BACKGROUND: To compare the diagnostic value between Phalen's test and reverse Phalen's test using a morphological change of the median nerve and the carpal tunnel in diabetics and normal controls seen by high-resolution ultrasonography and to research on an ultrasonography as an available tool for the screening and follow up aid-test of the carpal tunnel syndrome(CTS). METHODS: A cross-sectional area and a flattening ratio of the median nerve, and a cross-sectional area of the carpal tunnel were measured in neutral, maximally flexed(Phalen's test), and maximally extended (reverse Phalen's test) positions in 59 wrists of 30 normal controls and 60 wrists of 30 diabetics. RESULTS: 1) In controls and diabetics, the mean cross-sectional area of median nerve at the hamatum were 8.8/10.2 mm2, 8.0/9.5 mm2, 8.3/9.4 mm2, the mean flattening ratio were 3.0/3.0 mm2, 2.4/2.0 mm2, 3.2/3.0 mm2, the mean cross-sectional area of carpal tunnel were 176.5/197.7 mm2, 157.9/187.0 mm2, 170.6/192.5 mm2 in neutral, maximal flexion and maximal extension. 2) In controls, the cross-sectional area of median nerve and carpal tunnel were significantly decreased in maximal flexion(p<0.01), and in maximal extension(p<0.01). 3) In controls, the mean flattening ratio of median nerve was revealed significant change in maximal flexion(p<0.01), and in maximal extension(p<0.01). 4) In diabetics, the flattening ratio was significantly decreased in maximal flexion(p<0.01) with com- paring to neutral position. 5) In diabetics, the cross-sectional area of median nerve and carpal tunnel were significantly increased in all positions(p<0.05), and the mean flattening ratio of median nerve was similar to controls. CONCLUSION: In diabetics, increased cross-sectional area of median nerve can be explained by swelling of median nerve, also increased cross-sectional area of carpal tunnel is can be said to have taken place by the decreasing of the useful space in between the median nerve and carpal tunnel, this show that the diabetics have the high risk of the CTS. Phalen's test reveals higher degree of irritation to median nerve, The high-resolution ultrasonography is suggested as an available tool for the screening and follow up aid-test for the CTS
Carpal Tunnel Syndrome ; Follow-Up Studies ; Mass Screening ; Median Nerve* ; Ultrasonography ; Wrist*

Traumatic brain injury is caused by an impact on the head and results in cognitive, physical, neurobehavioral or emotional impairments. The severity of traumatic brain lesion depends on the direction, the intensity of the acting force and on the mobility of the head during the impact. The main purpose of severity classification is on the prediction of prognosis and the accurate treatment. Mild traumatic brain injury (MTBI) is mostly self-limiting and shows good prognosis. However, the discrimination between mild and moderate traumatic brain injury is sometimes challenging or confusing. For a definition of MTBI, it has been evolved in terms of period of loss of consciousness, memory loss, and alterations in mental state with or without focal neurological deficits. Any external mechanical impact can lead to MTBI. In addition, history related to the injury, neurological symptoms or signs, and radiological abnormalities are used to clinically diagnose MTBI. The diagnosis of MTBI is especially based on brief loss of consciousness, amnesia surrounding the traumatic event or posttraumatic amnesia, and transient focal neurological changes. Recently, the mainstream definition of MTBI includes patients with radiological abnormalities on computed tomography (CT) scans or magnetic resonance imaging (MRI). Therefore MTBI can be characterized by damage to the structure as well as functional disruption of the brain.

Spinal cord injury (SCI) often results in devastating neurological dysfunction. Therefore many of the SCI patients suffer with physical disabilities or social handicaps. Many obstacles have been known to affect adult spinal cord regeneration and functional recovery. However, scientific knowledge of the central nervous system (CNS) development and post-injury responses including pathophysiology of SCI has been expanded recently, which might produce potential promising therapies for this condition. These are as followed; (1) pharmacological neuroprotective agents, (2) administration of exogenous neurotrophic factors or augmenting intraneural cyclic AMP, (3) inhibition of nonpermissive environment of the injured spinal cord, (4) cellular transplantation, and (5) rehabilitation interventions with body-weight supported treadmill therapy and functional electrical stimulation. In addition, the precise evaluation of functional improvement or gait is also important in rehabilitation of SCI patients. Various evaluation tools have been developed and introduced in order to estimate a degree of improvement properly.
Adult ; Central Nervous System ; Cyclic AMP ; Electric Stimulation ; Gait ; Humans ; Nerve Growth Factors ; Neuroprotective Agents ; Outcome Assessment (Health Care) ; Regeneration ; Spinal Cord ; Spinal Cord Injuries ; Spinal Cord Regeneration ; Transplants

