Decreased inward rectifier and voltage-gated K⁺ currents of the right septal coronary artery smooth muscle cells in pulmonary arterial hypertensive rats

In vascular smooth muscle, K⁺ channels, such as voltage-gated K⁺ channels (Kv), inward-rectifier K⁺ channels (Kir), and big-conductance Ca²⁺-activated K⁺ channels (BK(Ca)), establish a hyperpolarized membrane potential and counterbalance the depolarizing vasoactive stimuli. Additionally, Kir mediates endothelium-dependent hyperpolarization and the active hyperemia response in various vessels, including the coronary artery. Pulmonary arterial hypertension (PAH) induces right ventricular hypertrophy (RVH), thereby elevating the risk of ischemia and right heart failure. Here, using the whole-cell patch-clamp technique, we compared Kv and Kir current densities (I(Kv) and I(Kir)) in the left (LCSMCs), right (RCSMCs), and septal branches of coronary smooth muscle cells (SCSMCs) from control and monocrotaline (MCT)-induced PAH rats exhibiting RVH. In control rats, (1) I(Kv) was larger in RCSMCs than that in SCSMCs and LCSMCs, (2) I(Kv) inactivation occurred at more negative voltages in SCSMCs than those in RCSMCs and LCSMCs, (3) I(Kir) was smaller in SCSMCs than that in RCSMCs and LCSMCs, and (4) I(BKCa) did not differ between branches. Moreover, in PAH rats, I(Kir) and I(Kv) decreased in SCSMCs, but not in RCSMCs or LCSMCs, and I(BKCa) did not change in any of the branches. These results demonstrated that SCSMC-specific decreases in I(Kv) and I(Kir) occur in an MCT-induced PAH model, thereby offering insights into the potential pathophysiological implications of coronary blood flow regulation in right heart disease. Furthermore, the relatively smaller I(Kir) in SCSMCs suggested a less effective vasodilatory response in the septal region to the moderate increase in extracellular K⁺ concentration under increased activity of the myocardium.

Analysis of the Development of the Nasal Septum and Measurement of the Harvestable Septal Cartilage in Koreans Using Three-Dimensional Facial Bone Computed Tomography Scanning

BACKGROUND: The septal cartilage is the most useful donor site for autologous cartilage graft material in rhinoplasty. For successful nasal surgery, it is necessary to understand the developmental process of the nasal septum and to predict the amount of harvestable septal cartilage before surgery. METHODS: One hundred twenty-three Korean patients who underwent three-dimensional (3D) facial bone computed tomography (CT) were selected for evaluation of the midsagittal view of the nasal septum. Multiple parameters such as the area of each component of the nasal septum and the amount of harvestable septal cartilage were measured using Digimizer software. RESULTS: The area of the total nasal septum showed rapid growth until the teenage years, but thereafter no significant change throughout the lifetime. However, the development of the septal cartilage showed a gradual decline due to ossification changes with aging after puberty in spite of a lack of change in the total septal area. The area of harvestable septal cartilage in young adults was 549.84+/-151.26 mm2 and decreased thereafter with age. CONCLUSIONS: A 3D facial bone CT scan can provide valuable information on the septal cartilage graft before rhinoplasty. Considering the developmental process of the septal cartilage identified in this study, septal surgery should not be performed until puberty due to the risk of nasal growth impairment. Furthermore, in elderly patients who show a decreased cartilage area due to ossification changes, septal cartilage harvesting should be performed carefully due to the risk of saddle nose deformity.

