This paper notes the effect of vasodilators on the cerebral vasospasm induced by experimental subarachnoid hemorrhage. Artificial subarachnoid hemorrhage produced by dual injection of non-heparinized autologous blood into the cisterna magna in rabbits with 72 hours interval gave rise to considerable narrowing or spasm of the basilar artery and its branches demonstrated by cerebral angiography. SAH was induced in 12 rabbits by injecting 1.3mL/kg or autologous fresh arterial blood into the cisterna magna, followed by suspending the rabbits in a head-down position at 30 degree for 1 hour in order to accumulate blood around the basilar artery. The animals were divided into 4 groups; a group receiving nifedipine, a group receiving aminophylline, a group receiving papaverine, a group receiving trifluoperazine HCl. Angiographically vertebrobasilar arterial spasm was demonstrated 3 days after the 2nd autologous blood injection into the cisterna magna. Radiographically visible spasm was resistant to the vasodilating drugs. Rabbits were sacrificed by the overdose injection of sodium phenobarbital at the end of experiment.
Aminophylline ; Angiography ; Animals ; Basilar Artery ; Cerebral Angiography ; Cisterna Magna ; Nifedipine ; Papaverine ; Phenobarbital ; Rabbits ; Sodium ; Spasm ; Subarachnoid Hemorrhage* ; Trifluoperazine ; Vasodilator Agents* ; Vasospasm, Intracranial*

We have experienced a rare case of multiple intracranial aneurysms associated with polycystic kidney and polycystic liver, which were incidental findings after minor leakage. A 57-year-old female was admitted with the chief complaint of severe headache under the impression of subarachnoid hemorrhage due to rupture of the intracranial aneurysm(which were appeared as the right middle cerebral artery and A-com aneurysm). The brain CT scan showed subarachnoid hemorrhage in the right sylvian fissure and the right temporal lobe. On physical examination, 2FB hard irregular palpable mass was noted on the right costal margin. On neurological examination, her neck was mildly stiff and other signs were within normal limit. We checked abdominal sonography, abdominal CT scan and carotid angiography preoperatively, and reviewed the literature about polycystic disease associated with intracranial aneurysm and discussed about it.
Angiography ; Brain ; Female ; Headache ; Humans ; Incidental Findings ; Intracranial Aneurysm* ; Liver ; Middle Aged ; Middle Cerebral Artery ; Neck ; Neurologic Examination ; Physical Examination ; Polycystic Kidney Diseases ; Rupture ; Subarachnoid Hemorrhage ; Temporal Lobe ; Tomography, X-Ray Computed

Two cases of the traumatic aneurysms of the pericallosal artery that occurred after closed head injury are reported. The mental deterioration, urinary in continence and crural-predominent hemiparesis are attributable to the delayed intracranial hemorrhage after rupture of the traumatic aneurysms of the pericallosal artery. As soon as the diagnosis has been confirmed by the cerebral angiography, surgical treatment is recommended to reduce the high mortality and morbidity and the procedure as in the congenital aneurysm.
Aneurysm* ; Arteries* ; Cerebral Angiography ; Diagnosis ; Head Injuries, Closed ; Intracranial Hemorrhages ; Mortality ; Paresis ; Rupture

The subacute necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease, is a benign, self-limited disorder of unknown cause. This rare disease is characterized by fever, lymphadenopathy, leukopenia, and elevated sedimentation rate. This disease preferentially affects young women. The diagnosis of this disease is confirmed by involved lymphnodes biopsy. Evidence for autoimmune dysfunction has been reported, but is usually lacking. According to the review of the literatures, a total of 192 cases of subacute necrotizing lymphadenitis were reported in Korea since 1983 mostly in literatures of pathology or internal medicine and only 7 cases in pediatrics. There was female predominance in a 141:51 ratio. However, among 25 cases of under 20 years of age, there was male predominance in a 16:9 ratio. The patients of under and over 20 years of age were 29 and 82, respectively among the age-known 111 cases of 192 reported. We experienced a 13-year-old boy, who had right cervical lymphadenitis with persisting high temperature and pain on lymph nodes for more than 10 days. An excisional cervical lymph node biopsy was performed and pathologic diagnosis was compatible with subacute necrotizing lymphadenitis. Most antibiotics were not effective, but fever subsided with one day of oral prednisolone therapy. Various laboratory studies for prolonged fever were negative except leukopenia and increased sedimentation rates. The CD4/CD8 ratios in acute and recovery stages were 1.1 and 1.5 respectively, showing mild decrease of CD4/CD8 ratio in the acute stage. Decreased T cell proportions in the acute stage were also noted.
Adolescent ; Anti-Bacterial Agents ; Biopsy ; Diagnosis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Internal Medicine ; Korea ; Leukopenia ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Lymphocyte Subsets* ; Lymphocytes* ; Male ; Pathology ; Pediatrics ; Prednisolone ; Rare Diseases

