Spasticity is a wide variety of motor problems to connote difficulty with coordinated movements, involuntary spasma, rigidity. Abnormal primitive reflexes and hyperactive reflexes. Electrophysiologically, spasticity is represented as the involuntary firing of motor units on a reflex basis at a polysynaptic spinal cord level, associated with interruption of descending cortical pathways. Although many procedures have been tried over the years to combat this spasticity, and the multitude of procedures indicates that none are entirely satisfactory, the reduction in spasticity produced by dentatotomy has been confirmed in many neurological centers. The F-wave is a late response recorded in the electromyography of a muscle following stimulation of its nerve supply. There is evidence that the size of the F-wave is dependent on motor neuron excitability. If such a relationship exists, procedures which are carried out to relieve motor neuron excitability might be expected to change F-wave size and it might therefore be possible to use the F-wave as an objective monitor during stereotactic dentatotomy. We have investigated this possiblity in 10 cats, weighing 2.8 to 3.7kg each. The size of F-wave Amplitude in experimental animals were devided into 2 groups, normal control group values(10 cats, before dentatotomy) and the dentatotomy group values(10 cats after dentatotomy). The F-wave size and F/M ratio were recorded from right tibialis anterior muscle after application of supramaximal stimulation(250 V. 100 mA. 2 Hz. 10 times) on the right peroneal nerve. The results were as follows: 1) The size of M-wave amplitude did not change significantly in experimental models(before dentatotomy, 2805.5+/-1012.3 microV;dentatotomy group, 2555.5+/-725.9 microV, P>0.05). 2) The individual size of F-wave showed a wide variability from each stimulus, which emphasizes the importance of using 0 stimulating responses. The mean value of F-wave amplitude before dentatotomy was 436.5+/-113.2microV. 3) The size of F-wave amplitude was significantly reduced after dentatotomy(before dentatotomy, 436.5+/-113.2microV;after dantatotomy: 212.5+/-49.3microV, P<0.05). The size of F-wave amplitude decreased about 48.6% after dentatotomy. 4) The F/M ratio also significantly reduced after dentatotomy(before dentatotomy, 17.1+/-6.6%;after dentatotomy, 8.5+/-1.2%, P<0.05) and mean reduction was 49.7%. The results demonstrated that the dentatotomy markedly decreased the size of F-wave amplitude in experimental cats and indicated that the monitoring of F-wave amplitude during dentatotomy might be useful as an objective monitor for the relief of spasticity.
Animals ; Cats* ; Dyskinesias ; Electromyography ; Fires ; Motor Neurons ; Muscle Spasticity ; Peroneal Nerve ; Reflex ; Spinal Cord

Intraspinal lipomas are rare, benign neoplasms, comprising less than 1% of all intradural spinal tumors. Such tumors occur in the thoracic and cervical region, however, extension into the posterior fossa is most unusual. A case of large cervical intradural spinal liplma with extension into the posterior fossa in adult female is presented. Clinical feature was slowly progressing quadriparesis. Brain and cervical spine computed tomography confirmed the diagnosis and Magnetic resonance imaging was very useful for delineation of the anatomy of the lipoma as an aid in planning the operation. Operative therapy consisted of combined suboccipital craniectomy, spinal laminotomy and laminoplasty, subtotal tumor decompression.
Adult ; Brain ; Decompression ; Diagnosis ; Female ; Humans ; Laminectomy ; Lipoma* ; Magnetic Resonance Imaging ; Quadriplegia ; Spine

Interference with visual pathways is usually not caused by intracranial aneurysms. Aneurysms of the anterior communicating artery rarely produce visual symptoms and signs in spite of their proximity to the visual pathways. The reason may be that these aneurysms rupture and present with subarachnoid hemorrhage before becoming large enough to exert significant pressure on the chiasm or optic nerves. The visual symptoms would be presented as visual field defect or impaired vision. These can be explained as the result of direct compression of the optic pathways, ischemic changes in the visual pathways caused by severe vasospasm after subarachnoid hemorrhage, or intraocular pathology such as retinal hemorrhage. 2 cases of anterior communicating artery aneurysms associated with visual symptoms are presented with a brief review of literatures.
Aneurysm ; Arteries ; Intracranial Aneurysm* ; Optic Nerve ; Pathology ; Retinal Hemorrhage ; Rupture ; Subarachnoid Hemorrhage ; Visual Fields ; Visual Pathways

