This experiment was designed for the evaluation of the usefulness of enzyme histochemistry in the determination of the lapse of time in brain wound, and also for the establishment of medicolegal 'biological time table' on brain wound. Brain injury was made by contusion and laceration of meninges and brain itself in rats. The results were as follows; 1) By routine histological technique, estimation of the lapse of time in brain wound could be possible 4 hours after the infliction of wound. 2) The earliest change of enzyme activities was recognizable by the decreased activities of ATPase and succinic dehydrogenase 30 minutes after the injury. These decreased enzyme activities were not recovered up to the 4th day after the brain injury. 3) Increased acid phosphatase activity was noticed 1 hour, and beta-glucuronidase, 2 hours after the injury in a mild degree. Both increased activities were pronounced following the lapse of time in brain wound. 4) No significant change was seen in alkaline phosphatase, monoamine oxidase, non-specific esterase and leucine aminopeptidase activities throughout the experimental period up to the 4th day. So the enzyme histochemistry of these enzymes seemed to be little valuable for the study on the timing of wound in brain injury. In the light of these results it appeared that the enzyme histochemistry, in particular of ATPase, succinic dehydrogenase, and acid phosphatase, for the estimation of timing of brain wound not only shortened the histological "lag period" up to 30 minutes after the injury, but also provided a useful information in determining the biological time table following the brain injury.
Acid Phosphatase ; Adenosine Triphosphatases ; Alkaline Phosphatase ; Animals ; Brain Injuries* ; Brain* ; Carboxylesterase ; Contusions ; Glucuronidase ; Histological Techniques ; Lacerations ; Leucyl Aminopeptidase ; Meninges ; Monoamine Oxidase ; Rats ; Succinate Dehydrogenase ; Wounds and Injuries

BACKGROUND: Coughing during emergence from general anesthesia is a common clinical problem and results in a number of undesirable side effects. Remifentanil stimulate micron-opioid peptide receptor known to be related to antitussive effect. The goal of this study was to evaluate the effect of remifentanil on coughing after general anesthesia with desflurane. METHODS: Fifty one ASA physical status I and II patients undergoing elective oral and maxillofacial surgery were randomly assigned to receive either remifentanil with 1 ng/ml effect site concentration or normal saline until extubation. The number and intensity of coughs were monitored during emergence and the recovery time was recorded. RESULTS: The incidence and number of coughing during emergence was significant less frequent in the remifentanil group (P < 0.05). The intensity of coughing was significant milder in the remifentanil group (P < 0.05). There was no significant difference between two groups in the recovery time. CONCLUSIONS: Continuous remifentanil infusion with 1 ng/ml effect site concentration during emergence from general anesthesia with desflurane decrease the incidence of coughing without delaying the recovery time.
Anesthesia, General ; Cough ; Humans ; Incidence ; Isoflurane ; Piperidines ; Receptors, Peptide ; Surgery, Oral

No abstract available.
Head Injuries, Penetrating*

STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the significance of the intraoperative postural reduction for kyphotic deformity in unstable burst fracture and confirm the relations of postural reduction and the final correction after loss of correction by posterior instrumentation. SUMMARY OF LITERATURE REVIEW: The loss of kyphotic correction after instrumentation in unstable burst fracture is found. Some methods have been developed to reduce the loss of correction. MATERIALS AND METHODS: 24 short-segment pedicle screw instrumentations in the patients with a unstable burst fracture were performed. We measured sagittal index, wedge angle of vertebral body and anterior vertebral height preoperatively, intraoperatively, postoperatively and at final follow-up. RESULTS: Sagittal index was 20.2 degrees preoperatively, 7.5 degrees intraoperatively, 0.9 degrees postoperatively and 7.2 degrees at final follow-up, so the loss of correction was 32.6%. Wedge angle of vertebral body was 20.3 degrees preoperatively, 10.1 degrees intraoperatively, 6.8 degrees postopera-tively and 9.4 degrees at final follow-up, so the loss of correction was 19.3%. Anterior vertebral height was 57.0%, 79.3%, 85.0%, and 78.8% respectively, so the loss of correction was 22.1%. The loss of correction occurred more in the disc space and less in the vertebral body itself. Postural reduction corrected 63% of sagittal index, 50% of wedge angle of vertebral body and 52% of anterior vertebral height. CONCLUSIONS: Postural reduction corrected kyphotic deformity appropriately. The correction by posterior instrumentation in unstable burst fracture was lost in some amount. The final correction was similar to the one by postural reduction. It is important to obtain the maximum postural reduction intraoperatively to prevent kyphotic deformity caused by loss of correction after surgery.
Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Retrospective Studies

