PURPOSE: Although platelet-rich plasma (PRP) potentiate the wound healing activity of adipose-derived stem cells (ADSCs), its effect cannot be sustained for a prolonged period of time due to short duration of action. This led us to design and produce platelet-rich fibrin (PRF), in an effort to develop a tool which lasts longer, and apply it on wound healing. METHODS: Two symmetrical skin defects were made on the back of seven nude mice. ADSCs were applied to each wound, combined with either PRP or PRF. The wound area was measured over 14 days. By day 16, the wound was harvested and histologic analysis was performed including counting of the blood vessel. RESULTS: The healing rate was more accelerated in PRP group in the first 5 days (p<0.05). However, PRF group surpassed PRP group after 6 days (p<0.05). The average number of blood vessels observed in the PRF group was 6.53 +/- 0.51, compared with 5.68 +/- 0.71 for the PRP group. CONCLUSION: PRF exerts a slow yet pervasive influence over the two-week course of the wound healing process. Thus, PRF is probably more beneficial for promoting the activity of ADSCs for a sustained period of time.
Acceleration ; Animals ; Blood Platelets ; Blood Vessels ; Fibrin ; Mice ; Mice, Nude ; Platelet-Rich Plasma ; Skin ; Stem Cells ; Wound Healing

OBJECTIVE: The purpose of this study was to objectively assess the efficacy of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using Technetium (Tc)-99m-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients who underwent STA-MCA bypass surgery. MATERIALS AND METHODS: Brain perfusion SPECT images obtained at baseline and after the administration of acetazolamide were reconstructed using statistical parametric mapping in 23 patients, both before and after STA-MCA bypass surgery. The clinical outcomes of the surgery were also recorded and compared with the hemodynamic changes. A voxel with an uncorrected p-value of less than 0.001 was considered to be statistically significant. RESULTS: SPECT images of the territory supplied by the bypass graft showed an increase in both cerebrovascular flow and reserve at baseline, and the increase was significantly higher following the administration of acetazolamide. All patients showed improvement of clinical symptoms and increased blood flow to the left temporal, parietal, and frontal cortices as well as the thalamus. CONCLUSION: Brain SPECT effectively and objectively demonstrated the improved outcomes of STA-MCA bypass surgery, and thus may be used in postoperative analyses.
Acetazolamide/diagnostic use ; Adult ; Aged ; Brain/*radionuclide imaging ; Brain Mapping/methods ; Carotid Stenosis/surgery ; *Cerebral Revascularization ; *Cerebrovascular Circulation ; Cysteine/analogs & derivatives/diagnostic use ; Female ; Follow-Up Studies ; Humans ; Image Processing, Computer-Assisted ; Intracranial Arteriosclerosis/surgery ; Male ; Middle Aged ; Middle Cerebral Artery/*surgery ; Models, Statistical ; Organotechnetium Compounds/diagnostic use ; Predictive Value of Tests ; Radiopharmaceuticals/diagnostic use ; Temporal Arteries/*surgery ; Tomography, Emission-Computed, Single-Photon/*methods ; Treatment Outcome

OBJECTIVE: Hemifacial spasm has characteristic and specific electrophysiological finding, lateral spread response(LSR). We study the correlation between change of lateral spread response during microvascular decompression(MVD) and clinical outcome after MVD. METHODS: Sixty two patients with hemifacial spasm who were treated with microvascular decompression from March 2000 to February 2003 were included in this study. The monitoring of intraoperative facial electromyography(EMG) and brain stem auditory evoked potential were performed. RESULTS: In 28 (44.7%) patients, there was persistence of lateral spread response after vascular decompression in root exit zone of facial nerve. Among these 28 patients, 9 had mild hemifacial spasm at discharge. Three out of 34 patients who had intraoperative disappearance of lateral spread response after MVD had mild hemifacial spasm. But Both groups, disappearance of LSR (Group I), and persistence (Group II) had only 2 patients with mild hemifacial spasm, and 5 patients at 3 months, respectively. CONCLUSION: Although intraoperative EMG monitoring is very useful in assessing the efficacy of MVD, the clinical outcome of MVD in patient with hemifacial spasm does not always correlate with EMG finding. The prognostic value of intraoperative LSR monitoring in the long-term results is questionable.
Decompression ; Electromyography ; Evoked Potentials, Auditory, Brain Stem ; Facial Nerve ; Hemifacial Spasm* ; Humans ; Microvascular Decompression Surgery

