The ultrastructural changes of sciatic nerve and immunohistochemical changes of beta-catenin, PCNA, substance P were studied at the proximal segment of rat sciatic nerve after compression injury. We used 90 Sprague Dawley rats and the sciatic nerve compressed using silicon tube. We divided experimental groups which were the compression group for 1 hour (1C), for 2 hours (2C), and for 3 hours (3C), the release group for 1 day (1C1R) and 3 days (1C3R) after the compression for 1 hour, the release group for 1 day (2C1R) and 3 days (2C3R) after the compression for 2 hours, the release group for 1 day (3C1R) and 3 days (3C3R) after the compression for 3 hours. The rats were sacrified and took the sciatic nerve specimen. The specimens were investigated under the light microscope after hematoxylin & eosin, toluidin blue, and immunohistochemical stainings. In the H & E finding, the axon of the 1C disappeared, but recovered at the 1C3R. The part of nerve fibers at the 2C were swollen, but began to be partially recovered at 2C3R. Most nerve fibers were enlarged at the 3C, but markedly decreased at the 3C1R. The beta-catenin reaction disappeared at the 1C, but almost recovered at the 1C3R. This reaction of the 2C disappeared in the large fibers, but began to be recovered in the small fibers at the 2C1R. This reaction of the 3C disappeared in the large fibers, but began to be recovered at the 3C1R and 3C3R. The PCNA reaction prominently appeared at the 1C3R and 2C3R, the more prominent reaction at the 3C1R, and markedly increased reaction at the 3C3R. The substance P reaction of the 1C1R was mild positive, and the 2C1R and 3C1R were strong positive. In the toluidin blue staining, the myelin sheaths near the perineurium began to be thickened at the 1C, but almost recovered at the 1C3R. Many myelin sheaths became to be very thickened at the 2C and 3C, but almost recovered at the 2C3R and 3C3R. In the electron microscopic findings, the myelin sheaths of the 1C underwent the demyelination with the separated lamellae and the increase microtubules. At the 1C3R, the axolemma was attached on the myelin sheath and the axon was recovered. the myelin sheaths of the 2C underwent the demyelination with the separated axolemma. At the 2C1R, the myelin sheath was recovered by the developing Schwann cells, many intraaxonal mitochondria of demyelinated nerve fibers. At the 2C3R, the myelin sheath tended to be recovered by the increased rough endoplasmic reticulum and mitochondria of Schwann cells, many intraaxonal mitochondria of demyelinated nerve fibers. The myelin sheaths of the 3C began to be underwent severe demyelination from the middle portion of the sheath and the vacuolization of intraaxonal mitochondria. At the 3C1R, the myelin sheaths were recovered and contained many extended microtubules, mitochondria, and small granules. At the 3C3R, severe demyelinated nerve fibers were recovered by increasing microtubules. The proximal retrograde degeneration of sciatic nerve by the acute compression appeared the loss of the axons and the swelling of nerve fibers. The beta-catenin reaction was disappeared by the compression, but recovered by releasing. This reaction may be played a important role of the recover of demyelination. The PCNA reaction of Schwann cells was increased by the nerve compression. In the substance P finding, the pain after the compression appeared at the 1 day after releasing. Electron microscopic changes after sciatic nerve compression were the demyelination, the separated lamellae and the increase of intraaxonal microtubules. After releasing, the nerve fibers were recovered by developing Schwann cell, the intraaxonal mitochondria, and the transported granules through extending microtubules.
Animals ; Axons ; beta Catenin* ; Demyelinating Diseases ; Endoplasmic Reticulum, Rough ; Eosine Yellowish-(YS) ; Hematoxylin ; Microtubules ; Mitochondria ; Myelin Sheath ; Nerve Fibers ; Peripheral Nerves* ; Proliferating Cell Nuclear Antigen* ; Rats* ; Rats, Sprague-Dawley ; Retrograde Degeneration ; Schwann Cells ; Sciatic Nerve ; Silicones ; Substance P*

