No abstract available.
Spondylolisthesis*

The authors studied 5 cases of idiopathic CNS hypersomnia who visited Division of Sleep Studies, Seoul National University Hospital in 1995. Detailed medical history was taken and nocturnal polysomnography(NPSG), multiple sleep latency test(MSLT)and human leukocyte antigen(HLA) typing were performed. Neither cataplexy nor hypnagogic hallucination was reported in all cases and in NPSGs, there were tendencies of increased sleep period time and decreased slow wave sleep time. In MSLT, all the subjects showed average sleep latencies less than 8 minutes without sleep-onset rapid eye movement period(SOREMP). In HLA typing, some correlation between idiopathis CNS hypersomnia and HLA DR4 was observed. in contrast to previous reports, overall treatment response with methylphenidate was remarkable. Therefore, the authors suggest that patients suspected of idiopathic CNS hypersomnia be actively evaluated and treated with rather optimistic perspective.
Cataplexy ; Central Nervous System* ; Disorders of Excessive Somnolence* ; Hallucinations ; Histocompatibility Testing ; Humans ; Leukocytes ; Methylphenidate ; Seoul ; Sleep, REM

The purpose of this study was to establish whether pre-injury administration of the methylprednisolone sodium succinate(MP) is effective for the treatment of acute spinal cord injury in rat, as it has ben demonstrated that high dose of MP is effective in the treatment of acute spinal cord injury. Spinal cord injury was made by dropping a rod weighing 10 gm from a height of 1.25, 2.5, and 5.0cm onto the rat spinal cord at T-10, which had been exposed via laminectomy. In order to determine the effectiveness, single dose of 5, 15 and 30mg/kg of MP was administrated at 10 minute before injury. The primary outcome was 24-hour spinal cord lesion volume estimated from spinal cord Na+ and K+ shifts. Surprisingly, we failed to find any statistically significant preventive effect compare to control vehicle. Until this result is clearfied, we recommend that acute pre-injury MP therapy be cautiously applied in operating room. The possible causes of this unexpected result are discussed.
Animals ; Laminectomy ; Methylprednisolone* ; Operating Rooms ; Rats ; Sodium ; Spinal Cord Injuries* ; Spinal Cord*

We studied the effectiveness of serotonin 1a agonist(8 OH DPAT) on the 24 hour ionic lesion volume produced by permanent occlusion of the middle cerebral artery(MCAo) in rats. A 4-hour intravenous infusion of 30 micro mg/kg/hr of 8 OH DPAT were given starting at 10 minutes after occlusion. Tissue concentrations of Na, K, and water at infarct and peri-infarct zone were measured by atomic absorption spectroscopy and by wet-dry weight measurements 24 hours after occlusion. Compared with vehicle treatment, 8 OH DPAT treatment reduced tissue water accumulation by 10% and 55% in the frontopyriform cortex(L1) and frontoparietal cortex(L2), sodium accumulation by 20% at L1 and 47% at L2, potassium loss by 24% at L1 and 44% at L2, cell volume fraction loss by 24% at L1 and 47% at L2. Finally the treatment reduced overall lesion volume by about 37%. All these changes were statistically significant at p<0.05. Our findings suggest strongly that 8 OH DPAT is neuroprotective in the rat MCAo model of focal cerebral ischemia.
Absorption ; Animals ; Brain Ischemia ; Cell Size ; Infarction, Middle Cerebral Artery* ; Infusions, Intravenous ; Ischemia* ; Middle Cerebral Artery* ; Potassium ; Rats* ; Receptor, Serotonin, 5-HT1A* ; Serotonin* ; Sodium ; Spectrum Analysis

No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.
Aorta ; Arteries ; Bradycardia ; Cause of Death ; Chest Pain ; Diagnosis ; Emergencies ; Heart Rupture* ; Hematoma ; Humans ; Infarction ; Myocardial Infarction ; Rupture ; Shock ; Transplants

Sinus histiocytosis with massive lymphadenopathy known as Rosai-Dorfman disease is characterized by painless bilateral cervical lymphadenopathy. Extranodal manifestations are uncommon and spinal involvement is rare. A 15-year-old man presented with intermittent midthoracic back pain only. He had no specific findings on neurologic examinations, hematologic and biochemical laboratory tests. Radiological examination of thoracic spine revealed collapse of T6 vertebrae with thoracic kyphosis and osteolytic lesion of T12 vertebra body. He underwent a removal of bone tumor, anterior reconstruction with mesh and pedicle screw fixation via posterior approach for pathologic confirmation and stabilization. Histopathologic study of the lesion revealed focal infiltration of large histiocytes showing emperipolesis. Immunochemistry stain of histiocytes was positive for CD68 and S-100 but negative for CD1a. This report presents a rare case and literature review of extranodal Rosai-dorfman disease in thoracic spine.
Adolescent ; Back Pain ; Emperipolesis ; Fractures, Compression* ; Histiocytes ; Histiocytosis, Sinus* ; Humans ; Immunochemistry ; Kyphosis ; Lymphatic Diseases ; Neurologic Examination ; Spine*

Essential hyperhidrosis is a condition with excessive secretion of sweat, which may be localized in any part of the body. Most common is palmar or plantar hyperhidrosis. Severe hyperhidrosis may cause serious psychological and occupational problems. Of the Numerous treatment recommended for this condition, only surgical removal of the sympathetic nerve supply seems permanently effective. Fifty-three patients were operated on for hyperhidrosis of the upper extrimity during the period from 1989 to 1992. Resection of the upper thoracic ganglia and the connecting sympathetic chain was carried out using a posterior approach. All hands of patients were dry immediately after the operation. During a follow up period of between three months to three years, there was no recurrence of palmar sweating. Fifteen of the patients showed compensatory hyperhidrosis in trunk, mild Hornor syndrome was noted in two cases. Most of the patients were satisfied with the surgical result.
Follow-Up Studies ; Ganglia ; Hand ; Humans ; Hyperhidrosis* ; Recurrence ; Sweat ; Sweating ; Sympathectomy*

BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

PURPOSE: We evaluated the diagnostic accuracy and clinical usefulness of fluoroscopy-guided bone biopsy. MATERIALS AND METHODS: A total of 31 patients with various skeletal lesions underwent fluoroscopy-guided bone biopsies. The targets were long bones in 16 cases, pelvic bones in 7 cases, spines in 6 cases, and ribs in the rest 2 cases. RESULTS: The overall accuracy was 71%(22/31). The accuracy was 100% in case of primary sarcoma and multiple myeloma. But it was low in malignant lymphoma(1/4), malignant fibrous histiocytoma(0/1), and nonossifying fibroma(0/1). CONCLUSION: Percutaneous fluoroscopy-guided bone biopsy is a simple, safe, not-expensive, and rather accurate diagnostic procedure in evaluation of bone tumors. In addition to that, it is useful in the managment planning and fllow-up of the patients.
Biopsy* ; Humans ; Multiple Myeloma ; Pelvic Bones ; Ribs ; Sarcoma ; Spine