BACKGROUND: The intrathecal grafting of adrenal chromaffin cells as a potential analgesic source, to delivery analgesic substances such as catecholamines and opioid peptides, is known to be effective at treating acute and chronic pain in several animal pain models. We tested whether the intrathecal implantation of encapsulated bovine chromaffin cells reduces cold allodynia in a rat model of neuropathic pain induced by chronic constriction injury of the sciatic nerve. METHODS: Bovine adrenal medullary chromaffin cells microencapsulated in sodium alginate-poly-l-lysin-alginate (APA) were implanted into the subarachnoid space of rats (n = 10) and foot cold sensitivity was investigated using an acetone test. At the end of the study, histology and capsule catecholamine production were evaluated. RESULTS: A significant reduction in cold allodynia was observed in animals implanted with chromaffin cells. In addition, the suppression of cold allodynia was reversed by naloxone. Abundant clusters of viable chromaffin cells stained with neutral red, were observed in the retrieved implants and after nicotine stimulation, and catecholamine was quantified. An ultrastructural study showed no fibrotic reaction against capsules, or disorganised capsules. CONCLUSIONS: These results suggest that intrathecal encapsulated chromaffin cells act as "mini pumps", which continuously deliver analgesic substances and produce analgesia in this chronic pain model of nerve injury-without immunosuppressant.
Acetone ; Analgesia ; Animals ; Capsules ; Catecholamines ; Chromaffin Cells* ; Chronic Pain ; Constriction ; Foot ; Hyperalgesia* ; Models, Animal ; Naloxone ; Neuralgia ; Neutral Red ; Nicotine ; Opioid Peptides ; Rats* ; Sciatic Nerve ; Sodium ; Spinal Cord* ; Subarachnoid Space ; Transplants

OBJECTIVE: This study is to report our experience of 40 cases of spinal schwannoma. METHODS: From 1995 to 2006, medical records were retrospectively reviewed in 40 cases of spinal schwannoma. RESULTS:We treated 40 spinal schwannomas in 38 (22 male and 16 female) patients. The mean age was 50.2. Four cases were sited in the cervical spine, 11 cases in the thoracic spine, and 25 cases in the lumbar spine. Two patients showed recurrences. Thirty-eight cases were intradural-extramedullary type and 2 cases were extradural. Two cases (5%) including 1 recurred case had no postoperative motor improvement. Ninety-five percents of patients improved on postoperative motor grade. CONCLUSION: Spinal schwannoma is mostly benign and extramedullary tumor. There were 2 recurred cases (5%) that had history of previous subtotal removal at first operation and had shown worse prognosis compared with the cases without recurrence. To reduce the recurrence of spinal schannoma, total excision of tumor mass should be done.
Humans ; Male ; Medical Records ; Neurilemmoma ; Prognosis ; Recurrence ; Retrospective Studies ; Spine

