The etiology of the postoperative discitis is not fully known, but most likely, the cause seems to be of a low grade infection and chemical and mechanical injuries. The incidence of these complication is from 0.12% to 2.6% of all cases. The characteristics of this disease are recurrence of severe lower back and gluteal pain, spasm of lumbar paravertebral muscle and elevated E.S.R. following the asymptomatic post-operative period, a roentgenogram showed an early destructive change in the adjacent vertebra, the narrowing of the intervertebral disc space, sclerotic changes in the vertebral bone and occasional fusion of the spine, and relatively good prognosis. We present a case of recurrent postoperative discitis with E.S.R. change and roentgenographic change.
Discitis* ; Incidence ; Intervertebral Disc ; Prognosis ; Recurrence ; Spasm ; Spine

Intracranial arachnoid cysts are uncommon congenital lesions of considerable interest and importance, the origins and exact nature of which remain uncertain. They account for about 1% of all intracranial space-occupying lesions4). Its predilection sites are in the sylvian fissure, the interhemispheral fissure, the cerebral convexity, the base of the brain, and over the midline of the cerebellum in the posterior fossa6)11). We are reporting a case of arachnoid cyst, developed in the left sylvian fissure in a ten years old male patient.
Arachnoid ; Arachnoid Cysts* ; Brain ; Cerebellum ; Humans ; Male

Defects in the dura mater can be result from craniocerebral trauma, neoplastic or inflammatory destruction surgical removal and congenital absence. Materials used for closure of dural defects were variable. Of these, autogenous fascia lata have been used for a long time. It seems interesting to study the histologic fate of the autogenous grafted fascia lata in the dural defects. After autogenous fascia lata graft to dural defect in 18 rabbits, the histologic fate of the autogenous grafted fascia lata was observed microscopically. The results are as follows: 1) The adhesions among the grafted fascia lata, arachnoid, pia mater and brain cortex were usually mild. This result may be due to either short period of observation or autogenous substitutional material. 2) The grafted autogenous fascia lata was revealed minimal inflammatory response and was ultimately reabsorbed. 3) The grafted autogenous fascia lata was replaced by granulation tissue and fibroblast originated from the host mesenchymal tissue.
Arachnoid ; Brain ; Craniocerebral Trauma ; Dura Mater ; Fascia Lata* ; Fascia* ; Fibroblasts ; Granulation Tissue ; Pia Mater ; Rabbits* ; Transplants

BACKGROUND: Pressure rise time (PRT) is the time in which the ventilator aclieves the set airway pressure in pressure-targeted modes, such as pressure control ventilation (PCV). With varying PRT, in principle, the peak inspiratory flow rate of the ventilator also varies. And if PRT is set to a shorter duration, the effective duration of target pressure level would be prolonged. which in turn would increase inspiratory tidal volume(Vti) and mean airway pressure(Pmean). We also postulated that the increase in Vti with shortening of PRT may relate inversely to the patients' basal airway resistance. METHODS: In 13paralyzed patients on PCV(pressure control 18±9.5cm H2, FIO2 0.6±0.3, PEEP 5±3cm H2O, f20/min, I : E, 1 : 2) with Servo 300(Siemens-Elema, Solna, Sweden)from various causes of respiratory failure, PRT of 10%, 5% and 0% were randomly applied. At 30min of each PRT trial, peak inspiratory flow (PIF, L/sec), Vti(ml), Pmean(cm H2O) and ABGA were determined. RESULTS: At PRT 10, 5% and 0%, PIF were 01.69±0.13, 0.77±0.19, 0.83±0.22, respectively(p<0.001). Vti were 425±94, 439±101, 456±106, respectively(p<0.001), and Pmean were 11.2±3.7, 12.0±3.7, 12.5±3.8, respectively(p<0.001). pH were 7.40±0.08, 7.40 ±0.92, 7.41±0.96, respectively (p=0.004) ; PaCO2 (mm Hg) were 47.4±15.8, 47.2±15.7, 44.6±16.2, respectively (p=0.004) ; PAO2 - PaO2 (mm Hg) were 220±98, 224±95, 227±94, respectively(p=0.004) ; and Vd/Vt as determined by (PaCO2 - P CO2/PaCO2 were 0.67±0.07, 0.67±0.08, 0.66 ±0.08, respectively(p=0.007). The correlation between airway resistance and change of Vti from PRT 10% to 0% were r=-0.243(0.498). CONCLUSION: Shortening of pressure rise time during PCV was associated with associated with increased tidal volume, increased mean airway pressure and lower PaCO2.
Airway Resistance ; Humans ; Hydrogen-Ion Concentration ; Respiratory Insufficiency ; Tidal Volume* ; Ventilation* ; Ventilators, Mechanical

