RESUMEN
Endoscopic retrograde cholangiopancreatography (ERCP) is a useful tool for the diagnosis and management of diseases of the pancreas and biliary tract. However, ERCP has a high risk of procedure-related complications compared with other endoscopic procedures performed in the upper gastrointestinal tract. The most common complications are pancreatitis, cholangitis, hemorrhage, and perforation. Extraluminal hemorrhagic complications after ERCP are relatively rare but potentially life threatening and should be identified and treated immediately. We report a case of subcapsular hepatic hematoma after guidewire injury during ERCP in a 64-year-old woman with choledocholithiasis who had undergone ERCP with guidewire-assisted papillotomy for stone extraction. Although subcapsular hepatic hematoma is a very rare complication after ERCP, it should be considered in the differential diagnosis of patients complaining of abdominal pain after ERCP.
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Femenino , Humanos , Persona de Mediana Edad , Dolor Abdominal , Sistema Biliar , Colangiopancreatografia Retrógrada Endoscópica , Colangitis , Coledocolitiasis , Diagnóstico , Diagnóstico Diferencial , Hematoma , Hemorragia , Páncreas , Pancreatitis , Tracto Gastrointestinal SuperiorRESUMEN
BACKGROUND AND OBJECTIVES: Cartilage offers the advantage of higher mechanical stability compared with membranous transplants but it may alter the acoustic transfer characteristics, which could depend on its thickness. So, author attempted to design the thin sliced cartilage island for grafting material by tragal cartilage. The purpose of this study is to understand the usefulness of the thin sliced cartilage technique by comparing with conventional temporalis fascia technique with the method of tympanometry. SUBJECTS AND METHOD: From March 2002 to August 2005, 101 cases of tympanoplasty type I using the thin sliced cartilage island technique and 50 cases of tympanoplasty type I using the temporalis fascia performed by one surgeon had been followed up for 6 months and reviewed. Static compliance, tympanometric width and tympanometric pattern were followed up after 6 month. RESULTS: The static compliance in the thin sliced cartilage island technique group was 72% and temporalis fascia group was 66% at normal compliance (0.2-1.6 ml). The tympanometric width in the thin sliced cartilage island technique group was 59% and temporalis fascia group was 54% at normal tympanometric width (60-150 mmH2O). The tympanometric pattern in the thin sliced cartilage island technique group was 67% and temporalis fascia group was 62% at normal tympanometric pattern (A type). CONCLUSION: There is no significant statistical difference between the thin sliced cartilage island and temporalis fascia observed in the impedence audiometry. The thin sliced cartilage island technique is suggested to be good for tympanoplasty.
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Pruebas de Impedancia Acústica , Acústica , Audiometría , Cartílago , Adaptabilidad , Oído Medio , Fascia , Mecánica , Trasplantes , TimpanoplastiaRESUMEN
BACKGROUND AND OBJECTIVES: This prospective, randomized double-blind study was performed to evaluate the analgesic effect of lesser palatine nerve block after pediatric tonsillectomy, and we measured analgesic efficacy and degree of blocks induced by ropivacaine. SUBJECTS AND METHOD: Children who weighed 20-40 kg and scheduled for an elective tonsillectomy were randomized into three groups. Patients received lesser palatine nerve block, using divided doses of 0.05 ml/kg of 0.2% ropivacaine (Naropin registered), 5 min prior to the beginning of tonsillectomy (Pre-block group) or immediately after surgery (Post-block group). Patients allocated into the control group did not receive any nerve blocks. Postoperative pain was measured immediately after surgery and at 3, 6, 12 and 24 hours following the operation by using a 0 to 4 points pain scale, based on a facial expression of pain scale ruler. Side effects and the number of analgesic inductions were observed for 24 hours postoperatively. RESULTS: No significant differences in the pain scores were observed immediately after surgery and at 3, 6, 12 and 24 hours after operation in the three group (p>0.05). The number of analgesic injections were similar in the groups. CONCLUSION: The results of this study reveal that the lesser palatine nerve block was not effective for postoperative pain control following pediatric tonsillectomy, and that the pre-emptive block offered no pain control benefit over the postoperative block. Therefore, we do not recommend lesser palatine nerve blocks for the management of postoperative pain after pediatric tonsillectomy.
