This experiment was performed to evaluate the morphological responses of the intestinal gland of the mouse, duodenum inoculated with Ehrlich carcinoma cells, following administration of adriamycin or acriflavine -guanosine composition (AG60, Taerim Pharm. Co. Seoul, Korea). Healthy adult ICR mice weighing 25 g each were divided into normal and experimental groups (experimental control group, adriamycin treated group, and AG60 treated group). In the experimental groups, each mouse was inoculated with 1 x10 7 Ehrlich carcinoma cells subcutaneously in the inguinal area. From next day, 0.2 ml of saline, adriamycin (2 mg/ kg), AG60 (5 mg/kg) or AG60 (30 mg/kg) were injected subcutaneously to the animals every other day, respectively. The day following the 7th injection of anticancer drugs, each mouse was injected with a single dose of 0.7 microCi/gm of methyl -3 H -thymidine (25 Ci/mmol, Amersham Lab., England) through tail vein. Seventy minutes after the thymidine injection, animals were sacrificed. The number of the labeled epithelial cells of the duodenal crypts (mean number of labeled epithelial cells per 3.5 mm length of mucosa) were observed and calculated. On histological study, in the duodenum of adriamycin treated groups, vesiculated epithelial cells of the intestinal villi, expanded lumen of the intestinal gland (G) and loosely arranged lamina propria were observed. But in the AG60 treated group, morphological changes of the duodenum were not observed. On autoradiographic study, number of the labeled cells of normal control, experimental control, adriamycin -treated, AG60 (5 mg/kg)-, and AG60 (30 mg/kg)-treated groups were 595.3 +/-48.96, 715.+/-89.11, 96.0 +/-15.62, 632.0 +/-83.16 and 370.3 +/-49.65, respectively. In the adriamycin and AG60 30mg/kg -treated group, poorly -labeled cells containing only a few silver grains of 3 H -thymidine were observed more frequently than in those of the normal control group. But in the experimental control group, number of the heavy labeled cells were observed more frequently than in those of the normal control group. From the above results, adriamycin and AG60 (30 mg/kg) may suppress the DNA synthesis of the cells of the duodenal crypts. But AG60 does not result any histological defect on the duodenal mucosa. These results suggest that AG60 is expected as one of most effective anticancer drugs.
Acriflavine ; Adult ; Animals ; Edible Grain ; DNA* ; Doxorubicin* ; Duodenum ; Epithelial Cells ; Epithelium* ; Humans ; Intestinal Mucosa ; Mice* ; Mice, Inbred ICR ; Mucous Membrane ; Seoul ; Silver ; Thymidine ; Veins

BACKGROUND: Both ketamine and priming may accelerate the onset time of neuromuscular blocking agents. We investigate the effect of low dose ketamine and cisatracurium priming on the intubating condition and onset time of cisatracurium. METHODS: After Institutional Review Board approval, 120 consecutive patients undergoing general anesthesia were randomly assigned to one of 4 groups. All patients were injected one of normal saline (group C), cisatracurium 0.01 mg/kg (group P), ketamine 0.5 mg/kg (group K) and combination of cisatracurium 0.01 mg/kg, and ketamine 0.5 mg/kg (group PK) diluted into a 5 ml solution, followed 3 minutes later by cisatracurium 0.15 mg/kg in group C and K, and 0.14 mg/kg cisatracurium in priming group. Onset time was recorded the electromyographical responses using single twitch and intubating conditions were evaluated at 60 seconds after cisatracurium administration. RESULTS: The mean onset time was most significantly accelerated in Group PK and was also significantly more accelerated in Group P and K compared with Group C (P < 0.008). It was 112.7 +/- 13.2, 91.4 +/- 17.9, 84.9 +/- 12.7 and 76.4 +/- 8.3 seconds in Group C, P, K, and PK, respectively. Intubating conditions were significantly improved in Group P, K and PK than Group C (P < 0.008). Especially, Group PK showed most significant improvement of intubating conditions. CONCLUSIONS: The combination of the low dose ketamine and cisatracurium priming accelerated the onset time and was improved the intubating conditions.
Anesthesia, General ; Atracurium ; Ethics Committees, Research ; Humans ; Intubation ; Ketamine ; Neuromuscular Blocking Agents

