The size and configuration of the lumbar spinal canal constitute one of the important factors in the production of symptoms referable to cauda equina and nerve roots of the lumbar spine and the narrowness of the spinal canal. Numerous attempts have been made to measure the size of the lumbar spinal canal, but most of those are not sufficient to measure the oblique diameter of the lumbar spinal canal. Also, echographic diagnosis is much simple, safe, less expensive and non-invasive and furthermore demonstrates much more accuracy than other alternative and radiographic procedures. The purpose of this study is to establish the range of normal values of the oblique diameter of the lumbar spinal canal in Korean Army-aged group by echographic method in the interest of facilitating clinical evaluation of the lumbar spinal canal stenosis. The author measured oblique diamenter of the lumbar spinal canal in thirty healthy persons of both sexes of ages between nineteen and twenty-five years by ultrasound using sonolayergraphy model SSL-21A. Distance from the ligamentum flavum to the posterior longitudinal ligament was measured in millimeters with dial vernier caliper. Actual distance of oblique diameter of the lumbar spinal canal is obtained by multiplication of the distance of echogram by calibration factor 2.22. The results were as follows; 1. The mean values of the oblique diameter of the lumbar spinal canal in male and female between nineteen and twenty-five years of age were 14.77±0.85mm and 14.87±0.82mm in Ll, 13.99±0.87mm and 14.13±0.96mm in L2, 13.40±0.69mm and 13.71±0.75mm in L3, 12.88±0.69mm and 12.93±0.68mm in L4, 14.58±0.79mm and 14.42±0.84mm in L5 respectively. 2. The oblique diameter of the lumbar spinal canal was the widest at the first lumbar vertebra, the next at the fifth lumbar vertebra and the narrowest at the fourth lumbar vertebra. 3. There was no difference of diameter of the lumbar spinal canal between both sexes.
Calibration ; Cauda Equina ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Ligamentum Flavum ; Longitudinal Ligaments ; Male ; Methods ; Reference Values ; Spinal Canal ; Spine ; Ultrasonography

No abstract available.
Alcoholics* ; Erythrocyte Indices* ; Humans

No abstract available.
Decompression* ; Facial Nerve* ; Melkersson-Rosenthal Syndrome*

No abstract available in English.
Carcinoma, Squamous Cell ; Clinical Study ; Epithelial Cells ; Wounds and Injuries

No abstract available.
Cochlear Implants*

OBJECTIVE: This study was conducted to evaluate the impairment of cognitive functions, which include verbal and visual memory, visuospatial function, and executive function, and also to investigate if there is improvement of cognitive impairment after antidepressant treatment in patients with major depressive disorder (MDD). METHODS: Fifteen female patients with non-psychotic MDD in mild to moderate severity and 25 age-matched female normal control subjects participated in this study. Clinical severity of depression was measured by Beck Depression Inventory (BDI), Zung's Self-Rating Depression Scale (Zung), and Hamilton Rating Scale for Depression (HAMD). Cognitive functions were tested using Ray Complex Figure Test (RCFT) to evaluate visuospatial function and visual memory, Stroop test to evaluate conflict monitoring, Wisconsin Card Sorting Test (WCST) to evaluate executive function, and Seoul Verbal Learning Test (SVLT) to evaluate verbal memory. Both clinical depression scales and cognitive function tests were conducted at baseline and after 12 months of antidepressant treatment. RESULTS: At baseline, there were deficits in immediate and delayed recall of SVLT in patients with MDD compared to normal control subjects, while the impairment in visuospatial function, visual memory, and executive function was not clear. After antidepressant treatment, improvement of executive function, i.e. percent of error response and perseverative response of WCST in MDD patients was greater than that in normal control subjects. Improvement of executive function, however, did not show a significant correlation with the change of clinical severity of depression. CONCLUSION: The verbal memory was the most prominent domain of cognitive dysfunction in non-psychotic depression with mild to moderate severity. Of further note, differential improvement in executive function was observed in MDD patients after antidepressant treatment, although the improvement in executive function was not directly associated with the improvement of clinical depression.
Depression ; Depressive Disorder, Major ; Executive Function ; Female ; Humans ; Memory ; Prospective Studies ; Stroop Test ; Verbal Learning ; Weights and Measures ; Wisconsin

The goal of surgical stone management is to achieve maximal stone clearance with minimal morbidity to the patient. Because of its efficacy, efficiency and low morbidity, extracorporeal shock wave lithotripsy(ESWL) is the first-line treatment for almost all urinary calculi. However, stone clearance after ESWL has been shown to be affected by the stone burden, location, chemical composition and kidney anatomy. Especially, the success rate for ESWL is reduced in lower pole stone(LPS). Percutaneous nephrolithotomy(PNL) and retrograde ureteroscopic intrarenal surgery(RIRS) are alternative treatment options for stones refractory to ESWL such as LPS. Although effective, PNLsubjects the patient to increased morbidity compared to ESWL and RIRS. Because of its low morbidity and relatively high success rate, RIRS for LPS is an attractive treatment modality in selective patients. We report a case of multiple renal pelvis and lower calyceal stones treated with ureteroscopy.
Humans ; Kidney ; Kidney Calculi ; Kidney Pelvis* ; Shock ; Ureteroscopy ; Urinary Calculi

