Ubiquitin-positive neuritic threads (UNTS) in the hippocampal CA 2-3 region are reported to occur exclusively in association with so-called diffuse Lewy body disease (DLBD). hi order to assess the association between the occurrence of Lewy bodies (LBs) and that of the UNTs, an immunohistochemical study on the hippocampus including the parahippocampal gyrus with antiubiquitin antibody (Chemicon Co., California, U.S.A.) was perfon-ned in four groups of patient's brains. All brains were selected from the large pool of brains referred to the Neuropadiology Laboratory of the University of Minnesota for studies of Alzheimer's disease. Group 1 consisted of 34 cases (20 male and 14 female) with LBs widespread in the frontal and temporal cortex and the brain stem nuclei (basal nucleus, substantia nigra, locus ceruleus and dorsal vagal nucleus) associated with varying degrees of degeneration of the substantia nigra; 21 (11 male and 10 female) combined with and 13 (9 male and 4 female) without Alzheimer's disease (AD) pathology. Group 2 included 12 cases (9 male and 3 female) in which LBs were observed only in the brain stem nuclei; 7 with and 4 without AD pathology. Group 3 consisted of 30 cases (9 male and 21 female) without LBs but with AD pathology and degeneration of the substantia nigra. Group 4 included 23 cases (11 male and 12 female) with neither LBs nor AD pathology but with degeneration of the substantia nigra. Ages of the patients varied among the groups. In the 46 cases in the first two groups with LBs. The mean age in the 28 cases with AD pathology was 77.3+/-8.9 and in the 18 cases without AD pathology it was 71.6+/-8.8 (P<0.05). In the 53 cases in groups 3 and 4 without LBs, which served as the controls, the mean ages were 80.8+/-7.7 and 74.0+/-9.7 respectively. UNTs were encountered in all (100%) of 34 cases of group I with widespread LBs which met the histological criteria of DLBD regardless of combined AD pathology. In 12 cases of group 2 with LBs confined to the brain stem, UNTs occurred in 3 (25%), 1 with and 2 without AD pathology. hi the group 3 cases with only AD pathology, UNTs occurred in 4 (13%) of 30 cases, while no UNTs were encountered in the 23 cases of group 4 without AD pathology or LBs. In conclusion, UNTs in the hippocampal CA 2-3 region occur invariably but not exclusively in association with widespread LBs, frequently when LBs are confined to the brain stem, and infrequently with AD pathology. It seems, therefore, that the UNTs are closely related to LBs and increase in ftequency as LBs spread beyond the brain stem with time, but the pathogenesis of the UNTs is little understood.
Female ; Male ; Humans

Rat thalamocortical slices maintain synoptic connections between thalamus and cortex. When perfused with low Mg++-ACSF, thalamocortical slices exhibited two main types of spontaneous bursting activity. One is monotonic burst of 3-15 Hz and another is multiphasic bursts which have a tonic burst firing period and a late phase of clonic burst firing. These bursts are similar in frequency and during to EEG recordings from human generalized seizures. Exploiting the advantages of in vitro preparations, the electrophysiological action of taurine were studied. Exogeneous application of taurine profoundly decreased spontaneous bursting activities, which it caused only slight reduction of electrically evoked response in cortical layer. Taurine-induced current was blocked by 40 uM bicuculline, GABA receptor antagonist, in acutely isolated coritcal neurons. These results suggest that endogeneous taurine may regulate the hyperexcitablility through GABAa receptor.
Animals ; Bicuculline ; Electroencephalography ; Fires ; Humans ; Neurons ; Rats* ; Receptors, GABA ; Seizures* ; Taurine* ; Thalamus