Effects of Antidepressant Treatment on Sexual Arousal in Depressed Women: A Preliminary fMRI Study

OBJECTIVE: There was a recent study to explore the cerebral regions associated with sexual arousal in depressed women using functional magnetic resonance imaging (fMRI). The purpose of this neuroimaging study was to investigate the effects of antidepressant treatment on sexual arousal in depressed women. METHODS: Seven depressed women with sexual arousal dysfunction (mean age: 41.7+/-13.8, mean scores of the Beck Depression Inventory (BDI) and the 17-item Hamilton Rating Scale for Depression (HAMD-17): 35.6+/-7.1 and 34.9+/-3.1, respectively) and nine healthy women (mean age: 40.3+/-11.6) underwent fMRI before and after antidepressant treatment. The fMRI paradigm contrasted a 1 minute rest period viewing non-erotic film with 4 minutes of sexual stimulation viewing an erotic video film. Data were analyzed by SPM 2. The relative number of pixels activated in each period was used as an index of activation. All depressed women were treated with mirtazapine (mean dosage: 37.5 mg/day) for 8 to 10 weeks. RESULTS: Levels of brain activity during sexual arousal in depressed women significantly increased with antidepressant treatment (p<0.05) in the regions of the hypothalamus (3.0% to 11.2%), septal area (8.6% to 27.8%) and parahippocampal gyrus (5.8% to 14.6%). Self-reported sexual arousal during visual sexual stimulation also significantly increased post-treatment, and severity of depressive symptoms improved, as measured by the BDI and HAMD-17 (p<0.05). CONCLUSION: These results show that sexual arousal dysfunction of depressed women may improve after treatment of depression, and that this improvement is associated with increased activation of the hypothalamus, septal area, and parahippocampal gyrus during sexual arousal.

Papel dos receptores serotoninérgicos do tipo 5-HT3 localizados no núcleo septal medial/banda diagonal de broca sobre o controle da pressão arterial em ratos / Role of serotonin receptor type 5-HT3 receptors located in the medial septal nucleus / diagonal band drill over the control of blood pressure in rats

Diversos estudos têm mostrado a participação das vias serotoninérgicas tanto centrais, quanto periféricas no controle cardiovascular. Os principais receptores serotoninérgicos envolvidos na regulação cardiovascular são do tipo 5-HT1A, 5-HT2, 5-HT3 e 5-HT7. A ativação serotoninérgica em diferentes áreas cerebrais resulta tanto em aumento, quanto diminuição da pressão arterial. As principais áreas cerebrais relacionadas com os efeitos cardiovasculares induzidos pela estimulação serotoninérgica são: região rostro ventrolateral do bulbo, núcleo paraventricular do hipotálamo, núcleo dorsal motor do vago, núcleo do trato solitário. Entre as estruturas prosencefálicas, tem sido mostrado que o complexo núcleo septal mediallbanda diagonal de Broca (SM/vDB) desempenha importante papel no controle do equilíbrio hidrossalino e cardiovascular. Desde que esta área apresenta receptores serotoninérgicos 5-HT3 e recebe aferências serotoninérgicas do núcleo mediano da rafe, os objetivos do presente estudo foram: a) investigar o papel dos receptores 5-HT3 localizados no SM/vDB sobre o controle cardiovascular b) analisar o padrão de expressão de c-Fos no cérebro de ratos induzido pelo bloqueio farmacológico dos receptores 5-HT3 presentes no SM/vDB. Ratos Wistar (280-300g) anestesiados com cetamina/xilazina (80/11,5 mg/kg; i.p.) foram submetidos a implante de cânulas no SM/vDB. Os animais foram novamente anestesiados 48 h antes dos experimentos para cateterização da carótida e veia femoral. Na sessão experimental a pressão pulsátil (PAP) foi registrada durante 30 minutos para cálculo dos valores basais de pressão arterial média (PAM) e da freqüência cardíaca (FC). A seguir os animais receberam no SM/vDB microinjeçães de m-CPBG (160 nmol), ondansetrona (160, 80 e 40 nmol) ou NaCI 0,9%, em um volume de 0,2 /-lI e a PAP foi registrada durante mais 100 minutos...

