OBJECTIVES: The purpose of this study was to assess the complications, duration of admission, cost effectiveness, radiologic stabilization of the anterior cervical bone fusion in the treatment of cervical disc disease with and without plating. MATERIALS AND METHODS: Fifty-two surgically treated patients for cervical disc disease were reviewed. Group I consisted of consecutive treated patients with iliac auto-bone graft without instrumentation after anterior cervical discectomy. Group II consisted of consecutive treated patients with iliac autologous-bone graft with CASPER cervical plate fixations. Radiologic fusion was decided when loss of end plate boundary between graft bone and vertebral body and immobile, maintenance of the disc space were evident on simple dynamic plain films. The patients were discharged after the stabilization of cervical motion by films was of tained. These groups were analysed multiple variably with Mann-Whitney U-test. RESULTS: Group I consisted of 18 patients, group II consisted of 34 patients. Mean age was 49.0+/-8.1 years, mean duration of admission was 17.27+/-10.51 days, mean costs for treatment was 1,970,000+/-475,000 won. In group I, mean age was 47.7(34-60) years, 16 patients had undergo on one-level operation, 2-patients had undergo on two-level operation, mean duration of admission was 28.7+/-10.4 days, mean costs for treatment was 2,194,473+/-561,639 won. The periods of stabilization was 6.6+/-3.36 weeks on radiologic study. Mean periods of out patient follow up was 16.8(6-64) weeks after discharge. Mean period of radiologic follow up was 17.3(4-6) weeks after surgical operation. In group II, mean age was 49.7(37-62) years and 18 patients one-level operation, 14-patients had undergo on two-level operation and 2-patients three-level operation. Mean duration of admission was 11.24+/-3.29 days, mean costs for treatment was 1,850,823+/-389,372 won. The periods of stabilization was 5.88+/-7.07 weeks on radiologic study. Mean period of out patients follow up was 16.7(4-60) weeks after discharge. Mean period of radiologic follow up was 12.4(3-52) weeks after surgical operation. The duration of admission showed statistical significance in Group II but other items showed no significant difference between two groups. CONCLUSIONS: The more economic, early life return and effective method of cervical disc disease in our series were evident in patients who had undergone, iliac bone graft and plate fixations after anterior discectomy.
Cost-Benefit Analysis ; Diskectomy ; Follow-Up Studies ; Humans ; Outpatients ; Transplants*

OBJECTIVE: In the central nervous system, gamma-aminobutyric acid (GABA) is well known to act as an inhibitory neurotransmitter by hyperpolarizing postsynaptic neurons through gating GABA-activated Cl- channels. To date, however, the functional roles of GABA remain unclear in the autonomic nervous system. In the present study, we characterize GABA-activated Cl- currents in the neurons of major pelvic ganglia (MPG). METHODS: MPG neurons, located on the lateral surfaces of the prostate gland, from male rats were enzymatically dissociated. Ionic currents were recorded using whole-cell variant patch-clamp technique. Membrane potential was recorded under current clamp mode. Current traces were filterd at 2kHz by using 4-pole Bassel filter in the amplifier. RESULTS: Application of GABA (100micrometer) induced inward currents in the neurons, with holding potentials being maintained below the Cl- equilibrium potential (ECl). The GABA response was concentration-dependent and its reversal potential was close to the theoretical ECl. The GABA-induced Cl- currents were largely blocked by bicuculline (10micrometer, n=5), a GABAA receptor antagonist, but were not affected by 9-AC and niflumic acid, chloride channel blockers. GABA also produced significant membrane depolarization (19mV, n=28). As in the case of the Cl- currents, the GABA-induced depolarizations were largely blocked by bicuculline(10micrometer, n=6), but not by DIDS(50micrometer, n=4), another chloride channel blocker. CONCLUSION: The data suggest that GABAergic roles may be due to it's activation of excitatory GABAA receptors, which are expressed in MPG neurons.
Animals ; Autonomic Nervous System ; Bicuculline ; Central Nervous System ; Chloride Channels ; gamma-Aminobutyric Acid* ; Ganglia* ; Humans ; Male ; Membrane Potentials ; Membranes ; Neurons* ; Neurotransmitter Agents ; Niflumic Acid ; Patch-Clamp Techniques ; Prostate ; Rats

