An Autopsy-Proven Case of Limbic-Predominant Age-Related TDP-43 Encephalopathy

Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a recently established neurodegenerative disease entity. LATE neuropathological change (LATE-NC) is characterized by a TDP-43 proteinopathy that mainly involves the amygdala and medial temporal structures, with or without hippocampal sclerosis. LATE-NC is typically observed in individuals aged 80 years or older and manifests clinically as amnestic memory decline. Herein, we report a case of LATE diagnosed by brain autopsy in an 82-year-old male who had an 11-year history of memory impairment. Pathological examination revealed high Alzheimer disease neuropathological changes, as well as amygdala-predominant Lewy body pathology. In addition, immunohistochemistry for TDP-43 revealed neuronal and glial cytoplasmic inclusions in the dentate gyrus of the hippocampus, amygdala, and inferior temporal cortex. Increasing awareness of the newly defined entity LATE will enhance our understanding of the neurodegenerative processes that occur in the oldest individuals.

Effect of ethanol extracts from red pepper seeds on antioxidative defense system and oxidative stress in rats fed high-fat, high-cholesterol diet

The purpose of the present study was to investigate the effect of ethanol extracts from red pepper seeds on the antioxidative defense system and oxidative stress in rats fed a high fat . high cholesterol diet. Rats were divided into four experimental groups which were composed of high fat . high cholesterol diet group (HF), high fat . high cholesterol diet with 0.1% ethanol extracts from red pepper seeds supplemented group (HEA), high fat . high cholesterol diet with 0.2% ethanol extracts from red pepper seeds supplemented group (HEB) and high fat.high cholesterol diet with 0.5% ethanol extracts from red pepper seeds supplemented group (HEC). Supplementation of ethanol extracts from red pepper seeds groups (HEA, HEB and HEC) resulted in significantly increased activities of hepatic glutathione peroxidase and catalase. Hepatic superoxide radical contents in microsome and mitochondria were significantly reduced in the groups supplemented with red pepper seeds ethanol extracts. Hepatic hydrogen peroxide content in the mitochondria was reduced in ethanol extracts from red pepper seeds supplemented groups. TBARS values in the liver were reduced in red pepper seeds ethanol extracts supplemented groups. Especially, HEB and HEC groups were significantly decreased compared to the HF group. Hepatic carbonyl values were significantly reduced in mitochondria in these supplemented groups. These results suggest that red pepper seeds ethanol extracts may reduce oxidative damage, by activation of antioxidative defense system in rats fed high fat . high cholesterol diets.

The Effect of the Histidine-Tryptophan-Ketoglutarate (HTK) Solution on Myocardial Protection in Isolated Rat Heart / 대한흉부외과학회지

BACKGROUND: The Histidine-Tryptophan-Ketoglutarate (HTK) solution has been shown to provide the excellent myocardial protection as a cardioplegia. The HTK solution has relatively low potassium as an arresting agent of myocardium, and low sodium content, and high concentration of histidine biological buffer which confer a buffering capacity superior to that of blood. Since HTK solution has an excellent myocardial protective ability, it is reported to protect myocardium from ischemia for a considerable time (120 minutes) with the single infusion of HTK solution as a cardioplegia. The purpose of this study is to evaluate the cardioprotective effect of HTK solution on myocardium when the ischemia is exceeding 120 minutes at two different temperature (10 to 12degrees C, 22 to 24degrees C) using the Langendorff apparatus. MATERIAL AND METHOD: Hearts from Sprague-Dawley rat, weighing 300 to 340 g, were perfused with Krebs-Henseleit solution at a perfusion pressure of 100 cm H2O. After the stabilization, the heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured. Single dose of HTK solution was infused into the ascending aorta of isolated rat heart and hearts were preserved at four different conditions. In group 1 (n=10), hearts were preserved at deep hypothermia (10~12degrees C) for 2 hours, in group 2 (n=10), hearts were preserved at moderate hypothermia (22~24degrees C) for 2 hours, in group 3 (n=10), hearts were preserved at deep hypothermia for 3 hours, and in group 4 (n=10), hearts were preserved at moderate hypothermia for 3 hours. After the completion of the preservation, the heart rate, left ventricular developed pressure, and coronary flow were measured at 15 minutes, 30 minutes, and 45 minutes after the initiation of reperfusion to assess the cardiac function. Biopsies were also done and mitochondrial scores were counted in two cases of each group for ultrastructural assessment. RESULT: The present study showed that the change of heart rate was not different between group 1 and group 2, and group 1 and group 3. The heart rate was significantly decreased at 15 minutes in group 4 compared to that of group 1 (p<0.05 by ANCOVA). The heart rate was recovered at 30 minutes and 45 minutes in group 4 with no significant difference compared to that of group 1. The decrease of LVDP was significant at 15 minutes, 30 minutes and 45 minutes in group 4 compared to that of group 1 (p<0.001 by ANCOVA). Coronary flow was significantly decreased at 15 minutes, 30 minutes, and 45 minutes in group 4 compared to that of group 1 (p<0.001 by ANCOVA). In ultrastructural assessment, the mean myocardial mitochondrial scores in group 1, group 2, group 3, and group 4 were 1.02+/-0.29, 1.52+/-0.26, 1.56+/-0.45, 2.22+/-0.44 respectively. CONCLUSION: The HTK solution provided excellent myocardial protection regardless of myocardial temperature for 2 hours. But, when ischemic time exceeded 2 hours, the myocardial hemodynamic function and ultrastructural changes were significantly deteriorated at moderate hypotherma (22~24degrees C). This indicates that it is recommended to decrease myocardial temperature when myocardial ischemic time exceeds 2 hours with single infusion of HTK solution as a cardioplegia.

