PURPOSE: To obtain magnetization transfer ratio(MTR) of the annulus fibrosus and nucleus pulposus and to assess the feasibility of utilizing the changes of these MTRs as an early indicator of disk degeneration. MATERIALS AND METHODS: MR images of lumbar spine with magnetization transfer(MT) technique in 42 patients were obtained. spin echo techniques (600/14) with same TR/TE with 1KHz off-resonance saturation were employed in 1.0T MR system. MTRs were calculated in two regions, anterior annulus fibrosus and nucleus pulposus, and the results were compared between the normal and degenerative disks, from grade I to IV, on T2-weighted images. RESULTS: MTRs of the nucleus pulposus were 17.6% in the normal disks, and 26.7%, 28.4%, 29.1%, 29.7% in degenerative disks, from grade I to IV, respectively, with a significant difference(P<0.05). On the other hand, MTRs in the annulus fibrosus were 30.2% in the normal disks and 31.5%, 33.2%, 32.1% and 35.6% in degenerative disks, from grade I to IV, respectively, without significant difference. CONCLUSION: Since MTRs are significantly higher in degenerative nucleus pulposus than those of the normal disks, increased MTRs in the nucleus pulposus can be used as an early sign of the degeneration of the nucleus pulposus.
Hand ; Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging* ; Spine

No abstract available.
Animals ; Dogs* ; Lactic Acid*

Patients with chronic renal failure, generally, sufferred from normocytic normochromic anemia caused by decreased level of erythropoietin. But, secondary erythrocytosis has been reported in patients with several renal diseases; renal artery stenosis or throm- bosis, polycystic kidney disease, bilateral hydronephrosis, etc. We report one case of chronic renal failure combined with polycythemia vera. The case was 32 year-old man whose chief complaints were dyspnea, back pain, itching sensation, headache. 6 month ago, the laboratory examination showed only proteinuria and hematuria without deterioration of renal function. The renal function was aggravated with an accelerated course, and bone marrow examination revealed hypercellularity (erythroid predominance), and renal biopsy showed the finding of the end stage of renal disease which may be originated from IgA nephropathy.
Adult ; Anemia ; Back Pain ; Biopsy ; Bone Marrow Examination ; Dyspnea ; Erythropoietin ; Glomerulonephritis, IGA* ; Headache ; Hematuria ; Humans ; Hydronephrosis ; Immunoglobulin A* ; Kidney Failure, Chronic* ; Polycystic Kidney Diseases ; Polycythemia Vera* ; Polycythemia* ; Proteinuria ; Pruritus ; Renal Artery Obstruction ; Sensation

One of the important functions of nervous system is to supply the information related to the injury. Therefore, for various kinds of injuries, to feel pain is thought to be the part of this important function. There are A-fiber (Type I AMHs, Type II AMHs) & C-fiber (CMHs) which respond to the mechanical & thermal stimuli as the nerve fibers of peripheral unit performing this function. The phenomena expressed to us by these stimuli are those reaction like the in- crease of heart rate and the elevation of blood pvessure by stimulation of the autonomic nervous system as well as pain. As it is, using these reactions which are the most popular parameter of pain expression during anesthesia, we make the depth of anesthesia deeper or use analgesics as adjuvants. In general, there are many kinds of analgesics for adjuvants of anesthesia or for elimination of postoperative pain. To compare the efficiency of those analgesics toward pain, the authors studied the inhibitory effects of analgesics on the increase of pulse rate and mean arterial pressure evoked by the thermal and mechanical stimulations in rats. We used the agents popularly used in nowadays 1) Tramadol HC1, known as a potent analgesics, 2) Nalbuphine, antagonist of opioids, 3) Meperidine and Morphine, opioids to com- pare the efficiency of hemodynamic augumentation by the thermal and mechanical stimulations with the control group. The results were as follows', 1) The inhibitory effects on the increase in pulse rate and mean arterial pressure evoked by the stimulations were in the decsing order of morphine, meperidine, nalbuphine, and tramadoL 2) The inhibitory effect of morphine on the incmnent of pulse rate and mean arterial pressme was evident. 3) Meperidine and nalbuphine, not so much potent as morphine in inhibitory also inhibit to a considerable degree. 4) In the case of tramadol, the increament of pulse rate evoked by the stimulations were inhibited to some extent, but it was proven not to inhibit the elevation of mean arterial pressure.
Analgesics* ; Analgesics, Opioid ; Anesthesia ; Animals ; Arterial Pressure ; Autonomic Nervous System ; Heart Rate ; Hemodynamics* ; Meperidine ; Morphine ; Nalbuphine ; Nerve Fibers ; Nervous System ; Pain, Postoperative ; Rats* ; Tramadol

