Spinal stenosis is defined as diminition in the size of the spinal canal that produces nerve entrapment resulting in symptoms, the most common of which is low back pain & radiating pain to leg. The central spinal canal contains the dura and other meninges, and inside these, the nerves of the cauda equina. The nerve root canal contains the spinal nerve from the point which the dura leaves the intervertebral foramina. Each foramen is a door through which the nerve enters to the nerve root canal. In its canal the nerve passes behind the disc and then in front of the superior articular process of the lower vertebra. Pathological and anatomical changes by various cases can produce narrowing of the central and nerve root canal. But they are sometimes not important because they are not severe enough to cause nerve entrapment and such medical treatment, Spinal stenosis is only significant when nerves are entraped, indicated by severe leg pain and sometime by sensory and motor changes. Spinal stenosis is classified into two groups: congenital and acquired. Among acquired groups, the combined type is most common and significant. Authors have experienced 61 cases of spinal stenosis and among these, 58 cases were treated surgically between 1981 and 1984 at the Department of Orthopaedic Surgery, Eulji Glneral Hospital, Daejeon. The following results were obtained. 1. There were 52 males and 33 females, and peak incidence in 5th and 6th decade(69%) 2. The most common type by Arnoldi's etiological classification was combined type(69%) 3. The most common chief complaint on admission was low back pain and radiating pain to leg (43%) 4. The most common sign was limitation of lumbar hyperextension (75.9%) and S.L.R.test was positive in only 12 cases(20.7%). 5. The common findings of myelography were hour glss appearance (39.7%) and complete block (27.6%), and simple radiologic findings were hypertrophy of facet joint, osteophyte formation in the periphery of vertebral bodies involved and narrowing of disc speace. 6. The A-P diameter of spinal canal was between 14.44 mm and 14.97 mm in simple findings, and the A-P diameter of dural sac between 8.10 mm and 9.19 mm in myelography. The spinal index was between 1:4.90 and 1:5.60. 7. Decompressive surgery was done in the 2 levels in 39 cases (67.3%), 3 levels in 10 cases (17.2%) and 1 level in 9 cases (15.5%). Discectomy was done in 40 cases (69%) and partial laminectomy was done in 58 cases (100%). 8. The most common site was L3,4-L4,5 (36.2%).
Cauda Equina ; Classification ; Dental Pulp Cavity ; Diskectomy ; Female ; Humans ; Hypertrophy ; Incidence ; Laminectomy ; Leg ; Low Back Pain ; Male ; Meninges ; Myelography ; Nerve Compression Syndromes ; Osteophyte ; Spinal Canal ; Spinal Nerves ; Spinal Stenosis ; Spine ; Zygapophyseal Joint

The computed tomographic (CT) and clinical findings in 9 patients with serologically confirmed Japanese encephalitis were reviewed. In 6 patients with prominent pyramidal and extrapyramidal symptoms and signs, the main CT finding was low density areas in the thalamus, internal capsule, basal ganglia, and midbrain. Low density areas were compatible with the anatomical distribution of pathologic lesions in Japanese encephalitis. Diffuse low density in the periventricular white matter was evident in 5 of 6 cases, with ventricular compression in 2 cases, between the 1st and 7th day of illness. There was enlargement of the third and lateral ventricles and cortical sulci dilatation in 3 cases on or after the 21st day of illness. In once CT scan obtained on the 10th day of illness, diffuse low density in the periventricular white matter was observed with enlargement of lateral ventricles and cortical sulci dilatation. Gyral enhancement was noted in 3 of 4 cases within 4 days after the onset of symptoms. There was a limited correlation between the clinical and CT findings.
Asian Continental Ancestry Group* ; Basal Ganglia ; Dilatation ; Encephalitis, Japanese* ; Humans ; Internal Capsule ; Lateral Ventricles ; Mesencephalon ; Thalamus ; Tomography, X-Ray Computed