Rat thalamocortical slices maintain synoptic connections between thalamus and cortex. When perfused with low Mg++-ACSF, thalamocortical slices exhibited two main types of spontaneous bursting activity. One is monotonic burst of 3-15 Hz and another is multiphasic bursts which have a tonic burst firing period and a late phase of clonic burst firing. These bursts are similar in frequency and during to EEG recordings from human generalized seizures. Exploiting the advantages of in vitro preparations, the electrophysiological action of taurine were studied. Exogeneous application of taurine profoundly decreased spontaneous bursting activities, which it caused only slight reduction of electrically evoked response in cortical layer. Taurine-induced current was blocked by 40 uM bicuculline, GABA receptor antagonist, in acutely isolated coritcal neurons. These results suggest that endogeneous taurine may regulate the hyperexcitablility through GABAa receptor.
Animals ; Bicuculline ; Electroencephalography ; Fires ; Humans ; Neurons ; Rats* ; Receptors, GABA ; Seizures* ; Taurine* ; Thalamus

PURPOSE: Uterine myoma is the most common benign uterine neoplasm, and assosiated with gynecologic and obsteric complications. Preoperative acurrate analysis of the number, location and type of the myoma is important, especially in reproductive women. We analyze the MR findings of uterine myoma for evaluation of the role of MR in diagnosis of uterine myoma. MATERIALS AND METHODS: We analyze MR findings of 76 myomas in 40 patients, and 34 myomas in 17 patients of them were confirmed by surgery. With 2. 0T Spectro-20000(Gold-star, Korea), TlWl axial images and T2Wl axial and sagittal images were obtained. Locations were classified into fundus, anterior body, posterior body, right body, left body, and cervix. Types were classified into submucosal, intramural, and subserosal. Associated findings were analiyed also. RESULTS: The most common location and type wre posterior body and intramural type, respectively. Ten myomas were confirmed on surgery only, and the causes were as follows:first, all 10 myomas were less than 2 cm in size;second, 1 subserosal myoma was abutted to a large ovarian mass;third, small myomas were abutted to each other, or small one was adjacent to larger one and considered as one large myoma. Degenerative change was noted in 50% of histologically confirmed cases. High signal halo on T2Wl was noted in 14%. CONCLUSION: MR is excellent in detection and localization of uterine leiomyoma larger than 2cm, and may be a preoperative diagnostic method of choice in patient who need myomectomy for preservation of childbearing function.
Cervix Uteri ; Diagnosis* ; Female ; Humans ; Leiomyoma* ; Myoma ; Uterine Neoplasms

A virus-associated hemophagocytic syndrome is characterized by high fever, liver dysfunction, coagulation abnormalities, pancytopenia, and a benign histiocytic proliferation with prominent hemophagocytosis in bone marrow, lymph node, spleen, and liver. Three phases of disease progression can be defined. In the first week, there is mild leukocytosis and myeloid hyperplasia in the marrow and the fever is resistant to antipyretics and antibiotics. In the second phase, usually corresponding to the 2nd to 3rd week of the illness, the fever persists and jaundice and hepatosplenomegaly may develop and the marrow now reveals the presence of atypical or transformed T lymphocytes and a scattering of histiocytes with hemophagocytosis. In the third phase, the disease progresses to a full-blown hemophagocytic syndrome with coagulopathy and lung infiltrates. The marrow in this stage is usually hypoplastic with florid histiocytic proliferation and hemophagocytosis and the patients usually die within 1-2 months. We describe a pregnant woman with fatal hemophagocytic syndrome. Virologic study strongly suggests that Epstein-Barr virus implicated in the pathogenesis of this patient.
Anti-Bacterial Agents ; Antipyretics ; Bone Marrow ; Disease Progression ; Female ; Fever ; Herpesvirus 4, Human* ; Histiocytes ; Humans ; Hyperplasia ; Jaundice ; Leukocytosis ; Liver ; Liver Diseases ; Lung ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Pregnancy* ; Pregnant Women ; Spleen ; T-Lymphocytes

