Efficacy and clinical trials of Salenvac-T, bivalent killed vaccine containing Salmonella Enteritidis and Salmonella Typhimurium / 대한수의학회지

Commercial bivalent killed Salmonella vaccine Salenvac-T has been used in several countries in order to prevent salmonellosis with Salmonella enterica serovars Enteritidis (SE) and Typhimurium (ST) in poultry. However, this vaccine has not been used in poultry farms in South Korea. In this study, we evaluated the efficacy of Salenvac-T vaccine to protect against the challenge of virulent SE and ST, and the effect of the vaccine on egg production and mortality in layer hens. The colonization of liver, spleen and cecum with challenged SE and ST was reduced in vaccinated chickens compared with that of unvaccinated control group. The twice vaccination with Salenvac-T induced elevated antibody responses against both SE and ST detected by enzyme-linked immunosorbent assay (ELISA). The higher average hen-day production was observed in the vaccinated layer hens than in the unvaccinated layer hens without significance. The average mortality was lower in the vaccinated layer hens during the experiment period. The antibody responses to both SE and ST were persistently detected in the vaccinated layers. In summary, vaccination with Salenvac-T reduces colonization of internal organs and induces good antibody responses, thereby results in higher performance and lower egg contamination with SE and ST in layer hens.

Cerebral Hemorrhage caused by Phenylpropanolamine

Phenylpropanolamine (PPA) is the major ingredient of over-the-counter drugs, including diet pills and nasal decon-gestants. We present a case of ICH induced by PPA in diet pills in a 36-year-old woman. She didn't have any medical concerns when she began taking diet pills, containing PPA, since 10 days before admission. A brain CT showed large ICHs on the right basal ganglia and lateral ventricle. Physicians should be alerted to the potential fatal side effects of PPA, in commonly used OTC drugs. (J Korean Neurol Assoc 19(3):298~301, 2001)

Effect of triflusal on the platelet aggregation in human whole blood

BACKGROUND AND PURPOSE: Triflusal(TR), 2-acetoxy-4-trifluoromethyl banzoic acid, is a platelet aggregation inhibitor structurally related to aspirin, proven to possess both in vitro and in vivo platelet antiaggregatoy activity. The aim of this study was to evaluate the effect of TR with different dosages on platelet function using platelet aggregation, adenosine triphosphate (ATP) secretion, and thromboxane generation after TR administration. METHODS: Twenty healthy volunteers (age 25-41years, 15 males 5 females) were randomly divided into two groups of ten subjects who were receiving one of two regimens (TR 300mg/day; TR 900mg/day) for seven days. Platelet functions including platelet aggregation by impedance methods using whole blood with ADP (5, 10uM) and collagen (1,2uM), ATP secretion and thromboxane B2 generation were determined. RESULTS: The inhibitory effect of platelet aggregation was observed in both groups. The degree of inhibitory effect was depended on the dosage of TR and the types of aggregating agent. Thromboxane B2 concentrations were significantly decreased by TR ingestion in both groups (p<0.01), but there was no differences in ATP secretion. CONCLUSIONS: This study show that TR exerts a remarkable platelet antiaggregation effect and inhibition of thromboxane synthesis in whole blood. In addition, the fact that TR does not affect ATP secretion means selective blocking of the platelet cyclooxygenase pathway.

