The authors reviewed the clinical findings and treatment results of 12 cases of spinal meningeal cysts which were detected in MRI of low back patients. In these lesions, large cysts without CSF communication can compressed the nerve roots within spinal canal and it is difficult to confirm the cause of symptom whether it is originated from cysts or from associated spinal disorders. The terms and classifications of spinal meningeal cysts were very confusing. Among 12 cases, we excised 3 cases of large cysts with gluteal and perianal pains that were caused by compressed sacral nerve roots. All three cases were type 2 cyst (classified by Nabors) and located in sacral canal. In one case associated with isthmic spondylolisthesis, posterolateral fusion and pedicle screw fixations were combined with cyst excision. In other two cases, there were not any spinal pathologic findings that compressed sacral nerve roots except mild degenerative changes and intervertebral disc herniation in lower lumbar and sacral levels All 3 excised cases showed good prognosis in more than one year follow up. The other cases were treated conservatively for the associated spinal disorders.
Classification ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Prognosis ; Radiculopathy ; Spinal Canal ; Spondylolisthesis

The intramedullary nailing for the tibial fracture has been used in selected cases of fresh diaphyseal fracture and nonunion. However, with modern technical improvement such as image intensifier and interlocking, the indications have been expanded considerably. Interlocking intramedullary nailing has been popularized because it enables preservation of the range of motion of the joint, early weight bearing and early bony union. Between August, 1989 and July, 1991 interlocking nailing in the tibial fracture has been performed for 53 cases with follow up more than one year. The results were as follows; 1. All were treated with closed nailing and static locking was performed as a principle. Only three cases needed dynamization of the 47 patients treated with static locking nailing. 2. The union rate was 96.296 and mean period of fracture union was 15.2 weeks. 3. In the distal one third of fracture, rigid fixation could be achieved by adjusted length by cutting the distal end. 4. In 7 proximal tibial fractures, 4 fractures were accompanied with complications such as nonunion, angulation deformity and shortening. Therefore, interlocking nail is inadequate treatment of proximal unstable fractures. 5. In the delayed and nonunion treated by interlocking nailing, bony union was achieved in all 3 cases without bone graft and cast immobilization.
Congenital Abnormalities ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Joints ; Range of Motion, Articular ; Tibia ; Tibial Fractures ; Transplants ; Weight-Bearing

OBJECTIVES: Peripheral benzodiazepine receptor has been suggested to be associated with the relief of anxiety response induced by stresses. This study was designed to observe the anxiolytic activity of peripheral benzodiazepine receptor. METHODS: Male Sprague-Dawley rats, weighing 200-250g were forced to suffer an immobilization stress for 2 hours. The level of anxiety by immobilization was performed by an elevated plus maze and was evaluated by the number of [3H]Ro5-4864 binding sites in the olfactory bulb. RESULTS: Saturation experiments followed by scatchard anlayses of the results showed that the density of peripheral benzodiazepine receptor increased and the affinity of the peripheral benzodiazepine receptor remained unchanged. It was found that there was no significant change in the cerebral cortex. Pretreatment with clonazepam, a central benzodiazepine receptor agonist, before an immobilization stress abolished the anxoius response on the performance of plus maze. In this group, upregulation of peripheral benzodiazepine receptor of olfactory bulb was not observed. Ro5-4864, a peripheral benzodiazepine receptor agonist, elicited an increase of anxiolytic response on the performance of plus maze. Progesterone, a precursor of neuroactive steroid, also increased anxiolytic response on the performance of plus maze. Pretreatment with PK11195, a peripheral benzodiazepine receptor antagonist, abolshed the anxiolytic effect of progesterone. CONCLUSIONS: From these results, it could be concluded that peripheral benzodiazepine receptor is closely associated with the relief of acute stress induced anxiety response via an increase of synthesis of neuroactive steroid.
Animals ; Anti-Anxiety Agents ; Anxiety* ; Benzodiazepines* ; Binding Sites ; Cerebral Cortex ; Clonazepam ; Humans ; Immobilization ; Male ; Olfactory Bulb ; Progesterone ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A* ; Up-Regulation