Background: and Purpose Spinocerebellar ataxias (SCAs) are the most common form of hereditary ataxias. Extracerebellar signs have been well described and are helpful in differentiating the SCA subtypes. However, there are few reports on the early-stage extracerebellar signs in various SCA subtypes. This study explored the clinical and magnetic resonance imaging (MRI) characteristics of early-stage SCAs in the Korean population. Methods: We retrospectively reviewed the medical records of genetically confirmed SCA patients with a disease duration of <5 years. Data on baseline characteristics, extracerebellar signs, and initial MRI findings were organized based on SCA subtypes. Results: This study included 117 SCA patients with a median age at onset of 40.6 years. The family history was positive in 71.8% of the patients, and the median disease duration and the score on the Scale for the Assessment and Rating of Ataxia at the initial visit were 2.6 years and 5.0, respectively. SCA3 was the most prevalent subtype, and oculomotor abnormalities were the most frequent extracerebellar signs in early-stage SCAs. Saccadic slowing was characteristic of SCA2 and SCA7, and gaze-evoked nystagmus was prominent in SCA6. Parkinsonism was relatively frequent in SCA8 and SCA3. Decreased visual acuity was specific for SCA7. Dementia was not an early manifestation of SCAs. Brain MRI revealed a pattern of pontocerebellar atrophy in SCA2 and SCA7, while SCA6 demonstrated only cerebellar cortical atrophy. Conclusions SCA patients exhibited diverse extracerebellar signs even in the early stage.Specific extracerebellar signs were characteristic of specific subtypes, which could facilitate differential diagnoses of early-stage SCAs.

Background: and Purpose Spinocerebellar ataxias (SCAs) are the most common form of hereditary ataxias. Extracerebellar signs have been well described and are helpful in differentiating the SCA subtypes. However, there are few reports on the early-stage extracerebellar signs in various SCA subtypes. This study explored the clinical and magnetic resonance imaging (MRI) characteristics of early-stage SCAs in the Korean population. Methods: We retrospectively reviewed the medical records of genetically confirmed SCA patients with a disease duration of <5 years. Data on baseline characteristics, extracerebellar signs, and initial MRI findings were organized based on SCA subtypes. Results: This study included 117 SCA patients with a median age at onset of 40.6 years. The family history was positive in 71.8% of the patients, and the median disease duration and the score on the Scale for the Assessment and Rating of Ataxia at the initial visit were 2.6 years and 5.0, respectively. SCA3 was the most prevalent subtype, and oculomotor abnormalities were the most frequent extracerebellar signs in early-stage SCAs. Saccadic slowing was characteristic of SCA2 and SCA7, and gaze-evoked nystagmus was prominent in SCA6. Parkinsonism was relatively frequent in SCA8 and SCA3. Decreased visual acuity was specific for SCA7. Dementia was not an early manifestation of SCAs. Brain MRI revealed a pattern of pontocerebellar atrophy in SCA2 and SCA7, while SCA6 demonstrated only cerebellar cortical atrophy. Conclusions SCA patients exhibited diverse extracerebellar signs even in the early stage.Specific extracerebellar signs were characteristic of specific subtypes, which could facilitate differential diagnoses of early-stage SCAs.