No abstract available.
Appendicitis* ; Barium* ; Enema*

BACKGROUND: We studied the accuracy, lateralization criteria of Wada test in patients with temporal lobe epilepsy(TLE). We also evaluated material specific memory and determined the stimulus which can classify best between right and left TLE among four different types of stimuli. METHODS: We examined Wada memory performance in 33 patients(15 left, 18 right) with TLE who underwent surgery and who were good seizure outcome at least 1 year follow-up. Twelve stimuli consited of figures, written words, geometric designs and real objects were presented after Amytal injection. The recognition memory test was performed at 10 minutes after the injection and hemisphere memory performance of each stimulus and total stimuli were obtained by(number of stimuli recognized / number of stimuli presented x 100%). Classification rate, best stimulus for lateralization, and suitable lateralization criteria were determined by discriminant analysis and Chi-square test. Hemispheric memory difference of each stimulus was analyzed by paired-sample Student's t-test in left temporal lobectomy(LTL) and right temporal lobectomy(RTL) groups. RESULTS: No significant difference was observed in pre-Wada memory score and in IQ between LTL and RTL group. The classification rate of Wada test in terms of lateralization by discriminant analysis was 81.82%. The accuracy was 75.8% at 10% and 15% lateralization criteria and was 63.6% and 45.5% at 20% and 25% lateraliza.
Amobarbital ; Classification ; Follow-Up Studies ; Humans ; Memory* ; Seizures ; Temporal Lobe

This is a report of 13 cases of surgically corrected ruptured aneurysm of the aortic sinus of Valsaha. The simultaneous trans-venous and trans-arterial catheterization and cineangiogram are the best diagnostic procedures. In 12 cases, the aneurysm originated from the right coronary sinus and only one from the noncoronary sinus. Eleven aneurysms ruptured into the right ventricle and 2 into the right atrium. Eight cases were associated with ventricular septa1 defect and 5 with aortic regurgitation. In three cases the Hancock porcine valve replacement was done. There was no surgical mortality.
Adolescent ; Adult ; Aortic Aneurysm/surgery* ; Aortic Rupture/diagnosis ; Aortic Rupture/surgery* ; Child ; Female ; Heart Catheterization ; Human ; Male ; Sinus of Valsalva/surgery*

Carbamylated hemoglobin (CarHb) is formed by the reaction of hemoglobin with cyanate derived from the spontaneous dissociation of in vivo urea. Previous studies have shown that formation of CarHb depends upon both the severity and the duration of renal failure. To study the clinical significances of CarHb in Korean patients with chronic renal failure, we measured CarHb levels by high-performance liquid chromatography in 159 CRF patients and 46 normal controls. Patients with CRF had a higher CarHb concentration than normal controls (107.9+/-58.8 vs 35.1+/-14.2 microgramVH/gHb; P<0.001). In patients with CRF, nondialysis group had a higher value than dialysis group (129.8+/-77.9 vs 98.7+/-46.1 microgramVH/gHb; P<0.05). There were no siginificant difference in CarHb levels between hemodialysis (92.0+/-35.8microgramVH/gHb) and peritoneal dialysis (106.7+/-55.3microgramVH/gHb) groups. CarHb levels were not different between diabetic and nondiabetic patients in predialysis and hemodialysis groups. Although there was a significant difference in peritoneal dialysis group, the BUN levels were also lower in diabetic patients than nondiabetic patients. There were no correlation between CarHb and HbA1c percentage in patients with diabetes. CarHb levels were positively correlated with BUN (r=0.489; P<0.001) and creatinine (r=0.458; P<0.01) concentrations. There were negative correlations between CarHb and both Kt/V (r=-0.358; P<0.05) and URR (r=-0.415; P<0.05) in hemodialysis patients. In conclusion, CarHb may be a useful index of uremic control in patients with chronic renal failure, and are independent of the mode of dialysis and the presence of diabetes.
Chromatography, Liquid ; Creatinine ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Renal Dialysis ; Renal Insufficiency ; Urea