BACKGROUND: Resistance of Mycobacterium tuberculosis to anti-tuberculosis (TB) drugs is almost exclusively due to spontaneous chromosomal mutations in target genes. Rapid detection of drug resistance to both first- and second-line anti-TB drugs has become a key component of TB control programs. Technologies that allow rapid, cost-effective, and high-throughput detection of specific nucleic acid sequences are needed. This study was to develop a high-throughput assay based on allele-specific primer extension (ASPE) and MagPlex-TAG microspheres to detect anti-TB drug resistance mutations. METHODS: DNA samples from 357 M. tuberculosis clinical isolates and H37Rv were amplified by multiplex PCR using four primer sets, followed by multiplex ASPE using 23 TAG-ASPE primers. The products were sorted on the TAG-ASPE array and detected by using the Luminex xMAP system. Genotypes were also determined by sequencing. RESULTS: Genetic drug susceptibility typing by the TAG-ASPE method was 100% concordant with those obtained by sequencing. Compared with phenotypic drug susceptibility testing (DST) as a reference method, the sensitivity and specificity of the TAG-ASPE method were 83% (95% confidence interval [CI], 79-88%) and 97% (95% CI, 90-100%) for isoniazid. For rifampin testing, the sensitivity and specificity were 90% (95% CI, 86-93%) and 100% (95% CI, 99-100%). Also, the sensitivity and specificity were 58% (95% CI, 51-65%) and 86% (95% CI, 79-93%) for ethambutol. CONCLUSIONS: This study demonstrated the TAG-ASPE method is suitable for highly reproducible, cost-effective, and high-throughput clinical genotyping applications.
DNA ; Drug Resistance* ; Ethambutol ; Genotype ; Isoniazid ; Microspheres ; Multiplex Polymerase Chain Reaction ; Mycobacterium tuberculosis ; Rifampin ; Tuberculosis ; Viperidae

PURPOSE: Even though Malassezia yeast may play an important role in the exacerbation of atopic dermatitis (AD), only a few studies of Malassezia infection have been conducted in children with AD. Thus, we compared each of clinical findings, including the severity of head and neck dermatitis and laboratory results depending on specific IgE against Malassezia furfur. METHODS: This cross-sectional study was carried out on 121 children aged 3 months to 18 years between April and July of 2014. Retrospective data was collected using the medical records, and patients were divided into 2 groups according to the presence of Malassezia sensitization. RESULTS: Specific IgE against Malassezia (group 1) was observed in 28 of all patients (23.1%). Group 1 children were at an older age (9.1+/-6.9 vs. 2.1+/-3.7, P<0.001). Group 1 children had a higher SCORing Atopic Dermatitis (SCORAD) index (46.4+/-21.0 ng/mL vs. 37.2+/-13.4 ng/mL, P=0.001), and total IgE (1,324.2+/-1,166.0 IU/mL vs. 209.5+/-532.5 IU/mL, P<0.001) compared to group 2 children (Malassezia-). In the group 1, the correlation between the Malassezia-specific IgE and 25-hydroxyvitamin D3 was negatively weak (r=-0.106) and not statistically significant (P=0.246). Furthermore, Malassezia-specific IgE and the SCORAD index (r=0.281, P=0.002) or total IgE (r=0.380, P<0.001) were positively correlated. CONCLUSION: The results of this study suggest that specific IgE against M. furfur may be helpful in assessing the severity of prepubertal children and early adolescents with AD involving the head and neck.
Adolescent ; Calcifediol ; Child* ; Cross-Sectional Studies ; Dermatitis* ; Dermatitis, Atopic ; Head* ; Humans ; Immunoglobulin E* ; Malassezia ; Medical Records ; Neck* ; Retrospective Studies ; Yeasts

