Postherpetic neuralgia is the most frequent complication of herpes zoster. Treatment of this neuropathic pain syndrome is difficult and often disappointing. Although postherpetic neuralgia is generally a self-limited condition, it can last indefinitely. Continuous epidural blockade for patients with acute zoster can shorten the duration of treatment. However, continuous epidural block has some complications such as infection, dural puncture, and total spinal and nerve damages. We report a case of myoclonus during continuous epidural block with ropivacaine, morphine, and ketamine in an acute zoster patient.
Amides ; Analgesia ; Herpes Zoster ; Humans ; Ketamine ; Morphine ; Myoclonus ; Neuralgia ; Neuralgia, Postherpetic ; Punctures

PURPOSE: One of the major keys to achieve successful osseointegration of the implant is its surface properties. The aim of this study was to investigate the bone response to dental implants with different surface characteristics using the rabbit tibia model. Tricalcium phosphate (TCP) coated, anodic oxidized and turned (control) surfaces were compared. MATERIALS AND METHODS: Seventy two implants were placed in the tibia of eighteen rabbits. Nine rabbits were sacrificed at 3 weeks of healing and the remaining nine were sacrificed at 6 weeks of healing. The bone-to-implant contact (BIC) and the bone volume density (BVD) were assessed by light microscope after 3 and 6 weeks of healing. RESULTS: Statistical analysis showed that no significant differences in the BIC and BVD were observed between the different implant surfaces and the control group at 3 weeks and 6 weeks of healing. Data also suggested that the BVD of all the surfaces showed significant difference at 3 and 6 weeks. CONCLUSION: The present study has showed that osseointegration occurred in all investigated types of surface-treated implants. In the current study all of the threads of the implants were observed to calculate BIC and BVD values (instead of choosing some of the threads from the bone cortex for example), which didn't make BIC or BVD percentage values better than in the control group, therefore the clinical relevance of these results remains to be shown.
Calcium Phosphates ; Dental Implants ; Light ; Nitrogen Mustard Compounds ; Osseointegration ; Rabbits ; Surface Properties ; Tibia

STUDY DESIGN: Ninty eight patients with multilevel spinal stenosis who were treated with posterior decompression and instrumented posterolateral fusion were reviewed retrospectively. All patients were divided two groups by pathologic level and surgery level. One is complete level decompression group (whole pathologic levels were decompressed) and the other is limited level decompression group (less than pathologic levels were decompressed). SUMMARY OF BACKGROUND DATA: Many patients with spinal stenosis haute multilevel pathology, which is very difficult problem to make surgical strategy for determination of decompression level. METHOD: Patients were reviewed using combination of clinical records, follow-up examinations and radiographs. Posterior decompression and instrumented posterolateral fusion were performed in all patients using pedicle screw fixation (TSRH 49 cases, Diapason 37 cases, CCD 12 cases) and either autogenous bone graft alone or autograft with allograft. The average follow-up period was 19.7 months. RESULTS: In the clinical results by the criteria of Kirkalldy-Willis, there was no difference between complete level decompression group and limited level decompression group. By the bone graft mothorts, fusion rate was no difference between autograft alone group and autograft with allograft group, but fusion periods were more shorter in autograft alone group than in autograft with allograft group(P>0.05). CONCLUSION: In multilevel spinal stenosis, the segments that associated with neurologic symptoms or seyeie stenosis on radiograph must be decompressed but the segments that not associated with neurologic symptoms and mild stenosis on radiograph do not need preventive decompression.
Allografts ; Autografts ; Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Pathology ; Retrospective Studies ; Spinal Stenosis* ; Transplants*

Vagal mononeuropathy is very rare. Diabetes mellitus is one of the causes of this rare disease condition. Here we report a 44-year-old woman who presented with an idiopathic vagal mononeuropathy and was finally diagnosed with diabetic vagal mononeuropathy. She presented with isolated dysphagia without hoarseness or other symptoms related with vagal dysfunction. Except for diabetes mellitus, no abnormalities were found by routine and specific checkups including brain imaging, gastroscopy, electromyography, and laryngoscopy. Finally, 12 days later, she abruptly developed hoarseness without other cranial nerve dysfunction.We suggest that her neurological symptoms originated from diabetes affecting the vagus nerve in isolation. Clinicians should pay attention to this association, especially when they encounter a patient with diabetes mellitus with sudden idiopathic dysphagia even without problems of vocalization.
Diabetes Mellitus

The authors report one-case of hyperthyroidism that occurred in a 56-year-old woman with bipolar disorder after 3 years of chronic lithium treatment. The high level in thyroid fuction test returned to normal after discontinuation of lithium. This case is shows that lithium-induced hyperthyroidism can be reversible.
Bipolar Disorder ; Female ; Humans ; Hyperthyroidism* ; Lithium Carbonate* ; Lithium* ; Middle Aged ; Thyroid Gland

