We had treated 24 patients who had nonunions of the carpal scaphoid from June 1987 to September 1995. 17 of 24 nonunions of carpal scaphoid were treated by K-wires fixation and autogenous iliac bone grafts. Another 7 cases were treated by Herbert screw fixation and autogenous iliac bone graft. 24 patients were followed up average 42.6 months and obtained following results; l. Among 24 cases, 23 cases were men and 19 cases were the third and fourth decade. Most common injury was the falling accidents (11 cases: 45.8%). 2. Most common pattern of fractures was waist type (20cases: 83.3%) in anatomical site and transverse type (15 cases: 75.0%) in pattern of fracture line. 3. Preoperative scapholunate angles (mean 52.9degrees: K-wires, 69.1degrees: Herbert screw) has been improved after open reduction and internal fixation by K-wires or Herbert screw (mean 46.2degrees: K-wires, 51.1degrees: Herbert screw). 6 cases had DISI deformity preoperatively with scapholunate angles over 70degrees (mean 80.0degrees: K-wires, 84.0degrees: Herbert screw) has been corrected after ORIF (mean 48.0: K-wires, 58.0: Herbert screw). 4. Bony unions were obtained in average 13.2 weeks in K-wires group and 9.8 weeks in Herbert screw group. 5. 13 cases (76.5%) in K-wires group and 6 cases (85.7%) in Herbert screw group were excellent and good result by Maudsley method. 6. The complications and sequalaes were present 4 cases in K-wires group with degenerative arthritis on radioscaphoidal and scapholunate joint and collapse of proximal pole and 1 case in Herbert screw group with screw malposition. So, We were thought that ORIF with K-wires and Herbert screw was effective treatment for nonunions of carpal scaphoid, especially Herbert screw fixation and autogenous iliac bone graft. In comparison of bony union and results of treatment, Herbert screw group was more effective than K- wires group.
Congenital Abnormalities ; Humans ; Joints ; Male ; Osteoarthritis ; Transplants

Gelastic Seizure(Ictal laughter) is frequently associated with hypothalamic hamartoma that is congenital tumor composed of heterotrophic and hyperplastic tissue located in the hypothalamus near the interpeduncular cistern, tuber cinereum, and mamillary body. The seizure usually begins in infancy or childhood and may be accompanied with precocious puberty and cognitive decline. A 14 year-old boy visited to our hospital because of paroxysmal frequent involuntary laughing regardless of emotional change. Brain MRI showed nonenhancing hypothalamic mass that had isointensity with gray matter on T1W1 and hyperintensity on T2Wl. So it was suspected that he had a gelastic seizure accompanied with hypothalamic hamartoma.
Adolescent ; Brain ; Hamartoma* ; Humans ; Hypothalamus ; Magnetic Resonance Imaging ; Male ; Mamillary Bodies ; Puberty, Precocious ; Seizures* ; Tuber Cinereum

Ever since transplant surgery became a common procedure. The early diagnosis of irreversible cessation of cerebral function has become an important need We analysed the findings of transcranial doppler of five cases. Two was diagnosed brain death by currently accepted criteria. Two cases showed absence of intracranial blood flow and normal to disturbed flow status of the cervical carotid artery. Three cases showed reverberating flow pattern with reflux phenomenon. Transcranial doppler investigation seems to provide a practical, non-invasive. And reliable disgnostic evidence for the arrest of cerebral circulation.
Brain Death* ; Brain* ; Carotid Arteries ; Diagnosis* ; Early Diagnosis

The ptosis secondary to cerebral hemispheric lesion (cerebral ptosis) is unusual and has not been well documented. Although the precise anatomical localization and clinical course of cerebral ptosis were not clear, there have been a few clinical and electrophysiologlcal reports that right hemisphere had its functional asymmetry or dominancy in the cortical control of eyelid movement. We present 4 patients of cerebral ptosis with acute onset of cerebral infarction in right middle cerebral artery territory. All of them are right-handed and presented acute onset of left hemiparesis and bilateral ptosis, but have no signs of involvement of oculomotor or sympathetic nerve pathway. In conclusion, the blepharoptosis could be caused by hemispheric lesion per se and be a sign of right hemispheric lesion rather than that of left one.
Blepharoptosis ; Cerebral Infarction ; Eyelids ; Humans ; Middle Cerebral Artery ; Paresis

