No abstract available.
Crowns*

Myoclonus is a rare side effect of gabapentin (GBP) and has been reported in patients with preexisting myoclonus, mental retardation, chronic static encephalopathy, diffuse brain damage, impaired renal function, or end stage renal disease. We report a case of myoclonus in a patient with normal renal function and no previous disorders. A 69-year-old female underwent diskectomy and foraminotomy at the left L4-L5 level. Postoperatively,she complained of paresthesia in her left leg, which was thought to be due to root manipulation during surgery. To relieve the paresthesia, she was given tramadol, an oral opioid agonist, and GBP. One week after GBP was increased to 900 mg per day, myoclonus developed, which severely impaired her normal activity. Her symptoms resolved 2 days after discontinuation of GBP. The coadministration of tramadol and GBP may mutually enhance the myoclonic potential of each drug. The causal relationship between GBP and myoclonus was suggested by cessation of myoclonus after GBP discontinuation despite continued therapy with tramadol.
Aged ; Amines ; Analgesics, Opioid ; Brain ; Cyclohexanecarboxylic Acids ; Diskectomy ; Female ; Foraminotomy ; gamma-Aminobutyric Acid ; Humans ; Intellectual Disability ; Kidney Failure, Chronic ; Leg ; Myoclonus ; Paresthesia ; Tramadol

Ganglioneuroma is a very rare benign tumor, arising from the mature sympathetic ganglion cells. The majority of ganglioneuroma are diagnosed in patients older than 10 years and are mostly often located in the posterior mediastinum, followed by the retroperitoneum. Ganglioneuroma is fully differentiated tumor that contains no immature elements. In general, ganglioneuroma is found incidentally, and no symptoms manifested. Complete surgical excision of ganglioneuroma is the treatment of choice. Herein, we report one case of ganglioneuroma arising from the retroperitoneal sympathetic chains in a 52 years old female patients.
Female ; Ganglia, Sympathetic ; Ganglioneuroma* ; Humans ; Mediastinum ; Middle Aged

BACKGROUND: Although graded exercise stress tests are widely used for the evaluation of cardiorespiratory performance, normal standards on respiratory gas exchange and ventilatory functions at maximal exercise in Koreans have not been well established. The purpose of this study is to provide reference values on these by sex and age, along with derivation of some of their prediction equations. METHOD: Symptom-limited maximal exercise test was carried out by Bruce protocol in 1,000 healthy adults consisting of 603 males and 397 females, aged 20~66 years. Among them VC, FEV1 and MVV were also determined in 885 cases. All the subjects were members of a health center, excluding athletes. During the exercise, subjects were allowed to hold on to front hand rail of the treadmill for safety purpose. RESULTS: The VO2 max/m2, VCO2 max/m2 and VE max/m2 were greater in males than in females and decreased with age. The RR max in men and women was similar but decreased slightly with age. The VT max was markedly greater in men but showed no significant changes with age in either gender. The mean of VT max/VC, VE max/MVV and BR revealed that there were considerable ventilatory reserves at maximal exercise even in older females. The regression equations of the cardinal parameters obtained using exercise time(ET, min), age(A, yr), height(Ht, cm), weight(W, kg), sex(S, 0=male; l=female), VC(L), FEV1(L) and VE max(L) as variables are as follows: VO2 max/m2(L/min)=1.449+0.073 ET-0.007A+0.010W-0.006Ht-0.209S, VCO2 max/m2(L/min)= 1.672+0.063ET-0.008A + 0.010W -0.005Ht -0.319S, VE max/m2(L/min)=58.161 +1.503ET - 0.315A-9.871S or VE max/m2(L/min)=47.873+6.548 FEV1-5.715 S, and VT max(L)=1.497+ 0.223VC-0.493S. CONCLUSION: Respiratory gas exchange and ventilatory variables at maximal exercise were studied in 1,000 non-athletes by Bruce protocol. During exercise, the subjects were allowed to hold on to hand rail of the treadmill for safety purpose. We feel that our results would provide ideal target values for patients and healthy individuals to be achieved, since our study subjects were members of a health center whose physical fitness levels were presumably higher than ordinary population.
Adult ; Athletes ; Exercise Test ; Female ; Hand ; Humans ; Male ; Physical Fitness ; Reference Values

STUDY DESIGNS: A retrospective study. OBJECTIVES: To analyze the clinical and radiological outcomes of spontaneous reduction via minimally invasive transforaminal lumbar interbody fusion (Mini-TLIF) as the treatment for low-grade symptomatic spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Although minimally invasive transforaminal lumbar interbody fusion is technically demanding, this procedure is an effective method for spontaneous reduction of low grade spondylolisthesis. MATERIALS AND METHODS: We analyzed consecutive series of 41 patients with low grade spondylolisthesis who underwent minimally invasive transforaminal lumbar interbody fusion, between April 2008 and July 2009. The minimum follow-up period was 2 years. Clinical evaluation was performed by an analysis of Visual Analogue Scale and Oswestry Disability Index. For the radiological evaluation, disc space height, slip percentage, and slip angle were analyzed. At the final follow-up, the fusion rate was analyzed according to the Bridwell's anterior fusion grade. RESULTS: For the evaluation of clinical outcomes, the Visual Analogue Scale for back pain decreased from 6.8+/-1.2 to 2.0+/-1.1, and that for radiating pain decreased from 7.9+/-1.3 to 1.7+/-1.1. Oswetry Disability Index decreased from 38.5+/-8.4 to 13.4+/-6.1. For the radiological evaluation, disc space height increased from 8.4+/-2.14mm to 11.8+/-1.54mm(P<0.05), slip percentage was reduced from 18.4+/-5.1% to 13.3+/-3.1%(P<0.05) and slip angle decreased from 10.6+/-4.5degrees to 6.2+/-3.4degrees (P<0.05). At the final follow-up, radiological union was obtained in 38 cases (92.7%). CONCLUSIONS: We conclude that minimally invasive transforaminal lumbar interbody fusion appears to be an effective method for spontaneous reduction of low grade spondylolisthesis if the surgeon becomes familiar with this method.
Back Pain ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spondylolisthesis

