No abstract available.
Dyspnea*

With the development of spinal fusion and internal fixation, rehabilitation mediclne, urinary control and antibiotics, the outlook for patients with cervical spine injuries has brightened considerably, as compared with half a century ago. However, splnal cord injury still remains as one of the most devastating accidents that man can Incur and still survive. There is increasing tendency to stabllize unstable cervical spine injuries surglcally for the benefit of early mobilization,.early rehabilitation, easy nursing care, and rigid stability of the spine. A clinical study was performed on 72 patients with 76 fractures and fracture-dislocatlons of the cervical spine, who were hospitalized and treated at Severance Hospital during the period between January 1970 and December 1978 and the following results were obtained. 1. The prevalent age distribution was between 30 and 50 years of age (59.7%), and the ratio between males and females was 5:1. The most common cause of injury was falling from a height (51.4%). 2. In overall patients, neurologic damage was found at first examination in 69.4%, and among these, complete paralysis below the injured level In 41.7%, incomplete paralysis in 25%, and nerve root injury in 2.7%. 3. The mechanisms of injury included flexion-rotation (50%), extension-distraction (18%), flexion-compression (12.5%), pure flexion (5.5%), axial compression (5.5%), and unclassified (8.3%). 4. Among 72 patients, emergency decompressive laminectomy was performed on 10 patients, anterior interbody fusion on 15 patients, posterior fusion with wiring on 3 patients and the rest of patients were treated conservatively. 5. There was no significant difference in the recovery of neurologic loss between conservatively and surgically treated patients, but it was thought better to stabilize the unstable fracture-dislocations surgically for early mobilization and rehabllitatlon.
Accidental Falls ; Age Distribution ; Anti-Bacterial Agents ; Clinical Study ; Early Ambulation ; Emergencies ; Female ; Humans ; Laminectomy ; Male ; Nursing Care ; Paralysis ; Rehabilitation ; Spinal Fusion ; Spine

"Capsaicin, the pungent principle of hot peppers, is a neurotoxin that depletes primary sensory neurons of neuropeptides like tachykinin. The objectives of these experiment was to examine the effects of capsaicin on Salmonel/a typhimurium-induced production of cytokines such as TNF-a, IL-1B, IL-6, IL-10 and IL-12 and on production of nitric oxide in peritoneal macrophages. In addition, the effects of capsaicin on survival rates of S. typhimurium-infected mice and on nuclear transcription factor (NF-kB) activation were also investigated. Mice were pretreated with a single s.c. injection of 100 ug of capsaicin and were infected i.v. with S. typhimurium (5xO5/mouse) in 0.2 ml volume after capsaicin pretreatment. The serum cytokine levels were measured 30, 60, 120, 180 and 240 min after Salmonella infection, using ELISA kits. The activation of NF-B was also examined by gel shift assay in spleens, thymuses and brains of mice that had been pretreated with a single s.c. injection of 100 ug of capsaicin. It was found that Sa/mone/la infection induced the production of TNF-a, IL-1B, IL-6, IL-10 and IL-12, but capsaicin pretreatment inhibited the production of TNF-a, IL-1B, IL-10 and IL-12, but enhanced IL-6 production 120 min after Salmonella infection. Interestingly, the capsaicin pretreatment inhibited the activation of NF-kB in spleens and thymuses. There were no differences in the numbers of bacteria in livers, brains, spleens, kidneys and lungs between capsaicin- pretreated mice and the control animals in applied experimental conditions. Suprisingly, however, capsaicin pretreatment increased both the survival rates of Sa/mone//a-infected mice and production of nitric oxide by peritoneal macrophages compared with capsaicin-untreated control mice. Taken together, these results indicate that the capsaicin-sensitive primary sensory neurons may play an important modulatory role in the production of cytokine, nitric oxide and NF-B activation and the pathogenesis of salmonellosis."
Animals ; Bacteria ; Brain ; Capsaicin* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Interleukin-10 ; Interleukin-12 ; Interleukin-6 ; Kidney ; Liver ; Lung ; Macrophages, Peritoneal ; Mice ; Neuropeptides ; NF-kappa B* ; Nitric Oxide* ; Salmonella Infections* ; Salmonella typhimurium ; Salmonella* ; Sensory Receptor Cells ; Spleen ; Survival Rate ; Tachykinins ; Thymus Gland ; Transcription Factors

