No abstract available.

Recently, continuous epidural catheter insertion is common practice not only in anesthesia but also in pain clinic. Meningitis is rare but serious complication of epidural analgesia. Acute bacterial meningitis occurred in a 82-year-old female patient with thoracic herpes zoster after continuous thoracic epidural analgeia. An MRI of thoracic region did not show an epidural abscess or granulation tissue. Gram stain and culture of the epidural catheter tip and the CSF yielded Staphylococcus aureus. Immediate treatment with antibiotics and supportive therapy was instituted and then the patient discharged without neurologic sequalae.
Aged, 80 and over ; Analgesia, Epidural* ; Anesthesia ; Anti-Bacterial Agents ; Catheters ; Epidural Abscess ; Female ; Granulation Tissue ; Herpes Zoster ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Pain Clinics ; Staphylococcus aureus

Animals ; Bone Remodeling ; Bone Transplantation ; Cell Differentiation ; Embryonic Development ; Extracellular Matrix ; Female ; Fractures, Bone ; Hyaluronic Acid ; Intention ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Pregnancy ; Rats ; Skull ; Sutures ; Tolonium Chloride ; Transplants ; Wound Healing ; Wounds and Injuries

No abstract available.
Compartment Syndromes*

OBJECTIVE: To obtain normal data of quantitative sensory test (QST) in Korean adult. METHOD: The subjects were 85 normal adults aging from 30 to 69 years old, who had no abnormal sensory and neurologic problem. We performed following three QSTs on dominant side and one verbal questionnaire. 1) Semmes-Weinstein monofilament wire system (0.05 G, 0.2 G, 2 G, 4 G, 10 G, 300 G) for touch sensation, 2) Rydel-Seiffer Tuning Fork for vibration sensation, 3) TSA-2001 Thermal sensory analyser for thermal sensation, 4)University of Texas Subjective Peripheral Neuropathy verbal questionnaire. RESULTS: 1) Touch perception score measured with Semmes-Weinstein monofilament wire system, declined with age (p<0.01). 2) Vibration perception score measured with the tuning fork, declined with age in foot (p<0.01). 3) Warm sense and heat pain threshold measured with TSA-2001 thermal sensory analyser increased with age, and cold sense and cold pain threshold declined with age. 4) Weight showed negative correlation with vibration perception score in man's foot. CONCLUSION: Normal data of three sensory test obtained from this study could be used for the early detection of peripheral neuropathy or loss of "protective sensation".
Adult* ; Aged ; Aging ; Foot ; Hot Temperature ; Humans ; Pain Threshold ; Peripheral Nervous System Diseases ; Surveys and Questionnaires ; Sensation ; Texas ; Touch Perception ; Vibration

PURPOSE: Sclerotherapy for renal cysts was performed, using 50% acetic acid as new sclerosing agent. Wereport the methods and results of this procedure. MATERIALS AND METHODS: Fifteen patients underwent sclerotherapyfor renal cyst, using 50% acetic acid. Because four patients were lost to follow-up, only 11 of the 15 wereincluded in this study. The renal cysts, including one infected case, were diagnosed by ultrasonograpy (n=10) ormagnetic resonance imaging (n=1). The patient group consisted of four men and seven women (mean age, 59 years;range, 23-77). At first, the cyst was completely aspirated, and 25 volume% of aspirated volume was replaced with50% sterile acetic acid through the drainage catheter. During the following 20 minutes, the patient changedposition, and the acetic acid was then removed from the cyst. Finally, the drainage catheter was removed, aftercleaning the cyst with saline. After treatment of infection by antibiotics and catheter drainage for 7 days,sclerotherapy in the infected case followed the same procedure. In order to observe changes in the size of renalcysts and recurrence, all patients were followed up by ultrasound between 2 and 8 months. We defined response totherapy as follows: complete regression as under 5 volume%, partial regression as 5-50 volume% and no response asmore than 50 volume% of initial cyst volume. RESULTS: No clinically significant complication occured during theprocedures or follow-up periods. All cysts regressed completely during follow-up of 8 months. Complete regressionoccurred as follows : two cysts at 2 months, seven cysts at 4 months, two cysts at 6 months. Two cysts showedresidues at the last follow-up, at 4 and 6 months, respectiivery. The volume of residual cysts decreased to under5 volume% of initial volume, however. Completely regressed cysts did not recurr during follow-up. CONCLUSION: Acetic acid sclerotherapy for renal cysts showed good results, regardless of the dilntion of sclersoing agent withresidual cyst fluid, and no significant complications. the procedure, therefore, appears to provide effectivetherapy for renal cysts.
Acetic Acid* ; Anti-Bacterial Agents ; Catheters ; Cyst Fluid ; Drainage ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Male ; Recurrence ; Sclerotherapy ; Ultrasonography

