No abstract available.
Acoustics* ; Ear, Inner ; Hearing* ; Neuroma, Acoustic* ; Semicircular Canals*

No abstract available.
Immunocompromised Host* ; Kluyvera* ; Sepsis*

The safety and efficacy of intravenous tissue plasminogen activator(tPA) on the condition of ruling out the significant risk were studied at 6 and 12 hours after cerebral artery embolization in rabbit model. The time selection was chosen to stimulate the analogous clinical situation. The safety and effectiveness of tPA in experimental and clinical treatment of acute coronary thrombosis have been established. Tissue plasminogen activator is an endogenous fibrin-specific serine protease with the potent thrombolytic activity that has been produced recently by recombinant DNA technology. The acute cerebral thromboembolic model was induced by injecting three 0.5X1.0mm fragments of autologous arterial thromi into internal carotid artery through the intra-arterial catheter. The autologous arterial thrombi was obtained from the traumatized arterial endothelium by scratching the lumen of auricular artery using modified spinal needle. The experimental group was divided into four groups : (1) group Ia : saline-treated(1 ml/kg) control group at 6 hours after embolization(n=10), (2) group Ib : tPA-treated(1 mg/kg) at 6 hours after embolization(n=10), (3) group IIa : saline-treated control group 12 hours after embolization(n=10), (4) group Iib : tPA-treated group 12 hours after embolization(n=13). The experimental rabbits were sacrificed at 24 hours after injection of tPA(1 mg/kg) or saline(1 ml/kg) in each group. Brain was cut into 0.5 cm thick coronal sections, which were stained with triphenyltetrazolium chloride to define the areas of infarction. The transparent plastic sheets were placed on the each section, and the total area of the brain slice and the area of infarction were measured by the plannimeter(as outlined by TTC staining). The percentage area of whole brain infarction was calculated as(the sum of infarcted area/the sum of brain slice areas)x100% for each rabbit. We also observed the pathologic findings with hematoxylin-eosin staining. The results were as follows : 1) Only 1 rabbit treated with tPA at 12 hours after occlusion exhibited the gross hemorrhage. 2) The infarcted area was limited to the basal ganglia and cortex in all group. 3) The mean percentage area of whole brain infarction averaged 18.6+/-1.94% in group Ia, 6.32+/-1.02% in group Ib, and 20.8+/-3.34% in group IIa, 6.78+/-1.40% in group IIb. One-way ANOVA test of infarction size showed the significant differences(p<0.05) between the tPA-treated group and the saline-treated control group, but no difference between the groups treated with same agent. 4) Under the study of microscope, infarcted area of saline-treated control group was more extended than that of tPA-treated group. Congulation necrosis and degeneration of neuronal cells could be seen. But the infarcted area of tPA-treated group was smaller than that of saline-treated control group. Only collection of foamy macrophages adjacent the necrotic area could be seen in tPA-treated group. These results suggest that tPA therapy may be safe and efficacious during the interval of 6 to 12 hours after embolization.
Arteries ; Basal Ganglia ; Brain ; Brain Infarction ; Carotid Artery, Internal ; Catheters ; Cerebral Arteries ; Coronary Thrombosis ; DNA, Recombinant ; Endothelium ; Hemorrhage ; Infarction ; Macrophages ; Necrosis ; Needles ; Neurons ; Plasminogen ; Plastics ; Rabbits ; Serine Proteases ; Tissue Plasminogen Activator*

BACKGROUND: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. METHODS: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. RESULTS: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were 156.7°, 152.2°, 61.1°, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. CONCLUSIONS: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.
California ; Elbow ; Follow-Up Studies ; Humans ; Humerus* ; Joint Capsule Release ; Methods ; Postoperative Complications ; Shoulder ; Surgeons ; Suture Anchors ; Sutures

We have experienced 20 cases of the cerebral rete mirabile from 1969 to 1975. All were proved by bilateral carotid angiography, and clinical assessment and angiographical analysis were attempted. The results were summarized as follows: 1. Age distribution was ranged from 5 to 55. The majority of 20 cases were age over 20 as 15 cases who were distributed evenly in each decade and 5 cases were age below 20. 12 cases were male and 8 female. 2. Authors classified the cases as the group of subarachnoid hemorrhage and non-subarachnoid hemorrhage conveniently. All cases of age below 20 comprised in the group of non-subarachnoid hemorrhage while majority of subarachnoid hemorrhage group were age over 20. 3. There were no contributory factors to cerebral rete mirabile with regard to past history and family background. 4. There were considerable differences in the symptoms and signs between the groups of subarachnoid hemorrhage and non-subarachnoid hemorrhage. Clinical manifestations were mainly headache and impairment of consciousness with meningeal sign in the group of subarachnoid hemorrhage. On the other hand, motor disturbance such as hemiparesis or monoparesis was occurred in the majority of non-subarachnoid hemorrhage and the minority showed speech impairment, seizure and choreiform movement. 5. All cases showed the characteristic angiographic findings of cerebral rete mirabile, which are occlusion or stenosis at the supraclinoid portion of internal carotid artery with abnormal fine vascular network around the base of brain and poor or non-visualizing anterior cerebral and middle cerebral arteries. The interesting picture was rete formation of ophthalmic artery in the orbit of 2 cases. There were no abnormal angiographic findings on the vertebral angiogram except retrograde filling to anterior cerebral and middle cerebral arteries through collateral channel from the posterior cerebral artery. 6. The prognosis of the cerebral rete mirabile seem to be favorable with regard to mortality. There were no death in our 20 cases during the period of observation.
Age Distribution ; Angiography ; Brain ; Carotid Artery, Internal ; Chorea ; Consciousness ; Constriction, Pathologic ; Female ; Hand ; Headache ; Hemorrhage ; Humans ; Male ; Middle Cerebral Artery ; Mortality ; Ophthalmic Artery ; Orbit ; Paresis ; Posterior Cerebral Artery ; Prognosis ; Seizures ; Subarachnoid Hemorrhage

