STUDY DESIGN: The authors analysed the recovery of clinical symptoms after percutaneous drainage and irrigation in pyogenic vertebral osteomyelitis. OBJECTIVES: To determine the role of percutaneous drainage and irrigation in pyogenic vertebral osteomyelitis. SUMMARY OF LITERATURE REVIEW: Pyogenic vertebral osteomyelitis is a relatively rare condition but its incidence is recently increasing due to common use of intravenous access devices and resultant nosocomial bacteremia. Management of the disease is not uniform and is controversial regarding the role of surgery and duration of use of antibiotics. At present, the role of percutaneous drainage of involved spines in treatment of pyogenic vertebral osteomyelitis is not well-known. MATERIALS AND METHODS: We report 3 cases of pyogenic vertebral osteomyelitis which were treated by continuous drainage with automated percutaneous lumbar discectomy device(APLD device) and draining tube after they haute failed to conservative treatment. APLD device, fluoroscopic guide, contrast media and continuous percutaneous draining tubes were used for this procedure. The percutaneous draining tubes were maintained for 7 to 11 days and each case was followed up for 6 to 10 weeks under admission. RESULTS: Symptoms were relieved 3 to 5 weeks after this procedure. The patients were followed up to 12 to 39 months and experienced no recurrence. CONCLUSIONS: Percutaneous drainage and irrigation with APLD device brought prompt and marked clinical recovery. It is indicated as a supplementary method to conservative treatment or in case of high operative risk patient due to poor general conditions. It has minimal invasiveness, short clinical course and low recurrence rate.
Anti-Bacterial Agents ; Bacteremia ; Contrast Media ; Diskectomy ; Drainage* ; Humans ; Incidence ; Osteomyelitis* ; Recurrence ; Spine

BACKGROUND: The action of the volatile anesthetics on various organs in the body is not well known. Since Furchgott (1980) discovered endothelium derived relaxing factor (EDRF) from endothelium, many studies have been tried. Many investigators were studied about the relationship between the EDRF and the effect of the volatile anesthetics on blood vessels too. But the effect of volatile anesthetics and the site of action on the blood vessel were still controversial. In this study, we evaluated that the effect and the action site of halothane and isoflurane on isolated aortic rings of the rabbit. METHODS: Each of obtained thoracic aorta from rabbits (1.5~2.5 Kg) was divided into 3~5 mm sized rings, and a half of that were denuded. All of the aortic rings were preconstricted with phenylephrine 1.5 10-7 Mole in warm organ bath filled with modified Krebs' solution, and then LNAME (inhibitor of nitric oxide synthase, 3 10-4Mole) was administered to one group of aortic rings. MB (inhibitor of soluble guanylate cyclase, 2 10-5Mole) was administered to another one group and neither of LNAME nor MB was administered to the other group. And then isoflurane or halothane was administered (1~4%) to all of aortic rings. The polygraph recorded the changes of tension of aortic ring which was transmitted through the force transducer. RESULTS: It was proved that basal EDRF was released from endothelium by the fact that intact aortic rings were more constricted after LNAME or MB administration. The intact aortic rings were constricted in all concentration of isoflurane and both intact and denuded rings were relaxed in 4% concentration of halothane. CONCLUSION: It is concluded that isoflurane in all concentrations has an endothelium -mediated vasoconstriction and 4% halothane produced vascular relaxation directly independent of existence of the endothelium of vessel.
Anesthetics ; Aorta, Thoracic ; Arginine* ; Baths ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Guanylate Cyclase ; Halothane* ; Humans ; Isoflurane* ; Methylene Blue ; Nitric Oxide Synthase ; Phenylephrine ; Rabbits ; Relaxation ; Research Personnel ; Transducers ; Vasoconstriction

No abstract available.
Humans ; Lymphocytes* ; Radiotherapy*

No abstract available.
Animals ; Hindlimb Suspension* ; Hindlimb*

BACKGROUND: Desflurane is a new inhaled anesthetic with the lowest blood/gas partition coefficient and enflurane is one of the major anesthetics in these days. But the effect of volatile anesthetics and the site of action on the blood vessel are still controversial. Since Furchgott (1980) discovered endothelium derived relaxing factor (EDRF) from endothelium, many investigators have studied about the relationship between the EDRF and the effect of the volatile anesthetics on blood vessels. In this study, we evaluated that the effect and the action site of enflurane and desflurane on isolated aortic rings of the rabbit. METHODS: Each of obtained thoracic aorta from rabbits (1.5~2.5 kg) was divided into 4~6 mm rings, and a half of that were denuded. All of the aortic rings were preconstricted with phenylephrine 1.5 10-7 Mole in warm organ bath filled with modified Krebs' solution, and then LNAME (inhibitor of nitric oxide synthase, 3 10-4Mole) was administered to one group of aortic rings. MB (inhibitor of soluble guanylyl cyclase, 2 10-5Mole) was administered to another one group and neither of LNAME nor MB was administered to the other group. And then enflurane (1%, 2%, 3%, 4%) or desflurane (6%, 9%, 12%) was administered to all of aortic rings. The polygraph recorded the changes of tension of aortic ring which was transmitted through the force transducer. RESULTS: It was proved that basal EDRF was released from endothelium by the fact that intact aortic rings were more constricted after LNAME or MB administration. The intact aortic rings were constricted in all concentration of enflurane and both intact and denuded rings were maintained from control tension in all concentrations of desflurane. CONCLUSION: It is concluded that enflurane in all concentrations has an endothelium-mediated vasoconstriction effect and desflurane in all concentrations has no effect on isolated aortic rings of rabbit.
Anesthetics ; Aorta, Thoracic ; Arginine* ; Baths ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Enflurane* ; Guanylate Cyclase ; Humans ; Nitric Oxide Synthase ; Phenylephrine ; Rabbits ; Research Personnel ; Transducers ; Vasoconstriction

