No abstract available.
Appendicitis* ; Child* ; Humans

For the diagnosis of carpal tunnel syndrome (CTS), a sensory conduction study of median nerve is the most sensitive parameter, by either antidromic or orthodromic recording. Many different sensory recordings have been developed to detect the mild or early cases of carpal tunnel syndrome. A comparison of the median and ulnar sensory responses using the 4th digit either orthodromically or antidromically has been one of the methods. However, a simultaneous comparison of both antidromic and orthodromic methods on the 4th digit has not been documented. For the comparison between the median and the ulnar sensory nerve conduction of the 4th digit recorded antidromically or orthodromically, conduction studies of the median and ulnar sensory nerves were performed using standard methods in normal populations as well as in patients with carpal tunnel syndrome. We studied 31 CTS patients (46 hands) with mean age of 54 years old (range, 25~70). Also, 51 subjects (102 hands) with mean age of 48 years old were studied as control. The difference of antidromic latencies between the median and the ulnar nerves was less than or equal to 0.4 msec in the control subjects and greater than or equal to 0.5 msec in the patients with carpal tunnel syndrome. The difference of orthodromic latencies was less than or equal to 0.5 msec in the control subjects and greater than or equal to 0.5 msec in the patients with carpal tunnel syndrome. By the antidromic and orthodromic methods, the mean difference between latencies of the median or ulnar nerve was not statistically significant. However the amplitude of median or ulnar nerve was 2 times larger by the antidromic method than by the orthodromic. We concluded that the latency difference of 0.5 msec or greater between the median and ulnar nerve sensory conductions from the 4th digit would be valuable for the diagnosis of CTS. The antidromic methods with larger amplitude may be more technically convenient to determine CTS than the orthodromic methods.
Carpal Tunnel Syndrome* ; Diagnosis ; Fingers* ; Humans ; Median Nerve ; Middle Aged ; Neural Conduction ; Ulnar Nerve

There are rare but serious complications-especially risk of paraplegia when instrumentation by surgery is used to correct a spinal deformity. Wake-up tests may be necessary during scoliosis or kyphosis surgery to ensure that spinal function remains intact. We tried four spinal fusions for ankylosing spondylitis of a 62 year-old woman. We were not able to fix the rod for fusion because of a presenting positive wake-up test in the previous two prone-positioned operations. In last operation we decided on normotensive anesthesia with fentanyl-propofol in a lateral decubitus position, and then surgical instrumentation was completed after we made sure of a negative weak-up test. There were no postoperative sequelae. The lateral approach to the thoracic disc space during spinal fusion may produce minimum disruption of the normal spinal musculoskeletal anatomy, avoid retraction of the spinal cord and preserve the neurovascular bundle and the segmental radicular arteries to the spinal cord.
Anesthesia ; Arteries ; Congenital Abnormalities ; Female ; Humans ; Kyphosis ; Middle Aged ; Paraplegia ; Scoliosis ; Spinal Cord ; Spinal Fusion* ; Spondylitis, Ankylosing ; Surgical Instruments

OBJECTIVE: The purpose of this study is to evaluate the types of aphasia and the clinicoanatomic correlation in aphasic patients with subcortical lesions, and to investigate the change in the types of aphasia during the recovery stage. METHOD: Twenty-three stroke patients (16 men and 7 women) with left subcortical lesion was investigated. On the basis of the brain CT or MRI findings, the patients were divided into the 4 groups. Language dysfuntion was evaluated using the modified Western Aphasia Battery (WAB) and the type of aphasia and aphasia quotient were determined. Initial examination was performed within 2 months post-onset in all of the patients and the follow-up examination was done after 6 months post-onset in 9 patients. RESULTS: The most common type was anomic aphasia (39%). The type of subcortical aphasia was variable regardless of the sites of left subcortical lesion. Aphasia quotient was significantly related with the lesion size (gamma = 0.05, p<0.05) and the initial Barthel index (gamma = 0.65, p<0.05). The scores of all the subtests of the modified WAB and aphasia quotient were significantly decreased in the group with the cortical involvement or the history of operation. On the follow-up examination, the scores of fluency, information and naming subtests were significantly increased. CONCLUSION: The most common type of aphasia was anomic aphasia and the type of subcortical aphasia was not correlated to the anatomic lesion. Severity of subcortical aphasia would be related with the lesion size, the history of operation or the cortical involvement. The prognosis of subcortical aphasia was generally good.
Anomia ; Aphasia* ; Brain ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Prognosis ; Stroke

