Objectives : The aim of this study was to assess the relationship between metabolic syndrome and erythrocyte deform ability in acute stroke patients. Methods : Among 88 of the recruited patients, 52 were diagnosed as metabolic syndrome. We assessed their general characteristics, risk factors. We compared the assessed variables between metabolic syndrome and control group. We analyzed the relationship between metabolic syndrome and erythrocyte deform ability. We analyzed relationship between cardiovascular risk factors and erythrocyte deformability. Results : The general characteristics waist and hip circumference, waist/hip ratio were higher in metabolic syndrome group. The metabolic syndrome group was also diagnosed with hypertension, DM, and hyperlipidemia more often than the control group. The blood test metabolic syndrome group showed higher triglycerides, total lipids, fasting blood sugar, and 2 hours postprandial plasma glucose level and lower HDL-cholesterol than the control group. There were more patients diagnosed with Dampness-Phlegm in the metabolic syndrome group. There were more patients showing lower erythrocyte deform ability in the metabolic syndrome group. The plasma homocysteine level was negatively correlated with erythrocyte deform ability. Conclusion : The results reconfirmed that the risk factors are more in metabolic syndrome group. The results indicated that metabolic syndrome lead to a lower erythrocyte deform ability in small vessel disease stroke patients. The Plasma homocysteine level was negatively correlated with erythrocyte deform ability.
Objective : Stroke caused from large vessel occlusion (LVO) has emerged as the most common stroke subtype worldwide. Intravenous tissue plasminogen activator administration (IV-tPA) and additional intraarterial thrombectomy (IA-Tx) is regarded as standard treatment. In this study, the authors try to find the early recanalization rate of IV-tPA in LVO stroke patients. Methods : Total 300 patients undertook IA-Tx with confirmed anterior circulation LVO, were analyzed retrospectively. Brain computed tomography angiography (CTA) was the initial imaging study and acute stroke magnetic resonance angiography (MRA) followed after finished IV-tPA. Early recanalization rate was evaluated by acute stroke MRA within 2 hours after the IV-tPA. In 167 patients undertook IV-tPA only and 133 non-recanalized patients by IV-tPA, additional IA-Tx tried (IV-tPA + IA-Tx group). And 131 patients, non-recanalized by IV-tPA (IV-tPA group) additional IA-Tx recommend and tried according to the patient condition and compliance. Results : Early recanalization rate of LVO after IV-tPA was 12.0% (36/300). In recanalized patients, favorable outcome (modified Rankin Scale, 0-2) was 69.4% (25/36) while it was 32.1% (42/131, p<0.001) in non-recanalized patients. Among 133 patients, non-recanalized after intravenous recombinant tissue plasminogen activator and undertook additional IA-Tx, the clinical outcome was better than not undertaken additional IA-Tx (favorable outcome was 42.9% vs. 32.1%, p=0.046). Analysis according to the perfusion/diffusion (P/D)-mismatching or not, in patient with IV-tPA with IA-Tx (133 patients), favorable outcome was higher in P/D-mismatching patient (52/104; 50.0%) than P/D-matching patients (5/29; 17.2%; p=0.001). Which treatment tired, P/D-mismatching was favored in clinical outcome (iv-tPA only, p=0.008 and IV-tPA with IA-Tx, p=0.001). Conclusion : The P/D-mismatching influences on the recanalization and clinical outcomes of IV-tPA and IA-Tx. The authors would like to propose that we had better prepare IA-Tx when LVO is diagnosed on initial diagnostic imaging. Furthermore, if the patient shows P/D-mismatching on MRA after IV-tPA, additional IA-Tx improves treatment results and lessen the futile recanalization.