PURPOSE: To describe the imaging findings of traumatic intracranial aneurysms (TICA) in children. MATERIALS AND METHODS: Five boys aged 3-15 (mean, 7) years with surgically confirmed TICA were included in this study. All had a history of nonpenetrating head trauma, and they underwent precontrast CT imaging immediately after the injury and follow-up CT or MRI. In all cases, angiography revealed the presence of aneurysms, which at surgery were shown to be pseudoaneurysms with severe adhesions. RESULTS: Angiography demonstrated that all aneurysms were located in the anterior cerebral artery (ACA) or its branches. The precise locations were the A2 segment of the ACA, the site of origin of the callosomarginal artery or its first branch, or of the anterior internal frontal artery, or between the first and second branch of the pericallosal artery. In all patients, precontrast CT performed immediately after trauma depicted subarachnoid hemorrhage (SAH) in the anterior interhemispheric fissure (AIHF). Follow-up precontrast CT showed nodular high density around the anterior falx in three, recurrent SAH in the AIHF in two, and intracerebral hemorrhage (ICH) with intraventricular hemorrhage in two. In two patients with a nodular high-density lesion, nodular enhancement was demonstrated at postcontrast CT, and in one, follow-up MRI revealed a nodular signal void around the anterior falx; nodular enhancement was seen at postcontrast imaging, and MR angiogram depicted a saccular aneurysm. In one patient, MRI demonstrated infarction in the caudate nucleus and ACA territory. CONCLUSION: If, after head injury, an area of nodular high density is revealed by CT, or a signal void by MRI, or if SAH or ICH is present around the anterior falx, the possibility of TICA should be considered.
Aneurysm ; Aneurysm, False ; Angiography ; Anterior Cerebral Artery ; Arteries ; Caudate Nucleus ; Cerebral Hemorrhage ; Child* ; Craniocerebral Trauma ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Subarachnoid Hemorrhage

PURPOSE: To assess the usefulness of breath-hold fast MR imaging of liver with fat suppression (FS) by application of chemical saturation technique in the diagnosis of regional fatty changed suspected in sonography. MATERIALS AND METHODS: Thirteen patients who had focal lesions with diffuse, homogeneous signal changes after FS through chemical saturation technique without additional changes of imaging parameter during MR imaging of liver were selected. T1-weighed fast low-angle shot and T2-weighted turbo spin-echo sequences were obtained with or without FS during each single breath-holding session. Subjective changes of signal intensity between the pre-FS and the FS images were compared with the sonographic findings in each lesion. RESULTS: Seven lesions of decreased signal intensity after FS on T1 or T2-weighted images, including three lesions only at FS T1 images, were regarded as focal fat infiltration. All seven lesions had compatible sonographic findings as homogenously echogenic areas. Another six lesions of subjectively increased signal intensity including two lesions only at FS T2 images were regarded as focal fat sparing. All six lesions had sonographic findings as homogenous echo poor areas suggesting focal fat sparing. In cases regarded as fat infiltration, score changes were more prominent at FS T1 images than FS T2 images(p=0.0002). In cases regarded as fat sparing, score changes were more prominent at FS T2 images than FS T1 images(p=0.042). CONCLUSION: Breath-hold fast T1 and T2-weighted MR imaging with and without chemical saturation pre-pulse may be sufficient for characterization of regional fatty changes in the different ferential diagnosis of focal hepatic lesion found at sonography.
Diagnosis ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Ultrasonography

PURPOSE: The purpose of this study is to compare and analyze the clinical results according to the complications occurring after laminoplasty for cervical myelopathy patients. MATERIALS AND METHODS: Among patients diagnosed as cervical myelopathy, 152 cases in which patients underwent cervical laminoplasty from March 2006 to March 2011 from Chungnam National University Hospital and had follow-up for at least two years were selected for the study, and the mean follow-up period was 39.7 months. The cases were divided into two groups; cases that underwent plate fixation for hinge fracture during cervical laminoplasty or showed postoperative spontaneous interlamina fusion were included in group A and cases that did not show such complications were included in group B. Clinical results were measured using visual analogue scale (VAS) score and Neck Disability Index (NDI) preoperatively, postoperatively, and on the final follow-up. RESULTS: Among 152 cases, 31 cases were included in group A and 121 cases in group B. Group A consisted of 11 cases of fixation due to intraoperative hinge fracture and 20 cases of postoperative spontaneous interlamina fusion. Mean preoperative VAS score was 7.52 in group A and 7.26 in group B, and mean postoperative VAS score was 2.87 in group A and 3.03 in group B. Mean NDI improved from 74.32% preoperatively to 43.84% postoperatively in group A and 75.74% preoperatively to 45.36% postoperatively in group B. In both groups, on postoperative follow-up, no significant difference of VAS score and NDI was found and both showed improvement compared to before surgery. CONCLUSION: The clinical results of cases that underwent plate fixation for hinge fracture that occurred during cervical laminoplasty and postoperative spontaneous interlamina fusion showed no significant difference compared to cases that did not show any complications.
Follow-Up Studies ; Humans ; Neck ; Spinal Cord Diseases*

PURPOSE: To evaluate the clinical symptoms and the associated intra-articular disorders of the polpliteal cyst. MATERIALS AND METHODS: We studied 56 patients, 60 cases of the popliteal cysts which. Had been treated with excision of the cyst after arthroscopy between May 1991 and February 2000. Arthroscopic findings and clinical results of the patients who had popliteal cyst were evaluated. RESULTS: Forty nine patients of the sixty patients of who had popliteal cyst showed intra-articular disorders. Tear of the meniscus and patello-femoral arthrosis with cartilage lesions were the most frequent intra-articular lesions. In 4 cases, recurrence of the popliteal cyst was noted. Two patients had tear of the meniscus and two had no intra-articular disorders. CONCLUSION: This study revealed that popliteal cysts frequently combined with intra-articular disorders. Arthroscopy of the knee joint seems worthwhile method for the patients who had popliteal cyst
Arthroscopy ; Cartilage ; Humans ; Knee Joint ; Knee* ; Popliteal Cyst* ; Recurrence

