO), can occur together in a pat,ient and the prognoses of these two diseases are different each other. OBJECTIVE AND METHOD: To estimate the extent of asthmatic component in patients with CAO and to evaluate the role of atopy as a predictable index for reversibility of airflow obstruction, 89 CAO patients who were older than 40 years were examined retrospectively. RESULT: Only 15 patients (16.8%) showed an increase of >15% in FEV20 to inhaled salbutamol (short-term responder). However, 18 out of 32 patients (56.3%), who were not responded significantly to inhaled bronchodilator and performed a follow-up lung function study, showed an increase of ) 15% in FEV20 to anti-asthmatic therapy including corticosteroid for 3-4 weeks (long-term responder). Peripheral blood eosinophil count only was different between short-term responder and short-term nonresponder, and there was no difference in all of the measurements between short-term responder and long-term responder. However, there were significant differences in smoking, wheezing on auscultation, peripheral blood eosinophil counts, serum total IgE levels, and MAST atopy score between long-term responder and long-term nonresponder. The increase in FEV, following shortor long-term therapy was related to peripheral blood eosinophil counts and MAST atopy score, and it was significantly great,er in patients with high eosinophil counts or high atopy score. CONCLUSION: About 2/3 of patients with CAO who were older than 40 years had an asthmatic component ap atopy may be useful to predict good bronchodilator response to anti-asthmatic therapy.
Albuterol ; Auscultation ; Bronchitis ; Eosinophils ; Follow-Up Studies ; Humans ; Immunoglobulin E ; Lung ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Sounds ; Retrospective Studies ; Smoke ; Smoking

OBJECTIVES AND METHODS: The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. RESULTS: Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinorna: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer..patients was 32.y %(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+GEM>22%) in lung cancer patients was 42.9% (15/35), but none in benign diseases. In (iffy-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. CONCLUSIONS: The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.
Aneuploidy ; Biopsy ; Cell Cycle ; Diagnosis ; Diploidy ; DNA* ; Flow Cytometry ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Neoplasms, Squamous Cell ; Ploidies* ; Surgical Instruments ; Thoracotomy

OBJECTIVE: Closure of a low transverse cesarean incision with one layer and two layer, we compared operative time, hemostasis, blood loss and postoperative sonohysteroperitoneographic findings. Study design: At our hospital 103 women were randomized to closure of a low transverse cesarean incision with either one continuous layer of a locking No. 1 chromic suture or two continuous of No. 1 chromic suture with the first layer locked between Mar. 1, 1998 and Dec. 31, 1998. After three months later, sonhysteroperitoneography was taken and then we evaluated uterus indirectly. RESULTS: A one layer closure required less operative time, 16 versus 20.8 minutes (p<0.01), less hemoglobin change, 0.44 versus 1.3 (p<0.01) and less suture materials (p<0.01). But postoperative follow up sonohysteroperitoneography, a one layer closure shows slightly thinning of isthmic layer of myometrium, two layer closure shows more adhesional band and both are similar other findings. CONCLUSION: A one layer does not significantly affect the clinical course than traditional two layer closure. So we recommended a one layer closure when its use is anatomically feasible.
Animals ; Female ; Follow-Up Studies ; Hemostasis ; Humans ; Mice ; Myometrium ; Operative Time ; Sutures ; Uterus

BACKGROUND: The Amplified Mycobacterium tuberculosis Direct Test (AMTDT) has been developed for the direct detection of M. tuberculosis complex in respiratory specimens. Traditional methods for diagnosis of extrapulmonary tuberculosis such as the acid-fast bacilli (AFB) stain have their well-known limitations. We investigated the usefulness of the AMTDT for a wide range of non-respiratory specimens to establish early diagnosis of extrapulmonary tuberculosis. METHODS: 346 specimens (219 urine, 117 pleural fluid, 6 ascitic fluid, 2 lymph node, 1 gastric aspirate, and 1 pus specimens) from 340 patients referred from November 1997 to September 1998 were tested by the AMTDT. The AMTDT results were evaluated by comparing with clinical diagnosis and smear results. RESULTS: The overall sensitivity, specificity, and positive and negative predictive values of the AMTDT were 82.9%, 93.8%, 64.2%, and 97.6%, respectively. There were no difference in sensitivity and specificity between pleural fluid and urine specimens. In 31 specimens from tuberculosis patients concurrently tested with AMTDT and stain, 15 were only AMTDT positive and 4 were only stain positive. Among the results considered to be false positive, 47.2% of cases were shown as being less than 150,000 relative light units (RLU). In 30 specimens from tuberculosis patients during or after treatment, all six of the patients with reactivation or aggravation were AMTDT positive, and one case was considered to be false positive. CONCLUSIONS: Our study demonstrates the efficacy of the AMTDT in diagnosing extrapulmonary tuberculosis. Prudent interpretation of the AMTDT's results is recommended in case of that being less than 150,000 RLU.
Ascitic Fluid ; Diagnosis ; Early Diagnosis ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Suppuration ; Tuberculosis