PURPOSE: To evaluate the characteristic color Doppler imaging of vertebral artery flow in the subclavian steal phenomenon. MATERIALS AND METHODS: The study group consisted of eight patients with reversed vertebral artery flow proved by color Doppler imaging. We classified this flow into two groups : (1) complete reversal ; (2)partial reversal, as shown by Doppler velocity waveform. Vertebral angiography was performed in six of eight patients ; color Doppler imaging and angiographic findings were compared. RESULTS: On color Doppler imaging, all eight cases with reversed vertebral artery flow showed no signal at the proximal subclavian or brachiocephalic artery. We confirmed shunting of six cases by performing angiography from the contralateral verterbral and basilar artery to the ipsilateral vertebral artery. On the Doppler spectrum, six cases showed complete reversal and two partial reversal. On angiography, one partial reversal case showed complete occlusion of the subclavian artery with abundant collateral circulation of muscular branches of the vertebral artery. CONCLUSION: On color Doppler imaging, a reversed vertebral artery suggests the subclavian steal phenomenon. In particular, partial reversal waveform may reflect collateral circulation.
Angiography ; Arteries ; Basilar Artery ; Collateral Circulation ; Humans ; Subclavian Artery ; Subclavian Steal Syndrome* ; Vertebral Artery

Cauda equina syndrome (CES) is often defined as a complex of symptoms and signs consisting of low back pain, bilateral sciatica, lower extremity weakness, saddle anesthesia, and bowel and bladder dysfunction. CES is considered to be neurosurgical emergency. Delayed or missed diagnosis of CES can result in serious morbidity and neurological sequelae. However, the diagnosis of CES is often difficult when one or more of these symptoms are absent or when these symptoms develop asymmetrically or incompletely. We report a case of urinary retention and sphincter dysfunction without sciatica or motor weakness following an L3 burst fracture in a 52-year-old male and discuss the atypical presentation of CES and treatment of traumatic CES.
Anesthesia ; Cauda Equina* ; Diagnosis ; Emergencies ; Humans ; Low Back Pain ; Lower Extremity ; Lumbar Vertebrae ; Male ; Middle Aged ; Polyradiculopathy* ; Sciatica ; Spine* ; Urinary Bladder ; Urinary Retention

No abstract available.
Child* ; Humans ; Meningitis* ; Scrub Typhus*

Purpose: this study was to evaluate the fitness of adjustable dental impression trays on the Koreans : the trays used in the previous study by Kim et al. as part of the dental adjustable tray development project were improved and modified. Material and method: The patterns of tray were made through CAD-CAM process, and a simple silicone-base molds were made from them. The trial products were reproduced by pouring polyurethane into these molds. 30 male students(Wonkwang University, Dental College) and 30 female students (Wonkwang Health Science College, Department of Dental Hygiene) were selected and Reversible hydrocolloid impression materials were used for this study. The fitness of the trays was evaluated by measuring the width and length of impression materials of each measurement sites. Results and conclusion: 1. In adapting the trays inside the mouth, a uniform width of impression material(3.6mm) was obtained in most sites due to the tooth stops and the inclined planes accommodating the width of the tray. 2. The thickness of impression material in the central part of the palate was a mean 9.8 mm, which turned out to be somewhat thick. 3. In the mandible, the thickness of the impression material in the lingual side inferior to the contact point of the 1st and 2nd molars was 2.7mm, and the thickness of the material in the lingual side of the rearmost margin was 2.5 mm. The thickness of the impression material of these areas was relatively thin.
Colloids ; Computer-Aided Design ; Female ; Fungi ; Humans ; Male ; Mandible ; Molar ; Mouth ; Palate ; Polyurethanes ; Tooth

Gas forming brain abscess is a rare disease caused by Klebsiella pneumoniae occurring in patients with impaired host defense mechanism such as diabetes mellitus or liver cirrhosis. A 59-year-old man with 2-year history of diabetes mellitus and 20-year history of liver cirrhosis presented to the hospital with headache. On the day after admission, severe headache was developed and he deteriorated rapidly. Brain CT showed a non-enhanced mass including multiple air density as well as surrounding edema seen in the right occipital lobe, and isodensity air-fluid level seen in the right lateral ventricle. Despite emergent ventricular drainage and intraventricular and intravenous administration of antibiotics, his condition progressively worsened to sepsis and to death after 5 days. Bacterial culture of blood and ventricular fluids disclosed a Gram (-) rod, Klebsiella pneumoniae. In this report we review the pathogenic mechanism and its management.
Administration, Intravenous ; Anti-Bacterial Agents ; Brain ; Brain Abscess ; Diabetes Mellitus ; Drainage ; Edema ; Headache ; Humans ; Klebsiella ; Klebsiella pneumoniae ; Lateral Ventricles ; Liver Cirrhosis ; Middle Aged ; Occipital Lobe ; Rare Diseases ; Sepsis