Awareness for Serious Spinal Complications Predicted after Acupuncture Procedures for Pain Control

OBJECTIVE: Acupuncture has been practiced to treat back pain in the oriental culture for several centuries and still occupies an integral part of traditional oriental medicine. Nowadays, it also comprises one aspect of the so-called alternative medicine, being increasingly practiced in western conturies. However, it has been sometimes practiced less carefully without awareness for adverse effects after acupuncture treatment. This study is performed to stress the concern about the serious complications possibly arising after acupuncture. METHODS: The medical records and radiological datas of 5 patients who suffered from serious complications after acupuncture from 1999 to 2002, were retrospectively reviewed. All 5 patients has treated with acupuncture for pain control before the admission. They did not have any medical problems such as diabetes mellitus, liver diseases, and hematologic problems. RESULTS: Epidural abscess was found in 4 patients and subdural hemorrhage in 1 patient. Among 4 patients with epidural abscess, 3 patients without myelitis had good recovery of neurologic symptoms. However, one patient who was combined with myelitis had poor outcome. One patient who was diagnosed subdural hemorrhage was improved with conservative treatment. CONCLUSION: Acupuncture has been and is being practiced extensively in medical field. However, it has been sometimes abused recklessly for the pain control related with spine, that might result in serious complications such as epidural abscess or subdural hemorrhage as in our cases. These results should raise concern about serious complications that may be developed in practicing the acupuncture.

Shear bond strength of orthodontic bracket with hydrophilic primer / 대한치과교정학회지

The purpose of this study was to evaluate the clinical effectiveness of hydrophilic primer, which claim to retain adequate bond strength on moistened enamel resulting from moisture or saliva contamination, by comparing the shear bond strength and adhesive failure patterns of brackets bonded using hydrophilic primer and conventional hydrophobic primer. Brackets were bonded to human premolars embedded in metal cylinders utilizing light cured adhesive, primed with either a hydrophilic primer(Transbond MIP primer) or a conventional hydrophobic primer(Transbond XT primer). Each sample was exposed to varying degrees of artificial saliva contamination during the priming process. The shear bond strength was measured using a universal testing machine, and the adhesive failure patterns after debonding were visually examined by stereomicroscope and assessed using the adhesive remnant index(ARI). The results were as follows: 1. In dry conditions, no significant differences in shear bond strength between Transbond MIP and Transbond XT primers were found. 2. Transbond MIP primer exhibited a significantly higher shear bond strength than Transbond XT primer in saliva-contaminated conditions, regardless of the degree of contamination. 3. When contaminated with one coat of saliva, Transbond MIP primer did not exhibit significant differences in shear bond strength compared to the dry condition. When contaminated with two coats of saliva, Transbond MIP primer exhibited a significantly lower shear bond strength compared to the dry condition. 4. The adhesive remnant index of the adhesive failure pattern had a tendency to decrease, as the degree of saliva contamination increased. Bracket-adhesive interface failure was observed in more than half of the saliva contaminated samples utilizing Transbond MIP primer, whereas the bond failure sites of the Transbond XT primer samples occurred almost exclusively at the adhesive-enamel interface in saliva-contaminated conditions. The results of this study suggest that in cases where moisture control is difficult, Transbond MIP primer is an effective alternative to conventional hydrophobic primers.

Simultaneous Ipsilateral Posteroventral Pallidotomy and Ventrolateral Thalamotomy for Advanced Parkinson's Disease

Stereotactic thalamotomy has traditionally provided good relief of tremor for patients with intractable tremor dominant in Parkinson's disease. However bradykinesia, dyskinesia and rigidity are less reliably treated with this technique. Although posteroventral pallidotomy(PVP) can alleviate dyskinesias appendicular bradykinesia and rigidity, tremor may not be completely ameliorated. Between January 1993 and May 1997, the authors performed posteroventral pallidotomy(PVP) on 69 patients with Parkinson's disease who had bradikinesia, rigidity, drug induced dyskinesia and tremor. Of these patients who had only PVPs 17(25%) patients had severe tremor, 20(29%) patients moderate tremor and 32(46 %) patients mild or no tremor after the surgery. We have combined ventrolateral thalamotomy(VLT ) and PVP in 37 patients with moderate to severe tremor. Of the 37 patients, who had both PVP and VLT, 27(73%) patients showed good improvement, and fair improve-ment in 10(27%). Except for 6 cases with transient dysarthria we did not encounter any other operative complications from the ipsilateral combined PVP and VLT. The combination of the two procedures appear to provide excellent relief for the majority of symptoms in patients suffering from advanced Parkinsons disease with rigidity bradykinesia, dyskinesia and tremor.

Glioblastoma Following Surgery of Cavernous Malformation: Case Report

The authors report a case of left parietal glioblastoma developed five years after surgical removal of the frontal cavernous malformation. A 36-year-old woman presented with history of seizure for 13 years and left frontal parasagittal mass on MRI. The mass was removed uneventfully, and the histopathologic examination revealed a cavernous malformation. Her seizure disappeared after the surgery. Five years later, the patient developed new symptoms of right leg weakness and paresthesia. Imaging studies followed by pathological study revealed left parietal, parasagittal glioblastoma, which was located posterior to the previous surgical field. Following surgery, she is now on regular follow up with radiation therapy and chemotherapy. The authors report this rare occurence of the glioblastoma following surgical removal of cavernous malformation with review of pertinent literatures.