Authors reviewed clinical recordings of 102 patients who were diagnosed as Guillain-Barre syndrome from 1979 to 1983 at Seoul National University Hospital. Among them, eighty-five cases were selected for the clinical study of Guillain-Barre syndrome through application of strict diagnostic criteria. And the following results were obtained. 1) There was a male preponderance (2.5:1) and an apparent predilection for the first and the second decades in this series. 2) Seasonal predilection was in summer and fall over five years. As judged from the uneven monthly incidence rate in each year, some epidemic tendency is likely to be in Guillain-Barre syndrome. 3) Sixty cases (71%) of this series had a history of antecedental events. The onset of neuritic symptoms occurred within one week from the preceding events in twenty-nine cases and one to two weeks in twenty cases. 4) The neuritic symptoms started from lower limbs in fifty cases (59%), upper limbs in eighteen (21%), cranial nerve distribution in six (7%) and developed nearly simultaneously in eleven (13%). 5) Most of the disabilities of the patients were devided into flaccid paralysis of limbs, cranial nerve dysfunction, autonomic dysfunction, respiratory difficulty and sensory abnormalities (paresthesia and myalgia). Autonomic dysfunction was observed in nine cases (11%), respiratory difficulty in thirty-one (37%), sensory abnormality in thirty-two (38%), and cranial nerve dysfunction in forty-seven (55%). 6) Authors devided the crainal nerve dysfunction into facial diplegia which was the most frequent form, bulbar palsy the next, masticatory muscle weakness the third, and ocular paresis the least. 7) There were two cases of Fisher syndrome (2.4%), three cases of polyneuritis cranialis (3.5%), and two cases of recurrence (2.4%) in this series. 8) Two cases (2.4%) died of respiratroy and bulbar dysfunction. Five cases (6%) had residual disability in motor function till six months follow-up.
Bulbar Palsy, Progressive ; Cranial Nerves ; Extremities ; Follow-Up Studies ; Guillain-Barre Syndrome ; Humans ; Incidence ; Lower Extremity ; Male ; Masticatory Muscles ; Miller Fisher Syndrome ; Neuritis ; Paralysis ; Paresis ; Recurrence ; Seasons ; Seoul ; Upper Extremity

This study examined the behavioral change and memory impairment following transient forebrain ischemia in 20 male rats: ten rats were subjected to sham operation. Inchemia was induced by a combination of bilateral common carotid artery occlusion and induced hypotension. During the recovery period, behavioral change was evaluated by open-field method. Histopathological examination was performed 7 days after ischemic insult. The results were as follows 1) Hippocampus CA 1 neuron was the most vulnerable to 10-minute forebrain ischemia. 2) There was increase in locomotor activity and rearing during early post-ischemic period. 3) Ischemia resulted in suppressed preening and grooming. From the above mentioned results, authors suggested that transient forebrain ischemia produced severe neuronal damage in CA l sector of hippocampus, therefore produced behavioral change and memory impairment.
Animals ; Carotid Artery, Common ; Grooming ; Hippocampus ; Humans ; Hypotension ; Ischemia* ; Male ; Memory* ; Motor Activity ; Neurons ; Prosencephalon* ; Rats*

PURPOSE: Pediatric-type sarcomas such as rhabdomyosarcoma (RMS), Ewing sarcoma (EWS), primitive neuroectodermal tumor (PNET), and desmoplastic small round-cell tumor (DSRCT) are rare in adults, with limited studies on their prognosis and optimal treatment strategies. We aimed to examine the outcome of children and adult patients with RMS, EWS, PNET, and DSRCT and relevant prognostic factors. MATERIALS AND METHODS: We retrospectively reviewed 220 pediatric-type sarcoma patients at a single institution between 1985 and 2011. Comparisons were made in order to examine differences in demographics, disease characteristics, and survival. Survival analyses were performed using the Kaplan-Meier method with log-rank tests and Cox proportional hazards models. RESULTS: A total of 220 consecutive patients were identified at our institute. Median age was 15.6 years (range, 0 to 81 years) and there were 108 children (49%) and 112 adult patients (51%). According to histological classification, 106 patients (48.2%) had RMS, 60 (27.3%) had EWS, 50 (22.7%) had PNET, and 4 (1.8%) had DSRCT. With a median follow-up period of 6.6 years, the estimated median overall survival (OS) of all patients was 75 months (95% confidence interval [CI], 27.2 to 122.8 months) and median event-free survival (EFS) for all patients was 11 months (95% CI, 8.8 to 13.2 months). No significant difference in OS and EFS was observed between adults and children. In multivariate analysis, distant metastasis (hazard ratio [HR], 1.617; 95% CI, 1.022 to 2.557; p=0.040) and no debulking surgery (HR, 1.443; 95% CI, 1.104 to 1.812; p=0.012) showed independent association with worse OS. CONCLUSION: Metastatic disease and no surgical treatment are poor prognostic factors for OS among pediatric-type sarcomas for both adults and children.
Adult* ; Child* ; Classification ; Demography ; Desmoplastic Small Round Cell Tumor ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence* ; Multivariate Analysis ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Rhabdomyosarcoma ; Sarcoma* ; Sarcoma, Ewing