No abstract available.
Humans ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder*

No abstract available.
Epidemiologic Studies*

No abstract available.
Alcohol Drinking* ; Smoking* ; Tobacco Products*

Lumbar ligimentum flava obtained from 21 patients of spinal stenosis and 10 patients who underwent surgery for vertebral fracture(control group) were studied with hematoxylin-eosin stain, Verhoff s elastic stain, and immunohistochemical stains for S-100 protein ad fibronectin. The chondroid metaplasia of ligamentum flavum found more frequently and widely in the group of spinal stenosis compared with control group. The elastic fibers were decreased in number and irregu- larly arranged at the bone attached area in the group of spinal stenosis. There was tendency to increase the amount of fibronectin in the stroma of the ligamentum flavum in the group of spinal stenosis. Above findings suggest that chondroid metaplasia and changes of the elastic fiber in the peripheral area of the ligamentum flavum are able to contribute the pathogenesis of spinal stenosis.
Coloring Agents ; Elastic Tissue ; Fibronectins ; Humans ; Ligamentum Flavum ; Metaplasia ; S100 Proteins ; Spinal Stenosis

PURPOSE: Autonomic dysreflexia represents one of the most serious medical emergencies in the care and rehabilitation of patients with spinal cord injury. We evaluated the effect of terazosin for the prevention of symptoms due to autonomic dysreflexia in patients with spinal cord injury. MATERIALS AND METHODS: The effect of terazosin was evaluated in 20 spinal cord injury patients with autonomic dysreflexia. All patients received terazosin as the only medication for the autonomic dysreflexia. Baseline measurements of blood pressure, the autonomic dysreflexia severity score and autonomic dysreflexia frequency score were recorded before terazoxin medication. Follow-up measurements were taken at 1 week, 1 month and 3 month after medication. All the data were statistically evaluated and the following results were obtained. RESULTS: The majority of patients(95%) had manifested headache and sweating. The autonomic dysreflexia severity score after terazosin medication decreased from an average of 9.0+/-0.6 at baseline to 6.8+/-0.7, 5.2+/-0.7 and 4.9+/-0.6 at 1 week, 1 month and 3 months repectively(p=0.001). And the autonomic dysreflexia frequency score after terazosin medication decreased from an average of 2.4+/-0.5 to 1.2+/-0.4 at 3 months. CONCLUSION: Tetazosin appears to be effective in preventing symptoms due to autonomic dysreflexia.
Autonomic Dysreflexia ; Blood Pressure ; Emergencies ; Follow-Up Studies ; Headache ; Humans ; Rehabilitation ; Spinal Cord Injuries* ; Spinal Cord* ; Sweat ; Sweating

BACKGROUND: The concept of "double crush syndrome (DCS)"-a proximal compressive lesion making the distal nerve more vulnerable to injury-is an intriguing hypothesis. However, recent studies did not show unitary results. This study was preliminarily undertaken in order to clarify the causal relationship of proximal compressive lesion and carpal tunnel syndrome (CTS) in an electrophysiologic aspect. METHODS: In the period between June 1998 and June 1999 there were 24 patients with CTS(33 limbs with CTS). With these CTS patients, thorough electrodiagnostic studies were performed to discover coexisting proximal compressive lesions along the median nerve and its corresponding cervical root lesions. RESULTS: In 10 of these limbs (30%), there was a electrodiagnostically-proven coexisting proximal compressive lesion(all cervical radiculopathies). But only 1 limb (3%) had an anatomically responsible association. Finally only 1 limb (3%) with CTS had a possibility of DCS. CONCLUSIONS: CTS and cervical radiculopathy are common disorders, so there is a high possibility of coexisting as a double primary lesion without a pathophysiological relationship. Our results do not support the double crush hypothesis. However, the possibility of a reversed double crush syndrome is suggested.
Carpal Tunnel Syndrome* ; Crush Syndrome* ; Extremities ; Humans ; Median Nerve ; Radiculopathy

OBJECTIVES: The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. METHODS: The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. RESULTS: Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). CONCLUSION: Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.
Academic Medical Centers ; Aged ; Compliance ; Delirium ; Follow-Up Studies ; Hospitalization ; Hospitals, General ; Humans ; Inpatients ; Korea ; Logistic Models ; Mood Disorders ; Outpatients ; Referral and Consultation

We reported a case of atypical thymic carcinoid tumor with ectopic ACTH syndrome which was proved by the presence of intracytoplasmic ACTH in the tumor cells using PAP method and electron microscopy. The patient was a 43-year-old housewife who was referred with Cushing's syndrome of unknown origin, and subsequantly followed by many disabling symptoms including, diabetes mellitus and electrolyte imbalance for which bilateral adrenalectomy was carried out. Thereafter, rapid rise in serum ACTH level and hyperpigmentation were followed. Pituitary irradiation was done under the impression of Nelson's syndrome despite of lacking evidence of pituitary tumor, but high serum ACTH persisted. Seven months after pituitary irradiation, two anterior mediastinal masses were first noticed and removed. Immunohistochemical and ultrastructural studies confirmed this neoplasm as a ACTH producing spindle cell variant of atypical thymic carcinoid tumor. When dealing with a patient who developed Nelson's syndrome-like phenomenon without apparent pituitary tumor, the possibility of ectopic ACTH syndrome caused by thymic carcinoid should be considered.

No abstract available.
Fractures, Bone*

Congenital indifference to pain is a rare disorder chsracterized by absence of normal subjective and objective responses to noxious stimuli in patients with intact central and peripheral nervous system. It is attributed to an abnormal affective response rather than to defective perception. Sensory apparatus of the patient was intact as far as can be determined. We experieneed a csse of congenital indifference to pain with decreased sweating.
Humans ; Pain Insensitivity, Congenital ; Peripheral Nervous System ; Sweat ; Sweating