We have experienced 40 cases of spontaneous intracerebral hemorrhage admitted to the Chung Ang University Hospital. We analized the result of the treatment of spontaneous intracerebral hemorrhage and assessed prognostic factors affecting the result of treatment of intracerebral hemorrhage. 1) The age distribution was ranged from 26 to 69 and 67.5% of them were in fourth and fifth decade. The ratio of male to female was about 5:3 and the age of the patients did not significantly influence on the result of operative or non-operative cases(P:0.22 P>0.05). 2) The predilection sites of hemorrhage were basal ganglia(60%) and thalamus(15%). 3) There was a correlation between the conscious status on admission and that of two weeks after admission, not so strong, in the operated cases. I.e., the higher Glasgow Coma Score on admission, the better results two weeks after admission. But such a correlation was not found in the non-operated cases(P:0.5732 P<0.01, P:0.1581 P>0.05). The hemorrhage in the dominant hemisphere had little correlation with the outcome(P:0.5068 P<0.01). 4) The pre or post-operative conscious status appeared to have no correlation with the hematoma volume. The large hematoma not always lead to poor prognosis when it was removed in proper time unless the secondary change of the hematoma did not develop(P:0.4257 P<0.05, P:0.4644 P<0.05). 5) The blood pressure on admission, not his proper pressure, had no correlation with the result two weeks after admission in the operated or non-operated cases(P:4988 P<0.01, P:0.4120 P<0.05). 6) The midline shift on the carotid angiogram had a closed correlation with the conscious status of the operated or non-operated cases in spite of little influence of hematoma volume to the conscious state(2:0.7350 P<0.01, P:0.5377 P<0.01).
Age Distribution ; Blood Pressure ; Cerebral Hemorrhage* ; Coma ; Female ; Hematoma ; Hemorrhage ; Humans ; Male ; Prognosis

Osteosarcoma is the most frequently encountered primary malignant tumor of the bone. But sarcoma of the skull are rare tumor to be observed even in an extensive neuropathological practice. We presents a case of skull neoplasm identified as osteosarcoma. A twelve year old male patient was admitted to our department because of the large palpable mass on the posterior parietal and occipital region with headache, nausea and vomiting. On admission moderate papilledema was noted in the both eyes. Other neurologic finding were within normal limits. Chest film and long bone series showed no evidence of abnormality. Skull films revealed a large round destructive area on the posterior parietal and occipital region and the right carotid angiogram revealed patch densities in the mass lesion which was supplied by the right occipital artery and possibly the right middle meningeal artery. Serum Alkaline Phosphatase was 14 BL Units. The findings on the pathology side was compatible with osteosarcoma.
Alkaline Phosphatase ; Arteries ; Headache ; Humans ; Male ; Meningeal Arteries ; Nausea ; Neurologic Manifestations ; Osteosarcoma* ; Papilledema ; Pathology ; Rabeprazole ; Sarcoma ; Skull Neoplasms ; Skull* ; Thorax ; Vomiting

The characteristic features of the Forestier's disease, ankylosing hyperostosis of the spine, consist essentially in marginal proliferation at the vertebral edges which are apt to unit their homologues to form bridges and to extend as a bony layer which thickens the vertebral cortex with an overgrowth of bone spreading like a flow. The disease had been long looked upon as vertebral spondylosis or other spinal diseases such as ankylosing spondylitis before Forestier first defined it as a new disease entity. The bony changes could be occurred everywhere on the spinal column, but are mainly confined to the anterior part of the thoracic spine, especially in the right side. It clinically may be of little significance because of little symptoms. Forestier reported 88% of the patients was over 50 years old and 65% was male of 45 cases. Although the pathogenesis is uncertain, a spinal expression of more diffuse ossifying diathesis may be considered. We are reporting a case of the Forestier's disease which was incidentally found on a 55 years old paraplegic patient who had suffered from back trauma.
Disease Susceptibility ; Humans ; Hyperostosis* ; Hyperostosis, Diffuse Idiopathic Skeletal ; Male ; Middle Aged ; Spinal Diseases ; Spine ; Spondylitis, Ankylosing ; Spondylosis