Painful nociceptive informations are well known to be transferred from nociceptors through spinal dorsal horn not only in different pathways but also in diverse nature depending on the type of noxious stimuli. There have been some controversies about the role of neuropeptide somatostatin in the transmission of the nociceptive information to the dorsal horn cells of the spinal cord. We performed the study in order to elucidate the effects of somatostatin on transmission of noxious stimuli in the spinal dorsal horn, comparing with those of morphine. Using carbon-filamented microelectrode, the single cell activities of wide dynamic range(WDR) neuron were recorded extracellularly at the lumbosacral enlargement of the spinal cord in cats after noxious mechanical(squeeze), thermal(heat lamp), and cold(dry ice) stimulation to the receptive field. The sciatic nerve was stimulated electrically to evoke, A4-fiber and C-fiber each other. Data were compiled into single pass time histograms or postsimulus time histograms. Twenty micro-gram of somatostatin was injected intravenously to study the changes of single cell activities in 20 minutes, which were compared with the effects of morphine(2m/kg). Then naloxone was administrated(0.1mg/kg) to know whether it antagonized the effects of somatostatin and morphine And those finding were also observed in inverted WDR cells. In WDR cell, somatostain decreased the cellular responses to noxious heat stimuli in 6cell(n=9), but increased those to cold stimuli in 4 cells(n=6). And the responses to noxious mechanical stimuli were so diverse that they were slightly increased in 7 cells(164%), decreased in 5 cells, and were not changed in 6 cells(n=18). A-response, the response to peripheral Ad-afferent activation, showed a tendency to be facilitated(n=6/9), while C-response had a slightly depressed tendency(n=4/9). Morphine strongly suppressed the responses of dorsal horn neurons to noxious heat(n=9/13), cold(n=2/2), mechanical stimuli(n=16/19) and electrical A-response(n=7/10), C-response(n=6/7). Following subsequent injection of naloxone, the effects of morphine on noxious stimuli evoked response were fully reversed but those of somatostatin were not antagonized. There was significant difference between the reversal effects of naloxone on morphine and somatostatin(p<0.05). From the above results it is concluded that somatostatin suppresses the transmission of nociceptive heat stimuli, especially via C-fiber, while facilitates that of nociceptive mechanical and cold stimuli via Adelta-fiber in spinal dorsal horn cells. Also the somatostatin appears to have different nociceptive mechanism from morphine.
Animals ; Cats* ; Horns ; Hot Temperature ; Microelectrodes ; Morphine* ; Naloxone ; Neurons ; Neuropeptides ; Nociceptors ; Peripheral Nerves* ; Posterior Horn Cells* ; Sciatic Nerve ; Somatostatin* ; Spinal Cord

Interrupted aortic arch may be defined as a discontinuity of the aortic arch. This uncommon anomaly was first described by Steidele in 1778 and was later classified into 3 types by Celoria and Patton. We experienced the case of a 25-year-old male with an interrupted aortic arch(Type B) which was well supplied by collateral circulations. Ligation of collateral supplies and a Y-graft replacement from ascending aorta to descending thoracic aorta and left subclavian artery was done. Postoperative aortogram revealed no collateral circulations and good continuity of the aorta without narrowing of the anatomic site. During the period of 2-month follow up, the patient was able to lead a relatively active life.
Adult ; Aorta ; Aorta, Thoracic ; Collateral Circulation ; Equipment and Supplies ; Follow-Up Studies ; Humans ; Ligation ; Male ; Subclavian Artery

The delayed vasospasm after aneurysmal subarachnoid hemorrhage is the main cause of morbidity and mortality in the treatment of intracranial aneurysm. Of 158 cases of ruptured intracranial aneurysm treated with radical surgery from October 1994 to December 1996, there were 29 cases of symptomatic vasospasm. Of these 12 cases were treated by intraarterial papaverine injection and/or transluminal balloon angioplasty. Refractoriness to conservative medical therapy was the main indicaiton for the endovascular treatment. Intraarterial papaverine injection was done in 11 cases and balloon angioplasty in 8 cases. After endovascular treatment, angiographic improvement was achieved in 9 cases(75%). Clinical improvement within 24 hours after treatment was observed in 8 cases(66.7%). There were two cases of complication; rupture of MCA and thromboembolism of distal branch. Outcome at the time of discharge were good recovery in 8 cases, moderate disability in 2, and death in 2. It is suggested that the endovascular method can be considered to be effective and powerful tool for the treatment of symptomatic vasospasm after aneurysmal SAH. But the complications related with this should be borne in mind. Exact indication and proper timing of endovascular treatment are to be further studied.
Aneurysm* ; Angioplasty, Balloon ; Intracranial Aneurysm ; Mortality ; Papaverine ; Rupture ; Subarachnoid Hemorrhage* ; Thromboembolism ; Vasospasm, Intracranial*

