BACKGROUND: Myelopathies are classified as intramedullary and extramedullary one on the basis of location of lesion. Though there are some characteristic clinical findings which can differentiate extramedullary from intramedullary lesions, it is not easy to tell extramedullary from intramedullary lesions in complicated cases. We performed this study to figure out the relationships between anatomic location (intramedullary or extramedullary), clinical parameters (motor and sensory symptoms and signs), and electrophysiologic findings in myelopathy. We also investigated the diagnostic value of motor evoked potential (MEP) compared with that of somatosensory evoked potential (SSEP) in myelopathy. The amplitude changes of compound muscle action potential (CMAP) after motor cortex stimulation have a lot of intra-individual and inter-individual variability, so were not used to determine pyramidal tract dysfunction in clinical ground. We analyzed CMAP amplitude changes in myelopathy. METHODS: Fifty-six patients with myelopathy demonstrated in MRI were studied. We defined abnormal CMAP amplitude changes as intra-individual inter-side amplitude ratio more than 50%. RESULTS: Lower MEP showed abnormal findings in 93% of tests and lower SSEP, 37% (p<0.05). The correla-tions between clinical parameters and electrophysiologic findings were higher in lower MEP (71%) than lower SSEP (42%) (p<0.05). CONCLUSIONS: The results of this study suggest that MEP is more useful than SSEP for detecting spinal cord dysfunction but as false positivity of lower MEP was considerable, MEP and SSEP are reciprocal diagnostic method for myelopathy. SSEP and MEP do not have significant diagnostic values in differentiating extramedullary from intramedullary myelopathy. The inter-side CMAP amplitude difference may indicate subclinical spinal cord dysfunction.
Action Potentials ; Evoked Potentials ; Evoked Potentials, Motor* ; Evoked Potentials, Somatosensory ; Humans ; Magnetic Resonance Imaging ; Motor Cortex ; Pyramidal Tracts ; Spinal Cord ; Spinal Cord Diseases*

No Abstract Available.
Cytomegalovirus* ; Enzyme-Linked Immunosorbent Assay* ; Humans*

Carpal tunnel syndrome is most commonly applied to compression neuropathy of the median nerve at the wrist, and is the most cause of buring pain, numbness and tingling in the thumb, index and long fingers, and in the lateral half of the palm, with or without progressive atrophy of the thenar muscles. Fifteen symptomatic hands of 13 patients of the carpal tunnel syndrome managed and operated at the Department of Orthopedic Surgery Severance Hospital from Jan. 1972 to Mar. 1982 were analized in clinical aspect. l. Among 13 patients, 3 were male and 10 were female. 2. Nine patients (69.2%) were affected on dominant hand. 3. Average duration of the symptoms was 17 months. 4. In electromyographic study, conduction delay of the motor fiber of the median nerve was found in 11 cases(73.3%) and sensory fiber in 13 cases(86.6%). Fibrillation of the thenar muscles was found in 11 cases(73.3%). 5. Ten patients, 11 cases were followed up from 11 months to 9 years and 11 months and 72.8% was improved.
Atrophy ; Carpal Tunnel Syndrome ; Clinical Study ; Female ; Fingers ; Hand ; Humans ; Hypesthesia ; Male ; Median Nerve ; Muscles ; Orthopedics ; Thumb ; Wrist

No abstract available.
Endometriosis* ; Female

Intravesical Bacillus Calmette-Guerin (BCG) therapy is an effective immunotherapy used for the treatment and prophylaxis of superficial bladder cancer. The mechanism through which BCG exerts its antitumor activity is not fully understood. However, several studies suggest that antitumor mechanism of BCG is associated with T-cell mediated immunity and lymphokines. In this report, the detection of IL-2(a lymphokine produced in response to BCG) in urine and serum specimens of patients treated with intravesical BCG is reported. Urine specimens of 10 superficial bladder cancers were obtained prior to BCG instillation, 4, 8, and 24 hours afterwards. Serum specimens of same patients were obtained before and 8 hours after BCG instillation. No change of serum IL-2 before and after BCG instillation were observed. Urinary IL-2 production increased significantly 4 and 8 hours (p<0.05) and decreased 24 hours after BCG instillation. Urinary IL-2 levels 24 hours after BCG instillation were similar to baseline values. Between urinary IL-2 of healthy men and cystitis patients were similar. These results suggest that BCG induce IL-2 production with highest level at 4 hours after BCG instillation and IL_2 might play a important role in antitumor mechanism of BCG. However, further studies are necessary to elucidate the antitumor mechanism of BCG.
Bacillus ; Cystitis ; Humans ; Immunotherapy ; Interleukin-2* ; Interleukins* ; Lymphokines ; Male ; Mycobacterium bovis* ; T-Lymphocytes ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Pectus arcuatum is a rare complex chest wall deformity. A 31-year-old female presented with a severely protruding upper sternum combined with a concave lower sternum. We planned a modified Ravitch-type operation. Through vertical mid-sternal incision, chondrectomies were performed from the second to fifth costal cartilages, saving the perichondrium. Horizontal osteotomy was performed in a wedge shape on the most protruding point, and followed by an additional partial osteotomy at the most concaved point. The harvested wedge-shape bone fragments were minced and re-implanted to the latter osteotomy site. The osteotomized sternum was fixed with multiple wirings. With chondrosternoplasty, a complex chest wall deformity can be corrected successfully.
Adult ; Bone Transplantation ; Congenital Abnormalities ; Costal Cartilage ; Female ; Funnel Chest ; Humans ; Osteotomy ; Pectus Carinatum ; Sternum ; Thoracic Wall

