A retrospective study was conducted to evaluate the changes in serum creatine kinase (CK) and lactic dehydrogenase (LDH) after coronary artery bypass grafting surgery. We studied 37 patients who had normal liver and kidney functions and who did not have the perioperative acute myocardial infarction. After measuring total serum LDH and isoenzyme 1 to 5, and seum CK and isoenzyme CK-MB, we compared pastoperative values to preoperative value. We also calculated the ratio of LD1 to LD2 (LD1 /LD2). Total LDH increased for postoperative 0 day, 1 day, 2 day, and 4 day. LD1, LD2 LD3 and LD4, increased for postoperative 0 day, 1 day, and 2 day, but LD5 increased for 0 day and 1 day. Total CK increased for 0 day, 1 day, and 2 day, but CK-MB did not increase postoperatively. LD1/LD2 increased at posoperative 2 day. Among the total 113 samples, the number of the cases of LD1/LD2 > 1 is 12.
Coronary Artery Bypass ; Creatine Kinase* ; Creatine* ; Humans ; Kidney ; Liver ; Myocardial Infarction ; Oxidoreductases* ; Retrospective Studies

OBJECTIVE: The present study was undertaken to evaluate the effectiveness of transforaminal epidural steroid injection (TFESI) with using a preganglionic approach for treating lumbar radiculopathy when the nerve root compression was located at the level of the supra-adjacent intervertebral disc. MATERIALS AND METHODS: The medical records of the patients who received conventional TFESI at our department from June 2003 to May 2004 were retrospectively reviewed. TFESI was performed in a total of 13 cases at the level of the exiting nerve root, in which the nerve root compression was at the level of the supra-adjacent intervertebral disc (the conventional TFESI group). Since June 2004, we have performed TFESI with using a preganglionic approach at the level of the supra-adjacent intervertebral disc (for example, at the neural foramen of L4-5 for the L5 nerve root) if the nerve root compression was at the level of the supra-adjacent intervertebral disc. Using the inclusion criteria described above, 20 of these patients were also consecutively enrolled in our study (the preganglionic TFESI group). The treatment outcome was assessed using a 5-point patient satisfaction scale and by using a VAS (visual assessment scale). A successful outcome required a patient satisfaction scale score of 3 (very good) or 4 (excellent), and a reduction on the VAS score of > 50% two weeks after performing TFESI. Logistic regression analysis was also performed. RESULTS: Of the 13 patients in the conventional TFESI group, nine showed satisfactory improvement two weeks after TFESI (69.2%). However, in the preganglionic TFESI group, 18 of the 20 patients (90%) showed satisfactory improvement. The difference between the two approaches in terms of TFESI effectiveness was of borderline significance (p = 0.056; odds ratio: 10.483). CONCLUSION: We conclude that preganglionic TFESI has the better therapeutic effect on radiculopathy caused by nerve root compression at the level of the supra-adjacent disc than does conventional TFESI, and the diffence between the two treatments had borderline statistical significance.
Triamcinolone Acetonide/*administration & dosage ; Spinal Stenosis/complications ; Retrospective Studies ; Radiculopathy/*drug therapy/etiology ; Patient Satisfaction ; Pain Measurement ; Middle Aged ; Male ; Lumbosacral Region ; Logistic Models ; Intervertebral Disk Displacement/complications ; Injections, Epidural/*methods ; Humans ; Glucocorticoids/*administration & dosage ; Fluoroscopy ; Female ; Bupivacaine/administration & dosage ; Anesthetics, Local/administration & dosage ; Aged ; Adult ; Adolescent

PURPOSE: The aim of this study was to describe the method and the value of cervical discography as correlated with the MR findings. MATERIALS AND METHODS: Twenty-one discs in 11 consecutive patients who underwent cervical discography were analyzed. MR and CT discography (CTD) were performed in all patients. Discography was performed after swallowing barium for visualizing the pharynx and the esophagus to prevent penetration. We also analyzed the preceding causes of the subjects' cervical pain. The results of the pain provocation test were classified into concordant pain, discordant pain and a negative test. MRI was analyzed according to the T2-signal intensity (SI) of the disc, disc height, annular bulging and disc herniation. The CTD was analyzed for degeneration or radial tear of the disc, epidural leakage of the contrast agent and pooling of the contrast agent at the periphery of the disc. The pain provocation tests were correlated with the MR and CTD findings. We used the chi-square test to analyze the results. RESULTS: Concordant pain was observed in 14 cases, discordant pain in 3 cases and there were negative tests in 4 cases. There were no complications related to the procedure. Four patients had undergone anterior cervical fusion and four patients had pain that developed after traffic injuries. The decreased T2-SI and annular bulging on MRI, disc degeneration and peripheral pooling of the contrast agent on CT were significantly correlated with pain provocation. CONCLUSION: When the diagnosis of disc disease is difficult with performing MRI, cervical discography with using swallowed barium solution to reduce the penetration of the esophagus or hypopharynx may play be helpful. The decreased T2-SI and annular bulging on MRI correlated significantly with a positive result on the pain provocation test.
Barium ; Deglutition ; Diagnosis ; Esophagus ; Humans ; Hypopharynx ; Intervertebral Disc Degeneration ; Magnetic Resonance Imaging ; Neck Pain ; Pharynx