Simultaneous early repair of the myelomeningocele and ventriculoperitoneal shunt in patients with myelomenimgocele and hydrocephalus not only decreases further brain damage, but also eliminates dangers of wound break down, CSF leak, and secondary CSF infection. During the years 1975-1990, we have experienced 45 patients with neural tube dysraphism which consist of 32 lipomyelomenigocele, 8 myelomeningocele, 3 meningocele and 2 encephalocele. Among those, 7 patients underwent simultaneous repair of myelomeningocele and insertion of ventriculoperitoneal shunt. 2 Patients developed wound infection, but none of the patients developed myelomeningocele repair break down or shunt infection in the follow up period of 1 to 4 years. All patients underwent neuropsychological testing during their follow up period and 5 patients were found to have their normal growth and developments. 1 patient developed low intelligence and moderate degree gait disturbance and the other 1 patient developed voiding difficulty. The authors suggest that this technique may be safe and helpful in some infants born with a myelomeningocele and hydrocephalus overt at birth.
Brain ; Encephalocele ; Follow-Up Studies ; Gait ; Humans ; Hydrocephalus* ; Infant* ; Intelligence ; Meningocele ; Meningomyelocele* ; Neural Tube ; Neuropsychological Tests ; Parturition ; Ventriculoperitoneal Shunt* ; Wound Infection ; Wounds and Injuries

No abstract available.
Diarrhea* ; Follow-Up Studies* ; Milk Hypersensitivity* ; Milk*

In order to study effect of corpus callosotomy for epileptic lesions located at sensory-motor cortex/cortices, changes in amplitude, frequency of background activity and frequency of abnormal discharges of postcallosotomy electroenencephalography(EEG) recordings were observed in the crystal penicillin induced epileptic models of rats. In control group of 10 rats, simple right(craniotomy was) done and needle electrodes were bilaterally inserted into parietal and occipital scalp, connected to EEG recording system. Experimentally induced epileptic group was obtained by instillation of 1-2 drops of crystal penicillin solution(800,000 IU/ml) at right parietal area(20 rats). Postcallosotomy group was consisted of the animals streotactically performed callosotomy with blunt ended stainless steel, sized 3 mm, width and 0.5 mm, thickness(20 rats). Preoprative and postoperative EEG recordings were obtained in each animals over 20 minates. The results were as follows; 1) Bialteral synchronous epileptic discharges were shown in experimetally induced epileptic group, which compared to control group. 2) Section of the corpus callosum caused the abolition of bilateral synchronous epileptic discharges, when compared to experimentally induced epileptic group. 3) Frequency of abnormal discharges in the contralteral hemisphere was more decreased than crystal penicillin-instillated lesion in postcallosotomy group. 4) The Background activity of postcallosotomy group was slower than control group. From the results of EEG analysis, corpus callosum might paly a important role in formation of bilateral synchronous discharges and callosotomy was seemed to be an effective method to control crystal penicillin induced epileptic rats, which had epileptic focus in sensory-motor cortex.
Animals ; Corpus Callosum ; Electrodes ; Electroencephalography ; Needles ; Penicillins ; Rabeprazole ; Rats* ; Scalp ; Seizures ; Stainless Steel

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

Pain is one of the most complex human experience and the commonest cause of stress and the most frequent symptom that makes people seek medical help. The mechanism of its production and perception are poor understood. Since the past, various procedures have been tried to control or relieve pain. It had been observed that acupuncture stimulation has been effective in the relief of painful conditions. However, up to the present there had been no definite proof that acupuncture treatment has cured any pathological condition. Work is at present proceeding to make this a practical possibility. Recently, in modern medical science, several experiments are in progress and in some cases, cure had been obtained but until these studies are completed and proved to be effective, it is impossible at the present stage to evaluate whether these occasional cures are statistically significant. So, we launched studies and observations at our pain clinic at St. Paul's Hospital employing the "Somatosensory evoked Potential",(SEP) responses for chronic pain patient to relieve pain with acupuncture. The median and sural nerve of patients with chronic pain were stimulated and recorded using the SEP. Recordings were made before and after the acupuncture therapy was initiated. We analyzed the recorded SEP responses to see if ther are any physiological effects of the acupuncture therapy in patients with chronic pain. Findings: The important changes of the SEP responses recorded during acupuncture therapy in patients with chronic pain were the suppression of the amplitude of the SEP waves and delayed latency of the responses, similar to those manifested by patients, who are under morphine therapy. Then, naloxone an antagonist to morphine was administered. The effects were the same, that is the SEP responses were reversed in both the patients under morphine therapy and those under acupuncture therapy. So, we postulated that, since the meridian system is closely connected to the posterior column of the spinal cord conducting system, which is concerned in the somatosensory conducting system, peripheral stimulation by acupuncture may bring about the so called "pain suppression of descending system", which is closely connected to the meridian system of acupuncture. Though it is quite early to draw positive and definite conclusions, the results are very encouraging. More cases and further observations are advocated.
Acupuncture Therapy ; Acupuncture* ; Chronic Pain* ; Humans ; Morphine ; Naloxone ; Pain Clinics ; Spinal Cord ; Sural Nerve