One of the important functions of nervous system is to supply the information related to the injury. Therefore, for various kinds of injuries, to feel pain is thought to be the part of this important function. There are A-fiber (Type I AMHs, Type II AMHs) & C-fiber (CMHs) which respond to the mechanical & thermal stimuli as the nerve fibers of peripheral unit performing this function. The phenomena expressed to us by these stimuli are those reaction like the in- crease of heart rate and the elevation of blood pvessure by stimulation of the autonomic nervous system as well as pain. As it is, using these reactions which are the most popular parameter of pain expression during anesthesia, we make the depth of anesthesia deeper or use analgesics as adjuvants. In general, there are many kinds of analgesics for adjuvants of anesthesia or for elimination of postoperative pain. To compare the efficiency of those analgesics toward pain, the authors studied the inhibitory effects of analgesics on the increase of pulse rate and mean arterial pressure evoked by the thermal and mechanical stimulations in rats. We used the agents popularly used in nowadays 1) Tramadol HC1, known as a potent analgesics, 2) Nalbuphine, antagonist of opioids, 3) Meperidine and Morphine, opioids to com- pare the efficiency of hemodynamic augumentation by the thermal and mechanical stimulations with the control group. The results were as follows', 1) The inhibitory effects on the increase in pulse rate and mean arterial pressure evoked by the stimulations were in the decsing order of morphine, meperidine, nalbuphine, and tramadoL 2) The inhibitory effect of morphine on the incmnent of pulse rate and mean arterial pressme was evident. 3) Meperidine and nalbuphine, not so much potent as morphine in inhibitory also inhibit to a considerable degree. 4) In the case of tramadol, the increament of pulse rate evoked by the stimulations were inhibited to some extent, but it was proven not to inhibit the elevation of mean arterial pressure.
Analgesics* ; Analgesics, Opioid ; Anesthesia ; Animals ; Arterial Pressure ; Autonomic Nervous System ; Heart Rate ; Hemodynamics* ; Meperidine ; Morphine ; Nalbuphine ; Nerve Fibers ; Nervous System ; Pain, Postoperative ; Rats* ; Tramadol

PURPOSE: To find characteristic MRI features of vermian medulloblastoma. MATERIALS AND METHODS: MRI studiesand medical records were retrospectively reviewed for 12 patients with surgically proven midline medulloblastoma. The assessment concerned appearance of the mass in relation to surrounding structures ; MR signal intensity ; the enhancement pattern ; the mass's location and size ; presence of a cystic/necrotic area, calcification, or vascular void ; extension through the foramen Luschka ; degree of hydrocephalus ; and presence of tonsillarherniation. RESULTS: The midline medulloblastoma commonly showed roundish moon-surface appearance, especially onthe axial T2-weighted images. All tumors showed heterogeneous signal intensities mainly due to intratumoralcystic/necrotic or hemorrhagic changes. The tumors were commonly located at mid- and/or inferior vermis. Occasionally the tumors extended through the foramen Luschka, and caused obstructive hydrocephalus of moderate tosevere degree. Post-con-trast study showed heterogeneous, dense contrast enhancement in the majority of patients. CONCLUSION: The MR finding of the moon-surface appearance formed by both the mass and the intratumoralcystic/necrotic change as seen on axial T2-weighted images could be helpful in the diagnosis of vermianmedulloblastoma.
Diagnosis ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Medical Records ; Medulloblastoma* ; Retrospective Studies

OBJECTIVE: The LiquoGuard® system is a new ventricular-type monitoring device that facilitates intracranial pressure (ICP)-controlled or volume-controlled drainage of cerebrospinal fluid (CSF). The purpose of this study is to report the authors' experience with the LiquoGuard® ICP monitoring system, as well as the clinical safety, usefulness, and limitations of this device in the management of patients with traumatic brain injury (TBI). METHODS: Intraventricular ICP monitoring was performed on 10 patients with TBI using the LiquoGuard® monitoring system. ICP measurements, volume of drained CSF, and clinical outcomes were analyzed and discussed. RESULTS: ICP monitoring was performed on 10 patients for a mean duration of 6.9 days. With a mean 82,718 records per patient, the mean initial ICP was 16.4 mm Hg and the average ICP across the total duration of monitoring was 15.5 mm Hg. The mean volume of drained CSF was 29.2 cc/day, with no CSF drained in 4 patients. Seven of 10 patients showed 1 or 2 episodes of abnormal ICP measurements. No patient exhibited complications associated with ICP monitoring. CONCLUSION: The LiquoGuard® system is a versatile tool in the management of TBI patients. Its use is both reliable and feasible for ICP monitoring and therapeutic drainage of CSF. However, episodes of abnormal ICP measurements were frequently observed in patients with slit ventricles, and further study may be needed to overcome this issue.
Brain Injuries* ; Cerebrospinal Fluid ; Drainage ; Humans ; Injections, Intraventricular ; Intracranial Pressure* ; Monitoring, Physiologic