No abstract available.
Breast* ; Lymphoma*

OBJECTIVES: The aim of this study was to compare endogenous plasma lithium concentrations among schizophrenic patients classified by DSM-IV subtype and control groups and to investigate the correlation of endogenous plasma lithium concentration and psychotic symptoms in schizophrenia. METHODS: Schizophrenic patients were selected among psychiatric inpatients without lithium medication and then classified by DSM-IV schizophrenia subtype. Schizophrenic patient groups were composed of 15 disorganized type, 15 paranoid type and 15 undifferentiated type schizophrenic patients. The control group was composed of 15 healthy subjects without any psychiatric disease. Endogenous plasma lithium concentrations were estimated by inductively coupled plasma atomic emission spectrometer. The psychotic symptoms in schizophrenic patients were classified as positive symptoms, negative symptoms and disorganized symptoms according to andreasen classification1 about SANS and SAPS items. Endogenous plasma lithium concentration among three subtypes of schizophrenia and control group was compared, and correlation between endogenous plasma lithium concentrations and psychotic symptoms was examined. RESULTS: 1) Schizoprenic patients showed higher endogenous plasma lithium concentration than control groups (p=0.033). Endogenous plasma lithium concentrations were significantly different among three subtypes of schizophrenia (p=0.001). Compared with the control group, disorganized type showed higher endogenous plasma lithium concentration, but paranoid type and undifferentiated type were not significantly different. 2) Disorganized symptoms correlated with endogenous plasma lithium concentration (r=0.416, p=0.004), but negative symptom and positive symptom did not significantly correlate with endogenous plasma lithium concentration (r=0.202, p=0.184. r=-0.216, p=0.155). CONCLUSION: These results suggested that schizophrenic patients with disorganized symptom show the differences in utilization or distribution of endogenous lithium.
Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Inpatients ; Lithium* ; Plasma* ; Schizophrenia*

BACKGROUND: Mivacurium has a considerably shorter duration of action than any other currently used nondepolarizing agent. Rocuronium, on the other hand, has a brief onset but an intermediate duration of action. The current study was undertaken to characterize the interaction between mivacurium and rocuronium in rabbits. METHODS: In the first study, the dose-response relations of mivacurium, rocuronium and their combination were studied in thirty rabbits during thiopental anesthesia. Rabbits, randomly assigned to three groups (n=10), received mivacurium 10, 20, or 30 microgram/kg; rocuronium 50, 70, or 90 microgram/kg; or an equieffective combination of both drugs (0.3 ED50 mivacurium 0.3 ED50 rocuronium; 0.5 ED50 mivacurium 0.5 ED50 rocuronium; or 0.7 ED50 mivacurium 0.7 ED50 rocuronium, where ED50 is the dose producing 50% depression of the twitch height). In the second study, twenty rabbits were randomly allocated to two groups (n=10) to receive mivacurium 0.18 mg/kg or rocuronium 0.6 mg/kg. When the twitch height recovered to 25%, each rabbit received mivacurium 16.4 microgram/kg. RESULTS: The calculated ED95 and ED50 for mivacurium were 29.1 4.2 (mean SD) and 16.4 3.3 microgram/kg, respectively. Corresponding rocuronium was 95.1 6.7 and 61.5 5.3 microgram/kg, respectively. The interaction between mivacurium and rocuronium was found to be synergistic. The measured ED50 of the mixture was only 54% of the predicted value assuming a purely additive interaction. In the second study, the times after mivacurium until 95% in mivacurium and rocuronium group were 18.1 4.6 min and 37.7 5.7 min, respectively (p<0.0001). CONCLUSIONS: The combination of mivacurium and rocuronium is synergistic interaction and after rocuronium induced neuromuscular block, mivacurium becomes a longer acting agent than the shorter agent.
Anesthesia ; Depression ; Hand ; Neuromuscular Blockade ; Rabbits* ; Thiopental

A 74-year-old patient presented with recurrent aneurysms in the infrarenal abdominal aorta and right common iliac artery 6 years after endovascular aortic repair using endografts in the same location. The patient underwent an aorto-bi-iliac replacement with removal of the stent graft. Two holes measuring 2 mm each were found in the removed graft, and they appeared to have been caused by wear from continuous friction between the endograft and the aortic wall.
Aged ; Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak* ; Endovascular Procedures ; Friction ; Humans ; Iliac Artery ; Transplants

OBJECTIVES: This study used cone-beam computed tomography (CBCT) images to categorize the relationships between the mandibular canal and the roots and investigated the prevalence of nerve damage. MATERIALS AND METHODS: Through CBCT images, contact and three-dimensional positional relationships between the roots of the mandibular third molar and the mandibular canal were investigated. With this data, prevalence of nerve damage according to the presence of contact and three-dimensional positional relationships was studied. Other factors that affected the prevalence of nerve damage were also investigated. RESULTS: When the mandibular third molar and the mandibular canal were shown to have direct contact in CBCT images, the prevalence of nerve damage was higher than in other cases. Also, in cases where the mandibular canal was horizontally lingual to the mandibular third molar and the mandibular canal was vertically at the cervical level of the mandibular third molar, the prevalence of nerve damage was higher than in opposite cases. The percentage of mandibular canal contact with the roots of the mandibular third molar was higher when the mandibular canal was horizontally lingual to the mandibular third molar. Finally, the prevalence of nerve damage was higher when the diameter of the mandibular canal lumen suddenly decreased at the contact area between the mandibular canal and the roots, as shown in CBCT images. CONCLUSION: The three-dimensional relationship of the mandibular third molar and the mandibular canal can help predict nerve damage and can guide patient expectations of the possibility and extent of nerve damage.
Cone-Beam Computed Tomography ; Humans ; Mandibular Nerve ; Molar, Third* ; Paresthesia ; Prevalence