Pheochromocytoma is a tumor which secretes catecholamine and produces remarkable hemodynamic changes during the perioperative period. It is reported that in cases where a patient with undiagnosed pheochromocytoma is operated on, the mortality rate can reach 25% to 50%. The subject in this study was a 55-year-old female patient who was diagnosed having a retroperitoneal mass which looked like a neurogenic tumor. During the manipulation, serious hypertension and tachycardia were developed. The authors at that time suspected a pheochromocytoma, interrupted the operation, and after insertion of arterial line and sodium nitroprusside infusion, the rest of the operation was restarted. After the extirpation of the tumor, as the patient suffered serious hypotension, the concentration of the inhalation agent was reduced, ephedrine was injected, the proper amount of fluid and blood were administered, and, as a result, the operation was carried out safely, and postoperative course was unremarkable.
Ephedrine ; Female ; Hemodynamics ; Humans ; Hypertension ; Hypotension ; Inhalation ; Middle Aged ; Mortality ; Nitroprusside ; Perioperative Period ; Pheochromocytoma* ; Tachycardia ; Vascular Access Devices

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

BACKGROUND AND OBJECTIVES:Conventional vestibular rotation testing with the head centered on the axis stimulates the semicircular canals evoking compensatory eye movements. By placing subjects off from the axis of rotation, the otolithic organ may also be simultaneously stimulated by additional linear acceleration forces. In the present study, we compared the rotation with subjects placed on axis to those placed in an eccentric position. MATERIALS AND METHOD:In the eccentric rotation, the head of subject was facing outward and placed eccentrically for 33cm on naso-occipital axis. Slow harmonic acceleration test and velocity step test were performed. RESULTS:The sinusoidal eccentric rotation at 0.32, 0.64 Hz produced a significantly higher vestibulo-ocular reflex gain than did on axis rotation. In velocity step test, initial slow component velocity was significantly higher in eccentric rotation than in centric rotation. CONCLUSION:These finding suggest that the gain enhancement due to eccentric rotation is a result of tangentiallinear acceleration, probably sensed by the otolithic organ. This study raises the possibility of using eccentric rotation for the diagnosis of the patients with otolithic dysfunction.
Acceleration ; Axis, Cervical Vertebra ; Diagnosis ; Exercise Test ; Eye Movements ; Head ; Humans ; Otolithic Membrane ; Reflex* ; Reflex, Vestibulo-Ocular ; Semicircular Canals

Abnormal coagulatioin is a frequent complication in patients with head injury. Hemostasis in 56 patients with head injuries, not associated with serious systemic injuries, was screened using platelt count, bleeding time, prothombin time, thrombin time, activated partial thrombin time, fibrinogen level, fibrin degradation product(FDP), protamin sulfate test, ethanol gelation test, and d-dimer test. Frequency of coagulopathy was 28.6% in all patients, 24.2% in the group of Glasgow Coma Scale(GCS) 9~15, and 36.8% in GCS 3~8. Patients with poor outcome, who had Glasgow Outcome Scale(GOS) 1~3, had higher frequency of abnormal laboratory results. Particularly, platelet was significantly reduced in the group of GOS 1~3 than GOS 4~5. In the patients without intracranial hematoma, fequency of coagulopathy was significantly higher in the patients with poor outcome than favorable outcome. In the group of GCS 3~8, patients with hematoma had significantly higher frequency of coagulopathy than patients without hematoma. Coagulopathy did not significantly changed the outcome of the patients. Most of the results of the tests except platelet count FDP returned to normal limit on the follow-up tests done 3 days later.
Bleeding Time ; Blood Platelets ; Coma ; Craniocerebral Trauma* ; Ethanol ; Fibrin ; Fibrinogen ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head* ; Hematoma ; Hemostasis ; Humans ; Platelet Count ; Thrombin Time