A clinical study of spinal tuberculosis was made on 81 patients, who had been treated at the Department of Orthopedic Surgery, Seoul Red Crose Hoapital, during the 4 years period from January 1974 to December 1977. The results obtained were as follows; 1) The patients have been increased since 1977. 2) The ratio of male to female was not significant, but the age distribution showed a peak incidence in the third decade. 3) The lumbar spine was most commonly involved, being in 43.4% of the cases, while the dorsal spine occupied 27.7%. Considering the age, however, the dorsal spine was most commonly involved in the children as compared to the lumbar spine in the adults 4) In 84.2% of the patients, chemotheraphy was begun prior to operation and in 57.8% for a period less than 4 weeks. 5) The major associated tuberculous lesions elsewhere and complications were pulmonary tuberculosis in 28.4% paraplegia in 27.2% and draining sinus or buldging mass over body surface in 21.0%. 6) The number of involved vertebral bodies was higher in children than in adults. 7) Paraplegia presented a peak incidence in the second decade (42.9%). The number of vertebral bodies involved and the extent of destruction and kyphotic angulation were more severe in the paraplegic group than in the nonparaplegic group. 8) In the paraplegic group, thoracic, cervico-thoracic, and thoraco-lumbal spines comprised 71.8% of the cases. In our experience, the paraplegic group of early onset was better than that of late onset in regard to prognosis for recovery. 9) 22 patients who had complete or incomplete paraplegia had a variety of pathological lesions in or near the spinal canal. The most, common lesion was a sequestrum or a sequestrated disc.
Adult ; Age Distribution ; Child ; Clinical Study ; Female ; Humans ; Incidence ; Male ; Orthopedics ; Paraplegia ; Prognosis ; Seoul ; Spinal Canal ; Spine ; Tuberculosis, Pulmonary ; Tuberculosis, Spinal

In accidents, the spines are generally subjected to one of five types of violence; pure flexion, flexion and rotation, extention, vertical compression, or direct shearing force by Holdsworth's report. Flexion and rotational violence, so-called, unstable rotational fracture-dislocation results in paraplegia commonly. The treatment of the fracture-dislocations of the thoracic and lumbar spine had varied widely during the past 100 years, including conservative and operative treatment, but there is no definitive study that convincingly show the superiority of either operative or nonoperative treatment till now. Ten cases of the unstable thoracolumbar vertebral fracture or fracture-dislocations during the past two years were reported in this paper. In unstable types on the thoracolumbar vertebral fracture or fracture-dislocations, direct blow was the most common cause of injury and the thoracolumbar junction extending from T10 to L1 was the most common location of injury in this report. Three among four paraplegic patients were received flexion and rotational violence and the remaining one, direct shearing force. All four paraplegic parients were operated. Among them two cases, the one who was performed open reduction and simple wire fixation and the other open reduction and Harrington instrumentation, recovered almost completely except mild motor weakness of lower extremities. All cases complained of remaining back pain more or less without relation to the method of treatment.
Back Pain ; Clinical Study ; Humans ; Lower Extremity ; Methods ; Paraplegia ; Spine ; Violence

PURPOSE: The objectives of this study are to identify the brain centers whose activity changes are related to sexually arousing visual stimuli and to identify the difference between young and middle-aged males by mapping the brain activity with using blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI). MATERIALS AND METHODS: Ten young heterosexual, right handed males with normal sexual function (mean age: 27 years, age range: 24 to 31) and ten middle-aged heterosexual, right handed males with normal sexual function (mean age: 52 years, age range: 46 to 55) were enrolled into this study. Real-time visual stimulation was performed with the subjects alternatively viewing erotic and non-erotic films to identify the activated brain regions associated with sexual response. Assessments with using a five-point scale were determined after visual stimulation to evaluate the subjective sexual arousal. Brain activity was mapped by performing BOLD-fMRI on a 1.5T MR scanner. After functional scanning, the high-resolution data was analyzed with the SPM analyzing program; the significance of activation was set at p<0.01 or p<0.001. RESULTS: The parietal lobe, frontal lobe, cingulate gyrus, caudate nucleus, thalamus and hypothalamus were noted as the areas of activation specifically associated with viewing the erotic film segments by the young males. For the middle-aged males, these areas were the parietal lobe, frontal lobe, right temporal lobe, cingulate gyrus and caudate nucleus. The thalamus and hypothalamus were activated in only the young males. CONCLUSIONS: We suggest that the non-activation of the hypothalamus and thalamus in middle-aged males may be associated with the lesser physiological arousal in response to the erotic visual stimuli. The non-invasive visualization of the central nervous system by functional MRI in healthy males has shown the possibility for evaluating the neuroanatomy of the brain that is associated with sexual arousal and its clinical application by comparing young and middle-aged males.
Arousal ; Brain* ; Caudate Nucleus ; Central Nervous System ; Frontal Lobe ; Gyrus Cinguli ; Hand ; Heterosexuality ; Humans ; Hypothalamus ; Magnetic Resonance Imaging ; Male* ; Neuroanatomy ; Oxygen ; Parietal Lobe ; Photic Stimulation ; Temporal Lobe ; Thalamus