5-fluorouracil(5-FU) and its derivatives have been prescribed preoperatively in Korea for oral administration to patients with gastric cancer as an adjuvant therapy. Since the conditions of the patients after gastrectomy may be different and thereby influence the absorption of 5-fluorouracil, we were interested in the pharmacokinetic changes of 5-fluorouracil absorption after gastric resection. Fourteen of 40 gastric cancer patients, who underwent radical subtotal gastrectomy with D2 lymphnode dissection for gastric cancer, were selected at Ewha Womans University Mok-Dong Hospital from May 1996 to December 1996. The plasma concentrations of 5-fluorouracil were determined before oral administration of 5-FU(500 mg/M2) at 15-min intervals for two hours, and then at 30-min intervals for two hours after oral administration during the pre- and the post-operative periods. High pressure liquid chromatography was used to determine the plasma concentrations of 5-FU. The pharmacokinetic indices included the area under the curve (AUC), the peak concentration (Cmax), and the time to peak concentration (Tmax). The mean postoperative AUC for 5-FU was 25.8+/-14.8% of the mean preoperative AUC, which was a significant decrease in the amount of 5-FU absorption postoperatively. The mean postoperative Cmax was 33.4+/-30.2% of the mean preoperative Cmax, which also meant a significant decrease of the peak concentration postoperatively. The Tmax of most patients were delayed postoperatively, but there was no significant change statistically. In conclusion, we found that the amount of absorbed 5-FU, as calculated by the AUC and the Cmax, significantly decreased after a subtotal gastrectomy by as much as 75 percent compared to the preoperation. Hence, it may be necessary to increase the dose of 5-FU after a subtotal gastrectomy by more than 75% of the preoperative dose. The subtotal gastrectomy did not have a significant effect on the absorptive velocity of 5-FU.
Absorption* ; Administration, Oral ; Area Under Curve ; Chromatography, Liquid ; Female ; Fluorouracil* ; Gastrectomy* ; Humans ; Korea ; Pharmacokinetics ; Plasma ; Stomach Neoplasms

5-fluorouracil(5-FU) and its derivatives have been prescribed preoperatively in Korea for oral administration to patients with gastric cancer as an adjuvant therapy. Since the conditions of the patients after gastrectomy may be different and thereby influence the absorption of 5-fluorouracil, we were interested in the pharmacokinetic changes of 5-fluorouracil absorption after gastric resection. Fourteen of 40 gastric cancer patients, who underwent radical subtotal gastrectomy with D2 lymphnode dissection for gastric cancer, were selected at Ewha Womans University Mok-Dong Hospital from May 1996 to December 1996. The plasma concentrations of 5-fluorouracil were determined before oral administration of 5-FU(500 mg/M2) at 15-min intervals for two hours, and then at 30-min intervals for two hours after oral administration during the pre- and the post-operative periods. High pressure liquid chromatography was used to determine the plasma concentrations of 5-FU. The pharmacokinetic indices included the area under the curve (AUC), the peak concentration (Cmax), and the time to peak concentration (Tmax). The mean postoperative AUC for 5-FU was 25.8+/-14.8% of the mean preoperative AUC, which was a significant decrease in the amount of 5-FU absorption postoperatively. The mean postoperative Cmax was 33.4+/-30.2% of the mean preoperative Cmax, which also meant a significant decrease of the peak concentration postoperatively. The Tmax of most patients were delayed postoperatively, but there was no significant change statistically. In conclusion, we found that the amount of absorbed 5-FU, as calculated by the AUC and the Cmax, significantly decreased after a subtotal gastrectomy by as much as 75 percent compared to the preoperation. Hence, it may be necessary to increase the dose of 5-FU after a subtotal gastrectomy by more than 75% of the preoperative dose. The subtotal gastrectomy did not have a significant effect on the absorptive velocity of 5-FU.
Absorption* ; Administration, Oral ; Area Under Curve ; Chromatography, Liquid ; Female ; Fluorouracil* ; Gastrectomy* ; Humans ; Korea ; Pharmacokinetics ; Plasma ; Stomach Neoplasms