Developmental Psychopathologies of Nine Preschool Children, Experiencing Single, Severe Trauma / 신경정신의학

OBJECTIVES: It has been known that children reved symptoms of Posttraumatic Stress Disorder (PTSD) after experiencing traumas similar to adults. But there are a few studies regarding the psychopathologies of PTSD in preschool children. Considering more active brain and psychological development in preschool children, it is expected that trauma of preschool children causes more serious psychopathologies than those of children with older ages or adults. This study aims to investigate psychopathologies of 9 preschool children experiencing a single, severe trauma, specifically in the respect of PTSD diagnosis. METHODS: Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient during lunch time at kindergarten, were evaluated for clinical diagnoses through semi-structured interviews using Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Research Diagnostic Criteria (RDC for Kiddies) of PTSD for preschool children. RESULTS: Five (56% by DSM-IV) and Six (67%, by RDC) out of 9 children were diagnosed as to have PTSD. Among those children with PTSD, four (44%) showed Separation Anxiety Disorder (SAD) and one (17%) showed Major Depressive disorder (MDD) as comorbid diagnoses. On subclinical level, two of 9 children (22%) suffered from separation anxiety, seven (78%) from aggressive behaviors, and two (22%) from depressive mood. Sleep disturbances (89%) and reexperiencing of trauma (89%) were the most prominent symptoms of PTSD in preschool children. CONCLUSION: While preschool children showed profiles of PTSD symptoms similar to those of adults, it was critical to use more developmentally sensitive diagnostic tools for a better detection of psychopathologies. Young children experiencing severe trauma showed other comorbid psychopathologies along with PTSD. For proper diagnosis and intervention, it is important to make an accurate clinical diagnosis based on developmentally appropriate diagnostic process and tools.

Clinical Analysis of Reoperation for Prosthetic Valve Replacement: Report of 12 cases / 대한흉부외과학회지

Between May 1986 and May 1996, 269 patients underwent prosthetic valve replacement. A bioprosthetic valve was replaced in 70 cases and mechanical valve was replaced in 232. Of this 12 patients performed reoperations for replacement, and the mean interval between primary valve operation and reoperation was 87.6 months for mitral valve and 87.7 months for aortic valve. There were 10 women and 2 men, agcd from 22 to 68 years(mean 45). A bioprosthetic valve was implanted in 8 cases and a mechanical valve was implanted in 4 cases for initial operation. llidications for reoperation were structural deterioration in 5 cases(42%), valve thrombus in 5 cases(42%) and endocarditis in 2 cases(17%). Operations performed included 3 aortic valve replacements(25%), 9 mitral valve replacements(75%). Wc used mechanical valve in llcases(92%) and tissue valve in 1 case(8%) for reoperation. There were 2 early operative deaths because of valve detachment and of acute respiratory failure. Among ten survivor's, there were no late deaths with follow up of 35.8 months.