Effects of naloxone on the contents of cAMP in hypothalamus and AVP in ventral septal area in fever rats / 中国应用生理学杂志

<p><b>AIM</b>To study the effects and mechanism of naloxone on the febrile response in IL-1beta-induced fever rats.</p><p><b>METHODS</b>The fever model was established by intracerebroventricular injection of IL-1beta in rats. The effect of naloxone on the body temperature of feverrats was observed. The contents of cAMP in hypothalamus and AVP in VSA were detected.</p><p><b>RESULTS</b>Naloxone alleviated IL-1beta-induced fever and the contents of cAMP in hypothalamus and AVP in VSA were correspondingly decreased (P < 0.01).</p><p><b>CONCLUSION</b>Naloxone could inhibit IL-1beta-induced fever in rats, and the mechanism might be due to inhibiting synthesis of cAMP in hypothalamus and promoting release of AVP in VSA.</p>

Analysis of the Development of the Nasal Septum according to Age and Gender Using MRI

OBJECTIVES: This study was designed to evaluate the normal development of the nasal septum in Koreans using sagittal MRI for the valuable clinical information on septal procedures. METHODS: Two hundred eighty patients who had their whole nasal septum visualized in the midline sagittal view were selected among the 3,904 patients with brain MRI from January, 2004 to December, 2006 at Dankook University Hospital. The patients who had a history of nasal septal surgery or nasal trauma were excluded. Following parameters are calculated and analyzed: lengths of bony and cartilage dorsum and septal cartilage-nasal bone overlap, total septal area, septal cartilage area and, the proportion of the cartilage area to septal area and the maximal harvestable cartilage for grafting were calculated using the PAC(TM) program. RESULTS: All the parameters were increased until adolescence. Thereafter, bony dorsal length, cartilage dorsal length, total dorsal length, total septal area and maximal harvestable cartilage for grafting have not changed significantly with age, while SC-NB overlap length, septal cartilage area, and proportion of the cartilage area to the total septal area were significantly decreased with age. The SC-NB overlap length was positively correlated with the septal cartilage area and the proportion of the cartilage area to the total septal area. CONCLUSION: The small septal cartilage area and its proportion to the total septal area were significantly correlated with a short overlap length of the septal cartilage under the nasal bone. Septal procedures should be carefully performed in the elderly due to the risk of incurring saddle nose.

Participação dos receptores serotoninérgicos do subtipo 5-HT³ localizados na área septal medial sobre o controle da ingestão de água e sal em ratos sódio-depletados / Participation of serotonin receptor subtype 5-HT ³ located in the medial septal area on the control of water intake and salt in sodium-depleted rats

A regulação do equilíbrio hidroelétrico é desempenhada por um conjunto de mecanismos viscerais e comportamentais, nos quais se incluem a ingestão de água e sal controlados por diversos neurotransmissores e áreas cerebrais. Estudos sugerem a participação de mecanismos Serotoninérgicos na indução das respostas fisiológicas relacionadas com a regulação da ingestão de água e sal. No presente estudo analisamos o envolvimento dos receptores 5-HT³ Serotoninérgicos localizados na ASM sobre a ingestão de água e sal em ratos sódio-depletados. Verificamos que a estimulação farmacológica específica dos receptores Serotoninérgicos 5-HT³ localizados na ASM, pelo agonista 5-HT³ seletivo m-CPBG, aumenta a ingestão de sal em ratos sódio-depletados. A especificidade deste efeito parece assegurada pelo fato de que o pré-tratamento com Ondansetrona, antagonista dos receptores Serotoninérgicos 5-HT³, aboliu completamente a elevação na ingestão de sal produzida pela administração do m-CPBG na ASM. Esse efeito Natriorexigênio parece não ser dependente de alterações na pressão arterial, visto que a micro-injeção na ASM do m-CPBG não foi capaz de modificar este parâmetro. Além disso, constatamos que a administração isolada do antagonista Ondasterona é incapaz de produzir efeito significativo sobre a ingestão de água e sal em ratos sódio-depletados. Tomando em conjunto os achados acima mencionados sugere-se que os receptores Serotoninérgicos do subtipo 5-HT³ localizados na ASM quando ativados farmacologicamente são capazes de ativar mecanismos centrais envolvidos com a procura e a ingestão de sódio.

