Injury to a peripheral nerve due to a drug injection is of particular concern, because of both its clinical and medicolegal implications. Among numerous agents, local anesthetic solutions are most frequently injected near the main nerve trunks. In spite of the low incidence of nerve fiber injury associated with these local anesthetic agents, there are several clinical reports of injury. The author experimentally induced injection injury into the rat sciatic nerve with 2% lidocaine HCL and 0.5% bupivacaine. The neurotoxicity of these agents to the peripheral nerve was observed by light and electron microscope. The results are as follows: 1) Some inflammatory round cells and vasodilation were observed in the surrounding loose areolar tissues immediately after injection. No fibroblast or fibrosis was observed on light and electron microscopic examinations. 2) Immediately after injection, the axons were seperated by the splitting of the collagen fibers between the axons. But within one week, the collagen fibers were reunited and compacted. 3) Most cytoplasmic organelles of the axon, including the microtubules and micro filaments, were quite normal and were not altered by injection injury. But the shape of the axon was changed and shrinked to create a large space from the myelin sheath. The above change returned to normal within one week. 4) The Schwann cells, maintained the normal structure of their cytoplasm and nucleus, but some Schwann cells were seperated from the axons, and floated in the collagen tissue. They were reunited with the axons within one week. 5) There were no significant histologic differences between lidocaine and bupivacaine. 6) The above changes were easily reversible and not severe enough to interfere with nerve function permanently. In conclusion, local injection of these agents is very safe to the peripheral nerve.
Anesthetics ; Animals ; Axons ; Bupivacaine ; Collagen ; Cytoplasm ; Fibroblasts ; Fibrosis ; Incidence ; Lidocaine ; Microtubules ; Myelin Sheath ; Nerve Fibers ; Organelles ; Peripheral Nerves* ; Rats ; Schwann Cells ; Sciatic Nerve ; Vasodilation

PURPOSE: This study aims to investigate the relationship between cement leakage into the disc during percutaneous balloon kyphoplasty and subsequent compression fractures in adjacent vertebrae during treatment of osteoporotic vertebral compression fracture. MATERIALS AND METHODS: 103 patients (118 vertebrae) who have been treated with balloon kyphoplasty due to osteoporotic compression fracture from June 2007 to July 2010 were retrospectively analyzed. The group was composed of 13 males and 90 females. The mean age was 75 years (57~95 years). The mean follow-up period was 10 months (6~30 months). Patients were divided into two groups; one with cement leakage into the disc and the other without cement leakage into the disc. The study was performed to determine whether subsequent compression fractures in adjacent vertebrae were related to several factors. RESULTS: The cement leakages into the disc occurred in 16 of 118 vertebrae. Of the 16 vertebrae with cement leakage into the disc, 5 (31%) had subsequent adjacent vertebral compression fractures; however, of the 102 vertebrae in which cement leakage did not occur, only 11 (11%) had subsequent adjacent vertebral compression fractures (p<0.05). Of the 16 vertebrae with cement leakage into the disc, subsequent adjacent vertebral compression fractures occurred 1 vertebrae of 10 vertebrae with definite trauma history. Out of the 6 vertebrae with cement leakage and no definite trauma history, 4 vertebrae (67%) had subsequent adjacent vertebral compression fractures (p<0.05). CONCLUSION: The cement leakage into the disc significantly increases the incidence of subsequent adjacent vertebral compression fractures. Most of the subsequent fractures occurred in the early post-operative period. When cement leakage into the disc occurred in patients with no definite trauma history such as slip down, the incidence of subsequent adjacent vertebral compression fracture increased significantly.
Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Incidence ; Kyphoplasty ; Male ; Retrospective Studies ; Spine

Nasopharyngeal teratomas are rare congenital tumors which mainly cause neonatal respiratory difficulty or feeding problems. We report an extremely rare case of nasopharyngeal teratoma in which a 34-year-old woman experienced a foreign body sensation. Simple radiographs and CT scans revealed the presence of an exophytically growing mass with a region of fatty attenuation and a well-formed tooth in the nasopharyngeal wall. The mass was surgically removed, and found at histopathology to be a mature teratoma.
Adult* ; Female ; Foreign Bodies ; Humans ; Sensation ; Teratoma* ; Tomography, X-Ray Computed ; Tooth

Recently, interest has been increased on the role of catecholamines in extrarenal potassium homeostasis. This study has undertaken to investigate the effects of epinephrine added to lidocaine for axillary block in HR, MAP, ABG, blood sugar and electrolytes (Na+, K+), and the effects of propranolol, beta-adrenergic blocker, on the data. The patients admitted to our hospital for operation of upper extremities were divided into three groups. Group I was 10 patients blocked with lidocaine 30 ml. Group II was 14 patients blocked with lidocaine 30 ml with epinephrine 0.3 mg(1:100,000). Group III was 10 patients pretreated with propranolol (10u/kg) and blocked with lidocaine 30 ml with epinephrine. After block, the results were as follows. 1) MAP decreased in all group and group III decreased more than group I. 2) HR increased all group and group III decreased more than group I. 3) ABG showed hypoventilatory pattern due to sedative effect by diazepam (0.15mg/kg). 4) Blood sugar value was increased in group I and II, showed increasing tendency in group III, but this tendency was not significant. 5) Blood K+ concentration decreased significantly and the maximal decrease was 0.5 mEq/L in 30 min after block, but there was not significant decrease in group III. This results indicate that clinical dose of epinephrine(1;100,000) decrease blood K+ concentration significantly and propranolol (10u/kg) pretreatment prevent K+ decreasing effect of epinephrine. In clinical practice, it is suggested that much care must be paid to use of local anesthetics with epinephrine to hypokalemic patients.
Anesthetics, Local ; Blood Glucose ; Brachial Plexus* ; Catecholamines ; Diazepam ; Electrolytes ; Epinephrine* ; Homeostasis ; Humans ; Hypnotics and Sedatives ; Lidocaine* ; Potassium ; Propranolol* ; Upper Extremity

