Pudenal somatosensory evoked potential (PSEP) and bulbocavernosus reflex (BCR) testing have been reported to be useful in the evaluation of erectile dysfunction and neurogenic bladder. 461 patients with sexual dysfunction were studied to determine the usefulness of the above tests. Abnormality of PSEP was found significantly in upper motor neuron (UMN) type spinal cord patients and average prolonged P1 latency was 47.4 +/- 9.8 msec. Lower motor neuron (LMN) type spinal cord patients revealed great abnormality in BCR latency with an average value of 44.9 +/- 14.5 msec on the right and 44.2 +/- 15.6 msec on the left. Additionally significant differences were obtained in patients with diabetes mellitus, pelvic trauma and spinal cord lesion of the UMN type in the study of PSEP. There was also a significant difference in the patients with diabetes mellitus, pelvic trauma and spinal cord lesion of the LMN type in the BCR study. The findings of our study suggest that PSEP together with BCR study is useful in assessing the integrity of the sacral reflex arc and the central afferent pathway, in differentiating the lesion site and in providing basic data for the management plan in sexual rehabilitation. Furthermore, because erection is under the influence of both the somatic and autonomic nervous system, BCR study and PSEP combined with currently studied electrical activity of the corpus cavernosum would provide a more accurate evaluation of the neurogenic erectile dysfunction patients.
Adult ; *Evoked Potentials, Somatosensory ; Genitalia, Male/*physiopathology ; Human ; Male ; Middle Age ; Penile Diseases/*physiopathology ; *Penile Erection ; Reaction Time ; Reflex/*physiology ; Urethra/*physiopathology

The association between pediatric Chiari malformation and the development of syringomyelia has been well documented. Scoliosis in the patient with syringomyelia is thought to be secondary to anterior horn cell damage, which innervate the muscles of trunk, by an asymmetrically expanded syrinx. In pediatric patients, the neurologic signs and symptoms due to Chiari malformation and syringomyelia show much lower frequency but the incidence of scoliosis is very high. Thus, the MRI study for the diagnosis of the underlying syringomyelia and Chiari malfornation is essential in pediatric scoliosis patients, which may otherwise be misdiagnosed for idiopathic scoliosis. We present a case of Chiari type I malformation associated with syringomyelia and scoliosis.
Anterior Horn Cells ; Child* ; Diagnosis ; Humans ; Incidence ; Magnetic Resonance Imaging ; Muscles ; Neurologic Manifestations ; Scoliosis* ; Syringomyelia*

No abstract available.

No abstract available.

A 40-year-old female patient who had tethered spinal cord with intraspinal lipoma and intractable pain of the lower leg and foot is reported. The pain started 5 years ago and exaggerated recently. A pea-size mass had been noted since birth at sacral region, which was excised 2 months prior to admission at the other clinic. Neurological examination revealed diffuse muscular wasting of the left foot, especially the sole, hypesthesia of the left sole with dysesthesia, bilaterally increased knee jerks, and absent left ankle jerk. The patient underwent L5 laminectomy, subtotal removal of extradural, intradural and intramedually lipoma with dural repair, and dorsal rhizotomy of ipsilateral L5 and S1 roots. At surgery, the neural elements were untethered with mass removal, adhesiolysis, and division of thickened arachnoid septum. The pain improved much after and was tolerable with some analgesics.
Adult* ; Analgesics ; Ankle ; Arachnoid ; Female ; Foot* ; Humans ; Hypesthesia ; Knee ; Laminectomy ; Leg ; Lipoma* ; Neurologic Examination ; Pain, Intractable* ; Paresthesia ; Parturition ; Rhizotomy ; Sacrococcygeal Region ; Spinal Cord*

Primary xanthoma of the bone is a rare benign neoplasm, and it is extremely rare to find this in the ribs. It is most commonly reported in soft tissue and it associated with hyperlipoproteinemia. A 54-years-old male who complained of left chest pain had an X-ray taken. It revealed a left 3rd rib tumor. The blood examinations for lipid and protein were normal. A resection was done for tissue examination. The mass was histolopathologically diagnosed as a xanthoma.
Chest Pain ; Humans ; Hyperlipoproteinemias ; Male ; Ribs ; Thoracic Wall ; Xanthomatosis

