Matrix Metalloproteinase Inhibitors Attenuate Neuroinflammation Following Focal Cerebral Ischemia in Mice

The aim of this study was to investigate whether matrix metalloproteinase (MMP) inhibitors attenuate neuroinflammation in an ischemic brain following photothrombotic cortical ischemia in mice. Male C57BL/6 mice were anesthetized, and Rose Bengal was systemically administered. Permanent focal ischemia was induced in the medial frontal and somatosensory cortices by irradiating the skull with cold white light. MMP inhibitors, such as doxycycline, minocycline, and batimastat, significantly reduced the cerebral infarct size, and the expressions of monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-alpha), and indoleamine 2,3-dioxygenase (IDO). However, they had no effect on the expressions of heme oxygenase-1 and neuroglobin in the ischemic cortex. These results suggest that MMP inhibitors attenuate ischemic brain injury by decreasing the expression levels of MCP-1, TNF-alpha, and IDO, thereby providing a therapeutic benefit against cerebral ischemia.

A case of septic pulmonary embolism due to pyelonephritis / 대한내과학회지

A septic pulmonary embolism (SPE) is a rare disease originating from septic thrombi from a primary site of infection. Pyelonephritis is a rare cause of inferior vena cava (IVC) thrombosis and SPE. We experienced a case of SPE associated with pyelonephritis, a perirenal abscess, and renal vein and IVC thrombosis in a patient with diabetes mellitus. Prompt antimicrobial therapy led to a successful outcome, with complete resolution of the thrombi. We report a case of SPE due to pyelonephritis with a review of the literature.

Fluoxetine and Sertraline Attenuate Postischemic Brain Injury in Mice

This study aimed to investigate whether selective serotonin reuptake inhibitors (SSRIs) attenuate brain injury and facilitate recovery following photothrombotic cortical ischemia in mice. Male ICR mice were anesthetized and systemically administered Rose Bengal. Permanent focal ischemia was induced in the medial frontal and somatosensory cortices by irradiating the skull with cold light laser. The animals were treated with fluoxetine or sertraline once a day for 14 d starting 1 h after ischemic insult. Treatment with fluoxetine and sertraline significantly reduced the infarct size. The Evans blue extravasation indices of the fluoxetine- and sertraline-treated groups were significantly lower than that of the vehicle group. Treatment with fluoxetine and sertraline shifted the lower limit of the mean arterial blood pressure for cerebral blood flow autoregulation toward normal, and significantly increased the expression of heme oxygenase-1 (HO-1) and hypoxia-inducible factor-1alpha (HIF-1alpha) proteins in the ischemic region. These results suggest that SSRIs, such as fluoxetine and sertraline, facilitate recovery following photothrombotic cortical ischemia via enhancement of HO-1 and HIF-1alpha proteins expression, thereby providing a benefit in therapy of cerebral ischemia.

Three Cases of Scrub Typhus with Acute Epiglottitis / 감염과화학요법

Scrub typhus is an endemic rickettsial disease with annual seasonal outbreak in Korea and its incidence is increasing. Recently, cases of scrub typhus with severe complications, such as septic shock, acute respiratory distress syndrome, acute renal failure, myocarditis, disseminated intravascular coagulation and meningitis have been increasingly reported. Acute epiglottitis is the one of potentially life- threatening scrub typhus related complications. Its initial clinical manifestations are sore throat, dysphagia or dyspnea. Although 22-62% of scrub typhus patients complain of sore throat, the etiology and optimal therapy are not yet known. We experienced 3 cases of scrub typhus-associated acute epiglottitis which rapidly responded to short-term corticosteroid administration.

Three Cases of Scrub Typhus with Acute Epiglottitis / 감염과화학요법

Scrub typhus is an endemic rickettsial disease with annual seasonal outbreak in Korea and its incidence is increasing. Recently, cases of scrub typhus with severe complications, such as septic shock, acute respiratory distress syndrome, acute renal failure, myocarditis, disseminated intravascular coagulation and meningitis have been increasingly reported. Acute epiglottitis is the one of potentially life- threatening scrub typhus related complications. Its initial clinical manifestations are sore throat, dysphagia or dyspnea. Although 22-62% of scrub typhus patients complain of sore throat, the etiology and optimal therapy are not yet known. We experienced 3 cases of scrub typhus-associated acute epiglottitis which rapidly responded to short-term corticosteroid administration.