A 57-year-old man complained of sudden hearing loss and vertigo as sole initial symptoms. Pure tone audiometry revealed severe bilateral sensorineural hearing loss. Brain MRI demonstrated multiple scattered small acute infarctions in the bilateral thalami, occipital lobe, cerebellum and ventral upper pons, however, none in the level of vestibulocochlear nuclei. Cerebral angiography revealed vertebrobasilar occlusion with collateral circulation. On the seventh day of the patient's hospital stay, he developed dysarthria, dysphagia and ataxia. Five months later, his hearing loss persisted, but other neurologic deficits improved substantially.
Ataxia ; Audiometry ; Brain ; Cerebellum ; Cerebral Angiography ; Collateral Circulation ; Deafness ; Deglutition Disorders ; Dysarthria ; Hearing Loss ; Hearing Loss, Bilateral* ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Infarction ; Length of Stay ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Occipital Lobe ; Pons ; Vertebrobasilar Insufficiency ; Vertigo*

Emery-Dreifuss muscular dystrophy is characterized by 1) early contractures of the elbows, Achilles tendons, and postcervical muscles, 2) slowly progressive muscle wasting and weakness with a humeroperoneal distribution in the early stages, and 3) cardiomyopathy with conduction defects and risk of sudden death. The inheritance is usually X-linked recessive but can be autosomal dominant and recessive. We report a case of 28-year old woman who presented with dizziness, palpitation, and progressive muscular weakness. Her ECG revealed high degree AV block and muscle biopsy demonstrated diffuse degenerative change consistent with Emery-Dreifuss muscular dystrophy. She was diagnosed as autosomal dominant Emery-Dreifuss muscular dystrophy by characteristic clinical features, and findings of ECG, nerve conduction test, electromyography and muscle biopsy findings. A VVI-type permanent pacemaker was implanted.
Achilles Tendon ; Adult ; Atrioventricular Block* ; Biopsy ; Cardiomyopathies ; Contracture ; Death, Sudden ; Dizziness ; Elbow ; Electrocardiography ; Electromyography ; Female ; Humans ; Muscle Weakness ; Muscles ; Muscular Dystrophy, Emery-Dreifuss* ; Neural Conduction ; Wills

PURPOSE: We wanted to analyze the radiological changes of the patients who underwent percutaneous endoscopic lumbar discectomy (PELD) for treating soft disc herniation. MATERIALS AND METHODS: We retrospectively reviewed 30 patients (32 cases) who were observed for a minimum of 3 years after they underwent PELD. The authors investigated the postoperative radiological changes after PELD and the related clinical outcomes. All the patients received plain X-rays, CT and MRI both preoperatively and at the final follow-up. The radiological parameters were evaluated, including the disc height, the disc signal intensity, the subchondral marrow signal intensity, the sagittal plane instability and the facet joint osteoarthritis. RESULTS: The average amount of removed disc was 1.363 g and a significant correlation was detected between the narrowing of disc height and the amount of removed disc. Although the disc height and the disc height ratio were significantly decreased (-0.97 mm and 86.9%, respectively), the angle of sagittal rotation was well maintained. There were 18 (56.3%) cases of disc signal changes, six cases (18.8%) of subchondral marrow signal changes, and three cases (9.4%) of facet joint osteoarthritis. The success rate was 90.6%. CONCLUSION: Although disc height narrowing was observed, there was no postoperative instability and the overall clinical outcome was satisfactory. Our results show that PELD is a useful and minimal invasive procedure for the selected patients who are suffering with lumbar disc herniation.
Bone Marrow ; Diskectomy* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Osteoarthritis ; Retrospective Studies ; Zygapophyseal Joint

PURPOSE: To evaluate the necessity of deltoid ligament repair in lateral malleolar fracture associated with medial clear space widening. MATERIALS AND METHODS: The 82 cases of 82 patients received surgical treatment for lateral malleolar fracture with medial clear space widening in our hospital from Jan. 1996 to Feb. 2002. 73 male and 9 female patients were included respectively. Average follow-up period was 13.2 month (12~50). The methods of internal fixation of lateral malleolar fracture were 66 cases by cortical screw, 16 by plate and screws, and 9 by transfixing screw. RESULTS: Satisfactory reduction was obtained in 65 of 73 cases by only internal fixation of lateral malleolar fracture. Transfixing screw was needed in 8 cases. There was no need for repair of deltoid ligament. In clinical evaluation, no cases of limitation of movement in ankle was seen at final follow-up time. In radiologic evaluation, average medial clear space widening before operation was 5.89 mm (4.5~13 mm) and that of last follow-up time was 2.54 mm (1.5~3.5 mm). 95.2% was above good result. CONCLUSION: In treatment of unstable lateral malleolar fracture associated with medial clear space widening due to rupture of deltoid ligament, we obtained satisfactory result by accurate anatomical reduction or internal fixation. In these cases, there were no need for repair of deltoid ligament.
Ankle ; Female ; Follow-Up Studies ; Humans ; Ligaments* ; Male ; Rupture