The pseudomonas spinal epidural abscess is a extremely rare disease. It is well known that early diagnosis and surgical evacuations of the lesions are very important for better treatment results. Two cases of cervical epidural abscess were admitted to our hospital with neck pain, chillness and quadriparesis. One month prior to admission, the two patients underwent stellate ganglion block at an same institution on the same day, to releive the pain in the neck and the scapular area. Antibiotic therapy was initiated immediately and surgical decompression was performed through a posterior approach. Total laminectomy of C4-C7 was done and greenish pus and granulation tissue from anterior epidural space were evacuated. Culture of the pus revealed pseudomonas aeruginosa. In both of these cases, stellate ganglion block was suspected causes of infection. First patient patient recovered completely, but second had severe neurological deficit with quadriparesis.
Decompression, Surgical ; Early Diagnosis ; Epidural Abscess* ; Epidural Space ; Granulation Tissue ; Humans ; Laminectomy ; Neck ; Neck Pain ; Pseudomonas aeruginosa ; Pseudomonas* ; Quadriplegia ; Rare Diseases ; Stellate Ganglion* ; Suppuration

Gelastic epilepsy characterized by paroxysmal involuntary laughing episodes is a relatively rare type of seizure which may occur singly or, more frequently, with other types of convulsions. Gelastic seizures have been observed in many different conditions, mainly hypothalamic hamartomas. We report a 21-year-old woman whose uncontrollable laughter was the only neurologic disturbance since 20 years of age. Physical and neurological examination did not reveal any abnormality. Neuropsychologic test was also normal. Brain magnetic resonance imaging was normal. During video-EEG monitoring, the clinical events usually consisted of aura of undescriable sensation lasting 1-2seconds followed by ictal laughter, without loss of consciousness and postictal manifestation. Ictal EEG showed bilateral interruption of background activity lasting 2-3seconds, followed by semirhythmic theta frequency activities over right frontotemporal region. Interictal EEG showed intermittent sharp waves or spike activities at right anterior temporal area. After Oxcarbamazepine treatment, she has never experienced the laughing seizures.
Brain ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Female ; Hamartoma ; Humans ; Laughter ; Magnetic Resonance Imaging ; Neurologic Examination ; Neuropsychological Tests ; Seizures ; Sensation ; Unconsciousness ; Young Adult

The authors analysed 215 ocular injured patients sent to ST. Mary's Industrial Accident Hospital for the last 5 years form January 1982 to December 1986. 1. Majority of patients(72.1%) were young adult and almost all were male(96.7%). 2. The occupational accident rate showed the highest among blacksmiths and tool makers(33.5%), followed by woodworkers(13.6%), and electrical set-up workers (9.4%). 3. The occurrence rate of ocular injury was the most frequent by the flying objects(75.8%), followed by struck-by(11.2%), and stabbed (7.8%). The source of the injuries were mostly metallic materials(68.1%), followed by non-metallic ma terials(11.9%), and pressure boilers(5.0%). 4. The incidence rate was about the same in non-penetrating injuries as penetrating injuries. But the visual prognosis was worse in penetrating cases than nonpenetrating cases(P<0.05). 5. The most frequent complication was traumatic cataract(32.0%), followed by corneal of scleral laceration(16.0%) and intraocular foreign body(11.9%). 6. In visual prognosis, the final visual acuity of 0.15 or higher was achieved in only 25.3% among those with initial visual acuity of lower than 0.02 but 66.2% among those with initial visual acuity of 0.02 or higher.
Accidents, Occupational* ; Diptera ; Humans ; Incidence ; Prognosis ; Visual Acuity ; Young Adult