PURPOSE: To investigate the usefulness of dynamic MR imaging in the differential diagnosis of brain tumors. MATERIALS AND METHODS: Dynamic MR imaging was performed in 43 patients with histopathologically proved brain tumrs. Serial images were sequentially obtained every 30 seconds for 3--5 minutes with use of spin-echo technique(TR 200msec/TE 15msec) after rapid injection of Gd-DTPA in a dose of 0.1mmol/kg body weight. Dynamics of contrast enhancement of the brain tumors were analyzed visually and by the sequential contrast enhancement ratio(CER). RESULTS: On the dynamic MR imaging, contrast enhancement pattern of the gliomas showed gradual increase in signal intensity(SI) till 180 seconds and usually had a longer time to peak of the CER. The SI of metastatic brain tumors increased steeply till 30 seconds and then rapidly or gradually decreased and the tumors had a shorter time to peak of the CER. Meningiomas showed a rapid ascent in SI till 30 to 60 seconds and then made a plateau or slight descent of the CER. Lymphomas and germinomas showed relatively rapid increase of Sl till 30 seconds and usually had a longer time peak of the CER. CONCLUSION: Dynamic MR imaging with Gd-DTPA may lead to further information about the brain tumors as the sequential contrast enhancement pattern and CER parameters seem to be helpful in discriminating among the brain tumors.
Body Weight ; Brain Neoplasms* ; Brain* ; Diagnosis, Differential ; Gadolinium DTPA ; Germinoma ; Glioma ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Meningioma

PURPOSE: To evaluate the usefulness of dynamic MR imaging in the differential diagnosis of intracranial tumorand abscess. MATERIALS AND METHODS: Dynamic MR images of 36 patients with surgically or clinically provenintracranial enhancing lesions were retrospectively reviewed. These lesions comprised 15 metastases, 14 gliomas,and seven abscesses. Images were sequentially obtained every 30 seconds for 3-5 minutes using the spin-echotechnique(TR/TE : 200 msec/15 msec) after bolus injection of gadolinium dimeglumine(2-3cc/sec). The dynamics ofcontrast enhancement of the lesions was analyzed visually and by calculating the sequential contrast-enhancementratio(CER). RESULTS: CER during the 30-second early dynamic phase was 93.16 in metastases, 67.78 in gliomas, and48.3 in abscesses(ANOVA, p<0.005). The contrast enhancement pattern of metastases showed rapidly increased signalintensity(SI) up to 30 seconds, followed by a relatively rapid decrease; less time was then required to reach theCER peak. In gliomas, SI increased gradually up to 180 seconds and then took a longer time to reach the CER peak.The SI of abscesses was similar to that of gliomas, with a more gradual increase for 30-60 seconds and a longertime for the CER peak to be reached. CONCLUSION: The contrast enhancement pattern and CER parameters seen ondynamic MRI can help differentiate intracranial tumor and abscess.
Abscess ; Brain Abscess* ; Brain Neoplasms* ; Brain* ; Diagnosis, Differential ; Gadolinium ; Glioma ; Humans ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Retrospective Studies

BACKGROUND: Tuberculous pleural effusion is the most common extrapulmonary site of all disease due to Mycobacterium tuberculosis. The diagnosis of tuberculous pleural effusion is most often established by histologic examination of pleural biopsy specimens. This study documents the utility of smear and culture of pleural fluid and pleural biopsy specimens for tubercle bacilli. METHODS: Between March 1998 and August 1999, we performed thoracentesis with or without pleural bio-psies on 148 patients with pleural effusion according to protocol with Abrams needle. Before the pleural biopsy, a diagnostic thoracentesis was performed. Aliquots of pleural fluid (30 mL) were submitted for biochemical, cytologic, and bacteriologic studies, Ziehl-Neelsen staining and culture in Lowenstein-Jensen medium. At least five samples of parietal pleural tissue were obtained, one for mycobacterial study and another for histologic study. RESULTS: Thirty-seven of the 148 patients were proved to have tuberculosis (24 men and 13 women) with a median age of 32 years (range, 21~91). Pleural biopsy was performed on 35 of the 37 patients with tuberculous pleural effusion. Granuloma was present in 33 of the 35 patients investigated with acid-fast bacilli in 9 patients. The smear for acid-fast bacilli of pleural fluid was positive in 1 patient and the culture for M. tuberculosis was positive in 5 of 37 patients. Pleural biopsy culture was positive in 3 of 35 patients. The 2 patients who could not carry out the pleural biopsy were positive in pleural fluid and pleural tissue mycobacterial culture, respectively. CONCLUSION: In our test, Ziehl-Neelsen staining and culture for M. tuberculosis of pleural fluid and pleural specimen gave a higher yield (5.4%) than the histologic methods alone in establishing the diagnosis of tuberculous pleural effusion.
Biopsy* ; Diagnosis ; Granuloma ; Humans ; Male ; Mycobacterium tuberculosis ; Needles ; Pleural Effusion* ; Prospective Studies* ; Rabeprazole ; Tuberculosis