The Effect of a Proton-pump Inhibitor in Unexplained Chronic Cough Patients / 결핵및호흡기질환

BACKGROUND: Recent studies have suggested an association between chronic cough and gastroesophageal reflux. Our study aimed to assess the utility of a proton-pump inhibitor in unexplained chronic cough patients. METHODS: Patients with chronic cough of unknown etiology were evaluated using a chest x-ray, methacholine challenge test, and an empirical trial of postnasal drip therapy. After excluding other potential causes of the cough, forty patients were included in the study and treated for 8 weeks with a proton-pump inhibitor. RESULTS: Eleven and three patients in the first and second 4 weeks were lost to follow-up, leaving twenty-six patients finally included in the study. Of these patients, two were unimproved, eight partially responded to the proton-pump inhibitor and sixteen responded completely after the 8 week treatment. CONCLUSION: We suggest that empirical treatment with a proton pump inhibitor in all patients with persistent cough, which is not secondary to asthma or postnasal drip syndrome, represents a practical and simple approach to this ailment.

Cardiovascular Effects of Endogenous GABA in the Nucleus Tractus Solitarius

BACKGROUND: The nucleus tractus solitarius (NTS), the region of the brain stem in which primary baroreceptor afferents teminate, is critically important in the normal regulation of arterial pressure (AP). In the NTS, excitatory amino acids such as L-glutamate serve as the main neurotransmitter in the regulation of AP. However, the function of GABA in the NTS has not been established. To test the function of GABA, we applied GABAergic agents to the NTS. METHODS: The experiments were conducted on adult male Sprague-Dawley rats weighing 300-500g. A cannula (PE-50 tubing filled with heparinized saline) was inserted into the femoral artery for recording of AP and heart rate(HR). Another cannula was inserted into the femoral vein for administration of nitroprusside or phenylephrine. After rats were placed on a sterotaxic instrument, the dorsal surface of the medulla was exposed, and with the aid of a surgical microscope, the NTS was visualized. Drug injections were made into the NTS using single- or three-barreled grass micropipettes pulled to an outer diameter of 80-100(micro)m and connected to a 1(micro)l Hamilton syringe. RESULTS: The follwing results were obtained in this experiment. Injection into the NTS of 10 or 20 nmol nipecitic acid, a selective inhibitor of GABA untake, produced an increase in AP. The pressor responses evoked by two doses of nipecotic acid were not significantly different. Injection of GABA(A) agonist, musciml(5 pmol in 80 nl artificial CSF) and GABA(B) agonist, baclofen (20 pmol in 80 nl) into the NTS of urethane-anesthetized rats prodused an increase in AP of 16.6+/-1.3 and 27.6+/-1.5 mmHg, respectively. Thus the pressor response to GABA(B) agonist was greater than to GABA(A) agonist. On the other hand, microinjection of GABA(A) antagonist, bicuculline and GABA(B) antagonist, phaclofen into the NTS decreased AP by approximately 13.4+/-1.0 and 20.9+/- mmHg, respectively. Thus injection of nipecotic acid into the NTS was greater in control group compared with the muscimiol or baclofen groups. The AP changes caused by i.v. injection of nitroprusside or phenylephrine were smallest in control group and greatest in the baclofen group. When calculated as baroreflex sensitivity, the change was greatest in control group and smallest in the baclofen group. CONCLUSION: From these results it was concluded that GABA in the NTS plays an important role in the regulation of AP, especially through GABA(B) receptors, and have an inhibitory effect on baroreceptor reflex.

The Diagnostic Value of Computed Tomography in Herniated Intervertebral Disc / 대한정형외과학회잡지

The Computed Tomography is the most exact method to find out some diesase, soft tissue or musculoskeletal system. It is searching examination distinguishing normal structure and abnormal states in the spine and spinal canal. This is almost an absolute diagnostic method for spinal stenosis, and it has a special forte becasue it can distinguish the soft tissue around the spine. Thus we can distinguish metastatic cancer, herniated intervertebral disc, hypertrophy of the yellow ligament, and spine tumor very easily. Thirty-two cases of herniated intervertebral disc in lumbar spine were treated for 18 months from Jan. 1981 to Jun. 1982. Of thirty two cases, 18 cases were underwent CT scanning and 9 cases were underwent CT scanning and myelography. We obtained following results: 1. In the 18 cases taking a CT scan we found 6 cases of bulging annulus, 7 cases of herniated disc, one case each of facet syndrome, lateral recess syndrome, and three cases had normal finding. 2. In 9 cases taking CT scan, myelography and operation, 7 cases showed the same positive findings, but one case showed the positive CT scan and myelography, negative surgical exploration, and another case showed positive myelography, negative CT scan surgical exploration. 3. In 9 cases who took only a CT scan, there were 6 cases in which myelography was impossible or refused. Among these 6 cases 4 patients took operation and showed positive findings. 4. The diagnosis of herniated intervertebral disc by means of the CT scan has been made more accurately by the supplementary use of metrizamide and improvement of interpretation. a. When the patient refuses myelography. b. For discrimination of other diseases than herniated intervertebral disc. c. When the patient is allergic to iodine dyes used in myelography. As mention above, not only herniated intervertebral disc, but also many other diseases in spine can be diagnosed and we can decide that the herniated intervertebral disc surgery would by desirable with only the CT scan as nonivasive diagnostic test.