Brain areas activated after ejaculation in healthy young human subjects.

Brain mechanisms for the refractory period that characteristically follows ejaculation in animals and human are poorly understood. The possibility of active inhibition of brain areas being responsible for the post-ejaculatory inhibitory state has not been ruled out. Using Blood Oxygen Level Dependent (BOLD) functional magnetic resonance imaging (fMRI) we have mapped brain areas in healthy young volunteers immediately after ejaculation. Functional imaging of the brain for 30 minutes beginning after three minutes of ejaculation induced by masturbation showed spatio-temporal activation in amygdala, temporal lobes and septal areas. The septal areas were observed to be active for a shorter duration than the amygdala and the temporal lobe. Thus the temporal sequence of involvement of the above neural structures may contribute to temporary inhibition of sexual arousal/penile erection during the post-ejaculatory refractory period in humans.

Effect of different needle-retained time of electroacupuncture on expression of nitric oxide synthase in the septum of the rat / 中国针灸

<p><b>OBJECTIVE</b>To probe into the relationship of different needle-retained time with therapeutic effects.</p><p><b>METHODS</b>Forty experimental rats were evenly randomized into 5 groups, electroacupuncture (EA) at "Zusanli" (ST 36) for 5 min, 15 min, 30 min and 60 min groups, who received EA for 5, 15, 30 and 60 min respectively, and a control group who did not receive EA. Nicotinamide adenosine dinucleotide phosphate diaphorase (NADPH-d) method and computer image analysis system were used to detect the meangray of nitric oxide synthase (NOS) positive neurons in the septum.</p><p><b>RESULTS</b>NOS positive neurons in the septum did not change as the EA for 5 min group compared with the control group (P > 0.05); the number of heavily staining NOS positive neurons increased significantly (P < 0.05) and the meangray of the NOS positive neurons significantly decreased (P < 0.01) in some septal subnuclei (lateral septum, and medial septum, vertical diagnonal band) after EA for 15, 30, 60 min as compared with the control group, and the numbers and the meangray of the NOS positive neurons in the septum were not significantly difference among the 3 EA groups.</p><p><b>CONCLUSION</b>NOS expression in the septum increases and keeps a same level from EA for 15 min to 60 min.</p>

A Mouse Model of Chronic Rhinosinusitis Induced by Streptococcus Pneumoniae / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A mouse has a great potential to be used in studying genetics and inflammatory process of the rhinosinusitis. The aim of this study was to observe effects of experimentally induced chronic rhinosinusitis on histopathology of the sinonasal mucosa in a mouse and to develop a chronic form of rhinosinusitis. MATERIALS AND METHOD: Thirty five, six-week old male C57BL/6 mice were used as follows: 7 normal controls without intervention, 7 Sham operated controls, 7 animals with ostial obstruction alone using Merocel, 7 animals implanted with Merocel plus 106 colony forming unit (CFU)/mL of Streptococcus pneumoniae and 7 animals implanted with Merocel plus 10(8) CFU/mL of S. pneumoniae. Six weeks after intervention, the animals were sacrificed and serially sectioned at 1 mm intervals and stained with Hematoxylin and Eosin. RESULTS: Increased epithelial thickness, goblet cell hyperplasia, epithelial disarray and inflammatory infiltration were observed in the experimental sinuses packed with Merocel alone or Merocel with bacterial inoculation, especially at the nasal septal area. However, there were no significant differences between the Merocel only inserted group and Merocel and bacteria inoculated group. CONCLUSION: Maxillary sinus ostial obstruction or ostial obstruction with S. pneumoniae inoculation induced chronic rhinosinusitis in C57BL/6 mice as indicated by the histologic change. This study could be used as a model of chronic rhinosinusitis for further study.

