Forry-two symptomatic hands of 29 patients with carpal tunnel syndrome operated during the period from Marth 1986 to December 1993 were analized in clinical aspect. Among 29 patients, 3(10.3%) were male and 26(89.7%)were female. The syndrome occured on the right side in 10(34.5%) patients, on the left in 6(20.7%) patients, and on both in 13(44.8%) patients. The causes of the syndrome were idiopathic(90.5%), trauma(7.1%), mass(2.4%). Paresthesia(57.1%) was the most common chief complanit, followed by numbness(35.7%), pain(21.4%), weakness(9.5%). Thenar muscie atrophy occured in 84.8%, positive Tinel sign in 83.3% and positive Phalen sign in 90.0%. Delay of motor conduction velocity of median nerve was noted in all cases and delay of sensory nerve conduction velocity in all cases. Denervation finding such as fibrillation or sharp waves were seen in all cases. The carpal tunnel release was performed in all cases, and 31 cases were treated by carpal tunnel tunnel release with internal neurolysis. 35 cases(83.3%) were excellent or good results. The cases were long duration were poorer results. No significant difference was found between the results in cases treated by carpal tunnel release alone and those in cases treated by carpal tunnel release with internal neurolysis of median nerve.
Atrophy ; Bryophyta ; Carpal Tunnel Syndrome ; Denervation ; Female ; Hand ; Humans ; Male ; Median Nerve ; Neural Conduction

No abstract available.

OBJECTIVE: To determine of the regulation of cyclooxygenase-2 (COX-2) expression by Interleukin-1beta in WISH cells. METHODS: Amnion WISH cells were incubated in media containing increasing concentrations of IL-1beta or with various inhibitors. Increased COX-2 expression was determined by Western blot analysis with anti-COX-2 antibody. Concomitant measurements of culture media PGE2 were made by an enzyme immunoassay. RESULTS: The COX-2 and prostaglandin E2 production induced by IL-1beta increased in a dose- and time-dependent manner. One of the regulating factors that induced COX-2 by IL-1beta was protein kinase C (PKC). PKC inhibitor, Ro 31-8220 was pretreated and continued treating by IL-1beta. Then, PKC inhibitor completely blocked COX-2 protein induction by IL-1beta. In contrast, COX-2 induction by IL-1beta after pretreating PKC stimulator, phobol 12-myristate 13-acetate was potentiated with synergism. Another factor in controlling COX-2 protein induction was identified as phosphatidylinositol 3-kinase (PI 3K). COX-2 protein induction by IL-1beta after pretreating PI 3K inhibitors, wortmannin and LY294002 strongly increased. This kind of result reflected that PI 3K act as negative regulator. COX-2 induction by IL-1beta was known to be regulated in not only transcription step, but also translation step after performing experiment of actinomycin and cycloheximide treatment. CONCLUSION: COX-2 protein and prostaglandin E2 production induced by IL-1beta were controlled by many factors in amnion cell. Among those factors, PKC and PI 3K have an important role, but their control mechanism act as positive and negative, respectively.
Amnion ; Blotting, Western ; Culture Media ; Cycloheximide ; Cyclooxygenase 2* ; Dactinomycin ; Dinoprostone ; Immunoenzyme Techniques ; Interleukin-1beta* ; Phosphatidylinositol 3-Kinase ; Protein Kinase C