BACKGROUND: Reperfusion of ischemic myocardium is clinically encountered during thrombolytic therapy of acute myocardial infarction, percutaneous transluminal coronary angioplasty(PTCA), and coronary artery bypass graft(CABG). Reperfusion results in endothelial dysfunction characterized by a reduced release of endothelium-derived relaxing factor(EDRF) in animal studies. Studies with experimental animals have emphasized the role of oxygen free radicals and lipid peroxidation in pathophysiology of reperfusion injury and myocardial stunning. The object of this study is to determine whether endothelial dysfunction was developed after open heart surgery and to evaluated the role of oxygen free radical and lipid peroxidation in reperfusion injury. METHODS: The study group was comprised 13 patients who underwent open heart surgery(male/female : 2/11, mean age : 43+/-4 year, Atrial septal defect in 4, Ventricular septal defect in 1, Mitral regurgitation in 2, Tetralogy of Fallot in 1, and Aortic stenosis and Regurgitation with Mitral stenosis in 5 patients). The endothelial function was evaluated with the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the continous infusion of acetylcholin, from 10(-9) to 10(-6) molar concentration to the coronary artery and intracoronary injection of 200microg nitroglycerin after acetylcholine infusion. The infusion study was performed before and 10 days after surgery. For analysis of the role of oxygen free radical and lipid peroxidation in reperfusion injury, blood samples for malondialdehyde and neutrophil respiratory burst test(hydrogen peroxide amount of neutrophils) were obtained in pre-declamping of aorta and 5 min, 10 min, and 20 min after declamping of aorta from coronary sinus. RESULTS: 1) The vasoconstrictor response to acetylcholine, 10(-9) to 10(-6)M concentration, at proximal and distal left anterior descending coronary artery, were increased significantly in post-operation infusion study but there was no singnificant difference in vasodilator response to nitroglycerin. 2) The mean absorbance value of malondialdehyde(MDA) in pre-declamping and 5min, 10min, and 20min after reperfusion were 96+/-12, 73+/-12, 89+/-11 and 77+/-12, respectively. There was no significant difference in plasma MDA level and hydrogen peroxide amount of neutrophils after reperfusion(aortic declamping). CONCLUSION: These data suggest that endothelium dependent vascular relaxation is impaired in patients with open heart surgery and post-ischemic reperfusion injury may be responsible for the abnormal response. But we did not determine the role of lipid peroxidation and oxygen free radical in reperfusion injury.
Acetylcholine ; Animals ; Aorta ; Aortic Valve Stenosis ; Coronary Artery Bypass ; Coronary Sinus ; Coronary Vessels ; Endothelium ; Free Radicals ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hydrogen Peroxide ; Lipid Peroxidation* ; Malondialdehyde ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Molar ; Myocardial Infarction ; Myocardial Stunning ; Myocardium ; Neutrophils ; Nitroglycerin ; Oxygen* ; Plasma ; Relaxation ; Reperfusion Injury* ; Reperfusion* ; Respiratory Burst ; Tetralogy of Fallot ; Thoracic Surgery* ; Thrombolytic Therapy