Maternal aggression in Wistar rats: effect of 5-HT2A/2C receptor agonist and antagonist microinjected into the dorsal periaqueductal gray matter and medial septum

The objective of the present study was to assess the role of the 5-HT2A/2C receptor at two specific brain sites, i.e., the dorsal periaqueductal gray matter (DPAG) and the medial septal (MS) area, in maternal aggressive behavior after the microinjection of either a 5-HT2A/2C receptor agonist or antagonist. Female Wistar rats were microinjected on the 7th postpartum day with the selective agonist alpha-methyl-5-hydroxytryptamine maleate (5-HT2A/2C) or the antagonist 5-HT2A/2C, ketanserin. The agonist was injected into the DPAG at 0.2 (N = 9), 0.5 (N = 10), and 1.0 æg/0.2 æl (N = 9), and the antagonist was injected at 1.0 æg/0.2 æl (N = 9). The agonist was injected into the medial septal area (MS) at 0.2 (N = 9), 0.5 (N = 7), and 1.0 æg/0.2 æl (N = 6) and the antagonist was injected at 1.0 æg/0.2 æl (N = 5). For the control, saline was injected into the DPAG (N = 7) and the MS (N = 12). Both areas are related to aggressive behavior and contain a high density of 5-HT receptors. Non-aggressive behaviors such as horizontal locomotion (walking) and social investigation and aggressive behaviors such as lateral threat (aggressive posture), attacks (frontal and lateral), and biting the intruder were analyzed when a male intruder was placed into the female resident's cage. For each brain area studied, the frequency of the behaviors was compared among the various treatments by analysis of variance. The results showed a decrease in maternal aggressive behavior (number of bites directed at the intruder) after microinjection of the agonist at 0.2 and 1.0 æg/0.2 æl (1.6 ± 0.7 and 0.9 ± 0.3) into the DPAG compared to the saline group (5.5 ± 1.1). There was no dose-response relationship with the agonist. The present findings suggest that the 5-HT2A/2C receptor agonist has an inhibitory effect on maternal aggressive behavior when microinjected into the DPAG and no effect when microinjected into the MS. Ketanserin (1.0 æg/0.2 æl) decreased locomotion when microinjected into the DPAG and MS, but did not affect aggressive behavior. We interpret these findings as evidence for a specific role of 5-HT2A/2C receptors in the DPAG in the inhibition of female aggressive behavior, dissociated from those on motor activity.

Qualitative and Quantitative Measurement of Brain Activity Associated with Visual Sexual Arousal in Males and Females: 3.0 Tesla Functional MR Imaging