The subacute necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease, is a benign, self-limited disorder of unknown cause. This rare disease is characterized by fever, lymphadenopathy, leukopenia, and elevated sedimentation rate. This disease preferentially affects young women. The diagnosis of this disease is confirmed by involved lymphnodes biopsy. Evidence for autoimmune dysfunction has been reported, but is usually lacking. According to the review of the literatures, a total of 192 cases of subacute necrotizing lymphadenitis were reported in Korea since 1983 mostly in literatures of pathology or internal medicine and only 7 cases in pediatrics. There was female predominance in a 141:51 ratio. However, among 25 cases of under 20 years of age, there was male predominance in a 16:9 ratio. The patients of under and over 20 years of age were 29 and 82, respectively among the age-known 111 cases of 192 reported. We experienced a 13-year-old boy, who had right cervical lymphadenitis with persisting high temperature and pain on lymph nodes for more than 10 days. An excisional cervical lymph node biopsy was performed and pathologic diagnosis was compatible with subacute necrotizing lymphadenitis. Most antibiotics were not effective, but fever subsided with one day of oral prednisolone therapy. Various laboratory studies for prolonged fever were negative except leukopenia and increased sedimentation rates. The CD4/CD8 ratios in acute and recovery stages were 1.1 and 1.5 respectively, showing mild decrease of CD4/CD8 ratio in the acute stage. Decreased T cell proportions in the acute stage were also noted.
Adolescent ; Anti-Bacterial Agents ; Biopsy ; Diagnosis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Internal Medicine ; Korea ; Leukopenia ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Lymphocyte Subsets* ; Lymphocytes* ; Male ; Pathology ; Pediatrics ; Prednisolone ; Rare Diseases

OBJECTIVE: The molecules related with the intracellular signal transduction system are one of the main targets for the mode of mechanisms of antidepressant treatment in depressive patients. In vivo and in vitro studies have provided the evidence that the transcription factor, CREB (c-AMP response element binding protein) is the key mediator of the therapeutic response to antidepressants. We investigated the relationship between the treatment response to fluoxetine for 6 weeks and the change of CREB immunoreactivity in peripheral T lymphocyte. METHODS: CREB-expression and phosphorylation were quantified via western blot, and binding activity between transcription factor and CRE-oligonucleotide via electrophoretic mobility shift assay (EMSA) in nuclear extracts from 14 normal controls and 31 depressed patients at 0 and 6th week during fluoxetine treatment (20 mg/day). Responder was defined as the > or =50% of reduction or < or =7 of HAM-D score. We compared the changes of CREB during 6 weeks of fluoxetine treatment between drug responders and non-responders using SPSS11.0. RESULTS: After six weeks of treatment with fluoxetine, the drug responders showed a significant increase in CREB (p=0.024 by t-test) and p-CREB (p=0.045 by Mann-Whitney U test) compared with the non-responders. The change of CREB immunoreactivity was positively correlated with the change of p-CREB (r=0.770, p=0.000 by Spearman's rho), and the change of p-CREB was also positively correlated with CRE-DNA binding (r=0.753, p=0.000 by Spearman's rho). CONCLUSION: These results suggest that CREB response in peripheral lymphocyte may reflect and mediate the response to antidepressant treatment in depressed patients.
Antidepressive Agents ; Blotting, Western ; Depression ; Electrophoretic Mobility Shift Assay ; Fluoxetine ; Humans ; Lymphocytes* ; Phosphorylation ; Response Elements ; Signal Transduction ; Transcription Factors

OBJECTIVE: Extensive neuronal death occurring in the Alzheimer's disease (AD) may be related with the apoptosis. Recent studies have suggested that regulatory failure of cell cycle appeared to be very early event of AD pathogenesis in neuronal cells as well as in peripheral lymphocytes. We compared the change of cyclin dependent kinases (Cdks), which is related with G1/S phase transition in the cell cycle, between AD patients and normal controls using peripheral lymphocytes. METHODS: We obtained Cdks from peripheral lymphocytes of 37 AD patients and 18 age-matched normal subjects. Cells in first culture were considered to be G-zero (G0) cells. We measured Cdk2, Cdk4, and Cdk6 at baseline (T0). Thereafter, we observed Cdks 24 hours later after using PHA (phytohemaglutinin) (N24). Meanwhile, we observed Cdks 24 hours later again with rapamycin treatment (T24). RESULTS: At baseline (T0), Cdk2 and Cdk6 were increased in AD patients compared to the control group (p< 0.001, p=0.038, respectively). Cdk2 was increased in AD patients more than control group after using PHA (T24, p=0.007). After rapamycin treatment for 24 hours (N24), Cdk2, Cdk4, and Cdk6 were increased in the patients compared to the controls (p=0.002, p=0.022, p=0.011, respectively). CONCLUSION: This results showed that the cell cycle regulating proteins in AD patients, which are related with G1/S phase transition, were increased in peripheral lymphocytes compared to those in normal controls. We provide the clue which demonstrate the cell cycle dysregulation in the patients with Alzheimer's disease.
Alzheimer Disease* ; Apoptosis ; Cell Cycle* ; Cyclin-Dependent Kinases ; Humans ; Lymphocytes* ; Neurons ; Phase Transition ; Sirolimus

Cerebral cysticercosis is relatively common disease in Korea. But cysts in the ventricular system are rare form. In the ventricular system, they occur most frequently in the 4th ventricle, more rarely in the lateral and 3rd ventricle. We have recently experienced a case of cerebral cysticercosis which involved the 3rd ventricle. A sixty-year old man was admitted because of generalized seizure attack followed by drowsy mentation. On admission, there were no specific localizing and lateralizing neurological abnormalities except bilateral, mild degree optic papilledema. Brain CT scan after intraventricular metrizamide administration disclose a cystic mass in the third ventricle. And the serum ELISA test was positive(patient's titer : 0.31, normal : below 0.18). Anterior transcallosal approach was performed and cystic mass was removed from the third ventricle. Pathological diagnosis of the specimen was cysticercosis. Following surgery, the patient's symptom cleared up and papilledema disappeared gradually.
Brain ; Cysticercosis* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Korea ; Metrizamide ; Papilledema ; Seizures ; Third Ventricle ; Tomography, X-Ray Computed

Objectives : We developed the instrument to assess the quality of life(QOL) for demented patients, 'Geriatric Quality of Life-Dementia(GQOL-D)'. The purpose of this study was to standardize the GQOL-D and to introduce administration results in Korean demented patients. METHODS: The normal subjects were 340 elderly people, aged over 55 years old, who were physically and cognitively normal. And the patient group was consisted of 69 demented patients. RESULTS: Both in normal group and in patient group, the internal consistency, Cronbach's = 0.87, 0.90, respectively, and item-total correlation was acceptable. And the test-retest reliability revealed the stability across time by r=0.86, 0.77, respectively. Criterion validity was found to be a high correlation between each itemand overall QOL' item, and adequate correlations between the GQOL-D and scales assessing cognition, psychological wellbeing, behavior and activities of daily living convinced convergent validity. In the result of factor analysis, 2 factors with a variance percentage of 37.7% were extracted. The mean score and standard deviation of items of the GQOL-D for two groups and differences in items such as memory, recreation/leisure, self esteem, general health, and mobility between groups were presented. CONCLUSION: It was confirmed that there is no difficulty for old people to carry out the GQOL-D. As it was suggested that there is enough room for intervening in dementia patients' emotional and behavioral difficulties, the GQOL-D will be useful in research and clinical practice for the patients with dementia.
Activities of Daily Living ; Aged ; Cognition ; Dementia ; Humans ; Memory ; Middle Aged ; Quality of Life* ; Self Concept ; Weights and Measures

BACKGROUND: Heart Rate Variability help us to diagnose the impairment of autonomic nervous system in patients with diabetes, hypertension, ischemic heart disease, chronic renal disease, and arrhythmia. Change of autonomic nervous system is related to circadian rhythm, stress, physical activity, and so on. Especially, impairment of vagal nervous system with age help us to expect sudden cardiac death, myocardial infarction, and arrhythmia. So we survey heart rate variability by using 24 hours holter monitoring to expect impairment of autonomic nervous system in elderly hypertensive patients. METHODS: In order to assess 24 hours heart rate variability, we use Del Mar Avionics 563 holter monitoring on 11 elderly hypertensive patients( > or =65 years), 12 younger hypertensive patients( <65 years), and 15 normal subjects. RESULTS: 1) Standard deviation of mean R-R interval, LF(low frequency), HF(high frequency), TPSD(total power spectral density) are more decreased in elderly hypertensive patients than in younger hypertensive patients in 24 hours health rate variability analysis(t-test p<0.05). 2) According to age, elderly control group had lower LF power spectral parameter than younger control group had, but other parameters were not decreased, and elderly hypertensive group had lower LF, HF, TPSD, SD of mean R-R interval than younger hypertensive group did(p<0.05). 3) In circardian rhythm, normal subjects had high HF power spectral parameter and low LF power spectral parameter at evening and night. On the other hand, elderly hypertensive group had constant low level of LF, HF power spectral parameter during the day and night. CONCLUSIONS: On heart rate variability analysis using by 24 hours Holter monitoring, heart rate variability was decreased, and impairment of autonomic nervous system was accelerated in elderly hypertensive patients.
Aged* ; Arrhythmias, Cardiac ; Autonomic Nervous System ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Hand ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Motor Activity ; Myocardial Infarction ; Myocardial Ischemia ; Nervous System ; Renal Insufficiency, Chronic