Heorrhage and infarct-like necrosis of anterior lobe of the pituitary gland is one of the characteristic pathologic findings of the autopsied cases of Korean Hemorrhagic Fever (KHF) patients, but there has been rare reports of hypopituitarism in patients with KHF. Recently we have experienced a patient with hyponatremia who had recovered from KHF. He was admitted to our hospital due to nausea, vomiting, and epigastric discornfort. To determine the function of the anterior pituitary gland, hormonal levels of target galnds and pituitary gland were measured, and combined pituitary stimulation test was performed. ACTH, GH, and prolactin deficiency were confirmed by combined pituitary stimulation test in this patient. There was no evidence of hypothalamic or other pituitary diseases by brain MRI. Our experience shows that KHF can be a cause of hypopituitarism and these findings should alert physicians the possibility of hypopituitarisrn in patients who had recovered from KHF.
Adrenocorticotropic Hormone ; Brain ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hyponatremia ; Hypopituitarism* ; Magnetic Resonance Imaging ; Nausea ; Necrosis ; Pituitary Diseases ; Pituitary Gland ; Pituitary Gland, Anterior ; Prolactin ; Vomiting

Transient hyperkalemia is well known to occur in man following intravenous administration of succinylcholine chloride. We studied the change of the serum potassium concentration after injection of succinylcholine in nonburn patients and electricburn patients, physical status 1 or 2 adopted by the American Society of Anesthesiologists. We compared two groups: Non-burn patient group(Group 1) as control, Electric burn patient group (Group 2) as experimental. The following results were obtained: 1) In non-burn patient group(Group 1) serum potassium concentration was slightly decreased in the 1st, 2nd, 3rd, 4th, 5th, 6th and 10th minute after succinylcholine injection compared with control, but nostatistical significance was noticed in this group. 2) In electric burn patient group (Group 2) serum potassium concentration was maximally increased compared with the controls. Statistical significance was noticed at the 2nd and 3rd minute after succinylcholine injection in this group.
Administration, Intravenous ; Burns, Electric* ; Humans ; Hyperkalemia ; Potassium ; Succinylcholine*

BACKGROUND: Adrenalectomy does impair the expression of hypothalamic NPY gene in the rat and replacement of glucocorticoid by intracerebroventricular(ICV) route resulted in a normalization of refeeding hyperphagia and weight gain in adrenalectomized(ADX), food-deprived rats. The purpose of this study was to assess the direct effect of CNS glucocorticoid on hypothalamic NPY gene expression which occurs following food deprivation in ADX rats. METHODS: Adult male Wistar rats were fitted with ICV cannulae and restricted the food intake for 14 days. Adrenalectomy and sham operation were done on the 10th day and single ICV corticosterone acetate(100ug/2uL) was given in one ADX group(ADX+CORT, n=9) and vehicle (2uL) was given in another ADX group(ADX+VEH, n=9) and sham rats(SHAM+VEH, n=7). After experiment, we measured NPY mRNA on arcuate nucleus by in situ hybridization. RESULTS: The rate of weight loss of ADX rats closely parallded that of sham-operated rats. Plasma glucose and insulin levels were not significantly different in three groups. Hybridization density on the ARC in ADX+VEH rats(0.42+/-0.02uCi/g: p<0.05) was significantly reduced compared to that in sham controls(0.68+/-0. 11uCi/g). ICV corticosterone injection increased the hybridization density in ADX+CORT rats(0.53+/-0.04uCi/g) compared to vehicle alone, although this did not reach that of controls. NPY gene expression was 40% in ADX+VEH rats and 62% in ADX+CORT rats compared to control rats. CONCLUSIONS: These results are consistent with the hypothesis that CNS glucocorticoid deficiency appears to be responsible for the impairment of refeeding hyperphagia in ADX rats and the effect of CNS glucocorticoid deficiency is a manifestation of impaired activation of hypothalamic NPY gene expression in the ARC.
Adrenalectomy ; Adult ; Animals ; Arcuate Nucleus ; Blood Glucose ; Catheters ; Corticosterone* ; Eating ; Food Deprivation ; Gene Expression ; Humans ; Hyperphagia ; In Situ Hybridization ; Insulin ; Male ; Rats* ; Rats, Wistar ; RNA, Messenger* ; Weight Gain ; Weight Loss

The cataract extraction in vitrectomized proliferative diabetic retinopathy(PDR) may be different from the ordinary non-vitrectomized patients in several points. We tried to know what`s the problems during the operation, how`s the visual outcomes and the postoperative complications in these eyes. In 18 previously vitrectomized PDR patients(25 eyes), we performed the extracapsular cataract extraction(ECCE) in 7 eyes and the phacoemulsification in 18 eyes. The intraoperative problems were insufficient dilation of pupil, unstability of (anterior and posterior) chamber depth, and difficulty in removal of cortex, which is firmly adherent to the posterior lens capsule. Opacity of posterior lens capsule, elevation of intraocular pressure, exudative pupillary membrane, posterior synechia and corneal edema were the major postoperative complications. In 22 eyes(88%), the visual acuity was increased more than 2 lines, Cataract extraction was easier and less postoperative complications these cases.
Cataract Extraction* ; Cataract* ; Corneal Edema ; Diabetic Retinopathy* ; Humans ; Intraocular Pressure ; Membranes ; Phacoemulsification ; Postoperative Complications ; Pupil ; Visual Acuity

No abstract available.
Brain* ; Child* ; Epilepsy* ; Humans ; Seizures*