The basis of surgical treatment of spondylolisthesis lies in the restoration of stability to the unstable spine and the decompression of the entrapped nerve root. Knodt's distraction rod has been thought to be one of effective distraction instruments promoting fusion for lumbar spine surgery. From December 1981 to May 1987, we performed surgical treatment of spondylolisthesis with Knodt's distraction rod instrumentation in 15 patients (Group I ) and fusion in situ in 7 patients (Group II ). Clinical analysis and changes of radiographic measurements of above two methods were evaluated and obtained following results. l. In Group I, the percentage slip and slip angle decreased to 12.1 ±6.3% and 0.2 ±6.6°, postoperatively, from 20.9 ±8.4% and 7.5 ±5.6°, respectively. In Group II, changed from 13.4 ±9.4%, 7.8 ±6.1°to 11.4 ±9.6%, 11.0 ±5.2°, respectively. 2. In Group I, the average reduction rate was 42.1% postoperatively, but decreased to 20.5% at follow-up. 3. The percentage posterior disc height increased to 49.0 ±6.7% postoperatively, from 27.4 ±10.0% in Group I and decreased to 34.7 ±5.3% at follow-up. But, in Group II, no significant changes observed. 4. The lumbar lordosis in Group I and Group II, decreased to 26.0 ±8.3°and 29.8 ±13.8°, postoperatively, from 35.5 ±7.8°and 37.6 ±1.4°, respectively. 5. There was no significant difference in clinical results between two groups. 6. Postoperstive complications in Group I, were one case of rod breakage with pseudarthrosis, 3 cases of voiding difficulty and superficial wound infection, in Group II, were 2 cases of superficial wound infection and 3 cases of transient voiding diffeculty.
Animals ; Decompression ; Follow-Up Studies ; Humans ; Lordosis ; Pseudarthrosis ; Spine ; Spondylolisthesis ; Wound Infection

We report an unusual case of primary extranodal non-Hodgkin's lymphoma combined with sinusitis in an AIDS patient. A 39-year-old male presented with sinusitis as initial manifestation. A nasal endoscopy revealed nasal polyposis with mucopurulent discharge in both middle meatus and paranasal sinus (PNS) CT scans demonstrated pansinusitis without lamina papyracea or skull base defect. He received antiretroviral and antibiotics therapy due to low CD4 count representing immunocompromised state. The patient was not followed up for observation and he returned with reduced right visual acuity and diplopia, and proptosis after 6 months. A PNS CT scan showed bilateral sinonasal polyposis with pansinusitis and soft tissue density in the right orbit and frontal lobe through bone defect of lamina papyracea and skull base. Endoscopic sinus surgery for orbital decompression and biopsy of intraorbital mass was performed under general anesthesia. The mass was infiltrated into orbital contents and was confirmed as an diffused large B-cell lymphoma with anaplastic variant. The patient received radiotherapy because his general condition was poor. Proptosis and ocular pain were decreased; however, he complained of a persistent headache. Brain CT and MRI showed diffused parenchymal edema around brain abscess in the right frontal lobe. Stereotactic evacuation of the right brain abscess was performed. He has no specific complaints for the last 14 months and antiretroviral therapy is concluded at the present.
Acquired Immunodeficiency Syndrome ; Adult ; Anesthesia, General ; Anti-Bacterial Agents ; B-Lymphocytes* ; Biopsy ; Brain ; Brain Abscess ; CD4 Lymphocyte Count ; Decompression ; Diplopia ; Edema ; Endoscopy ; Exophthalmos ; Frontal Lobe ; Headache ; Humans ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Male ; Orbit ; Radiotherapy ; Sinusitis* ; Skull Base ; Tomography, X-Ray Computed ; Visual Acuity

Although quantitative EEG parameters, such as spectral band powers, are sensitive to centrally acting drugs in dose- and time-related manners, changes of the EEG parameters are redundant. It is desirable to reduce multiple EEG parameters to a few components that can be manageable in a real space as well as be considered as parameters representing drug effects. We calculated factor loadings from normalized values of eight relative band powers (powers of 0.5, 1.0~2.0, 2.5~4.0, 4.5~5.5, 6.0~8.0, 8.5~12.0, 12.5~24.5, and 25~49.5 Hz bands expressed as ratios of the power of 0.5-49.5 Hz band) of EEG during pre-drug periods (11:00~12:00) by factor analysis and constructed a two-dimensional canonical space (reference canonical space) by canonical correlation analysis. Eight relative band powers of EEG produced by either physostigmine or yohimbine were reduced to two canonical scores in the reference canonical space. While changes of the band powers produced by physostigmine and yohimbine were too redundant to describe the difference between two drugs, locations of two drugs in the reference canonical space represented the difference between two drug's effects on EEG. Because the distance between two locations in the canonical space (Mahalanobis distance) indicates the magnitude of difference between two different sets of EEG parameters statistically, the canonical scores and the distance may be used to quantitatively and qualitatively describe the dose-dependent and time-dependent effects and also tell similarity and dissimilarity among effects. Then, the combination of power spectral analysis and statistical analysis may help to classify actions of centrally acting drugs.
Animals ; Electroencephalography ; Factor Analysis, Statistical ; Physostigmine ; Rats ; Yohimbine

