Asymptomatic Cerebral Vasoconstriction after Carotid Artery Stenting.

BACKGROUND AND PURPOSE: Carotid artery stent placement is widely performed for treatment of carotid stenosis. The purpose of this study is to present our observations on cerebral vasoconstriction in ipsilateral anterior circulation during immediate poststenting angiography in patients with near-total occlusion of the proximal ICA. MATERIALS AND METHODS: We retrospectively reviewed patient data from December 2008 to December 2018. There were 28 patients with carotid near-total occlusion. Two neuroradiologists reviewed the final cerebral angiographic finding of carotid artery stent placement to evaluate the presence of vasoconstriction or vasodilation. RESULTS: A total of 28 patients with near-total occlusion (mean ± standard deviation age, 69.0 ± 6.5 years; 92.9% male) were analyzed. Ten patients showed vasoconstriction in the treated territory, and 18 patients did not show vasoconstriction after carotid artery stenting. There were no statistically significant differences in comorbidity, frequency of symptomatic lesions, antiplatelet medication, mean procedure time, and initial NIHSS and baseline modified Rankin scale scores between the 2 groups. However, vasoconstriction is more likely to happen in patients with isolated territory from the contralateral anterior and posterior circulation (66.7% in the isolated territory group and 12.5% in the not-isolated territory group; P < .05). No headache or neurologic deficit was noted in all 10 patients with cerebral vasoconstriction. CONCLUSIONS: Cerebral vasoconstriction may occur after carotid artery stenting more frequently than expected. It occurs more frequently in patients with near-total occlusion and with isolation of the cerebral circulation. A large-scale study is necessary to assess the clinical implications of cerebral vasoconstriction after carotid artery stenting.

Characteristics of testosterone deficiency syndrome in men with chronic kidney disease and male renal transplant recipients: a cross-sectional study.

OBJECTIVES: Testosterone deficiency syndrome (TDS) is common among male patients with chronic kidney disease (CKD). We compared the characteristics of TDS in men with CKD versus renal transplantation (RT) with those of age-matched normal controls. MATERIALS AND METHODS: The 129 patients were: RT recipients (n = 25) group I, CKD patients (n = 37) group II, and controls (n = 67). We performed estimates of testosterone, hemoglobin (Hgb), hematocrit (Hct), glucose, creatinine, and lipid profile. Self-assessment questionnaires-International Index of Erectile Function (IIEF), Aging Males' Symptoms (AMS), Center for Epidemiologic Studies Depression Scale-were used to evaluate erectile function, testosterone deficiency, and depression, respectively. We also investigated morning erection as well as the presence and duration of erectile dysfunction (ED). RESULTS: Group I (RT) showed significantly higher serum testosterone levels than group II (CKD), who displayed significantly worse erectile function, more severe testosterone deficiency symptoms, and a greater trend toward depression. Similarly, the prevalences of ED and TDS were significantly greater in group II than group I. Group I and controls differed significantly only in the results of serologic tests, such as serum creatinine, Hgb, and glucose and lipid profiles, but not in serum testosterone levels, scores of self-assessment questionnaires, or prevalence of ED or TDS. Serum testosterone levels correlated significantly with scores on the IIEF and AMS questionnaires in both group II and controls, but not group I. CONCLUSIONS: RT recipients showed higher serum testosterone levels and a lower prevalence of TDS with milder symptom severity than CKD patients. RT recipients beyond the early acute posttransplant period, displayed serum testosterone levels and TDS prevalence similar to those of healthy controls. Unlike CKD patients and normal controls, serum testosterone did not significantly influence TDS symptoms in RT recipients.

Combination therapy of testosterone enanthate and tadalafil on PDE5 inhibitor non-reponders with severe and intermediate testosterone deficiency.