Purpose: Flash 3D (pixon(R) method; 3D OSEM) was developed as a software program to shorten exam time and improve image quality through reconstruction, it is an image processing method that usefully be applied to nuclear medicine tomography. If perfoming brain diamox perfusion scan by reconstructing subtracted images by Flash 3D with shortened image acquisition time, there was a problem that SNR of subtracted image is lower than basal image. To increase SNR of subtracted image, we use LEAP collimators, and we emphasized on sensitivity of vessel dilatation than resolution of brain vessel. In this study, our purpose is to confirm possibility of application of LEAP collimators at brain diamox perfusion tomography, identify proper reconstruction factors by using Flash 3D. Materials and methods: (1) The evaluation of phantom: We used Hoffman 3D Brain Phantom with $^{99m}Tc$. We obtained images by LEAP and LEHR collimators (diamox image) and after 6 hours (the half life of $^{99m}Tc$: 6 hours), we use obtained second image (basal image) by same method. Also, we acquired SNR and ratio of white matters/gray matters of each basal image and subtracted image. (2) The evaluation of patient's image: We quantitatively analyzed patients who were examined by LEAP collimators then was classified as a normal group and who were examined by LEHR collimators then was classified as a normal group from 2008. 05 to 2009. 01. We evaluate the results from phantom by substituting factors. We used one-day protocol and injected $^{99m}Tc$-ECD 925 MBq at both basal image acquisition and diamox image acquisition. Results: (1) The evaluation of phantom: After measuring counts from each detector, at basal image 41~46 kcount, stress image 79~90 kcount, subtraction image 40~47 kcount were detected. LEAP was about 102~113 kcount at basal image, 188~210 kcount at stress image and 94~103 at subtraction image kcount were detected. The SNR of LEHR subtraction image was decreased than LEHR basal image about 37%, the SNR of LEAP subtraction image was decreased than LEAP basal image about 17%. The ratio of gray matter versus white matter is 2.2:1 at LEHR basal image and 1.9:1 at subtraction, and at LEAP basal image was 2.4:1 and subtraction image was 2:1. (2) The evaluation of patient's image: the counts acquired by LEHR collimators are about 40~60 kcounts at basal image, and 80~100 kcount at stress image. It was proper to set FWHM as 7 mm at basal and stress image and 11mm at subtraction image. LEAP was about 80~100 kcount at basal image and 180~200 kcount at stress image. LEAP images could reduce blurring by setting FWHM as 5 mm at basal and stress images and 7 mm at subtraction image. At basal and stress image, LEHR image was superior than LEAP image. But in case of subtraction image like a phantom experiment, it showed rough image because SNR of LEHR image was decreased. On the other hand, in case of subtraction LEAP image was better than LEHR image in SNR and sensitivity. In all LEHR and LEAP collimator images, proper subset and iteration frequency was 8 times. Conclusions: We could archive more clear and high SNR subtraction image by using proper filter with LEAP collimator. In case of applying one day protocol and reconstructing by Flash 3D, we could consider application of LEAP collimator to acquire better subtraction image.
A 6-year-old female Boston terrier dog was presented with seizure episode, forelimb paraparesis, excessive panting, and ataxia. On physical and neurological examination, episcleral vessel engorgement, delayed postural reaction, delayed pupillary light reflex (both direct and consensual), and crossed forelimb were noted. Serum biochemical profiles were not remarkable other than mildly elevated hepatic enzymes. On cerebrospinal fluid analysis, elevated protein concentration was observed. In magnetic resonance imaging scans, the left frontal brain lesion with ring enhancement strongly suggested the presence of intracranial tumor. Concurrently, secondary hydrocephalus and syringomyelia were also observed. The dog was euthanized at 4 months after initial presentation because of aggravated neurological signs. This case was definitely diagnosed as an intracranial anaplastic oligodendroglioma based on postmortem histopathologic examination.
We investigated the toxic effects of carbaryl on early embryo development in the African clawed frog, Xenopus laevis. To test the toxic effects, frog embryo teratogenesis assays using Xenopus were performed. Embryos were exposed to various concentrations of carbaryl ($5{\sim}320\;{\mu}M$). $LC_{100}$ for carbaryl was $320\;{\mu}M$, and the $LC_{50}$ determined by probit analysis was the concentration of $235.68\;{\mu}M$. Exposure to $160\;{\mu}M$ of carbaryl resulted in 10 different types of severe external malformations. Histological examination revealed dysplasia of the eyes, heart, guts, somatic muscle, dorsal, liver, blood vessel and swelling of the pronephric ducts. Malformation of neural tissue and brain was not severe even in the high dose of carbaryl. Benzidine blood stain showed distinct inhibition of inducing erythrocytes in embryos and animal cap explants. Electron micrographs of embryo revealed retinal detachment, loose photoreceptor lamella and the degeneration of sarcomeres in the carbaryl-treated group. The mitochondrial degeneration was also observed in the test group.
During the 35 month period from November 1966 to November 1967 and from June 1971 to March 1973 I had experienced 127 cases of non fatal wounds of chest in Viet-Nam. .Among these 127 cases, 62[45.4%] were gun shot wounds, 49[35.8%] were shrapnel wounds and the other were traffic accident. stab wounds and miscellanous. Approximately 21% of gun shot wound were perforating and 79% were penetrating but all cases of shrapnel wounds were penetrating. Of these 127 cases. 90% evacuated to hospital within 6 hours and average time 2.5 hours. The tranfusion requirement of these cases ranged from zero to 36 pints of whole blood with an average of 2.600cc. Initial intrathoracic findings were hemopneumothorax and hemothorax mostly. and the incidence of open thoracotomy was 9.5%[12cases] and closed thoracotomy was 82.8%[104cases], which were contrast to the reports from Korean conflict. I had experienced 24 cases with complication, such as large hematoma in lung parenchyme[8 cases], atelectasis[4 cases], pyothorax [3 cases], pneumonia [3 cases], fibrothorax [3 cases], pleural effusion [2 cases] and wound infection [2 cases]. Mortality rate for entire group was 4.7% but the cases associated with brain injury was 100%, with spinal cord injury was 50%, with large vessel 50%, and abdominal injury was 33.3%, and nobody died solely of thoracic injury.