Brunner's gland adenoma is characterized by benign proliferation of the normal Brunner's gland, and is a relatively rare disease that accounts for only 10% of benign duodenal tumors. It is usually found in the bulb and second portion of the duodenum, but is rarely found in the pylorus. The clinical manifestations vary from non-specific upper abdominal symptoms to obstruction, intussusception and gastrointestinal hemorrhage. It is a benign lesion but rarely undergoes malignant transformation. Management of Brunner's gland adenoma involves complete removal of the lesion. We experienced a 43-year-old man who had complained of melena and dyspnea on exertion. An esophagogastroduodenoscopy and computed tomography of the upper gastrointestinal tract demonstrated the presence of a 5.5x4.0 cm sized hyperemic and lobulated large mass with hemorrhage that originated from the pylorus and was intussuscepted into the duodenum. Resection of the tumor revealed that it was a Brunner's gland adenoma on a histological examination.
Adenoma* ; Adult ; Anemia* ; Duodenum ; Dyspnea ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intussusception* ; Melena ; Pylorus* ; Rare Diseases ; Upper Gastrointestinal Tract

Brunner's gland adenoma is characterized by benign proliferation of the normal Brunner's gland, and is a relatively rare disease that accounts for only 10% of benign duodenal tumors. It is usually found in the bulb and second portion of the duodenum, but is rarely found in the pylorus. The clinical manifestations vary from non-specific upper abdominal symptoms to obstruction, intussusception and gastrointestinal hemorrhage. It is a benign lesion but rarely undergoes malignant transformation. Management of Brunner's gland adenoma involves complete removal of the lesion. We experienced a 43-year-old man who had complained of melena and dyspnea on exertion. An esophagogastroduodenoscopy and computed tomography of the upper gastrointestinal tract demonstrated the presence of a 5.5x4.0 cm sized hyperemic and lobulated large mass with hemorrhage that originated from the pylorus and was intussuscepted into the duodenum. Resection of the tumor revealed that it was a Brunner's gland adenoma on a histological examination.
Adenoma* ; Adult ; Anemia* ; Duodenum ; Dyspnea ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intussusception* ; Melena ; Pylorus* ; Rare Diseases ; Upper Gastrointestinal Tract

We studied the effects of acetylcholinesterase inhibitors, donepezil and galantamine, and an N-methyl-D-aspartate (NMDA) receptor blocker, memantine, on sleep-wake architecture in rats. Screw electrodes were chronically implanted into the frontal and parietal cortex for the electroencephalography (EEG). EEG was recorded with a bio-potential amplifier for 8 h from 09:30 to 17:30. Vibration was recorded to monitor animal activity with a vibration measuring device. Sleep-wake states such as wake (W), slow-wave sleep (S) and paradoxical or rapid eye movement sleep (P), were scored every 10 sec by an experimenter. We measured mean episode duration and number of episode to determine which factor sleep disturbance was attributed to. Donepezil and memantine showed a significant increase in total W duration and decreases in total S and P duration and delta activity. Memantine showed increases in sleep latency and motor activity. Changes of S and P duration in memantine were attributed from changes of mean episode duration. Galantamine had little effect on sleep architecture. From these results, it is showed that galantamine may be an anti-dementia drug that does not cause sleep disturbances and memantine may be a drug that causes severe sleep disturbance.
Animals ; Cholinesterase Inhibitors ; Electrodes ; Electroencephalography ; Galantamine ; Indans ; Memantine ; Motor Activity ; N-Methylaspartate ; Organothiophosphorus Compounds ; Piperidines ; Rats ; Sleep, REM ; Vibration

BACKGROUND/AIMS: The aims of this study were to validate the prognostic value of the JIS score for HCC and to compare discriminatory ability and predictive power with other staging systems such as Okuda, TNM and CLIP. METHODS: We analyzed the clinical records of 210 patients who were diagnosed as HCC from 2000 to 2002. Univariate and multivariate survival analyses were done to find out factors to affect survival. To validate prognostic value of those staging systems, survival curve was obtained and analyzed by the Kaplan-Meier's method, and to compare discriminatory ability and predictive power, Homogeneity LR chi-square test and AIC score were used. RESULTS: The median survival was 19.5 months (19.1+/-14.9). The number of patients and 3-year survival rate for those staging systems were Okuda 1(126, 57.7%), 2(63, 9.0%) and 3(21, 0.0%) (p<0.001); TNM I (34, 63.1%), II (71, 59.4%), III (50, 22.4%), IV-A (6, 14.3%) and IV-B (1, 6.5%) (p<0.001); CLIP 0 (79, 68.5%), 1 (39, 34.2%), 2 (36, 16.7%), 3 (25, 20.0%), 4 (18, 5.1%), 5 (9, 11.1%) and 6 (4, 0.0%) (p<0.001) and JIS 0 (26, 78.9%), 1 (65, 65.3%), 2 (43, 21.9%), 3 (40, 25, 8.0%) and 5 (11, 2.0%)(p<0.001) in univariate analysis using Kaplan-Meier analysis. Homogeneity LR chi-square test showed more stratification power in JIS (Okuda, 102.8; TNM, 128.2; CLIP, 148.4 and JIS, 185.6) and AIC score showed superior predictive power in JIS system (Okuda, 1228.5; TNM, 1130.3; CLIP, 1117.1 and JIS, 1093.6). CONCLUSIONS: The proposed JIS system is useful system to predict survival of HCC patients. The discriminate ability of the JIS score is much better than other staging systems and has better prognostic predictive power compared to other staging systems.
Aged ; Carcinoma, Hepatocellular/*mortality/pathology ; Female ; Humans ; Liver Neoplasms/*mortality/pathology ; Male ; Middle Aged ; Multivariate Analysis ; *Neoplasm Staging ; Predictive Value of Tests ; Prognosis ; Severity of Illness Index ; Survival Analysis