PURPOSE: To establish the interobserver and intraobserver reliability of the Coonrad classification for an idiopathic coronal curve pattern. MATERIALS AND METHODS: Radiographs of 257 idiopathic scoliosis patients that had a rib humping of more than 1 cm and a Cobb angle of more than 10 were reviewed. The interobserver and intraobserver reliability was assessed by a comparison of the classification of the curves between four observers. RESULTS: In the Coonrad classification, a 1A type-curve occurred in 37 cases, the 1B type-curve occurred in 27 cases, the 2A type-curve occurred in 70 cases, a 2B type-curve occurred in 22 cases, a 3 type-curve occurred in 44 cases, a 4 type-curve occurred in 6 cases, a 5 type-curve occurred in 15 cases, a 6 type-curve occurred in 22 cases, a 7 type-curve occurred in 13 cases and a 8 type curve occurre in 1 case. The interobserver reliability for the Coonrad classification was 0.60 and the intraobserver reliability was 0.71. CONCLUSION: The Coonrad classification proved to be relatively reliable, but revealed some confusion, particularly between type 2A and type 3. Also, there seemed to be no advantage in using this method of determining the treatment modality compared with the conventional scoliosis classification system.
Adolescent* ; Classification* ; Humans ; Ribs ; Scoliosis*

No abstract available.
Embolism, Air*

It is important to follow strict indications for surgery and recognize prognostic factors in order to get good results in the surgical treatment of herniated nucleus pulposus. 55 patients with herniated nucleus pulposus were studied who had had laminectomy and discectomy and were followed up for more than 1 year in order to analyze the correlation between various factors including history, physical examination and radiologic finding and surgical results. Age, sex, symptom duration, location of the herniation, smoking, occupation, physical examination, disc height change, MRI findings, operation time and bleeding volume were evaluated as prognostic factors that seemed to influence surgical result. The results are as follow 1. Female had significantly better surgical results than male (P<0.05). 2. Non-smokers had significantly better surgical result than smokers (P<0.01). 3. In MRI finding, protruded disc had significantly better surgical result when it had involved spinal canal posterolaterally than centrally (P<0.01). 4. The less bleeding volume, the better surgical result (P<0.05).
Diskectomy ; Female ; Hemorrhage ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Occupations ; Physical Examination ; Smoke ; Smoking ; Spinal Canal

Spasticity is common stroke in patients, and its management has been considered as one of the major problems in stroke rehabilitation. The goal of this study was to determine if transcutaneous electrical nerve stimulation(TENS) and acupuncture would reduce the muscle spasticity. To estimate the efficacy of electrical stimulation for the treatment of spasticity TENS(100 Hz, asymmetric bipolar pulse current) was applied to the skin over the extensor muscles of spastic limbs for 20 minutes, once a day in six stroke patients. In addition, acupuncture was also applied to the acupoints of extensor muscles of all extremities and face for 20 minutes twice a day to determine the efficacy of acupuncture for the treatment of spasticity in six stroke patients. As controls subjects, six stroke patients were examined without TENS or acupuncture treatment. In experimental groups, the efficacy of treatment was measured 1, 5, 10, 15 days and 20 days after treatment with either TENS or acupuncture using the spasticity measurement methods (modified Ashworth scale, ankle clonus score, and H/M ratio). Based on the results from the present study, we have concluded that the H/M ratios of affected spastic limbs were significantly higher than those of unaffected limbs (p<0.05). TENS and acupuncture therapies lessened the spasticity of affected limbs of stroke patients when measured with the modified Ashworth scale however not with the H/M ratios nor with the ankle clonus scores.
Acupuncture Points ; Acupuncture* ; Ankle ; Electric Stimulation ; Extremities ; Humans ; Muscle Spasticity ; Muscles ; Rehabilitation ; Skin ; Stroke* ; Transcutaneous Electric Nerve Stimulation*

