No abstract available.
Congenital Hypothyroidism*

OBJECTIVES: Previously the authors reported age-related changes in the activities of anti-oxidative enzyme activities and protein expressions in the tongues of rats. Because more information is required about relations between aging and oxidative stress and anti-oxidative enzyme efficiency, the authors investigated differences between the expression of master regulator of anti-oxidative enzymes (nuclear factor erythroid 2-related factor 2 [Nrf2]), levels of reactive oxygen species (ROS), and mitochondrial structures in the tongues of young and aged Fischer 344 rats. METHODS: Age-dependent changes in Nrf2 protein and ROS were determined by Western blotting and using chemical kits, respectively. Tongue specimens were examined by electron microscopy. The study was conducted using rats aged 7 months (young, n=8) or 22 months (old, n=8). RESULTS: Nrf2 protein levels in the tongues of aged rats were lower than in young rats. ROS levels were higher in older rats and mitochondrial structural deficits were observed their tongues. Three young rats showed moderate mitochondrial degeneration, whereas profound degeneration with mitochondrial cristae disruption, swelling, rupture, or intramitochondrial vacuole formation was observed in all 8 old rats. Notably, mitochondrial rupture was observed in 5 old rats. CONCLUSION: Antioxidant defense systems of old rats were compromised by Nrf2 deficiency, which could lead to the deleterious accumulation and release of ROS and probably mitochondrial structural deficits in aged tongue tissues.
Aging ; Animals ; Blotting, Western ; Microscopy, Electron ; Mitochondria ; NF-E2-Related Factor 2 ; Oxidative Stress ; Rats* ; Reactive Oxygen Species* ; Rupture ; Tongue* ; Vacuoles

No abstract available.
Carcinoma, Transitional Cell* ; Hematuria* ; Humans ; Urinary Bladder*

OBJECTIVE: This study was conducted to assess the efficacy and safety of endovascular mechanical thrombectomy (EMT) for patients diagnosed with basilar artery (BA) occlusion. MATERIALS AND METHODS: We retrospectively analyzed clinical and imaging data of 16 patients diagnosed with BA occlusion who were treated with endovascular intervention from July 2012 to February 2013. Direct suction using the Penumbra system and thrombus retrieval by the Solitaire stent were the main endovascular techniques used to restore BA flow. The outcomes were evaluated based on rate of angiographic recanalization, rate of improvement of National Institutes of Health Stroke Scale (NIHSS) score, rate of modified Rankin Scale (mRS) at discharge and after 3 months, and rate of cerebral hemorrhagic complications. Successful recanalization was defined as achieving Thrombolysis In Cerebral Infarction (TICI) of II or III. RESULTS: Sixteen patients received thrombectomy. The mean age was 67.8 +/- 11 years and the mean NIHSS score was 12.3 +/- 8.2. Eight patients treated within 6 hours of symptom onset were grouped as A and the other 8 patients treated beyond 6 hours (range, 6-120) were grouped as B. Successful recanalization was met in six patients (75%) for group A and 7 (87.5%) for group B. Favorable outcome occurred in 4 patients (50%) for group A and 5 (62.5%) for group B. CONCLUSION: Our study supports the effectiveness and safety of endovascular mechanical thrombectomy in treating BA occlusion even 6 hours after symptom onset.
Basilar Artery ; Cerebral Infarction ; Endovascular Procedures ; Humans ; National Institutes of Health (U.S.) ; Retrospective Studies ; Stents ; Stroke ; Suction ; Thrombectomy ; Thrombosis

