No abstract available.

Aconitine is a main component of Aconitum carmichaeli, a Chinese herb known to be effective for arthritis and neuralgia. Many senior citizens consume the herb as a folk remedy. Aconitine-associated cardiogenic toxicity has been observed but aconitine-induced cerebrovascular event has not been reported so far. We report two elderly patients who became unconscious and showed neurological dysfunction soon after ingesting aconitine for pain control. We speculate that the aconitine induced cardiac arrhythmia. This resulted in cardiogenic emboli formation with subsequent large territory cerebral infarction.
Aconitine

The purpose of this study was to evaluate the effect of estrogen receptor on the degenerative change of articular cartilage by observation of different changes of histology, matrix glycosaminoglycan and chondrocyte proliferation. In sixty-four Newzealand rabbits, experimental instability was made to induce degenerative changes by sectioning the anterior cruciate ligament, medial collateral ligament and medial meniscus of the left knees. In the oophorectomy group (32 rabbits), knee surgery was performed at 6 weeks following bilateral oophorectomy. In the non-oophorectomy group (32 rabbits), knee surgery was performed without oophorectomy. Four rabbits were killed at 0, 1, 2, 4, 8, 12, 16, 20 weeks, respectively, after the knee operation. Total immunohistochemical scores of estrogen receptor were evaluated between the two groups. Histologic evaluation of H-E staining was conducted by alcian blue staining. Evaluation of chondrocyte proliferation was carried out by immunohistochemistry using monoclonal antibody to 5-bromo-2 -deoxyuridine. The stainability of each staining was calculated using semi-quantitative analysis and statistical differences were evaluat- ed by ANOVA test and LSD multiple comparison test. Total immunohistochemical scores of estrogen receptor in the non-oophorectomy group were higher than the oophorectomy group (P<0.05). In the non-oophorectomy group, the histologic scores and the histochemical scores of glycosaminoglycan were lower than the oophorectomy group after 4 weeks and 8 weeks respectively (P<0.05). The immunohistochemical score of BrdU was the highest at 2 week and then decreased after 4weeks in both groups. The immunohistologic scores of non-oophorectomy group was significant higher than oophorectomy group between 1 and 4 weeks (P<0.05). Our results suggested that the estrogen might aggravate the degenerative change of the knee joint in rabbits by decreasing matrix glycosaminoglycan and increasing chondrocyte proliferation.
Adult* ; Alcian Blue ; Anterior Cruciate Ligament ; Bromodeoxyuridine ; Cartilage, Articular* ; Chondrocytes ; Collateral Ligaments ; Estrogens* ; Female ; Humans ; Immunohistochemistry ; Knee Joint ; Knee* ; Lysergic Acid Diethylamide ; Menisci, Tibial ; Ovariectomy ; Rabbits

The parathyroid cyst is a relatively uncommon disease and usually identified during the operation for a presumed thyroid mass. Thirteen cases of parathyroid cyst (2 males, 11 females) treated from 1981 to 1993 were reviewed. Ages ranged from 17 to 59 years(mean, 41 years). Gross measurement of the tumor size varied from 1.0 to 10.0 cm in diameter with a mean of 4.8cm. All of the 13 patients presented with a chief complaint of painless anterior cervical mass. Only one complained of mild symptom of dyspnea and voice change due to huge cyst in paratracheal space. No functional cyst was identified. Diagnostic studies included ^99mTc thyroid scan (n=11), ultrasonography (n=10), computerized tomography (n=4) and fine needle aspiration(FNA) (preoperative, n=4; intraoperative, n=3). All diagnostic precedures but needle aspiration were nonspecific. Cysts were found in right inferior parathyroid(n=4), left inferior parathyroid (n=7), or anterior superior mediastinum (n=2). The FNA of the cyst contents revealed watery clear fluid with elevated parathyroid hormone level and was diagnostic in each cases. Four patients were treated initially with needle aspiration, of which only one patient was successful, and 3 patients who were unsuccessful to needle aspiration and the remaining 9 were effectively treated with surgical extirpation. Our experience suggested that needle aspiration may be of significant help in diagnosis and treatment of parathyroid cyst, but most of the patient could be treated successfully by surgical extirpation with an excellent chance for curability.
Biopsy, Fine-Needle ; Diagnosis ; Dyspnea ; Humans ; Male ; Mediastinum ; Needles ; Parathyroid Hormone ; Thyroid Gland ; Ultrasonography ; Voice

The authors present a rare case of tuberculous spondylitis and a large abscess in the left psoas muscle that occurred after spinal surgery for an acute traumatic burst fracture of the L2 vertebral body. We retrospectively reviewed the patient's first magnetic resonance imaging (MRI) we found that some unusual findings, indicative of psoas abscess had been overlooked. As a result, diagnosis and treatment of tuberculous psoas abscess and spondylitis were considerably delayed. Despite the critical condition of patients in a similar emergency, surgeons should always pay close attention to the radiological findings and clinical symptoms of the patient before considering a surgical intervention or biopsy.
Abscess ; Biopsy ; Emergencies ; Humans ; Magnetic Resonance Imaging ; Psoas Abscess ; Psoas Muscles ; Retrospective Studies ; Spondylitis ; Tuberculosis

