Spontaneous spinal epidural hematoma are rare disease and the cause of bleeding in epidural hematoma remains unknown in most of the cause. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced I case of spontaneous spinal epidural hematoma at thoracic location. Laboratory examination showed no evidence of coagulopathy and hepatic disease. The patient had good surgical outcome after emergent decompressive laminectomy.
Anticoagulants ; Hematoma ; Hematoma, Epidural, Spinal* ; Hemorrhage ; Humans ; Laminectomy ; Rare Diseases ; Risk Factors

No abstract available.
Otoacoustic Emissions, Spontaneous*

OBJECTIVE: It has been suggested that hysterectomy has a disturbing influence on bowel function, mainly constipation. We performed a prospective study to assess the changes of ano-rectal physiology after hysterectomy. METHODS: Fourteen consecutive patients were assessed before and two months after hysterectomy. A detail questionnaire was devised to allow assessment of bowel function and ano-rectal pressure test and balloon expulsion test were performed before and after hysterectomy. The parameters measured in ano-rectal pressure test included the minimal sensible volume, ano-rectal resting pressure, maximal squeezing pressure, recto-anal inhibitory reflex and balloon expulsion test. Data analysis was carried out by paired t-test. Statistical significance was inferred when the p value was<0.05. RESULTS: Among the fourteen patients, the straining in defecation was found in three patients after operation, other defication habits were not significantly changed after hysterectomy(P>0.05). There were no significant changes in ano-rectal pressure test after hysterectomy. The disturbance of balloon expulsion capacity was increased in four patients after hysterectomy(29%). CONCLUSION: Our results demonstrate that hysterectomy does not cause a decrease in ano-rectal pressure and rectal sensitivity, but has an adverse effect on rectal expulsion capacity in a some of patients.
Constipation ; Defecation ; Humans ; Hysterectomy* ; Physiology ; Prospective Studies ; Surveys and Questionnaire ; Reflex ; Statistics as Topic

No abstract available.
Brain Stem* ; Classification* ; Hemorrhage*

Systolic time interval measurements were made sequentially during second, third trimesters and postpartum period. Recordings were made in the supine position after bed rest for at least five minutes in order to obtain a steady state. In second trimester, pre-ejection period index (PEPI) was significantly shortened and left ventricular ejection period index(LVETI) remained normal while PEP/LVET decreased. Four possible mechanisms may be involved to account for the alterations in hemodynamic changes during this period(late stage of second trimester) : (1) increased metabolic demands of pregnancy: (2) hemodynamic effects of hypervolemia: (3) circulatory adjustments secondary to an arteriovenous shunt-like effect of the placental circulation: (4) cardiovascular effect of steroid hormone. The third trimester was characterized-by a markedly shortened LVETI, a prolonged PEPI and PEP/LVET. This findings are consistent with impaired left ventricular performance and are probably due to decreased left ventricular preload resulting from diminished venous return secondary to inferior vena caval obstruction by the large gravid uterus. In the postpartum period, the PEPI and PEP/LVET remained elevated and the LVETI shortened in the supine position. It is concluded that alterations in systolic time intervals occur normally during the course of uncomplicated pregnancy and persist into the postpartum period.
Bed Rest ; Female ; Hemodynamics ; Humans ; Placental Circulation ; Postpartum Period* ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third* ; Supine Position ; Systole* ; Uterus

No abstract available.

A technique radiogrequency localization and coagulation of articular nerves supplying the lumbar facets is described and reported from a series of 46 patients with clinical diagnosis of facet syndrome over a 4-year period. None of them had clinical or radiologic evidence of a lumbar disc hrniation, and all had exhausted conservative treatment. The literature reviewed for anatomical accuracies in denervation of the medial branch of posterior primary(dorsal) ramus. The technique of facet denervation is simple and safe and relief of pain was achieved in 78% of the patient, the morbidity remains quite low.
Denervation* ; Diagnosis ; Humans ; Low Back Pain*

The authors analyzed 52 cases of spinal cord tumor who had been operated upon at the department of neurosurgery of the Koryo General Hospital from 1983 to 1992. The results were summerized as followings: 1) The spinal cord tumor was most common in the 6th decade of age(52 cases, 28.8%) and the ratio of male to female was 1.26:1. 2) The pathologic diagnosis was neurogenic tumor in 25 cases(48.1%), metastatic tumor in 12 cases(23.1%), glial tumor in 6 cases(11.5%), and meningeal tumor in 3 case(5.7%) in order frequency. 3) The tumors were located most frequently in the thoracic area(19 cases, 36.5%) and in the intradural extramedullary space(28 cases, 53.9%). 4) The most common initial presentation was pain(27 cases, 51.9%) and on admission 14 cases(26.9%) showed paraparesis. 5) The rate of abnormality of the plain radiologic study was 59.6% and the most common positive finding was the pedicle erosion(15 cases, 28.8%). 6) The computed tomographic scanning with water soluble contrast media was useful in planning of operation to provide the exact relationship between the tumor, spinal cord and location of dura. 7) The total removal was possible in 27 cases(51.9%). 8) The follow-up results after 19.4 months of the mean follow-up duration in 46 cases were recovery in 29 cases(63.0%), improvement in 12 cases(26.0%), stationary state in 3 cases(6.5%), worse in 2 cases(4.3%). It was excellent particulary in cases of intradural-extramedullary tumor. 9) The incidence of metastatic tumor was 23.1%(12 cases) and the lung was most common primary focus. The follow-up result of metastatic tumor was poor than the other tumors.
Contrast Media ; Diagnosis ; Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Lung ; Male ; Meningeal Neoplasms ; Neurosurgery ; Paraparesis ; Spinal Cord Neoplasms* ; Spinal Cord*

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*