No abstract available.

An automated percutaneous lumbar discectomy(APLD) have been apphed for contained lumbar disc herniation. But suggested that more exclusion criteria than disc containment was needed to improve success rate. The purposes of this study are to evaluate cIinical outcome of more than 4 years follow up of APLD, to analysis the cause of failure for longer follow up period, and to define prognostic factor of APLD. The l04 patients with contained lumbar disc herniation were treated with APLD from March 1990 to November 1992 in National Medical Center. The surgical candidates were contained focal disc herniation in MRI, sciatica than back pain, failure to conservative management at least 6 weeks and clinical and radiological correlation. And patient were excluded from this data if they had history of previous lumbar surgery and compensation claims. Among them 74 cases were followed up for over 4 years (Mean: 5.3 years). The results were accessed by questionnaire using telephone or OPD follow up. The overall success rate was 84% on 3 months follow up, but 68.9% on more than 4 years follow up by four subjective criterias (Onik, 1987). Causes of decreasing success rate were reoperation, recurrence without specific cause or after sprain and heavy work. 76% of failed cases occurred within 1 year and 40% of them underwent open discectomy. The patient sex, treated level, duration of symptom were not influenced on success rate, but age was factor related to success rate. In this study we can assess the effectiveness of APLD within 3 months in most cases and then change treatment option according to patients status, and it seems that we need more exclusion criteria than disc containment in MRI and refined patient selection in order to decrease the failures.
Back Pain ; Compensation and Redress ; Containment of Biohazards ; Diskectomy* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Patient Selection ; Surveys and Questionnaires ; Recurrence ; Reoperation ; Sciatica ; Sprains and Strains ; Telephone

Serum CA 125 was measured during early chemotherapy in 34 patients from January, 1991 to December, 1994 with ovarian cancer to investigate if serial measurmemts of antigen level could be used as a prognostic parameter. Serum CA 125 was determined after the first, second, and third course of chemotherapy. There was significant correlation between high serum CA 125 levels(>35U/ml) after the third course of chemotherapy and advanced FIGO stage, large residual tumor volume after cytoreductive surgery, but there was no significant correlation with patient age, tumor differentiation, and hitologic type. And high serum level of CA 125 after the third course of chemotherapy was significantly correlate with poor response to chemotherapy(p<0.0001), but there was no significant correlation with the finding of second-look laparotomy. CA 125 was a significant parameter in all three courses of chemotherapy but its correlation with 5-year survival was improved with the number of courses of the chemotherapy. Patientswith high serum CA 125 level(>35U/ml) after the third course had a 0% 5-year survival. This should be compared with a 89.5% 5-year survival in patients who had serum CA 125 level of 35U/ml or less(p<0.0001). As a consequence of this study, chemotherapy of patients with high CA 125 levels after the third course may be discontinued and replaced by other chemotherapy or palliative therapy.
Drug Therapy* ; Humans ; Laparotomy ; Neoplasm, Residual ; Ovarian Neoplasms* ; Palliative Care

Metronidazole is widely used for the treatment of trichomoniasis, giardiasis, amebiasis, and anaerobic infections. It pro-duces a number of neurological side effects including peripheral neuropathy, encephalopathy, cerebellar dysfunction, and seizures. A 66-year-old male patient was admitted to our department because of a tingling sensation in both toes as well as ataxia with dizziness which had developed five prior to admission. He had had been diagnosed with hepatoma and had an operation in 1993. One month before admission, he felt a febrile sensation and was diagnosed as having abdominal abscess by an ultrasonography, and took about 30g of metronidazole until visiting our emergency room. A nerve conduc-tion test revealed sensorimotor polyneuropathy in the four extremities. A brain MRI showed symmetrically increased signal intensities without enhancement in the supratentorial white matter and the dentate nucleus of the cerebellum. After stopping metronidazole, his neurological symptoms began to improve and on the following MRI taken seven weeks later, the symmetrically increased signal intensities in the dentate nucleus of the cerebellum were nearly disappeared.
Abdominal Abscess ; Aged ; Amebiasis ; Ataxia ; Brain ; Carcinoma, Hepatocellular ; Cerebellar Diseases* ; Cerebellar Nuclei ; Cerebellum ; Dizziness ; Emergency Service, Hospital ; Extremities ; Giardiasis ; Humans ; Magnetic Resonance Imaging* ; Male ; Metronidazole ; Peripheral Nervous System Diseases ; Polyneuropathies ; Seizures ; Sensation ; Toes ; Ultrasonography