PURPOSE: Speech and language development is an useful indicator of the overall development of children. Since speech and language delay can lead to emotional, social, and learning problems, the early intervention is very important. We examined 137 children with speech or language problems including 22 children of functional articulation disorders of their clinical features. METHODS: 137 children with speech or language problems in the Department of Pediatrics, Uijeongbu St. Mary's Hospital from January 2004 to December 2007 were reviewed for sex, age, developmental and language test findings retrospectively. Especially, in 22 children diagnosed with functional articulation disorders, articulation test findings were analyzed. RESULTS: 1) The mean age of 137 children was 46.8 months, the ratio of male to female was 2.5:1, and the most frequent age group was 24-35 months. The chief complaints included language delay(67.2%), mispronouncing speech sound(27%), stuttering(3.6%), learning disability(2.2%). The diagnoses of them were developmental language disorder(70.8%), functional articulation disorders(16.1%), mental retardation(5.8%), stuttering(2.9%), tongue tie(0.7%), normal language pattern(3.6%). 2) The mean age of 22 patients with functional articulation disorders was 63 months, the ratio of male to female was 1.4:1, and the most frequent age group was 60-71 months. The mean percentage of consonant correct of Picture Consonant Articulation Test was higher in older age group. In the types of phonetic errors substitutions were most common. Distortions, omissions, and additions were followed in the order of frequency. Substitutions and distortions were common in word initial and medial but omissions in word final. It is appeared that the patients had the difficulties in pronouncing alveolar fricative, palatal affricate, liquid, and velar plosive which mature lately in older children. Mainly palatal affricate, alveolar fricative, and velar plosive were substituted for alveolar plosive and the liquid and alveolar fricative were distorted as gliding. CONCLUSION: Categorizing the cause of language and speech delay is essential to make an adequate treatment plans and decrease the late complications. The future studies for the early screening, more suitable tests in Korean, treatment guidelines or prognosis are needed.
Articulation Disorders ; Child ; Early Intervention (Education) ; Female ; Humans ; Language Development ; Language Development Disorders ; Language Tests ; Learning ; Male ; Mass Screening ; Pediatrics ; Prognosis ; Retrospective Studies ; Tongue

In the assessment of thoracolumbar burst fractures, computed tomography(CT) is superior to other imaging modalities, especially when a more definitive assessment of the posterior elements of the spine or the nueral canal is desired. A few authors have reported the relationship between traumatic spinal canal stenosis and neurologic deficits. Authors analysed 64 patients with thoracolumbar burst fractures about the relationship between traumatic spinal canal stenosis and neurologic deficits using plane x-ray findings and CT scans. The results were as follows; 1. There was no difference of kyphotic angle and anterior vertebral height loss between neurologic deficit group on lateral plane x-ray findings. 2. The incidence of injury of the superior endplate was 100%(64/64); of the inferior endplate 53%(36/64); of the posterior element 45.3%(29/64). 3. Twenty(69.0%) of 29 patients with disruption of posterior element had neurologic deficits, while fourteen(40.0%) of 35 patients without disruption had neurologic deficits. 4. Spinal canal ratio of 35.3% or more at the epiconus level, 56.0% or more at the conus medullaris level, and 65.3% or more at the cauda equine level were significant factors for neurologic deficits in thoracolumbar burst fractures. Spinal canal ratio of 22.0% or less at the epiconus level, 34.5% or less at the conus medullaris level, and 43.1% or less at the cauda equine level were not accompanied with neurologic dieficit in thoracolumbar burst fractures. 5. Fifteen(68%) of 22 patients with neurologic deficit in epiconus and conus medullarsis level had the horsehoe or crescent shape of patient spinal canal, eight (66.7%) of 12 patients with neurologic deficit in cauda equine level had the horsehoe or crescent shape of spinal canal.
Constriction, Pathologic ; Conus Snail ; Humans ; Incidence ; Neurologic Manifestations ; Spinal Canal ; Spinal Cord ; Spine ; Tomography, X-Ray Computed