No abstract available.
Bupivacaine* ; Morphine* ; Prospective Studies*

Fracture of the occipital condyle is rare. We report the case of a patient with this fracture who presented with negative plain films and delayed hypoglossal nerve palsy. Diagnosis was estabilished with high resolution computed tomography. In a trauma patient with neck or occipital pain, with or without cranial nerve palsy, this fracture should be considered, even if a plain radiograph is negative.
Cranial Nerve Diseases ; Diagnosis ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Neck

No abstract available.
Aneurysm*

We present a case of Brown-Sequard syndrome due to a massive cervical disc herniation at C5/6 level, presenting sings of sudden and severe spinal cord compression. The lesion was diagnosed by MRI and herniated cervical disc was removed under the surgical microscope via anterior route. The result of operation was good. A brief review of the literature is given.
Brown-Sequard Syndrome* ; Magnetic Resonance Imaging ; Spinal Cord Compression

No abstract available.
Kidney Transplantation*

BACKGROUND: Priming significantly shortened the onset of neuromuscular blockade(NMB), but also results in a high incidence of side effects. This study was designed to determine the effect of infusion priming method on the side effects, intubation condition, and onset of NMB compared with divided priming method. METHOD: The effects of different priming method of vecuronium on onset time and endotracheal intubation condition were investigated. 40 patients were studied in two parts. In control part, 20 patients were allocated into two groups(n=10 in each group) receving 10, 20 g/kg vecuronium as a priming dose, followed by a intubating dose(0.1 mg/kg-priming dose) 3 min later; the other part, 20 patients were allocated into two groups(n=10 in each group) receving 0.2 mg/kg/hr vecuronium continuous intravenous infusion, followed by a intubating dose(0.1 mg/kg-total infusion dose) 3, 5 min later. Onset time is calculated by single twitch stimulation test from injection of the intubating dose to maximum depression of the single twitch. Intubatin condition was appreciated based on vocal cord reflex, coughing, and jaw relaxation and scored. RESULTS: The times to fade out on the single twitch of the intravenous infusion priming group were shorter than control priming group. There was no difference between control priming group and infusion priming group to evaluate the intubation conditions. Side effects in the continuous infusion group were lesser than control priming group. CONCLUSION: This results suggest that the use of continuous infusion method is one of the promising methods to shorten the neuromuscular blockade and to provide more comfort to the patients.
Cough ; Depression ; Humans ; Incidence ; Infusions, Intravenous* ; Intubation ; Intubation, Intratracheal* ; Jaw ; Neuromuscular Blockade ; Reflex ; Relaxation ; Vecuronium Bromide* ; Vocal Cords

The authors report a case of thoracic disc herniation at T11/12 level which was downward migrated, presenting with signs of progressive spinal cord compression. The lesion was diagnosed by MRI. The operation was done by transthoracic transpleural approach using surgical microscope and the rib was not resected due to floating ribs of T11, 12. A Carbon cage with cancellous bones were used for the graft at the partial corpectomy site. The result of operation was good.
Carbon* ; Magnetic Resonance Imaging ; Ribs ; Spinal Cord Compression ; Transplants

PURPOSE: Receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) have been shown to be important regulators of osteoclastogenesis during bone remodeling, and their expressions were examined during fracture healing in a mouse model of tibial fracture. However, studies linking RANKL and OPG in patients with head injury and fracture are lacking. We evaluated the changes in serum levels of RANKL and OPG in patients with head injury and fracture (head injury group) and in patients with fracture (fracture group) and compared these with levels found in healthy control subjects. MATERIALS AND METHODS: 18 male patients of head injury and fracture and 20 male patients of fracture alone were enrolled. 20 healthy men were recruited to serve as controls. Within the first few hours of admission to hospital, at 4, 8 and 12 weeks after injury 20 ml of blood were obtained from 18 patients with head injury and fracture and 20 patients with fracture only. RESULTS: RANKL levels were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. OPG levels were significantly higher in the head injury group than in the fracture group at 4, 8 and 12 weeks after injury. RANKL/OPG ratios were significantly lower in the head injury group than in the controls immediately after and 4, 8 and 12 weeks after injury, and were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. CONCLUSION: We have shown changes in the profiles of RANKL, OPG and RANKL to OPG ratio. The altered RANKL, OPG and RANKL/OPG ratio in the head injury group lasted longer than in those of the fracture group.
Animals ; Bone Remodeling ; Craniocerebral Trauma ; Fracture Healing ; Head ; Humans ; Male ; Mice ; Osteoprotegerin ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B ; Tibial Fractures

PURPOSE: To evaluate the frequency of peritumoral bone marrow(BM) edema accompanying benign giant celltumor(GCT) of the appendicular bone by magnetic resonance(MR) imaging and to correlate MRI findings with those ofplain radiography and bone scintigraphy. MATERIALS AND METHODS: Eighteen cases of pathologically proven benignGCT of the appendicular bone were retrospectively analyzed using MR images, plain radiographs and bonescintigrams. A plain radiograph was available in 15 cases, and a scintigram in six. Marrow edema was defined asperitumoral signal changes which were of homogeneous intermediate or low signal intensity(SI) on T1WI and high SIon T2WI, relative to the SI of normal BM, and homogeneous enhancement on Gd-DTPA-enhanced T1WI. The transitionzone, sclerotic margin and aggressiveness of the lesion were assessed on the basis of plain radiographs. BM edemaseen on MR images was correlated with plain radiographic and scintigraphic findings. RESULTS: 1. Peritumoral BMedema was seen on MR images in 10 of 18 cases (55.5%). 2. In 8 of 15 cases for which plain radiographs wereavailable, MR imaging revealed BM edema. In six of these eight, transition zone was wide, while in two it wasnarrow. Six of seven patients without marrow edema showed a wide transition zone, and in one this was narrow.There was significant correlation between BM edema shown by MR imaging and the transition zone seen on plainradiographs (x2, p<0.05). But The aggressiveness shown by plain radiographs correlated only marginally, while thepresence of sclerotic rim did not correlate. 3. All six cases for which a bone scintigram was available showed anextended uptake pattern. In five of the six, MR imaging revealed edema. CONCLUSION: Peritumoral BM edema wasfrequently seen (55.5%) in the GCTs of appendicular bone ; it was more often shown in association with a widetransition zone by plain radiographs.
Bone Marrow* ; Edema* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Magnetic Resonance Imaging ; Radiography ; Radionuclide Imaging ; Retrospective Studies

PURPOSE: To investigate the causes of gastric wall shortening in early gastric cancer, upper gastrointestinal study was correlated with pathologic findings. MATERIALS AND METHODS: We evaluated 41 cases(M :F=1.7:1, average age=49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I; none, Grade II ;intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumor invasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, and morphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wall shortening on upper gastrointestinal series. RESULTS: Submucosal fibrosis was present in 4 cases in Grade I (n=21), 4 cases in Grade II (n=6) and 8 cases in Grade III (n=10). Positive conversing mucosal folds were seen in 5 cases in Grade I (n=17), 0 case in Grade II (n=2) and 9 cases in Grade III (n=9). Gastric wall shortening was significantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (p=.0001 and p=.002, respectively) CONCLUSION: Upper gastrointestinal finding of gastric wall protrusion in patients with early gastric cancer should not misinterprete as advanced gastric cancer since the finding could be a result of submucosal fibrosis.
Fibrosis ; Humans ; Retrospective Studies ; Stomach Neoplasms*