Metronidazole is widely used for the treatment of trichomoniasis, giardiasis, amebiasis, and anaerobic infections. It pro-duces a number of neurological side effects including peripheral neuropathy, encephalopathy, cerebellar dysfunction, and seizures. A 66-year-old male patient was admitted to our department because of a tingling sensation in both toes as well as ataxia with dizziness which had developed five prior to admission. He had had been diagnosed with hepatoma and had an operation in 1993. One month before admission, he felt a febrile sensation and was diagnosed as having abdominal abscess by an ultrasonography, and took about 30g of metronidazole until visiting our emergency room. A nerve conduc-tion test revealed sensorimotor polyneuropathy in the four extremities. A brain MRI showed symmetrically increased signal intensities without enhancement in the supratentorial white matter and the dentate nucleus of the cerebellum. After stopping metronidazole, his neurological symptoms began to improve and on the following MRI taken seven weeks later, the symmetrically increased signal intensities in the dentate nucleus of the cerebellum were nearly disappeared.
Abdominal Abscess ; Aged ; Amebiasis ; Ataxia ; Brain ; Carcinoma, Hepatocellular ; Cerebellar Diseases* ; Cerebellar Nuclei ; Cerebellum ; Dizziness ; Emergency Service, Hospital ; Extremities ; Giardiasis ; Humans ; Magnetic Resonance Imaging* ; Male ; Metronidazole ; Peripheral Nervous System Diseases ; Polyneuropathies ; Seizures ; Sensation ; Toes ; Ultrasonography

Cerebral venous thrombosis (CVT) is a disease sometimes associated with a wide variety of clinical signs and symp-toms. Single or multiple cranial nerve palsies without evidence of any other signs and symptoms have not, so far, been considered as a relevant syndrome of CVT. A 49-year-old woman was admitted to our hospital because of diplopia, vertigo with tinnitus and ataxia which had begun approximately three weeks before. Neurological examination revealed a right 6th nerve palsy by a red glass test and an impaired tandem walking test. Laboratory tests including CSF exami-nation and brain MRI were normal but MR venography and following 4-vessel angiography showed thrombosis in the left transverse and sigmoid sinuses and suspicious thrombosis in the right lateral sinus. She was treated with heparin and proceeded to get well.
Abducens Nerve Diseases ; Angiography ; Ataxia ; Brain ; Colon, Sigmoid ; Cranial Nerve Diseases ; Cranial Nerves* ; Diplopia ; Female ; Glass ; Heparin ; Humans ; Lateral Sinus Thrombosis* ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Phlebography ; Thrombosis ; Tinnitus ; Transverse Sinuses* ; Venous Thrombosis ; Vertigo ; Walking

Purpose: Contrast sensitivity, the ability to distinguish the relative difference in luminance of an object from its surrounding or adjacent objects, is a useful measure of visual function. In granular corneal dystrophy type 2 (GCD2), opacity of the corneal stroma causes deterioration in visual function. We compared the contrast sensitivity of GCD2 patients before and after phototherapeutic keratectomy (PTK) to evaluate the perioperative visual function in these patients. Methods: This study included 22 eyes of heterozygote GCD2 patients. The visual acuity and contrast sensitivity were measured before and after PTK. The contrast sensitivity was measured in mesopic and photopic background luminances, with glare (G) levels of 0-2 (G0, G1, and G2, respectively) and spatial frequencies at 1.5, 3, 6, 12, and 18 cycles per degree (cpd). Results: The contrast sensitivity increased after PTK at 1.5 and 3 cpd in mesopic and photopic conditions with G0-2 glare (p < 0.05). At 6 cpd, the contrast sensitivity increased in the mesopic condition with G1 glare, and in the photopic condition with G0-2 glare (p < 0.05). However, there was no change in contrast sensitivity at any glare level at 12 and 18 cpd after PTK. Conclusions In GCD2 patients, the contrast sensitivity increased significantly after PTK. The vision of GCD2 patients, which is decreased due to corneal opacity, is improved after PTK.