Clinical Manifestation of Thalamogeniculate Artery Territory Infarction

BACKGROUND: In terms of localizing value, the clinical features of small lesion confined to thalamus are of great interest. The clinical manifestations frequently comprise hemiparesis, hemianesthesia, and neuropsychological abnormalities and the main cause of thalamic infarct is thought to be an arteriolopathy. To better understand the relationship between the location of thalamic lesion and clinical features, we studied the charateristics of patients with thalamogeniculate artery(TGA) territory infarction, which is most common site of thalamic infarction. METHODS: We reviewed 732 ischemic stroke patient registered to our stroke database over 4-year period. On the basis of MRI, we identified 33 cases of small thalamic infarction(<2cm). Among them, 21 cases had a lesion purely confined to TGA territory. RESULTS: The clinical type of manifestations were sensorimotor(10), pure sensory(7), hemiataxia+sensory(2), hemiataxia+ sensorimotor(1) and involunatry movement(1), respectively. No cases had neuropsychological abnormalities. Only 19% of total cases developed classical Dejerine-Roussy syndrome on short term follow-up. Most patients had hypertension and/or diabetes with the absence of large vessel abnormalities on MRA, but none had the cardioembolic source. CONCLUSION: The lesion sizes of pure sensory thalamic infarction were relatively small. The classical Dejerine-Roussy syndrome had been originally described as the effect of TGA occlusion but uncommon in our series.

Renal Tubular Acidosis Mimicking Guillain Barre Syndrome

The typical attacks of hypokalemic periodic paralysis come on during sleep or at late night. The patients usually awaken to find mild or severe weakness of the limbs and the attacks evolve over minutes to several hours. Once established, the weakness lasts a few several hours in most cases. However, our two patients due to the hypokalemia of renal tubular acidosis showed more prolonged, progressive courses of flaccid, hyporeflexic motor weakness. Especially one patient also showed slowed motor nerve conduction velocities which were normalized after potassium correction of one day. So we initially mistook the motor weakness for Guillian Barre Syndrome.

Renal Tubular Acidosis Mimicking Guillain Barre Syndrome

The typical attacks of hypokalemic periodic paralysis come on during sleep or at late night. The patients usually awaken to find mild or severe weakness of the limbs and the attacks evolve over minutes to several hours. Once established, the weakness lasts a few several hours in most cases. However, our two patients due to the hypokalemia of renal tubular acidosis showed more prolonged, progressive courses of flaccid, hyporeflexic motor weakness. Especially one patient also showed slowed motor nerve conduction velocities which were normalized after potassium correction of one day. So we initially mistook the motor weakness for Guillian Barre Syndrome.

Striatocapsular Infarction: Clinical Feature, Pathogenesis, and Radiologic Characteristic

Background and purpose : Striatocapsular infarction (SCI) has recently been described as a distinct type of stroke and forms an Important subgroup of sub-cortical infarction. The aims of this study were to define the clinical profile, pathogenesis and radiological features of the SCI. METHODS: Based on computed tomographic (CT) and magnetic resonance (MR) findings, 24 patients with SCI were selected from among 599 patients admitted consecutively to our Institute from January, 1993 to June, 1995 and reviewed with attention to clinical characteristics and radiological findings retrospectively. SCI defined as the following CT and MR imaging criteria :the area of infarction included the internal capsule and striatum, the maximum diameter of the lesion exceeded 20mm without cortical involvement Results : The study population consisted of 12 men and 12 women, aged 33 to 80 years. The most common clinical presentation was a stuttering progression of the motor weakness, sensory change and accompanying cortical dysfunction. Eight patients presented with a lacunar syndrome(3:pure motor syndrome and 5:sensory motor syndrome). The 13 patients had the sign of cortical dysfunction. Only one patients experienced TIA in ipsilateral carotid territory. Risk factors for atherosclerosis were hypertension in 10 (42%) patients, diabetes in 4(17%), smoking in 9(41%), and hypercholesterolemia in 2(8%). The presumed mechanism of stroke was large artery thrombosis in 15 (63%) patients (13 MCA, 4 ICA) :definite cardioembolism in 6(25%), (arterial fibrillation in 5, myocardial infarction in 2) : embolic infarction with tandem arterial pathology in1 : Moyamoya disease in 1 : undetermined cause in 1. Conclusions : We conclude that, SCI occurs mostly due to occlusive disease of cerebral large vessel and not due to a disseminated in situ occlusion of the long penetrating arteries as in lacunas. It is important because the different pathological mechanisms demand different therapeutic strategies.