We reported two cases of diabetic hyperglycemic hyperosmolar coma treated with maintaining continuous ambulatory peritoneal dialysis(CAPD) in chronic renal failure(CRF) patients with CAPD. Hyperglycemia is common complication in CAPD, but there were only few reports of severe hyperglycemia accompanying with hyperosmolar coma in CRF patients on CAPD therapy. Furthermore, to date, no specific management for CAPD patients with nonketotic hyperosmolar coma has been established. The best strategy for management of hyperosmolar coma with CAPD patients is changing CAPD therapy to HD. Recently, we experienced two cases of hyperglycemic hyperosmolar coma in diabetic CAPD patients successfully treated with intravenous hydration and insulin therapy without discontinuing CAPD therapy. Because no such case has been reported, we report two cases of diabetic hyperosmolar coma with CAPD treated without conversion to HD. These cases suggest that adequate fluid replacement accompanying electrolytes and osmotic balance as well as insulin therapy might be a major role for safe treatment of hyperglycemic hyperosmolar coma in patient with CAPD.
Coma* ; Electrolytes ; Humans ; Hyperglycemia ; Insulin ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis

We reported two cases of diabetic hyperglycemic hyperosmolar coma treated with maintaining continuous ambulatory peritoneal dialysis(CAPD) in chronic renal failure(CRF) patients with CAPD. Hyperglycemia is common complication in CAPD, but there were only few reports of severe hyperglycemia accompanying with hyperosmolar coma in CRF patients on CAPD therapy. Furthermore, to date, no specific management for CAPD patients with nonketotic hyperosmolar coma has been established. The best strategy for management of hyperosmolar coma with CAPD patients is changing CAPD therapy to HD. Recently, we experienced two cases of hyperglycemic hyperosmolar coma in diabetic CAPD patients successfully treated with intravenous hydration and insulin therapy without discontinuing CAPD therapy. Because no such case has been reported, we report two cases of diabetic hyperosmolar coma with CAPD treated without conversion to HD. These cases suggest that adequate fluid replacement accompanying electrolytes and osmotic balance as well as insulin therapy might be a major role for safe treatment of hyperglycemic hyperosmolar coma in patient with CAPD.
Coma* ; Electrolytes ; Humans ; Hyperglycemia ; Insulin ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis

OBJECTIVE: The birth weight distributions are obtained to be classified according to the duration of pregnancy, and then compared with other results already published in literature to verify the difference. METHODS: A total of 17,291 deliveries in Gachon medical center hospital from January 1996 to December 1999 is retrospectively reviewed. The data of 28~42th week of gestation are analysed, and the 10th, 25th, 50th, 75th and 90th percentiles of birth weight are determined for each week and also according to sex and parity. Furthermore the 10th, 50th, 90th percentiles are compared with those from other reports. RESULTS: 1. The 10th, 50th, 90th percentiles of birth weight classifed according to gestational age are as follow : in 28th week of pregnancy, 1,068, 1,240 and 1,812 g; in 32th week, 1,470, 1,890 and 2,266 g; in 36th week, 2,170, 2,720 and 3,240 g; in 40th week, 2,910, 3,370 and 3,870 g; in 42th week, 2,977, 3,475 and 4,023 g.2. The mean birth weight of the male neonates is greater than that of the female ones from 37th week to 41th week (p<0.01).3. Comparisons of 10th, 50th, 90th percentiles of birth weight with Park groups show that there is an increase of birth weight by 100~144 g. CONCLUSION: Comparison of the birth weight-gestational age table with ones published by other groups shows that infants tend to be heavier.
Birth Weight ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Male ; Parity ; Parturition* ; Pregnancy ; Retrospective Studies