BACKGROUND: The membrane permeability transition of mitochondria has been suggested to be involved in toxic and oxidative forms of cell injury. Mitochondrial dysfunction is considered to play a critical role in neurodegeneration in Parkinson's disease. Despite the suggestion that indole beta-carbolines may be neurotoxic, these compounds provide a protective effect against cytotoxicity of other neurotoxins. In addition, the effect of indole beta-carbolines on change in the mitochondrial membrane permeability due to reactive nitrogen species (RNS), which may lead to cell death, has not been clarified. METHODS: Differentiated PC12 cells were used as the experimental culture model for the investigation of neuronal cell injury, which occurs in Parkinson's disease. The effect of indole beta-carbolines (harmalol and harmine) on differentiated PC12 cells against toxicity of S-nitroso-N-acetyl-DL-penicillamine (SNAP) was determined by measuring the effect on the change in transmembrane potential, cytochrome c release, formation of ROS, GSH contents, caspase-3 activity and cell viability, and was compared to that of R-(-)-deprenyl. RESULTS: Specific inhibitors of caspases (z-LEHD.fmk, z-DQMD.fmk) and antioxidants (N-acetylcysteine, dithiothreitol, melatonin, carboxy-PTIO and uric acid) depressed cell death in PC12 cells due to SNAP. beta-Carbolines and R-(-)-deprenyl attenuated the SNAP-induced cell death and GSH depletion concentration dependently with a maximal inhibitory effect at 25-50 microM. The compounds inhibited the nuclear damage, decrease in mitochondrial transmembrane potential, cytochrome c release and formation of reactive oxygen species caused by SNAP in PC12 cells. beta-Carbolines and R-(-)-deprenyl attenuated the H2O2-induced cell death and depletion of GSH. CONCLUSIONS: The results suggest that indole beta-carbolines attenuate the SNAP-induced viability loss in PC12 cells by inhibition of change in the mitochondrial membrane permeability, which may be caused by free radicals. Indole beta-carbolines appear to exert a protective effect against the nitrogen species-mediated neuronal cell injury in Parkinson's disease comparable to R-(-)-deprenyl.
Animals ; Antioxidants ; Carbolines* ; Caspase 3 ; Caspases ; Cell Death* ; Cell Survival ; Cytochromes c ; Dithiothreitol ; Free Radicals ; Melatonin ; Membrane Potentials ; Membranes ; Mitochondria ; Mitochondrial Membranes ; Neurons ; Neurotoxins ; Nitrogen* ; Parkinson Disease* ; PC12 Cells ; Permeability ; Reactive Nitrogen Species ; Reactive Oxygen Species

The Marcus ankle arthrodesis was carried out in 16 patients at department of orthopaedic surgery of Korea Veterans Hospital from January 1989 to December 1993. All of patients were reviewed and evaluated with subjective and functional rating scales according to the Mazur scoring system. The average follow up was 23 months, ranging from 12 months to 60 months. The Marcus ankle arthrodesis involves a chevron osteotomy, tibial onlay graft medially, internal fixation with staples and screws. According to the Mazur score, the results were 6 cases of Excellent, 7 cases of Good. The average Mazur score was 75.1. There were 4 cases of complication, a non-union, a superficial wound infection, a bursitis, and a tendon injury. In summary the Marcus ankle arthrodesis by chevron osteotomy seems to be a good procedure, which gives solid bony union with short duration, relief of pain, normal looking ankle configuration without leg length discrepancy and good function with few complications.
Ankle ; Arthrodesis ; Bursitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Inlays ; Korea ; Leg ; Osteotomy ; Tendon Injuries ; Transplants ; Weights and Measures ; Wound Infection

BACKGROUND: Defects in mitochondrial function have been shown to participate in the induction of neuronal cell injury. The extracellular-signal-regulated kinase (ERK) signaling pathway plays a crucial role in almost all cell functions, including proliferation, differentiation, survival, and death. However, the effect of ERK inhibition on oxysterol-induced apoptosis remains uncertain. METHODS: This study assessed the effect of ERK inhibition on the apoptotic effect of 7-ketocholesterol. RESULTS: Treatment with 7-ketocholesterol increased phosphorylated-ERK1/2 levels in differentiated PC12 cells, while the total amount of ERK was not altered. 7-Ketocholesterol decreased Bid and Bcl-2 levels, increased Bax and p53 levels, and promoted cytochrome c release, which elicits the activation of caspases (-8, -9, and -3), nuclear damage, and cell death. ERK and farnesyltransferase inhibitors inhibited the 7-ketocholesterol-induced phosphorylation of ERK1/2, activation of apoptosis-related proteins, and cell death in PC12 cells. CONCLUSIONS: The ERK and farnesyltransferase inhibitors, which did not exhibit toxicity, may inhibit the 7-ketocholesterol toxicity on differentiated PC12 cells by suppressing the activation of the caspase-8-dependent pathway as well as activation of the mitochondria-mediated cell-death pathway, leading to the activation of caspases. The inhibition of ERK may confer a beneficial protective effect against the neuronal cell injury induced by cholesterol oxidation products.
Animals ; Apoptosis ; Caspases ; Cell Death ; Cholesterol ; Cytochromes c ; Farnesyltranstransferase ; Ketocholesterols ; Neurons ; PC12 Cells ; Phosphorylation ; Phosphotransferases ; Proteins