STUDY DESIGN: This study is a retrospective evaluation of the high lumbar disc herniations. OBJECTIVE: The purposes of this study is to observe the clinical and radiological findings and out-comes of the high lumbar disc herniations, thus providing a guideline for making diagnosis and for proper treatment modality. SUMMARY OF LITERATURE REVIEW: High lumbar disc herniations at the L1 -2, L2-3 and L3-4 levels represent less than 5% of all disc herniations. The location of pain was highly complected. The represented symptoms and signs such as motor, sensory and reflex changes were variable and potentially misleading in suggesting a level of the disc herniation. MATERIAL AND METHODS: Thirty-one patients with high lumbar disc herniations were retrospectively evaluated. Seventeen patients were treated conservatively and fourteen patients underwent surgery. Review of results was undertaken by an independent observer using a proven outcome assessment measure. RESULTS: The incidence of high lumbar disc herniation is 4.7%(L1-2: 13%, L2-3: 29%, L3-4: 58%) with declining frequency as the level ascends. The peak age incidence is 6th decade in male and 5th decade in female. The positive rate of femoral nerve stretching test(74%) is higher than that of straight leg raising test(51%). In fourteen operative cases, the positive rate of straight leg raising test is 86%. The accuracy of MRI findings in predicting the type of herniated disc is 93%. In results of operation thirteen cases showed more than fair grade(93%). CONCLUSION: The age incidence of the high lumbar disc herniation is older than that of the lower lumbar disc herniation. The femoral nerve stretching test is more useful than straight leg raising test in making diagnosis of high lumbar disc herniations. The prognosis after treatment is comparable with high lumbar disc herniations.
Diagnosis ; Female ; Femoral Nerve ; Humans ; Incidence ; Intervertebral Disc Displacement ; Leg ; Magnetic Resonance Imaging ; Male ; Prognosis ; Reflex ; Retrospective Studies

Pseudomembranous colitis (PMC) is a frequent cause of morbidity and mortality among hospitalized patients. Although diarrhea is the most common manifestation, PMC may be associated with intraperitoneal fluid accumulation in the severe cases. And a few cases showing both ascites and pleural effusion have been reported in patients with PMC. We report a case of PMC who showed elevated serum and ascites levels of carcinoembryonic antigen (CEA) with a normal CEA level in pleural effusion and who successfully recovered after oral administration of metronidazole. After treatment, the serum CEA level returned to the reference range.
Administration, Oral ; Ascites ; Carcinoembryonic Antigen* ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Humans ; Metronidazole ; Mortality ; Pleural Effusion ; Reference Values

PURPOSE: To establish central control of a penile erection, the centrally elicited erectile effects of apomorphine hydrochloride and various vasoactive agents were investigated after intracerebroventricular administration. MATERIALS AND METHODS: Anesthetized male Sprague-Dawley rats were used for the study. After intracerebroventricular administration of normal saline(NS), apomorphine hydrochloride(AH), prostaglandin E1(PGE1), sodium nitroprusside(SNP), phenylephrine hydrochloride(PE) and phentolamine(PT) under a stereotaxic setting, the intracavernosal pressure(ICP), systolic femoral artery pressure(FAP), heart rate(HR), time to first response, duration and number of erectile response and adverse reactions were evaluated for 60 minutes. To show if the centrally elicited erection by agents in native setting were effective, the above criteria were re-evaluated after a bilateral pelvic neurotomy and bilateral orchiectomy. RESULTS:Cerebral proerectile effects were elicited by AH with no significant changes in the FAP and HR, but with PGE1, SNP, PE and PT significant changes in both the FAP and HR were observed. The ICP/FAP ratio was highest with SNP at 0.75+/-0.08. The mean time to first response was shortest with AH at 18.1+/-5.1min. The mean duration was longest with AH at 39.4+/-10.9min. The number of responses was highest with AH at 2.7+/-1.1. Adverse reactions, such as stretching, yawning and ejaculation, were simultaneously observed during increases in the ICP. In the case of a bilateral pelvic neurotomy or bilateral orchiectomy, these elicited erectile responses disappeared. CONCLUSIONS: Vasoactive agents, such as SNP, PGE1 and PE, had a cerebral proerectile effect, but AH showed more an evidently potent proerectile effect in the aspects of ICP, time to first response and duration of erectile response. Testosterone and the pelvic nerve are suggested to be essential for a central proerectile response.
Alprostadil ; Animals ; Apomorphine* ; Ejaculation ; Femoral Artery ; Heart ; Humans ; Male ; Orchiectomy ; Penile Erection ; Phenylephrine ; Rats* ; Rats, Sprague-Dawley ; Sodium ; Testosterone ; Vasodilator Agents ; Yawning