PURPOSE: The prognosis of stage IV stomach cancer patients is very poor and the effectiveness of radical surgery including extended lymphadenectomy and combined resection in these patients is still controversial. The purposes of this retrospective study were to identify the prognostic factors and to evaluate the effectiveness of extended lymphadenectomy and combined resection in stage IV stomach cancer paients. MATERIALS AND METHODS: Of 585 patients who were operated for stomach cancer at the NMC from Jan. 1987 to Oct. 1993, 154 patients of stage IV stomach cancer (121 patients who had distant metastasis and 33 patients who had not) were identified. We analyzed data of these 154 patients to find the characteristic clinicopathological features, the prognostic factors and the proper extent of surgical treatment. RESULTS: Comparing with stage I, II and III groups, larger tumor size, higher proportions of Borrmann type IV and undifferentiated carcinoma and higher rates of lymph node metastasis and combined resection were noticed in stage IV stomach cancer group. In combined resection, pancreas tail was mainly resected due to tumor invasion but spleen was mainly resected for the completeness of lymph node dissection. In multivariate analyses, peritoneal metastasis and postoperative residual tumor were independent prognostic factors. The overall 5-year survival rate was 14.6%. Stage IV stomach cancer patients without distant metastasis had better 5-year survival rate than that of those who had distant metastasis (34.3% vs 7.9%, p=0.00001). CONCLUSIONS: Radical procedures including extended lymphadenectomy and combined resection of the invaded organs should be considered in the stage IV stomach cancer patients without distant metastasis.
Carcinoma ; Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm, Residual ; Pancreas ; Prognosis ; Retrospective Studies ; Spleen ; Stomach Neoplasms* ; Stomach* ; Survival Rate

Objective: : Emergency superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis in patients with large vessel occlusion who fails mechanical thrombectomy or does not become an indication due to over the time window can be done as an alternative for blood flow restoration. The authors planned this study to quantitatively measure the degree of improvement in cerebral perfusion flow using perfusion magnetic resonance imaging (MRI) after bypass surgery and to find out what factors are related to the outcome of the bypass surgery. Methods: : For a total of 107 patients who underwent emergent STA-MCA bypass surgery with large vessel occlusion, the National Institute of Health stroke scale (NIHSS), modified Rankin score (mRS), infarction volume, and hypoperfusion area volume was calculated, the duration between symptom onset and reperfusion time, occlusion site and infarction type were analyzed. After emergency STA-MCA bypass, hypoperfusion area volume at post-operative 7 days was calculated and analyzed compared with pre-operative hypoperfusion area volume. The factors affecting the improvement of mRS were analyzed. The clinical status of patients who underwent emergency bypass was investigated by mRS and NIHSS before and after surgery, and changes in infarct volume, extent, degree of collateral circulation, and hypoperfusion area volume were measured using MRI and digital subtraction angiography (DSA). Results: : The preoperative infarction volume was median 10 mL and the hypoperfusion area volume was median 101 mL. NIHSS was a median of 8 points, and the last normal to operation time was a median of 60.7 hours. STA patency was fair in 97.1% of patients at 6 months follow-up DSA and recanalization of the occluded vessel was confirmed at 26.5% of patients. Infarction volume significantly influenced the improvement of mRS (p=0.010) but preoperative hypoperfusion volume was not significantly influenced (p=0.192), and the infarction type showed marginal significance (p=0.0508). Preoperative NIHSS, initial mRS, occlusion vessel type, and last normal to operation time did not influence the improvement of mRS (p=0.272, 0.941, 0.354, and 0.391). Conclusion : In a patient who had an acute cerebral infarction due to large vessel occlusion with large ischemic penumbra but was unable to perform mechanical thrombectomy, STA-MCA bypass could be performed. By using time-to-peak images of perfusion MRI, it is possible to quickly and easily confirm that the brain tissue at risk is preserved and that the ischemic penumbra is recovered to a normal blood flow state.

Vertebral artery (VA) occlusion is frequently encountered, usually without acute ischemic injury of the brain. However, when it is accompanied by hypoplasia or stenosis of the opposite VA, brain ischemia may develop due to insufficient collateral supply. Both hemodynamic instability and embolic infarction can occur in VA occlusion, which may cause severe symptoms in a patient. Extracranial carotid-VA bypass should be considered for symptomatic VA occlusion patients, especially when the patient has repeated ischemic brain injuries. In this report, the cases of three extracranial carotid-VA bypass patients are introduced, along with a brief description of the surgical techniques. All three cases were treated with different bypass methods according to their disease location.