OBJECTIVE: The authors present an investigation of the effect of transglutaminase(TG) on the recovery of somatosensory evoked potentials in the rat model of spinal cord injury. METHODS: Female Sprague-Dawley rats(280-310g) were used for this study. Rats were divided into two groups: TG treated and control. The lesion was made by transecting the right dorsal column of the thoracic spinal cord without damage to the vasculature using specially devised micro-glass pipette after laminectomy. For TG treated group, normal saline with TG were injected into the lesion site using micro-pipette through the opening of the dura. Saltatory repetitive somatosensory evoked potentials(SSEPs) recording were carried out on post-injury 6th and 12th week. RESULTS: The amplitudes of N19 were 1.28+/-1.60 microV on 6th week, 3.45+/-3.63 microV on 12th week in control group(n=10) and 1.46+/-1.75 microV on 6th week and 5.01+/-2.65 microV on 12th week in TG-treated group(n=11). Statis-tically significant recovery of SSEPs were seen in TG-treated group(p=0.003, Wilcoxon Signed Ranks Test). In TG-treated group, vacuolated degeneration around the lesion site was rarely observed on histological evaluation. CONCLUSION: This study demonstrates the possibility of long-term survival and saltatory recording of SSEPs in small animals like rats, after selective spinal cord injury. In addition, this study shows that TG is a factor facilitating the recovery of injured axon of central nervous system.
Animals ; Axons ; Central Nervous System ; Evoked Potentials, Somatosensory* ; Female ; Humans ; Laminectomy ; Models, Animal* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord Injuries* ; Spinal Cord*

The craniopagus twins to be described were admitted to SNUH on 20 Nov, 1981. Their mother was a healthy woman of 32 and Caesarean Section was performed at the 38th week at a local clinic. Their combined weight was 4.75kg and their subsequent progress was satisfactory. They were grown at the nursery of SNUH. Twin B had anemia and congestive heart failure. On the 181th day of life, twin B developed sudden respiratory arrest. About 25 minutes after death of twin B, we performed emergent operation to separate them for survival of twin A. We obtained the interesting findings as followings;A dural shelf was present on one side of junction, a leptomeningeal coverage on the other. Cerebral hemisphere was interdigitated on the side of leptomeningeal coverage. Pons were interconnected by nervous band.
Anemia ; Cerebrum ; Cesarean Section ; Female ; Heart Failure ; Humans ; Mothers ; Nurseries ; Pons ; Pregnancy

OBJECTIVE: This study was designed to clarify the phasic changes and distinctive spectral features of the brain abscess in the in vivo proton MR spectroscopy during the processes of abscess formation in rats, in relation to MR images. METHODS: Staphylococcus aureus was stereotactically inoculated into the predetermined location of the right frontal brain of SPF controlled Sprague-Dawley female rats(200-250gm). T1 weighted image(WI), T2WI and gadolinium enhanced image(CEMR) were obtained serially prior to each MR spectroscopy in order to visualize the infected lesions. RESULT: Three characteristic peaks, from proton MR spectroscopy, were found. A dominant peak was shown at 1.3ppm, which was due to the high concentration of mobile lipid or lactate, and smaller two peaks were shown at 0.8-1.0ppm and 1.9ppm, due to the small concentration of aminoacid(leucine, isoleucine. valine) and acetate, respectively. The lactate peak has increased during the stage of cerebritis and started to decrease in its early capsulation stage, finally invisible in its late capsulation stage(p=0.0001). The change of lactate peak was conspicuous at the early stage of cerebritis while the change of MR image was rather subtle. The aminoacids peak remained small throughout all stages. The acetate peak was shown in the late stage of cerebritis. However, it's peak area of integration was not exactly measured because of overlapping on the N-acetylaspartate peak. On the other hand, the peak of N-acetylaspartate and creatines, which could be observed in normal brain, remained at low level after sharp decrease in the early stage of cerebritis(p=0.004, p=0.005). The cholines peak decreased in the early stage of cerebritis, but it was not statistically significant(p=0.124). CONCLUSION: From this study, we were able to observe the characteristic MR spectroscopic features of each stage even from such a small volume of abnormal lesions with a 2X2X3mm 3 voxel size. Furthermore, based on our results that inflammatory change could be detected earlier by MR spectroscopy than by MR images, MR spectroscopy may be applied for early diagnosis of the brain abscess.
Abscess ; Animals ; Brain Abscess* ; Brain* ; Early Diagnosis ; Female ; Gadolinium ; Hand ; Humans ; Isoleucine ; Lactic Acid ; Magnetic Resonance Spectroscopy ; Protons* ; Rats* ; Rats, Sprague-Dawley ; Staphylococcus aureus

