No abstract available.

Click sound can evoke myogenic potentials in active sternocleidomastoid(SCM) muscle. These are due to activity of vestibular afferent rather than cochlear, which produce very short latency inhibition of ipsilateral motor unit activity. We investigated the click-evoked vestibulocollic reflexes in neck muscles to find out the significance and relationship of latency and amplitude of myogenic potentials between two different methods of muscles activation. EMGs were recorded from surface electrode evoked by sound stimuli(95dB SPL, 5/sec repetitive rate, 512 times) over SCM muscles on each side. Myogenic potentials have two biphasic responses which were termed P1, N1, P2, N2 based on the polarity of their components. The subjects were 24 normal volunteers. EMG recordings were obtained from 12 subjects(Group 1) who keeped head 10 cm above ground in supine position to activate their neck flexors to the degree required through the averaging runs(bilateral SCM muscles activation method). EMGs from another 12 subjects(Group 2) were recorded by rotating head to the opposite side to activate SCM muscle throughout the procedure(unilateral SCM muscle activation method). The latencies and amplitudes of myogenic potentials in the SCM muscle after stimulation were analysed and compared between the two methods. The latencies(msec) of P1 and N1 were 11.2+/-2.4, 21.7+/-1.1 respectively in Group 1 and 13.3+/-2.4, 23.0+/-1.1 respectively in Group 2. The amplitude(uV) of P1-N1 were 38.78.1 in Group 1 and 33.28.1 in Group 2. There were no significant differences in latencies and amplitudes of P1 and N1 between the groups(p<0.05). Unilateral muscle activation is easier and comfortable than the bilateral muscle activation and there were no significant difference in latency and amplitude of P1. The myogenic potential of unilateral vestibular function loss disappeared in a patient who was labyrinthectomized but there was normal response of potential in a patient who is profound sensory neural hearing loss. Click evoked myogenic potentials is a simple method of examining vestibulocollic reflex. Click evoked myogenic potential is related to vestibular status.
Electrodes ; Head ; Healthy Volunteers ; Hearing Loss ; Humans ; Muscles ; Neck ; Neck Muscles ; Reflex* ; Supine Position

The vascular injuries that occur with lumbar discectomy are serious and often fatal complications. The incidence of such injuries is very low, but they are probably underestimated due to the various clinical manifestations such as retroperitoneal hemorrhage, hematoma and iliac artery-IVC vein fistula. A delayed diagnosis, and especially in case of iliac-IVC fistula, results in high output heart failure and cardiopulmonary insufficiency. We report here on 2 cases of iliac arteriovenous fistula that occurred after lumbar discectomy. An 18-year-old man and a 37-year-old man were admitted to our department with the symptoms of high output heart failure 3 and 24 days, respectively, after lumbar discectomy was performed. Both of them presented with clinical manifestations of pulmonary edema, tachycardia, hydrothorax and high output heart failure. One man died after an iliac artery stent graft and one man was salvaged after left common iliac vein ligation, aorto-common iliac artery bypass and left common iliac vein-IVC bypass surgery. Prompt diagnosis and aggressive treatment can hep to salvage the patients from these fatal complications. A high index of suspicion for this malady, based on the clinical signs, is mandatory.
Adolescent ; Adult ; Arteriovenous Fistula ; Blood Vessel Prosthesis ; Delayed Diagnosis ; Diagnosis ; Diskectomy* ; Fistula* ; Heart Failure ; Hematoma ; Hemorrhage ; Humans ; Hydrothorax ; Iliac Artery ; Iliac Vein ; Incidence ; Ligation ; Pulmonary Edema ; Tachycardia ; Vascular System Injuries ; Veins