OBJECTIVES: The aim of study was to examine the prevalence of night eating syndrome(NES) and its correlates in schizophrenic outpatients. METHODS: The 14 items of self-reported night eating questionnaire(NEQ) was administered to 201 schizophrenic patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating, and weight-related quality of life using Beck's Depression Inventory(BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. RESULTS: The prevalence of night eaters in schizophrenic outpatients was 10.4%(21 of 201). Comparisons between NES group and non-NES group revealed no significant differences in sociodemographic characteristics, clinical status and BMI. Compared to non-NES, patients with NES reported significantly greater depressed mood and sleep disturbance, more binge eating pattern, and decreased weight-related quality of life. While 'morning anorexia' and 'delayed morning meal'(2 of 5 NES core components in NEQ) were not differed between groups, 'nocturnal ingestions', 'evening hyperphagia', and 'mood/sleep' were more impaired in NES group. CONCLUSION: These findings are the first to describe the prevalence and its correlates of night eaters in schizophrenic outpatients. These results suggest that NES has negative mental health implications, although it was not associated with obesity. Further study to generalize these results is required.
Ambulatory Care Facilities ; Bulimia ; Depression ; Eating* ; Humans ; Mental Health ; Obesity ; Outpatients* ; Prevalence* ; Quality of Life

Although tumor necrosis factor (TNF)-alpha antagonist is a successful treatment modality for various autoimmune diseases, including rheumatoid arthritis (RA), ankylosing spondylitis and psoriatic arthritis, many adverse effects have been reported. Cutaneous adverse reactions of TNF-alpha antagonist include skin rash, urticaria, lupus like rash, seborrheic dermatitis and different kinds of psoriasiform dermatitis. We report a case of psoriasiform dermatitis during TNF-alpha antagonist treatment in a 50-year-old woman with RA. The patient has been treated with adalimumab. After 2 months, she developed pruritic erythematous eruption and desquamative lesions on the head and limbs, which were defined as psoriasiform change by a skin biopsy. These skin lesions are successfully treated with combination therapy, including cessation of adalimumab, corticosteroid and phototherapy.
Antibodies, Monoclonal, Humanized ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Biopsy ; Dermatitis ; Dermatitis, Seborrheic ; Exanthema ; Extremities ; Female ; Head ; Humans ; Middle Aged ; Phototherapy ; Skin ; Tumor Necrosis Factor-alpha ; Urticaria ; Adalimumab

PURPOSE: To evaluate the usefulness of new liquid embolic materials for portal vein embolization (PVE). MATERIALS AND METHODS: The liquid embolic material, Embol, was obtained by hydrolytic reaction of polyvinyl acetate (PVAc). Several Embols with a different hydrolysis ratio and polymer concentration were prepared and named, an example was Embol-78-12. These were percutaneously injected through a 5-Fr catheter into the left portal vein of six pigs, and radio-opacity under X-ray fluoroscopy and the possibility of reflux were evaluated. RESULTS: The radio-opacity of Embol-78-8, Embol-73-10, and Embol-73-12 was too low to recognize reflux, but was excellent when Embol-78-12 or (Embol-78-12 + Lipiodol) was used; it was still difficult to prevent reflux, however. With the use of a balloon catheter, however, complete embolization became possible. CONCLUSION: Embol-78-12 injection through a balloon catheter seems to be useful for clinical PVE.
Animals ; Catheters ; Fluoroscopy ; Hydrolysis ; Polymers ; Polyvinyls ; Portal Vein* ; Swine*