PURPOSE: Many reports have shown that the efficacy of intravesical therapy for bladder cancer is, in part, limited by the poor penetration of drugs into the urothelium. The present study evaluated the effect of glyceryl monooleate (GMO) on the delivery and penetration of paclitaxel into the bladder of rabbits, when given as an intravesical dose. MATERIALS AND METHODS: The urine, plasma, and tissue pharmacokinetics were determined in rabbits treated for 120min with paclitaxel (500g/20ml) by an intravesical instillation. Two formulation of GMO/paclitaxel were evaluated, according to the proportion of water, 15% and 30%, with Taxol was used as a control. The animals were observed for clinical signs of toxicity, and necropsy performed. RESULTS: At 120min post-instillation, the bladders were emptied and excised. The urine paclitaxel concentrations were decreased by 39.6 and 41.2% in the two experimental groups, and by 25.2% in the control group. The paclitaxel concentrations in the urothelium were 53 and 56% of the urine concentration in the two experimental groups, respectively, but by only 11% in the control group. The concentration then declined exponentially in the underlying capillary perfused tissues, reaching equilibrium at a depth of 1,400-1,700um. The plasma concentrations were extremely low compared with those in the urine and bladder tissues, and were not associated with clinical toxicity. CONCLUSIONS: These results indicate that GMO improves the delivery of paclitaxel and increases the concentration in the bladder tissue. These results suggest that the intravesical delivery of GMO/paclitaxel/water provide a significant bladder tissue targeting advantage, and that paclitaxel represents a viable candidate drug for intravesical bladder cancer therapy.
Administration, Intravesical* ; Animals ; Capillaries ; Drug Delivery Systems* ; Paclitaxel* ; Pharmacokinetics ; Plasma ; Rabbits* ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urothelium ; Water

The purpose of this study is to show the correlation between the range of spinal motion and the severity of chronic lower back pain. The subjects of this study were 40 female patients with chronic lower back pain over a 6 months' duration. The range of spinal and hip joint motion was measured with a electrogoniometer, and the severity of back pain was evaluated with the Rolland's score and Pollard's pain disability index. Results were as follows. There was a correlation between the severity of pain and the range of lumbar lateral flexion, rotation, and extension (p< 0.05). Age, height, weight and body mass index had no correlation with the range of spinal motion. These results suggest that the range of lumbar spinal motion can be used as an objective measure for the evaluation of classifying chronic lower back pain patients and for planning and following their treatment.
Adult ; Back Pain/*physiopathology ; Chronic Disease ; Female ; Human ; Middle Age ; *Range of Motion, Articular ; Rotation ; Spine/*physiopathology ; Support, Non-U.S. Gov't

The Nuss procedure has good cosmetic effects, but it could be cause of bleeding and organ injury during dissection of the anterior mediastinum. We have made an effort to overcome the defects of the traditional method through the anterior mediastinum, thus we developed a transilluminated introducer that made it safer and simpler to operate within a 1 cm incision only. A total of 67 patients underwent the Nuss procedure using the transilluminated introducer. Thirty-six patients underwent the procedure with the transilluminated introducer only (age<14 years). Thirty-one patients had an additional thoracoscopy (age> or =14 years). There were no major complications, such as massive bleeding or organ injury in the thoracic cavity during or after the Nuss procedure. Our findings demonstrated that the anterior mediastium could be dissected simply and safely by the use of a transilluminated introducer during the Nuss procedure without fatal major complications, such as bleeding and organ injury.
Cosmetics ; Funnel Chest ; Hemorrhage ; Humans ; Mediastinum ; Thoracic Cavity ; Thoracic Wall ; Thoracoscopy

PURPOSE: To investigate the alteration of lower extremity movement during maintaining balance test with their eyes closed in chronic ankle instability (CAI) patients compared to healthy group with and without plantar cutaneous sensation. METHODS: Ten healthy volunteers (age, 23.40±2.22 years; height, 165.42±6.67 cm; weight, 60.93±13.42 kg) and 10 CAI patients (age, 23.90±2.56 years; height, 166.89±10.50 cm; weight, 67.43±12.96 kg), were recruited. Subjects immersed both feet in an ice water for 10 minutes and performed three trials of a single-leg stance balance test with their eyes closed while standing on a force plate for 10 seconds. RESULTS: CAI group showed increased knee flexion, reduced knee external rotation, and hip internal rotation compared to the healthy group from single-limb stance with eyes closed after diminished plantar cutaneous sensation. However, there was no significant interaction between group and time. CONCLUSION: These findings indicate that the postural kinematic analyses revealed that individuals with CAI used different strategy of controlling their lower extremities, which alters transverse plane motion of hip and knee compared to the healthy group in order to compensate for their ankle deficits after freezing the plantar cutaneous.
Ankle ; Foot ; Freezing ; Healthy Volunteers ; Hip ; Humans ; Ice ; Knee ; Lower Extremity ; Sensation ; Water