BACKGROUND: Subthalamic nucleus (STN) activity increases in patients and animal models of Parkinson's disease. It has been proposed that the STN may play a role in the progressive death of nigral dopamine (DA) neurons in PD. We studied the role of the excitatory afferents from the STN in the death of nigral DA neurons after a striatal 6-hydroxy-dopamine (6-OHDA) injection in a 6-OHDA-induced early Parkinson rat model. METHODS: Nigral DA neurons were counted using of tyrosine hydroxylase immunolabeling. Sprague-Dawley rats were subjected to unilateral, ibotenic acid-induced destruction of the STN 3 weeks after producing the early Parkinson model by injecting an intrastriatal 6- OHDA (8.75 microgram). Sham lesions of the STN were made by injecting phosphate-buffered saline. One week after STN ablation, lesions of nigrostriatal DA neurons were induced by repeated intrastriatal injections of 6-OHDA (8.75 microgram). RESULTS: Intrastriatal injections of 6-OHDA caused a progressive loss of nigral tyrosine hydroxylase-positive DA neurons in a dose dependent manner (3.5 microgram, 8.75 microgram, 17.5 microgram). The dose of 8.75 microgram of 6-OHDA was suitable for the early Parkinson model. Previous ablation of the STN significantly attenuated the loss of DA neurons in rats receiving 6-OHDA. Sham lesions of the STN did not affect DA neuron death induced by the toxin. CONCLUSIONS: The results indicate that excitatory inputs from the STN may contribute to the 6-OHDA-induced death of nigral DA neurons in the early state of Parkinson's disease.
Animals ; Dopamine ; Dopaminergic Neurons* ; Humans ; Models, Animal* ; Neurons ; Oxidopamine ; Parkinson Disease* ; Rats* ; Rats, Sprague-Dawley ; Substantia Nigra ; Subthalamic Nucleus ; Tyrosine ; Tyrosine 3-Monooxygenase

No abstract available.
Lupus Erythematosus, Systemic* ; Pseudotumor Cerebri*

BACKGROUND AND OBJECTIVES: It had been well known that Lipoprotein(a) had proatherogenic and thrombogenic action because of structural similarity with plasminogen. However the role of Lipoprotein (a) (Lp(a)) in the development of ischemic cerebrovascular disease had not sufficiently clarified. The aim of this study was to evaluate the effect of diabetes mellitus (DM) and hypertension (HBP) to the role of Lp(a) as a risk factor of ischemic cerebrovascular disease. METHOD: For comparing Lp(a) and the lipid profile of ischemic stroke group (5, N=232) with those of control group (C, N=158), we divided each group into four subgroups according to the existance of DM and HBP: stroke patients and control subjects with DM only(DMS, N=27; DMC, N=44), those with HBP only(HBPS, N=94; HBPC, N=44), those with both of DM and HBP (DMHBPS, N=46; DMHBPC, N=29), and those with none of DM and HBP(NS, N=65; NC, N=41). We evaluated Lp(a) and the lipid profile measured less than 72 hour after onset of stroke and 3 month later in 33 ischemic stroke patients. Also we divided the stroke group into two subgroups according to the type (large artery thrombotic vs small artery perforating) and the age of onset (below 50 year-old vs above 50 year-old), and compared Lp(a) and the lipld profile in each subgroups. RESULT: 1. In control group, the Lp(a) in DMC was significantly higher t that in NC. 2. The Lp(a) compared between HBPC & HBPS and between & NS were statistically significant. 3. The Lp(a) in DMS revealed no significant difference compared with that in DMC. 4, The type of ischemic stroke did not give specific Lp(a) level. 5. The Lp(a) in the young age onset revealed no significant difference compared with that in the old age onset. CONCLUSION: The Lp(a) is likely to contribute to the ischemic stroke at independent risk factor, However it is seemed that the role of Lp(a) as a risk factor of the ischemic stroke is evaluated after being subdivided according existence of DM.
Age of Onset ; Arteries ; Diabetes Mellitus ; Humans ; Hypertension* ; Lipoprotein(a) ; Middle Aged ; Plasminogen ; Risk Factors* ; Stroke

We have studied thirty two cases of inappropriately treatable and intractable epileptics to various anti-convulsants. Zonisamide had a definite anti-epileptic activity in eleven subjects(52.4%) of intractble epilepsy. Five patients(45.5%), who were previously inappropriately treatable epileptic patients became seizure free on zonisamide. Two subjects were withdrawn from study because of side effect and two subjects were also withdrawn because of uncontrolled seizure. Zonisamide is not only effective in intractable epileptic patients but also in first trial for untreated epileptic patients.
Epilepsy ; Humans ; Seizures

No abstract available.
Arthritis, Rheumatoid* ; Vasculitis*

The present report discusses four cases of chronic renal failure, which developed symptoms of parkinsonism in response to levosulpiride. The temporal relationship between levosulpiride discontinuation and the disappearance of parkinsonism suggests a causal link. In addition, decreased striatal dopamine transporter bindings assessed by [I-123] IPT SPECT were observed in two patients suggesting that a dopamine blocking agent causes the dysfunction of nigrostriatal dopaminergic neurons and that such injury may be involved in the pathogenesis of drug-induced parkinsonism.
Dopamine ; Dopamine Plasma Membrane Transport Proteins ; Dopaminergic Neurons ; Humans ; Kidney Failure, Chronic ; Parkinsonian Disorders ; Tomography, Emission-Computed, Single-Photon