O1igodendrocytes are known to be responsible for the synthesis and maintenance of myelin sheath in the central nervous system, and their functional disturbance leads to defect in myelination. But, the fine mechanism of myelination by oligodendrocytes is not yet known, and iron metabolism in central nervous system is suspected to be related with myelination process by oligodendrocytes. Carbonic anhydrase-II[CA-II], transfe-rrin, and ferritin are known to be present at oligodendrocytes and suspected to play a role in iron metabolism of central nervous system. In this study, demyelination and remyelination of ICR mouse brains were induced using cuprizone, the copper-chelating agent, and immunohistochemical changes of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes at corpus callosum were observed. During demyelination by cuprizone feeding, the numbers of CA-II- and transferrin-immunoreactive oligodendrocytes were decreased. Especially, the decrease ratio of CA-II-positive cells was great. In contrast, the number of ferritin-positive oligodendrocytes was increased during demyelination by cuprizone feeding. Cessation of cuprizone feeding leaded remyelination and the numbers of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes were returned to normal level. In conclusion, the derangement of iron metabolism in oligodendrocytes may be related to demyelination mechanism of central nervous system, and the CA-II is suspected to have an important role in iron metabolism of oligodenrocytes in relation to demyelination and remyelination induced with cuprizone.
Animals ; Brain ; Carbon* ; Central Nervous System ; Corpus Callosum ; Cuprizone* ; Demyelinating Diseases ; Ferritins ; Iron ; Iron-Binding Proteins* ; Metabolism ; Mice* ; Mice, Inbred ICR ; Myelin Sheath ; Oligodendroglia ; Transferrin

Decreased number of the Neuropeptide-Y[NPY] immunoreactive neurons in the corpus striatum and primary motor cortex of aged rat was detected by the immunohistochemical method. The animals were categorized into control and aged group and we used 10 Sprague-Dawley rat weighing 250-300gm for control group. 10 Sprague-Dawley rat weighing over 600gm for aged group. The number of NPY-immunoreactive neurons in corpus striatum and primary motor cortex were counted under the light microscope and the following results were obtained. 1. The NPY-immunoreactive neurons were evenly distributed in corpus striatum and in the primaty motor cortex, the NPY-immunoreactive neurons were concentrated within the layer II, III and layer V, VI. The typical NPY-immunoreactive perikarya was multipolar shape. 2. Decreased number of NPY-immunoreactive neurons were detected in some areas of corpus striatum and primary mortor cortex of the aged rat. 3. Decrease of NPY-immunoreactive neurons were most prominent in the caudate-putamen and there were moderate decrease of NPY-immunoreactive neurons in the primary motor cortex, mild decrease of NPY-immunoreactive neurons in the nucleus accumbens but the NPY-immunoreactive neurons were not observed in the globus pallidus in both control and aged rat. NPY is supposed to act as a neurotransmitter of local circuit neurons in the striatum and may exert its potent vasoconstrictor effects on cerebral vessels which influences on the microcirculation of cerebral cortex and striatum. So our results seems to provide an important data on change of the function in the striatum and primary motor cortex of aged rat brain.
Aging ; Animals ; Brain ; Cerebral Cortex ; Corpus Striatum* ; Globus Pallidus ; Microcirculation ; Motor Cortex ; Neurons* ; Neuropeptide Y* ; Neuropeptides* ; Neurotransmitter Agents ; Nucleus Accumbens ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002. We checked the preoperative factors; sex, age, history of previous serum creatinine over 2.0 mg/dL, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors; IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/dL. RESULT: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/dL in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6.4%) in the patients whose creatinine level have not increased over 2.0 mg/dL. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/dL are diabetes, the history of previous serum creatinine over 2.0 mg/dL and left ventricular ejection fraction. CONCLUSION: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2.0 mg/dL and left ventricular ejection fraction. Postoperative ARF could be the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.
Acute Kidney Injury* ; Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Vessels* ; Creatinine ; Dialysis ; Fluid Therapy ; Humans ; Hypertension ; Medical Records ; Mortality ; Postoperative Complications ; Pulmonary Edema ; Risk Factors ; Stroke Volume ; Thoracic Surgery