OBJECTIVE: Many researchers believe that the hypothermia shows neuroprotective effect on brain injury. To understand the molecular mechanism of the hypothermic treatment, this study investigated its effects on the expression of cell death or survival related proteins such as p53, Bcl-2 and Bax in the rat traumatic brain injury(TBI) model. METHODS: Twenty rats (Spraque Dawley, 200~250g) were subjected to the brain injury of moderate severity (2.4~2.6atm) using the fluid percussion injury device and five rats were received only same surgery as controls. During 30minutes after the brain injury, the hypothermia group was maintained the body temperature around 34 degrees C while the control group were maintained that of 36 degrees C. Five rats in each group were sacrificed 12h or 24h after brain injury and their brain sections was analyzed for physical damages by H-E stains and the extent of apoptosis by TUNEL assay and immunohistochemical stains. The tissue damage after TBI was mainly observed in the ipsilateral cortex and partly in the hippocampus. RESULTS: Apoptosis was observed by TUNEL assay and the Bax protein was detected in both sample which harvested 12h and 24h after TBI. In the hypothermia treatment group, tissue damage and apoptosis were reduced in HE stains and TUNEL assay. In hypothermia treatment group rat shows more expression of the Bcl-2 protein and shows less expression of the Bax protein, at both 12h and 24h after TBI. CONCLUSION: These results show that the hypothermia treatment is an effective treatment after TBI, by reducing the apoptotic process. Therefore, it could be suggested that hypothermia has a high therapeutic value for treating tissue damages after TBI.
Animals ; Apoptosis ; bcl-2-Associated X Protein ; Body Temperature ; Brain ; Brain Injuries* ; Cell Death ; Coloring Agents ; Hippocampus ; Hypothermia* ; In Situ Nick-End Labeling ; Neurons* ; Neuroprotective Agents ; Percussion ; Rats

OBJECTIVES: The purpose of this study is to evaluate the radiological charactersitics related to the formation of peritumoral edema in meningiomas. METHODS: Fifty patients with meningioma were examined by magnetic resonance images and cerebral angiography. The predictive factors associated peritumoral edema, such as, tumor size, peritumoral rim (cerebrospinal fluid cleft), shape of tumor margin, signal intensity of tumor in T2WI, and pial blood supply were evaluated. RESULTS: Tumor size, peritumoral rim and pial blood supply correlated with peritumoral edema on univariate analyses. But in multivariate analyses, pial blood supply was statistically significant as a factor for peritumoral edema in meningioma. CONCLUSION: In our results, pial blood supply is significant contributing factor for peritumoral edema in meningioma.
Cerebral Angiography ; Edema* ; Humans ; Meningioma* ; Multivariate Analysis

OBJECTIVE: The authors report a simple and reliable method for cervical open-door laminoplasty secured by titanium miniplate. METHODS: Sixteen patients with cervical myelopathy secondary to multilevel cervical spondylosis or ossification of the posterior longitudinal ligament were treated with an expansive open-door laminoplasty using titanium miniplates to stabilize the posterior elements described by O'Brien et al between February 1998 and June 2002, and all had a minimum of 6 months of follow-up(mean 22.5months) review. Plain radiographs were used to measure sagittal canal diameter and monitor construct integrity. The neurological outcome was evaluated before and after operation using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. RESULTS: Only 1 titanium miniplate construct was failed out of 69 levels in 16 patients during follow-up period, but decompression was maintained. After surgery, in 15 patients(93.7%) different levels of clinical improvement were demonstrated, and in four of them(25%) full recovery was observed. The sagittal canal diameter and JOA score increased from 13.3+/-2.2mm and 9.19 preoperatively to 20+/-2.4mm and 12.88 postoperatively(p<0.01). CONCLUSION: The use of titanium miniplate to stabilize the posterior elements after laminoplasty is a simple, durable, and effective technique to maintain the increased sagittal canal diameter of the spinal canal and have another advantage of compatability of magnetic resonance imaging.
Asian Continental Ancestry Group ; Decompression ; Follow-Up Studies* ; Humans ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Orthopedics ; Spinal Canal ; Spinal Cord Diseases ; Spondylosis ; Titanium*