BACKGROUND: As a result of the extensive changes in burn care over the last few decades, including prevention of infection, burn survival has greatly increased. However, infection is still one of the main causes of death in severe burn cases, despite the progression in intensive care. But no recent comprehensive survey of infection has been carried out. OBJECTIVES: This retrospective study of bacteriological profile and antibiotic sensitivity patterns of isolates from a burn unit was carried out to provide burn care to plan future steps to reduce further the incidence of sepsis. METHODS: A retrospective review of burn wound infection in 623 patients treated in the burn center at the Hangang Sacred Heart Hospital, over a 2-year period (1998 - 2000) was carried out. RESULTS AND CONCLUSIONS: From wound cultures, Pseudomonas aeruginosa was most commonly isolated (24.7%) followed by Staphylococcus aureus (15.8%), Acinetobacter baumannii (14.5%), Enterococcus faecium (10.4%), Enterococcus faecalis (9.1%), coagulase negative staphylococcus (7.7%), Escherichia coli (6.6%), alpha-hemolytic streptococcus (5.3%), Klebsiella spp. (3.9%), Candida (3.2%), Serratia marcescens (2.9%), and Proteus spp. (2.1%). The most common isolate from blood cultures was Staphylococcus aureus (39.9%) followed by Enterococcus faecium (17.2%), coagulase negative staphylococcus (8.7%), Pseudomonas aeruginosa (7.5%), Enterococcus faecalis (4.7%), Candida (3.7%), Acinetobacter baumannii (3.7%), Serratia marcescens (3.5%), Enterobacter aerogens (2.8%), and Enterobacter cloaca (2.8%). The concordance rate of the results of the wound culture and blood culture was 96.0% in the Pseudomonas aeruginosa, 51.3% in the Staphylococcus aureus, 16.7% in the Enterococcus faecalis, 10.5% in the coagulase negative staphylococcus. Vancomycin and teicoplanin were effective in 100% of gram-positive organism. The drugs effective in gram-negative organism were cefepime, aztreonam, imipenem, piperacillin+tazobactam, ticarcillin+clavulanic acid, and amikacin.
Acinetobacter baumannii ; Amikacin ; Aztreonam ; Burn Units ; Burns* ; Candida ; Cause of Death ; Cloaca ; Coagulase ; Enterobacter ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Heart ; Humans ; Imipenem ; Incidence ; Critical Care ; Klebsiella ; Proteus ; Pseudomonas aeruginosa ; Retrospective Studies ; Sepsis ; Serratia marcescens ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Teicoplanin ; Vancomycin ; Wound Infection ; Wounds and Injuries

Gold therapy of rheumatoid arthritis is effective, but adverse reactions are also common. There are some cutaneous, hematologic, renal, and pulmonary side effects which have been associated with immunologic abnormalities. Also, hypersensitivity pneumonitis induced by gold therapy was rarely reported in literature. But, the mechanism for the induction of the pulmonary disease is not blown. We report a case of seropositive rheumatoid arthritis presented as gold induced hypersensitivity pneumonitis which was confirmed by the peripheral blood lymphocyte stimulation test with gold.
Alveolitis, Extrinsic Allergic* ; Arthritis, Rheumatoid ; Hypersensitivity* ; Lung Diseases ; Lymphocyte Activation* ; Lymphocytes*

BACKGROUND: Transperitoneal laparoscopy for renal surgery is now a common procedure. Previous studies have suggested that retroperitoneal laparoscopy is associated with greater carbon dioxide absorption. We compared carbon dioxide absorption and hemodynamic variables in patients undergoing transperitoneal laparoscopy for renal or adrenal surgery with that of patients undergoing intraperitoneal laparoscopy for colon surgery. METHODS: Thirty two patients undergoing laparoscopic surgery were divided into laparoscopic renal surgery group (n = 16) and laparoscopic colon surgery group (n = 16). We measured hemodynamic changes and arterial blood gases before CO2 insufflation, 10 minutes, 70 minutes after insufflation and 30 minutes after exsufflation in each groups. RESULTS: There was no significant difference in carbon dioxide absorption in patients who underwent transperitoneal laparoscopy compared to intraperitoneal laparoscopy at any interval. CONCLUSIONS: In contrast to previous reports, our study suggests that transperitoneal laparoscopy is not associated with greater carbon dioxide absorption compared to intraperitoneal laparoscopy.
Absorption* ; Carbon Dioxide* ; Carbon* ; Colon ; Gases ; Hemodynamics ; Humans ; Insufflation ; Laparoscopy*