PURPOSE: The purpose of this study was to evaluate the clinicopathological significance of the microvessel density and macrophage and mast cell counts in invasive breast carcinomas. MATERIALS AND METHODS: 45 invasive breast carcinomas were immunohistochemically stained with the endothelial antigen, CD34, and macrophage marker, CD68. 0.1% toluidine blue was used to highlight mast cells. The microvessel and mast cell counts were performed at x200 magnification and the macrophages at x400 magnification. RESULTS: With the 45 invasive breast carcinomas, there were no statistically significant associations between the mast cell, macrophage and microvessel counts and the tumor size and lymph node status. ER and PR negative mast cells infiltrated more than in cases of positive stati, with statistical significance (p-value=0.010 and 0.005, respectively). The macrophage counts were negatively correlated with the PR status (p-value=0.030). With respect to the c-erbB-2 status, there was no significance correlation with the mast cell, macrophage and microvessel counts. The mast cell counts showed significantly positive correlation with the microvessel counts in the invasive breast carcinomas (p-value=0.015). In a comparison of the macrophage counts with the microvessel counts, a positive tendency for both parameters, but without statistical significance (p-value=0.310). CONCLUSION: Increasing numbers of mast cells and macrophages were recruited in invasive breast carcinomas, which contribute to angiogenesis. The microvessel density in invasive breast carcinomas had no statistically significant association with the tumor size, lymph node status, and histological grade, presence of DCIS component, estrogen/progesterone receptor status and cerbB-2 status. The evaluation of angiogenesis using these methods is not thought to provide an independent clinicopathological factor in invasive breast carcinomas.
Antigens, CD34 ; Breast Neoplasms ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Lymph Nodes ; Macrophages* ; Mast Cells* ; Microvessels* ; Tolonium Chloride

PURPOSE: To evaluate the clinical usefulness of defecogrophy in diagnosing the etiology and pathophysiology of constipation. A retrospective study of 56 constipated patients who had no abnormalities in colonoscopy, barium enema and rectal exam were done. METHODS: Fifty-six patients (12 men, 44 women) with constipation underwent defecography and 37 of the patients underwent colonic transit studies. Fluoroscopically guided defecography was performed with barium paste introduced into the rectum. RESULTS: Normal defecography finding was observed in thirteen of the 56 patients. Rectocele, spastic levator syndrome (nonrelaxing puborectalis syndrome), sigmoidocele, rectal prolapse, rectal intussusception were observed in 67% (38/56), 30% (20/56), 7% (4/56), 5% (3/56) and 2% (1/56) of the patients, respectively. More than one pathological finding was found in 23 (53%) patients. Of the 38 rectoceles, 17 cases were found to be associated with spastic levator syndrome. In solitary rectocele, the anorectal angles at rest, during straining were 92.65 9.08o, 108.09 14.35o, while 99.85 11.85o, 95.90 17.84o, in spastic levator syndrome. In 36 difficult bowel movements, 66% (24/36), 30% (11/36), 3% (1/36) were found to have rectocele, spastic levator syndrome, and sigmoidocele, respectively. Normal colonic transit time was observed in twenty six of the 37 patients. Abnormal findings included colonic inertia in 3 (8%) patients, hindgut dysfunction in 4 (11%) patients, and, outlet obstruction in 4 (11%) patients. Of the normal colonic transit time in 26, rectocele in sixteen, rectal prolapse in 1, spastic levator in 2 were observed. Rectoceles were observed in 2 out of 3 colonic inertia, in all 4 hindgut dysfunction, in 1 out of 4 outlet obstruction. CONCLUSIONS: Our findings suggest that constipation is often a disorder of defecation rather than a impairment of colonic motility. Defecography should be considered first of all in evaluating the pathophysiology of constipation, especially for whom complaining of difficult bowel.
Barium ; Colon ; Colonoscopy ; Constipation* ; Defecation ; Defecography* ; Enema ; Humans ; Intussusception ; Male ; Muscle Spasticity ; Rectal Prolapse ; Rectocele ; Rectum ; Retrospective Studies

Retinotomy, cutting of the retina, can be helpful in hte management of giant retinal tears, subretinal strands, and retinal incarceration. Relaxing retinotomies are used in the presence of retinal shortening or fibrous proliferation and contraction, and usually performed in the peripheral or equatorial retina. To fascilitate retinal attachment, the authors used intraocular scissors to perform radial retinotomy in the macula of two patients during vitrectomy surgery. We obtained a successful result using retinotomy in the macula as an adjunct to repair of retinal detachment with macular hole formation.
Humans ; Retina ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Vitrectomy