BACKGROUND AND OBJECTIVES: While it has been reasonably well demonstrated that allergy is a risk factor for patients of otitis media with effusion (OME), the causal mechanism is not well understood. Although Th2 cytokines are known to mediate allergic inflammatory reactions, there have been no reports about the presence of other Th2 cytokines in the middle ear effusions of OME patients except for IL-4. The aim for this study was to determine whether Th2 cytokines, IL-5, IL-10 and IL-13, were present in the middle ear effusions, and whether these cytokines were present in higher concentrations in the effusions of allergic patients than of non-allergic patients. MATERIALS AND METHOD: Thirty ears of twenty nine patients with persistent OME were assayed for the cytokines using enzyme-linked immunosorbent assay (ELISA). Ten of these patients, which are 11 ears, were confirmed allergy positive by multiple allergosorbent test (MAST). The statistical differences in the positive rates of each cytokines between the allergy and the non-allergy groups were assessed by chi 2 test or Fisher's exact test, and the statistical differences in the measured concentrations of each cytokines between the two groups were assessed by Mann-Whitney U test. RESULTS: The positive rates of each cytokines and the level of IL-5 were not statistically different between the allergy and the non-allergy groups. However, the levels of IL-10 and IL-13 in the non-allergy group were significantly higher than in the allergy group. CONCLUSION: The higher levels of IL-10 and IL-13 of the non-allergy group suggest that more active anti-inflammatory cellular responses exist in the middle ear of the non-allergic patients with OME than of the allergic patients, or that at least the different inflammatory processes exist between the two groups with regard to the pathogenesis of OME.
Cytokines* ; Ear ; Ear, Middle ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypersensitivity* ; Interleukin-10* ; Interleukin-13* ; Interleukin-4 ; Interleukin-5* ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Risk Factors

Chronic granulomatous disease is characterized by recurrent life-threatening infections and the formation of granulomatous lesions caused by the failure of phagocytic oxidative microcidal activity that has resulted from a defect of the oxidase system. The fungal osteomyelitis of the spine in this disease is almost always caused by Aspergillus, and its treatment is not yet established although surgical management, antifungal agents, granulocyte transfusions or combination methods have been reported. We report a patient with aspergillosis who had a long-standing pulmonary lesion which subsequently spread to the adjacent thoracic wall and spine. After decompression and drainage by costotransversectomy, the severe pain was relieved but the kyphosis increased and a paraplegia developed slowly because of resistance to the antifungal therapy and the inability to perform a bone graft. The patient died 2 months after the operation because of pulmonary complications.
Antifungal Agents ; Aspergillosis* ; Aspergillus ; Decompression ; Drainage ; Glucose Oxidase ; Granulocytes ; Granulomatous Disease, Chronic* ; Humans ; Kyphosis ; Osteomyelitis ; Oxidoreductases ; Paraplegia ; Spine* ; Thoracic Wall ; Transplants

BACKGROUND AND OBJECTIVE: The long-term effects of beta-irradiation on intimal hyperplasia (IH) within the stented segment and vessel, and the lumen dimensions of non-stented adjacent segments, have not been sufficiently evaluated in patients with ISR. The long-term (24 months) effects of beta-irradiation ((188)Re-MAG3-filled balloon) were evaluated using intravascular ultrasound (IVUS) in patients with in-stent restenosis (ISR). SUCJECTS AND METHODS: A two-year follow-up IVUS was performed in 30 patients with patent ISR segments at the 6-monthly follow-up angiography. Serial IVUS images were acquired at 5 equidistant intra-stent sites and 3 different reference segment sites (1, 2 and 4 mm from stent margin). RESULTS: The mean intra-stent IH area and IH burden significantly increased between 6 and 24 months-from 2.1+/-1.1 to 2.6+/-1.4 mm2 (p<0.001) and from 26+/-10 to 33+/-14% (p<0.001), respectively. There were significant decreases in the mean external elastic membrane (from 10.1+/-3.9 to 9.7+/-3.9 mm2, p=0.015) and lumen area (from 5.6+/-2.3 to 5.1+/-2.3mm2, p=0.021) within the distal reference segments between 6 and 24 months. Target lesion revascularization (TLR) was performed between 6 and 24 months in 6 patients (20%) following the beta-irradiation therapy. There were no significant differences between the TLR and non-TLR groups, with the exception of a smaller minimum lumen CSA at 24 months in the TLR group. CONCLUSION: Because of a small amount of late loss between 6 and 24 months, most irradiated ISR vessel segments remained stable for up to 2 years. However, quantitative evidence of late catch-up was evident in most patients and was significantly associated with 24-month TLR in some patients with a smaller minimum lumen area.
Angiography ; Brachytherapy* ; Follow-Up Studies ; Humans ; Hyperplasia ; Membranes ; Stents ; Ultrasonography*

