Follow-Up Studies ; Humans ; Mandible ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Prognathism ; Recurrence

PURPOSE: alpha-Ketoglutarate (alphaKG), a Krebs cycle intermediate, is extensively used in the kidney as a fuel substrate and as a counter anion for organic acid secretion. It is known to be taken up by the proximal tubule cells via the brush-border as well as basolateral membranes. We explored biochemical characteristics of the brush-border and basolateral alphaKG transport systems in pars convoluta and pars recta of the proximal tubule, respectively. METHODS: Brush-border and basolateral membrane vesicles (BBMV and BLMV) were isolated from rabbit renal outer cortex and outer medulla by Percoll gradient centrifugation. Vesicular uptake of alphaKG was determined by rapid Millipore filtration method using alpha-14[C]KG as a substrate. RESULTS: Both BBMV and BLMV showed a Na-gradient dependent uphill transport of alphaKG. The systems in both membranes were similarly inhibited by Li and activated by Na (Hill coefficient of 1.4). Kinetic analyses indicated that the Na-alphaKG cotransporters in the BBMV had a lower substrate affinity as compared with those in the BLMV. The transport systems in BLMVs showed a similar Km but different Vmax between the outer cortex (Km: 34 uM, Vmax: 3.3 nmol/mg protein/10s) and outer medulla (Km: 37, Vmax: 1.8). On the other hand, the systems in BBMVs were different in both Km and Vmax between the outer cortex (Km: 194, Vmax: 3.3) and outer medulla (Km: 89, Vmax: 1.7). CONCLUSION: The findings suggest that both axial and apical to basolateral heterogeneity of the Na-alphaKG cotransport system in proximal tubules may be due to a physiological adaptation to efficiently utilize alphaKG in the kidney.
Adaptation, Physiological ; Biological Transport, Active ; Centrifugation ; Citric Acid Cycle ; Filtration ; Hand ; Ketoglutaric Acids ; Kidney Tubules ; Kidney* ; Membranes ; Population Characteristics ; Symporters

OBJECTIVES: Deep brain stimulation (DBS) of subthalamic nuclei (STN) is one of the current modalities of refractory epilepsy, but its exact mechanism and route of action have not been elucidated yet. We investigated the effect of STN stimulation on the development and propagation of seizures in the rats with lithium-pilocarpine induced status epilepticus in its functional anatomy. METHODS: Both pilocarpine injection and high frequency stimulation on STN (HFSSTN) were provided to rats (STN group, n=12), but pilocarpine injection with no stimulation was done on the sham group (n=8). The latency to first discrete ictal discharges and the latency to status epilepticus (SE) were analyzed and the electrical stimulation lasted for 30, 60, 90, 120 minutes after its first discrete spikes. After stimulation, the rats were immediately decapitated for immunohistochemistry and histologic examination. RESULTS: Both the latency to first discrete ictal discharges and the latency to the onset of SE were delayed in the STN group than in the sham group. The latency to the first SE was also more delayed in the STN group (42.7+/-7.9 min) than in the sham group (p<0.05). Remarkably, there was marked Fos immunoreactivity (FIR) on the reticular thalamic nuclei in the STN group, but not in the sham group. CONCLUSIONS: Increased FIR in the reticular thalamic nuclei during HFSSTN suggested that the facilitation of the inhibitory thalamic output prevented generalized motor seizure behavior. We assume that HFSSTN has a pivotal role in the suppression or progression to SE, but cannot prevent seizure onset.
Animals ; Deep Brain Stimulation ; Electric Stimulation* ; Epilepsy ; Immunohistochemistry ; Pilocarpine ; Rats* ; Seizures ; Status Epilepticus* ; Subthalamic Nucleus* ; Thalamic Nuclei

BACKGROUND: The multifocal hypointense cerebral lesions (MHCLs) on gradient echo (GE)-MRI and white matter changes on T2WI have been thought to be indicative of microangiopathy. The purpose of this study is to elucidate the relationship between MHCLs and white matter (WM) changes and the clinical significance of WM changes in stroke patients. METHODS: We retrospectively reviewed MRI and clinical data of 115 patients with stroke (56 female and 59 male). Periventricular and deep white matter hyperintensity (PVHI and DWMHI) were measured by semiquantative rating scale proposed by Mantyla. The round, hypointense signal, less than 7 mm in diameter on GE-MRI were counted as MHCLs. The association between risk factors of stroke and MHCLs on GE-MRI and sum of the white matter change scores and total number of MHCLs were analyzed, respectively. RESULTS: MHCLs on GE-MRI were significantly associated with old age (p<0.05) and hypertension (p<0.001) among risk factors of stroke. The distribution of MHCLs in subcortical area is associated with hypertension (p<0.05) and total number of MHCLs was significantly associated with sum of the white matter change scores (p<0.05). CONCLUSIONS: MHCLs on GE-MRI were significantly associated with severity of WM changes. Severe WM change may be an indicator of advanced small artery disease of the brain with an increased risk factor for bleeding. This should be taken into consideration when treating patients with stroke.
Arteries ; Brain ; Female ; Hemorrhage ; Humans ; Hypertension ; Magnetic Resonance Imaging* ; Retrospective Studies ; Risk Factors ; Stroke*