Ischemic stroke is a serious neurological complication of infective endocarditis. Intravenous tissue plasminogen activator (t-PA), which has only been approved for treatment of hyperacute stroke, has been excluded as an ischemic stroke treatment due to infective endocarditis according to current expert consensus guidelines. Here, we describe a case of a hyperacute stroke patient treated with intravenous t-PA, who was later diagnosed with infective endocarditis.

Five cases of intracranial lipoma diagnosed by MR are presented. MR imaging was performed on a 0.2T permanent unit using T1 weighted, proton density-weighted, and T2 weighted spin echo sequences. In two patients, gadolinium-enhanced T1 weighted image was also obtained. The lipomas were located dorsolaterally to the splenium of the corpus callosum (n=1), inferior to the splenium (n=2), in quadrigeminal plate(n=1) and in the presumed corpus callosum area in the case of agenesis of corpus call?um (n=1). The size and shape of the lipomas were variable. No contrast enhancement was seen in post contrast study. Sagittal T1 weighted image appeared to be the most useful imaging plane for the demonstration of the relationship between the lipoma ad the adjacent normal structures. The Homogenous signal intensity paralleling the fat signal and the characteristic location of the lesion are considered to be helpful in the differential diagnosis from dermoid cyst or teratoma.
Corpus Callosum ; Dermoid Cyst ; Diagnosis, Differential ; Humans ; Lipoma* ; Magnetic Resonance Imaging* ; Protons ; Teratoma

Five cases of intracranial lipoma diagnosed by MR are presented. MR imaging was performed on a 0.2T permanent unit using T1 weighted, proton density-weighted, and T2 weighted spin echo sequences. In two patients, gadolinium-enhanced T1 weighted image was also obtained. The lipomas were located dorsolaterally to the splenium of the corpus callosum (n=1), inferior to the splenium (n=2), in quadrigeminal plate(n=1) and in the presumed corpus callosum area in the case of agenesis of corpus call?um (n=1). The size and shape of the lipomas were variable. No contrast enhancement was seen in post contrast study. Sagittal T1 weighted image appeared to be the most useful imaging plane for the demonstration of the relationship between the lipoma ad the adjacent normal structures. The Homogenous signal intensity paralleling the fat signal and the characteristic location of the lesion are considered to be helpful in the differential diagnosis from dermoid cyst or teratoma.
Corpus Callosum ; Dermoid Cyst ; Diagnosis, Differential ; Humans ; Lipoma* ; Magnetic Resonance Imaging* ; Protons ; Teratoma

No abstract available.
Anencephaly* ; Autopsy*

OBJECTIVE: The purpose of this study was to compare the plasma amitriptyline and nortriptyline level between before and after fluoxetine addition with patients who were currently taking amitriptyline. METHOD: From the inpatient and outpatient unit of Soon Chun Hyang University Hospital, Chunan, fourteen subjects who were taking amitriptyline 25mg more than 1 week at least were given fluoxetine 20mg. Before and 2 weeks after fluoxetine addition the plasma level of amitriptyline and nortriptyline are analyzed simultaneously by High Performance Liquid Chromatography(HPLC) At the same times, HAM-D(Hamilton Rating Scale for Depression) score and the UKU(Uldvalg for Klinske Unders phi gelser) side effect scale were checked. RESULTS: After fluoxetine addition to the patients who were taking amitriptyline, the plasma level of amitriptyline, nortriptyline and sum of amitriptyline and nortriptyline had risen. The mean plasma amitriptyline level increased from 168.9+/-89.4ng/ml to 183.0+/-102.0ng/ml after fluoxetine addition(p=0.011) but the change was not statistically significant. The mean plasma nortriptyline level increased significantly from 114.3+/-70.2ng/ml to 168.0+/-86.2ng/ml after fluoxetine addition(p=0.011) In addition, the mean plasma level of total amitriptyline and nortriptyline increased significantly from 283.1+/-125.3ng/ml to 350.9+/-78.4ng/ml after fluoxetine addition(p=0.016) After fluoxetine addition, no significant change was noted in the UKU side effect scale score. CONCLUSION: As consequence of comparson of plasma amitriptyline and nortriptyline level before and after fluoxetine addition mean amitriptyline, nortriptyline and total plasma level was increased after fluoxetine addition. This suggests that coadministration of amitriptyline and fluoxetine may induce improvement of depressive symptom in depressive patients by way of increased plasma level of amitriptyline.
Amitriptyline* ; Chungcheongnam-do ; Depression ; Fluoxetine* ; Humans ; Inpatients ; Nortriptyline ; Outpatients ; Plasma*