OBJECTIVE: This study was conducted to assess the efficacy and safety of endovascular mechanical thrombectomy (EMT) for patients diagnosed with basilar artery (BA) occlusion. MATERIALS AND METHODS: We retrospectively analyzed clinical and imaging data of 16 patients diagnosed with BA occlusion who were treated with endovascular intervention from July 2012 to February 2013. Direct suction using the Penumbra system and thrombus retrieval by the Solitaire stent were the main endovascular techniques used to restore BA flow. The outcomes were evaluated based on rate of angiographic recanalization, rate of improvement of National Institutes of Health Stroke Scale (NIHSS) score, rate of modified Rankin Scale (mRS) at discharge and after 3 months, and rate of cerebral hemorrhagic complications. Successful recanalization was defined as achieving Thrombolysis In Cerebral Infarction (TICI) of II or III. RESULTS: Sixteen patients received thrombectomy. The mean age was 67.8 +/- 11 years and the mean NIHSS score was 12.3 +/- 8.2. Eight patients treated within 6 hours of symptom onset were grouped as A and the other 8 patients treated beyond 6 hours (range, 6-120) were grouped as B. Successful recanalization was met in six patients (75%) for group A and 7 (87.5%) for group B. Favorable outcome occurred in 4 patients (50%) for group A and 5 (62.5%) for group B. CONCLUSION: Our study supports the effectiveness and safety of endovascular mechanical thrombectomy in treating BA occlusion even 6 hours after symptom onset.
Basilar Artery ; Cerebral Infarction ; Endovascular Procedures ; Humans ; National Institutes of Health (U.S.) ; Retrospective Studies ; Stents ; Stroke ; Suction ; Thrombectomy ; Thrombosis

OBJECTIVE: This study was conducted in order to demonstrate the initial experience of the Solitaire AB stent in mechanical intracranial thrombectomy. METHODS: We conducted a retrospective review of 40 consecutive patients who underwent intra-arterial Solitaire AB stent thrombectomy for treatment of acute ischemic strokes between October 2010 and November 2011. Demographic, clinical, and radiological presentations and outcomes were studied. RESULTS: Twenty six men and 14 women with a mean initial National Institutes of Health Stroke Scale (NIHSS) score of 14.1 (range, 8-26) and a mean age of 65.4 (range, 32-89) years were included in this study. Occlusion sites were as follows: internal carotid artery (n = 11), middle cerebral artery M1 (n = 22), M2 (n = 5), and basilar artery (n = 2). Successful revascularization was achieved in 36 (90%) patients. The mean NIHSS score was 11.6 (range, 1-23) at 24 hours after the procedure, and 42.5% of patients showed a modified Rankin scale score of < or = 2 at 90 days. New occlusion by migrated emboli was observed in one (2.5%) case. Post-procedural intracerebral hemorrhage occurred in only one case (2.5%), with an all-cause mortality of two (5%). CONCLUSION: The Solitaire AB device is a relatively safe and effective tool for use in performance of mechanical thrombectomy in patients with acute ischemic stroke.
Basilar Artery ; Carotid Artery, Internal ; Cerebral Hemorrhage ; Female ; Humans ; Male ; Middle Cerebral Artery ; National Institutes of Health (U.S.) ; Retrospective Studies ; Stents ; Stroke ; Thrombectomy

OBJECTIVE: Delayed cerebral ischemia due to vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is a leading cause of morbidity and mortality. Recent reports have confirmed that intra-arterial infusion of calcium-channel blockers, which are widely used to counteract vasospasm, is effective for treating SAH with a low risk of complications. Here we report on our experience with intra-arterial nicardipine angioplasty in a consecutive series of 32 patients with SAH. METHODS: This retrospective review evaluated a series of 32 consecutive patients with symptomatic vasospasm that was treated with intra-arterial nicardipine. The patients included in the study were diagnosed with aneurysmal SAH between January 2007 and February 2011. All the patients underwent microsurgical clipping or endovascular coiling. Angioplasty using intra-arterial nicardipine was performed in those patients who were refractory to medical therapy such as triple H therapy. RESULTS: The 32 patients underwent a total of 55 procedures. The total amount of nicardipine used in each angioplasty procedure did not exceed 12 mg, with a maximum dose of 3 mg for each vessel. The Glasgow Coma Scale (GCS) score improved in all patients with an average improvement of 2.4 (range : 1~5). During angioplasty, there were no complications such as thromboembolic events and/or acute transitory spasm. The clinical results were evaluated using the modified Rankin Scale (mRS). Good outcomes (mRS 0~2) were determined in 19 (63.3%) of the 30 patients. The 11 patients (36.7%) with poor outcomes initially had a high Hunt and Hess grade (III or IV) or they had intra-operative complications (mRS: 3~6). CONCLUSION: Our study results support the effectiveness and safety of low-dose nicardipine when performing intra-arterial angioplasty for the treatment of vasospasm after aneurysmal SAH.
Aneurysm ; Angioplasty ; Brain Ischemia ; Glasgow Coma Scale ; Glycosaminoglycans ; Humans ; Infusions, Intra-Arterial ; Nicardipine ; Retrospective Studies ; Spasm ; Subarachnoid Hemorrhage

