No abstract available.
Adolescent* ; Humans ; Intervertebral Disc* ; Spine*

No abstract available.

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors

Hip subluxation and dislocation are common orthopaedic problems in children with cerebral palsy. Selective posterior rhizotomy(SPR) is a neurologic procedure aimed in reducing spasticity. Several recent studies have indicated a decrease in spasticity and functional improvement after SPR, and also decrease the tendency toward hip subluxation in children with cerebral palsy. This is a retrospective study to examine whether SPR halts hip subluxation. Between May 1994 and July 1996, 22 children below age of 5 underwent SPR. Twenty children were spastic diplegic types and 2 were mixed type and quadriplegic type respectively. Approximately 50-80% of L2-Sl level dorsal roots was cut, and 13 children had 50% of both Ll roots cut. Migration percentage score (MP) was used to determine progression of hip subluxation during the follow up period (12 36 mos.; Average 15 mos.). Of the total 44 hips in 22 patients, 45.5% (20 hips) improved, 34% (15 hips) remained unchanged, and 20.5% (9 hips) were worsened after SPR. Radiographic stability was achieved in 79.5%. Ll root cut rate (Ll SPR) was 55.5% for improved hips, 67% for unchanged hips, and 50% for worsened hips. Two patients had undergone orthopaedic procedure for progressive hip migration. Most patients experienced postoperative hip stability after SPR, but 20.5% were worsened and 2 patients had orthopaedic procedure. Also it is unlikely that Ll root involvement prevents progression of hip migration.
Cerebral Palsy* ; Child ; Dislocations ; Follow-Up Studies ; Hip* ; Humans ; Muscle Spasticity ; Retrospective Studies ; Rhizotomy* ; Spinal Nerve Roots

Spontaneous spinal subdural hematoma (SSDH) is a very rare condition. We report a case of SSDH presenting with Brown-Sequard syndrome, treated by surgical evacuation. A 77-year-old woman was hospitalized for back pain without trauma history. As she showed progressive sensory loss and right-side dominant paraparesis, we performed magnetic resonance imaging and confirmed the SSDH in the thoracic area. Therefore, she underwent emergent operation and the hematoma was evacuated successfully. After the operation, the patient showed improvement in neurologic function.
Aged ; Back Pain ; Brown-Sequard Syndrome* ; Female ; Hematoma ; Hematoma, Subdural, Spinal* ; Humans ; Magnetic Resonance Imaging ; Myelodysplastic Syndromes* ; Paraparesis ; Spinal Cord Injuries ; Thrombocytopenia

BACKGROUND: A rehabilitation hospital has the characteristics of longer hospital stay, a variety of medical and paramedical personnels involved in treatment, and more probability of the primary care giver being a nonmedical person. The purpose of this study is to describe the characteristics of nosocomial infection in a rehabilitation hospitals METHODS: Surveillance was done in a rehabilitation hospital affiliated university hospital from June to August 1996, May to June 1997, and July to September 1999. Nosocomial infection was investigated by an infection control practitioner (JCP) according to the Center for Disease Control and Prevention (CDC)'s definitions visiting the rehabilitation wards regularly. RESULTS: The overall NI rates were 3.83 in 1996, 4.42 in 1997 and 1.91 in 1999 per 1,000 patient days, and the urinary tract infection (UTI) rates were 2.82 in 1996, 2.87 in 1997 and 1.07 in 1999 per 1,000 patient days. Both of overall NI rate and UTI rate in 1999 decreased significantly compared with that in 1996 and 1997 (P<0.001). Comparing the ward specific NI rate, the average NI rate of the spinal cord injury ward was the highest (5.67 per 1,000 patient days) and that of the pediatric rehabilitation ward was the lowest (0.83 per 1,000 patient days). UTI constituted of the largest proportion of NIs. The distribution of UTI showed a decreasing tendency from 73.47% in 1996 to 56.00% in 1999, but the distribution of gastrointestinal infection showed an increasing tendency from 4.08% and 5.40% in 1997 and 1996 to 24.00% in 1999. The commonly isolated organisms were E. coli (33.63%), Enterococcus spp. (12.73%) and C. difficile (7.27%). It reflected that the main infection was UTI. CONCLUSION: The main NI in rehabilitation hospital was the UTI. It means that the infection control program of rehabilitation hospital should be focused on the control of UTI. Surveillance in the rehabilitation hospital enabled us to describe the characteristics of nosocomial infection in the rehabilitation hospital. NI rate was decreased through continuous communications and educations with factual datum and involvement of various medical and paramedical personnels. These results show that NI surveillance is crucial for an efficient infection control program.
Allied Health Personnel ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection* ; Enterococcus ; Humans ; Infection Control ; Infection Control Practitioners ; Length of Stay ; Primary Health Care ; Rehabilitation* ; Spinal Cord Injuries ; Urinary Tract Infections