Significance of High Density Lesion on Immediate follow-up CT scan after Intraarterial Thrombolysis for Acute Ischemic Stroke

BACKGROUND: Although intracranial hemorrhage is a dreadful complication of thrombolytic therapy in acute ischemic stroke, increased densities on immediate CT after intraarterial thrombolytic therapy in some cases, does not have any clinical deterioration and improve dramatically on follow-up CT. This unusual observation inspired us to determine the nature of the lesion of increased density on immediate CT finding, after intraarterial thrombolytic therapy. SUBJECTS AND RESULTS: Eight patients presenting with acute middle cerebral artery or internal carotid artery territory strokes were treated by emergency intraarterial urokinase with superselective catheterization. Fight of them had the areas of increased density in the territory sustaining the ischemic event on the immediate CT, performed within 30 minutes after thrombolytic therapy. Most lesions resolved definitely on follow-up scan within 48 hours of their detection. No cases were associated with clinical deterioration. CONCLUSION: As those lesions were cleared so fast without any clinical deterioration, the area of increased density should not necessarily be interpreted as hemorrhage alone. The density change on immediate CT after intraarterial thrombolysis partially attributable to extravasated pure contrast materials.

MR Imagings of Chronic Acquired Hepatic Failure

Neuroimaging of the brain is useful diagnostic evaluation of patients with hepatic encephalopathy msofar as it is able to exclude other causes of abno rmal mental status. Recently, changes of basal ganglia on MRI characteriwd by increased signal mtensity on Tl-weighted images were reported m patients with liver cirrhosis. Signal abnormality involves mainly the globus pallidus and seems to be specific for patients with chronic liver disease. Its pathogenesis and significance are obscure, and no pathological reports have been made. We experienced 3 cases of Chronic acquired hepatic failure whose MRI showed increased signal in-tensity in the basal ganglia on Tl-weighted imaging. Our findings su-ggest that basal ganglia signal abnormality could arise as a marker of brain impairment related to deposition of an unidentified paramagnetic substance or altered intracellular water relaxation.

High Signal Intensity in The Posterior internal capsule in ALS Patient: A case Report

In amyotrophic lateral sclerosis(ALS) patients, cervical magnetic resonance imagings are usually performed to rule out surgically treatable cervical cord pro-blems. So the chance to evaluate portions above cervical cord such as brainstem, internal capsule, and cerebral cortex is extremely rare. During evaluation of 34-year-old patient who progressively developed ALS after left brachial plexus injury, we observed bilateral, asymmetric, and high signal intensity lesions at the posterior third quarter of the posterior limb of internal capsule and the lateral third quarter of the cerebral peduncle on proton density image as well as T2 weighted image. The properties of these bilateral lesions suggest that they represent large, degenerated fibers of the corticospinal tract in ALS patient other than normal hyperintense foci in the internal capsule.

Spontaneous Dissecting Aneurysm of the Intracranial Portion of Vertebral Artery

Spontaneous dissection of the vertebrobasilar arterial system is less common than that of the carotid system. These dissections are usually found extracranially or in a combination of intracranial and extracranial location. Pure intracrainl involvement is uncommon. Particularly in oriental country. This vascular anomaly is one of the important causes of posterior circulation stroke in young and middle-aged adults. Lf manifested as brainstem, ischernia, the usual symptoms and signs are typically neck or occipital pain followed later by particular features of the lateral medullary syndrome. Etiology remains obscure in most cases of spontaneous dissection and management is still controversial. We present three cases of dissecting aneurysm of the intracranial portion of unilateral vertebral artery. The two patients manifested as lateral medullary syndrome with sudden neck pain and digital substracted angiogram revealed proximal narrowed segments and distal fusiform dilatation of the unilateral vertebral arter.,v. The other patient manifested as subarachnoid hemmorrhage and angiographically dilatation at the junction of vertebral artery and posterior inferior cerebellar artery was noted. In operative field, two cases were confirmed as dissecting aneurysm.