Several studies have suggested combination therapy with testosterone supplementation in patients not responding to PDE5 inhibitors. Considering the pathophysiological basis for testosterone supplementation, the present study aims to identify whether combination therapy allows persistence of treatment effect after testosterone discontinuation. Furthermore, we evaluated whether the degree of testosterone depletion affects treatment outcome from combination therapy. Hypogonadal patients (<350 ng dl(-1)) with erectile dysfunction who previously did not respond to PDE5 inhibitors were treated with testosterone enanthate injections and daily tadalafil. Patients were stratified into two groups depending on the level of testosterone deficiency, with 250 ng dl(-1) as a reference point. Following testosterone supplementation (12 weeks) and combination therapy (12 weeks), patients with severe testosterone deficiency showed higher IIEF (International Index of Erectile Function) erectile function (EF) domain score (16.47±4.019 vs 12.36±4.051, P=0.001) and more patients responding satisfactorily to treatment by general assessment (57.9 vs 16.0%, P=0.009), despite reaching similar levels of serum total testosterone (602±169 ng dl(-1) vs 698±165 ng dl(-1), P=0.057). Testosterone supplementation was then discontinued and patients were maintained only on daily tadalafil (12 weeks). The severe depletion group maintained higher EF domain scores than baseline (13.06±3.38 vs 7.20±2.24, P=0.0004), despite testosterone levels returning to baseline. The results suggest that combination therapy was more beneficial to patients with severe testosterone depletion, possibly by improving underlying pathophysiology.

Pretreatment of polyethylene terephthalate substrate for the growth of Ga-doped ZnO thin film.

The effect of the pretreatment of polyethylene terephthalate (PET) substrate on the growth of transparent conducting Ga-doped ZnO (GZO) thin film was investigated. Because of its high gas and moisture absorption and easy gas permeation, PET substrate was annealed at 100 degrees C in a vacuum chamber prior to the sputtering growth of GZO thin film for the outgassing of impurity gases. GZO thin film was deposited on the pretreated PET substrate by rf-magnetron sputtering and significantly improved electrical properties of GZO thin film was achieved. Electrical and structural characterizations of the GZO thin films were carried out by 4-point probe, Hall measurement, and scanning electron microscopy, and the effects of the pretreatment on the improved properties of GZO thin films were discussed. This result is not only useful to PET substrate, but also could be applicable to other plastic substrates which inevitably containing the moisture and impurity gases.

Chronic inflammatory demyelinating polyradiculoneuropathy in children: characterized by subacute, predominantly motor dominant polyeuropathy with a favorable response to the treatment.

OBJECTIVES: Chronic inflammatory demyelinating polyradiculopathy (CIDP) is less well-studied in children than in adults, probably due to its relative rarity. This study was performed in order to characterize the clinical features of CIDP in children. MATERIALS AND METHODS: Twenty-eight patients with CIDP who were followed up for more than 1 year were included, and were divided into a child (n = 7, age <16) and an adult group (n = 21, age >or=16). Then, we have assessed the initial progression pattern, clinical course, and serial nerve conduction findings in each patient. Finally, differential features in child and adult group were analyzed. RESULTS: Distinguishing features in the child group include subacute progression within less than 2 months, predominant motor system involvement in lower extremities, and marked improvement in response to immune modulating therapy. Our study also suggested that serial nerve conduction study may be useful in assessing the effectiveness of the treatment in children. CONCLUSIONS: Our study showed that children with CIDP have some distinguishing features from adults in terms of clinical course and response to treatment.

Expression of transforming growth factor-beta1 and hypoxia-inducible factor-1alpha in renal transplantation.

Chronic allograft nephropathy (CAN) includes pathologic changes of interstitial fibrosis, tubular atrophy, and fibrous intimal thickening. Transforming growth factor (TGF)-beta1 is a fibrogenic cytokine involved in renal allograft fibrosis. Hypoxia-inducible factor (HIF)-1alpha is induced as an adaptive response to hypoxia triggering the production of fibrogenic cytokines such as TGF-beta1. Between January 1995 and February 2005, we performed 71 renal allograft biopsies in 61 recipients. Immunohistochemical studies were performed with an immunoperoxidase technique using as the primary antibody either a rabbit anti-human TGF-beta1 polyclonal or a mouse anti-human HIF-1alpha monoclonal reagent. The glomerular TGF-beta1 expression in recipients diagnosed with glomerulonephritis was significantly greater than other pathologic groups (P < .05), and the glomerular TGF-beta1 expression in the heavy proteinuria group (> or =2.5 g/d) was significantly greater than the low proteinuria group (<1.0 g/d; P < .05). The tubular and interstitial TGF-beta1 and HIF-1alpha expressions in CAN were greater than in other groups (P < .05). The tubular TGF-beta1 expression among the graft loss group was significantly greater than the graft function group (P < .05).