A possible therapeutic effect of acetyl-L carnitine (ALCAR) on peripheral nerve injuries and the expression of Jun, the protein products of immediate-early genes(IEGs), in the spinal cord were investigated after sciatic nerve injury in Sprague-Dawley rats. Experimental animals were divided into 3 groups: intact sciatic nerve as a control group, surgical repair alone, and surgical repair with ALCAR treatment. Toe-spreading response, pinprick response, and compound action potential were measured to evaluate the recovery of sciatic nerve injury. Recovery of behavioral function and electrophysiological function both improved in the surgical repair with ALCAR treatment group. Weak basal expression of Jun was shown in the ventral horn the of spinal cord in the control group. In the surgical repair alone group or the surgical repair with ALCAR treatment group, Jun expression persisted until 28 days after injury in the ventral horn of the spinal cord. Moreover, the surgical repair with ALCAR treatment group showed more increased expression of Jun than the surgical repair alone group. These results suggest that ALCAR facilitates the functional recovery after peripheral nerve injury.
Acetylcarnitine ; Action Potentials ; Animals ; Carnitine* ; Horns ; Peripheral Nerve Injuries ; Rats* ; Rats, Sprague-Dawley ; Sciatic Nerve* ; Spinal Cord

In the case of a soft tissue defect which requires thin & pliable tissues, the choice of donor site is limited due to flap bulkiness and donor site morbidity. To overcome these problems, a variety of perforator-based flaps such as paraspinous and parasacral perforator flap, deep inferior epigastric perforator flap, gluteal perforator flap, and thoracodorsal artery perforator flap have recently been introduced. We experienced 8 cases of soft tissue defects from December 1996 to March 1999 using the thoracodorsal artery perforator flap for reconstruction. We could elevate the cutaneous flap with preservation of the latissimus dorsi muscle flap only when it was based on one cutaneous perforator. Defatting procedure was possible for further thinning of skin flap. In one case, axillary defect after release of postburn scar contracture was repaired with island perforator flap and the other seven cases were repaired with free flap. The results were satisfactory. We believe the thoracodorsal artery perforator flap is useful for reconstruction of soft tissue defects which are large or under conditions requiring thin flap.
Arteries* ; Cicatrix ; Contracture ; Free Tissue Flaps ; Humans ; Perforator Flap ; Skin* ; Superficial Back Muscles ; Tissue Donors