Recently, interest has been increased on the role of catecholamines in extrarenal potassium homeostasis. This study has undertaken to investigate the effects of epinephrine added to lidocaine for axillary block in HR, MAP, ABG, blood sugar and electrolytes (Na+, K+), and the effects of propranolol, beta-adrenergic blocker, on the data. The patients admitted to our hospital for operation of upper extremities were divided into three groups. Group I was 10 patients blocked with lidocaine 30 ml. Group II was 14 patients blocked with lidocaine 30 ml with epinephrine 0.3 mg(1:100,000). Group III was 10 patients pretreated with propranolol (10u/kg) and blocked with lidocaine 30 ml with epinephrine. After block, the results were as follows. 1) MAP decreased in all group and group III decreased more than group I. 2) HR increased all group and group III decreased more than group I. 3) ABG showed hypoventilatory pattern due to sedative effect by diazepam (0.15mg/kg). 4) Blood sugar value was increased in group I and II, showed increasing tendency in group III, but this tendency was not significant. 5) Blood K+ concentration decreased significantly and the maximal decrease was 0.5 mEq/L in 30 min after block, but there was not significant decrease in group III. This results indicate that clinical dose of epinephrine(1;100,000) decrease blood K+ concentration significantly and propranolol (10u/kg) pretreatment prevent K+ decreasing effect of epinephrine. In clinical practice, it is suggested that much care must be paid to use of local anesthetics with epinephrine to hypokalemic patients.
Anesthetics, Local ; Blood Glucose ; Brachial Plexus* ; Catecholamines ; Diazepam ; Electrolytes ; Epinephrine* ; Homeostasis ; Humans ; Hypnotics and Sedatives ; Lidocaine* ; Potassium ; Propranolol* ; Upper Extremity

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.
Evaluation Studies as Topic*

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.
Evaluation Studies as Topic*

Two Years Reports of "Journal of Korean Neuropychiatric Association" during 2001 to 2003 were evaluated by 17 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropychiatric Association" will develope a good journal.
Evaluation Studies as Topic*

PURPOSE: To assess the location and associated findings of fractures of the posterior lumbar vertebral ring apophysis as seen on MRI. MATERIALS AND METHODS: We retrospectively evaluated MR findings in 77 patients (86 lesions) with lumbar apophyseal ring fractures. Their age ranged from ten to 67 (mean 33-1) years. To confirm the presence of verterbral ring fractures, CT was performed in 29 patients (31 lesions) within two weeks of MR imaging. Open laminectomy was performed in ten patients, percutaneous automated nucleotomy in three, and LASER operation in four. RESULTS: The most common location of fractures was the superior margin of L5 (36 lesions 41.9%), next was superior margin of S1 (21 lesions, 24.4%). On CT, a bony fragment was seen in 28 patients (30 lesions); the positive predictive value of MR was 99.7 %. Multiple lesions were seen in nine patients. Associated disc herniation and bulging were noted in 64 (74.4%) and 15 lesions (17.4%), respectively, and a high signal intensity rim aound the bony fragment on T1 weighted image was noted in 33 (38.4%). Other associated findings were spondylolysis in eight patients, retrolisthesis in five, and spondylolisthesis in three. Operative outcomes were variable. The results of open laminectomy were better than those of percutaneous automated laminectomy or LASER operation. CONCLUSION: In patients with lumbar apophyseal ring fractures, their exact location and associated findings could be evalvated by MRI, which was therefore useful in the planning of appropriate surgery.
Humans ; Laminectomy ; Lumbar Vertebrae* ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spondylolisthesis ; Spondylolysis

BACKGROUND: Non-small lung cancer(NSCLC) develops as a result of the accumulation of multiple genetic abnormalities. Loss of heterozygosity(LOH) is one of the most frequent genetic alterations that is found in NSCLC, and the chromosomal regions that display a high rate of LOH are though to harbor tumor suppressor genes(TSGs). This study was done to determine the frequency of LOH in 21q with the aim of identifying potential TSG loci. METHOD: Thirty-nine surgically resected NSCLCs were analysed. Patietns peripheral lymphocytes were used as the source of the normal DNA. Five microsatellite markers of 21q were used to study LOH : 21q21.1(D21S1432, and D21S1994) ; 21q21.2-21.3(D21S1442) ; 21q22.1(21S1445) ; and 21q22.2-22.3(D21S266). The fractional allelic loss(FAL) in a tumor was calculated as the ratio of the number of markers showing LOH to the number of informative markers. RESULT: LOH for at least one locus was detected in 21 of 39 tumors(53.8%). Among the 21 tumors with LOH, 5(21.8%) showed LOH at almost all informative loci. Although statistically not significant, LOH was found more frequently in squamous cell carcinomas(15 of 23, 65.2%) than in adenocarcinomas(6 of 16, 37.5%). In the squamous cell carcinomas the frequency of LOH was higher in stage II-III (80.0%) than in stage I (53.8%). The FAL value in squamous cell carcinomas(0.431±0.375) was significantly higher than that found in adenocarcinomas(0.192±0.276). CONCLUSION: These results suggest that LOH on 21q may be involved in the development of NSCLC, and that TSG(s) that contribute to the pathogenesis of NSCLC may exist on 21q.
Arm* ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Chromosomes, Human, Pair 21* ; DNA ; Loss of Heterozygosity* ; Lung ; Lymphocytes ; Microsatellite Repeats