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Niño , Humanos , Método Doble Ciego , Expresión Facial , Bloqueo Nervioso , Dolor Postoperatorio , Estudios Prospectivos , TonsilectomíaRESUMEN
Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin-Goltz syndrome, shows autosomal dominant pattern of inheritance with variable expressivity. The most important features are the occurrence of basal cell carcinoma and odontogenic keratosis. Recently, we experienced a case of nevoid basal cell carcinoma syndrome with multiple odontogenic keratocysts, basal cell carcinoma on cheek, cerebral calcification and palmar pits. We report this case with literature review.
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Síndrome del Nevo Basocelular , Carcinoma Basocelular , Mejilla , Queratosis , Quistes Odontogénicos , TestamentosRESUMEN
To evaluate the nutritional status according to the degree of metabolic acidosis(MA) and determine that MA is a risk factor for malnutrition, we screened the laboratory data of 37 hemodialysis(HD) patients who were clinically stable for more than 6 months and taken bioelectrical impedence analysis(BIA) twice 6 months apart to check lean body mass (LBM). Mean age of patients was 49.1+/-15.0 years and sex ratio 1:2.4. Mean serum albumin level was 3.97+/-0.36g/dl and weekly Kt/V and normalized protein catabolic rate(nPCR) were 3.04+/-0.85 and 0.99+/-0.21g/kg/day. According to mean total CO2 content during the periods between BIA, the patients were divided to three groups[group 1(n=16):&18mEq/L, group 2(n=9):18 or =21mEq/L). Group 1 had significantly higher body weight gain than group 2 and 3(1.82+/-1.62 vs. 0.77+/-3.13 and 1.35+/-3.85kg, P<0.05), and higher LBM gain(1.99+/-4.38 vs. 3.35+/-7.99kg, P<0.05), nPCR(1.05+/-0.20 vs. 0.91+/-0.13g/kg/day, P<0.05), intact parathyroid hormone(88.4+/-78.7 vs. 32.0+/-26.5pg/ml, P< 0.05), and phosphate(5.4+/-1.3 vs. 3.9+/-1.3mg/dl, P< 0.05) than group 3. There were no differences in age, serum albumin, BUN, creatinine and weekly Kt/V among three groups. Mean total CO2 level was inversely correlated with body weight gain and LBM gain. In conclusion, metabolic acidosis in stable HD patients may be the result of high protein intake and not related to decrease of body weight by protein catabolism.
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Humanos , Acidosis , Peso Corporal , Creatinina , Desnutrición , Metabolismo , Estado Nutricional , Diálisis Renal , Factores de Riesgo , Albúmina Sérica , Razón de MasculinidadRESUMEN
Recently nerve entrapments or nerve root compressions are common clinical symdromes. However, a clear understanding of both pathophysiological and morphological changes is lacking and it may not be completely established in the experimental model for chronic nerve compression, compared with a surprising review of peripheral nerve exposed to various acute damage. Adult Sprague-Dawley rats weighing 250 to 300g were used as the experimental model to elucidate histopathological changes in chronic nerve compression, which were produced by banding the sciatic nerve(normally 1.2mm in diameter) with the length of 1cm silastic tubings with inner diameter, 0.6mm(Group I), 0.9mm(Group II) and 1.5mm(Group III) in each. Specimens were obtained for light and electron microscopic studies postoperatively at 1 and 3 months following by nerve conduction study. Grossly in group I, the sciatic nerve was compressed to approximately 50% of its normal in cuff area and in thin strand on distal part at 1 month and more progressed at 3 months. The sciatic nerve of group II demonstrated 75% of control and distal part in 50% compression at 1 month, but the nerve seemed not to be affected by tubing. Light microscopic findings revealed Wallerian degeneration and diminished large myelinated fiber particularly in the periphery of nerves with 34% of transverse nueral percentage in group I at postoperative 1 month. Above findings were progressed to epineurial scarring and fibrosis at 3 months. There were marked diminution and deformity in large myelinated fiber in group II, but it was not more severe than the ones of group I. Electron microscopic findings in this group revealed the appearance of small regenerating unit clusters and thinly myelinated fibers. In group III, histological findings were not much different from that of normal nerve. Nerve conduction study revealed the decrease in conduction velocity to mean 10 M/sex in group I at 1 month and no electrical conduction at 3 months. In group II, diminution of conduction velocity in 73% of normal range at 1 month was noted, and 82% at 3 months. These findings explain correspondingly the histopathological changes in part of chronic nerve entrapment syndromes and appeal the need of further investigation in this experimental model.