Selective arterial embolization can reduce the size and pressure whtihin the nidus of the arteriovenous malformations(AVMS) and diminish the number of feeding pedicles, making subsequent surgical excision technically easier and safer, especially in those AVM patients whose lesions are judged to be inoperable or respectable with major risk. Authors have successfully and repeatedly performed selective arterial embolizations with polyvinyl alcoholfoam(PVA foam) and isobutyl-2-cyanoacrylate(IBCA) to a large AVM at the left basal ganglia, thalamus and lateral ventricles, and a large cortical AVM near right motor strip.
Arteriovenous Malformations* ; Basal Ganglia ; Humans ; Lateral Ventricles ; Polyvinyls ; Thalamus

Approximately half of the patients with systemic lupus erythematosus(SLE) develop localized or diffuse lymphadenopathy during the evolution of the disease. But hilar and mediastinal lymph node enlargement due to SLE is rare. The histologic findings of lupus lymphadenitis range from nonspecific lymphadenitis with variable degrees of cellular necrosis to the less common but more specific appearance of extensive necrosis. Advanced lesions are characterized by hematoxylin bodies and condensation of DNA on the vessel walls. Hematoxylin bodies are amorphous homogeneous violet or lilac colored structures composed of partially depolymerized DNA, mixed with protein, carbohydrates and globulins which may be seen deposited on vessel walls and within the paracortex of lymph node. They are virtually diagnostic of SLE and would exclude malignant lymphoma. SLE with mediastinal lymphadenopathy is rare so we report this case with a review of literatures, which was diagnosed by hematoxylin bodies on pathologin findings of cervical lymph node.
Carbohydrates ; DNA ; Globulins ; Hematoxylin ; Humans ; Lupus Erythematosus, Systemic* ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases* ; Lymphoma ; Necrosis ; Viola

BACKGROUND/AIMS: We conducted a prospective, randomized, double-blinded, placebo-controlled trial to investigate the effect of hyoscine-N-butyl bromide during colonoscopy. METHODS: A total of 133 patients undergoing colonoscopy were randomized to receive either 20 mg of hyoscine-N-butyl bromide (n=70) or normal saline solution (n=63) via intramuscular injection as premedication. RESULTS: The mean cecal intubation time and withdrawal time in the hyoscine-N-butyl bromide group were significantly shorter than those of the control group (5.26+/-2.78 min vs. 6.74+/-4.89 min; p=0.032, 5.42+/-1.54 min vs. 6.18+/-2.54 min; p=0.038, each). The spasm grade in the hyoscine-N-butyl bromide group was significantly lower than that of the control group (p<0.001). No significant differences were found in the polyp detection rate (15.7% vs. 28.6%; p=0.073) and adenoma detection rate (10.0% vs. 15.9%; p=0.311). Difficulty of colonoscopy for the endoscopists and nurses (p=0.853; p=0.732), the patient's comfort (p=0.891) and the patient's willingness to repeat colonoscopy (85.7% vs. 82.5%; p=0.932) were also similar in both groups. CONCLUSIONS: Premedication with intramuscularly administered hyoscine-N-butyl bromide do not demonstrate any additional benefits except reducing the colonoscopy insertion time.
Adenoma ; Colonoscopy ; Humans ; Injections, Intramuscular ; Intubation ; Parasympatholytics ; Polyps ; Premedication ; Prospective Studies ; Scopolamine Hydrobromide ; Sodium Chloride ; Spasm

Gangliogliomas are rare benign tumors of the central nervous system consisting of neoplastic ganglion and low grade glial cells. The purpose of our investigation was to evaluate the clinical, radiological, surgical, and pathological features and outcome of ten patients with intracranial ganglioglioma who underwent surgery between June 1989 and December 1996. The mean follow-up period was about 24 months(range, 6-66 months) after their initial operation. The series consisted of six males and four females, and their mean age was 29.7 years. The mean length of symptoms was 9.1 years. Seizure was the most common presenting symptom and occurred in eight of ten patients. MRI findings were variable, and showed no characteristic patterns. The temporal lobe was the most common site of involvement(6/10). During surgery, a sharp demarcation between tumor and normal brain tissue was seen in seven of ten cases. Five of ten cases were solid, and the remaining cases were cystic in two, cystic with mural nodule in two, and soft, suckable in one. Total resection was possible in seven of ten patients. Diagnosis was established by identifying a mixture of abnormal astrocytic and neuronal components. Two patients showed astrocytic predominance; four, a neuronal predominance; and four, an equal admixture of cell types. All cases were benign. Other histopathological findings included microcystic change, desmoplasia, eosinophilic granular body, microcalcification, and lymphocytic infiltration. At the time of writing, all seven patients who underwent total resection were alive without recurrence; of the three who underwent subtotal resection, two were alive and in a stable condition, while in the other, the tumor had progressed within 12 months of surgery and adjuvant radiation therapy had thus been required. The patients was, though, still alive. In seven of eight patients, the frequency of seizure had markedly decreased. Our study confirms that this tumor is a distinct clinical and histological entity with a predilection for the temporal lobe. Although the number of patients and follow-up period are limited, this study also shows that epilepsy is extremely well controlled and that survival after surgical resection is good.
Brain ; Central Nervous System ; Diagnosis ; Eosinophils ; Epilepsy ; Female ; Follow-Up Studies ; Ganglioglioma* ; Ganglion Cysts ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroglia ; Neurons ; Recurrence ; Seizures ; Temporal Lobe ; Writing