PURPOSE: The present study utilized 3.0 Tesla functional MR imaging to identify and quantify the activated brain regions associated with visually evoked sexual arousal, and also to discriminate the gender differences between the cortical activation patterns in response to sexual stimuli. MATERIALS AND METHODS: A total of 24 healthy, right-handed volunteers, 14 males (mean age: 24) and 10 females (mean age: 23), with normal heterosexual function underwent functional MRI on a 3.0T MR scanner (Forte, Isole technique, Korea). The sexual stimulation consisted of a 1-minute rest with black screen, followed by a 3-minute stimulation by an erotic video film, and concluded with a 1-minute rest. The fMRI data was obtained from 20 slices (5 mm slice thickness, no gap) parallel to the AC-PC (anterior commissure and posterior commissure) line on the sagittal plane, giving a total of 2,100 images. The brain activation maps and the resulting quantification were analyzed by the statistical parametric mapping program, SPM 99. The mean-activated images were obtained from each individual activation map using one sampled t-test. The FALBA program, which is a new algorithm based on the pixel differentiation method, was used to identify and quantify the brain activation and lateralization indices with respect to the functional and anatomical terms. RESULTS: In both male and female volunteers, significant brain activation showed in the limbic areas of the parahippocampal gyrus, septal area, cingulate gyrus and thalamus. It is interesting to note that the septal areas gave a relatively lower activation ratio with high brain activities. On the contrary, the putamen, insula cortex, and corpus callosum gave a higher activation ratio with low brain activities. In particular, brain activation in the septal area, which was not reported in the previous fMRI studies under 1.5 Tesla, represents a distinct finding of this study using 3.0 T MR scanner. The overall lateralization index of activation shows left predominance (LI=35.3%) in the limbic system during sexual stimulation. The gender differences of brain activation in response to sexual arousal were characterized as follows. The activation area observed in males was the hypothalamus in the limbic system, whereas in females it was the cingulate gyrus, head of caudate nucleus, insula and corpus callosum. These findings reveal dissimilarities between males and females in neuronal responses to sexual arousal. As for the overall lateralization of activation in the limbic system, male volunteers gave a lateralization index that was greater than that of females by 300%. CONCLUSION: Our findings confirmed that neuroanatomical regions are associated with visually evoked sexual arousal and also with gender differences in response to sexual stimulation. Given that data from time-course traces of activation pattern and findings are observed by different stimuli, such as tactile and olfactory sense, it might be helpful to evaluate the neurophysiological mechanism for sexual arousal, and furthermore, to develop new diagnostic tools for sexual dysfunction and disorder.

Influência dos subtipos dos receptores da angiotensina II do núcleo paraventricular sobre as respostas fisiológicas induzidas pela angiotensina II injetada na área septal medial / Influence of angiotensin II receptor subtypes of the paraventricular nucleus on the physiological responses induced by angiotensin II injection into the medial septal area

OBJECTIVE: We determined the effects of losartan and PD 123319 (antagonists of the AT1 and AT2 angiotensin receptors, respectively), and [Sar , Ala8] ANG II (a relatively peptide antagonist of angiotensin receptors) injected into the paraventricular nucleus (PVN) on water and 3 percent NaCl intake, and the diuretic, natriuretic, and pressor effects induced by administration of angiotensin II (ANG II) into the medial septal area (MSA) of conscious rats. METHODS: Holtzman rats were used . Animals were anesthetized with tribromoethanol (20 mg) per 100 grams of body weight, ip. A stainless steel guide cannula was implanted into the MSA and PVN. All drugs were injected in 0.5-mul volumes for 10-15 seconds. Seven days after brain surgery, water and 3 percent NaCl intake, urine and sodium excretion, and arterial blood pressure were measured. RESULTS: Losartan (40 nmol) and [Sar , Ala8] ANG II (40 nmol) completely eliminated whereas PD 123319 (40 nmol) partially blocked the increase in water and sodium intake and the increase in arterial blood pressure induced by ANG II (10 nmol) injected into the MSA. The PVN administration of PD 123319 and [Sar , Ala8] ANG II blocked whereas losartan attenuated the diuresis and natriuresis induced by MSA administration of ANG II. CONCLUSION: MSA involvement with PVN on water and sodium homeostasis and arterial pressure modulation utilizing ANGII receptors is suggested

Adrenoceptors of the medial septal area modulate water intake and renal excretory function induced by central administration of angiotensin II