Spondylolisthesis is the slippage of all or part of one vertebra onto another. The term is derived from the Greek words spondylos and olisthesis. Wiltse, Macnab, and Newman combined their concepts in what remains the most widely accepted classification. Wiltse and Rothman in 1989 suggested a common congenital component in the etiology of dysplastic and isthmic types and added the postsurgical group to the original classification. The precise anatomy of the pars lesion is extremely important in understanding the pathogenesis. The pars interarticularis is the connecting link between pedicles, transverse processes, laminae, and the two articular facets acting as the pivot center. The L5-S1 articulation, being in the coronal plane, is more stable than the sagittal placement of the L4-5 facet joint. The fifth lumbar vertebra is stabilized by a large L5 transverse process, which supports strong muscular and ligamentous(iliolumbar) attachment. An increased lumbar lordosis increases the shear stress at the L4-5 level. Both congenital and isthmic types are often associated with spina bifida of the L5 or S1 segments. There seems to be a definite sex and racial difference, with black women (1.1%) having the lowest prevalence and white men(6.4%) the highest. The increased prevalence is in Alaskan natives and young sportsmen, ranging from 11% to 35%. Repetitive flexion, combined flexion-extension and both forcible hyperextension and rotation of the lumbar spine predispose to a pars stress fracture. Most of isthmic type develops during the first year of school, and by age 7 the prevalence is 4%. A further 1.4% of cases occur during adolescence, most between 11 and 15 years of age. In patients under 25 years of age with low back pain and isthmic spondylolisthesis, this lesion is most probably the cause of the symptoms(18.9%). In patients older than 40 years, it is seldom the only cause of low back pain (5.2%). The radicular pain is found in 14% of patients with isthmic spondylolisthesis. Degenerative spondylolisthesis results from long standing intersegmental instability. 10% of women over 60 years had a 1st or 2nd degree. It occurs 6 times more often at the L4-5 level and 5 times more often in women, mostly in those older than 40 years. The patient may have back pain (5.6%) with or without leg pain and/or may have intermittent claudication (80%). In traumatic spondylolisthesis, acute fractures of the pars interarticularis are rare and are always due to fracture of the other part of the posterior elements caused by severe trauma. In pathological spondylolisthesis, the bony strength is insuffient to resist forward motion of the proximal vertebra on the one below. In postsurgical spondylolisthesis, the most common etiology is extensive decompression with sacrifice of the facet joints.
Adolescent ; Animals ; Back Pain ; Classification* ; Decompression ; Female ; Fractures, Stress ; Humans ; Intermittent Claudication ; Leg ; Lordosis ; Low Back Pain ; Natural History* ; Population Groups ; Prevalence ; Spinal Dysraphism ; Spine ; Spondylolisthesis* ; Zygapophyseal Joint

IgE-mediated sensitization to natural rubber latex can induce immediate hypersensitivity reactions ranging from contact urticaria to life threatening anaphylaxis. Recent reports suggest that asthma is also relatively frequent manifestation of latex allergy. In this case report, lat,ex induced asthma is described in an operat.ing room nurse regularly exposed t,o latex gloves. Her latex sensitivity was detected by skin prick testing. Specific bronchial provocation test with latex extract showed an early asthmatic reaction. Her symptoms had been much improved after avoidance. Occupational asthma induced by latex may be not uncommon among health care workers.
Anaphylaxis ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Delivery of Health Care ; Humans ; Hypersensitivity, Immediate ; Latex ; Latex Hypersensitivity ; Personnel, Hospital* ; Rubber ; Skin ; Urticaria

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus or superior orbital fissure has been termed Tolosa-Hunt syndrome. We have experienced a case of Tolosa-Hunt syndrome in an 11 year old boy who has diagnosed with several clinical signs and symptoms such as severe ocular pain, headache, ptosis, proptosis, slight limitation of eyeball motion, nausea and vomiting, and the brain and orbital C-T scan which shows the right ethmoid and sphenoid sinusitis and inflammatory thickening of dura an the planum spenoidale.
Brain ; Cavernous Sinus ; Child ; Exophthalmos ; Headache ; Humans ; Inflammation ; Male ; Nausea ; Ophthalmoplegia ; Orbit ; Sphenoid Sinus ; Sphenoid Sinusitis ; Temazepam ; Tolosa-Hunt Syndrome* ; Vomiting

