Spontaneous spinal epidural hematoma are rare disease and the cause of bleeding in epidural hematoma remains unknown in most of the cause. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced I case of spontaneous spinal epidural hematoma at thoracic location. Laboratory examination showed no evidence of coagulopathy and hepatic disease. The patient had good surgical outcome after emergent decompressive laminectomy.
Anticoagulants ; Hematoma ; Hematoma, Epidural, Spinal* ; Hemorrhage ; Humans ; Laminectomy ; Rare Diseases ; Risk Factors

No abstract available.
Muscle, Skeletal*

A case of traumatic thoracolumbar epidural hemorrhage is presented in a 37-year-old man with ankylosing spondylitis. The patient complained neck and back pain right after the accident but paralegia and difficult urination followed 2 days later. Spine CT showed thoracolumbar epidural mass, which was confirmed to be hemorrhage associated with spine fracture and was solely responsible for paraplegia.
Adult ; Back Pain ; Hematoma, Epidural, Spinal* ; Hemorrhage ; Humans ; Neck ; Paraplegia ; Spine ; Spondylitis, Ankylosing* ; Urination

A technique radiogrequency localization and coagulation of articular nerves supplying the lumbar facets is described and reported from a series of 46 patients with clinical diagnosis of facet syndrome over a 4-year period. None of them had clinical or radiologic evidence of a lumbar disc hrniation, and all had exhausted conservative treatment. The literature reviewed for anatomical accuracies in denervation of the medial branch of posterior primary(dorsal) ramus. The technique of facet denervation is simple and safe and relief of pain was achieved in 78% of the patient, the morbidity remains quite low.
Denervation* ; Diagnosis ; Humans ; Low Back Pain*

The authors analyzed 52 cases of spinal cord tumor who had been operated upon at the department of neurosurgery of the Koryo General Hospital from 1983 to 1992. The results were summerized as followings: 1) The spinal cord tumor was most common in the 6th decade of age(52 cases, 28.8%) and the ratio of male to female was 1.26:1. 2) The pathologic diagnosis was neurogenic tumor in 25 cases(48.1%), metastatic tumor in 12 cases(23.1%), glial tumor in 6 cases(11.5%), and meningeal tumor in 3 case(5.7%) in order frequency. 3) The tumors were located most frequently in the thoracic area(19 cases, 36.5%) and in the intradural extramedullary space(28 cases, 53.9%). 4) The most common initial presentation was pain(27 cases, 51.9%) and on admission 14 cases(26.9%) showed paraparesis. 5) The rate of abnormality of the plain radiologic study was 59.6% and the most common positive finding was the pedicle erosion(15 cases, 28.8%). 6) The computed tomographic scanning with water soluble contrast media was useful in planning of operation to provide the exact relationship between the tumor, spinal cord and location of dura. 7) The total removal was possible in 27 cases(51.9%). 8) The follow-up results after 19.4 months of the mean follow-up duration in 46 cases were recovery in 29 cases(63.0%), improvement in 12 cases(26.0%), stationary state in 3 cases(6.5%), worse in 2 cases(4.3%). It was excellent particulary in cases of intradural-extramedullary tumor. 9) The incidence of metastatic tumor was 23.1%(12 cases) and the lung was most common primary focus. The follow-up result of metastatic tumor was poor than the other tumors.
Contrast Media ; Diagnosis ; Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Lung ; Male ; Meningeal Neoplasms ; Neurosurgery ; Paraparesis ; Spinal Cord Neoplasms* ; Spinal Cord*

