In order to evaluate the value of vertebral angiography in assessment of hemifacial spasm, we reviewed retrospectively the vertebral angiography of 28 patients(30 cases) with surgically proved hemifacial spasm but normal CT scans of posterior fossa. There were 9 males and 19 females. Angiography revealed vascular focus of hemifacial spasm located at anterior inferior cerebellar artery, posterior inferior cerebellar artery, and vertebral artery in 19, 9, and 2 cases respectively. Right side was involved in 20 cases. All involved vessels were elongated, tortuous, and dilated. In conclusion, vertebral angiography was valuable in evaluating hemifacial spasm of vascular origin in the posterior fossa.
Angiography* ; Arteries ; Female ; Hemifacial Spasm* ; Humans ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Vertebral Artery

The flexion reflex is generally known as a withdrawal reflex in response to a painful stimulus. Since Sherrington's first detail report in 1910, it has been established that the flexion reflex is a central reflex evoked by a painful stimulus applied to the skin or afferent nerves. Recent studies indicate that the reflex is not a single component but has two components, the early and the late. Although many aspects of the reflex is known, it is still obscure as to the pathways for the low components of the reflex. The central reflex are of the each component has not been localized systematically. Furthermore, there are considerable discrepancies in literatures regarding to the type of afferent nerve fiber responsible for the flexion reflex. The present study was, therefore, conducted to find out the pathways for the flexion reflex including the location of the central reflex are and the afferent nerve fiber types in an experimental animal. Sixteen healthy adult cats(2-3.5kg) were preanesthetized with ketamine hydrochloride(20 mg/kg, im.) and decerebrated anemically by ligating the basilar artery and the bilateral common carotid arteries. Animals were paralyzed with gallamine triethiodide and kept under artificial respiration. The flexion reflex was elicited by stimulating the sural nerve and recorded as a form of compound action potential from the nerve supplying to the semitendinous muscle. The central reflex are of the flexion reflex was localized by comparing the reflex components of decerebrate cats with those of decerebrated and spinalized cats. The type of afferent nerve fiber responsible for each component of the flexion reflex was identified by recording afferent volleys from the sural nerve at 40-50 mm proximal to the stimulating site. The results are summarized as follows: 1) The flexion reflex is composed of two components, the early and the late. The early and the late components have a latency of 7.8 and 173.8 msec, and a duration of 7.3 and 906.3 msec, respectively. 2) The central reflex are of the early component and most of the late component is in the spinal cord while some of the late component is mediated by either rostral part of the spinal cord or the brain stem, most likely medulla oblongata. 3) The afferent nerve fibers responsible for the early component are A and A fibers and that of the late component is C fibers. In general, temporal summation from C fibers is necessary to elicit the late component. These results indicate that the two componts of the flexion reflex have different pathways. This may imply that the two components have different functional role.
Action Potentials ; Adult ; Animals ; Basilar Artery ; Brain Stem ; Carotid Artery, Common ; Cats ; Gallamine Triethiodide ; Humans ; Ketamine ; Medulla Oblongata ; Nerve Fibers ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Reflex* ; Respiration, Artificial ; Skin ; Spinal Cord ; Sural Nerve

No abstract available.
Drug Resistance* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium*

Among all of the cerebrovascular problems that which has the highest mortality and worst prognosis is the problem of intraventricular hemorrhage. The mortality is highest immediately following the hemorrhage. Because direct surgical intervention is thought to be very dangerous in patients with intraventricular hemorrhage most of these patients have been treated conservatively. This study gives the results of evacuation of the intraventricular blood plus the placement of external draninage catheters which decrease the intraventricular pressure and provide and outlet for the blood should the patient have further hemorrhage. Such a procedure is associated with clinical improvement which better prepares such patients for subsequent surgical treatment. Eighteen patients who had intraventricular hemorrhage between June 1973 and April 1974 are analyzed as to the results of this operative treatment. Also the literature concerning this new method is reviewed. The operative procedure was as follows: Under local anesthesia using 1% procaine unilateral or bilateral burr holes were made in the frontal area. Ventriculostomy was made through these oles. The ventricle was irrigated with physiologic saline removing the hematoma or the bloody ventricular fluid. The irrigation was continued until the fluid became relatively clear. Following the initial irrigation, the cannular was removed and a Nelaton catheter placed into the ventricle. The catheter was fixed to the scalp and connected to a drainage bottle under aseptic conditions. The ventricular drainage was maintained at 200 mmH2O for 7-10 days. Prior to surgery 2 million units of procaine penicillin was injected into the ventricle. Postoperatively, 5mg of Gentamycin was injected through the catheter twice a day. Surgical drainage of the ventricle was done 3 hours to 7 days after the onset of clinical signs of hemorrhage. The external ventricular drainage was maintained for an average of 7.0 days. RESULTS: 10 patients(56%) improved and could be discharged. 4 died of recurrent intraventricular hemorrhage, of gastrointestinal bleeding, or of myocardial infarction during hospitalization. However, all of these 4 patients showed some clinical improvement following the operative procedure. Only "4" patients expired after surgery. This mortality of 44% is considerably less than the usually found mortality of 80-100% for intraventricular hemorrhage and 60-70% in subarachnoid hemorrhage. On the basis of this study a more active treatment of patients with intraventricular hemorrhage, including operative drainage of the ventricles is proposed.
Anesthesia, Local ; Catheters ; Drainage* ; Gentamicins ; Hematoma ; Hemorrhage* ; Hospitalization ; Humans ; Mortality ; Myocardial Infarction ; Penicillin G Procaine ; Procaine ; Prognosis ; Scalp ; Subarachnoid Hemorrhage ; Surgical Procedures, Operative ; Ventricular Pressure ; Ventriculostomy

