To keep the patent airway during a general anesthetic procedure or when handling an unconscious patient is the most important concern as well as responsibility and/or duty of the anesthesiologist. Many delicate operations could and can be performed because of the development of anesthetic techniques aad methods, especially through the introduction of endotracheal intubations. However, at times, an endotracheal tube can unfortunately be a hazardous instrument-lethal instead of lifesaving. The authors experienced a case of left main bronchial obstruction with a thick mucus plug immediately following the completion of oro-endotracheal intubation. This was successfully remedied by direct bronchoscopic aspiration under transtracheal spray. In such a circumstance as this, the newly designed instrument, namely; a bronchofiberscope, is a real necessity.
Humans ; Intubation ; Intubation, Intratracheal* ; Mucus*

Arachnoid cysts are benign developmental cysts that occur between aachnoid layers, which represent approximately 1 percent of all intracranial space-occupying lesions, their most common location being the middle cranial fossa. Current surgical treatment options for intracranial arachnoid cyst are either craniotomy and excision of cyst or shunting of cyst contents extracranially. We treated 10 cases of intracranial arachnoid cyst by excision during last two years. For the best surgical curability, we have, not only removed the cyst wall and adhesive gliotic tissue as possible, but also made the opening to basal cistern for communication. During average 8.4 months follow up, we observed, not specific morbidity and mortality, but good clinical improvement and brain expansion. As above result, if haven't specific problem, the direct surgical removal may be the primary choice for intracranial arachnoid cyst, especially in children with noncommunicating type in sylvian.
Adhesives ; Arachnoid Cysts* ; Brain ; Child ; Cranial Fossa, Middle ; Craniotomy ; Follow-Up Studies ; Humans ; Mortality

Clinical presentation of supplementary motor area (SMA) syndrome includes complete akinesia of the contralateral side of the body and mutism, with secondary recovery of neurologic deficit. Multi-joint coordination is frequently impaired following the development of a brain lesion and is generally restricted by abnormal patterns of muscle activation within the hemiparetic limb, clinically termed muscle synergies. However, no work to date has confirmed this observation with the aid of objective methods, such as gait analysis, and the development of reflex pattern has not been suggested as a possible cause. We describe two unusual cases of flexor synergy after tumor resection of SMA lesions.
Brain ; Brain Neoplasms ; Extremities ; Gait ; Lower Extremity* ; Motor Cortex ; Muscles ; Mutism ; Neurologic Manifestations ; Reflex

No abstract available.
Antibodies* ; Rheumatic Diseases*

Several growth factors and polypeptides were studied for the regeneration of periodontal supporting tissues which had been lost due to periodontal disease. But these are not commonly used for regenerators of bone tissue or alveolar bone, because of the insufficiency of studies on their side effects, genetic engineering for mass production and stability for clinical application. Recently, many natural products, which have advantage of less side effects and possibility of long-term use, have been studied for their capacity and effects of anti-bacterial, anti-inflammatory and regenerative potential of periodontal tissues. Cnidii Rhizoma, Rhinocerotis Cornu and Drynariae Rhizoma have been traditionally used as a drug for treatment of bone disease in oriental medicine. The purpose of this study was to examine the ability of alkaline phosphatase synthesis of MC3T3-E1 cells when above medicines were supplimented. MC3T3-E1 cells were cultured with alpha-MEM(negative control), dexamethasone(positive control), and each natural products for 3 and 5 days. And then ALP synthesis was measured by spectrophotometer for enzyme activity and by naphthol AS-BI staining for morphometry. Except Cnidii Rhizoma, all of the natural products of this study induced higher activity of ALP synthesis than controls. Among them Drynariae Rhizoma induced the highest activity. In the aspects of culturing time, all medicines did not showed the difference between 3 and 5 days, but 10-7g/ml group of Rhinocerotis Cornu showed significant increase at 3 days than at 5 days. These results indicate that several natural products have a inducing ability of ALP synthesis on osteoblasts.
Alkaline Phosphatase* ; Biological Products* ; Bone and Bones ; Bone Diseases ; Genetic Engineering ; Intercellular Signaling Peptides and Proteins ; Medicine, East Asian Traditional ; Osteoblasts ; Peptides ; Periodontal Diseases ; Polypodiaceae ; Regeneration