Clinical Analysis of Traumatic Diaphragmatic injuries: Report of 28 cases / 대한흉부외과학회지

The records of 28 patients with traumatic diaphragmatic injuries seen at Masan Samsung Hospital from march 1986 o March 1995 were reviewed. We treated 21 male and 7 female patients ranging in ages from 5 to 68 years. Thc diaphragimatic injuries were due to blunt trauma in'20 cases(Trawc accident 18, compression injury 1, Human trauma 1) and penetrating injuries 8 cases (all stab wound). Most common symptoms were dyspnea 27 (96%), chest pain 26 (93%), abdomianl pain 8 (29%), comatose mentality 36 (11 %). Chest X-ray were elevated diaphragm in 20 cases(71%) find hemothorax in 18 cases (64%) and 25 cascs (89%) were diagnosed or suspected as diaphragmatic inju,rims prcopcrativcly. The repair of 28 cases were performed with thoracic approach in 20 cases, abdominal approach 7, thoracoabdominal approach in 1 cases. There were 5 death (18%) and all death related to the severity of associated injury. (hypovolcmic shock 3, combined head injury 1, renal failure 1).

A Clinical Study of the Medistinal Tumors and Cysts: 27 cases analysis / 대한흉부외과학회지

We have experienced 27 cases of primary medistinal tumors and cyst from April, 1986 to April 1996. At Masan Samsung General Hospital. The results of the anslysed were as follows. 1. Of 27 medistinal tumors and c,pests, 9 patients were male and 18 patients were female(m : f = 1 : 2). 2. The most common chief complaint was chest discomfort or pain(8 cases 30 %) and 17 patients(63%) were asymptomatic. 3. The most common primary medistinal tumor was Neurogenic tumor in 9 cases(33 %) followed by Thymoma in 7 cases(26 %), teratoma in 6 cases(22 %). 4. The incidence of malignancy of all case was 3 cases(11 %), all cases were symptomatic and the most common malignancy was malig. thymoma(3 cases,43 %). 5. The anterior mediastinum was the most common tumor location with 15 cases(56 %) followed by posterior 11(41 %) and middle mediastinum 1(4 %). Anterior mediastinum tumors were predominantly thymomas and teratoma and posterior mediastinal tumors were neurogenic tumors. 6. Complete removal of tumor was achieved in 26 cases(96 %) and open biopsy was done on 1 case. 7. Postoperative complications were continued lumbar shunt drainage in 1 case and wound infection in 1 case. 8. There was no case of postoperative mortality and good clinical course in surgically completely resected cases.

A Case of Dietary Treatment of Vitamin B12 Non-responsive Methylmalonic Acidemia

Methylmalonic acidemia is a metabolic disorder of amino acid and fatty acid metabolism. A Female infant, who was diagnosed as methylmalonic acidemia based on findings; methylmalonic aciduria, metabolic acidosis with increased anion gap, hyperammonemia, has been followed up for 9 months. She has been placed on the planned diet according to Ross metabolic formula nutrition support protocol. The diet is composed of protein 2.0g/kg/day, ILE 80mg/kg/day, MET 30mg/kg/day, THR 75 mg/kg/day, VAL 85mg/kg/day and total calorie 115Cal/kg/day with the distribution of protein: carbohydrate: fat = 1: 4: 5. The practical dietary prescription consisted of whole milk 8.6g, OS-1 2.1g, glucose 7.1g, rice 3.6g and vegetable oil 0.7ml per each 100ml of liquid diet. After the administration of specially prescribed amino acid mixture, OS-1, her body weight caught up from less than 3 percentile at 3 month to 50 percentile at 9 month. Plasma levels of amino acids, ILE, MET, THR, VAL were maintained within normal values. However, her development lagged 3-4 months behind the developmental milestones appropriate for her chronological age. The plasma ammonia and bicarbonate levels were normalized. The urinary excretion of methylmalonic acid has been markedly decreased during follow-up. We could maintain the patient,s growth and biochemical indices within normal range by prescribing specially made amino acid mixture. However, the development seemed to be delayed inspite of strict metabolic controls, it indicating that further long term follow-up is needed.

Comparative Study of Tracheal Anastomotic Techniques / 대한흉부외과학회지

Although several reports were presented recently about bronchial arterial revascularization in clinical lung transplantation, one factor peculiar to the lung transplantation is the ischemia of the donor bronchus. Poor bronchial healing occurs frequently following clinical lung transplantation and this has been major cause of mortality and morbidity. There have been many attempts to solve bronchial anastomotic complications. Telescoping technique, one of those attempts, was advocated by San Antonio Group recently. This experiment was performed to evaluate the effect of telescoping anastomotic technique upon the healing of the tracheo-bronchial anastomosis. We used rabbits(weighing about 800 g) as experimental animal. METHOD: Resection of middle one third of cervical trachea and reanastomosis was performed by simple interrupted anastomotic technique in Group 1(n=15) and by telescoping anastomotic technique in Group 2(n=15). RESULT: Anastomotic sites in the telescoping technique group showed significant increase of fibrosis in the early postoperative days(< 5days) and remarkable band-like fibrous union compared to the simple interrupted group.

