Deformities of Spine and Lower Extremities in Teenagers with Cerebral Palsy

OBJECTIVE: To investigate the state of musculoskeletal deformities in spine and lower extremities in teenagers with cerebral palsy. METHOD: 79 teenagers with cerebral palsy attending special schools were examined for deformities of the spine and the lower extremities with physical examinations and radiographic studies. RESULTS: The number of cases with scoliosis was 47 (59.5%) and the mean of Cobb's angle was 21.7 degrees. There were 42 joints (26.6%) of hip subluxation and 10 joints (6.3%) of hip dislocation out of 158 hip joints. The mean of migration percentage was 53.6%. 30 participants (38.0%) had pelvic obliquity. The coxa valga appeared in 147 hip joints (93.0%), with the mean of femur neck-shaft angle was 156.0 degrees. It had a casual link with migration percentage (p<0.001). 131 knee joints (82.9%) had the increased popliteal angle and 113 knees (71.5%) had patella alta. 72 cases (91.1%) had equinus feet, and 49 cases (62.0%) had planovalgus feet deformities on radiographic studies. As the score of Gross motor function measure (GMFM) was decreased, the migration percentage (p<0.01), the Cobb's angle (p<0.01), the popliteal angle increased (p<0.001) and femur neck- shaft angle (p<0.05). CONCLUSION: Teenagers with cerebral palsy are highly risk to develop musculoskeletal deformities in their spine and the lower extremities. Therefore, a close medical inspection should be paid on this group.

The influence of N-6-cyclopentyladenosine and magnesium on norepinephrine release in the rat hippocampus

As it has been reported that the depolarization-induced norepinephrine (NE) release is modulated by activation of presynaptic A-1-adenosine heteroreceptor and various lines of evidence indicate that A-2-adenosine receptor also presents in hippocampus, and that the adenosine effect is magnesium dependent, the present study was undertaken to delineate the role of adenosine receptors in the modulation of hippocampal NE release. Slices from the rat hippocampus were equilibrated with (3H)-NE and the release of the labelled product, (3H)-NE, was evoked by electrical stimulation (3 Hz, 5 V cm-1, 2 ms, rectangular pulses), and the influence of various agents on the evoked tritium outflow was investigated. N-6-cyclopentyladenosine (CPA), in concentrations ranging from 0.1 to 10 micrometer, decreased the (3H)-NE release in a dose-dependent manner without changing the basal rate of release, and these effects were significantly inhibited by 8-cyclopentyl-1,3-dipropylxanthine (DPCPX, 2 micrometer) treatment. When the magnesium concentration was reduced to 0.4 mM or completely removed, the evoked NE release increased along with decreased basal rate of release. In contrast, increasing the magnesium concentrations to 2.4 and 4 mM, decreased the evoked NE release. The CPA effects on evoked NE release were reduced by magnesium removal, but potentiated by 2.4 mM magnesium in the medium. 5-(N-cyclopropyl)-carboxamodiadenosine (CPCA, 1 & 10 micrometer), an A-2-agonist, decreased the evoked tritium outflow, and this effect was also abolished by DPCPX pretreatment. CGS, a powerful A-2-agonist, did not affect the evoked NE release. However, the effects of CPCA and CGS on evoked NE release were significantly increased by pretreatment of DPCPX in the magnesium-free medium. These results indicate that inhibitory effect of A-1-adenosine receptor on NE release is magnesium-dependent, and A-2-receptor may be present in the rat hippocampus.

The Effect of the Experimental Spinal Cord Injury on the Thyroid Function

Serum thyroxine(T4), effective thyroxine index(ETI) and thyroid stimulating hormone(TSH) were measured in 60 albino rats following laminectomy and cord injury produced by weight drop method. Thyroid hormones were measured at one and 100 minutes and, at 1, 3 and 7 days after injury by radioimmunoassay method. At 1 and 100 minutes, T4 was significantly reduced in both laminectomy and cord injured groups. TSH at 1 and 100 minutes were also elevated significantly. Gradual normalization of T4 and TSH showed at 7 days. It appeared likely that the opimal time to the administration of exogenous thyroid hormone would be before the 7th day of cord injury.

The Study on Experimental Brain Herniation

Cerebral herniations were successfully produced in experimental animals during the expansion of intracranial balloon or laminaria. Visualizing structures deep in the brain, cat's heads were instantaneously frozen with liquid nitrogen and were sectioned in the midline longitudinally. The cerebral herniations were assessed by measureing the distance between parts of various anatomical structures on the brain in mid-sagittal sectional plane. Transtentorial rostrocaudal herniation of the brain stem was evident and more marked in the group of bilateral lesions than in the groups of frontal and temporal lesions. Infratentorial lesions produced transtentorial upward herniation of a part of anterior cerebellar vermis and downward herniation of the cerebellar tonsil through the foramen magnum. The risk of brain herniation was noted to be greater in rapid expanding lesions with balloon than the more slowly developing lesions with laminaria.

A Case of Pleomorphic Xanthoastrocytoma

A case of pleomorphic xanthoastrocytoma of the temporal lobe in a 27 year-old man who had severe frontal headache and diplopia is presented. Brain computed tomographic scan revealed a relatively wel demarcated, slightly hyperdense mass with cyst surrounding low density in left temporoparietal area. After contrast enhancement, the mass was totally removed. Despite of their highly pleomorphic and bizzarre cytology, which suggests a malignant behavior, these tumors appear to have a relatively favorable prognosis.