To investigate the relationship between the pubertal spurt in body height and bone maturity of the hand-and-wrist in normal occlusion, the author X-rayed the hand-and-wrists of 1, 141 students (male 614, female 527) and assessed their bone maturity. In this study, eleven skeletal stages were selected, The bones used to determine skeletal maturity were the ulnar sesamoid of the metacapophalangeal joint of the first finger, the epiphyses of the proximal, middle, distal phalanges of the third finger, and middle phalanx of the fifth finger, and distal epiphysis of the radius. From the longitudinal data for height, an assessment was made of the change in growth velocity. The pubertal growth stage was divided into onset and peak height velocity phases. The results were as follows; 1. The onset of the pubertal growth was between the pp3=and MP3=stage for boys, and between the MP3=and MP5= stage for girls; the mean age of onset was 10.6 years for boys and 9.0 years for girls. 2. The peak height velocity was between the S and MP3cap stage for boys, and between the MP3cap and MPMP5cap stage for girls; the mean age of peak height velocity was 12.5 years for boys and 10.9 years for girls. 3. As the stages of bone meturity progressed from DP3u, to PP3u, MP3u, Ru, the peak height velocity had been reached, and the growth rate retarded, therefore the approach to full physical maturity was attained. 4. The evidence for the period of onset, peak height velocity and bone maturation sugggested that girls were in advance of boys. During the latte part of pubertal growth, the rate of boys' bone maturation was faster than that of grils'.
Age of Onset ; Body Height ; Epiphyses ; Female ; Fingers ; Humans ; Joints ; Radius

Background & Objective: The number of ischemic stroke is increasing steadily. The recent stroke prevention strategies have targeted risk factors for preventing ischemic stroke. Community-based data that quantify the prevalence of these risk factors are needed to develop effective stroke prevention strategies. This study was performed aiming to establish customized prevention strategies by investigating vascular risk factors of ischemic stroke among the healthy adults in an urban population in Korea. Methods: The Prevention of Stroke and Dementia (PRESENT) survey collected data associated with stroke risk factors between 2007 and 2009 in Ansan city, Korea. Of 46,537 people, 2,843 were selected by random sampling, and final population included 358 men and 422 women over 50 years old. We checked modifiable risk factors, such as hypertension, diabetes mellitus, smoking, hyperlipidemia, atrial fibrillation, cardiovascular disease, obesity, and physical inactivity. Results: The mean age of study subjects was 60.1±8.2 years; 55.5% had hypertension, 18.6% had diabetes mellitus, 17.7% were current smoker, 44.9% had hyperlipidemia, 1.7% had atrial fibrillation, and 4.5% had cardiovascular disease. Men had more risk factors for stroke, and higher rates of diabetes mellitus and current smoking. However, women had higher cholesterol and obesity rates and lower physical activity. The proportion of individuals with >1 risk factor for stroke increased with age. Hypertension, diabetes mellitus, and cardiovascular diseases also increased with age, but low-density lipoprotein levels and current smoking decreased. Conclusions: This study provides valuable information to develop customized strategic policies for primary and secondary stroke prevention.
Stroke

The paint gun is an industrial instrument which ejects paint through a small opening with pressure of l,500 to 3,000 Ib/inch. In case of the paint-gun injury, the paint penetrates through a tiny wound of skin and spreads widely along the fascial plane or tendon sheath. It destroys the tissues rapidly. Moreover, the toxicity of the paint material evokes acute inflammatory reaction which is accompanied by localized swelling, erythema, heat and sometimes generalized symptoms (i.e fever). Local toxic reaction leads to swelling, circulatory disturhance and foIlowed hy gangrene of the tissue. Sometimes tissue condition is too desperate to survive and bring about amputation unfortunately. Authors treated eleven patients of the paint gun injury f'rom March 1988 to April 1995. The paint materials were removed thoroughly via large skin incision as immediately as possible after the injury. Usually the wound is left to be open for seven to ten days and is followed by delayed primary wound closure. In our experience of three cases of delayed removal( two, five and seven days after injury), the outcomes were poor with problems of pain, sensory disturhance, limitation of finger motio, and two cases of digit amputation. On doing paint gun injection, right hand was used to hold the paint-gun and left hand was used to hold the cable. Our study showed right hands were injured mainly(nine cases). It means the paint gun injury is caused by inattention of work partner.
Amputation ; Erythema ; Fingers ; Gangrene ; Hand ; Hot Temperature ; Humans ; Paint* ; Skin ; Tendons ; Wounds and Injuries

No abstract available.
Carotid Arteries* ; Stents* ; Thrombosis*

Posterior reversible encephalopathy syndrome associated with hypertension rarely presents with predominant involvement of the brainstem and is relative sparing of the supratentorial regions. A relative paucity of brainstem signs and symptoms, despite extensive neuroimaging abnormalities therein, support the diagnosis. Although elevation of blood pressure is common in acute cerebral infarction, concomitant brainstem edema has not been reported. We describe here the clinical and neuroimaging features of an unusual brainstem hyperintensity associated with acute ischemic stroke. The neuroimaging abnormalities improved after stabilization of blood pressure, distinguishing this syndrome from brainstem infarction.
Blood Pressure ; Brain Stem ; Brain Stem Infarctions ; Cerebral Infarction ; Diagnosis ; Edema ; Hypertension* ; Magnetic Resonance Imaging* ; Neuroimaging ; Posterior Leukoencephalopathy Syndrome ; Stroke