The particle size of suspended particulates was measured by a Andersen air sampler from Mar. 1982 to Feb. 1984 in a part of Seoul. It was concluded as follows: 1) The arithmetic concentration of suspended particulates was 147.8 microgram/m3 in Spring, 136.9 in Summer, 131.9 in Autumn and 158.1 in Winter respectively. 2) The cumulative distribution of suspended particulates size in logarithmic diagram showed similar to normal log distribution. 3) The atmospheric particulate matters showed a bimodal size distribution on the base of unit particle concentrations, which divided at approximately 2 micrometer in the diameter. 4) While the fine particulates less than 2.1 micrometer was 35.4-45.0%, the coarse particulates was 55.0-64.5%. 5) The higher the concentration of suspended particulates, the more increased the ratio of fine particulates. The higher the concentration of suspended particulates, the lower median size of suspended particulate as well. 6) The respirable dust particulates less than 4.7 micrometer was 52.2-62.9% in seasonal average through the 2 year samples. With the above result, air pollution concerned with public health could be evaluated and the control measures also are suggested.
Air Pollution ; Atmosphere* ; Dust ; Particle Size* ; Public Health ; Seasons ; Seoul*

Although the histologic grade of astrocytic neoplasms of the brain have been used as a prognostic factor, the lack of an objective criteria is possible to create the disagreement of classification. We evaluated 25 cases of astrocytic neoplasms of brain to document the usefulness of prolifera-tive potential of tumor as a prognostic indicator and the correlation with histologic grade by Nils Ringertz. The Ringertz's classification was relatively simple in an application among the variable systems and easy to define the differentiate from grade to grade. The examined cases were com-prised of 7 astrocytomas, 9 anaplastic astrocytomas and 9 glioblastoma multif6rmes. The prolife-rative potential of tumors were measured by Ag-NORs count, PCNA labeling index and flow cytometric analysis. The mean numbers of Ag-NORs per cell and PCNA labeling index were sig-nificantly differ among each histologic grade. In addition, abnormal DNA content and high prolif-erative index were frequently identified in anaplastic astrocytoma and glioblastoma multiforme. Therefore, the Ag-NORs counts, PCNA labeling index, DNA index and proliferative index were well correlated with the histologic grade.

A propecive analysis of 50 patients with acute interhemisphric subdural hemorrhage and tentorial hemorrhage, an unusual pattern of acute subdural hematoma, who were managed in a uniform way was analyzed to related outcome to hemorrhagic site, initial Glasgow Coma Scale(GCS) and combined injuries. The incidence of acute interhemisphric subdural hemorrhage(ISH) and tentoria hemorrhage(TH) after head trauma was 3.83%, 50 cases among 1303 head injured cases. And 80% of the above hemorrhage disapperaed within two weeks after trauma. There was no significant relationship between feature of hemorrhage and intial GCS(P>0.05), but there was highly significant relationship between initial GCS and Glasgow Outcome Scale(GOS) (p<0.001). There noted significant relationship between initial combined injury and GOS(p<0.01), and also brainstem injury and GOS(p<0.001).
Brain Stem ; Coma ; Craniocerebral Trauma ; Head ; Hematoma, Subdural* ; Hematoma, Subdural, Acute ; Hemorrhage* ; Humans ; Incidence

We reviewed retrospectively the results of stabilization of femoral neck fracture using multiple cannulated screws, in 20 patients who were treated at the department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital from January 1991 through July 1995. With the average follow up of 2 years (from 1 year to 4.5 years), we analyzed these patients with the adequacy of reduction by Garden's alignment index and the functional results of the hip by the Lunceford method. The mean age of patients was 70 years (ranged from 34 to 88 years). The types of fracture according to Garden's classification were fifteen cases of Garden stage I or II, and five cases of Garden stage III or IV. The average interval from injury to operation was four days, ranging from I to 14 days. The adequacy of reduction by Garden's alignment index were as follows: anatomic in 8, acceptable in 10 and poor in 2 cases. According to the Lunceford method, the functional results were as follows: excellent in II, good in 6, fair in 1 and poor in 2 cases, respectively. We found that good result out of the femoral neck fractures, especially for stage I and II with the anatomical and acceptable reduction, can be expected by multiple cannulated screw fixation and early ambulation as possible.
Classification ; Early Ambulation ; Femoral Neck Fractures* ; Femur Neck* ; Follow-Up Studies ; Heart ; Hip ; Humans ; Retrospective Studies

Spondylolisthesis and spondylolysis is one of the major causes of the low back pain and orthopaedic surgeons frequently encounter this problems with increasing tendency. In 19th century, spondylolisthesis had been studied by the European obstetrician as the main cause of dystocia. Advancement of the radiological techniques enabled us to know more precise degree of slipping. Therefore, many surgical techniques have been used. Spondylolysis has been also studied as the precursor of the spondylolisthesis. This report is based upon the analysis of the records of 26 patients who had operated at the Department of Orthopaedic Surgery of National Medical Center from 1972 to 1981. The results were as follows. 1. Most common age group was 30–50 age group and theres no sexual difference. 2. Most common symptoms were lumbago and radiating pain and the most common sign was Lasegue sign. 3. Most common type was isthmic type and location was 5th lumbar vertebra, and degree of slipping was grade I by Meyerding's method. 4. The fusion of the grafted bone were observed in 24 cases among 26 cases: of which the duration were 3 months in 16 cases and remaining 8 cases had duration between 3 and 6 months. 5. Postoperative analysis under the basis of the functional recovery was satisfactory in 93% of cases by Gill's criteria.
Dystocia ; Female ; Humans ; Low Back Pain ; Methods ; Pregnancy ; Spine ; Spondylolisthesis ; Spondylolysis ; Surgeons ; Transplants

No abstract available in English.
Gangrene