It is well known that hypertension is associated with left ventricular diastolic dysfunction which frequently precede systolic dysfunction. To determine whether nifedipine could improve left ventricular diastolic function in hypertensive patients, we studied 15 hypertensive patients and 15 normotensive subjects matched for sex, age with Doppler echocardiography. After oral administration of 10mg of nifedipine, there were no significant changes in Doppler-derived transmitral diastolic filling indexes of normotensive subjects. On the other hand, although peak flow velocity in atrial systole(PFVA), time velocity integral in atrial systole(TVIA) did not change significantly after nifedipine, nifedipine significantly increased peak flow velocity in early diastole(PFVE) from 40.2+/-6.4cm/sec to 46.5+/-10.9cm/sec(p<0.005), time velocity integral in early diastole(TVIE) from 5.24+/-1.2cm to 5.97+/-1.43cm(p<0.001), the ratio of PFVE/PFVA from 0.69+/-0.11 to 0.76+/-0.12(p<0.05), the ratio of TVIE/TVIA from 1.18+/-0.21 to 1.29+/-0.24(p<0.05), deceleration slope(DS) from 244.9+/-51.9cm/sec2 to 289.9+/-49.1cm/sec2 (p<0.001) and decreased isovolumic relaxation time(IVRT) from 132.3+/-10.3msec to 117.2+/-13.5msec(p<0.001), deceleration time(DT) from 168.8+/-30.3msec to 154.9+/-29.8msec(p<0.05) in hypertensive patients. These fimdings indicated that nifedipine improves Doppler-derived early diastolic filling indexes in hypertensive patients and may be related to improvement of active relaxation of left ventricle in early diastole.
Administration, Oral ; Deceleration ; Diastole ; Echocardiography, Doppler* ; Hand ; Heart Ventricles ; Humans ; Hypertension ; Nifedipine* ; Relaxation

Glial cells play a critical role in morphine tolerance, resulting from repeated administration of morphine. Both the development and the expression of tolerance are suppressed by the analgesic lamotrigine. This study investigated the relationship between the ability of lamotrigine to maintain the antinociceptive effect of morphine during tolerance development and glial cell activation in the spinal cord. In a rat model, morphine (15 microg) was intrathecally injected once daily for 7 days to induce morphine tolerance. Lamotrigine (200 microg) was co-administered with morphine either for 7 days or the first or last 3 days of this 7 day period. Thermal nociception was measured. OX-42 and GFAP immunoreactivity, indicating spinal microglial and astrocytic activation were evaluated on day 8. Tolerance developed after 7 days of intrathecal morphine administration; however, this was completely blocked and reversed by co-administration of lamotrigine. When lamotrigine was coinjected with morphine on days 5-7, the morphine effect was partially restored. Glial cell activation increased with the development of morphine tolerance but was clearly inhibited in the presence of lamotrigine. These results suggest that, in association with the suppression of spinal glial cell activity, intrathecally coadministered lamotrigine attenuates antinociceptive tolerance to morphine.
Analgesics/*pharmacology ; Animals ; Antigens, CD11b/metabolism ; Astrocytes/cytology ; Drug Tolerance ; Immunohistochemistry ; Male ; Microglia/cytology ; Morphine/*pharmacology ; Nerve Tissue Proteins/metabolism ; Neuroglia/cytology/*metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord/*cytology ; Triazines/*pharmacology