A femoral artery aneurysm (FAA) is a rare disease with the symptoms of nerve and vein compression, lower extremity ischemia, local pain, pulsating mass, and rupture. Compression of the femoral vein may cause the symptoms of lower extremity venous insufficiency, which accounts for nearly 10% of FAA patients. (Case) A 55 year-old female was hospitalized, suffering from swelling, heaviness and venous ectasia of the left lower extremity. Preoperative CT angiography revealed a 3 cm-sized FAA and compression of the femoral vein due to the aneurysm in her left inguinal area. The aneurysm extended from the distal external iliac artery (EIA) to both the proximal superficial femoral artery (SFA) and profunda femoris artery (PFA). After an aneurysmectomy, interposition grafting from the EIA to the SFA with reimplantation of PFA was done. Immediately after the operation, the symptoms dramatically disappeared, and the follow-up CT revealed the decompressed femoral vein.
Aneurysm* ; Angiography ; Arteries ; Dilatation, Pathologic ; Female ; Femoral Artery* ; Femoral Vein ; Follow-Up Studies ; Humans ; Iliac Artery ; Ischemia ; Leg* ; Lower Extremity ; Middle Aged ; Rare Diseases ; Replantation ; Rupture ; Transplants ; Veins ; Venous Insufficiency

Congenital aural atresia requires reconstructive surgery because of its negative effect against hearing and cosmetic problem. Two surgical methods, anterior and transmastoid approaches, have been designed for the surgery and many surgeons have advocated any techniques depending on their surgical experiences and advantages of each method. We analyzed retrospectively 53 cases of congenital aural atresia operated with the use of one of both approaches, and got the clinical, audiological and surgical results as follows. 1) Postoperative dressing period was shorter in the anterior approach(34.5 days) than in the posterior one(44.2 days). 2) Hearing results are better in the anterior approach. 3) Postoperative complications include granulation tissue formation, drum lateralization, external auditory canal stenosis and temporary facial nerve weakness. And it happened more frequently in the anterior approach than the posterior one. 4) Facial nerve anormaly was noted in 16 cases(30.2%) and cholesteatoma in 5 cases(9.4%).
Bandages ; Cholesteatoma ; Constriction, Pathologic ; Ear Canal ; Facial Nerve ; Granulation Tissue ; Hearing ; Postoperative Complications ; Retrospective Studies

We examined the ultrastructural features of the lung parenchyma and the expression of apoptosis of the respiratory cells by TUNEL technique. Male Sprague-Dawley rats (n=30) were intra-tracheally injected with cadmium (2.5 mg/kg) into both lungs. The light and electron microscopic features of the lung tissues were examined on Days 1, 3, 7 and 10 after the injection of cadmium. Specimen preparations for the light and electron microscopic TUNEL stains were performed. Ultrastructurally, on Days 1 and 3, the alveolar spaces were filled with edematous fluid, and desquamated type I epithelial cells. On Days 7 and 10, the alveolar spaces and interstitium were patchy infiltrated with young fibroblasts and some collagen deposition. The light microscopic TUNEL stain showed that apoptosis of the alveolar cells was most prominent on Day 1, and then the number of apoptosis was markedly decreased on Days 3, 7 and 10. The electron microscopic TUNEL stain showed the electron dense homogenous nuclear expression, and the formation of intra-nuclear blebs which protrude to the outside of nuclei. On Days 7 and 10, there are frequent apoptotic nuclear bodies in the alveolar macrophages. We could examine the identification of the equivocal apoptotic cells and various morphologic expression of apoptotic nuclei on the electron microscopic TUNEL stain.
Acetone/pharmacology ; Animals ; Apoptosis ; Cadmium/metabolism/*pharmacology ; Cell Nucleus/metabolism ; *In Situ Nick-End Labeling ; Lung/*cytology/*injuries/pathology/*ultrastructure ; Male ; Microscopy, Electron ; Microscopy, Electron, Scanning ; Pulmonary Alveoli/metabolism ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't ; Time Factors

