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

Pseudoxanthoma elasticum (PXE) is an uncommon heritable disorder of elastin characterized by cutaneous, ocular and vascular abnormalities. Typical skin lesion shows yellowish papules and redundant skin folds on the neck, axilla and groin due to degeneration and calcification of elastic fibers in deep dermis. As in all heritable disorders of connective tissue, no curative therapy is presently know. Redundant and unsightly skin folds about the neck can be improved by surgery, but irregular papular lesion on skin does not improved by surgery. A-44-year-old female who had a skin lesion and angioid streak was treated as follows: Skin folds on the neck were excised successfully without any significant problem such as intraoperative bleeding, wound dehiscence or hypertrophic scar formation. To evaluate whether we could smooth the irregular skin surface due to multiple papules, laserbrasion with a SLT contack Nd:YAG laser system was performed experimentally on a limited area which was located on the right supracla-vicular area about 2 x 3cm in size. An acceptable aesthetic appearance was achieved with surgical excision 12 months after the operation. Biopsy of the laserbrasion site revealed disappearance of the calcium deposit. This study emphasizes the possibility of using laserbrasion in solving troblesome skin lesion of the PXE.
Angioid Streaks ; Axilla ; Biopsy ; Calcium ; Cicatrix, Hypertrophic ; Connective Tissue ; Dermis ; Elastic Tissue ; Elastin ; Female ; Groin ; Hemorrhage ; Humans ; Neck* ; Pseudoxanthoma Elasticum ; Skin ; Wounds and Injuries

OBJECTIVES: Percutaneous vertebroplasty has recently been introduced as an interesting therapeutic alternative for the treatment of thoracolumbar vertebral body fractures in elderly persons with osteoporosis. The authors present the early results of this method. METHOD AND MATERIAL: From July 1999 to April 2000, percutaneous transpedicular technique was used in 20 patients (2 men and 18 women) whose mean age was 67.5 years old(range 59-79) with painful vertebral compression(22) and burst(2) fractures. The interval between fracture and vertebroplasty ranged 1 day to 4 months. The procedure involved percutaneous puncture of the injured vertebra via transpedicular approach under fluoroscopic guidance, followed by injection of polymethylmetacrylate(PMMA) into the vertebral body through a disposable 11-guage Jamshidi needle. RESULT: The most common cause of fracture was slip down and the most frequent injured level was the twelfth thoracic spine. The procedure was technically successful bilaterally in 18 patients(9 thoracic and 15 lumbar spines) with an average injection amount of 7.7ml PMMA in each level. Seventeen(94.4%) patients reported significant pain relief immediately after treatment. Two leaks of PMMA were detected with postoperative CT in spinal epidural space and extravertebral soft tissue without clinical symptoms. CONCLUSION: Although this study represents the early results, percutaneous vertebroplasty seems to be valuable tool in the treatment of painful osteoporotic vertebral body fractures in elderly, providing acute pain relief and early mobilization.
Acute Pain ; Aged ; Early Ambulation ; Epidural Space ; Fractures, Compression ; Humans ; Male ; Needles ; Osteoporosis ; Polymethyl Methacrylate ; Punctures ; Spine ; Vertebroplasty*

The tracheostomy is increasingly being performed. In most cases, the tracheostomy sites are left to heal by secondary intention, so it leaves a depressed and wide scar that is cosmetically disfigured. Another problem os that the scar is also attached directly to the trachea itself and will move vertically with the trachea during the act of swallowing. Even though the tracheostomy scar is cosmetically acceptable, the mobility and retraction of the scar is a continual nuisance to the patient. We performed a retrospective study on 9 patients who had undergone revision of the depressed thracheostomy scar by the Renner Method from June, 1997 to February, 1999. The method includes transverse fusiform incision of the original scar and excision of the depressed portion of the scar to the level of the trachea itself. To prevent attachment of the skin and trachea, a bilateral subcutaneous flap and muscle flap were simply advanced to the midline and overlapped. Then the rest of scar that was not depressed was deepithelized and flipped to augment the soft tissue volume in the central depressed area. Satisfactory results were achieved in all patients without hematoma, infection, hypertrophic scar, and keloid formation. We believe this simple Renner method is one of the best ways of performing posttracheostomy scar revision.
Cicatrix* ; Cicatrix, Hypertrophic ; Deglutition ; Hematoma ; Humans ; Intention ; Keloid ; Retrospective Studies ; Skin ; Trachea ; Tracheostomy

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

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

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

BACKGROUND: A lots of fires were happened every years. And then, the many peoples have died because of foe. It is important to plane for initial field emergency management that the major cause of death and injury type is analysed by large scaled fire. METHOD: We have analysed the fire victims by large scaled fire from Jan. 1995 to Dec. 1995 in Korea. We analysed systemic factors, environmental factors, patient factors which was acquired from medical records and interviews with victims, victim's famaly, rescuer. RESULT: The total number of victims are 130 and the mortality rate is 61.5% (80 patients). The major injury and cause of death were inhalation injury and trauma. The injury type of fire victims are 19 cases of inhalation injury, 13 cases of laceration,5 cases of burn,5 cases of contusion,4 cases of blephaloconjunctivitis. In fire deaths, the 78 victims (97.5%) were death associated with the gas inhalation, and the only 2 fire deaths were due to trauma. This result of the cause of death was higher inhalation injury than previously reported literature because most fires of our study was happened at the closed-maze area. CONCLUSION: When the fee was happened at closed-maze area, many victims foiled to escape the space because of smoke, toxic inhalants from combustible interior decoration, and then were death.
Cause of Death ; Emergencies* ; Emergency Treatment* ; Fees and Charges ; Fires* ; Humans ; Inhalation ; Korea ; Medical Records ; Mortality ; Smoke ; United Nations