• Journal of Korean Neurosurgical Society
• /
• v.65 no.6
• /
• pp.868-874
• /
• 2022

Spontaneous intracranial hypotension (SIH) most commonly manifests as bilateral subdural hematoma (SH). SIH cases mostly resolve spontaneously but further treatment would be needed via blind epidural blood patch (EBP). Cerebrospinal fluid (CSF) leakage in EBP-refractory cases can be treated surgically only if the localization of CSF leakage is detectable but it cannot be possible in most of the cases. Also surgical evacuation of SH secondary to SIH (SH-SIH) is not favorable without blocking the CSF leakage. Thus the management of these patients is a challenge and alternative treatment options are needed. Although middle meningeal artery embolization (MMAE) is an effective treatment option in non-SIH SH, there is no report about its application in the treatment of SH-SIH. We present two cases of SH-SIH which their clinical and radiological findings were completely resolved by bilateral MMAE treatment.

• The Korean Journal of Physiology and Pharmacology
• /
• v.27 no.1
• /
• pp.95-103
• /
• 2023

Rosiglitazone is a thiazolidinedione-class antidiabetic drug that reduces blood glucose and glycated hemoglobin levels. We here investigated the interaction of rosiglitazone with Kv3.1 expressed in Chinese hamster ovary cells using the wholecell patch-clamp technique. Rosiglitazone rapidly and reversibly inhibited Kv3.1 currents in a concentration-dependent manner (IC₅₀ = 29.8 µM) and accelerated the decay of Kv3.1 currents without modifying the activation kinetics. The rosiglitazonemediated inhibition of Kv3.1 channels increased steeply in a sigmoidal pattern over the voltage range of -20 to +30 mV, whereas it was voltage-independent in the voltage range above +30 mV, where the channels were fully activated. The deactivation of Kv3.1 current, measured along with tail currents, was also slowed by the drug. In addition, the steady-state inactivation curve of Kv3.1 by rosiglitazone shifts to a negative potential without significant change in the slope value. All the results with the use dependence of the rosiglitazone-mediated blockade suggest that rosiglitazone acts on Kv3.1 channels as an open channel blocker.

• Journal of Chest Surgery
• /
• v.10 no.2
• /
• pp.241-249
• /
• 1977

Atrial septal defect is one of the most frequently encountered congenital heart disease. Up to December 31, 1976, 1682 cardiac patients received cardiac catheterization in the cardiac department of Yonsei university medical college. Out of the 1682 cardiac patients 723 cases had congenital heart disease and only 116 cases had congetial atrial septal defect. This amounted to 16.04% of all those with congenital heart disease. 58 cases of congenital atrial septal defect operated in the chest surgery department were presented. Of these 58 cases of atrial septal defect, 27 cases were male and 31 cases were female. Their ages ranged from 5 years to 54 years. The systolic pressure of the main pulmonary artery of 40 out of the 58 cases of atrial septal defect was below 40% of that of the systemic blood pressure: in 6 cases, the range of the systolic pressure of the main pulmonary artery was 50-90mmHg; in 12 cases, the range of the systolic pressure of the main pulmonary artery was 40-50mmHg. Average age of these was 30. 1 years. This study tends to show that Korean patients with atrial septal defect even though younger have a slight higher systolic pressure of the main pulmonary artery than Western patients have. The pulmonary blood is 1.5-2.5 times of systemic blood flow in 52 cases out of 58 cases of atrial septal defect.In only one of the 58 cases of atrial septal defect, the Rp was found to be as high as 45% of Rs. All other cases were below this level.51 cases had ostium secundum defect, 4 out of these cases had ostium secundum defect combined with mitral incompetence and 6 out of them had double ostium secundum defect. The remaining 7 cases had ostium primum defect. Their atrial defects were repaired under direct vision utilizing extracorporeal circulation, by hemodilution technic combined with moderate hypothermia. 44 cases [2nd atrial septal defect] were repaired by direct sutures while 14 cases, including the 7 cases ostium primum defects needed patches [1 pericardium and 13 teflon patch]. In 4 cases there were single defects while showed two defects. However the associated septal defect was so small that it could be closed by direct sutures. The size of the defect ranged between 6.0cm2and 10.0cm2 in 19 cases[33.7%]: the smallest being 0. 5cm2 and the largest 24cm2. The surgical mortality was 2 cases [3.4%]. These one case with ostium primum defect, could not be resuscitated on operation table. The cause of death in this case was myocardial failure and MI. The other, a case of ostium primum defect had a second operation on the first operative day due to massive bleeding from LV vent-line insertion site.The patient died on 26th post-operative day due to sepsis.