PURPOSE: Current trend in implant dentistry is changing from external connection to internal connection. To evaluate the splinting of external and internal connection implant on screw loosening, 2-units prosthesis was fabricated with BioPlant System(R) of external connection type and Lifecore STAGE-1 Single Stage Implant System(R) of internal connection type. MATERIAL AND METHOD: Experimental group is classified into three groups. 1) G1-EE: 2-units prosthesis was fabricated with two BioPlant System. of external connection type. 2) G1-EI: 2-units prosthesis was fabricated with one BioPlant System(R) of external connection type and one Lifecore STAGE-1 Single Stage Implant System(R) of internal connection type. 3) G1-II: 2-units prosthesis was fabricated with two Lifecore STAGE-1 Single Stage Implant System(R) of internal connection type. In fabricating 2-units prosthesis, two hexed abutments are recommended when two implants are installed parallel, otherwise one hexed abutment is used on major occlusal force area and one nonhexed abutment is used on the other area. Since it is rare to find two implants being parallel, it is hard to fabricate prosthesis with passive adaptation using two hexed abutments. It is much more difficult to acquire passive adaptation when using hex abutment compared to nonhex abutment. To evaluate the influence of hexed and nonhexed abutment on screw loosening, 2-units prosthesis was fabricated with hexed and nonhexed abutment. Experimental group is classified into three groups. 1) G2-HH: 2-units prosthesis was fabricated with two hexed abutments. 2) G2-HN: 2-units prosthesis was fabricated with one hexed abutment and one nonhexed abutment. 3) G2-NN: 2-units prosthesis was fabricated with two nonhexed abutments. RESULT: The results of comparing the detorque value after loading on a each prosthesis periodically are as follows. 1. In splinting group of external and internal connection implant, G1-II group demonstrated the biggest detorque value, followed by G1-EI group and G1-EE group. 2. There is no notable significance between external connection implant of G1-EI group and G1-EE group and also no significance between internal connection implant of G1-EI group and G1-II group. 3. G2-HH group showed higher detorque value than G2-HN and G2-NN group. From the results, we can concluded that using both external connection and internal connection implant together is clinically acceptable and in order to acquire a good passive adaptation in fabricating 2-units implant prosthesis we can use two nonhexed abutments.
Bite Force ; Dentistry ; Prostheses and Implants ; Splints

PURPOSE: Oxygen is indispensable for survival and aerobic metabolism in all mammalian cells. Inadequate oxygen triggers a multifaceted cellular response negatively impacting important physiological functions which are observed in clinical diseases such as stroke, drowning, cardiac arrest, hazardous gas poisoning, myocardial infarction and vascular dementia. In this study, we investigated the neuroprotective effect of a synthetic delta-opioid agonist, [D-Ala2, D-Leu5] enkephalin (DADLE), and its role in ischemic neuronal injury. METHODS: This experiment was conducted in vitro using a primary culture of rat cortical neurons. Ischemia induction was performed using a hypoxic chamber. To test the degree of neuronal viability, as protected by delta-opioid stimulation with DADLE under ischemia, we used three independent approaches including a lactate dehydrogenase assay, MTT assay, and an immunofluorescent staining assay for viable cells. In addition, the gene expressions of caspase-3 and heat shock protein 70 were analyzed using real-time PCR. RESULTS: Incubation of the cortical neurons with DADLE protected them from ischemia-induced cytotoxicity, as observed by all three independent viability assays. Also, we found that its neuroprotective effect might be related with suppression of the caspase-3 gene. CONCLUSION: The results of this study suggested that DADLE exhibits a neuroprotective effect against ischemia-induced neuronal cell death.
Animals ; Caspase 3 ; Cell Death ; Dementia, Vascular ; Drowning ; Enkephalin, Leucine-2-Alanine ; Enkephalins ; Gas Poisoning ; Gene Expression ; Heart Arrest ; HSP70 Heat-Shock Proteins ; Ischemia ; L-Lactate Dehydrogenase ; Myocardial Infarction ; Neurons ; Neuroprotective Agents ; Oxygen ; Rats ; Stroke

PURPOSE: Oxygen is indispensable for survival and aerobic metabolism in all mammalian cells. Inadequate oxygen triggers a multifaceted cellular response negatively impacting important physiological functions which are observed in clinical diseases such as stroke, drowning, cardiac arrest, hazardous gas poisoning, myocardial infarction and vascular dementia. In this study, we investigated the neuroprotective effect of a synthetic delta-opioid agonist, [D-Ala2, D-Leu5] enkephalin (DADLE), and its role in ischemic neuronal injury. METHODS: This experiment was conducted in vitro using a primary culture of rat cortical neurons. Ischemia induction was performed using a hypoxic chamber. To test the degree of neuronal viability, as protected by delta-opioid stimulation with DADLE under ischemia, we used three independent approaches including a lactate dehydrogenase assay, MTT assay, and an immunofluorescent staining assay for viable cells. In addition, the gene expressions of caspase-3 and heat shock protein 70 were analyzed using real-time PCR. RESULTS: Incubation of the cortical neurons with DADLE protected them from ischemia-induced cytotoxicity, as observed by all three independent viability assays. Also, we found that its neuroprotective effect might be related with suppression of the caspase-3 gene. CONCLUSION: The results of this study suggested that DADLE exhibits a neuroprotective effect against ischemia-induced neuronal cell death.
Animals ; Caspase 3 ; Cell Death ; Dementia, Vascular ; Drowning ; Enkephalin, Leucine-2-Alanine ; Enkephalins ; Gas Poisoning ; Gene Expression ; Heart Arrest ; HSP70 Heat-Shock Proteins ; Ischemia ; L-Lactate Dehydrogenase ; Myocardial Infarction ; Neurons ; Neuroprotective Agents ; Oxygen ; Rats ; Stroke