Clinical Evaluation of Open Thoracotomy Cases in Spontaneous Pneumothorax / 대한흉부외과학회지

Spontaneous pneumothorax is the sudden collapse of a lung usually caused by air leakage from a subvisceral pleural bleb. Responses to closed thoracostomy,thoracentesis and simple observation are usually prompt and effective. But in some cases, these are unsucceful and open thoracotomy is indicated. A clinical evaluation was performed on 242 cases(236 patients) of open thoracotomy in spontaneous pneumothorax who were admitted and treated at department of Thoracic and Cardiovascular Surgery. Masan Samsung General Hospital during the past 9 years from January 1988 to December 1996. The results were as follows 1. The sex ratio was male predominance(M:F=11.7:1). 2. The most common age group were 2nd, 3rd decades(2nd=29.3%, 3rd=30.2%). 3. The most common chief complaints were chest pain and dyspnea(chest pain=41.7%, dyspnea=36.8). 4. The etiologic factors of spontaneous pneumothorax were primary spontaneous pneumothorax(86.4%), tuberculosis(9.1%), COPD(3.7%) and pleuritis(0.8%). 5. The site of spontaneous pneumothorax was 52.1% in right, 45.4% in left and 2.5% in both. 6. The common indications of open thoracotomy were recurrence(44.2%), persistent air leakage(31.8%) and inadequate expansion(15.7%). 7. The operative procedures were bullectomy or mechanical pleurodesis through posterolateral thoracotomy or median sternotomy. 8. The most frequent location of bulla or bleb were apical segment of RUL(35.1%) and apicoposterior segment of LUL(41.3%). 9. The number of bulla or bleb were mainly 1 to 5(88%), and there were no significant differences among operation indications. 10. The size of bulla or bleb were mainly below 5cm(81%)and small bulla(5cm)were predominant in persistent air leakage and inadequate expansion group. 11. The pleural adhesion was seen in 54.5%.(Recurrence group 64.1%, Persistent air leakage group 51.9%,Inadequate expansion group 47.4%).

Surgical treatment of pulmonary aspergillosis / 대한흉부외과학회지

No abstract available.

Bechet's disease with multiple arterial aneurysms / 대한흉부외과학회지

No abstract available.

Clinical evaluation of 32 cases aortocoronary bypass with saphenous vein / 대한흉부외과학회지

No abstract available.

Long term results and clinical evaluation of lung cancer / 대한흉부외과학회지

No abstract available.

Surgical management of cardiac tamponade / 대한흉부외과학회지

No abstract available.

Surgical treatment of aneurysm of the ascending aorta with aortic insufficiency / 대한흉부외과학회지

No abstract available.

Clinical analysis of open heart surgery: review of 477 cases / 대한흉부외과학회지

No abstract available.

Responses of vasopressin release in patients with cardiopulmonary bypass anesthetized with enflurane and morphine

Changes in plasma level of arginine vasopressin (AVP), arterial pressure, and urine flow were studied before, during and after cardiopulmonary bypass (CPB) in 11 patients with congenital heart disease. Anesthesia was induced with thiopental sodium (3-5 mg/kg) and was maintained with enflurane (1.0-1.5%), 50% N2O in O2 and morphine (0.5 mg/kg). Concentration of plasma AVP increased slightly from 3.8 +/- 1.5 pg/ml after induction and increased 3-fold after sternotomy. Plasma AVP level increased to 132 +/- 26 pg/ml and 218 +/- 54 pg/ml after 5 and 60 min on CPB, respectively. When the circulation returned to normal, plasma AVP level decreased gradually but was still significantly higher at 24 hr (13.4 +/- 2.5 pg/ml). Marked osmolar diuresis was induced with mannitol in the priming solution used during the CPB: increases in urine flow, Na excretion and osmolar clearance. Possible mechanisms of marked increase in AVP release and differences of AVP responses during CPB reported by other investigators are discussed.