This study was designed for the investigation of the effectiveness and limitation of the endovascular coil embolization of intracranial aneurysms. From July 1995 to October 1997, the authors treated 25 patients of intracranial aneurysm with endovascular coil embolization. There were 15 cases of ruptured aneurysms and 10 cases of unruptured aneurysms. The main reasons for the coil embolization were difficult anatomical location and poor neurological condition. Total 28 aneurysms were tried to embolize with coil. Among these, 12 aneurysms were occluded completely, 12 aneurysms partially, and 1 vertebral artery fusiform aneurysm was treated by coil occlusion of the proximal vertebral artery. The complete occlusion was possible in 10 cases of 15 small aneurysms(66.7%), and in 2 cases of 6 large aneurysms(33.3%). Only partial occlusion was achieved in all 3 giant aneurysms. Of 18 small neck aneurysms(4mm) could be occluded completely. There were 3 cases of failure, 2 cases being catherizatioin failure because of the tortuous vessel and 1 case due to local vasospasm. The complications related to the coil embolization were the perforation of the aneurysm caused by the catheterization in 2 cases, rebleeding after partial embolization of the aneurysm in 2 patients of Hunt-Hess grade 4 and 5, and infarction caused by parent vessel occlusion by coil protrusion in 2 cases. In conclusion, the coil embolization can be an alternative modality in the treatment of intracranial aneurysms. But the complete occlusion is not always possible in all cases, and the risk of the rebleeding is still remained in the partially occluded aneurysms. The long-term study is needed to confirm the definite effectiveness of the coil embolization in the treatment of intracranial aneurysms.
Aneurysm ; Aneurysm, Ruptured ; Catheterization ; Catheters ; Embolization, Therapeutic* ; Humans ; Infarction ; Intracranial Aneurysm* ; Neck ; Parents ; Vertebral Artery

BACKGROUND: It is well known that coronary arterial thrombosis plays an important role in the pathogenesis of acute coronary syndrome and this has focused interest on the role of the fibrinolytic system, especially tissue plasminogen activator(t-PA) and plasminogen activator inhibitor-1(PAI-1), which are major determinants of fibrinolytic system. But there are considerable variations in the reported association between these two components and acute coronary syndrome. METHODS: To evaluate association between t-PA, PAI-1 and myocardial infarction, plasma level of t-PA and PAI-1 in resting state and after venous occlusion were measured and analysed in patients with previous myocardial infarction at least 6 months after the acute phase, who showed less than 70% luminal narrowing angiographically and control group. The relationship between t-PA, PAI-1 antigen and activity and relation to age, serum triglyceride, cholesterol, and peak creatine kinase(CK) enzyme were also analyzed. RESULTS: 1) In resting state, there was a significant difference of plasma level of both t-PA and PAI-1 antigen, activity between patient and control group(10.72+/-3.28 vs 8.16+/-4.03ng/ml, 0.53+/-0.34 vs 0.02+/-0.07U/ml, 26.24+/-8.30 vs 20.82+/-8.82ng/ml, 14.62+/-5.97 vs 6.99+/-6.44U/ml)(p<0.05), and resting plasma level of PAI-1 activity showed a good correlation with peak creatine kinase(CK) enzyme(r=0.76, p<0.01). 2) After venous occlusion, plasma level of t-PA antigen was significantly increased(8.16+/-4.03 vs 9.87+/-3.86ng/ml)(p<0.05) whereas t-PA activity and PAI-1 antigen were not significantly changed in control group. In patient group, t-PA antigen, t-PA activity and PAI-1 antigen were significantly inceased after venous occlusion(10.72+/-3.28 vs 14.66+/-5.41ng/ml, 0.53+/-0.34 vs 1.41+/-1.69U/ml, 26.24+/-8.30 vs 29.87+/-8.78ng/ml)(p<0.05). PAI-1 activity was significantly decreased after venous occlusion in both groups(6.99+/-6.44 vs 6.06+/-5.99U/ml, 14.62+/-5.97 vs 12.67+/-6.46U/ml)(p<0.05). CONCLUSION: Both fibrinolytic and anti-fibrinolytic systems are augmented in resting and after fibrinolysis stimulation test in patient group. These findings suggested a impairment of fibrinolytic system in patient group and a possibility that both elevated plasma levels of t-PA and PAI-1 may be markers of coronary artery disease.
Acute Coronary Syndrome ; Cholesterol ; Coronary Artery Disease ; Creatine ; Fibrinolysis ; Humans ; Myocardial Infarction* ; Phenobarbital ; Plasma* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Thrombosis ; Tissue Plasminogen Activator* ; Triglycerides