PURPOSE: Acute abdominal pain can be the result of many different pathophysiological processes. Among the many possible causes, acute mesenteric ischemia is a life threatening condition if the diagnosis is delayed. Generally, the mortality rate for other disease has gradually decreased; however, the mortality rate for acute mesenteric ischemia has not changed significantly and it continues to be 75% to 80% for acute mesenteric arterial embolism or thrombosis and 44% for acute mesenteric venous thrombosis. The aim of this study was to conduct an analysis of the clinical characteristics and mortality of the patients with acute mesenteric ischemia according to the etiology. METHOD: From 1989 to 2004, 43 patients were treated for acute mesenteric ischemia. Their mean age was 59 years, ranging from 24 to 81, and the male to female gender ratio was 24:19. We retrospectively analyzed their initial symptoms, the age and gender distribution, the treatment modalities and the mortality rates. RESULT: The causes of acute mesenteric ischemia were arterial embolism in 27 cases, arterial thrombosis including arterial dissection in 7 cases and venous thrombosis in 9 cases. Almost all of the patients complained of acute abdominal pain and abdominal tenderness. The overall mortality rate was 30.2% and the rates were 37.0% for mesenteric artery embolism, 42.9% for mesenteric artery thrombosis and 0% for mesenteric venous thrombosis. CONCLUSION: In this study, the causes of acute mesenteric ischemia were mesenteric artery embolism and thrombosis, including dissection and mesenteric venous thrombosis. The factors influencing the mortality were the cause of the acute mesenteric ischemia, the extent of involvement of the mesenteric vessels and the extent of bowel necrosis. Thus the most important things for the treatment of acute mesenteric ischemia are early diagnosis and proper treatment.
Abdominal Pain ; Diagnosis ; Early Diagnosis ; Embolism ; Embolism and Thrombosis ; Female ; Humans ; Ischemia* ; Male ; Mesenteric Arteries ; Mortality ; Necrosis ; Retrospective Studies ; Thrombosis ; Venous Thrombosis

Obstructive jaundice produced by periportal tuberculous adenitis in the absence of pulmonary tuberculosis is quite rare. We are reporting the case of a 58-year-old woman who presented with constitutional symptoms and biochemical evidence of biliary tract obstruction. By abdominal sonogram and CT scan, a mass around the head of pancreas and periportal area was detected. The ERCP showed fistula connected proximal common bile duct to lymph node. The patient underwent laparotomy and recognized tuberculous adenitis of periportal lymph node which caused biliary tract obstruction with fistula.
Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Female ; Fistula ; Head ; Humans ; Jaundice, Obstructive ; Laparotomy ; Lymph Nodes ; Lymphadenitis* ; Middle Aged ; Pancreas ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; Yemen*

No abstract available.
Glutens ; Humans ; Pilot Projects ; Urticaria

PURPOSE: Though the nonoperative management of liver injury (NOMLI) has frequently been employed for traumatic liver injuries, the indications for NOMLI for grade IV liver injuries are still controversial. To determine the usefulness of the NOMLI in grade IV liver injuries, the clinical features of an operative management (n=26) and a NOMLI group (n=20) were compared. METHODS: For the 10 years up until Feb. 2004, 46 grade IV liver injury cases, according to the AAST liver injury scale, at the Kyung Pook National University Hospital, were selected for this study. The clinical features, grade of liver injury and outcomes of treatments were reviewed retrospectively. RESULTS: Of the 46 cases 40 (87%) and 6 (13%) were male and female, respectively. The mean ages of the male and female cases were 37.6 (15.2 and 34.5 (16.7 years, respectively. The causes of liver trauma were vehicle accident (71.7%, 33/46), industry accident (26.1%, 12/46) and violence (2.2%, 1/46). The accompanying abdominal injury was not present in the NOMLI group compared to 30.8% (8/26) in the operative management group. NOMLI was more than 2 times more frequently indicated after Feb. 1999. The mortality in operative management group was 11.5% (3/26) compared with none in the NOMLI group. 20% (4/20) of NOMLI group failed due to delayed bleeding and eventually had to undergo operations and the 80% (16/20) of NOMLI group was successful. The morbidity in successful NOMLI group was bile collection (6.25%, 1/16) and empyema (6.25%, 1/16). CONCLUSION: Nonoperative management for grade IV liver injury in hemodynamically stable patients without accompanying abdominal injury was successful. However, continuous monitoring and immediate operative management should be prepared for the delayed bleeding.
Abdominal Injuries ; Bile ; Empyema ; Female ; Hemorrhage ; Humans ; Liver* ; Male ; Mortality ; Retrospective Studies ; Violence ; Wounds and Injuries