Chronic compression or ischemia of the spinal cord in the cervical spine causes a clinical syndrome known as cervical myelopathy. Recently, a new term “degenerative cervical myelopathy (DCM)” was introduced. DCM encompasses spondylosis, intervertebral disk herniation, facet arthrosis, ligamentous hypertrophy, calcification, and ossification. The pathophysiology of DCM includes structural and functional abnormalities of the spinal cord caused by static and dynamic factors. In nonoperative patients, cervical myelopathy has a poor prognosis. Surgical treatments, such as anterior or posterior decompression accompanying arthrodesis, arthroplasty, or laminoplasty, should be considered for patients with chronic progressive cervical myelopathy. Surgical decompression can prevent the progression of myelopathy and improve the neurologic status, functional outcomes, and quality of life, irrespective of differences in medical systems and sociocultural determinants of health. The anterior surgical approach to the cervical spine has the advantage of removing or floating the intervertebral disk, osteophytes, and ossification of the posterior longitudinal ligament that compress the spinal cord directly. The posterior surgical approach to the cervical spine is mainly used for multisegment spinal cord compression in patients with cervical lordosis. In this review article, we addressed the pathophysiology, clinical manifestations, differential diagnosis, and treatment options for DCM.

No abstract available.
Classification* ; Humans ; Stomach Neoplasms* ; Survival Rate*

Carbon monoxide is colorless, oolorless, tasteless and non-irritating gas produced by the incomplete combustion of carbonaceous rnaterial. It combines with hemoglobin and displaces oxygen because the affinity of hemoglobin for carbon monoxide is two hundred times greater than oxygen. Symptoma and signs of carbon monoxide poisoning include headache, nausea, vomiting, dizziness, collapse, unconsciousness, blindness, convulsion, coma and skin lesions. Recently we have observed seven patients with carbon monoxide poisoning who expressed cutaneous syrnptoms. In this work we investigated the pathogenesis of cutaneous manifestations of carbon monoxide poisoning through clinical, histologic and electronmicroscopic study. The results are summarized as follows: 1. Mental states of the patients were comatose in two, Semicomatcse in two, stuporous in two, and drowsy in one patient. In routine laboratory tests, we observed elevated blood sugar in six, elevated sorum creatinine phosphokinase in four and abnormal findings in urinalysis in all patients. 2. Cutaneous lesions were vesicobullae, plaque or swelling, erythema, gangrene and 'ulceration in order of frequency and located in the dependent areas in six caies. 3. Histopathologically, the sites of the bullae were subepidermal in four cases and intraepidermal in. one case and there was one case with ulceration. 4. In electronmicroscopic findings, secretory and ductal cells showed degenerative
Blindness ; Blood Glucose ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Coma ; Creatinine ; Dizziness ; Erythema ; Gangrene ; Headache ; Humans ; Nausea ; Oxygen ; Seizures ; Skin ; Stupor ; Ulcer ; Unconsciousness ; Urinalysis ; Vomiting

PURPOSE: Lower caliceal stones treated with ESWL do fail to pass more frequently than middle or upper caliceal stones. We analyzed the results of ESWL of renal caliceal stones according to the location of calix. MATERIALS AND METHODS: We reviewed the stone-free rate in 119 caliceal stone patients treated with 3rd generation lithotriptor, EDAP LT-02 according to the caliceal location of the stone. Location of the stones were upper calix in 30, middle calix in 30, and lower calix in 59 patients. RESULTS: Stone-free rate was 90.0%(27/30 patients) in middle caliceal stones, 74.6%(44/59 patients) in lower caliceal stones, and 66.7%(20/30 patients) in upper caliceal stones. CONCLUSIONS: Stone-free rate of lower caliceal stones is higher than upper caliceal stones.
Humans ; Lithotripsy* ; Shock*

No abstract available.
Extracorporeal Circulation* ; Heart* ; Potassium* ; Thoracic Surgery*

No abstract available.

BACKGROUND: Despite improvement of mortality in acute myocardial infarcrtion, high mortality rate associated with cardiogenic shock remains essentially unchanged. We have reviewed our result of coronary intervention in 15 patients and found relative survival advantage. METHODS: Between Sep. 1992 and Aug. 1995, 15 consecutive patients(M. 10, F. 5) with cardiogenic shock in acute myocardial infarction were treated with coronary intervention using ballon PTCA. IABP was inserted in all patients prior to PTCA. RESULTS: 1) Most commonly found infarct related artery was left anterior descending artery(11) followed by right coronary artery(3) and left main coronary artery(1). 2) Successful reperfusion rate was 86.7%(13/15), and in-hospital mortality rate was 26.7%(4/15). 3) In-hospital mortality was higher in elderly patients compared with less than 70yaer old patients(0%(0/11)vs. 75.0%(3/4)(P < 0.05). 4) Mortality rate was lower in single vessel disease than multivessel disease(11.1%(1/9) vs. 50%(3/6) p<0.05). CONCLUSION: Although this study is uncontrolled, the date suggest that urgent coronary intervention for improving coronary perfusion may reduce mortality of acute myocardial infarction complicated by cardiogenic shock, particularly with single vessel disease and young age group.
Aged ; Arteries ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Shock, Cardiogenic*