The authors report here on a rare case of aneurysm involving the distal lenticulostriate artery (LSA) in a 66-year-old man who presented with intracerebral hemorrhage (ICH) in the right basal ganglia and also intraventricular hemorrhage (IVH). Three-dimensional computed tomography angiography (3D-CTA) and conventional cerebral angiography showed a 4 mm, round-shaped aneurysm in the right distal LSA and this was combined with moyamoya-like disease. We performed proximal clipping of the aneurysm using a microsurgical technique and we evacuated the hematoma. After the operation, there was recurrent bleeding around the operation site and hydrocephalus gradually developed, and we implanted a ventriculo-peritoneal (V-P) shunt. The patient did well after the final shunt surgery and rehabilitation. Presently, he has no motor weakness or significant neurologic deficit, but mild cognitive dysfunction remains. When spontaneous ICH occurs in an unusual site, a thorough investigation is important to rule out a structural vascular abnormality.
Aged ; Aneurysm ; Angiography ; Arteries ; Basal Ganglia ; Cerebral Angiography ; Cerebral Hemorrhage ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Neurologic Manifestations

PURPOSE: To evaluate the usefulness and the application of three dimensional digital rotational imaging (3D DRI) by the evaluation of fractures. MATERIALS AND METHODS: Sixteen patients with clinically diagnosed or suspicious fracture were involved in this study. The lesion or suspicious sites of all 16 cases were spines (n=7), pelvis (n=3) and so on (n=6; knee, elbow, ankle, wrist and foot). In all cases, conventional radiography, multiplanar 2D (slice thickness/pitch=3 or 5 mm/1:1)and volume rendering 3D reconstructed single detector helical CT (HiSpeed Advantage, GE Medical Systems, Milwaukee, WIS) scans and 3D DRI (Integris V-5000,Philips Medical Systems, The Netherlands) with multiplanar intersection and gray scaling as postprocessing technique were performed. 3D DRI was evaluated and compared with conventional radiography, multiplanar 2D CT and volume rendering 3D CT. RESULTS: 3D DRI provided more detail and additional information in 14 cases (88%), comparing with 2D and 3D CT scans. Two fractures were revealed only on 3D DRI other than conventional radiography and CT scans and one case was revealed on 2D CT and 3D DRI. In all cases, we could acquired more detail and additional information from 3D DRI than from 3D CT in the acquisition of 3D imaging. 3D DRI didn't change the classification of fracture in 12 of 13 cases (92%),which revealed the fracture on the conventional radiography or CT. CONCLUSION: 3D DRI can diagnose and evaluate the fracture rapidly and easily with anatomical and spatial resolution by acquisition of 3D imaging with postprocessing using DRI.
Ankle ; Classification ; Elbow ; Humans ; Imaging, Three-Dimensional ; Knee ; Pelvis ; Radiography ; Spine ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Wrist

OBJECTIVE: Cerebral aneurysms which cause oculomotor nerve [cranial nerve (CN) III] palsy, are frequently found with a daughter sac of the aneurysm dome. We assumed that CN III might be compressed by the daughter sac and it would be more helpful not to fill the daughter sac with coils than vice versa during endosaccular embolization for recovering from CN III palsy, because it may give a greater chance for the daughter sac to shrink by itself later. We reviewed the initial results of our experiences of such cases. METHODS: Among 9 aneurysms accompanied by CN III palsy, 7 (6 unruptured, 1 ruptured) showed a daughter sac. We tried to fill the main dome completely and spare the daughter sac from coil filling to increase the possibility of decompression. We evaluated the short-term effectiveness of this concept using medical records and angiograms. RESULTS: After initial embolization, all of CN III palsy caused by unruptured aneurysms (6/6) resolved completely after various periods (3-90 days) of time. No adverse effects were noted during and after the procedures except for one case of harmless coil stretching during coil filling using double microcatheter. CONCLUSION: During the coil embolization of the cerebral aneurysm causing CN III palsy, sparing the daughter sac from coil packing while tightly packing the main dome, can be helpful in increasing the effectiveness of decompression. However, a long-term follow-up will be required.
Aneurysm ; Decompression ; Intracranial Aneurysm ; Medical Records ; Nuclear Family ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paralysis