Nutrient removal processes for low strength wastewater.

For nutrient removal from low strength wastewater, biological nutrient removal (BNR) processes available at present are not efficient due to the shortage of organic carbon. By using the carbon source obtained from the degradation of return sludge, it was attempted to enhance the efficiency of denitrification and phosphorus release. Based on its degradation mechanism, the ENR (Endogenous Nitrate Respiration) process was developed and compared with the conventional A2/O (Anaerobic/Anoxic/Aerobic), MUCT (Modified University of Cape Town) processes. In the experiment, the specific phosphorus release rates of A2/O, MUCT, and ENR processes were 0.8, 2.3, and 2.6 mg PO1-P g1 MLVSS-h. As the nitrate concentration decreased below 3.0 mg NO1-N l1 due to the endogenous nitrate respiration, the effluent nitrate of the ENR process was lower than the A2/O process and the MUCT process by 25% and 10% while the phosphorus removal efficiencies increased by 15% and 6%, respectively. It was found that the ENR process was an effective and economical alternative for removing nutrient from low strength wastewater

Effect of ouabain on relaxation induced by cromakalim in human and canine mesenteric arteries.

We investigated the effect of cromakalim, a K+ channel opener, that activates indirectly the Na(+)-K+ pump, in association with increased K+ conductance in the mesenteric arteries. In 65% of human mesenteric arteries tested, the concentration-dependent relaxation curves for cromakalim were biphasic: the low concentration (< 10(-7) M) effect was preferentially inhibited by ouabain, whereas the higher concentration effect was significantly inhibited by glibenclamide. In branches of canine mesenteric artery, the cromakalim-induced relaxation was inhibited by pretreatment with ouabain (1 microM) as well as by glibenclamide (1 microM). The reduction in contraction of human and canine mesenteric arterial strips caused by cromakalim was totally reversed by pretreatment with ouabain (1 microM) or glibenclamide (1 microM). On the other hand, in canine mesenteric artery, cromakalim caused a significant stimulation of 22Na+ influx and ouabain-sensitive 86Rb+ uptake in association with increased 86Rb+ efflux, all of which were inhibited by glibenclamide (1 microM). Thus, it is suggested that cromakalim possesses the additional property to stimulate the Na(+)-K+ pump through an elevation in intracellular Na+, resulting in strong relaxation of blood vessels.

Pseudoexfoliation syndrome--case report and review of clinical features.

Pseudoexfoliation syndrome is characterized by the presence of gray-white flakes on the pupillary borders and anterior lens capsule, increased trabecular meshwork pigmentation, and association with glaucoma. We describe 3 patients with this syndrome seen at Asan Meidcal Center Department of Ophthalmology in 1989, and we focus on their clinical features and management. We believe that patients with this syndrome are not as rare in Korea as has been thought, judging by scant report of cases in the past.

Structure of 3-(4-methoxyphenyl)-4-phenyl-4H-1,2,4-triazole.

C15H13N3O, Mr = 251.29, triclinic, P-1, a = 9.294, (1), b = 11.394 (4), c = 13.375 (2) A, a = 103.60 (2), beta = 96.82 (1), gamma = 107.47 (2) degrees, V = 1285 A3, Z = 4, Dx = 1.30 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 0.92 cm-1, F(000) = 528, T = 295 K, final R = 0.045 for 2311 observed [Fo greater than or equal to 5 sigma(Fo)] reflections. There are two molecules in the asymmetric unit. The triazole rings are planar with the phenyl substituents twisted with respect to these planes. The two molecules in the asymmetric unit are different in the relative twists of the phenyl groups.