We investigated the role of alpha-adrenergic antagonists and clonidine injected into the medial septal area (MSA) on water intake and the decrease in Na+, K+ and urine elicited by ANGII injection into the third ventricle (3rdV). Male Holtzman rats with stainless steel cannulas implanted into the 3rdV and MSA were used. ANGII (12 nmol/æl) increased water intake (12.5 ± 1.7 ml/120 min). Clonidine (20 nmol/æl) injected into the MSA reduced the ANGII-induced water intake (2.9 ± 0.5 ml/120 min). Pretreatment with 80 nmol/æl yohimbine or prazosin into the MSA also reduced the ANGII-induced water intake (3.0 ± 0.4 and 3.1 ± 0.2 ml/120 min, respectively). Yohimbine + prazosin + clonidine injected into the MSA abolished the ANGII-induced water intake (0.2 ± 0.1 and 0.2 ± 0.1 ml/120 min, respectively). ANGII reduced Na+ (23 ± 7 æEq/120 min), K+ (27 ± 3 æEq/120 min) and urine volume (4.3 ± 0.9 ml/120 min). Clonidine increased the parameters above. Clonidine injected into the MSA abolished the inhibitory effect of ANGII on urinary sodium. Yohimbine injected into the MSA also abolished the inhibitory effects of ANGII. Yohimbine + clonidine attenuated the inhibitory effects of ANGII. Prazosin injected into the MSA did not cause changes in ANGII responses. Prazosin + clonidine attenuated the inhibitory effects of ANGII. The results showed that MSA injections of alpha1- and alpha2-antagonists decreased ANGII-induced water intake, and abolished the Na+, K+ and urine decrease induced by ANGII into the 3rdV. These findings suggest the involvement of septal alpha1- and alpha2-adrenergic receptors in water intake and electrolyte and urine excretion induced by central ANGII

Immunocytochemical Localization of Transforming Growth Factor-alpha in the Forebrain of the Rat / 대한해부학회지

The distribution of Transforming growth factor-alpha (TGF-alpha) was examined in the rat forebrain by immunocytochemistry. TGF-alpha immunoreactivity was observed in the cerebral hemispheres, thalamus and hypothalamus. Neurons in the olfactory and septal area, cerebral cortex, hippocampus, striatum, amygdala, and different nuclei of the thalamus and hypothalamus showed immunoreactivity. The intensity of the immunoreaction was high in the hippocampus, pyramidal cell layers of cerebral cortex, reticular and ventral thalamic nuclei, and paraventricular and supraoptic hypothalamic nuclei. In addition, a few labelled glial cells appeared at random in the forebrain. These results indicate that both neurons and glial cells appear to synthesize TGF-alpha in normal forebrain of the rat. However, TGF-alpha immunoreactivity was more widely distributed in neurons than glial cells. Therefore, although the role of TGF-alpha in the central nervous system remains elusive, the present data support the concept that TGF-alpha may act as a trophic factor in the adult rat forebrain.

Endoscopic surgery for obstructive hydrocephalus

Endoscopic surgery is popular in the neurosurgical field. The purpose of this study was to determine the role of endoscopy in obstructive hydrocephalus. From 1989 to 1999, we performed 81 endoscopic third ventriculostomies and 10 septostomies. Seventy-one of 81 operations were performed with endoscopic third ventriculostomy alone and 10 patients had endoscopic third ventriculostomy and ventriculoperitoneal shunt simultaneously. Age distribution varied from 2 months to 62 years of age. Our selection criteria included aqueductal stenosis (39 patients) and obstructive hydrocephalus due to tumor or cyst (42 patients). The most common candidate for endoscopic septostomy was atresia of the foramen of Monro (4 patients). Endoscopic septostomy was also performed to simplify shunting in patient; with multiseptated ventricle due to shunt infection, germinoma, thalamic tumor, craniopharyngioma, cyst and brain abscess. Sixty-five of 71 patients who were treated with endoscopic third ventriculostomy alone showed successful results (91.5%). However, 6 patients had unsatisfactory results and they needed a ventriculoperitoneal shunt. With no mortality, transient surgical complications were observed in 7 patients: 2 transient diabetes insipidus from electrical injury to the pituitary stalk, 1 epidural hematoma from sudden drainage of CSF, 1 delayed intraventricular hemorrhage. 2 obstruction of fenestration site and 1 transient memory disturbance from injury to the fornix. Endoscopic septostomy was useful in simplifying shunting in all cases with complicated hydrocephalus. Endoscopic surgery is straightforward and effective in appropriately selected cases with obstructive by drocephalus.

