Motor weakness is one of the neurological complication that can occur after aneurysmal subarachnoid hemorrhage (SAH); incidence of motor weakness of 14~29% has been reported. Detailed information on the pathogenic mechanism of motor weakness is essential for brain rehabilitation because it enables estimation of the severity of injury, establishment of scientific rehabilitative strategies, and prediction of motor outcomes by clinicians. However, the exact pathogenic mechanisms of motor weakness following aneurysmal SAH have not been clearly elucidated. In this article, 14 previous studies on pathogenic mechanisms in patients with aneurysmal SAH were reviewed according to the location of the lesion (cerebral cortex, brainstem, spinal cord, and peripheral nerve). The following pathogenic mechanisms have been suggested: vasospasm, cerebral ischemia, hydrocephalus, compression of cerebral cortex, neural injury, spinal cord infarction, and radiculo-neuropathy. Considering the high incidence of aneurysmal SAH and motor weakness following aneurysmal SAH, we believe that the pathogenic mechanisms of motor weakness have been relatively understudied. More effort should be taken to investigate this important topic.
Subarachnoid Hemorrhage

No abstract available.
Macrophages, Peritoneal* ; Nitric Oxide ; Nitric Oxide Synthase* ; Shock* ; Tumor Necrosis Factor-alpha

Transhiatal gastric transpositions were performed in two case of long gap esophageal atresia without tracheoesophageal fistula. The patients were a 12 months old female and an 18 months old male. Stamm type gastrostomies were performed at other hospitals in both cases. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. The proximal and distal esophageal pouches were excised by transcervical and transhiatal route, respectively. The mobilized stomach was pulled up to the neck through esophageal hiatus and posterior mediastinal route. The esophagogastrostomy, the only one anastomosis of this procedure, was performed in the neck. There was no clinical evidence of anastomotic leakage, stricture, regurgitation, difficulty of gastric emptying, hoarseness or respiratory problem. Transhiatal gastric transposition seems to be a safe and easy alternative surgical procedure for esophageal replacement in long gap esophageal atresia.
Anastomotic Leak ; Arteries ; Constriction, Pathologic ; Esophageal Atresia* ; Female ; Gastric Emptying ; Gastroepiploic Artery ; Gastrostomy ; Hoarseness ; Humans ; Infant ; Male ; Neck ; Spleen ; Stomach ; Tracheoesophageal Fistula

Hemorrhagic shock is one of the most common causes of death in patients with multiple trauma and therefore rapid control of bleeding is the main strategy to save these patients. Resuscitative balloon occlusion of the aorta (REBOA) has been applied in several trauma cases and because of the effectiveness of this procedure it has been adopted in the trauma field. Herein, we report the first successful case of REBOA in Korea performed on a 46-year-old man with hemorrhagic shock after a fall from a height of 14-stories. The patient visited our hospital emergency room with hypovolemic shock, we performed Resuscitative Endovascular Balloon Occlusion of the Aorta under bed side blind technique. His vital sign was stabilized after procedure, then we could performed endovascular bleeding control. The patient was discharged on his 33rd in-hospital day without invasive procedure and major scar.
Aorta* ; Balloon Occlusion* ; Cause of Death ; Cicatrix ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Korea ; Middle Aged ; Multiple Trauma ; Shock* ; Shock, Hemorrhagic ; Vital Signs

Oro-facial dyskinesia (OFD) is involuntary, abnormal, uncontrolled and stereotyped movements, consisting of forehead furrowing, eye opening and closing, smacking and pursing of the lips, lateral deviation and protrusion of the tongue, and occasionally lateral deviation and protrusion of the jaw.1 OFD is known to have various complications including speech difficulty, chewing and eating disorders, and social embarrassment; facial muscle stiffness, mucosal and gingival traumatic lesions. In addition, it may leads to cranio-mandibular joint (TMJ) complications in the presence of intense and prolonged abnormal movements, with pain and degeneration.1,2 There is no previous report of TMJ dislocation due to OFD. In this report, we describe a patient who developed bilateral anterior TMJ dislocation due to OFD which occurred following intra-cranial hemorrhage (ICH).
Movement Disorders ; Dyskinesias

This article provides an update on tinnitus for audiologists and other clinicians who provide tinnitus-specific services. Tinnitus can be attributable to hearing loss, somatosensory system dysfunction, or auditory cortex dysfunction, with hearing loss being the most common cause and serious underlying pathologies being rare. Hearing loss does not always lead to tinnitus, and patients with tinnitus do not always suffer from hearing loss. The first scenario is explained by a so-called inhibitory gating mechanism, whereas the second assumes that all tinnitus sufferers have some degree of hearing impairment, which might not be detected in standard audiological examinations. The treatments should aim at symptomatic relief and management of associated distress. Current treatment options include pharmacotherapy, education, counseling, cognitive behavioral therapy, and sound therapy.