A glycogen storage disease(GSD) type I is a metabolic disease caused by a deficiency in one of the components of the glucose-6-phosphatase(G-6-Pase) system. This disorder results in hypoglycemia, hepatomegaly, lactic acidemia, hyperlipidemia, and hyperuricemia. Common long(-)term complications include growth retardation, gout, hepatic adenomas, osteoporosis and renal disease. However the cardiovascular system is rarely involved, and only six cases of pulmonary hypertension associated with GSD I have been reported in the literature. We experienced a case of pulmonary hypertension with type I GSD. A 31-year-old man, who had discovered type I GSD and received portocaval shunt operation 22 years ago, was admitted to the hospital with the chief complaint of dyspnea. Echocardiographic examination and cardiac catheterization revealed severe pulmonary hypertension. Nitric oxide and oral prostacycline derivative(beraprost) were tried without acute favorable response. After one year with beraprost, dyspnea, exercise capacity and hemodynamic parameters were improved. We report this case with a review of the literature.
Adenoma ; Adult ; Cardiac Catheterization ; Cardiac Catheters ; Cardiovascular System ; Dyspnea ; Echocardiography ; Epoprostenol ; Glycogen Storage Disease* ; Glycogen* ; Gout ; Hemodynamics ; Hepatomegaly ; Humans ; Hyperlipidemias ; Hypertension, Pulmonary* ; Hyperuricemia ; Hypoglycemia ; Metabolic Diseases ; Nitric Oxide ; Osteoporosis

OBJECTIVES: The aims of this study were to investigate the factors affecting the fatigue and stress in male manufacturing workers. METHODS: A questionnaire investigating general characteristics, lifestyle factors, job characteristics, fatigue and stress was distributed to 896 subjects. From 851 respondents, 11 responses with insufficient data were excluded. The data were analyzed to investigate the factors affecting personal fatigue and stress. RESULTS: Among the general characteristics, both fatigue and stress in the older group were significantly lower than in the younger group (p<0.05). Fatigue in the group with higher education was significantly higher than in the group with only high school education (p<0.05). The group who lived alone had significantly more stress (p<0.05). Among lifestyle factors, people who exercised regularly had significantly lower fatigue and stress than those who did not (p<0.05). Fatigue was negatively correlated with decision latitude, supervisor support, and coworker support. Stress was positively correlated with job demand and negatively correlated with decision latitude, supervisor support, and coworker support. Fatigue and stress were positively correlated with each other. Multiple linear regression analysis showed that among job characteristic factors, coworker support affected fatigue while job demand and supervisor support affected stress. CONCLUSIONS: Fatigue and stress were positively correlated, but the job characteristics that affected each were different. This suggests that for effective management of fatigue and stress, the details of job characteristics need to be considered individually for the intervention and prevention of fatigue and stress.
Data Collection ; Education ; Fatigue* ; Humans ; Life Style ; Linear Models ; Male* ; Questionnaires

Carcinosarcoma of the stomach is regarded as a rare malignant neoplasm composed of both carcinomatous and sarcomatous components in a given tumor. Few cases have been reported since 1904. This is a case of carcinosarcoma of the stomach in a 61-year-old man. He suffered from indigestion, vomiting, and epigastric pain. Endoscopic finding showed a huge protruding mass with intact mucosa on the posterior wall of the antrum up to the pylorus. Surgery was performed and carcinosarcoma with pancreatic invasion was confirmed by pathology.
Carcinosarcoma* ; Dyspepsia ; Humans ; Middle Aged ; Mucous Membrane ; Pathology ; Pylorus ; Stomach ; Vomiting