Aneurysms of the coronary arteries are rare. They may be due to atheroselerosis, mucocutaneous lymph node syndrome, mycotic emboli, syphilis or trauma and occasionally they are congenital. The prognosis appears to be poor and death can occur suddenly from rupture of the aneurysm, peripheral coronary embolism or bacterial endocarditis. Recently surgical treatment has been successful. In a 5 year old patient with ventricular septal defect, two aneurysmal sacs located at the cardiac crux and just posterior to it was proved by coronary angiography and MRI, and successfully excised at operation.
Aneurysm* ; Child, Preschool ; Coronary Angiography ; Coronary Vessels* ; Embolism ; Endocarditis, Bacterial ; Heart Septal Defects, Ventricular ; Humans ; Magnetic Resonance Imaging ; Mucocutaneous Lymph Node Syndrome ; Prognosis ; Rupture ; Syphilis

OBJECTIVE: To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis in patients who had failed medical management. METHODS: A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. RESULTS: There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from 3.78+/-0.78 preoperatively to 4.78+/-0.35 at final follow up and mean VAS score was improved from 7.43+/-0.54 to 2.07+/-1.12. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. CONCLUSION: According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.
Anti-Bacterial Agents ; Bone Transplantation ; Coinfection ; Debridement ; Decompression ; Discitis ; Female ; Follow-Up Studies ; Humans ; Liver Diseases ; Male ; Military Personnel ; Mycobacterium tuberculosis ; Spine ; Staphylococcus ; Transplants ; Tuberculosis ; Tuberculosis, Pulmonary

The study of blink reflexes was carried out to demonstrate the correlations, if there were, between the stage of diffuse axonal injury(DAI) and the abnormality of blink reflexes. The blink reflex was recorded in 20 healthy adult subjects and 22 patients with DAI who were classified according to Adams' classification(DAI I; 7, DAI II; 9 and DAI III; 6). The latencies and amplitudes of R1 and R2 in patients with DAI were compared with those of healthy subjects. The results were as follows; 1) In 20 subjects of patient group, the latencies of R1 were all within a normal range. In 2 subjects, the difference in latencies between the two sides was above 1.4 msec. 2) In 15 subjects, R2 was absent or delayed, and reduced in the size of amplitude in all. Nine were affected bilaterally, and 4 were unilaterally. 3) Seventy one percent of patients in each stage represented abnormal findings. 4) There were no correlations between the DAI stage and the blink reflex. This study demonstrated that the polysynaptic R2 was more profoundly suppressed than the oligosynaptic R1 in a diffuse axonal injury because of a loss or decrease of suprapontine facillitation, which influenced the trigeminal spinal complex and the interneuron of lateral reticular formation.
Adult ; Axons ; Blinking* ; Diffuse Axonal Injury* ; Humans ; Interneurons ; Reference Values ; Reticular Formation

No abstract available.
Drug Therapy* ; Humans* ; Leukopenia*

No abstract available.
Endometrial Neoplasms* ; Female

Accidents, Occupational ; Accidents, Traffic ; Brain ; Diagnosis ; Facial Bones ; Female ; Frontal Bone ; Frontal Sinus ; Headache Disorders ; Humans ; Male ; Maxilla ; Nose ; Postoperative Complications ; Sex Ratio ; Surgery, Oral

Collagen ; Head ; Maxilla ; Maxillary Fractures ; Maxillary Sinus ; Mouth ; Mucous Membrane ; Nasal Cavity ; Neck ; Orbit ; Postoperative Complications ; Zygoma