A Clinical Study on the Treatment of Medical Collateral Ligament Injuries / 대한정형외과학회잡지

In military training, the knee joint is more susceptible to trauma than any other joint in the body. Chronic knee instability is a difficult problem for both the patient and the orthopaedic surgeon who must correct the disability. To achieve the best possible result, the surgeon must first make the correct diagnosis and be aware of the type or types of instability that exist. There may be associated instability in a rotatory plane as described by Slocum and Larson, and the surgeon must examine carefully for this. Various surgical techniques have been used in the past to repair the knee static stabilizers such as ligaments and capsule. Since the introduction of the dynamic concept of rotatory instability and the need for muscular reinforcement of static repair, most orthopaedists have attempted to back up their reapirs with various types of dynamic stabilization such as the pes anserinus transfer and advancement of semimembranosus. 39 cases of medial instability of the knee joint were analysed clinically in the department of orthopaedic surgery of Busan Armed Froce General Hospital from Feb. 1977 to Feb. 1980 and following results were obtained. 1. All of the cases were military personnels, most of them were privates and P.F.C. showed most frequent incidence in 19 cases (49%). 2. Sports injury was a main causes of the knee instability. 3. The highest incidence in severity of the lesion was grade III in 21 cases (54%). 4. Among 39 cases of ligamentous injuries of medial side, rupture of collateral ligament alone were 30 cases, and mixed injuries with cruciate were 9 cases. 5. The pes transfer was performed in all of the cases with acute medial collateral rupture, and even in the cases with instability after primary repair, good results were obtained by carrying out dynamic muscle or tendon transfer. 6. In some cases, the patient did not feel much discomfort for the remaining static instability in valgus stress test after dynamic reconstruction. This was thought to be overcome by dynamic force during use of the leg. 7. For the purpose to prevent further stretching of repaired ligaments, derotation brace were recommended in 5 cases of dynamic reconstructive surgery.

Clinical Observations on the Bladder Neck Contracture of Adult Males / 대한비뇨기과학회지

The bladder neck contracture is not uncommon in children and adult. The etiology remains controversial despite extensive studies, however it is usually accepted that bladder neck contracture is congenital in children and is due to previous lower urogenital infections in most of adult males. In spite of various modalities of treatment its high recurrence rate has been a perplexing problem. During the period from January 1, 1973 to December 31, 1976, 90 cases of adult male bladder neck contractures were studied clinically. Transurethral vesical neck resection was performed on 15 cases and phenoxybenzamine treatment was taken on 9 cases. The following results were obtained. 1) The age range of the patients in this study was from 17 to 79 years. 27.8% of the cases were between 30 and 39 years old and the most patients of group III were observed beyond 40 years of age. 2) The patients of group III usually has longer history of symptoms than group I and II patients. 55.6% of the cases had the onset of one year to 5 years. 3) Analysis of the 90 cases shows that common urinary symptoms were frequency(70%), diminished and weak stream(66.7%) and tenesmus(44.4%). 4) 88% of the cases was associated with the one or more diseases of chronic prostatitis, posterior urethritis or verumontanitis. 5) The bladder trabeculation was the most common finding(91.1%). In 73.3% of the cases interureteric ridge was elevated. Vesical outlet was narrowed as reversed V shape in almost all cases. 6) In 68.8% of the cases urine findings was normal, Pyuria was observed in 20% and microscopic hematuria in 16.6%. 7) Transurethral vesical neck resection was performed in 15 cases; All preoperative symptoms were relieved in 10 cases, but no improvement was observed in 5 cases. 8) 9 cases were treated with sympatholytic drug, phenoxybenzamine and significant improvement of all obstructive symptoms was obtained after 10 days or 2 weeks of treatment in all cases.