This is a preliminary report on a method of evaluating recovery from general anesthesia with fifty-four randomly selected anesthetized patients in the Hanyang Medical Center. This method is usefull not only for the reduction of post-anesthetic complications in the recovery room, but is also an excellent training program for residents, interns and nurses in recovery room duties. It is a simple, direct, self-performance, objective test with pencil and paper to measure recovery from general anesthesia. Since this test measures sensory and paychomotor performances, it is valuable as a critical determinant of recovery from anesthesia. Even though this method has several variables dependent upon individual operator skill and tenhicque with regard to surgical procedures and medications administered, it provides an excellent measure of recovery from clinical general anesthesia and may also serve as a medicolegal record for one-day surgical out-patients.
Anesthesia ; Anesthesia, General ; Education ; Humans ; Outpatients ; Recovery Room

PURPOSE: The authors investigated the process of endochondral ossification quantitatively and objectively in respect to proliferation and apoptosis. MATERIALS AND METHODS: Fractures were made on the left tibiae of 72 male Sprague-Dawley rats. The fracture callus was harvested at the 5th, 7th, 9th, 11th, 14th, and the 21st day after fracture. Cellular DNA content was analyzed with image cytometry, and proliferative index was determined from the data. The Ki-67 antigen expression was semiquantitatively measured by the immunohisto-chemical method. TUNEL was used for in situ localization of apoptotic cells. The expression of cell cycle inhibitors, P21 and P27, was investigated with Northern blotting. RESULTS: The proliferation index was highest on the 5th day, then gradually decreased until the 11th day. The expression of Ki-67 antigen gradually decreased with time. Apoptotic cells increased in accordance with enhanced bone formation within chondroid callus. The expression of p21 and p27 was highest on the 11th and the 14th day. CONCLUSIONS: These findings show that proliferative activity decreased with the reduction of mesenchymal tissue and the appearance of mature chondroid tissue. The apoptosis of hypertrophic chondrocytes occurred in accordance with enhanced bone formation. P21 and P27 had a certain role in the differentiation of chondrocytes.
Apoptosis* ; Blotting, Northern ; Bony Callus ; Cell Cycle ; Cell Proliferation* ; Chondrocytes ; DNA ; Fracture Healing* ; Humans ; Image Cytometry ; In Situ Nick-End Labeling ; Ki-67 Antigen ; Male ; Osteogenesis ; Rats, Sprague-Dawley ; Tibia

Pseudoaneurysm of splenic artery may arise from a vascular erosion by the inflammatory processes around the splenic artery, particularly in acute pancreatitis and chronic pancreatitis, which may cause rupture of pseudoaneurysm and life threatening hemorrhage. Collective experience with this massive hemorrhage is attended by a high mortality rate even with prompt therapy, and conservative management is associated with an almost 100 per cent of mortality rate. Identification of the bleeding site at laparotomy may be exceedingly difficult, which makes the preoperative detection of bleeding source desirable. Peripancreatic vascular lesions can be identified by angiography, and in selected cases the risk of urgent operation to control massive hemorrhage may be obviated by embolization. The authors have recently experienced a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatic pseudocyst. We managed this child successfully with an urgent procedure of transcatheter arterial embolization and another elective surgery of pancreatic pseudocyst.
Aneurysm, False* ; Angiography ; Child* ; Hemorrhage ; Humans ; Laparotomy ; Male ; Mortality ; Pancreatic Pseudocyst ; Pancreatitis ; Pancreatitis, Chronic ; Rupture ; Splenic Artery* ; Tomography, X-Ray Computed

No abstract available.
Adult* ; Cholesterol* ; Gyeongsangbuk-do* ; Humans ; Jeollanam-do* ; Triglycerides*