The erectile response is peripherally mediated by cavernous nerve that contains thoracolubar sympathetic nerve and sacral parasympathetic nerve. It is known that thoracolubar sympathetic nerve involves in detumescence and sacral parasympathetic nerve in tumescence, however there are some opinions that rhoracolubar sympathetic nerve participates in psychogenic erectile mechanism. We previously reported that by the comparison with electrostimulation-induced erection, apomor- phine-induced erection was a vascular event. The aim of our study was to determine the infraspinal neural pathway of APO-induced erection. The sham operated rats remained normal in all measured respects. All rats having undergone neurotomy ot the hypogastric nerves showed APO-induced erection except one. The only 5 rats having undergone neurotomy of the pelvic nerves showed APO-induced erection. Erections could be elicited upon cavernous or pelvic nerves stimulation in all rats having undergone neurolomy of the hypogastric nerves. Among 17 rats having undergone neurotomy of the pelvic nerve erection could be elicited upon cavernous nerves slimulation in 14 rats, however. the intracavernous pressure (47.9+/-16.5 mmHg) was lower than that found in sham-operated rats. Erectile response in these 14 rats appeared to result from stimulation of penile neurons coming from the major pelvic ganglion. In contrast to no response in sham-operated rats, stimulation of the hypogastric nerves also resulted in erections in 7 out of 17 rats. In conclusion, this present study suggests that APO-induced ereclion is primarily mediated via the sacral parasympathetic nerve system and may be mediated by the thoracolumbar sympathetic pathway following injury to the parasympathetic nerve system. Furthermore we can guess the possibility that the neural pathway of psychogenic erection is same that of AP0- induced erection.
Animals ; Apomorphine ; Ganglion Cysts ; Models, Animal* ; Neural Pathways* ; Neurons ; Rats*

OBJECTIVES: There are evidences of apoptotic neuronal cell death in Alzheimer's disease (AD). Recent studies suggested AD pathogenesis in the central nervous system as well as in peripheral lymphocytes. The object of this study is to compare the cell viability and the proliferation activity in AD patients with healthy normal control by using peripheral lymphocytes. METHODS: We analyzed the cell viability and the proliferation activity of phytohemagglutinin (PHA)-activated lymphocytes from 73 AD patients and 31 normal contols. The cell viability and the proliferation activity were measured at baseline (T0), 24 hours (T24), 48 hours (T48), 72 hours (T72), 96 hours (T96), by the tryphan blue method and the BrdU proliferation activity method, respectively. RESULTS: The cell viability of PHA-activated peripheral lymphocytes in AD patients was significantly decreased at T72, T96 compared with healthy controls (F=8.034, p<0.001). In AD patients, the decline of proliferation activity appeared in earlier than healthy normal controls. CONCLUSION: This study suggests that there is a decreased cell viability and the proliferation activity of peripheral lymphocytes in AD patients. These finding may be related with the increased apoptosis in Alzheimer's disease.
Alzheimer Disease* ; Apoptosis ; Bromodeoxyuridine ; Cell Death ; Cell Survival* ; Central Nervous System ; Humans ; Lymphocytes* ; Neurons

Matrix metalloproteinases (MMPs) are a family of host-derived proteolytic enzymes and implicated in the remodeling and degradation of extracellular matrix under both physiological and pathological conditions. Connective tissue degradation in periodontal diseases is thought to be due to excessive MMP activities over their specific inhibitors. The effects of lipopolysaccharide (LPS) from Prevotella intermedia, one of the major putative pathogens of periodontitis, on the expression of mRNA for MMPs and tissue inhibitors of metalloproteinases (TIMPs) in human gingival and periodontal ligament fibroblasts were examined by reverse transcriptase-polymerase chain reaction (RT-PCR). The expression of mRNAs encoding MMP-1, -2, -3, -10, and -14 was increased in human gingival fibroblasts treated with P. intermedia LPS, whereas MMP-11 and TIMP-2 mRNA expression was decreased in these cells stimulated with LPS. P. intermedia LPS increased the MMP-1, -2, -10, -11, and -14 mRNA expression and decreased TIMP-1 and -2 mRNA expression in human periodontal ligament fibroblasts. These findings imply that P. intermedia LPS may play an important role in the connective tissue degradation in periodontitis.
Connective Tissue ; Extracellular Matrix ; Fibroblasts* ; Humans* ; Matrix Metalloproteinases* ; Metalloproteases* ; Peptide Hydrolases ; Periodontal Diseases ; Periodontal Ligament* ; Periodontitis ; Prevotella intermedia* ; Prevotella* ; RNA, Messenger* ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2