Ginseng Radix(GR) had been used widely from oriental medicine and the effects of it have been investigated by many researchers. The purpose of present study was to investigate the effects of GR on the cell cycle progression and its molecular mechanism in human fetal osteoblast. The results were as follows. Increased cell proliferation was observed in cells exposed to 100 ng/ml, 10 ng/ml of GR-1 at 12 hours and 24 hours, 1 microgram/ml of GR-1 at 48 hours, and 100 microgram/ml, 10 microgram/ml of GR-2 at 12 hours, all treatment groups of GR-2 at 24 hours(p<0.05). S phase and G1 phase was increased in the group of treated with 100 ng/ml of GR-1, with 10 microgram/ml and 1 microgram/ml of GR-2, with 100 microgram/ml and 10 microgram/ml of GR-3 in the cell cycle analysis. The cell cycle regulation protein levels of Cyclin D1, Cyclin E, CDK 2, CDK 4 and CDK 6 were increased in the group of treated with 1 microgram/ml and 100 ng/ml of GR-1, with 10 microgram/ml and 1 microgram/ml of GR-2, with 100 microgram/ml and 10 microgram/ml of GR-3. On the other hand, p21 was decreased in the treatment group with 1 microgram/ml and 100 ng/ml of GR-1, with 10 microgram/ml and 1 microgram/ml of GR-2, 10 microgram/ml of GR-3, and p53 and p16 was decreased in the treatment group with 100 ng/ml of GR-1, 100 microgram/ml GR-3 and pRb was decreased in the all treatment groups except 1 microgram/ml of GR-1. These results suggested that GR increases the cell proliferation and the cell cycle progression in human fetal osteoblast, which is linked to increased cell cycle regulation protein levels of Cyclin D1, Cyclin E, CDK 2, CDK 4, CDK 6 and decreased cell cycle regulation protein levels of p21, pRb.
Humans

OBJECTIVE: To investigate whether transcranial direct current stimulation (tDCS) can improve dysarthria in stroke patients. METHOD: Twelve patients who developed dysarthria after acute middle cerebral artery (MCA) infarction were included in this study. In a prospective, double blinded, randomized case control study performed between January 2007 and December 2008, six patients were randomized to anodal tDCS application and conventional speech therapy, and six patients were randomized to the sham group which received only conventional speech therapy. tDCS was delivered for 30 minutes at 2 mA with 25cm2, five times/week, for a total two weeks. The effects were assessed in maximal phonation time (MPT), alternative motion rates (AMR)-Pa, AMR-Ta, AMR-Ka, and sequential motion rates (SMR)-PaTaKa using the Multi-Media Dimension Voice Program. RESULTS: Pre-treatment patient evaluation showed no significant difference between the two groups for all parameters. The MPT, AMR-Pa, AMR-Ta, AMR-Ka, and SMR-PaTaKa were improved pre- and post-treatment in the stimulation group, while MPT, SMR-PaTaKa were improved in the sham group (p<0.05). The AMR-Pa significantly improved in the stimulation group compared to the sham group (p<0.05). CONCLUSION: As these results demonstrated the beneficial effects of anodal tDCS on dysarthria, tDCS can successfully be used as a treatment modality for patients suffering from dysarthria after stroke.
Case-Control Studies ; Dysarthria ; Humans ; Infarction ; Middle Cerebral Artery ; Phonation ; Prospective Studies ; Salicylamides ; Speech Therapy ; Stress, Psychological ; Stroke ; Voice

Brachial amyotrophic diplegia is a rare disease presenting with severe weakness that is completely confined to the upper limbs over time without upper motor neuron sign. It might be a stable and relatively benign variant of motor neuron disease and should be differentiated from other motor neuropathies. A 60-year-old man presented with a two year history of symmetrical muscle wasting and weakness in his arm and shoulder girdle. Bulbar and leg muscle were not affected and he was independent in ambulation. Nerve conduction studies revealed normal except the low amplitude of median and ulnar compound muscle action potential with no evidence of conduction block. Needle electromyography showed denervation potential and neuropathic motor unit action potential throughout the upper limb. We report this case with a brief review of related literatures.
Action Potentials ; Amyotrophic Lateral Sclerosis ; Arm ; Denervation ; Electromyography ; Humans ; Leg ; Middle Aged ; Motor Neuron Disease ; Motor Neurons ; Muscles ; Needles ; Neural Conduction ; Rare Diseases ; Shoulder ; Upper Extremity ; Walking

The treatment of recurrent supratentorial glioma is one of the most challenging and at the same time one of the oldest problem in neurosurgery, especially in case of multiple recurrence. We have experienced 15-year-old male, multiple recurrent supratentorial glioma patient who was subjected to 6 times of operation, radiation therapy and chemotherapy druing 5 year follow-up period. We reveiewed the literature and discussed about recurrent rate, malignant change, method of management and indication of reoperation in low grade glioma.
Adolescent ; Astrocytoma* ; Drug Therapy ; Follow-Up Studies ; Glioma ; Humans ; Male ; Neurosurgery ; Recurrence ; Reoperation

No abstract available.
Cartilage, Articular*