Effect of cadmium (Cd) intoxication on renal acid-base regulation was studied in adult male Sprague-Dawley rats. Cd intoxication was induced by subcutaneous injections of CdCl2 at a dose of 2 mg Cd/kg/day for 3-4 weeks. In Cd-intoxicated animals, arterial pH, PCO2 and plasma bicarbonate concentration decreased, showing a metabolic acidosis. Urine pH and urinary bicarbonate excretion increased and titratable acid excretion decreased with no change in ammonium excretion. In renal cortical brush-border membrane vesicles derived from Cd-exposed animals, the Na /H antiporter activity was significantly attenuated. These results indicate that chronic exposures to Cd impair the proximal tubular mechanism for H secretion (i.e., Na /H antiport), leading to a metabolic acidosis.
Acidosis ; Acidosis, Renal Tubular* ; Adult ; Ammonium Compounds ; Animals ; Cadmium ; Cadmium Chloride ; Humans ; Hydrogen-Ion Concentration ; Injections, Subcutaneous ; Ion Transport ; Kidney ; Male ; Membranes ; Plasma ; Rats* ; Rats, Sprague-Dawley

Effects of cadmium (Cd) intoxication on renal endosomal accumulation of organic cations (OC ) were studied in rats using 14C-tetraethylammnium (TEA) as a substrate. Cd intoxication was induced by s.c. injections of 2 mg Cd/kg/day for 2-3 weeks. Renal cortical endosomes were isolated and the endosomal acidification (acridine orange fluorescence change) and TEA uptake (Millipore filtration technique) were assessed. The TEA uptake was an uphill transport mediated by H /OC antiporter driven by the pH gradient established by H -ATPase. In endosomes of Cd-intoxicated rats, the ATP-dependent TEA uptake was markedly attenuated due to inhibition of endosomal acidification as well as H /TEA antiport. In kinetic analysis of H /TEA antiport, Vmax was reduced and Km was increased in the Cd group. Inhibition of H /TEA antiport was also observed in normal endosomes directly exposed to free Cd (but not Cd-metallothionein complex, CdMt) in vitro. These data suggest that during chronic Cd exposure, free Cd ions liberated by lysosomal degradation of CdMt in proximal tubule cells may impair the endosomal accumulation of OC by directly inhibiting the H /OC antiporter activity and indirectly by reducing the intravesicular acidification, the driving force for H /OC exchange.
Animals ; Biological Transport, Active ; Cadmium ; Cations ; Citrus sinensis ; Endosomes* ; Filtration ; Fluorescence ; Ion Transport ; Ions ; Kidney ; Proton-Motive Force ; Rats* ; Tea ; Tetraethylammonium*

Between 1 and 2% of benign cystic teratomas undergo malignant transformation. This occurs most frequently in postmenopausal women, who account for only 10% of benign cystic teratoma. A wide variety of neoplasms arise in the mature tissues of otherwise benign teratomas. Of the malignancies arising in teratomas, squamous carcinoma is the most common (83%) with sarcomas accounting for 7%, adenocarcinoma and carcinoid tumors make up most of the others. The presentation in Stage I disease does not differ from that of benign cystic teratoma, except that ascites is occasionally present. In the more advanced neoplasms, the symptoms are those of epithelial ovarian cancer of the same stage. Differential diagnosis between squamous cell carcinoma and benign mature teratoma is difficult but seems to be related to age, size, serum tumor marker (SCC, CA125, CEA). Prognosis of squamous cell carcinoma in mature cystic teratoma was reported much poorer than other epithelial ovarian cancers In the early stages, treatment is possible through surgical intervention alone, but when advanced, 5 year survival rate shows less than 15 percent. We experienced two cases of squamous cell carcinoma of ovary arising in mature teratoma and present with a brief review of literature.
Adenocarcinoma ; Ascites ; Carcinoid Tumor ; Carcinoma, Squamous Cell* ; Diagnosis, Differential ; Female ; Humans ; Ovarian Neoplasms ; Ovary* ; Prognosis ; Sarcoma ; Survival Rate ; Teratoma*

A 38-year-old woman, affected by chronic myeloid leukemia, received a BMT from his HLA identical brother. A mild acute graft-versus-host disease (GVHD) developed during the first month after the BMT. A typical clinical and electrophysiological feature of myasthenia gravis (MG) developed 3 months after the BMT requiring medication with pyridostigmine and steroids. Laboratory findings including acetylcholine receptor antibody and other autoantibodies were negative. MG is a well-characterized autoimmune disease which, on rare occasions, is also diagnosed as chronic GVHD after BMT. We report a first case of MG during an acute GVHD period. Since the patient had a myasthenic symptom during an acute GVHD period and no evidence of antibody mediated autoimmunity, this is likely to be an immune complication of acute GVHD. (J Korean Neurol Assoc 19(1):60~61, 2001
Acetylcholine ; Adult ; Autoantibodies ; Autoimmune Diseases ; Autoimmunity ; Bone Marrow Transplantation* ; Bone Marrow* ; Female ; Graft vs Host Disease ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Myasthenia Gravis* ; Pyridostigmine Bromide ; Siblings ; Steroids

No abstract available.
Cervical Ripening* ; Cervix Uteri* ; Dinoprostone* ; Female ; Misoprostol* ; Pregnancy ; Pregnancy*

Pericarotid syndrome is the combination of a postganglionic Horner's syndrome and ipsilateral head and facial pain, which is caused by diverse pathologic processes in and around the internal carotid artery. We report a case of peri-carotid syndrome which presented Horner's syndrome and ipsilateral periodic severe hemicrania associated with malig-nant lymphma lapping internal carotid artery. After surgical removal of the mass and chemotherapy, miosis, ptosis, and ipsilateral hemicrania improved.
Carotid Artery, Internal ; Drug Therapy ; Facial Pain ; Head ; Headache ; Horner Syndrome ; Lymphoma* ; Miosis ; Pathologic Processes