Dieulafoy's vascular malformation is a rare cause of massive gastrointestinal bleeding. Most often it occurs in stomach within 6 cm from the gastroesophageal junction. Only a few cases have been reported to occur in the small intestine and colon. Occasionally, Dieulafoy's lesion of small intestine is difficult to recognize because of rarity, a paucity of symptoms and negative findings on barium studies. Therefore, this lesion needs to be considered in a patient with massive lower gastrointestinal bleeding. We report a case of Dieulafoy's vascular malformation in ileum 2 m proximal to ileocecal value in a 41-year-old woman who visited emergency clinic because of hematemesis, dizziness and vomiting. Small intestine revealed a wide-caliber artery within the submucosa showing intimal thickening, medial muscular hypertrophy and thrombosis.
Adult ; Arteries ; Barium ; Colon ; Dizziness ; Emergencies ; Esophagogastric Junction ; Female ; Hematemesis ; Hemorrhage* ; Humans ; Hypertrophy ; Ileum* ; Intestine, Small ; Stomach ; Thrombosis ; Vascular Malformations* ; Vomiting

A through understanding of the biomechanics of the cervical spine is necessary to apply its knowledge to management of cervical disorders intelligently. In this article authors tried to fully review the biomechnics of cervical spine by, first, going over the basic anatomical and physiological characteristics of the cervical spine. Then, with these in mind, related kinemtics are reviewed with discussion of some of important clinical applications related to these facts. Finally, diagnostic points of cervical instability are stressed which can be used some of the guidelines in management of such patients in actual clinical situations.
Biomechanical Phenomena ; Humans ; Spine*

BACKGROUNDS: Percutaneous radiofrequency neurotomy of posterior primary ramus has been in use as a treatment for persistent, mechanical low back pain for two decades. However, there has been limited studies regarding to prognostic factors related to outcome. We report our experience with at least 2-year follow up with special aftention on prognostic factors. METHODS: Of total 228 patients who underwent percutaneous radiofrequency neurotomy (PRN) of posterior primary ramus for refractory low back pain during last 3 years, 128 patients whose pain was considered to be originated from facets joints or their surrounding soft tissue and responded to temporary blocks were assigned to a group II. All patients had more than 6 months of pain. These patients were compared with 100 patients to whom PRN were provided for chronic nonspecific low back pain without all inclusion criteria (Group I). RF procedures were done under local anesthesia with C-arm intensifier guidance. Pain reliefs were estimated at 1week, 1month, 6months and 2 years using visual analog scale(VAS). For patients with more that 50% reduction of previous pain was regarded as positive responder. Various clinical variables such as age, sex, symptom duration, types of pain, bilaterality, and previous surgery were studied for prognostic factors. RESULTS: Positive responders were 56% at 1week, 46% at lmonth, 18% at 6months, and 13% at 2years after PRN in group I, and 78.9% at lweek, 75.4% at lmonth, 62.5% at 6months, and 54.7% at 2years in group II. Some variables were found to be significantly related to outcome including prominent local tenderness, percussion tenderness, combination of symptoms with pain on gefting up, extension, transitional movement, pain radiating to buttock and/or posterior thigh, and good immediate response. Age, sex, symptom duration, bilaterality, imaging study results, previous lumbar surgery, and degrees of pain relief from diagnostic block were not related to outcome. CONCLUSIONS: These results indicate that PRN of posterior primary ramus has a moderate overall long-term beneficial effect, with no morbidity in our series. But, the long-term good results will be anticipated only in properly selected patients with low back pain originating from facet joints and surrounding structures.
Anesthesia, Local ; Buttocks ; Follow-Up Studies ; Humans ; Joints ; Low Back Pain* ; Percussion ; Thigh ; Zygapophyseal Joint

The computed tomographic findings in 5 patients with the central neurofibromatosis were reviewed. Atypical choroid plexus calcification was evident in 3 of 5 patients in the anterior half of lateral ventricle, foramen of Monro and third ventricle. The cause of this abnormal calcification is unknown yet, but it may have the diagnostic significance for central neurofibromatosis.
Cerebral Ventricles ; Choroid Plexus* ; Choroid* ; Humans ; Lateral Ventricles ; Neurofibromatosis 2* ; Third Ventricle

Authors performed film mammography in 2167 patients with breast complaints who had visited to Yong DongSeverance hospital, Yonsei University from October 1, 1983 to September 30, 1985. Authors analysed 62 cases offilm mammographic findings and 35 cases of ultra mammographic findings among confirmed 62 fibroadenomas and alsoauthors analysed histopathologic cell type and ultra mammographic findings of confirmed fibroadenomas. The resultsfollowed: 1. The most prevalent age group was 3rd and 4th decade(74%). 2. The common dense breast pattern by Wolfeclassification were P2 and DY patterns(80%) in film mammograhy. 3. The most common size of fibroadenomas was1.1-3.0cm (71%) in long diameter. 4. Film mammographic findings of fibroadenoma generally showed single mass in 54lesions(87%), well defined margin of mass in 45 lesions (58%) and halo sign in 62 lesions(80%). Well definedmargin of mass is prominant in ductal cell dominant fibroadenoma(71%) , however lobulation of margin is commonlyseen instromal component dominant fibroadenoma(15%) and spiculated margins of mass can be seen in mixedfibroadenoma(6%) and stromal component dominant fibroadenoma(3%). Halo sing of fibroadenoma was commonly seen inductal cell dominant fibroadenoma(86%) and stomal component dominant fibroadenoma(85%). 5. Ultra mammographicfindings of fibroadenoma showed oval shaped mass in 26 lesions(15%) with smooth margin of mass in 43 lesions(84%)and showed mostly intermediate internal echo in 48 lesions(94%). Relationship between histopathologic cell typeand ultra mammographic findings were. Round shaped mass(67%), lateral shadowing (74%) was common in mixed type offibroadenoma, lobulated margin of mass(45%), intermediate(94%) with unifrorm(78%) internal echo was common instromal dominant type of fibroadenoma and smooth contour (100%), uniform internal echo fo mass(83%) was common inductal cell dominant type of fibroadenoma. Most ultra mammographic L/T Iratio of fibroadenoma was 0.5-1.0 in 37lesions(73%) 6. The diagnostic accuracy of film mammogahy in fibroadenoma was 92%, however combined imagingmodalities raised the diagnostic accuracy into 95%.
Breast ; Clothing ; Fibroadenoma ; Humans ; Mammography ; Shadowing (Histology)