OBJECTIVE: The treatment of complex intracranial aneurysms remains challenging. One approach is the application of surgical flow alteration to treat aneurysms that are neither clippable, trappable, or coilable. The efficacy and limitations of surgical flow alteration have not yet been established. METHODS: Cases of complex aneurysms treated with surgical flow alteration (proximal occlusion with or without bypass, distal occlusion with or without bypass and bypass only) were included in this retrospective study. RESULTS: Among a total of 16 cases, there were 7 giant aneurysms (> or =25 mm diameter) and 9 large aneurysms (>10 mm diameter); 15 of 16 aneurysms were unruptured. There were 8 aneurysms located in the anterior circulation, while the other 8 were in the posterior circulation. Aneurysms were treated with proximal occlusion in 10 cases and distal occlusion in 5 cases; in 1 case, the aneurysm occluded spontaneously after bypass without parent artery occlusion. All but 2 cases underwent prior or concurrent bypass surgery. Complete obliteration of the aneurysm at the latest imaging follow-up was shown in 12 of 16 cases (75.0%). Bypass patency was confirmed in 13 of 15 cases (86.7%). Surgery-related morbidity developed in 3 cases (18.8%, Glasgow outcome scale of 4) and all were perforator infarctions. There were no mortalities. CONCLUSION: Surgical flow alteration resulted in a high rate of aneurysmal obliteration with acceptable morbidity. Although several limitations remained, it could represent an alternative method for treating complex aneurysms.
Aneurysm ; Arteries ; Brain ; Follow-Up Studies ; Glasgow Outcome Scale ; Humans ; Infarction ; Intracranial Aneurysm* ; Mortality ; Parents ; Retrospective Studies

The authors present surgical experience with 33 patients who had incurred unstable thoracic or lumbar spine pathology(22 degenerative lumbar spine disease, 6 trauma, 3 tumor, 2 vertebral tuberculosis) and who were intraoperatively stabilized with the Texas Scottish Rite-Hospital(TSRH) universal instrumentation system over 20 months period. The 11 men and 22 women(mean age 45 years, range 23 to 71 years) presenting with signs or symptoms of neural compression underwent surgery consisting of neural decompression, internal fixation, and bone grafting. Spondylolisthesis were fused in situ without reduction. For thoracic and thoracolumbar junction pathology, multisegment fixations were performed. A 95% fusion rate was obtained with a mean follow-up period of 15 months. There were no cases of instrumentation failure. Major postoperative complications included 2 isolated nerve root deficits(one transient, one permanent) and 3 pulmonary embolism(one fatal). The construct design of the TSRH system offers some advantag es compared to other forms of interal fixation:simple assembly, rigid stability, safety, and ability to remove easily. This system provides a highly successful method to obtain arthrodesis for unstable thoracic or lumbar spine.
Arthrodesis ; Bone Transplantation ; Decompression ; Follow-Up Studies ; Humans ; Male ; Pathology ; Postoperative Complications ; Spinal Fusion ; Spine* ; Spondylolisthesis ; Texas

Lymphangioma is a benign vascular lesion that shows the characteristics of subepithelial tumor, which can proliferate in the lymphatic system. Only a few cases of multiple lymphangimas of the colon, the so called "colonic lymphanigomatosis", have been currently reported on the medical literature. Because lymphangioma is absolutely a benign tumor, it does not require any specific treatment, except for rare disease-related symptoms or complications such as anemia, intussusception and protein-losing enteropathy. Endoscopic resection for this tumor has sometimes been performed for both diagnostic and therapeutic purposes. We recently experienced a case of multiple colonic lymphangomas that arose in the ascending colon of a 46-year-old male patient and these lesions were found during performance of colonoscopy. The final diagnosis was confirmed by a pathologic examination of the specimen that was obtained via endoscopic resection. Follow-up colonoscopy at 1 year after the initial examination showed complete resolution of the previously noted lesions without any specific treatment. We report here on a very rare case of colonic lymphangiomatosis along with a brief review of the relevant literature.
Anemia ; Colon ; Colon, Ascending ; Colonoscopy ; Follow-Up Studies ; Humans ; Intestine, Large ; Intussusception ; Lymphangioma ; Lymphatic System ; Male ; Middle Aged ; Protein-Losing Enteropathies