Maspin is a recently described gene with tumor suppressor activity. The gene product is a 42 kD protein with homology to the serpin family of protease inhibitors and may play a role as an inhibitor of tumor cell invasion. The prior observation that invasive breast cancers and their metastases showed decreased maspin protein expression by immunostaining supports this speculation. However, the role of maspin in breast cancer progression has not been studied in detail. We, therefore, studied maspin protein expression in a series of hyperplasia, atypical ductal hyperplasia, intraductal carcinoma and invasive carcinomas. Immunohistochemical staining (IHC) for maspin was performed on paraffin sections of 136 breast specimens using a commercially available monoclonal antibody. Among the 106 cases studied were 36 moderate/florid ductal hyperplasia, 11 atypical ductal hyperplasia (ADH), 29 intraductal carcinoma (IDC) (4 low grade, 13 intermediate grade, 12 high grade) and 30 invasive ductal carcinomas. Thirty cases of normal breast were also studied as control group. IHC stains were scored using a semiquantitative scoring system. The mean IHC scores for maspin for normal, moderate/florid hyperplasia, atypical ductal hyperplasia, intraductal carcinoma, and invasive carcinoma were 5.51 1.30, 7.36 0.72, 3.82 1.60, 4.48 2.69, 3.97 3.30, respectively. These scores for each category were statistically significant (p<0.05), except between ADH and IDC. Maspin protein expression was increased in most cases of moderate/florid hyperplasia, while maspin expression was more heterogeneous in ADH and IDC. In high grade IDC, maspin protein expression was stronger than low and intermediate grade IDC, and this suggests the possibility of a compensatory cellular response against the forces driving further tumor progression. Two thirds of invasive ductal carcinomas expressed maspin protein weakly and focally. All metastatic carcinomas of lymph nodes were negative for maspin. It is possible that high grade IDC with strong maspin expression may represent a subset less likely to progress to invasive cancer. This speculation merits investigation in clinical outcome studies.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Coloring Agents ; Humans ; Hyperplasia* ; Lymph Nodes ; Neoplasm Metastasis ; Outcome Assessment (Health Care) ; Paraffin ; Protease Inhibitors

No abstract available.
Antibodies, Monoclonal* ; Herpesvirus 3, Human*

Candidosis, the most common fungal infection involving the central nervous system, is rarely diagnosed during life. The authors present a case of candidal granuloma of the caudate area in a 31-year-old, otherwise healthy man with episode of intermittent antibiotic therapy. There was no extracranial fungal lesions, Ventriculoperitoneal shunt and biopsy followed by treatment with Amphotericin-B resulted in a favorable outcome.
Adult ; Biopsy ; Central Nervous System ; Granuloma* ; Humans ; Ventriculoperitoneal Shunt

Six hundred fifty-one metacarpal bones of Koreans were studied for variations in articular and non-articular surface and the number, position and direction of the diaphyseal nutrient foramina. The facets for articulation of the metacarpal bone with one another showed very frequent variations from the standard text-book description. The number and the sites of entry of the diaphyseal nutrient foramina also showed considerable variations. These findings show no apparent racial difference in variations of metacarpal bones between a Korean and an Indian.
Metacarpal Bones*

The surgical methods of injured peripheral nerve were limited to end-to-end neurorrhaphy, nerve graft, neurotization, etc. Recently, Several studies were executed about end-to-side neurorrhaphy in peripheral nerve injury. The purpose of this study is to investigate the axonal regeneration of end-to-side neurorrhaphy in rats, as alternative surgical method for peripheral nerve injury comparing with the state of normal, denervated, and end-to-end neurorrhaphy. Sixty female Sprague-Dawley rats were divided into four groups; group I as normal control group, group II as denervated control group, group III as end-to-end neurorrhaphy group, group IV as end-to-side neurorrhaphy group. At postoperative 4, 8, 12, 16, 20 and 24 week, nerve regeneration was assessed through electrophysiologic and histological studies. The results obtained were as follows: 1. In electrophysiologic test, the mean amplitude was higher in normal control group(group I) than either in end-to-end neurorrhaphy group(group III) or in end- to- side neurorrhaphy group(group IV)(p < 0.05). But there is no significant difference between group III and group IV. 2. The mean number of regenerating myelinated nerve fibers was higher in group I than either in group III or in group IV(p < 0.05). But there is no significant difference between group III and group IV, except at postoperative 16 week. 3. The mean number of motor end-plates at postoperative 24 week was 20.5 in group III and 18.2 in group IV, but there is no significant difference between group III and group IV. In conclusion, end-to-side neurorrhaphy through an epineural window could induce distal nerve regeneration by collateral sprouting of main peripheral nerve and positively reflected in functional improvement of the target muscle.
Animals ; Axons ; Female ; Humans ; Motor Endplate ; Nerve Fibers, Myelinated ; Nerve Regeneration* ; Nerve Transfer ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Transplants