A new technical method using bone plugs with oblique posterior interbody fusion(OPIF) was designed to increase the fusion rate. One hundred-seventy-five patients were operated for lumbar instability between November 1990 and December 2000. The L5/S1 segment was affected in 129 cases(74%) of the patients. Oblique posteior interbody fusion with bone plugs by unilateral approach was performed in all patients. Eight-nine percent of these patients showed good surgical results. This stable transplant interbody fusion has the several advantages. Foreign substance is not used and this method increases fusion rate and cost-effective. OPIF using bone plugs along with Oh's screw could provide sufficient stability for segmental instability of the lumbar spine including spondylolisthesis of the lumbar spine, with or without concurrent herniated intervertebral disc or spondylotic narrowing.
Humans ; Intervertebral Disc ; Spine ; Spondylolisthesis

No abstract available.
6-Cyano-7-nitroquinoxaline-2,3-dione* ; Cycloheximide* ; Dizocilpine Maleate*

A case of basilar impression surgically treated in a female patient aged 22 years is presented. A myriad of abnormal neurologic findings were present that were secondary to compression of neural tissue by anormalous bony structure at craniovertebral junction. Metrizamide computerized tomography with coronal and sagittal reconstruction identified bony abnomalities and displacement of the surrounding neural structures. The surgical intervention for the treatment of the basilar impression consisted of ventral decompression by transoral odontoidectomy and of dorsal decompression by an enlargement of foramen magnum and by laminectomy of C1, followed by occipito-atlanto-axial bony fusion.
Decompression ; Female ; Foramen Magnum ; Humans ; Laminectomy ; Metrizamide ; Neurologic Manifestations ; Platybasia*

BACKGROUND AND OBJECTIVES: The aim of this study was to determine the effect of ethanol on the regulation of vascular tone. MATERIAL AND METHODS: Using rat aorta ring, isometric contraction and 45Ca uptake were measured. Phorbol 12,13-dibutyrate (PDBu), phenylephrine, KCl were used for the regulation of smooth muscle tone. RESULTS: Ethanol induced transient contraction in rat aorta ring by dose-dependent manner. Ethanol suppressed the dose dependent contractile responses of vascular strip by phenylephrine, KCl and PDBu. Endothelium-dependent relaxation by acetylcholine was inhibited by ethanol. Ethanol depressed 45Ca uptake by high KCl but not by phenylephrine or PDBu in rat aorta. n-butanol selectively suppressed tonic contraction by high KCl, but t-butanol did not at the same concentration of butanol in rat aorta. PDBu-induced contraction was selectively suppressed by n-butanol but not by t-butanol. CONCLUSIONS: These findings suggest that the action of ethanol on phospholipase D is involved in the decreased response of rat aorta strip by vasoconstrictors.
1-Butanol ; Acetylcholine ; Animals ; Aorta* ; Ethanol* ; Isometric Contraction ; Muscle, Smooth* ; Phenylephrine ; Phorbol 12,13-Dibutyrate ; Phospholipase D ; Protein Kinase C ; Rats* ; Relaxation ; tert-Butyl Alcohol ; Vasoconstrictor Agents

Impact injuries to the surgically exposed dura overlying the lumbar cord at L2 were produced in cats. Cytochrome oxidase activities in frozen-dried sample of spinal cord gray matter were measured and analyzed as a step in the investingation of the possible effects of spinal cord trauma on mitochondria. As conservative index of mitochondria damage in gray matter resulting from inactivation on cytochrome oxidase activity, electron microscopic studies of mitochondrial ultrastructural changes in traumatized gray matter were performed. The effects of Naloxone on the alteration of the cytochrome oxidase activities and ultrastructures of the mitochondria in the gray matter were studied. A drop in cytochrome oxidase activities to approximately 50% of normal value was found as early as 15 minutes post-trauma, which greatest decrease at 1/2 hour and 1 hour post-trauma. Ultrastructural changes of the mitochondria continued to proceed with the lapse of time after the injury. Mitochondriae were slightly enlarged with decreased number of cristae at 15 minutes post-trauma. Enlargement of the mitochondria with disintegration of cristae and electron-lucent area in the matrices were observed at 1 hour and 4 hour post-trauma. As relatively less change to the mitochondrial ultrastructures was observed in the Naloxone-treated group than in the non-treated group, the results of this study suggest that Naloxone confers beneficial effects in enhancing the cytochrome-oxidase activity and preserving the mitochondrial ultrastructures from injury.
Animals ; Cats ; Cytochromes* ; Electron Transport Complex IV* ; Mitochondria ; Naloxone* ; Reference Values ; Spinal Cord Injuries* ; Spinal Cord*