OBJECTIVES: The purpose of this study was to aid in the prediction of tumor cell tolerance to radiotherapy and/or chemotherapy. MATERIALS AND METHODS: Human epidermoid carcinoma A-431 cell line were irradiated by 2, 4, 6, 8, 10Gy at a dose rate of 210cGy/min using 60Co Irradiator ALDORADO 8 and then were exposed to bleomycin or cisplatin at concentration of 2mug/mul for 1 hour. The viable cells were determined for each radiation dose and/or each drug at the 4th day and cell surviving curves were obtained using semiautomated MTT assay. RESULTS: The surviving fraction after irradiation of 2Gy was 0.99, and there was not significant difference of surviving fraction in comparison with the control group on A-431 cell line(p>0.05). But there were significant differences of surviving fractions at doses of 4, 6, 8, 10Gy in comparison with the control group(p<0.05). The cytotoxicity of bleomycin or cisplatin was significantly different in comparison with the control group on A-431 cell line (p<0.05). And the cytotoxicity of cisplatin was greater than that of bleomycin on A-431 cell line (p<0.05). There were significant differences of surviving fractions after irradiation of 2, 4, 6, 8, 10Gy with bleomycin or cisplatin in comparison with each group of irradiation only on A-431 cell line(p<0.05). There were significant differences of surviving fractions between the groups of irradiation with bleomycin and cisplatin at doses of 2, 4Gy(p<0.05), but there were not significant differences of surviving fractions at doses of 6, 8, 10Gy on A-431 cell line (p>0.05).
Bleomycin ; Carcinoma, Squamous Cell ; Cell Line* ; Cisplatin ; Drug Therapy ; Humans ; Radiation Tolerance* ; Radiotherapy

OBJECTIVES: The purpose of this study was to aid in the prediction of tumor cell tolerance to radiotherapy and/or chemotherapy. MATERIALS AND METHODS: Human epidermoid carcinoma A-431 cell line were irradiated by 2, 4, 6, 8, 10Gy at a dose rate of 210cGy/min using 60Co Irradiator ALDORADO 8 and then were exposed to bleomycin or cisplatin at concentration of 2mug/mul for 1 hour. The viable cells were determined for each radiation dose and/or each drug at the 4th day and cell surviving curves were obtained using semiautomated MTT assay. RESULTS: The surviving fraction after irradiation of 2Gy was 0.99, and there was not significant difference of surviving fraction in comparison with the control group on A-431 cell line(p>0.05). But there were significant differences of surviving fractions at doses of 4, 6, 8, 10Gy in comparison with the control group(p<0.05). The cytotoxicity of bleomycin or cisplatin was significantly different in comparison with the control group on A-431 cell line (p<0.05). And the cytotoxicity of cisplatin was greater than that of bleomycin on A-431 cell line (p<0.05). There were significant differences of surviving fractions after irradiation of 2, 4, 6, 8, 10Gy with bleomycin or cisplatin in comparison with each group of irradiation only on A-431 cell line(p<0.05). There were significant differences of surviving fractions between the groups of irradiation with bleomycin and cisplatin at doses of 2, 4Gy(p<0.05), but there were not significant differences of surviving fractions at doses of 6, 8, 10Gy on A-431 cell line (p>0.05).
Bleomycin ; Carcinoma, Squamous Cell ; Cell Line* ; Cisplatin ; Drug Therapy ; Humans ; Radiation Tolerance* ; Radiotherapy

Neurological diseases such as Alzheimer, Parkinson, and ischemic stroke have increased in occurrence and become important health issues throughout the world. There is currently no effective therapeutic strategy for addressing neurological deficits after the development of these major neurological disorders. In recent years, it has become accepted that adult neural stem cells located in the subventricular and subgranular zones have the ability to proliferate and differentiate in order to replace lost or damaged neural cells. There have been many limitations in the clinical application of both endogenous and exogenous neurogenesis for neurological disorders. However, many studies have investigated novel mechanisms in neurogenesis and have shown that these limitations can potentially be overcome with appropriate stimulation and various approaches. We will review concepts related to possible therapeutic strategies focused on the perspective of neurogenesis for the treatment of patients diagnosed with Alzheimer disease, Parkinson disease, and ischemic stroke based on current reports.
Adult ; Alzheimer Disease* ; Humans ; Nervous System Diseases ; Neural Stem Cells ; Neurogenesis* ; Neurons* ; Parkinson Disease* ; Stroke*