No abstract available.
Allografts*

Attention has been paid to the thiocarbanilide derivative and the authors synthesized some new compounds of thiocarbanilides for experimental studies on tuberculosis and leprosy. The series of newly synthesized chemical compounds of thiocarbanilides were studied for comparision with the already known antimycobacterial agents; INH, PAS, Streptomycin and D. D. S. The strains of Mycobacterium tubercubsis (H37 Rv, Ravenel, and B. C. G.) and Mycobacterium phlei were used for the in vitro experiments. In the in vivo experiments, the strain of Mycobacterium tuberculosis var. bovis (Ravenel) was employed. The strain of Mycobacterium leprae murium (Hawaiian strain) was used for the murine leprosy experiments. The experimental animals for the in vivo tests were white mice (CFW strain) and these were extensively employed in tuberculosis and leprosy as well. Sixteen cases of Various types of human leprosy, were treated with one of the newly synthesized thiocarbanilides (L-4). Among the newly synthesized chemical compounds of thiocarbanilides studied for their antituberculous and antimurine leprosy activity in vitro and in vivo experiments, two compounds were shown to be suppressive agents for those infections without significant toxicity. These two compounds were named tentatively as L-1 and L-4. 1) LD50 of L-1 was 1,054 mg/kg and that of L-4 was 1,028 mg/kg, while the LD50 of INH was 650 mg/kg and PAS was 4,000mg/kg orally in the experimental animals. 2) L-1 and L-4 showed remarkable suppressive activity in vitro using solid media with 100r/ml. concentration. These data were parallel to 1r/ml. of INH and 50r/ml. of PAS. The inferiority of L-1 and L-4 to INH and PAS in vitro studies might have been due to the water insolubility of these compounds while INH and PAS were readily soluble in water. 3) In vivo experiments with L-1 showed a much-more superior antituberculous effect than was found with INH and PAS. 4) A method of grading the bacterial count in a homogenized tissue suspension of visceral organs (lungs, liver, spleen and kidneys) using the simple technique of the Gaffky scale was accurate and time saving technique in screening the results of the chemotherapeutic agents in tuberculosis. 5) Among the newly synthesized compounds L-4 showed the most remarkable suppressive effect on murine leprosy. The suppressive results were similar to those of INH. 6) The method of measuring the size and the weight of leproma at the inoculated site was simple and is an adequate screening test for chemotherapeutic effect in murine leprosy. 7) In the trials with human leprosy 16 cases of various types, using L-4, the effectiveness in clinical as well as in bacteriological improvement was remarkable. a) After L-4 treatment decrease in bactriologica1 indices and remarkable clinical improvement after a relative1y short period of treatment were observed. b) L-4, up to the maximum daily dose of 500 mg, can be safely administered orally to the patients without any significant side reactions. c) L-4 could be used with remarkable clinical improvement for the patients in lepra reactions.
Adult ; Animals ; Comparative Study ; Erythema Nodosum/drug therapy ; Female ; Human ; Leprosy/*drug therapy ; Male ; Mice ; Thiourea/*therapeutic use

PURPOSE: The products of the ras oncogene are proteins of 188 or 189 amino acids and 21,000 molecular weights, termed simply p21 proteins. But the exact roles of c-ras proteins in cell proliferation and differentiation as well as in neoplastic transformation are little understood. The purpose of this study is to investigate the function of the p21 protein to the human colon cancer cell lines according to the exposure time and dosage of p21. METHODS: The authors divided tumor cell lines into 3 groups as follows; group 1 (control, colon cancer cell lines without administration of p21 or polyclonal antibody), group 2 (administration of p21 with labelling of 3H-thymidine and leucine), group 3 (simultaneous administration of p21 protein and polyclonal antibody with labelling of 3H-thymidine and 3H-leucine). After deciding the most effective dose of p21 protein and culture time with target cells in preliminary studies, the morphologic changes of target cells with administration of p21 protein and the p21 expression and interaction with anti-p21 polyclonal antibody were examined by phase contrast microscopy each other. RESULTS: The results were obtained as follows: 1. The most effective dose of the p21 with the colon cancer cell in increase uptake of 3H-thymidine and 3H-leucine were 50 ng but there were some differences in culture time of the 3H-leucine; 96 hours in SBA-1, 72 hours in HT-29 and 120 hours in SW-1116. 2. The increase uptakes of the 3H-thymidine by the different dosage of p21, 50 ng vs 200 ng were 131% (50 ng), 160% (200 ng) in SBA-1, 203% (50 ng), 123% (200 ng) in HT-29, and 127% (50 ng), 189% (200 ng) in SW-1116; and increase uptakes of 3H-leucine were 130% (50 ng), 159% (200 ng) in SBA-1, 113% (50 ng), 165% (200 ng), and 164% (50 ng), 169% (200 ng) in SW-1116. 3. There were some cellular proliferation and morphological changes of the colon cancer cells such as ruffling of the cell membrane, vesicle formation or rounding of the cell after administration of the mutant p21, but such changes were not observed after simultaneous administration of the mutant p21 and anti-p21 polyclonal antibody. CONCLUSIONS: The role of p21 protein has not been to make manifest wholly. In our study, the p21 protein induce the cell proliferation and morphological changes.
Amino Acids ; Cell Line* ; Cell Line, Tumor ; Cell Membrane ; Cell Proliferation ; Colon* ; Colonic Neoplasms* ; DNA* ; Genes, ras ; Humans ; Microscopy, Phase-Contrast ; Molecular Weight ; Proto-Oncogene Proteins p21(ras)