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*

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*

Of the many potential source of free radial generation, the enzyme xanthine oxidase has been shown to be important in ischemia in non-cerebral tissues. Oxygen-derived free radicals have been implicated in various pathological conditions including ischemia. Xanthine oxidase serve as a source of oxidizing agents such as superoxide radical and hydrogen peroxide. It is investigated that the effect of a specific xanthine oxidase inhibitor, allopurinol, on infarct size in a model of continuous partial cerebral ischemia in rats. Infarct volume was measured by triphenyl tetrazolium chloride staining of brains removed 24 hours after middle cerebral arterial occlusion. Cortical tissue was more effectively protected than basal tissue, especially in allopurinol pretreated group. On histological examinations, hemispheric swelling, PMN cell infiltration and endothelial damage were noted irrespective of allopurinol treatment. It was speculated that free radicals are important in infarction secondary to partial continuous cerebral ischemia and that xanthine oxidase may by the primary source of these radicals.
Allopurinol* ; Animals ; Brain Infarction* ; Brain Ischemia ; Brain* ; Free Radicals ; Hydrogen Peroxide ; Infarction ; Infarction, Middle Cerebral Artery* ; Ischemia ; Middle Cerebral Artery* ; Oxidants ; Rats ; Superoxides ; Xanthine Oxidase

The author investigated the cerebral circulatory and metabolic effects of systemic and intracisternal administration of nicardipine in a canine model of chronic cerebral vasospasm. Twenty-one dogs were assigned to one of three groups; control, intravenous nicardipine, and intracisternal nicardipine. All animals received a total of 12 ml of fresh unheparinized autologous blood via three cisternal injections. Sequential measurements of cerebral blood flow(CBF), cerebral metabolic rate of oxygen(CMRO2), and cerebral metabolic rate of glucose(CMRG) were chacked four times in nine days. Animals were sacrificed at Day 9 and amount of clot remained in brainstem and basal cistern was graded accordingly. Significant improvement of cerebral blood flow was noted in Day 6, Day 9 of intracisternal group and in Day 3, Day 6 of intravenous group(each, p<0.05) with slight better results seen in intracisthernal group. Results of sequential changes of CMRO2 and CMRG indicated possible role of nicardipine in protective effects on deleterious neuronal damage following ischemic changes after vasospasm, but definitive statements on this subject matter should be reserved until further study, espedially on morphologic examinations is carried on, Significantly less amount of clot remained in intracisthernal group may be due to effects of nicardipine in its inhibitory action on platelet aggregation, and/or stimulatory effect on prostacyclin production. These factors along with other possible factors should be speculated.
Animals ; Brain Stem ; Calcium* ; Dogs ; Epoprostenol ; Neurons ; Nicardipine ; Platelet Aggregation ; Vasospasm, Intracranial

A study of effect of local hypothermia upon the spinal cord was performed in cats. With a cuff, a cooler, to which was attached connecting tubes to a refrigerator, the experimental technique was deviced to cool the spinal cord locally at midthoracic level. Cold liquid, saline at a temperature of +/-1.1 degrees C, was circulated in closed system through the tubing into the cuff which was snugly rested on the dorsal surface of the spinal cord as a heat exchanger. The temperatures were measured with thermocouples at various sites in the spinal cord before, during, and after the cooling every two minutes upto twenty minutes. In the cord underneath the cuff, the mean precooling temperature of 35.4 degrees C in normal control group was lowered to 11.0 degrees C during the first two minutes of cooling. After this in initial rapid drop in temperature, there was a further gradual reduction of 4.5 degrees C upto 20 minutes cooling to be 6.5 degrees C. The lowest mean temperatures recorded throughout cooling were 4.3 degrees C at dorsal surface and 6.9 degrees C at center of the cord. And the temperature lowering was nearly not noted beyond the cord 1 cm apart from an edge of cuff in rostral and caudal directions. For comparison, the temperature in the cord that had not been injured was also measured. The rate of cooling in the cord underneath the cuff seemed to be faster than in the control group of animal in which the cord was not injured. Another design of this experiment was an evaluation of the protective effect of local hypothermia with respect to cord edema and injury associated cord hemorrhage. Immediately after intravenous administrations of fluorescin the spinal cords were contused with impaction injury. These injured cords were removed ar different time intervals after trauma, and spread or distribution of fluorescin in frozen sectioned specimens was observed under ultraviolet illumination with fluorescence microscope. In all cooling groups, pathological pictures were reduced in its degree and extent more than those in the control group, and that, earlier the cooling after the injury to the cord, better the result was outcome. It would be well to say that local hypothermia might be within the margin of safety and beneficial in the management of spinal cord injury in this experiment.
Administration, Intravenous ; Animals ; Cats ; Edema ; Fluorescence ; Hemorrhage ; Hot Temperature ; Hypothermia* ; Lighting ; Spinal Cord Injuries ; Spinal Cord*