Necrotic enteritis (NE) caused by Clostridium (C.) perfringens commonly occurs in domestic broiler farms since antibiotic supplementation in poultry feed has been banned. We evaluated the antibacterial activities of medicinal plant extracts against C. perfringens isolates to select alternative compounds for preventing NE. We compared antibacterial activities using two methods and evaluated susceptibilities of the isolates based on minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Two (Fraxinus rhynchophylla Hance [FRH] and Geranium koreanum Kom. [GKK]) of the 30 plant extracts had potent antibacterial activities against C. perfringens ATCC 13124 in two assays. The MIC values for FRH and GKK against 20 C. perfringens isolates were 128~256 microg/mL and 32~128 microg/mL, respectively. The geometric MIC mean values for the two extracts were 147.2 microg/mL and 68.8 microg/mL, respectively. The MBCs for the two extracts against the same strains were 1,024~2,048 microg/mL and 256~1,024 microg/mL, respectively. The geometric mean MIC and MBC for GKK were about two-fold lower than those of FRH. The modified spot-on-lawn assay may be useful for measuring primary antibacterial potential. FRH and GKK are expected to be used as feed additives to prevent or treat NE in veterinary practice.
Chickens* ; Clostridium ; Clostridium perfringens* ; Enteritis ; Fraxinus* ; Geranium* ; Microbial Sensitivity Tests ; Plant Extracts ; Plants, Medicinal ; Poultry

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome presents with various clinical features, including seizures, stroke-like episodes, encephalopathy, myopathy, cardiac involvement, and diabetes. However, due to its clinical heterogeneity, the diagnosis of MELAS syndrome is complex and difficult. The present report describes an 18-year-old male who was diagnosed with MELAS syndrome following the onset of type 1 diabetes. The patient had suffered from ataxia, mental retardation, and recurrent headaches for several years; following hospitalization for loss of consciousness, he was treated for cerebellar atrophy and Wolf-Parkinson-White (WPW) syndrome. Although the patient had no history of lactic acidosis, the recent onset of type 1 diabetes and his medical history of encephalopathy and WPW syndrome suggested MELAS syndrome. The diagnosis of MELAS syndrome was confirmed by molecular genetic testing, which revealed a point mutation (A3243G) in the patient's mitochondrial DNA.
Acidosis, Lactic ; Adolescent ; Ataxia ; Atrophy ; Diabetes Mellitus, Type 1* ; Diagnosis ; DNA, Mitochondrial ; Headache ; Hospitalization ; Humans ; Intellectual Disability ; Male ; MELAS Syndrome* ; Molecular Biology ; Muscular Diseases ; Point Mutation ; Population Characteristics ; Seizures ; Unconsciousness ; Wolff-Parkinson-White Syndrome

OBJECTIVES: The purpose of this study was to examine the correlation between exposure to acetone and isopropyl alcohol (IPA) and the acquisition dyschromatopsia. METHODS: A study was performed on exposure group of 116 people exposed to and a group of 36 people not exposed to organic solvents were selected and examined. Their smoking and alcohol habits, symptoms, and exposure history were surveyed through questionnaires and interviews. Then dyschromatopsia was evaluated with the Lanthony D-15 d test in a room with standardized intensity of illumination. RESULTS: The statistical prevalence of dyschromatopsia was significantly higher in the exposed group (30.2%) compared to that found in the control group (19.4%). Out of the 116 subjects in the exposed group, 30 people had acquired dyschromatopsia (25.86%). The variables affecting the color confusion index, such as age, exposure, and the duration of exposure, were statistically significant variables. CONCLUSIONS: He prevalence of dyschromatopsia was found to be not significantly higher in the group with exposure to organic solvents compared to that found in the control group. In addition, a statistically significant correlation was found between exposure to organic solvents and the color confusion index.
2-Propanol ; Acetone ; Prevalence ; Questionnaires ; Smoke ; Smoking ; Solvents