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Adulto , Humanos , Cicatriz , Anomalías Congénitas , Fibrosis , Modelos Teóricos , Vaina de Mielina , Síndromes de Compresión Nerviosa , Conducción Nerviosa , Nervios Periféricos , Radiculopatía , Ratas Sprague-Dawley , Valores de Referencia , Nervio Ciático , Degeneración WallerianaRESUMEN
We investigated the somatosensory evoked potentials(SEPs) changes and subsequent changes of the ventricular enlargement in different stages of kaolin-induced hydrocephalus. 8 week-old fifty five cats weighing 900g to 1300g, were studied in this experiment. These animals were divided into 2 groups ; a normal control(5 cats), kaolin-induced hydrocephalic groups(50 cats). The kaolin-induced hydrocephalic groups were subdivided into 5 subgroups of 10 cats each ; kaolin induced 1,2,4,6 and 8 weeks hydrocephalic groups after an intracisternal injection of the kaolin. At the each stage of the kaolin-induced hydrocephalic animals, the following parameters were obtained ; somatosensory evoked potentials(SEPs) and the size of enlargement of the ventricles at the each stage of 1,2,4,6 and 8 weeks after intracisternal kaolin injection. The results were as follows: 1) A significant elevation of the intracranial pressure(ICP) was observed in 2 weeks after kaolin injection and peak value(ICP : 10.2+/-0.9mmHg) in 4 weeks after kaolin injection. 2) The mean latencies of these wave components in somatosensory evoked potentials(SEPs) responses were 6.27+/-0.12 msec in Po, 8.41+/-0.25 msec in No, and 12.55+/-0.36 msec in P1 and the mean central conduction time(P1-P0) was 6.10+/-0.16 msec in the normal control animals. 3) Changes of amplitude and latency in SEPs were more prominent in 4 weeks after kaolin injection and progressively prolonged latencies of each wave components and CCT were resulted in 6 and 8 weeks after kaolin injection. 4) In hydrocephalic animals, the size of the ventricle(septum pellucidum (SP)-caudate nucleus(CN) distance) was moderately increased to 5.19+/-0.43mm in 1 week after kaolin injection and continued to increased in maximum size up in the 4th week after injection. However there was no further increase in ventricular size after 4th weeks. 5) A close correlation was found between SEPs and ventricular enlargement at the each stage of kaolin-induced hydrocephalic animals. In conclusion, it is assumed that the detection of SEPs in hydrocephalus is a quite valuable prognostic tool to evaluate the functional integrity of the nerve conduction system near the paraventricular area which might be involved in ventricular enlargement.
