RESUMEN
BACKGROUND: Diffusion tensor MRI (DTI) is a new imaging technique and enables us to analyze the structural damage of fiber pathways and to monitor the time course of Wallerian degeneration of the pyramidal tract in stroke patients. We used DTI to investigate structural changes of the infarct area and the associated descending corticospinal tract in patients with subcortical infarct. METHODS: We examined 24 consecutive patients who presented with acute single cerebral infarct in the subcortical area and who also had undergone an MRI study within 7 days after symptom onset. Clinical outcome was assessed using the National Institutes of Health Stroke Scale (NIHSS) at admission, 7 days, 14 days and 30 days and modified Rankin Scale (mRS) at admission and 30 days. Each of the indices was achieved by post processing the acquired DTI data and correlated with the NIHSS. RESULTS: In infarct region, fractional anisotropy (FA) was significantly decreased compared with matched-contralateral regions (0.39 vs. 0.53, p<0.001). In the distal to the infarct, FA was significantly decreased at internal capsule (0.62 vs. 0.64, p=0.019), not at pons (0.51 vs. 0.53, p=0.103). The decrease of anisotropy at infarct region correlated positively with the NIHSS at 7, 14 and 30 days and mRS at 30 days after stroke, but the decrease of anisotropy at internal capsule did not correlate with the NIHSS. CONCLUSIONS: This study shows the potential of DTI to detect and monitor the structural degeneration of fiber pathways and to establish the prognosis in patients with acute subcortical cerebral infarct.
Asunto(s)
Humanos , Anisotropía , Infarto Cerebral , Difusión , Cápsula Interna , Imagen por Resonancia Magnética , Puente , Pronóstico , Tractos Piramidales , Accidente Cerebrovascular , Degeneración WallerianaRESUMEN
CD44 is a cell adhesion molecule with numerous isoforms created by mRNA alternative splicing. Expression of CD44 variants has been suggested to play a potential role in tumor progression and metastasis. We designed primers CD44V, CD44V6/7, CD44R1 and CD44V6-10 to analyze and compare the roles of each CD44 variants. Expressions of CD44 variants were investigated in normal colonic mucosa, the lymph nodes which was histopathologically free of cancer cell, and cancer tissues of 44 human colorectal cancer patients by RT-PCR method. The expression of CD44V was observed in 28 out of 39 (71.8%) tumors and 7 out of 11 (63.6%) N1 normal regional lymph nodes, and CD44V6/7 was observed in 28 out of 39 (71.8%) tumors and 9 out of 11 (81.8%) N1 normal regional lymph nodes. The expressions of CD44V and CD44V6/7 were most frequently observed compared with any other CD44 variants. In normal colonic mucosa, the expression of CD44 variants are low but in cancer tissue and its regional lymph node, the expression of CD44V and CD44V6/7 were significantly higher and more frequent than any other CD44 variants (p<0.05). These results suggest that CD44V and CD44V6/7 can be a molecular marker for colorectal cancer and its micrometastasis to the regional normal lymph node.
Asunto(s)
Humanos , Empalme Alternativo , Receptores de Hialuranos/genética , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/inmunología , Expresión Génica , Ganglios Linfáticos/patología , Ganglios Linfáticos/inmunología , Isoformas de Proteínas/genéticaRESUMEN
The microfilaments of hepatocyte are distributed throughout the vicinity of cell membranes, especially numerous around the region of bile canaliculus, and provide the maintenance of cell shape, cellular wall tension, canalicular motility, the secretion for bile, etc. To evaluate the relationship between the microfilament and alteration of cell shape, we examined the morphological changes of cultured rat hepatocytes, following treatments with phalloidin or cytochalasin D with fluorescent and electron microscopes. 1. In the fluorescent micrographs, actin microfilament was distributed near the plasma membrane and bile canaliculus. 2. Both drugs, phalloidin or cytochalasin D, produce the cytoplasmic protrusions from the surface. Their shapes were pedunculated with narrow neck or bulged with broad base, respectively. 3. In the phalloidin treated group, cytoplasmic protrusion was seperated from the internal cytoplasm by microfila-ments networks at the narrow base. In contrast, in the cytochalasin D treated group, cytoplasm was bulged with broad base and kept in direct continuity with the canalicular ectoplasm. 4. Pericanalicular ectoplasm of phalloidin treated group was widened and accumulated with microfilaments. But, bile canaliculus of cytochalasin D treated group was markedly dilated and devoid of microvilli, and the ectoplasm was almost disappeared. Considering above results, dysfunction of microfilaments leads to the structural changes and inhibition of bile secretion of hepatocytes.
Asunto(s)
Animales , Ratas , Citoesqueleto de Actina , Bilis , Canalículos Biliares , Membrana Celular , Forma de la Célula , Citocalasina D , Citoplasma , Hepatocitos , Microvellosidades , Cuello , FaloidinaRESUMEN
We conducted a retrospective study of 104 patients to examine the efficacy of two methods of urinary bladder management after total hip arthroplasty under spinal anesthesia. Patients who had total hip replacement was randomly assigned either to Group I, in which indwelling catheters were placed during the operation and removed the next morning, or Group II, in which urinary retention was managed by intermittent catheterization as needed. After the removal of the indwelling catheter, the patients in Group I had a lower incidence of urinary retention than those in Group II. Bladder distention(volume above 700ml) was more common in Group II and was associated with an increased need for subsequent long-term catheterization. There was no significant difference between the groups in the rates of urinary tract infection. We conclude that the short-term use of an indwelling catheter after extended surgery, such as joint replacement, reduces the incidence of urinary retention and bladder overdistention, without increasing the rate of urinary tract infection.
Asunto(s)
Humanos , Anestesia Raquidea , Artroplastia de Reemplazo de Cadera , Cateterismo , Catéteres , Catéteres de Permanencia , Incidencia , Articulaciones , Estudios Retrospectivos , Vejiga Urinaria , Retención Urinaria , Infecciones UrinariasRESUMEN
This is a follow up study on consecutive series 50 patients of total hip arthroplasty to assess for transient leg-length inequality. The authors report a clinical experience of 50 patients who have been pelvis tilt before total hip replacement. Retrospectively reviewed for the presence of pelvic obliquity preoperative and at the 1, 3 and 6 months follow-up visits. The results were as follows. Fourty-eight patients(96%) with functional leg length inequality related pelvic obliquity were improved within 6months postoperative follow up period after total hip arthroplasty. Two patients(4%) had persistent functional leg length inequality that affected factors-old age, female and soft tissue tightness due to pelvic obliquity. We believe that in most of these patients, the transient functional leg length inequality has a self-limited course, whereas in a small number, the profoud sense of inequality remains.
Asunto(s)
Femenino , Humanos , Artroplastia de Reemplazo de Cadera , Estudios de Seguimiento , Diferencia de Longitud de las Piernas , Pierna , Pelvis , Estudios Retrospectivos , Factores SocioeconómicosRESUMEN
No abstract available.