Human seminal plasrna (HSP) is mixture of secretion derived from various glands associated with male reproductive tract which comprises approximately 80-90% of the volume of normal ejaculate. The present study was undertaken in an effort to explore the effect of HSP pretreatment on the production of IL-1B, TNF-a and IL-12, in mice, and to investigate if HSP may cause to induce active systemic anaphylaxis (ASA) in mice. In addition, effects of HSP pretreatment on contact hypersensitivity to trinitrochlorobenzene (TNCB), antibody response to polyvinylpyrroridone (PVP), a thymus-independent antigen and on ASA induced by egg albumin (OVA) were also studied in this study. For the experiments of contact hypersensitivity, antibody response and cytokine production, mice were pretreated i.p. daily with 0.3ml of HSP or sterile saline alone (control) for 3 consecutive days before antigen sensitization or lipopolysaccharide injection for the cytokine induction. For the experiments of OVA- induced anaphylaxis, mice were pretreated by a single s.c. injection of HSP 0.3ml per mouse before sensitization. For induction of ASA in mice by HSP, a group of mice were sensitized i.p. 2 consecutive days with 0.3ml of HSP and one day with 0.3 ml of HSP plus 2x10(9) B. pertussis and 1.0 mg of alum (schedule A) or another group of mice were sensitized i.p. with a single i.p. injection of 0.3 ml of HSP with 2x10' B. pertussis and 1.0 mg of alum (schedule B). All sensitized and unsensitized control mice were challenged i.v. with 0.2ml of HSP 14 days after HSP sensitization, and mortality were observed. It was found that HSP pretreatment inhibited the production of IL-lB, TNF-a and IL-12, and also inhibited OVA-induced ASA, contact hypersensitivity to TNCB and anti-PVP antibody production. Interestingly, ASA was induced by HSP irrespective of the applied sensitization schedule. Taken together, this study may provide the direct evidences that HSP may inhibit the production of IL-1B, TNF-a and IL-12 and this may be the first to show the induction of ASA by HSP in mice.
Anaphylaxis* ; Animals ; Antibody Formation ; Appointments and Schedules ; Dermatitis, Contact ; Humans* ; Interleukin-12 ; Male ; Mice* ; Mortality ; Ovum ; Picryl Chloride ; Semen* ; Whooping Cough

Capsaicin, the pungent principle of hot peppers, is a neurotoxin that depletes unmyelinated primary sensory neurons (polymodal nociceptors) of neuropeptides like tachykinins. However, the role of capsaicin-sensitive sensory nerve in the production of cytokines, penicillin V (PEV)-induced active fatal anaphylaxis and other immune responses is not yet fully established. Neonatal mice were pretreated s.c. with a single injection of 10 ug of capsaicin per mouse in volume of 20 ul within 5 days of age. Using 5-8 week old mice pretreated as neonates with capsaicin, the capsaicin- pretreated and vehicle-treated control mice were examined for various parameters of immune responses described above. For the induction of active fatal anaphylaxis with PEV, 8 week old mice pretreated as neonates and age-matched capsaicin- untreated control mice were sensitized i.p. with 500 ug of PEV-ovalbumin conjugate plus 2*10(9) B. pertussis and 1.0 mg alum and challenged i.v. with PEV-bovine serum albumin conjugate 14 days later. It was found that neonatal capsaicin-pretreatment significantly enhanced contact hypersensitivity to TNCB and hemagglutination response to SRBC, but significantly inhibited the proliferation response of rnurine splenocyte to Con A and LPS. Interestingly, neonatal capsaicin pretreatment significantly inhibited the intensity of PEV-induced active fatal anaphylaxis and decreased the mortality due to anaphylactic shock. It also significantly inhibited LPS- induced production of cytokines such as TNF-a, IL-1B, IL-6, IL-10, and IL-12. The capsaicin-pretreatment also resulted in an inhibition of the activation of NF-kB. Taken together, these data showed for the first time that neonatal capsaicin-pretreatment significantly inhibited an antibiotic (PEV)-induced anaphylaxis and production of various cytokines, and suggest that capsaicin-sensitive primary sensory nerve may play an important regulatory role in active fatal anaphylaxis and cytokine production, thus potentially presenting tools for immune intervention. In particular, the data presented also indicated the possibility to selectively down-modulate cytokine production and NF-kB activation may offer a broad application for therapeutic intervention in neuroimmunological diseases and other pathological situations.
Anaphylaxis ; Animals ; Capsaicin* ; Cytokines ; Denervation* ; Dermatitis, Contact ; Hemagglutination ; Humans ; Infant, Newborn ; Interleukin-10 ; Interleukin-12 ; Interleukin-6 ; Mice ; Mortality ; Neuropeptides ; NF-kappa B ; Penicillin V ; Sensory Receptor Cells ; Serum Albumin ; Tachykinins ; Whooping Cough