No abstract available.
Aneurysm* ; Carotid Artery, Internal*

Over the past few decades, interest in minimally invasive spine surgery (MISS) has increased tremendously due to its core principle of minimizing approach-related injury while providing outcomes similar to traditional open spine procedures. With technical and technological advancements, MISS has expanded its utility not only to simple spinal stenosis, but also to complex spinal pathologies such as metastasis, trauma, or adult spinal deformity. In this article, we review the techniques and technology in MISS and discuss the indications, benefits, and limitations of MISS.

BACKGROUND: The antitumor effects of herpes simplex virus thymidine kinase(HSV-tk) and ganciclovir(GCV) strategies for cancer gene therapy have a the following advantages:1) a direct cytotoxicity to HSV-tk modified cancer cells by GCV 2) a cell death by the local transfer of toxic metabolites from the HSV-tk modified cells to nearby unmodified tumor cells(bystander effect), and 3) in vivo bystander effect such as antitumor-immunity. Retroviral and adenoviral sequences can silence transgene expression in cells and mice. In this study, we investigated the above described advantages of HXV-tk/GCV strategy in Lewis lung cell and mouse lung cancer model using retroviral vector and adenoviral vector. Also, we observed whether the expression of a silenced gene can be reactivated by treating cell with butyrate. METHODS: Retrovirus-HSV-tk and adenovirus-HSV-tk vectors were used for the transduction of Lewis lung carcinoma(LLC) cells. The change of HSV-tk expression by butyrate was measured by Western blot.The antitumor activities containing bystander effect were observed in vivo(by MTT assay) and in vivo tumor models of various combinations of LLC and LLC-tk. RESULTS: 1. Butyrate induced the enhancement of HSV-tk expression from adenovirally transduced cells but not from retrovirally transduced cells. 2. Both retrovirus-HSV-tk and adenovirus-HSV-tk vectors with GCV treatment were effective for killing of tumor cell in vitro and suppression of LLC tumorigenicity. Bystander effect was responsible for killing of mixture of LLC-tk and LLC in vitro and in vivo-tumorigenicity model. CONCLUSION: Butyrate could augment adenoviral vector seems to be an effective approach for lung cancer therapy.
Adenoviridae ; Animals ; Butyrates ; Bystander Effect ; Carcinoma, Lewis Lung* ; Cell Death ; Genes, Neoplasm ; Genetic Therapy* ; Herpes Simplex* ; Homicide ; Lung ; Lung Neoplasms ; Mice* ; Phosphotransferases* ; Retroviridae ; Simplexvirus* ; Thymidine ; Transgenes ; Zidovudine*

BACKGROUND: Nitric oxide (NO) may act as an oxygen radical scavenger or as an antioxidant, and inhibit neutrophil superoxide anion production. In contrast, NO combines with superoxide to form peroxynitrite, a very damaging material whose decomposition RESULTS in the generation of a hydroxyl radical. This study was designed to determine the role of NO in the development of acute lung injury and lipid peroxidation induced by lipopolysaccharide (LPS) in rats. METHODS: Male Sprague-Dawley rats (200 - 250 g) were given one of the following treatments; intraperitoneal normal saline 0.5 ml, intraperitoneal E. coli LPS (5 mg/kg) in 0.5 ml normal saline, 4 mg/kg L-N(6)-(1-iminoethyl)lysine (L-NIL) + LPS, or L-arginine (80 mg/kg) + LPS. Four hours after treatment, the rats were killed by an intraperitoneal pentobarbital injection (100 mg/kg) and plasma nitrate/nitrite concentration (Griess reagents) and lipid peroxide (LPO) concentration of the lung (Yagi's method) were measured (n = 8). In the other sets of experiments, myeloperoxidase activity of the lung (n = 5) and protein concentration of the bronchoalveolar lavage (BAL) fluid (BCA protein assay reagents, n = 4) were assayed. RESULTS: LPS treatment increased plasma nitrate/nitrite concentrations approximately 6 times (20.9 1.8nM, P < 0.01) compared with the control group (3.6 +/- 0.7nM), and L-NIL treatment prevented this increase. L-NIL plus LPS treatment resulted in greater increase of LPO concentrations of the lung compared with the control (P < 0.05). Myeloperoxidase activity and protein concentrations of BAL fluids were higher in LPS and L-NIL plus LPS treatment groups than the control group. CONCLUSIONS: These results suggest that inhibition of the increase of NO by selective inducible NO synthase inhibitor L-NIL may increase lipid peroxidation in septic rats.
Acute Lung Injury* ; Animals ; Arginine ; Bronchoalveolar Lavage ; Humans ; Hydroxyl Radical ; Indicators and Reagents ; Lipid Peroxidation* ; Lung ; Male ; Neutrophils ; Nitric Oxide Synthase ; Nitric Oxide* ; Oxygen ; Pentobarbital ; Peroxidase ; Peroxynitrous Acid ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Superoxides

No abstract available.

BACKGROUND: Portable glucometers are often utilized at the patient's bedside in the ICU or operating room for frequent measurements of the blood glucose concentration. Many of these devices are based on a glucose oxidase method that may be influenced by PO2. The aim of this study was to evaluate the influence of a high PO2 of arterial blood on measured glucose values compared with venous blood. METHODS: Forty adult patients who underwent surgery with general anesthesia were included in this study. Each patient had a cannula inserted into the radial artery and a central venous catheter through the right internal jugular vein. Two hours after the induction of anesthesia, we drew arterial and venous blood and measured the blood glucose concentration using both a bedside glucometer based on a glucose oxidase method and a laboratory glucometer based on a hexokinase method. We also measured blood gas, electrolyte, and hematocrit values. Statistical analyses were performed with repeated measure ANOVA, multiple linear regression, and Bland-Altman's analysis. Data is expressed as mean +/- SD. RESULTS: The arterial blood glucose concentration measured by the glucose oxidase method (119.5 +/- 25.0 mg/dl) was significantly lower than the venous blood (133.5 +/- 24.8 mg/dl) and hexokinase method (134.2 +/- 27.1 mg/dl). There was no significant difference between the venous blood glucose concentration by the glucose oxidase method and hexokinase method. When we used the correction formula: corrected glucose value = arterial glucose value by glucose oxidase method + 0.1053 X PaO2 - 5.414, the bias improved from - 14.6 mg/dl to 1.0 mg/dl. CONCLUSIONS: The blood glucose concentration measured by the glucose oxidase method is more accurate in venous blood than oxygenated arterial blood. When we measure the blood glucose level using the glucose oxidase method, we should consider the influence of high oxygen tension.
Adult ; Anesthesia ; Anesthesia, General ; Bias (Epidemiology) ; Blood Glucose* ; Catheters ; Central Venous Catheters ; Glucose Oxidase* ; Glucose* ; Hematocrit ; Hexokinase ; Humans ; Jugular Veins ; Linear Models ; Operating Rooms ; Oxygen* ; Radial Artery

No abstract available.
R Factors* ; Shigella*

OBJECTIVE: Detection of focal non-hemorrhagic lesion (NHL) has become more efficient in diffuse axonal injury (DAI) patients using an MRI. The aims of this study are to find out the radiological distribution, progress of NHL and its clinical significance. METHODS: Between September 2005 and October 2011, 32 individuals with NHLs on brain MRI were enrolled. NHLs were classified by brain location into 4 major districts and 13 detailed locations including cortical and subcortical, corpus callosum, deep nuclei and adjacent area, and brainstem. The severity of NHL was scored from grades 1 to 4, according to the number of districts involved. Fourteen patients with NHL were available for MRI follow-up and an investigation of the changes was conducted. RESULTS: Thirty-two patients had 59 NHLs. The most common district of NHL was cortical and subcortical area; 15 patients had 20 NHSs. However the most common specific location was the splenium of the corpus callosum; 14 patients had 14 lesions. The more lesions patients had, the lower the GCS, however, this was not a statistically meaningful difference. On follow-up MRI in 14 patients, out of 24 lesions, 13 NHLs resolved, 5 showed cystic change, and 6 showed atrophic changes. CONCLUSION: NHLs were located most commonly in the splenium and occur frequently in the thalamus and the mesial temporal lobe. Because most NHS occur concomitantly with hemorrhagic lesions, it was difficult to determine their effects on prognosis. Since most NHLs resolve completely, they are probably less significant to prognosis than hemorrhagic lesions.
Brain ; Brain Injuries ; Brain Stem ; Corpus Callosum ; Diffuse Axonal Injury ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Temporal Lobe ; Thalamus

PURPOSE: To evaluate the efficacy of transcatheter arterial embolization(TAE) in children with blunt splenicinjury. MATERIALS AND METHODS: The results of transcatheter splenic arterial embolization in nine children whosuffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated byCT, and the findings were evaluated according to the classification of Mirvis et al. ; two patients were grade 3and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if apatient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintainhemodynamic stability ; or (2) rapid Hb/Hct decrease ; or (3) both. Splenic function was subsequently estimatedaccording to the results of 99mTc-sulfur colloid scintigraphy and/or CT scanning. RESULT: TAE was suscessful inall nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil.Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches.Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. CONCLUSION: TAEof the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injuryin children, and can preserve splenic function.
Child* ; Classification ; Colloids ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Critical Care ; Radionuclide Imaging ; Retrospective Studies ; Splenic Artery ; Tomography, X-Ray Computed

Symptoms of deep cerebral vein thrombosis (DCVT) are variable and nonspecific. Radiologic findings are essential for the diagnoses. In the majority of cases of deep internal cerebral venous thrombosis, the thalamus is affected bilaterally, and venous hypertension by thrombosis causes parenchymal edema or venous infarction and may sometimes cause venous hemorrhage. Intravenous injections of mannitol can be administered or decompressive craniectomy can be performed for reduction of intracranial pressure. The objectives of antithrombotic treatment in DCVT include recanalization of the sinus or vein, and prevention of propagation of the thrombus. Herein, the authors report DCVT which was successfully treated by low molecular weight heparin.
Brain Edema ; Cerebral Infarction ; Cerebral Veins ; Decompressive Craniectomy ; Edema ; Hemorrhage ; Heparin, Low-Molecular-Weight ; Hypertension ; Infarction ; Injections, Intravenous ; Intracranial Pressure ; Intracranial Thrombosis ; Mannitol ; Thalamus ; Thrombosis ; Veins ; Venous Thrombosis