Purpose: Paclitaxel is an anticancer drug that blocks cell division by stabilizing microtubules. Even though paclitaxel has been shown to be effective in killing bladder cancer cell lines in vitro, the in vivo absorption was extremely low. A paclitaxel formulation was prepared in solution only, which was bioadhesive, and its effects evaluated in the MBT-2 cell line and in C3H2 bladder cancer mice. In addition, the toxicity of the paclitaxel formulation was also evaluated. Materials and Methods: A muco-adhesive oily paclitaxel formulation was made by the combining of monoolein, tricaprylin, Tween 80 and paclitaxel. MBT-2 cells were cultivated in different concentration of taxol, and the tumoricidal activity measured by the indirect methylthiazol-2-yl-2, 5-diphenyl tetrazolium bromide (MTT) assay. In an in vivo study, the treatment regimen for the s.c. C3H2 mice was five consecutive once daily administrations, beginning on day 4 post tumor implant. The length and width of the tumors were measured twice a week, and the tumor volume calculated. On day 21, the tumor volume change and toxicity were evaluated. Results: The average particle size of paclitaxel-loaded lipid nanoparticle was about 600nm, with a polydispersity of 1,000. Only 2.6% of the MBT-2 cells were viable after 24 hour of treatment with the formulation at a paclitaxel concentration of 10mug/ml, while showing minimal toxicity of the formulation without paclitaxel. Paclitaxel-loaded lipid nanoparticles, administered orally, allowed significant antitumor activity in C3H2 mice (p<0.05). Conclusions: Paclitaxel-loaded lipid nanoparticles have a remarkable cytotoxic effect against MBT-2 cells, in a dose dependent manner, and the oral paclitaxel-loaded lipid nanoparticle therapy had an inhibitory effect on bladder tumors in a MBT-2 model, but without systemic toxicity. Therefore, oral paclitaxel-loaded lipid nanoparticles may be used for advanced bladder cancer patients.
Absorption ; Animals ; Cell Division ; Cell Line ; Homicide ; Humans ; Mice* ; Microtubules ; Nanoparticles* ; Paclitaxel ; Particle Size ; Polysorbates ; Tumor Burden ; Urinary Bladder Neoplasms* ; Urinary Bladder*

With regard to various pathologic conditions, it is important to understand not only MR findings, which dependon the anatomic location of intraventricular lesions, but also the anatomic location most appropriate for surgicalintervention. In this paper we will analyze and demonstrate the incidence and characteristic MR findings ofvarious intraventricular tumors according to the location of ventricles.
Incidence

INTRODUCTIONChildren with Down syndrome (DS) are at increased risk of developing distinctive clonal myeloid disorders, including transient abnormal myelopoiesis (TAM) and myeloid leukaemia of DS (ML-DS). TAM connotes a spontaneously resolving congenital myeloproliferative state observed in 10%-20% of DS newborns. Following varying intervals of apparent remission, a proportion of children with TAM progress to develop ML-DS in early childhood. Therefore, TAM and ML-DS represent a biological continuum. Both disorders are characterised by recurring truncating somatic mutations of the GATA1 gene, which are considered key pathogenetic events.

METHODSWe herein report, to our knowledge, the first observation on the frequency and nature of GATA1 gene mutations in a cohort of Malaysian children with DS-associated TAM (n = 9) and ML-DS (n = 24) encountered successively over a period of five years at a national referral centre.

RESULTSOf the 29 patients who underwent GATA1 analysis, GATA1 mutations were observed in 15 (51.7%) patients, including 6 (75.0%) out of 8 patients with TAM, and 9 (42.9%) of 21 patients with ML-DS. All identified mutations were located in exon 2 and the majority were sequence-terminating insertions or deletions (66.7%), including several hitherto unreported mutations (12 out of 15).

CONCLUSIONThe low frequency of GATA1 mutations in ML-DS patients is unusual and potentially indicates distinctive genomic events in our patient cohort.

Cohort Studies ; Down Syndrome ; complications ; genetics ; Exons ; Female ; GATA1 Transcription Factor ; genetics ; Gene Deletion ; Genomics ; Humans ; Infant, Newborn ; Leukemia, Myeloid ; complications ; genetics ; Leukemoid Reaction ; complications ; genetics ; Malaysia ; Male ; Mutation ; Referral and Consultation ; Remission Induction