No abstract available.
Enterotoxigenic Escherichia coli* ; Enterotoxins*

The authors analyzed 103 cases of chronic subdural hematoma(SDH) treated in the department of Neurosurgery, Yonsei University Hospital from January 1976 to September 1983. All of the cases were operated on except a single case, which was treated conservatively. The results of the analysis are summarized as follows: 1) The chronic SDH occurred most frequently in the 5th decade, and 71.8% of the patients were older than their 4th decade. The chronic SDH were far more common in men(84.5%) than women(15.5%). 2) Seventy two patients(79.6%) had a history of previous head injury. Chronic alcoholism was noted in thirteen patients(12.6%). 3) Presenting symptoms and signs in decreasing order were headache(76.9%), motor weakness(44.7%), mental disturbance(43.7%), papilledema(42.7%), and vomiting(35%). 4) Brain CT scan was not only the most accurate diagnostic procedure but also important for planning operative intervention as well as evaluating the prognosis. Four patterns of CT densities were noted in chronic SDH;hypodense(43.3%), isodense(37.8%), hyperdense(13.5%), and mixed density(5.4%). Cerebral expansion rates decreased with age, which was less than 80% in patients over their 40s. The chronic SDH was found on the right side in 45.6% of cases and 41.8% on the left, while 12.6% of chronic SDH were bilateral. 5) Operative procedures in 102 cases, were as follows; 32 Simple burr hole closed drainage, 31 Simple burr hole open drainage, 31 craniotomy and membranectomy, and 10 craniectomy and membranectomy. In conclusion, simple burr hole closed system drainage is the most effective and the least invasive procedure for the treatment of chronic SDH. Membranectomy with craniotomy or craniectomy should be reserved for such cases as recollection of SDH, failure of brain expansion, solid hematoma, and extensive swelling of the white matter subjacent to the hematoma.
Alcoholism ; Brain ; Craniocerebral Trauma ; Craniotomy ; Drainage ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Neurosurgery ; Prognosis ; Surgical Procedures, Operative ; Tomography, X-Ray Computed

STUDY DESIGN: Prospective study. OBJECTIVES: To assess the correlation between symptom improvement and spinal canal dimensions in patients who underwent selective nerve root block for lumbar spinal stenosis. SUMMARY OF LITERATURE REVIEW: When the canal size is relatively small, the pressure on the nerve root increases. Decompressive surgery relieves more pain in such patients. MATERIALS AND METHODS: From July 2009 to March 2011, 141 patients received selective nerve root block for 1-level central lumbar spinal stenosis in our hospital. We evaluated the patients using a visual analog scale (VAS) before the procedure and 1 hour, 1 month, and 3 months following the procedure. We measured the spinal canal using magnetic resonance imaging. RESULTS: There was no significant correlation between spinal canal dimensions and the pre-procedure VAS. We divided the patients into 3 groups using the average and the standard deviation of the patients' spinal canal dimensions (<73.1 mm², 73.1-172.5 mm², >172.5 mm²) (p<0.01). One hour after the procedure, the VAS scores changed by 1.43±1.8, 1.62±1.7, and 1.53±1.5, respectively, with no significant differences among the 3 groups. However there were significant differences in the VAS changes 1 month and 3 months following the procedure, with results of 2.39±1.7 and 1.39±1.5, 4.65±2.1 and 4.28±2.3, and 4.97±2.2 and 6.83±1.9 (p<0.01), respectively. CONCLUSIONS: The smaller the area of the spinal canal, the less likely symptoms were to improve after selective nerve root block. The results of this study will help predict the effects of selective nerve root block in spinal stenosis patients.
Humans ; Lumbosacral Region ; Magnetic Resonance Imaging ; Nerve Block ; Prospective Studies ; Spinal Canal* ; Spinal Stenosis* ; Visual Analog Scale

No abstract available.
Animals ; Evoked Potentials* ; Rats*

Background: Many Korean women with single eyelids wish to have their eyes enlarged through double eyelidplasty, and many of them also want to have additional procedures in order to have a larger perceived size of their eyes, with the desire for their eyes to resemble those with inborn double eyelids. Thus, in this study, we performed eye measurements and evaluated the usefulness of the eyeball exposure area to differentiate the overall eye size according to the nature of double eyelids (inborn or operated). Methods: This study involved 92 eyes with natural double eyelids (group A) and 76 eyes with only double eyelidplasty (group B). The two groups were compared through measurements of the exposed eyeball area (EEA) and palpebral fissure height (PFH). To compare the usefulness of the EEA for the perceived eye size, the PFH value was also measured by adjusting it to a percentage value. Results: The mean value of the PFH was 9.95±0.67 mm in group A and 8.48±1.04 mm in group B. The adjusted percentage value of the PFH relative to the corneal diameter (11.3 mm) was 88.05% in group A and 75.04% in group B. The EEA was 85.59%±3.25% in group A and 82.89%±6.36% in group B. The difference between the two groups was 13.01% in terms of PFH and only 2.7% in terms of EEA. Conclusions The values of PFH and EEA were higher in group A, but EEA was more useful for evaluating the perceived eye size between the two groups.

OBJECTIVES: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients.SUMMARY OF LITERATURE REVIEW: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. MATERIALS AND METHODS: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. RESULTS: The average area of the spinal canal was 81.40±53.61 mm2 in the surgical group, compared to 127.75±82.55 mm2 in the nonsurgical group (p=0.042). The muscle area in the spinal canal was 5.17±1.30 cm2 in the surgical group, whereas it was 6.40±1.56 cm2 in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). CONCLUSIONS The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.

Avascular necrosis (AVN) is defined as the cellular death of bone and bone marrow components due to the loss of blood supply, and associated with post-traumatic or non-traumatic events. AVN usually involves the epiphysis of a long bone, such as the femoral and humeral heads, which are susceptible to osteonecrosis. Many studies have been conducted but they were restricted to investigations of femoral head avascular necrosis. The presence of osteonecrosis in the proximal femur may impair biological fixation after total hip arthroplasty. We report a 56-year-old male patient with avascular necrosis located not only at the femoral head, but also in the entire femur, including the medullary cavity, who underwent total hip arthroplasty 2 years earlier along with a review of the relevant literature.
Arthroplasty, Replacement, Hip ; Bone Marrow ; Epiphyses ; Femur ; Head ; Humans ; Humeral Head ; Male ; Middle Aged ; Necrosis ; Osteonecrosis

STUDY DESIGN: Retrospective study of prospectively-collected data. OBJECTIVES: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. SUMMARY OF LITERATURE REVIEW: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. MATERIALS AND METHODS: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. RESULTS: The average area of the spinal canal was 81.40±53.61 mm2 in the surgical group, compared to 127.75±82.55 mm2 in the nonsurgical group (p=0.042). The muscle area in the spinal canal was 5.17±1.30 cm2 in the surgical group, whereas it was 6.40±1.56 cm2 in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). CONCLUSIONS: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.
Fitness Centers ; Humans ; Lumbosacral Region ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Canal ; Spinal Stenosis ; Sprains and Strains