PURPOSE: Although the pudendal nerve terminal motor latency (PNTML) is normally used, there is no definite test that accurately reflects the function of the pudendal nerve. This study was undertaken to determine the relative accuracy of the various methods in measuring the function of the pudendal nerve. METHODS: Thirty one female patients (age 51.3+/-15.7) with a defecation disorder (constipation 20, fecal incontinence 11) were evaluated prospectively using a neurophysiologic test and balloon reflex manometry. Five parameters such as the right and left PNTML, anal mucosal electrosensitivity, latency and the amplitude of the rectoanal contractile reflex (RACR) were analyzed statistically for their correlation. RESULTS: There was no significant inter-test correlation among the parameters. However, the intra-test correlations between the parameters such as the right and left PNTML (r=0.9629, P<0.001)/latency and the RACR amplitude (r= -0.3770, P=0.0366) were found to be significant. CONCLUSION: The accuracy of these tests in evaluating the pudendal neuropathy could not be determined. However, because it can be assumed that a measurement of the RACR in addition to RNTML is technically accurate, it there will need to be more study for it to be used as an alternative to a PNTML measurement.
Defecation ; Fecal Incontinence ; Female ; Humans ; Manometry ; Prospective Studies ; Pudendal Nerve* ; Pudendal Neuralgia ; Reflex

Traumatic brain injury could be used to describe all injuries to the brain caused by external mechanical forces. It shows a variety of clinical manifestations from mild to severe forms and can result to death. Moderate to severe injuries can produce disabilities on physical, cognitive, behavioral, and emotional aspects. Animal models of traumatic brain injury have been developed to reproduce characteristics of human brain injury, to understand molecular and cellular pathophysiology and neurobehavioral outcomes following trauma and to find out the promising pharmacological drugs or rehabilitative skills to treat. This article reviewed the current experimental traumatic brain injury models, including weight drop, fluid percussion, and controlled cortical impact, and also the neurobehavioral assessments that are most commonly used to measure loss of function.
Animals ; Brain ; Brain Injuries ; Humans ; Models, Animal ; Percussion

OBJECTIVE: To evaluate the mixed nerve action potential of the medial and lateral plantar nerve conduction studies in diabetic patients with the various factors. METHOD: 69 healthy adults without foot trauma as control group and 78 diabetic patients without foot trauma as subject group were studied. The study was performed by using the orthodromic surface stimulation and recording method of evaluating of the mixed nerve action potential of the medial and lateral plantar nerve conduction studies. RESULTS: The differences in the distal latency (p<0.05), amplitude (p<0.05) and nerve conduction velocity (p<0.05) of the mixed nerve action potential of the medial and lateral plantar nerve conduction studies were statistically significant between the diabetic group and the normal control group. Same results also could be obtained in diabetic patients relating to longer duration of diabetes, presence of diabetic retinopathy, higher blood glucose level, longer duration of oral hypoglycemic agent and insulin treatment (p<0.05). CONCLUSION: The mixed nerve action potential of the medial and lateral plantar nerve conduction studies are useful for the detection of diabetic neuropathic foot.
Action Potentials* ; Adult ; Blood Glucose ; Diabetes Mellitus ; Diabetic Retinopathy ; Foot ; Humans ; Insulin ; Neural Conduction*

Malignant germ cell tumors of the ovary are uncommon neoplasms. Although 20-25% of all ovarian tumors are derived from germ cells, only about 3% of germ cell tumors are malignant. Mixed germ cell tumors contain at least two malignant germ cell elements. These lesions should be managed with combination chemotherapy, preferably BEP. Recently we experienced a case of mixed germ cell tumor with 6 components of germ cell and sarcomatous change in a 11 year old girl. Preoperative CA-125, B-hCG, aFP, LDH, a-1-antitrypsin were elevated and the final pathologic report was mixed germ cell tumor composed of endodermal sinus tumor, embryonal carcinoma, mature and immature teratoma, choriocarcinoma, dysgerminoma and sarcomatous change, Postoperative chemotherapy with 6 courses of BEP regimen was performed and all tumor markers became normal after 4 courses of chemotherapy. What we interested in this case was several components of germ cells and sarcomatous change and the sarcomatous change might be derived from the mature cystic teratoma component, so we present this case with a brief review of the literatures here.
Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pregnancy ; Teratoma ; Biomarkers, Tumor