Coronary artery fistulas (CAFs) are one of the most rare cardiac anomalies. Some patients with CAF may suffer from ischemic chest pain that originates from combined significant coronary artery spasm (CAS). Spontaneous regression of CAF has been reported in a few cases, almost all of which were infants. We report an adult patient who presented with ischemic chest pain due to multiple coronary arteries to pulmonary artery fistulas and combined significant CAS induced by intracoronary acetylcholine provocation test. Spontaneous regression of one of the fistulas was observed at 2-year angiography follow-up.
Acetylcholine ; Adult ; Angiography ; Arteriovenous Fistula ; Chest Pain ; Coronary Vasospasm ; Coronary Vessel Anomalies ; Coronary Vessels ; Fistula ; Follow-Up Studies ; Humans ; Infant ; Pulmonary Artery ; Spasm

No abstract available.
Achondroplasia ; Continuous Positive Airway Pressure ; Sleep Apnea, Obstructive

The authors investigated the serial changes of height and Cobb angle in the fused segments in the anterior cervical fusion. Patients who underwent anterior cervical fusion and fixation were investigated from September 1993 to August 1997. Total of 52 cases who met the following entry criteria were included in this study: (a) no history of prior cervical spine surgery or concomittent posterior fusion, (b) an anatomic radiculopathy or myelopathy that correlated with a radiographic study at the corresponding level, and(c) the clinical follow-up period of at least ten months. The radiographic data were obtained retrospectively from routine clinical radiographs, which included neutral radiographs preoperatively, immediate-postoperatively, and at 4-6 months postoperatively. The heights of the fixed segment were increased significantly after the operation(p<0.05 on Oneway ANOVA on ranks), and then decreased to preoperative value at last follow-up. The lordotic angles were increased after the operation and maintained throughout the study period(p<0.05 on Oneway ANOVA). In conclusion, on the contrary to the general belief that plate fixation can prevent the decrease in the segmental height, we found that the gain of height lasted only temporarily. Despiter this, postoperatively increased lordotic curve was maintained through the study period in spite of height loss. Therefore, we think that the lordosis of the cervical spine may reflects most of functional status of the whole cervical spine rather than height gain of the fused segment.
Animals ; Follow-Up Studies ; Humans ; Lordosis ; Radiculopathy ; Retrospective Studies ; Spinal Cord Diseases ; Spine

BACKGROUND: Recently, the mass media serves a major role in the public health education, but have not been proven whether they are being appropriately utilized in the elderly. The aim of this study was to identify the elderly person's concern in the mass media health information and utilization behavior. METHODS: Between March to June 2008, one to one survey with the elderly people over 60 years was performed in two elderly welfare centers, one public health center, and two secondary hospitals outpatients and inpatients in Seoul and Chungju. RESULTS: A total of 999 subjects were included. By multivariate analysis, factors significantly associated with low concern in the mass media health information were low educational level, non-exercise group, and low concern in own health (P = 0.001, 0.009, < 0.001, respectively). The most frequently utilized health information source was the mass media. By comparing the frequency of health information utilization, women, low educational level, low income, non-exercise group, underweight, low level of self-evaluated health status, and low concern in health information were significantly associated with the lowest quintile of utilization (P value: < 0.001, 0.005, 0.05, < 0.001, 0.002, 0.03, 0.005, respectively). However, the presence of chronic diseases, such as hypertension, diabetes, had no association. CONCLUSION: In community-dwelling elderly, important factors associated with concern in and utilization of the mass media health information were concern in health, self-evaluated health status, exercise status and socioeconomic factors such as education or income level, rather than comorbid chronic disease.
Aged ; Chronic Disease ; Female ; Humans ; Hypertension ; Inpatients ; Mass Media ; Multivariate Analysis ; Outpatients ; Public Health ; Socioeconomic Factors ; Thinness