PURPOSE: To assess clinical difference between total knee replacement (TKR) performed with tourniquet and diluted adrenine infiltration without tourniquet. MATERIALS AND METHODS: We analyzed the postoperative transfusion amount, intraoperative blood loss, operation time, range of motion and postoperative thigh pain in 60 cases. 30 cases (group I) were performed TKR with tourniquet and the others (group II) were performed TKR using diluted adrenaline (2.5mg of 1:1000 epinephrine diluted in 500 ml of normal saline) infiltration without tourniquet. Closed suction drainage was not used in all patients. RESULTS: In gruop I, the intraoperative blood loss was average 407.6 ml, pre- and postoperative hemoglobin average 12.6 and 9.4 g/dl, postoperative transfusion average 1.83 unit, operative time average 116.5 minutes and range of motion (at preoperative, at 7days and 6 weeks after the operation) average 116.3 degrees, 90.7degrees and 103.4degrees. In group II, the intraoperative blood loss was average 398.2 ml, pre- and postoperative hemoglobin average 13.1 and 9.7 g/dl, postoperative transfusion amount average 1.76 unit, operative time average 118.3 minutes and range of motion average 113.6 degrees, 89.2 degrees, and 105.7degrees. But average postoperative thigh pain score was significantly higher in group I (average 3.7) than group II (average 0.9). CONCLUSION: There was no significant difference in intraoperative blood loss, pre- and postoperative hemoglobin, postoperative transfusion amount, operative time and range of motion between the two groups. But we could decrease the thigh pain after TKR, not using the tourniquet.
Arthroplasty, Replacement, Knee ; Epinephrine* ; Humans ; Operative Time ; Range of Motion, Articular ; Suction ; Thigh ; Tourniquets

Herpes simplex encephalitis (HSE) is the most common form of encephalitis, with predilection for the temporal lobes and insular cortex. The presence of RBCs is a characteristic finding of CSF analysis and hemorrhagic transformation of the lesions on CT or MRI is not a rare, because the hemorrhagic necrosis is an important pathologic finding of HSE. However, intracerebral hematoma is rarely reported. We report a case of PCR proven HSE with hemotomas in both the medial temporal lobes, which has not been reported.
Encephalitis ; Encephalitis, Herpes Simplex ; Hematoma ; Herpesvirus 1, Human ; Methylmethacrylates ; Necrosis ; Polymerase Chain Reaction ; Polystyrenes ; Temporal Lobe

Inflammatory demyelinating diseases are usually diagnosed based on characteristic clinical and radiological findings. However, some demyelinating diseases have been presented as growing large mass-like lesions, and it is difficult to differentiate those demyelinating lesions from brain tumors. We report three cases of demyelinating diseases mimicking brain tumors. These cases suggest that the inflammatory demyelinating diseases have a wide spectrum and they can present with the same radiological features of brain tumors.
Brain Neoplasms* ; Demyelinating Diseases* ; Multiple Sclerosis

The authors applied ADDES-HV parent evaluation scale for the purpose of screeing test to 538 2nd grade elementary school students from March 1994 to May. The results were as follows: There was no differences in scores of ADHD between schools. In comparing the male and female between three school students, male students showed signifieant high scores (p<0.05) than female students in the score of ADDES-HV subscale and total. There was no significant differences in ADDES-HV scale between male students and female students in both ADHD patients and normal controls. In reliability test for test and retest, the reliability coefficient was higher satisfatorily and that of inattention was 0.80, inpulsivity was 0.69, hyperactivity was 0.63 and the total score was 0.82. In reliability test by internal consistancy, the Cronbach a coefficient of patient group was 0.85(p<0.05) and that of normal control was 0.84(p<0.05). The Concurrent validity between ADDES-HV scale and DSM- III -R scale was 0.57(p<0.05) in ADHD patient group and 0.84(p<0.05) in normal control group. In discriminant validity test between ADHD patient group and normal control, the ADHD patient group showed higher score(p<0.05). The total disciminant capacity of the patient group in ADDES-HV scale was 94.44%. When we regard the cut off point as standard deviation 1.5, the male student was 80 score and the female student was 69 score. In this point of view, ADDES-HV scale was proved to be the useful screening test tool for ADHD research and showed higher reliability and validity in applying to Korean subjects.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Daegu* ; Female ; Humans ; Male ; Mass Screening ; Parents ; Reproducibility of Results

No abstract available.
Hemorrhage* ; Trigeminal Nerve*