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Animales , Gatos , Potenciales Evocados Somatosensoriales , Hidrocefalia , Caolín , Conducción NerviosaRESUMEN
We performed callosotomy and amygdalo-hippocampectomy in medically intractable seizure patients. Symptom duration of these patients was over 2 years and seizure was not controlled with anticonvulsants in spite of high level in drug monitoring according to their seizure type. 7 patients with generalized epilepsy were treated by anterior callosotomy and 8 patients with temporal lobe epilepsy were treated by amygdalo-hippocampectomy. Anyone of these patients were not dead and discovered permanent complications. And so these methods, anterior callostomy and amygdalo-hippocampectomy seems to be relatively safety and effective methods in treatment of medically intractable seizure.
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Humanos , Anticonvulsivantes , Monitoreo de Drogas , Epilepsia Generalizada , Epilepsia del Lóbulo Temporal , ConvulsionesRESUMEN
The nimodipine, calcium-channel blocker, is known to specific to brain tissue and effect on the ischemic stroke. To evaluate the efficacy and tolerability of nimodipine, we studied the 37 patients with Organic Brain Syndrome(OBS) who admitted to St. Mary's Hospital from January to August, 1989. We followed up for 12 weeks of their 18 items of neurologic outcome. The results and conclusion were as follows: 1) The pretreatment SCAG(Sandoz Clinical Assessment-Geriatric Scale) was used as a base-line measurement and the efficacy of the therapy was evaluated entirely in terms of changes in SCAG after 3, 6, 9 and 12 weeks of treatment. The total score was changed with meaningful improvement(p<0.01). 2) Among the 18 items of symptoms, the confusion, the level of alertness, the memory and the orientation were the area that have showed the most improvement. 3) No effect on heart, blood chemistry or other side effect was noted during medication. 4) We also found that those improvement has no specific relation to age, sex and causes of OBS. These result indicate that nimodipine has a possible therapeutic benefit in patients with OBS, especially who have the symptoms of confusion and impaired recent memory. These result should encouraged us to do further study such as double blind placebo in order to clarify the genuine pharmacological efficacy.
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Humanos , Encéfalo , Química , Corazón , Memoria , Nimodipina , Accidente CerebrovascularRESUMEN
Motor evoked potential(MEP) and sensory evoked potential(SEP) were recorded in 30 experimental cats in accordance with change of intracranial pressure. MEP was obtained on the thoracic cord after electric stimulation through a ball electrode directly installed on the cerebral motor cortex. SEP was elicited on the cerebral cortex after stimulation of thoracic cord. Experimental animals were composed of control group(10 cats) and raised intracranial pressure (ICP) group(20 cats) which included a group of 10 cats with 30 mmHg increased ICP and another group of 10 cats with 50 mmHg elevated ICP. Each evoked potential according to changes in ICP was obtained and the results were as follows: 1) MEP in control group showed that latency was 14.8+/-0.8 msec and amplitude was 24.4+/-2.1 microV. MEP after elevation of ICP showed more profound change in 50 mmHg increased ICP group than in 30 mmHg increased ICP group. Latency was prolonged by 152%(37.4+/-1.8 msec) of control group and amplitude was reduced to 82%(4.58+/-1.2 microV) of control group in the 50 mmHg increased ICP group. Recovery of MEP changes from increased ICP by reduction of the pressure was more prominent in 30 mmHg elevated group than 50 mmHg elevated group. 2) In control group SEP showed that latency was 25.38+/-1.5 msec and amplitude was 22.8+/-1.4 microV. SEP after elevation of ICP showed more profound change in 50 mmHg increased ICP group than 30 mmHg increased ICP group. Latency of SEP in 50 mmHg increased ICP group was prolonged by 54%(39.18+/-2.2 msec) of control group and amplitude reduced by 47%(10.98+/-0.9 microV) of control group was more prominent in 30 mmHg elevated group than 50 mmHg elevated group. changes in MEP after raised ICP were more remarkable than that of SEP. The degree of Recovery from raised ICP was more prominent in 30 mmHg group than 50 mmHg group. This study indicates that because change of MEP is more sensitive than that of SEP in the evaluation of cerebral function in case of increased ICP, MEP might be a paramount indicator in the evaluation of cerebral injury. Recording of MEP as well as ICP monitoring system might be a new method for the early detection of changes in cerebral function.