BACKGROUND: Reperfusion of ischemic myocardium is clinically encountered during thrombolytic therapy of acute myocardial infarction, percutaneous transluminal coronary angioplasty(PTCA), and coronary artery bypass graft(CABG). Reperfusion results in endothelial dysfunction characterized by a reduced release of endothelium-derived relaxing factor(EDRF) in animal studies. Studies with experimental animals have emphasized the role of oxygen free radicals and lipid peroxidation in pathophysiology of reperfusion injury and myocardial stunning. The object of this study is to determine whether endothelial dysfunction was developed after open heart surgery and to evaluated the role of oxygen free radical and lipid peroxidation in reperfusion injury. METHODS: The study group was comprised 13 patients who underwent open heart surgery(male/female : 2/11, mean age : 43+/-4 year, Atrial septal defect in 4, Ventricular septal defect in 1, Mitral regurgitation in 2, Tetralogy of Fallot in 1, and Aortic stenosis and Regurgitation with Mitral stenosis in 5 patients). The endothelial function was evaluated with the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the continous infusion of acetylcholin, from 10(-9) to 10(-6) molar concentration to the coronary artery and intracoronary injection of 200microg nitroglycerin after acetylcholine infusion. The infusion study was performed before and 10 days after surgery. For analysis of the role of oxygen free radical and lipid peroxidation in reperfusion injury, blood samples for malondialdehyde and neutrophil respiratory burst test(hydrogen peroxide amount of neutrophils) were obtained in pre-declamping of aorta and 5 min, 10 min, and 20 min after declamping of aorta from coronary sinus. RESULTS: 1) The vasoconstrictor response to acetylcholine, 10(-9) to 10(-6)M concentration, at proximal and distal left anterior descending coronary artery, were increased significantly in post-operation infusion study but there was no singnificant difference in vasodilator response to nitroglycerin. 2) The mean absorbance value of malondialdehyde(MDA) in pre-declamping and 5min, 10min, and 20min after reperfusion were 96+/-12, 73+/-12, 89+/-11 and 77+/-12, respectively. There was no significant difference in plasma MDA level and hydrogen peroxide amount of neutrophils after reperfusion(aortic declamping). CONCLUSION: These data suggest that endothelium dependent vascular relaxation is impaired in patients with open heart surgery and post-ischemic reperfusion injury may be responsible for the abnormal response. But we did not determine the role of lipid peroxidation and oxygen free radical in reperfusion injury.
Acetylcholine ; Animals ; Aorta ; Aortic Valve Stenosis ; Coronary Artery Bypass ; Coronary Sinus ; Coronary Vessels ; Endothelium ; Free Radicals ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hydrogen Peroxide ; Lipid Peroxidation* ; Malondialdehyde ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Molar ; Myocardial Infarction ; Myocardial Stunning ; Myocardium ; Neutrophils ; Nitroglycerin ; Oxygen* ; Plasma ; Relaxation ; Reperfusion Injury* ; Reperfusion* ; Respiratory Burst ; Tetralogy of Fallot ; Thoracic Surgery* ; Thrombolytic Therapy

Advances in medical science have produced significant progress in the area of wound healing. Yet, despite proper administration of initial medical treatment, burns or radiation induced wounds often develop into chronic wounds or develop other complications such as scar contractures. In these type of patients, chronic wounds and the potential accompanied ulcers are difficult to heal as malignant changes may occur to the wounds especially in the absence of or in the delay in timely medical treatment. In our beauty oriented society today people have shown great interest in improving their image and many obese patients want to undergo suction-assisted lipectomies or abdominoplasties. Abdominoplasty is an effective procedure to remove locally accumulated fat and to reshape abdominal contours by tightening the muscles of the relaxed abdominal wall. Our medical research conducted on two patients, one with contact burn injuries accompanied by upper abdominal ulcers suffered for fifty years and another with radiation impaired wounds accompanied by lower abdominal ulcers due to cancer treatment for seven years, has shown that through the proper use of abdominoplasty. We have eliminated all possibilities that may trigger the re-occurrence of Marjolin's ulcers which may become malignant. Additionally, we have been able to heal chronic wounds and functionally improve our patient's restrictions of movement caused by the scar contractures by completely removing the lesions, erythemas and discharges from the ulcer areas by performing upper and lower abdominoplasties while still obtaining cosmetically satisfactory results.
Abdominal Wall ; Abdominoplasty ; Beauty ; Burns ; Cicatrix ; Contracture ; Erythema ; Humans ; Lipectomy ; Muscles ; Ulcer ; Wound Healing

OBJECTIVE: The purpose of this study is to identify risk factors for subarachnoid hemorrhage(SAH) in Korea. METHODS: The clinical record and environmental data of 250 patients who had admitted our hospital between September 2001 and May 2003 were reviewed retrospectively by the neurosurgical nursing practitioners. RESULTS: In this study, the peak age for presentation with ruptured intracranial aneurysm was around 5th decade which is most active period of his or her life. The peak time of aneurysm rupture was from 6 to 12 A.M.(34.8%) and the onset of SAH occurred the most frequently at work(30.4%). The prevalence of hypertension in SAH patients was 42.8%, That of cigarette smoking in men and in women were 81.7% and 15.8% respectively. Hypertension was significantly corrected with the amount of hemorrhage based on Fisher Grading system(P<0.05). The consumption of smoking and the amount of hemorrhage was closely correlated also(P<0.05). CONCLUSION: Hypertension and cigarette smoking may be closely related to aneurysmal SAH. Undoubtedly, they are significantly related to massive, fatal SAH with poor neurologic condition. To prevent reduce aneurysmal SAH, cessation of smoking, anti-hypertensive medication and stress control are most important basic step in promotion of public health.
Aneurysm* ; Causality* ; Female ; Hemorrhage ; Humans ; Hypertension* ; Intracranial Aneurysm ; Korea ; Male ; Nursing ; Prevalence ; Public Health ; Retrospective Studies ; Risk Factors ; Rupture* ; Smoke* ; Smoking*