OBJECTIVE: Spontaneous intracranial hemorrhage is still common cause of death in the hematologic disorder including leukemia. The authors examine laboratory & radiological findings in patients with intracranial hemorrhage caused by hematologic disorder. METHODS: From March 1998 to May 2002, 42 patients with hematologic disease complicated by intracranial hemorrhage were transferred from hematology department. The patients were normotensive and had not trauma history. In all patients, intracranial hemorrhages were diagnosed with the brain computerized tomography. Surgical treatment was performed in one case. RESULTS: Underlying hematologic disorders included aplastic anemia (4), acute myeloblastic leukemia (20), acute lymphoblastic leukemia (6), chronic myeloblastic leukemia (8), myelodysplastic syndrome (2), multiple myeloma (1), and polycythemia vera (1). Intracranial hemorrhage subtypes consisted of intracerebral hemorrhage (39) including mainly subcortical lobar hemorrhage (28), and subarachnoid hemorrhage (3). Twenty (48%) of the 42 patients had multifocal hematomas. Thirty six patients (86%) had moderate and severe thrombocytopenia (less than 100x10(9)/L). Twenty four patients (57%) had moderate and severe leukocytosis (greater than 20x109/L). CONCLUSION: It showed that (1) the risk factors of intracranial hemorrhage in hematologic disorders are thrombocytopenia, leukocytosis and disseminated intravascular coagulopathy ; (2) intracerebral hemorrhage in hematologic disorders occur preferentially in the subcortical portion ; (3) intracranial hemorrhage in hematologic disorders consist of various combinations of subcortical lobar hemorrhage, subarachnoid hemorrhage, subdural hemorrhage and intraventricular hemorrhage ; (4) intracerebral hemorrhage in hematologic disorders tend to be multiple.
Anemia, Aplastic ; Brain ; Cause of Death ; Cerebral Hemorrhage ; Granulocyte Precursor Cells ; Hematologic Diseases ; Hematology ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Intracranial Hemorrhages* ; Leukemia ; Leukemia, Myeloid, Acute ; Leukocytosis ; Multiple Myeloma ; Myelodysplastic Syndromes ; Polycythemia Vera ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Risk Factors ; Subarachnoid Hemorrhage ; Thrombocytopenia

The authors report a case of a 24-year-old man with unilateral sphenoid dysplasia in the absence of NF-I. Preoperatively, the patient was presented with pulsating exophthalmos and headache. The patient underwent cranioorbital sphenoid wing reconstruction with split calvarial bone graft. Postoperatively, he showed relieved headache and significant reduction of exophthalmos by exophthalmometry. There were no evidence of osteomyelitis and neurologic complication.
Exophthalmos ; Headache ; Humans ; Neurofibromatoses* ; Neurofibromatosis 1* ; Osteomyelitis ; Transplants ; Young Adult

Metastatic adenocarcinoma to the brain usually appears low-to-moderate attenuation on non-enhanced computed tomography. However, metastatic mucinous adenocarcinoma shows strikingly high attenuation, even simulating hemorrhage in some cases. We present a rare case of a mucin-containing metastatic adenocarcinoma of the rectum mimicking cerebral hemorrhage.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Brain ; Cerebral Hemorrhage* ; Hemorrhage ; Mucins* ; Rectum

OBJECTIVE: The authors present the complications after resection of the tumors involving the cavernous sinus and the efficacy and role of the adjuvant therapy in the management of the residual or recurrent tumors invading the cavernous sinus. METHODS: From March 1998 to May 2002, ten patients with cavernous sinus tumors were treated in our hospital. The tumors limited to the outer wall of cavernous sinus were excluded in this study. Pathological diagnoses were meningiomas in seven and pituitary adenomas in three patients. RESULTS: Tumors of the extracavernous portion were removed totally except for two cases. Cavernous sinus was opened in seven patients, among which subtotal removal was achieved in four, and partial removal in three patients. In the remaining three patients, the cavernous sinus was neither opened nor exposed. All patients with intracavernous exploration were complicated by ptosis and extraocular muscles paralysis. Radiotherapy was administered to 6 cases. At present, there is no tumor progression except for one patient with malignant meningioma. CONCLUSION: In patients with large tumors involving the cavernous sinus, especially invading the cavernous internal carotid artery, we recommend subtotal or partial resection of the tumor followed by radiation therapy to prevent permanent postoperative sequele.
Carotid Artery, Internal ; Cavernous Sinus* ; Diagnosis ; Humans ; Meningioma ; Muscles ; Paralysis ; Pituitary Neoplasms ; Radiotherapy