No abstract available.
Actinomycosis*

PURPOSE: The purpose of this study was to investigate the characteristics of the patients who had undergone vasovasostomy and to analyze the reasons for an increase in the number of these operations. MATERIALS AND METHODS: From January 1999 to April 2007, 105 patients were analyzed by examining their medical records and conducting telephone surveys. The patients were divided into two groups before and after insurance payments for a vasovasostomy. Analysis of the differences between the two groups was performed by grouping the patients who had a vasovasostomy before July 2004 and those who had a vasovasostomy after July 2004. RESULTS: Among the 105 patients, 35 patients (0.58/month) had a vasovasostomy before receiving their insurance payment. However, the number of operations increased by more than 4 times (70 patients, 2.33/month) after insurance repayment (p<0.05). After the payment, the proportion of patients willing to have a vasovasostomy due to changing their mind increased, whereas the proportion of patients willing to have a vasovasostomy for remarriage and loss of a child decreased (p<0.05). The overall patency and birth rates were 87.6% and 76.1%, respectively (43 boys and 37 girls). Among such factors as the age of the patient and his spouse, the duration of ligation and the presence of seminal fluid and sperm, the duration of ligation was the only factor that showed relevance to the anatomical patency (p<0.05). There were no variables that showed significant relevance to the pregnancy rate. CONCLUSIONS: The main reason of vasectomy reversal was to have another child. The numbers of vasovasostomies were influenced by the medical insurance payment. The duration of ligation affected the anatomical patency rate. The overall patency rate was 87.6% and the birth rate was 76.1% in this study.
Birth Rate ; Child ; Humans ; Insurance ; Ligation ; Marriage ; Medical Records ; Parturition ; Pregnancy Rate ; Spermatozoa ; Spouses ; Telephone ; Vasovasostomy

Evaluation of seizure disorders revealed the important role of CT in establishing an etiologic diagnosis. The authors analized 207 patients who were checked at Seoul National University Hospital from October, 1977 to August, 1980. Over half of the cases were of normal findings(58%). The most frequent lesion was atrophic changes of the brain(16.4%). Other abnormalities were parasitic lesions, vascular anomalies, brain tumors, infarctions, porencephalic cysts, etc. There were higher rates of positive findings in focal seizures, and in patients with a short history of seizure disorders, and in patients of older age over 40.
Brain Neoplasms ; Diagnosis ; Epilepsy* ; Humans ; Infarction ; Seizures* ; Seoul

OBJECTIVES: The present study takes part of the agricultural district cohort study of a certain county located in Gyeonggido and aims to investigate the difference of the heart rate variability(HRV) according to the social support level. METHODS: We used data from 1727 participants of a health promotion program who are older than 40 years old. A physical examination, as well as a one-to-one interview to obtain sociodemographic characteristics, was performed with each participant. In addition, the participants completed the Medical Outcomes Study-Social Support Survey(MOS-SSS) for their the social support level to be assessed, and their HRV were measured to evaluate their autonomic function. The entire group was divided in two groups according to its MOS-SSS points to facilitate the research. Those who were evaluated as the high 25%(432 persons) were denominated as high social support (HSS) group and those who were evaluated as the low 25%(425 persons) were denominated as poor social support(PSS) group. RESULTS: The two groups showed significant differences on the sociodemographic factor such as mean age and gender composition(p<0.05). Comparing the indices related to the HRV, the HSS group had the following values higher than the PSS group : SDNN(F=4.938, p=0.027), TP(F=8.088, p=0.005), VLF(F=6.220, p=0.013) LF (F=3.873, p=0.049). CONCLUSION: According to the research, the PSS group showed dysfunction on their autonomic nervous system comparing to the HSS group. The social support helps an individual overcome difficulties, helps the adaptation during the changes of circumstances and in stressful situations it serves like a buffer. Based on that, it's possible to define that a low social support level gave an impact on the autonomic function. Also, using the fact that the HRV can evaluate the autonomic function in an objective view, it was possible to visualize that it has a potential to be used as an assistant factor to evaluate the social support.
Autonomic Nervous System ; Cohort Studies ; Health Promotion ; Heart ; Heart Rate ; Physical Examination