• Journal of Chest Surgery
• /
• v.10 no.2
• /
• pp.230-240
• /
• 1977

Atrial septal defect is one of the most frequently encountered congenital heart disease. Up to December 31, 1976, 1682 cardiac patients received cardiac catheterization in the cardiac department of Yonsei university medical college. Out of the 1682 cardiac patients 723 cases had congenital heart disease and only 116 cases had congetial atrial septal defect. This amounted to 16.04% of all those with congenital heart disease. 58 cases of congenital atrial septal defect operated in the chest surgery department were presented. Of these 58 cases of atrial septal defect, 27 cases were male and 31 cases were female. Their ages ranged from 5 years to 54 years. The systolic pressure of the main pulmonary artery of 40 out of the 58 cases of atrial septal defect was below 40% of that of the systemic blood pressure: in 6 cases, the range of the systolic pressure of the main pulmonary artery was 50-90mmHg; in 12 cases, the range of the systolic pressure of the main pulmonary artery was 40-50mmHg. Average age of these was 30. 1 years. This study tends to show that Korean patients with atrial septal defect even though younger have a slight higher systolic pressure of the main pulmonary artery than Western patients have. The pulmonary blood is 1.5-2.5 times of systemic blood flow in 52 cases out of 58 cases of atrial septal defect.In only one of the 58 cases of atrial septal defect, the Rp was found to be as high as 45% of Rs. All other cases were below this level.51 cases had ostium secundum defect, 4 out of these cases had ostium secundum defect combined with mitral incompetence and 6 out of them had double ostium secundum defect. The remaining 7 cases had ostium primum defect. Their atrial defects were repaired under direct vision utilizing extracorporeal circulation, by hemodilution technic combined with moderate hypothermia. 44 cases [2nd atrial septal defect] were repaired by direct sutures while 14 cases, including the 7 cases ostium primum defects needed patches [1 pericardium and 13 teflon patch]. In 4 cases there were single defects while showed two defects. However the associated septal defect was so small that it could be closed by direct sutures. The size of the defect ranged between 6.0cm2and 10.0cm2 in 19 cases[33.7%]: the smallest being 0. 5cm2 and the largest 24cm2. The surgical mortality was 2 cases [3.4%]. These one case with ostium primum defect, could not be resuscitated on operation table. The cause of death in this case was myocardial failure and MI. The other, a case of ostium primum defect had a second operation on the first operative day due to massive bleeding from LV vent-line insertion site.The patient died on 26th post-operative day due to sepsis.

• Journal of Chest Surgery
• /
• v.31 no.2
• /
• pp.168-172
• /
• 1998

Inferior sinus venosus defect is a rare lesion in which there is a large interatrial communication adjacent to the atrial connection of the inferior caval vein. The defect is located posteriorly and inferiorly, outside the confines of the true atrial septum, and partial anomalous pulmonary venous connections are the rule. We underwent surgical repair in four patients with inferior sinus venosus defect and partial anomalous pulmonary venous return. There were three males and one female with an age range from four months to 25 years. A cross- sectional echocardiogram and cardiac catheterization had been performed preoperatively in all patients, but the correct diagnosis had been made in only one case. Surgical repair was indicated due to congestive heart failure, and one patient of 4-month-old needed urgent operation. The repair was accomplished by suturing a untreated autologous pericardial patch to the right of the pulmonary veins, so that the defect was closed and all the pulmonary venous blood was directed to the left atrium. The preoperative knowledge of the unusual anatomy allows the surgeon to repair the anomaly without difficulties. For the patients in whom interatrial communication and anomalous pulmonary venous return are suggested, surgeon has to pay careful attention to the anatomical landmarks to avoid incorrect placement of the patch.

• Journal of Life Science
• /
• v.24 no.4
• /
• pp.437-446
• /
• 2014

Problems appear when triptans are taken orally. For example, the bioavailability of triptan is reduced by the digestive system, and the drug level in the blood reduces rapidly over time; there is also a possibility of gastrointestinal disorder. To improve side effects, a transdermal patch has been prepared in hydrogel form. The polymer matrix that makes up the hydrogel uses PVA; PEG is used as an additive to induce inter/intra hydrogen bonding of the PVA and almotriptan drug is added. In addition, to accelerate micro-phase separation between PVA chains, liquid nitrogen is used. In FT-IR analysis, the absorption bands of PVA, PEG, and almotriptan were found. The degree of crystallinity, the water uptake ability and tensile strength were increased with increasing PEG content. In drug release tests, the amount of drug released increased depending on the PEG content. In this study, hydrogels with 10 wt% PEG showed better performance in drug release. Approximately 60% of the total drug amount was released in 2 hr, and the drug continued to release for 1 day. Thus, the prepared hydrogel patch is suitable as a transdermal formulation for the second dose administration of triptans to patients who require recurrent migraine treatment within 24 hr after the first administration.

