Posterior epidural migration of a sequestrated intervertebral lumbar disc is rare with only five cases ever reported in the literature so far. The objective of this paper is to report our experience of such a extremely rare case with a review the literature

No abstract available in English.
Clinical Study ; Dislocations ; Spine

These study was designed to observe the appearance and the characteristics of apoptotic cells during the development of knee joint in rat. The fetus were collected on the 16th, 17th, 18th, 19th, and 20th day of pregnancy. In this study, TUNEL staining, electron microscopic investigation and immunocytochemical gold labeling techniques were used. In the immuno-cytochemical gold labeling techniques, primary antibodies were used, which were to be polyclonal rabbit anti-mouse/ rat Bax, polyclonal rabbit anti-tissue transglutaminase C, and polyclonal goat anti-cpp32p20. The samples were observed under JEOL 1200 EX-II transmission electron microscope. The results were as follows. 1. In a 16-day-old fetus, between femur and tibia cartilages, mesenchymal cells were observed. Mesenchymal cells had marginated heterochromatin and dilated rough endoplasmic reticulum. 2. In a 17-day-old fetus, the knee joint clefts were first formed. In the primordial cruciate ligaments between the cartilages, capillaries were scattered. The apoptotic cells, which had fragmented and condensed nucleus, showed in the synovium. And necrotic cells, which had nuclear chromatin margination, perinuclear cisternae, and dilated rough endoplasmic reticulum, also were observed in the joint cleft surface. 3. From the 18-day-old fetus, phagocytic synovial cells and secretory synovial cells could be confirmed. The apoptotic cells were not seen. 4. In a 17-day-old fetus, a few cells were positive for TUNEL reaction in the joint cleft region. 5. In a 17-day-old fetus, Bax were marked on the mitochondria, endoplasmic reticulum of apoptotic cells. Also, it was marked at the phagocytosed apoptotic bodies in the neighboring cells. 6. In a 17-day-old fetus, the tissue Transglutaminase C were marked in the perinuclear region, vacuoles, cell membrane and extracellular matrix of the apoptotic cells. Also, it was marked at the phagocytosed apoptotic bodies in the neighboring cells. 7. In a 17-days-old fetus, CPP32 labeling were marked in the cytoplasm of the apoptotic cells. Practically, it was distributed between the phagocytosed apoptotic bodies and the neighboring cells. On the basis of above findings, it is obvious that the joint cleft are first formed in a 17-day-old fetus, a few cells are to be TUNEL positive signals, and the apoptotic cells contain Bax, tissue Transglutaminase C, and CPP32. Therefore the apoptotic cells and the necrotic cells are appeared in the 17-day-old fetus, and these cells are concerned with joint cleft formation.
Animals ; Antibodies ; Apoptosis ; Capillaries ; Cartilage ; Cell Membrane ; Chromatin ; Cytoplasm ; Endoplasmic Reticulum ; Endoplasmic Reticulum, Rough ; Extracellular Matrix ; Femur ; Fetus ; Goats ; Heterochromatin ; In Situ Nick-End Labeling ; Joints ; Knee Joint* ; Knee* ; Ligaments ; Mitochondria ; Pregnancy ; Rats* ; Synovial Membrane ; Tibia ; Vacuoles

Agar ; Bacteria ; Bacterial Load ; Chlorhexidine ; Mouth ; Povidone-Iodine ; Saliva ; Sheep ; Stem Cells

BACKGROUND: We investigated the association between socioeconomic status and adherence to health check-ups in a Korean population aged 40 years or older. METHODS: This cross-sectional study included 12,311 participants who participated in the 2010–2012 Korean National Health and Nutrition Examination Survey. Self-reported questionnaires were used to assess each participant's socioeconomic status (household income, occupation, and education) and adherence to health check-ups. RESULTS: Men with a higher income (highest vs. lowest: odds ratio [OR], 1.799; 95% confidence interval [CI], 1.296–2.497) and men with a higher education level (≥12 vs. < 6 years: OR, 1.488; 95% CI, 1.078–2.054) and office workers compared with manual workers (men: OR, 1.431; 95% CI, 1.077–1.902; women: OR, 1.783; 95% CI, 1.256–2.532) appeared to undergo more health check-ups. In particular, men and women with a higher income and education appeared more likely to undergo opportunistic health check-ups (men: highest vs. lowest income: OR, 2.380; 95% CI, 1.218–4.653; ≥12 vs. < 6 years education: OR, 2.121; 95% CI, 1.142–3.936; women: highest vs. lowest income: OR, 4.042; 95% CI, 2.239–7.297; ≥12 vs. < 6 years education: OR, 2.475; 95% CI, 1.283–4.775). CONCLUSION: A higher socioeconomic status was associated with a higher rate of participation in health check-ups. More efforts are needed to identify the factors associated with disparity in adherence to health check-ups.
Adult* ; Cross-Sectional Studies ; Education ; Female ; Health Promotion ; Humans ; Male ; Nutrition Surveys* ; Occupations ; Odds Ratio ; Public Health ; Social Class*