OBJECTIVES: This study investigated the prevalence and psychosocial correlates of depressive symptoms in patients with hypertension.METHODS: The participants were 124 outpatients with hypertension who were treated at the Department of cardiology, Chosun University Hospital. Each subject was assessed concerning depressive symptom severity, state-trait anger, ego resilience, social conflict, and perceived stress using self-report questionnaires. A logistic regression model was constructed to examine the impact of psychosocial factors on depressive symptoms.RESULTS: A total of 37.1% of participants were identified as having depressive symptoms. Depressive symptoms were positively correlated with perceived stress, trait anger, social conflict, and state anger. On the other hand, ego resilience was negatively correlated with depressive symptoms. Further, perceived stress and state anger were related to a higher risk of depressive symptoms whereas ego resilience were associated with a lower risk of depressive symptoms.CONCLUSION: This study demonstrated a high prevalence of depressive symptoms in patients with hypertension. Moreover, several possible risk and protective psychosocial factors of depressive symptoms were determined. Especially, our findings suggest that improving ego resilience as well as lowering perceived stress and state anger would be important in the prevention and management of depression in patients with hypertension.
Anger ; Cardiology ; Depression ; Ego ; Hand ; Humans ; Hypertension ; Logistic Models ; Outpatients ; Prevalence ; Psychology

Villonodular synovitis, also called pigmented villonodular synovitis, is the benign lesion with the characteristic of locally aggressive proliferation of mononuclear histiocyte and giant cell. Typically it involves single joint, especially about 80% of disease occurs in the knee joint. Villonodular synovitis of the temporomandibular joint is very rare disease. Differential diagnosis includes synovial chondromatosis and tumors of the temporomandibular joint. Optimal treatment consists of complete excision of the mass and removal of the synovium including adjacent affected bony structures. This is a case report of villonodular synovitis developed in the temporomandibular joint.
Chondromatosis, Synovial ; Diagnosis, Differential ; Giant Cells ; Histiocytes ; Joints ; Knee Joint ; Rare Diseases ; Synovial Membrane ; Synovitis ; Synovitis, Pigmented Villonodular ; Temporomandibular Joint

Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia. Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia. We presented two cases in which thrombotic complications developed during iLA. We demonstrated the two possible causes of thrombotic complications during iLA; stasis due to low blood flow and inadequate anticoagulation.
Extremities ; Hemorrhage ; Hypercapnia ; Ischemia ; Lung* ; Thrombosis ; Ventilation

A ruptured bladder, or extravasation from the bladder, is almost always associated with trauma. Spontaneous extravasation, or iatrogenic extravasation, is extremely rare, with only few reported cases. Herein, two cases of bladder rupture, which occurred during voiding cystourethrography (VCUG), one in an 18 month old patient and the other in a 6 week old patient, due to instill dye by high pressure, are presented.
Humans ; Infant ; Rupture* ; Urinary Bladder*

OBJECTIVES: Delirium is a common postoperative complication in old adults associated with adverse events including functional decline, longer lengths of stay, and risk of institutionalization. The purpose of this study is to evaluate the incidence, preoperative, intraoperative, and postoperative risk factors of postoperative delirium in spine surgery. METHODS: Seventy-nine patients who underwent spine surgery were included. Preoperative assessments included current medical illness, number of comorbid problems, and the number of medications by past medical history, medical record, and interview with patients and caregivers. Intraoperative risk factors were evaluated. Laboratory data were checked preoperatively and postoperatively. The presence of delirium was determined by the Korean version of Delirium Rating Scale (K-DRS). RESULTS: Postoperative delirium was found in patients (7.6%). There was an association suggested between older age and postoperative delirium in spine surgery (p<0.05). An association was suggested between increasing numbers of medical conditions and postoperative delirium (p<0.05). Preoperative hemoglobin, hematocrit, sodium, potassium, calcium, albumin levels and postoperative hemoglobin and total protein levels were in the delirium group was significantly lower than those in control group (p<0.05). CONCLSION: This study showed that the postoperative delirium in spine surgery is not rare and several preoperative and postoperative factors are involved in the development of delirium. This pilot study is the first prospective trial in the area of postoperative delirium in spine surgery with a small sample size and short-term period, so further research with large sample size will be necessary.
Adult ; Aged ; Calcium ; Caregivers ; Delirium* ; Hematocrit ; Humans ; Incidence ; Institutionalization ; Medical Records ; Pilot Projects* ; Postoperative Complications ; Potassium ; Prospective Studies ; Risk Factors ; Sample Size ; Sodium ; Spine*