To select optimal neurointensive treatments for patients with severe head injury, effects of osmotic agents (OT) with/without hypothermia (HT) and barbiturates (BT), and following patients outcome were evaluated by continuous monitoring using bifrontal regional oxygen saturation (rSO2), jugular bulb oxygen saturation (SjO2), jugular bulb temperature (Tjb), intracranial pressure (ICP), and cerebral perfusion pressure (CPP). SjO2 and rSO2, ICP, CPP, and Tjb were continuously monitored in 23 patients with severe head injury[Glasgow Coma Scale ≤ 8, ages 10-62]. The effects of BT and OT (n = 6), HT and OT (n = 9), and OT alone (n = 8) were compared on these parameters. Evaluations were performed in terms of: a) Effects of pentobarbital dose (≤ 1.0, 1.1-2.0, 2.1-3.0, and ≥ 3.1mg/kg/h). b) Effects of Tjb (≥ 38, 36-37.9, 34-35.9 and ≤ 33.9°C). c) Frequency (%) of abnormal values (ICP ≥ 20mmHg, CPP ≤ 60mmHg, SjO2 < 55 or > 75%, and rSO2 < 60 or < 80%). d) Patients' outcome (Glasgow Outcome Scale at 3 months after injury)
Results: a) ICP decrease and CPP increase were significantly correlated with pentobarbital dose. b) ICP decrease and CPP increase were also significantly correlated with Tjb decrease. c) Number of abnormal values ICP was significantly higher frequency in BT than those in HT or OT. CPP were significantly lower frequency in HT than those in BT and OT. SjO2 and rSO2 at the non-affected side were not significantly different among three groups. In the affected side, rSO2 < 60% were significantly higher frequency in BT, and rSO2 > 80% were significantly high in HT. d) Good functional outcome (good recovery or moderate disability) was significantly higher in HT than those in BT or OT alone cases.
Conclusion: Despite CPP decrease and abnormal rSO2 during acute phase of severe head injury are identified, good functional outcome will be expected by HT in comparison with BT and OT alone.

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The author examined the developmental changes in serotonin (5-HT) levels and locomotor activity in neonatal 5-HT-denervated rats. 5, 7-dihydroxytryptamine (5, 7-DHT) were injected into lateral ventricle on the 3rd and 6th days after birth (dose : 25-200 μg). Monoamine levels were analyzed on the 8th, 14th and 28th days, and their behavior was assessed by open-field apparatus on the 28th days. 5-HT levels in the hippocampus, striatum and cerebral cortex were dramatically decreased in 5, 7-DHT-lesioned rats, but in the brainstem, they were increased in the 5, 7-DHT 25μg group. The locomotor activities reduced dose-dependently on the 28th days. Additionally, the repeated administration of 6R-Tetrahydrobiopterin (6R-BH₄) dose-dependently recovered the decrease of locomotion induced by 5, 7-DHT treatment, and significantly enhanced 5-HT turnover ratio (5-HIAA/5-HT), particularly, in the striatum and posterior cortex. These results suggest that the developmental changes by neonatal 5-HT depletion might influence on 5-HTergic terminals and locomotor activities in immature rats, and the behavioral restoration by 6R-BH₄ might be due to the enhancement of 5-HT turnover.

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It is suggested that the caffeine-induced locomotor stimulant effect was expressed through central dopaminergic neurotransmissions. The aim of this study is to examine the influence of nomifensine, a selective dopamine re-uptake inhibitor, administration on the caffeine-induced locomotor stimulant effect in rats. Locomotor activity was evaluated by the Open-Field apparatus. Caffeine administration in rats caused to increase locomotor activity dose-dependently. This effect of caffeine was increased when nomifensine was chronically administrated beforehand. Moreover, the same effects were observed between 3, 7-dimethyl-1-propargyl-xanthine (DMPX), a selective adenosine A₂ receptor antagonist, and nomifensine administrations. These results suggest that the stimulant effect of caffeine on locomotor activity in rats as related to central dopaminergic neurotransmission, and expressed through its blockade of adenosine A₂ receptors in central dopaminergic presynaptic sites.

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A 40-year-old woman presented fever of 38 to 39°C on December 30, 2001. Several days later, she noticed a painful mass in the right anterior neck. She was treated with antibiotics and antipyretics by her home doctor, however, her symptoms remained unimproved. Therefore, she was admitted to our hospital on January 7, 2002. On admission, her temperature was 38.9°C and tender swelling mass (3 × 3 cm in size) was palpable in right anterior neck. Laboratory examinations revealed increased WBC, raised CRP, mild hyperthyroidism and marked elevation of serum thyroglobulin level. Cervical CT imaging indicated the presence of a well delineated and low density mass in the right lobe of the thyroid gland. By fine needle aspiration of the thyroid mass, purulent fluid was collected. Based on the findings of no bacterial growth upon culture but infiltration of neutrophils, the lesion was diagnosed as acute suppurative thyroiditis. The symptoms were relieved by treatment with antibiotics (cefotiam hydrochloride), accompanied by a reduction in neck mass. The pyriform sinus fistula was not identified by pharyngolaryngofiberscopy and barium esophagogram.
Acute suppurative thyroiditis is known to have mostly onset in childhood, and about 90% of the lesion develop in the left lobe by reason of embryological process. We reported here, a rare case of adult onset of acute suppurative thyroiditis whose lesion was in the right lobe of thyroid gland.

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