The supranuclear control of eye movement invo l ves the pathway extending from the cerebral cortex to theocular motor nuclei located in the brain stem. This paper de-scribes the normal supranuclear pathway, whichcontrols eye movement. We also include magnetic resonance imaging findings of the typical ocular manifestationscaused by disorders involving the supranuclear pathway, providing the anatomic ex-planations for certain clinicalsigns.
Brain Stem ; Cerebral Cortex ; Eye Movements ; Magnetic Resonance Imaging ; Ocular Motility Disorders*

BACKGROUND: The purpose of this study was to investigate the differences in health behaviors and dietary habits between the metabolically healthy group and the metabolically abnormal group in overweight and obese subjects based on the data of National Health and Nutrition Survey (NHANES). METHODS: Using the NHANES data (2007–2010), a total of 18,188 subjects were grouped into the metabolically healthy group and the abnormal group using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definition. Then we compared their health behaviors, dietary behaviors and nutrient intakes after adjustment for variables in overweight and obese groups. RESULTS: The proportion of metabolic abnormalities tended to increase with increasing age in both overweight and obesity groups.(P for trend <0.001) After adjusting various confounding variables, the odds ratio (95% confidence interval) of skipping any meal and breakfast for metabolically abnormality were 1.318 (1.066–1.631) and 1.354 (1.076–1.705) in male obese group and those of skipping breakfast and carbonated drink intake were 1.578 (1.168–2.133) and 1.540 (1.188–2.492) in female obese group. Daily potassium intake (P=0.032) and daily vitamin C intake (P=0.048) in the male overweight group and daily water intake (P=0.046) and daily carbohydrate intake (P=0.038) in the female overweight group were associated with metabolically abnormality. CONCLUSIONS: There were differences in health behaviors and nutrient intake according to metabolically abnormality in overweight and obese groups.
Adenosine Triphosphate ; Adult ; Ascorbic Acid ; Breakfast ; Carbonated Beverages ; Cholesterol ; Confounding Factors (Epidemiology) ; Drinking ; Education ; Female ; Food Habits ; Health Behavior* ; Humans ; Male ; Meals ; Nutrition Surveys ; Obesity* ; Odds Ratio ; Overweight* ; Potassium

OBJECTIVE: Radiation injury includes radiation necrosis and apoptosis. The purpose of this study is whether steroids and calcium channel blockers are effective for the prevention of single high dose irradiation-induced apoptosis in the rat brain. METHODS: Eighty Sprague-Dawley rats were divided into four experimental groups: Control(nontreated, n=20), Dexamethasone-treated(0.1mg/kg, n=20), Prednisolone-treated(2mg/kg, n=20), Nimodipine-treated (0.5mg/kg, n=20). After drug was administered, the right hemisphere of rat's brain was exposed to a single 10Gy dose of gamma rays using Ir-192. All brains underwent histological examination at 1 week, 2 weeks, 4 weeks, and 8 weeks after irradiation to evaluate cortical thickness and number of apoptotic cells. Apoptotic cells were detected by TUNEL assay. RESULTS: In nimodipine-treated group, apoptotic cell count was reduced significantly, compared to that of control(non treated) group at 4 and 8 weeks after irradiation(p<0.05). The decrease of cortical thickness was reduced significantly in nimodipine-treated group, compared to that of control group(p<0.05). There was no significant changes in the number of apoptotic cells and cortical thickness in prednisolone and dexamethasone-treated groups compared with those of control. CONCLUSION: These results suggest that nimodipine treatment may have effects on the prevention of radiation-induced apoptosis. If it could be established that calcium channel blockers inhibit radiation injury, they might be useful in radiation therapy. Further investigation of calcium channel blockers including dosage effectiveness, intracellular calcium ion concentration and effects on tumor tissue are necessary to clarify the usefulness of nimodipine.
Animals ; Apoptosis* ; Brain* ; Calcium Channel Blockers ; Calcium Channels* ; Calcium* ; Cell Count ; Dexamethasone ; Gamma Rays ; In Situ Nick-End Labeling ; Necrosis ; Nimodipine ; Prednisolone ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley ; Steroids