In this study, we investigated whether PLGA microspheres in combination with hyaluronic acid (HA) gel have appropriate properties as a bulking agent for urologic injection therapies and whether the implantation of PLGA microspheres and HA gel induces angiogenesis in the newly formed tissues. In order to investigate whether this bulking agent is injectable, this material was injected through 24-gauge needles into the subcutaneous dorsum of the mouse. The bulking agent was easily injected without needle obstruction. Histological analyses of the hybrid tissues at 2 weeks showed that host cells at the surrounding tissues migrated into the spaces between the implanted PLGA microspheres and formed tissue-like structures. An inflammatory response to the implants was mild at 2 weeks and diminished at 8 weeks. Importantly, extensive ingrowth of blood vessels was observed in the hybrid tissues formed by the injection of PLGA microspheres and HA, whereas blood vessels rarely formed in the hybrid tissues formed by the injection of PLGA microspheres only. The implant volume was conserved for almost the entire implantation period. Histological analyses of the distant organs of the bulking agent-implanted animals, such as the lungs, liver, heart, brain, kidney, and spleen, showed no evidence of the injected microsphere migration. These results show that PLGA microspheres in combination with HA possess the appropriate characteristics for a bulking agent for urologic injection therapies and induce extensive blood vessel formation in the hybrid tissues.
It has been proposed that nitirc oxide is involved in the pathogenesis of cerebral ischemia-reperfusion. Because superoxide production is also enhanced during reperfusion, the cytotoxic oxidant peroxynitrite could be formed, but it is not known if this occurs following global forebrain ischemia-reperfusion. We examined whether peroxynitrite generation is increased in the vulnerable regions after forebrain ischemia-reperfusion. Transient forebrain ischemia was produced in the conscious rat by four-vessel occlusion. Rats were subjected to 10 or 15 min of forebrain ischemia. Immunohistochemical method was used to detect 3-nitrotyrosine, a marker of peroxynitrite production. 3-Nitrotyrosine immunoreactivity was enhanced in the hippocampal CA1 area 3 days after reperfusion. Furthermore, in rats subjected to ischemia for 15 min, this change was also observed in the lateral striatal region and the lateral septal nucleus $2{\sim}3$ days after reperfusion. The cresyl violet staining of adjacent sections showed that neuronal cell death was induced in parallel with the nitrotyrosine immunoreactivity in the hippocampal CA1 area and the lateral striatal region. Our findings suggest that oxygen free radical accumulation and consequent peroxynitrite production play a role in neuronal death caused by cerebral ischemia-reperfusion.
A migraine is a recurrent, throbbing headache generally felt on one side of the head. Migraines usually begin in early childhood, adolescence, or young adult life. Its accurate pathogenesis is still unknown but migraines are caused by a rapid widening and narrowing of blood vessel walls in the brain and head. The classic migraine and the common migraine are the two main types. The onset of classical migraine may be signalled by visual disturbances in what is called the 'aura' stage. Visual aura is most common among the auras of classical migraine. Common migraine (or migraine without aura) and classical migraine may be accompanied by various combinations of symptoms such as nausea, vomiting, and sensitivity to light and sound. Recently we have exprienced 2 cases of migraine patients and whose conditions were improved through trigger point needling and Oriental medical treatment.
This study was carried out to investigate the toxicological effects of carbofuran on the histological and fine structures in the kidney, liver, and brain of rat and also to clarify compensatory effects of phenobarbital sodium (PB) and 3-methylcholanthrene(3-MC) on the carbofuran toxicity. SPF albino rats were treated with carbofuran(3.8mg/kg), PB(60mg/kg), 3-MC(60mg/kg), carbofuran+PB, carbofuran+3-MC and subjected to the light microscopic study. In the kidney of rat, hemorrhage and extremely atropic change of renal corpuscles were frequently observed at 48 hrs after carbofuran treatment. Combination treatment groups of carbofuran and PB or 3-MC showed atrophic changes were largely recovered at 6 hrs, and the tissue findings of the kidney became similar to those of control group at 48 hrs after treatment. In the liver of rat treated only carbofuran, the degenerative and necrotic changes of hepatic lobules were frequently observed at 48 hrs after carbofuran treatment. Combination treatment of carbofuran and PB or 3-MC showed the hepatic lobules were similar to those of control groups at 6 hrs after the combination treatment. In the brain of rat treated with carbofuran alone, degenerative changes and dilation of capillary vessel of cerebral cortexes were observed at 48hrs after treatment. Combination treatment of carbofuran and PB or carbofuran and 3-MC showed the cerebral cortexes were similar to those of control groups at 6 hrs after the treatment. These results suggest that PB and 3-MC could regenerate the toxicity of carbofuran to the tissue of kidney, liver and brain of rat.
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