OBJECTIVE: Percutaneous techniques are rapidly replacing traditional open surgery. This is a randomized controlled trial study of clinical outcomes of Percutaneous Plasma Disc Coagulation Therapy (PDCT) in patients with HLD(herniated lumbar disc) as a new percutaneous access in comparison with Automated Percutaneous Lumbar Discectomy (APLD) in its clinical application and usefulness as a reliable alternative method. METHODS: The authors analyzed 25 patients who underwent PDCT randomized 1:1 to 25 who underwent APLD between June, 2010 and October, 2011. All patients had herniated lumbar disc diseases. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. RESULTS: The age of the patients who underwent PDCT ranged from 29 to 88 years with a mean age of 51.8 years. The age of the APLD undergone patients' population ranged from 30 to 66 with a mean age of 46.0 years. The average preoperative VAS score in PDCT was 7.60 and 1.94 at 7months post-operatively, and in APLD was 7.32, and 3.53 at 7 months post-operatively (p<0.001). In Macnab's criteria, 20 patients (80%) had achieved favorable improvement (excellent and good) in PDCT group. In Macnab's criteria, 16 patients (64%) had achieved favorable improvement in APLD group (p<0.001). CONCLUSION: PDCT can be considered a viable option as a new percutaneous access to herniated lumbar disc. PDCT showed to be more effective than APLD in this study, allowing stable decompression and safe minimally invasive operation to an area desired by the operator in lumbar disc herniation patients, although further long term clinical evaluations are still necessary.
Decompression ; Diskectomy ; Humans ; Plasma ; Weights and Measures

STUDY DESIGN: To present preliminary results of PLIF (Posterior lumbar interbody fusion) and pedicle screw fixation in the lum-bar pyogenic discitis. OBJECTIVES: To evaluate the advantages and effects of PLIF and posterior instrumentation over recurrence of infection in lum-bar pyogenic discitis which are resistant to antibiotics. SUMMARY OF LITERATURE REVIEW: To the date, anterior removal of the focus followed by interposing autogenous bone graft without additional instrumentation and postoperative long-term immobilization has been the standard operative procedure. MATERIALS AND METHODS: 10 consecutive patients who had lumbar pyogenic discitis were treated by posterior approach from October 1997 to March 1999. RESULTS: Based on MRI or CT finding, 9 solid union at 3-4 months after operation and 1 suspicious union at 1 year after opera-tion were observed. The mean preoperative lordotic angle of the affected segments was 9 degree compared to 20 degree after postoperation and 17 degree at last follow up. As for functional result of Kirkaldy-Willis, outcome was excellent in 3, good in 5, fair in 2, none poor case. The duration of postoperative bed rest period was an average of 3 days. CONCLUSIONS: PLIF with instrumentation in lumbar pyogenic discitis is a useful treatment in posterior epidural abscess,coexis-tent spinal stenosis and lower lumbar level where anterior fixation is impossible. It is especially indicated in the case of scanty antevertebral abscess with minimal bone destruction. Its main advantage is early ambulation.
Abscess ; Anti-Bacterial Agents ; Bed Rest ; Discitis* ; Early Ambulation ; Follow-Up Studies ; Humans ; Immobilization ; Magnetic Resonance Imaging ; Recurrence ; Spinal Stenosis ; Surgical Procedures, Operative ; Transplants

PURPOSE: The purpose of this study is to describe the imaging characteristics of oligodendroglioma in childhood. MATERIALS AND METHODS: Eight CT scans and 12 MR images were retrospectively reviewed in 12 children (mean age, 9.5 years) with pathologically-proven oligodendroglioma. The most frequent symptoms were seizure and headache, with a mean duration before diagnosis of 21 months. Location, MR signal intensity, calcification,intratumoral hemorrhage, cystic change, peritumoral edema and contrast enhancement were retrospectively analyzed. RESULTS: The supratentorial location was most frequent (9/12, 75%) and the majority of tumors were located peripherally or subcortically (7/9, 78%). On MR, most tumors demonstrated low signal intensity on T1WI and high signal intensity on T2WI ; cystic change was frequent (10/12, 83%). Tumor enhancement was seen in 60% of cases (6/10), with various enhancement patterns. Intratumoral hemorrhage was seen in two cases. On CT, the tumors were usually hypodense and calcification was noted in two cases (2/8, 25%). Peritumoral edema and mass effect of the tumor were seen in five (5/12,42%). Hydrocephalus was associated in two cases. CONCLUSION: In childhood, most oligodendrogliomas demonstrate a peripherally located supratentorial mass, with frequent cystic change. Calcification or intratumoral hemorrhage were less frequent than in previously reported adult series.
Adult ; Child ; Diagnosis ; Edema ; Headache ; Hemorrhage ; Humans ; Hydrocephalus ; Oligodendroglioma* ; Retrospective Studies ; Seizures ; Tomography, X-Ray Computed