The expression of new rat Ulip mRNA in the developing rat brains / 대한해부학회지

One cDNA was cloned out of developmentally differentially expressed genes in developing rat brains with ordered differential display method (ODD). The expression of cloned cDNA was observed from embryonal day 12 (E12), peaked at postnatal day 7 (P7), decreased to undetectable level at adult. By sequencing and sequence search with GenBank data, it was revealed that cloned cDNA was very similar to mouse Unc-33-like phosphoprotein (Ulip), which is known to be involved in the axonal outgrowth, thus, named as new rat Ulip (nrUlip). In situ hybridization histochemistry of developing rat brains showed that nrUlip mRNA was highly expressed in the area for differentiating neurons and the expression was observed just after neurogenesis in the various brain areas including thalamus, septal area, cerebral cortex, caudate-putamen, hippocampus, cerebellum, and dentate gyrus in the order of neurogenesis. These developmental expression pattern was well matched with the result of ODD. This may justify ODD as one of the best way to clone the genes differen-tially expressed among samples. These results and high sequence homology of nrUlip to mouse Ulip related with axonal outgrowth suggest that nrUlip may be also involved in the outgrowth of axon.

A Case of Giant Coronary Arteriovenous Fistula with Coronary Steal Demonstrated by Dobutamine Stress Echocardiography and (99m)Tc-MIBI SPECT

We present a case of giant coronary arteriovenous fistula between left main coronary artery and pulmonary artery in a 60-year-old female who presented with anginal symptom. Dobutamine stress echocardiography and myocardial perfusion scan with (99m)Tc-MIBI revealed a reversible perfusion defect in the septal region. Coronary angiography demonstrated a giant coronary arteriovenous fistula origination from the left main coronary artery and draining into the pulmonary artery. This appears to be the first case in which dobutamine stress echocardiography and myocardial perfusion scan with (99m)Tc-MIBI demonstrated myocardial ischemia due to coronary steal in patient with a coronary arteriovenous fistula.

A Clinical Study on the Regional Ejection Fraction and Regional Wall Motion In Acute Myocardial Infarction

Regional left ventricular dysfunction is common in patients with coronary artery disease and accurate analysis of regional dysfunction is of particular interest. For the quantitative assessment of regional dysfunction, we measured regional ejection fraction by radial sector division method in 19 patients with acute myocardial infarction and 13 normal controls who had multigated blood pool scan. And two independent observer analyzed regional wall motion using 5 point grading system in 18 patients undergoing radionuclide ventricular cineangiography. The results obtained were as follows : 1) Regional wall motion scores for the gated blood pool study agreed completely in 72 of 108 segments (66.7%) and agreed within 1 grade in 88 of 108 segments(81.5%) and agreement rate is lowest in the septal area. 2) Global left ventricular ejection fraction was 63.2+/-4.2% in normal controls, 36.6+/-6.8% in extensive anterior wall infarction group and 52.6+/-9.7% in inferior wall infarction group. The value of extensive anterior wall infarction group was significantly lower than that of inferior wall infarction group(p<0.005). 3) Regional left ventricular ejection fraction by radial sector division method in normal control group were as follows : area 1 ; 56.5+/-6.7%, area 2 : 77.9+/-4.8%, area 3 ;84.3+/-5.5%, area 4 : 76.8+/-6.6%, area 5 ; 84.7+/-7.6%, area 6 ; 85.9+/-11.2%, area 7 ; 75.5+/-12.3%, area 8 ; 74.9+/-14.0%, area 9 ; 75.5+/-8.8%, area 10 ; 54.2+/-11.0%, 11 ; 34.5+/-16.3, area 12 ; 37.1+/-18.0%. 4) Mean regional ejection fraction in 7 patients with anterior wall infarction showed significantly lower values in area 4 to area 8, and in area 2 to area 5 in case of inferior wall infarction group. 5) We thought that regional ejection fraction obtained by radial sector division method is valuable index for the management and evaluation of patients with coronary artery disease.