• Asian-Australasian Journal of Animal Sciences
• /
• v.20 no.11
• /
• pp.1761-1769
• /
• 2007

This experiment was conducted to determine the extent to which susceptibility to cortisol-induced follicle shutdown is influenced by fleece phentotype. Twenty Finewool (10 sheep low fibre diameter, low coefficient of fibre diameter-LL and 10 low fibre diameter, high coefficient of variation of fibre diameter-LH) and twenty Strongwool (10 low fibre diameter, low coefficient of variation of fibre diameter-HL and 10 high fibre diameter and high coefficient of variation of fibre diameter-HH) sheep of 9 months of age were individually penned in an animal house and were injected intramuscularly with an aqueous suspension of hydrocortisone acetate at a rate of 1.42 mg/kg body weight for a period of two weeks. Fibre diameter was measured from clipped tattooed patch wool samples. Follicle activity was measured by histological changes in skin biopsies taken weekly. Blood samples were collected at two-week intervals and plasma cortisol measured. Increased plasma cortisol concentration significantly (p<0.05) reduced clean wool production and mean fibre diameter dropped to its lowest level four weeks after commencement and two weeks after the cessation of cortisol injection. Elevation of plasma cortisol concentration significantly (p<0.0001) increased the percentage of inactive follicles two weeks after injection started. High fibre diameter groups (Strongwool sheep; i.e. HL+HH) had significantly (p<0.0001) higher percentage of follicle shutdown than low fibre diameter groups (Finewool sheep; i.e. LL+LH). Average percentage of shutdown follicles for Finewool (LL+LH) and Strongwool (HL+HH) Merino sheep was $9.8{\pm}0.9$ and $13.5{\pm}0.9$ respectively. Shutdown of primary follicles was more pronounced in Finewool than Strongwool sheep. There was no significant effect of coefficient of variation of fibre diameter on propensity to follicle shutdown induced by exogenous cortisol. It is concluded that elevation in plasma cortisol concentration is inhibitory to the normal activity of follicles in Strongwool sheep but that variation in fibre diameter has little or no effect.

• Journal of Veterinary Clinics
• /
• v.34 no.6
• /
• pp.441-444
• /
• 2017

A 15-year-old spayed female Miniature Schnauzer was presented for unilateral foreleg lameness and pain. On physical examination, left elbow joint swelling and stiffness were identified. On a computed tomography (CT) scan, a periosteal reaction of the left humerus from the distal metaphysis to the epiphysis and cortical destruction of the medial condyle was observed. Based on blood tests, histopathology, and immunohistochemistry, it was concluded as a skeletal histiocytic sarcoma. Since the patient's pain was not controlled despite application of a fentanyl patch, a left forelimb amputation was decided upon as part of the palliative therapy. Metronomic chemotherapy with toceranib phosphate and pamidronate was initiated. Toceranib was administered for 3 months without the development of any adverse effects except mild neutropenia. However, 3 months after initiating treatment, the toceranib was discontinued due to moderate gastrointestinal disturbances. Over the next 2 months, a left mandibular bone mass and cortical bone destruction in the bilateral tibia and tarsal joint were identified on CT. The patient became unwilling to eat and was noted to have severe skeletal pain. The anorexia and lethargy were progressively worsening and the owner decided to euthanize the patient. A necropsy was performed and the patient was definitively diagnosed with disseminated histiocytic sarcoma based on histopathologic and immunohistochemical analyses. This report describes a Miniature Schnauzer dog with DHS managed with surgical removal and metronomic chemotherapy with toceranib that survived with an improved quality of life for 7 months.

• Journal of Chest Surgery
• /
• v.12 no.3
• /
• pp.207-214
• /
• 1979

This 3-year-old girl was observed frequent exertional dyspnea and cyanosis at crying since birth. She was not premature baby and delivered at full term normally. On physical examination, she was underdeveloped-body weight 13.5 kg, height 99 cm.- and cyanotic. There was severe clubbing on fingers. There was grade II/VI ejection systolic murmur on left lateral border of the sternum. The preoperative examinations [EKG, echocardiogram, cardiac catheterization and biventriculogram] showed that complicated T.G.A. combined vena cava[S.D.D.]. Preoperatively, we decided the corrective surgery of Rastelli operation using a. pulmonary valved conduit. The operation was performed under total circulatory arrest using deep profound hypothermia combining with extracorporeal circulation. On operation, the anatomy of the heart showed that, 1. The subaortic conus was seen and subaortic muscles were hypertrophied. 2. The VSD[type II], behind the subaortic conus-about 1 cm. in diameter, was visible only through LV cavity and, 3. The pulmonary valve ring was hypoplastic and pulmonary valvular stenosis was seen also. The subpulmonic area [LV outflow tract] was obstructed with hypertrophied muscle and mitral valve. 4. Left superior vena cava was drained to RA via coronary sinus. 5. LAD coronary artery was originated from right coronary artery and ran anterior to the pulmonary artery. According to above anatomy, we performed the VSD closure with Teflon patch, and Mustard operation combined with LV-to-pulmonary artery bypass graft using the valve contained [Hancock 16 mm] conduit. Postoperatively, adequate blood pressure could be maintained under the state of using inotropic agent [epinephrine]. On the second postoperative day, the patient died of cardiac arrest due to low cardiac output syndrome, acute renal failure and pulmonary edema.

• Tuberculosis and Respiratory Diseases
• /
• v.50 no.2
• /
• pp.258-264
• /
• 2001

A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low $C_3$ and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.