Tuberculous meningitis, which commonly causes thick granulations over the base of the brain, is a frequent cause of post-meningitic hydrocephalus. Raised intracranial tension affects the cause of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a V-A(V-P) shunt significally alters the course of the disease. The results in 5 cases have been detailed and discussed. Operation could be performed even in an active stage of the disease without much fear of milliary dissemination.
Brain ; Hydrocephalus* ; Intracranial Pressure ; Tuberculosis, Meningeal*

A man with bilateral primitive persistent trigeminal artery combined with cerebral rete mirabile is reported. Direct both common carotid artery angiogram is described with a brief discussion of the embryogenesis of carotid-basilar anastomosis and cerebral rete mirabile. Associated findings of previously reported cases of persistent trigeminal artery and cerebral rete mirabile are briefly reviewed. Persistent of the bilateral trigeminal artery associated with hemorrhage from cerebral rete mirabile seems worthy of notation. The angiographic findings were as follows; 1) The characteristic angiographic findings are bilateral occlusion at the cavernous portion of internal carotid artery. 2) Retrograde filling of middle cerebral artery from the collateral anastomotic channel was showed. 3) Anterior and posterior cerebral arteries are filled from leptomeningeal anastomotic channel and cerebral rete anastomosis. Authors suggested that the persistent trigeminal artery is congenital origin and cerebral rete mirabile may suspect to the secondary change.
Arteries* ; Carotid Artery, Common ; Carotid Artery, Internal ; Embryonic Development ; Female ; Hemorrhage ; Middle Cerebral Artery ; Posterior Cerebral Artery ; Pregnancy

We have recently managed a patient, 31-year-old male, who has been in the state of inferior paraparesis due to cervical disc herniation. The centrally herniated disc material was removed through the posterior approach to the lesion under the general anesthesia in left lateral position. Two days after the operation with removal of herniated disc at C5-6interspace, the subject developed quadriparesis and difficulty in urination in which the weakness of upper extremities were more severe that of the lower extremities. The signs developed postoperatively were very much compatible with those of central cord syndrome, There was improving after the removal of the hematoma and of additional herniated material at second operation which was forced to be done due to development of central cord syndrome in severe degree following the primary surgery. Recovery from neurological dysfunction in order of good and better improvement was of leg, arm, voiding and finger.
Adult ; Anesthesia, General ; Arm ; Central Cord Syndrome* ; Fingers ; Hematoma ; Humans ; Intervertebral Disc Displacement ; Leg ; Lower Extremity ; Male ; Paraparesis ; Quadriplegia ; Upper Extremity ; Urination

A case of the tuberous sclerosis, 14-years old boy, was observed. In his father and sister, the cerebral tubers were noted by brain computerized tomography. This disease has been reported occasionally in dermatologic and psychiatric department because of adenoma sebaceum, mental retardation and epilepsy respectively, but it has not been reported at neurosurgical department in Korea. The histopathology of the brain lesion showed atypical cell(tuberous sclerosis cell), gliosis and nonspecific calcification which confirmed the diagnosis of tuberous sclerosis.
Adolescent ; Brain ; Diagnosis ; Epilepsy ; Fathers ; Gliosis ; Humans ; Intellectual Disability ; Korea ; Male ; Sclerosis ; Siblings ; Tuberous Sclerosis*

PURPOSE: The purpose of this study was to evaluate the radiological and clinical results of modified scarf osteotomy for hallux valgus with lesser metatarsalgia. MATERIALS AND METHODS: Total 19 patients (24 feet) were reviewed by medical records and radiographs. All patients were female and the mean age at the time of operation was 46.4 years. The mean follow-up time was 14.8 months. We modified original scarf osteotomy by adding the procedure of closing wedge osteotomy at the medial side of distal fragment for achieving of the supination of the first metatarsal head. Additionally, Akin osteotomy of the first proximal phalanx was done in 16 patients (20 feet) and no lesser metatarsal operation was done. First-second intermetatarsal, hallux valgus and distal metatarsal articular angles were analyzed radiologically before and after the operation. And 3-dimensional CT was used to evaluate the supination of the first metatarsal head. Clinical results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) score and persistence of lesser metatarsalgia. RESULTS: First-second intermetatarsal and hallux valgus angles were reduced from the mean pre-operative values of 14.2degrees and 32.5degrees to 8degrees and 12.5degrees, respectively, 12 months after the operation. And the supination of the first metatarsal head was confirmed by 3-dimensional CT. The mean AOFAS score improved from 41.4 points pre-operatively to 87.2 points at follow-up. Lesser metatarsalgia still remained in 2 patients (2 feet). CONCLUSION: Modified scarf osteotomy would be an effective surgical procedure, especially, for achieving downward displacement and supination of the first metatarsal head in hallux valgus with lesser metatarsalgia.
Animals ; Ankle ; Displacement (Psychology) ; Female ; Follow-Up Studies ; Foot ; Hallux ; Hallux Valgus ; Head ; Humans ; Medical Records ; Metatarsal Bones ; Metatarsalgia ; Osteotomy ; Supination