Cavernous Hemangioma of the Bladder: Report of a Case / 대한비뇨기과학회지

Cavernous hemangioma of the bladder is the rarest of all bladder tumors. Less than 75 cases were reported in the literatures since Broca reported the first case in 1869. We report a case of cavernous hemangioma of the bladder in a 7-year-old girl and literatures were reviewed.

Pararenal Pseudocyst : Report of a Case / 대한비뇨기과학회지

Pararenal pseudocyst is a collection of fluid within the renal fascia outside the renal capsule and a relatively rare clinical entity which commonly occur as a result of trauma. either accidental or operative. Histologically, the wall is composed mostly of dense collagenous fibrous connective tissue. with no cellular elements capable of cyst formation. A case of pararenal pseudocyst associated with renal hypertension developed in 6 year-old boy after blunt abdominal trauma was reported.

Effect of Acute Carbon Monoxide Poisoning on Acid Phosphatase Activity of Prostate Gland In Rat: Histochemical Study / 대한비뇨기과학회지

Effect of acute carbon monoxide poisoning on prostatic acid phosphatase in white rat hag been studied histochemically. The experimental animals were exposed to 0.25% and O. 5% of carbon monoxide from 5 minutes to 4 hours duration. Gomori's modified method was used for acid phosphatase test. Following results are obtained: 1. The acid phosphatase activity increases after 30minutes of exposure in both experimental groups, 0.25% and 0.5% of carbon monoxide, and the changes of acid phosphatase activity become more significant according to the duration of exposure. 2. The changes of acid phosphatase activity are similar in both experimental groups exposed to 0.25% and 0.5% of carbon monoxide. 3. No significant histopathological changes are observed in rat prostate gland.

Bilateral Slipped Upper Femoral Epiphysis: A case report / 대한정형외과학회잡지

During s period of rapid growth in adolescence, weakening of the epiphyseal plate and shearing stress of incumbent body weight may cause the femoral head to become displaced from its normal relation to the femoral neck. Slipped upper femoral epiphysis was firstly described by Ambrose Pare in 1572, and many cases have been reported in Europe and America, and extremely rare in Korea. This particular case is a 15-year-old boy. Slipping was evident on the initial X-ray taken at a local provincial hospital approximately 1 year prior to come to this hospital. Owing to the capital epiphysis subluxated with coxa magna deformity, we performed Herndons operation as the first step of treatment. And schedule to do subtrochanteric wedge osteotomy for correction of residual deformity on right hip later on. Varization of left hip is also considered.

A Clinical analysis of Treatment of Trichanteric Hip Fractures / 대한정형외과학회잡지

The fact that trochanteric hip fractures are best treated by internal fixation is generally accepted in recent time, since this method provides satisfactory positioning of the fragments and obviates the hazards of recumbency. Consecutive seventy-two cases of trochanteric hip fractures were treated at the Department ef Orthopaedic Surgery, National Medical Center from 1965 to 1974. Despite death and lack of follow-up of certain cases, the late results were analysed and presented in 41cases out of 72 cases. 1. In sex difference, 30 of the patients were males and 11 were females. Forty-one percents of the patients were over 51 years of age, and the most common age group was 4th decade. 2. The most common cause of fracture was due to traffic accident. 3. Among 41 cases, 36 were treated with open reduction and internal fixation, and the rest were treated conservatively. Various devices were available for internal fixation; 21 Smith-Peterson or Thornton nails with McLaughlin plates, 5 Jewett nailing, 4. Smith-Peterson nailing plus Multiple screwing, 5 compression screwing and one multiple pinning. 4. Early weight bearing was permitted in 6 cases provided firm internal fixation after anatomical reduction, in an average of 5 weeks postoperatively. Three unstable intertrcchanteric fractures were treated by primary medial displacement fixation in valgus position, and got satisfactory results. 5. The average time in fracture healing was 16 weeks roentgenologically. 6. Complications after internal fixation were most common in the patients of Boyd and Griffin Type III fracture. 7. Owing to short duration of follow up, the number of patients who were treated with various sliding nails and compression hip screws were excluded in this paper.

Extra-adrenal Pheochromocytoma Causing Renal Artery Stenosis / 대한비뇨기과학회지

Extra-adrenal pheochromocytoma accounts for about 10 to 15 percent of all such tumors and the combination of pheochromocytoma and renal artery stenosis is rare. We report an unusual case of extra-adrenal pheochromocytoma causing renal artery stenosis which was developed in a 11-year-old boy and the literatures were reviewed.

Primary Carcinoma of the Ureter: Report of Two Cases / 대한비뇨기과학회지

Two cases of primary carcinoma of the ureter were reported with review of the literatures.