Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic

Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic

OBJECTIVE: To prove that the skin of paralysed limb of spinal injured rat is more susceptible to a thermal injury than control, and to find out that the possible relating factors for explaining the increased susceptibility of skin. METHOD: Of total 69 male Sprague-Dawley rats, 50 were randomly divided into two groups, the spinal injured of which cords were transected at T10-13 level and the control. They were subdivided into 5 subgroups according to the duration of thermal injury. Infrared ray was used for thermal injury. Arterial cannulation was done in the femoral artery for blood gas analysis. Temperature was measured with a digital thermometer. Biopsy samples were stained with HE, and also immunohistochemical staining for heat shock protein 70 (HSP-70) was done. RESULTS: After thermal injury, the spinal injured group showed more severe tissue damage and a higher temperature elevation than the control. There was a tendency of decreased blood pH and pO2, and increased pCO2. Contrary to the control, the immunoreactivity of HSP-70 was very tiny or rarely present in the spinal injured group. CONCLUSION: This study suggest that the increased susceptibility of skin to the thermal injury in spinal injured rats may be related to the vasomotor instability. And, the poor expression of HSP-70 from the skin of spinal injured rat can be a factor for the explanation of the defective cellular protective response in spinal cord injury.
Animals ; Biopsy ; Blood Gas Analysis ; Catheterization ; Extremities ; Femoral Artery ; Heat-Shock Proteins ; HSP70 Heat-Shock Proteins ; Humans ; Hydrogen-Ion Concentration ; Infrared Rays ; Lower Extremity* ; Male ; Rats* ; Rats, Sprague-Dawley ; Skin* ; Spinal Cord Injuries ; Thermometers

Background & Objective: The number of ischemic stroke is increasing steadily. The recent stroke prevention strategies have targeted risk factors for preventing ischemic stroke. Community-based data that quantify the prevalence of these risk factors are needed to develop effective stroke prevention strategies. This study was performed aiming to establish customized prevention strategies by investigating vascular risk factors of ischemic stroke among the healthy adults in an urban population in Korea. Methods: The Prevention of Stroke and Dementia (PRESENT) survey collected data associated with stroke risk factors between 2007 and 2009 in Ansan city, Korea. Of 46,537 people, 2,843 were selected by random sampling, and final population included 358 men and 422 women over 50 years old. We checked modifiable risk factors, such as hypertension, diabetes mellitus, smoking, hyperlipidemia, atrial fibrillation, cardiovascular disease, obesity, and physical inactivity. Results: The mean age of study subjects was 60.1±8.2 years; 55.5% had hypertension, 18.6% had diabetes mellitus, 17.7% were current smoker, 44.9% had hyperlipidemia, 1.7% had atrial fibrillation, and 4.5% had cardiovascular disease. Men had more risk factors for stroke, and higher rates of diabetes mellitus and current smoking. However, women had higher cholesterol and obesity rates and lower physical activity. The proportion of individuals with >1 risk factor for stroke increased with age. Hypertension, diabetes mellitus, and cardiovascular diseases also increased with age, but low-density lipoprotein levels and current smoking decreased. Conclusions: This study provides valuable information to develop customized strategic policies for primary and secondary stroke prevention.
Stroke

No abstract available.
Wernicke Encephalopathy*

This rare venous congenital anomaly has been diagnosed preoperatively in a 24-year-old female with complaints of the right flank and low back pain, and urinary frequency. In the I. V. P. the dilated upper right ureter forms a reversed "J" appearance. The right R.G.P. shows the "S"-shaped course of the ureter. The vena cavogram discloses crossing with the right R. G. P. at L3-4 intervertebral space level. 2.5cm. of strictured, postcaval segment of ureter is excised and end-to-end oblique anastomosis is done over splinting ureteral catheter. 4 months after the operation, the I. V. P. shows marked improvement of hydronephrosis and satisfactory drainage of urine compared with the preoperative films.
Drainage ; Female ; Humans ; Hydronephrosis ; Low Back Pain ; Retrocaval Ureter* ; Splints ; Ureter ; Urinary Catheters ; Young Adult

No abstract available.
Brain Injuries* ; Brain* ; Dentate Gyrus*

OBJECTIVE: A Zero-profile device is a cervical stand-alone cage with integrated segmental fixation device. We characteristically evaluated the radiological changes as well as clinical outcomes in the application of Zero-profile devices compared with stand-alone cages and anterior cervical plates with iliac bone grafts for the cervical disease. METHODS: Retrospectively, total 60 patients at least more than one year follow-up were enrolled. Twenty patients were treated with Zero-profile devices (Group A), twenty patients with stand-alone cages (Group B) and twenty patients with anterior cervical plates and iliac bone grafts (Group C) for a single level cervical disease. The clinical outcomes were evaluated by Odom's criteria and Bazaz-Yoo dysphagia index. The radiologic parameters were by subsidence and the changes of the midpoint interbody height (IBH), the segmental kyphotic angle (SKA), the overall kyphotic angle (OKA) in index level. RESULTS: Although there was no significant clinical difference according to the Odom's criteria among them(p=0.766), post-operative dysphagia was significantly decreased in the Group A and B compared with the Group C (p=0.04). From the immediate postoperative to the last follow-up time, the mean change of IBH decrement and SKA increment were significant in the Group B compared with the Group A (p=0.025, p=0.033) and the Group C (p=0.001, p=0.000). The subsidence rate was not significant among all groups (p=0.338). CONCLUSION: This Zero-profile device is a valuable alternative to the anterior cervical discectomy and fusion with a low incidence of postoperative dysphagia and without segmental kyphotic change.
Cervical Vertebrae ; Deglutition Disorders ; Diskectomy* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kyphosis ; Postoperative Complications ; Retrospective Studies ; Transplants*

The urachus is a fibrous cord that arises from the anterior bladder wall and extends cranially to the umbilicus. Traditionally, infection has been treated using a two-stage procedure that includes an initial incision and drainage which is then followed by elective excision. More recently, it has been suggested that a single-stage excision with improved antibiotics is a safe option. Thus, we intended to compare the effects of the two-stage procedure and the single-stage excision. We performed a retrospective review on nine patients treated between May 1990 and September 2005. The methods used in diagnosis were ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and cystoscopy. The study group was comprised of three males and six females with a mean age of 28.2 years (with a range from three to 71 years). Symptoms consisted of abdominal pain, abdominal mass, fever, and dysuria. The primary incision and drainage followed by a urachal remnant excision with a bladder cuff excision (two-stage procedure) was performed in four patients. The mean postoperative hospitalization lasted 5.8 days (with a range of three to seven days), and there were no reported complications. A primary excision of the infected urachal cyst and bladder cuff (single-stage excision) was performed in the other five patients. These patients had a mean postoperative hospitalization time of 9.2 days (with a range of four to 15 days), and complications included an enterocutaneous fistula, which required additional operative treatment. The best method of treating an infected urachal cyst remains a matter of debate. However, based on our results, the two-stage procedure is associated with a shorter hospital stay and no complications. Thus, when infection is extensive and severe, we suggest that the two-stage procedure offers a more effective treatment option.
Urachal Cyst/*microbiology/*surgery/ultrasonography ; Retrospective Studies ; Middle Aged ; Male ; Length of Stay ; Humans ; Female ; Drainage ; Child, Preschool ; Child ; Bacterial Infections/*surgery/ultrasonography ; Aged ; Adult

No abstract available.
Coal* ; Rhabdomyolysis*