Cervical epidural steroid injection is frequently used in the conservative management of neck pain and cervical radiculopathy. Epidural cervical transforaminal injections are usually well-tolerated with mild side effects such as transient decreased sensory and motor function, or headache due to dural puncture. Although there are a few case reports about adverse effects of cervical epidural injection in the literature, it can cause severe complications such as large hematoma, infarction by spinal vascular injury. Subdural hematoma has been occurred much less common rather than epidural hematoma in the spinal cord. We report a rare catastrophic case of cervical spinal subdural hematoma with quadriparesis after cervical transforaminal epidural block.
Headache ; Hematoma ; Hematoma, Subdural* ; Hematoma, Subdural, Spinal ; Infarction ; Injections, Epidural ; Neck Pain ; Punctures ; Quadriplegia* ; Radiculopathy ; Spinal Cord ; Vascular System Injuries

PURPOSE: This study was performed to determine the relation between cord blood plasma cytokines responses and development of cerebral palsies in premature infants. METHODS: Interleukin-1beta(IL-1beta), Interleukin-6(IL-6), Tumor necrosis factor-alpha(TNF-alpha) were measured using ELISA kits in premature infants(n=60) who were admitted to St. Benedict Hospital from September 2001 to June 2003. Retrospective study was done by review of medical records. RESULTS: Cord blood levels of IL-1beta, IL-6 and TNF-alpha in the cerebral palsy group were higher, especially IL-6 but were not significant, compared with the control group. Cord blood levels of IL-6 in the cerebral palsy without asphyxia, sepsis, PROM, RDS and pneumonia were significantly different, compared with the control group. CONCLUSION: Cord blood levels of IL-1beta, IL-6 and TNF-alpha in the cerebral palsy group were increased, but concentrations of IL-6 increased significantly. Cord blood levels of IL-6 may be a useful value to predict the development of cerebral palsy, because they are related to IL-6 rather than to TNF-alpha & IL-1beta in this study.
Asphyxia ; Cerebral Palsy* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Fetal Blood* ; Humans ; Infant, Newborn ; Infant, Premature* ; Interleukin-6 ; Medical Records ; Necrosis ; Paralysis ; Plasma ; Pneumonia ; Retrospective Studies ; Sepsis ; Tumor Necrosis Factor-alpha

No abstract available.
Adolescent ; Ataxia Telangiectasia/*genetics ; Ataxia Telangiectasia Mutated Proteins/*genetics ; Base Sequence ; Chromosome Inversion ; Chromosomes, Human, Pair 14/genetics ; Chromosomes, Human, Pair 7/genetics ; DNA Mutational Analysis ; Female ; Humans ; Karyotyping ; Magnetic Resonance Imaging ; Mutation ; RNA Splicing ; Translocation, Genetic

BACKGROUND: Left ventricular function and left ventricular hypertrophy often show weak correlation with the degree of blood pressure in hypertensive patients. So we assessed correlation of hemodynamic load to left ventricular hypertrophy and left ventricular performance, and whether left ventricular wall stress is the major factor on the regulation of left ventricular function. METHODS: Relationships between echocardiographic hemodynamic parameters and indices of left ventricular hypertrophy and left ventricular function were evaluated in 40 patients with essential hypertension who have not been previously treated. RESULTS: Left ventricular mass index correlated weakly with blood pressure, cardiac index, and stroke volume. End-diastolic left ventricular relative wall thickness, as an index that assess the severity of concentric hypertrophy showed significantly negative correlation with cardiac index (r=-0.49, p<0.001),stroke index(r=-0.46, p<0.001) and a positive correlation with total peripheral resistance (r=0.55, p<0.001). Furthermore, patient with cardiac indices tend to have higher end-diastolic wall thickness at any given level of blood pressure. Fractional shortening suggesting left ventricular systolic function was not related with blood pressure. stroke volume, cardiac index, left ventricular mass index, and peak systolic wall stress. In contrast there were significant negative correlations between fractional shortening with mean wall stress index (r=-0.42, p<0.005) and with end-systolic wall stress (r=-0.72, p<0.001). CONCLUSIONS: These results suggest that anatomic and hemodynamic changes may be pathophysiologically interdependent and left ventricular function was regulated by the level of left ventricular wall stresses reflecting afterload (blood pressure).
Blood Pressure ; Echocardiography ; Hemodynamics* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Stroke Volume ; Vascular Resistance ; Ventricular Function, Left