BACKGROUND: The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. MATERIAL AND METHOD: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37oC (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. RESULT: In the group that was rapidly thawed, the expression of TUNEL (+) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. CONCLUSION: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopreserved arterial allografts. The expression of TUNEL (+) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.
Allografts ; Aorta* ; Arteries ; Cryopreservation ; Edema ; In Situ Nick-End Labeling ; Rupture ; Transplants

BACKGROUND: Interstitial pneumonia is associated with an increased risk of lung cancer but the outcome of surgical resection in this setting is unknown. The purpose of this study was to determine the relationship between pre-operative interstitial pneumonia (IP) and post-operative respiratory failure. MATERIAL AND METHOD: A retrospective review of 672 patients with lung cancer who underwent curative pulmonary resection at the Hospital of Catholic University Medical College between 1997 and 2005 was undertaken. The patients were divided into two groups according to preexisting interstitial pneumonia and not by the pre-operative chest HRCT or findings of pathologic papers. The pre-operative data and cancer-related findings were analyzed between the IP group and non-IP group, and between the respiratory failure group and non-failure group in IP patients. RESULT: Twenty-eight patients (4.2%) of the developed post-operative respiratory failure and this proved to be fatal in 21 of these patients. We could find preoperative interstitial pathology in 53 patients (7.9%) among the 672 patients. The incidences of respiratory failure were 11.3% (6/53 cases) and 3.6% (22/619 cases) in IP group and non-IP group respectively. CONCLUSION: Interstitial pneumonia was considered one of the risk factors for developing postoperative acute respiratory failure in patients with lung cancer.
Humans ; Incidence ; Lung Diseases, Interstitial* ; Lung Neoplasms* ; Lung* ; Pathology ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Retrospective Studies ; Risk Factors ; Thorax

PURPOSE: Since acute respiratory failure was one of the most fatal postoperative complications in lung cancer surgery, to know its incidence, and predisposing factors is very important. The purpose of this study was to determine the relationship between pre-operative interstitial pneumonia (IP) and post-operative acute respiratory failure. MATERIALS AND METHODS: A retrospective review of 672 patients with lung cancer who underwent curative pulmonary resection at the Hospital of Catholic University Medical College between 1997 and 2005 was undertaken. The patients were divided into two groups according to preexisting interstitial pneumonia or not by pre-operative chest HRCT or findings of pathologic papers. RESULTS: Twenty-eight patients (4.2%) developed post- operative respiratory failure and this proved to be fatal in 21 of these patients. We could find preoperative interstitial pathology in 53 patients (7.9%) among the 672 patients. The incidences of respiratory failure were 11.3% (6/53 cases) and 3.6% (22/619 cases) in IP group and non-IP group respectively. CONCLUSION: Interstitial pneumonia considered of one of the risk factors for developing postoperative acute respiratory failure in patients with lung cancer.
Causality ; Humans ; Incidence ; Lung Diseases, Interstitial* ; Lung Neoplasms* ; Lung* ; Pathology ; Postoperative Complications ; Respiratory Insufficiency* ; Retrospective Studies ; Risk Factors ; Thorax

When tracheal invasion of a malignant tumor or tracheal stenosis of a benign origin exists at the lower or anterior part of the trachea, tracheal intubation or conventional tracheostomy may be difficult, and in these cases a modified tracheostomy through the lower or lateral part of the trachea would be necessary. We present 6 cases of modified tracheostomy performed with satisfactory results in severe tracheal stenosis that developed in the lower or anterior part of the trachea.
Intubation ; Trachea ; Tracheal Stenosis* ; Tracheostomy*

BACKGROUND: In the past, radiotherapy was the gold standard for the treatment of upper esophageal cancer, but the long-term follow-up was disappointing. There is still ongoing debate on the surgical management of these patients. This study was undertaken to update our experience with upper esophageal carcinoma and to evaluate the effectiveness of surgery. MATERIAL AND METHOD: From May 1995 to December 2005, 147 patients with esophageal cancer underwent surgery at our hospital. They were divided into two groups: one group consisted of 23 patients with upper esophageal (cervical and upper thoracic) cancer and another group consisted of 124 patients with lower esophageal (middle thoracic, lower thoracic and abdominal) cancer. We evaluated the effectiveness of surgical treatment between the 2 groups by measuring the rate of complete surgical resection, the postoperative complications, the postoperative mortality, tumor recurrence, the average life expectancy and the long-term survival. RESULT: On comparing both groups, there was no significant difference in the distribution of the pathological stage and no significant difference in the percentage of performing complete surgical resection. The percentage of postoperative complications was 39.1% (9 out of 23 patients) in the upper esophageal cancer group, and this was significantly higher than 16.9% (21 out of 124 patients) in the lower esophageal cancer group (p<0.05). However, there was no significant statistical difference between the groups for the percentages of postoperative mortality, tumor recurrence or the postoperative average life expectancy. CONCLUSION: There was no significant difference in operative mortality or surgical effectiveness between the 2 groups. Therefore, we thought that surgical treatment is also effective for treating upper esophageal cancer, but further investigation with large patient populations will be required.
Esophageal Neoplasms* ; Follow-Up Studies ; Humans ; Life Expectancy ; Mortality ; Postoperative Complications ; Radiotherapy ; Recurrence