PURPOSE: To evaluate the usefulness of dynamic contrast-enhanced T2*-weighted MR imaging for assessing cerebral hemodynamics in acute cerebral infarction. MATERIALS AND METHODS: We performed dynamic T2*-weighted imaging(TR/TE/flip angle : 40/26/10 degrees, 64 x 128 matrix, 5 sec scan time) in conjunction with conventional T1- andT2-weighted imaging and MR angiography in 20 patients with acute cerebral infarction. The regions of ischemia seenon T2-weighted image(high signal intensity), MR angiogram(vascular stenosis or occlusion) and dynamic contrast-enhanced T2*-weighted image(perfusion defect) were topographically compared with each other. Relative cerebral blood volumes(rCBVs) of the ischemic regions and of contralateral normal regions were calculated fromsignal intensity data measured on dynamic contrast-enhanced T2*-weighted images, and were compared. RESULTS: Regions of ischemia were topographically well correlated on T2-weighted image, MR angiogram and dynamic contrast-enhanced T2*-weighted image in all but two patients, of whom one had recanalization of the occluded artery and the other had a small infarction. rCBVs were asymmetrically reduced in the ischemic regions in all butone patient who had recanalization of the occluded artery. CONCLUSION: Dynamic contrast-enhanced T2*-weighted imaging is a useful method in the qualitative and quantitative assessment of cerebral hemodynamics in acutecerebral infarction. The use of this imaging technique along with conventional MR imaging and MR angiography provides better hemodynamic information in acute cerebral infarction.
Angiography ; Arteries ; Cerebral Infarction* ; Constriction, Pathologic ; Hemodynamics* ; Humans ; Infarction ; Ischemia ; Magnetic Resonance Imaging

Magnetic resonance (MR) imaging techniques that measure cerebral perfusion have become increasingly important. It is due to the limitation of other imaging modalities (single photon emission computed tomography, SPECT ; positron emission tomography, PET etc.) and conventional MR imaging to detect cerebral perfusion, and its ability to identify and quantitate changes in cerebral perfusion may have a substantial effect on both the diagnosis and treatment of cerebrovascular disease. We evaluated the cerebral perfusion and arterial recanalization of large territorial infarction in acute, subacute and chronic stage by MR image and MR angiography and tried to correlate with motor improvement. Twenty six patients with large territorial infarction of middle cerebral artery (MCA, n=23) or posterior cerebral artery (PCA, n=3) were included in this study. In conjunction with conventional brain MR imagings, thirty-four dynamic susceptibility contrast-enhanced MR imagings (DSC-MRI) and MR angiography were performed in acute (< lweek, n=22), subacute (1-3 weeks, n=7), and chronic (3-5weeks, n=5) stages of cerebral infarction. Regional cerebral blood volumes (rCBVs) were calculated on a pixel-by-pixel basis and rCBV images were generated. Perfusion of infarcted areas were compared to contralateral normal regions by rCBV ratio (rCBV of infarcted area/that of contralateral), and arterial recanalization of infarcted area were investigated by MR angiographies. Motor power of the hemiparetic side of the patients was observed during the first 5 weeks after the stroke onset. The rCBVs of ischemic regions increased in subacute period than acute period and decreased again in chronic period (p<0.01, Kruskal Wallis one-way ANOVA), and these patterns were also correlated with visual findings of rCBV images. Recanalization of occluded arteries was found on MR angiagraphy in 3 patients (13.69.1) in acute, 6 patients (85.7%) in subacute and 4 patients (80.0%) in chronic infarction. The increase of "rCBV ratio" was more frequently seen in recanalization than no recanalization cases but we could not statistically analyze the difference due to small size of sample. In MCA infarctions, there is no significant relationship between rCBV with motor improvement during first 5 weeks after the onset. DSC-MRI is noninvasive, more widely available than other functional images (SPECT and PET) and easier to perform in an emergency setting. By providing information about hemodynamics, which is not available with conventional T1 or T2-weighted images, DSC-MRI will be helpful in describing the pathaphysiologic characteristics of stroke.
Angiography ; Arteries ; Blood Volume ; Brain ; Cerebral Infarction* ; Diagnosis ; Emergencies ; Hemodynamics ; Humans ; Infarction ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Perfusion* ; Positron-Emission Tomography ; Posterior Cerebral Artery ; Stroke ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon