This study analyzed 88 patients who sustained a cervical spine injury during the past 4 years(Jan, 1993-May, 1996) in whom had 33 anterior, 21 posterior interventions were underwent and 34 remaining patients recieved conservative treatment with halovest. In 45 cases of upper cervical injuries, 16 operations were done. Among these, anterior approach was used in 3 patients and posterior approach in 13 patients. In 43 cases of lower cervical injuries, 39 operations were done. The anterior approach was used in 30 patients, posterior approach in 9 patients, and bilateral approached in remaing 4 cases. For patients with a predominent posterior ligamentous or osteoligamentous lesion, we selected anterior approach, when closed reduction was possible. Whenever the facet joint remained interlocked, a posterior approach was chosen. This report does not mentioned priority of anterior procedure at any case. Although clinical experience does not support the experimental data, we examined the reliability of anterior approach with use of internal fixation.
Humans ; Ligaments ; Spine* ; Zygapophyseal Joint

BACKGROUND: Cerebral hyperperfusion syndrome is a recognized complication of carotid endarterectomy, with a reported incidence of 0.3 to 1.2%. Monitoring of regional cerebral blood flow (rCBF) may limit neurological damage. This study was planned to investigate the changes of rCBF according to inhalational anesthetic agents. METHODS: 2.40+/-0.04 kg weighed New Zealand White Rabbits were undergone transient brain ischemia by bilateral carotid artery ligation for 20 minutes. The rCBF was measured by Bowman Perfusion Monitor. RESULTS: The value of rCBF in pre-ligation state was not significantly different among the three groups. rCBF in sevoflurane group was decreased to 46% of baseline value during ischemia and increased to 143% just after reperfusion. rCBFs in isoflurane and enflurane groups were abruptly increased instead of decrease like sevoflurane group. The values of rCBF was more increasing after reperfusion in isoflurane and enflurane groups. rCBFs in all groups were return to baseline value 10 minutes after reperfusion. CONCLUSIONS: This results was suggested that sevoflurane might be contributed to create a neurologic damage during ischemia and the hyperperfusion was seen in all three anesthetic agents. The clinical investigation may be needed to establish the value of this experiment.
Anesthetics* ; Brain Ischemia ; Carotid Arteries* ; Endarterectomy, Carotid ; Enflurane ; Incidence ; Ischemia ; Isoflurane ; Ligation ; Perfusion ; Rabbits ; Reperfusion

Atlato-axial instability is a serious condition that often requires operation. Atlanto-axial subluxation may cause severe symptoms; and threaten the intergrity of the spinal cord, leading to quadriplegia or sudden death. A techique of combining C1-C2 posterior screw fixation with a supplemental bone wire fusion has been advocated for the management of atlantoaxial instability. It was used in 9 patients with this disorder. Patients ages ranged from 20 years to 52 years; follow-up period ranged from 3 to 16 months with a mean of 9.8 months. All nine patients gained immediate rigid fixation of C1,2 with this technique. Of these 9 patients, instability occurred due to trauma in seven, os odotoideum in one and os odontoideum with trauma in another one. One patient was presented with nonunion and C1,2 instability after a Halovest applications a result of type II odontoid fracture. All 9 patients were placed in a philedelphia collar for 12weeks and all achieved solid fusion. Posterior atlantoaxial facet screw fixation provides immediate multidirectional rigid fixation of C1,2 and is mechanically superior to siring or clamp fixation. This technique maximizes success without the need for a supplemental rigid external orthosis.
Bone Wires ; Death, Sudden ; Follow-Up Studies ; Humans ; Orthotic Devices ; Quadriplegia ; Spinal Cord ; Spinal Fusion ; Transplants*

The authors had analysed retrospectively a series of 286 consecutive patients with head injury who were admitted to the department of neurosurgery. Dong Gang Hospital between March and July, 1992. 59 cases underwent craniotomy for evacuation of intracranial hematoma and/or placement of subarachnoid bolt for intracranial pressure monitoring under general anesthesia. Patients with a Glasgow Coma Scale(GCS) Score of 8 or less had significantly higher serum glucose levels postoperatively than patients with GCS score of 12 to 15(p<0.05). Patients who subsequently remained in a vegetative state or died had significantly higher glucose levels postoperatively than patients who had good outcome or moderate disability(p<0.05). Among the more severely injured patients(GCS Score< or =8), a serum glucose level greater than 200mg/dl on admission is associated with a significantly worse outcome(p<0.05). The results suggest that severely head-injured patients frequently showed hyperglycemia and the elevted serum glucose level may worsen the neurological outcome in such patients.
Anesthesia, General ; Blood Glucose* ; Coma ; Craniocerebral Trauma ; Craniotomy ; Glucose ; Hematoma ; Humans ; Hyperglycemia ; Intracranial Pressure ; Neurosurgery ; Persistent Vegetative State ; Retrospective Studies

The following is the authors' case report of a 24-year-old man with solitary osteochondroma on the C1 posteior arch. The patient experienced an acute onset of cervical cord compression symptome after rotation injury. Cervical magnetic resonance imaging and cervical computed tomography reveald extensive extradural cervical spinal cord compression. As a result surgical removal of osteochondroma was performed. Osteochondroma is a rare cause of spinal pathology and neurological dysfunction. The above case of cervical osteochondroma with spinal cord compression is reported and the patholgical, clinical and radiological features are discussed with brief review of the literature.
Humans ; Magnetic Resonance Imaging ; Osteochondroma* ; Pathology ; Spinal Cord Compression ; Young Adult

We managed a 27-year-old woman, who suffered from a type II odontoid fracture, with a halo-vest. After 12 weeks, we confirmed bony fusion on cervical spine CT and managed her with a neck collar. During the OPD follow up, we checked the cervical spine film every 1 month. After two and half months, displaced odontoid process was noted on routine cervical film, and a bony gap was found at the previous fracture wite on cervical spine CT. There is only one report in the literlature describing a nonunion after radiographically confirmed healing of a type II odontoid fracture. We report this case in order to emphasize the importance of scheduled follow up examination and evaluate precipitating factors of delayed nonunion of odontoid fracture.
Adult ; Female ; Follow-Up Studies ; Humans ; Neck ; Odontoid Process ; Precipitating Factors ; Spine

OBJECTIVES: Neurotensin (NT), of which functions are evoked by its interaction with neurotensin receptors (NTR), coexists with mesolimbic dopamine and regulates endogenous dopamine release. Recent studies have shown that NT with NTR exerts neuroleptic-like activity within the central nervous system and may play an important role in the pathogenesis and in the treatment of schizophrenia. We have examined the genetic association between schizophrenia and tetranucleotide repeat polymorphism in the 3'-flanking region of the NTR gene to investigate the possible contribution of the NTR gene to the schizophrenia susceptibility. METHODS: Among 23 alleles identified, the subjects were 120 patients (male 91, female 29) with schizophrenia and 106 normal healthy controls (male 84, female 22). They were unrelated native Korean. PANSS was used to determine positive or negative subgroup in the schizophrenic patients.Using polymerase chain reaction and polyacrylamide gel electrophoresis, tetranucleotide repeat polymorphism (CCTT and CTTT) in the 3'-flanking region of NTR gene was observed. For a comparison of NTR gene's allelic frequencies between patients with schizophrenia and normal healthy controls, chi-square test and Bonferroni's correction was performed. RESULTS: The frequency of A10 allele (base pair size=399) was significantly higher in normal healthy controls than schizophrenia (x2=16.4902, df=1, p<.000). In the comparison between schizophrenic patients with negative symptoms and normal controls, the frequency of A10 allele was significantly higher in normal healthy control subjects than patients with schizophrenia (x2=21.33, df=1, p<0.001). In the case of male, the frequency of A10 allele of schizophrenia was significantly higher than normal controls (x2=13.71, df=1, p<0.001). CONCLUSIONS: NTR gene was negatively associated with schizophrenia. NTR gene's tetranucleotide repeat polymorphism may provide some protective function against schizophrenia.
Alleles ; Central Nervous System ; Dopamine ; Electrophoresis, Polyacrylamide Gel ; Female ; Humans ; Male ; Microsatellite Repeats ; Neurotensin* ; Polymerase Chain Reaction ; Receptors, Neurotensin* ; Schizophrenia*

BACKGROUND AND OBJECTIVES: Performing oncologically safe, wide surgical excisions and postoperative volumetric restoration of resected tongues to gain functional recovery are contrary problems to deal with in performing glossectomy. There is no report about the volumetric restoration of a resected tongue according to resecting devices until now. The purpose of this study is to clarify the difference of postoperative volumetric changes of a resected tongue using a scalpel, electrocautery and laser with or without closure. MATERIALS AND METHOD: We used 12 rabbits for each group according to the resecting devices and also equally divided each group according to the closure or non-closure method. The volumetric changes of a resected tongue were measured by the Archimedes principles in one, two, three, and six months postoperatively. RESULTS: Regardless of resecting devices, the postoperative volume of a resected tongue was gradually increased as elapsed time. The nonclosure method was better than the closure method with respect to the volumetric restoration of the resected tongue regardless of the resecting devices, but there was no statistical significance of volumetric restoration between the closure and nonclosure methods in each group (p>0.05). The superior resecting device for the volumetric restoration of a resected tongue was diode laser, especially compared to electrocautry, in both closure and nonclosure method (p<0.05). CONCLUSION: The volumetric restoration after resection of the tongue using laser and nonclosure method are superior to electrocautery and to the closure method, respectively.
Electrocoagulation* ; Glossectomy ; Lasers, Semiconductor* ; Rabbits ; Tongue*

Objective: To investigate the therapeutic efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) as consolidation treatment after completing first-line treatment in patients with advanced ovarian cancer. Methods: A retrospective chart review was conducted on patients treated at the Comprehensive Gynecologic Cancer Center between January 2014 and 2019. Based on the inclusion criteria, 24 eligible patients who received HIPEC (paclitaxel 175 mg/m2, for 90 minutes, at 42°C) (HIPEC group) as consolidation treatment after terminating the adjuvant chemotherapy were identified. Another 24 patients who met the inclusion criteria and did not receive HIPEC were matched, representing the non-HIPEC group. Disease-free survival (DFS) and overall survival (OS) were examined between the two groups. Results: The median DFS was 28.7 and 24.2 months in the HIPEC and non-HIPEC groups, respectively (P=0.688). The 3-year DFS rates in the HIPEC and non-HPEC groups were 39.5% and 32.6%, respectively. However, the median OS was not determined. The 5-year OS rates in the HIPEC and non-HIPEC groups were 86.2% and 81.3%, respectively (P=0.850). One patient developed grade 3 neutropenia. Other patients experienced mild adverse events after HIPEC. Conclusion This study suggests that consolidation HIPEC could not support the survival benefit after completing the first-line treatment for patients with advanced ovarian cancer, although no severe specific safety issues were found. Therefore, randomized trials evaluating consolidation HIPEC for the management of ovarian cancer are warranted.

Objective: To investigate the therapeutic efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) as consolidation treatment after completing first-line treatment in patients with advanced ovarian cancer. Methods: A retrospective chart review was conducted on patients treated at the Comprehensive Gynecologic Cancer Center between January 2014 and 2019. Based on the inclusion criteria, 24 eligible patients who received HIPEC (paclitaxel 175 mg/m2, for 90 minutes, at 42°C) (HIPEC group) as consolidation treatment after terminating the adjuvant chemotherapy were identified. Another 24 patients who met the inclusion criteria and did not receive HIPEC were matched, representing the non-HIPEC group. Disease-free survival (DFS) and overall survival (OS) were examined between the two groups. Results: The median DFS was 28.7 and 24.2 months in the HIPEC and non-HIPEC groups, respectively (P=0.688). The 3-year DFS rates in the HIPEC and non-HPEC groups were 39.5% and 32.6%, respectively. However, the median OS was not determined. The 5-year OS rates in the HIPEC and non-HIPEC groups were 86.2% and 81.3%, respectively (P=0.850). One patient developed grade 3 neutropenia. Other patients experienced mild adverse events after HIPEC. Conclusion This study suggests that consolidation HIPEC could not support the survival benefit after completing the first-line treatment for patients with advanced ovarian cancer, although no severe specific safety issues were found. Therefore, randomized trials evaluating consolidation HIPEC for the management of ovarian cancer are warranted.