BACKGROUND: We are now detecting an increasing number of solitary pulmonary nodules (SPNs) that are difficult to diagnosis. The purpose of this study was to evaluate the useful radiologic findings for differentiating benign from malignant pulmonary nodules. MATERIAL AND METHOD: The high-resolution CT (HRCT) findings of SPNs smaller than 3 cm in largest diameter were evaluated in 134 patients with malignant and benign nodules in regard to internal structures, margin characteristics, and surrounding parenchymal responses. RESULT: The nodules with the area of ground-glass attenuation (GGA) greater then 50% were noted in adenocarcinoma, inflammatory lesions and some of metastatic tumors, and the lesions greater than 90% were noted only in adenocarcinoma. The area of GGA in non-adenocarcinoma, benign tumors and tuberculomas were less than 50%, and mainly less than 10%. The findings of air bronchogram, spiculation, lobulation, vascular involvement, and pleural indentation were some noted at every types of malignant tumors, but especially high over than 30% in adenocarcinomas. CONCLUSION: Most peripheral lung adenocarcinomas form a characteristic radiologic findings especially in HRCT. Evaluation of these findings would be helpful in differentiating between lung cancer, especially adenocarcinoma, and other lesions.
Adenocarcinoma ; Diagnosis ; Humans ; Lung ; Lung Neoplasms ; Solitary Pulmonary Nodule* ; Tuberculoma

Bell's palsy is a relatively common, unilateral facial paralysis of unknown etiology. The purpose of this study was to evaluate the prognostic value of several electrophysiologic tests in Bell's palsy. Blink reflex (BR), side-to-side compound muscle action potential (CMAP) amplitude comparison, and side-to-side nerve excitability test (NET) threshold differ once have been studied during the first 2 weeks in 66 patients with Bell's palsy. According to the early response of BR(Rl), the patients were divided into 3 groups: Rl< or = 13ms(17cases) ; Rl>13ms(22cases), and absent BR(27cases). There was a remarkable tendency towards a satisfactory recovery from paralysis if BR occurred during the first 2 weeks from onset(p<0.001). In patients with normal BR, 88.2% had a satisfactory recovery, when the reflex was absent a bad prognosis was given in 59.3% of the patients. According to side-to-side CMAP amplitude comparison, the patients were divided into 2 groups; CMAP amplitude comparison > or = 25% (35cases), and CMAP amplitude comparison <25% (31cases). There was a tendency towards a satisfactory recovery from paralysis if side-to-side CMAP amplitude comparison was more than 25% (p < 0,003). In patients with more than 25% of CMAP amplitude comparison, 82.9% of the patients had a satisfactory recovery, but in patients with less than 25% of CMAP amplitude comparison, 51.6% of the patients had a bad prognosis. According to side-to-side NET threshold difference, the patients were divided into 2 groups, NET threshold difference < or = 3.5mA(43cases), and NET threshold difference >3.5mA (23cases). When the threshold of electrical excitability on both sides differs 3.5mA or more an unsatisfactory recovery has strongly to expected(p<0.001). In patients with less than 3.5mA of NET threshold, 81.4% had a satisfactory recovery, but in patients with more than 3.5mA of NET threshold, 60.9% had a bad prognosis. BR, side-to-side CMAP amplitude comparison, and side-to-side NET threshold difference seem to be useful independent indices for predicting the prognosis an early stage of the paralysis.
Action Potentials ; Bell Palsy* ; Blinking ; Facial Paralysis ; Humans ; Paralysis ; Prognosis ; Reflex