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Animales , Gatos , Corteza Cerebral , Estimulación Eléctrica , Electrodos , Potenciales Evocados , Presión Intracraneal , Corteza MotoraRESUMEN
Pseudoaneurysm of extracranial high internal carotid artery was rare lesion. Left hemiparesis was suddenly developed after 6 hours following penetrating injury at right mastoid area by air gun. On brain computerized tomography relatively well defined low density was noted at right temporo-parietal area. On right caratid angiography round aneurysmal dilatation, 2.5x3 cm sized was present at the site of metallic shadow in the atlas. The pseudoaneurysm was treated by the method of direct surgical approach, removal of aneurysm and end to end anastomosis with autogenous saphenous vein interposition bypass graft without difficulty. Postoperative course was not uneven.
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Aneurisma , Aneurisma Falso , Angiografía , Encéfalo , Arteria Carótida Interna , Dilatación , Apófisis Mastoides , Paresia , Vena Safena , TrasplantesRESUMEN
In order to study effect of corpus callosotomy for epileptic lesions located at sensory-motor cortex/cortices, changes in amplitude, frequency of background activity and frequency of abnormal discharges of postcallosotomy electroenencephalography(EEG) recordings were observed in the crystal penicillin induced epileptic models of rats. In control group of 10 rats, simple right(craniotomy was) done and needle electrodes were bilaterally inserted into parietal and occipital scalp, connected to EEG recording system. Experimentally induced epileptic group was obtained by instillation of 1-2 drops of crystal penicillin solution(800,000 IU/ml) at right parietal area(20 rats). Postcallosotomy group was consisted of the animals streotactically performed callosotomy with blunt ended stainless steel, sized 3 mm, width and 0.5 mm, thickness(20 rats). Preoprative and postoperative EEG recordings were obtained in each animals over 20 minates. The results were as follows; 1) Bialteral synchronous epileptic discharges were shown in experimetally induced epileptic group, which compared to control group. 2) Section of the corpus callosum caused the abolition of bilateral synchronous epileptic discharges, when compared to experimentally induced epileptic group. 3) Frequency of abnormal discharges in the contralteral hemisphere was more decreased than crystal penicillin-instillated lesion in postcallosotomy group. 4) The Background activity of postcallosotomy group was slower than control group. From the results of EEG analysis, corpus callosum might paly a important role in formation of bilateral synchronous discharges and callosotomy was seemed to be an effective method to control crystal penicillin induced epileptic rats, which had epileptic focus in sensory-motor cortex.
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Animales , Ratas , Cuerpo Calloso , Electrodos , Electroencefalografía , Agujas , Penicilinas , Rabeprazol , Cuero Cabelludo , Convulsiones , Acero InoxidableRESUMEN
From March 1966 to July 1988, 22 patients were diagnosed as discitis among the 2106 operation with total or hemilaminectomy in Department of Neurosurgery of Catholic University Medical College. Main symptoms were severe low back(95%) and buttock pain(86%). Physical examination showed severe paravertebral spasm and tenderness. The erythrocyte sedimentation rate was always elevated in all cases and averaged to 43 mm/hr. X-ray examination of the lumbar spine showed typical findings of decreased intervertebral space, subchondral sclerosis and bony fusion. In bacterial culture staphylococcus aureus and streptococcus epididymis were grown. Good long-term results were seen in all cases.
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Humanos , Masculino , Sedimentación Sanguínea , Nalgas , Discitis , Epidídimo , Neurocirugia , Examen Físico , Esclerosis , Espasmo , Columna Vertebral , Staphylococcus aureus , StreptococcusRESUMEN
Total body irradiation has been applied to treat acute leukemia and chronic granulocytic leukemia. 20 patients with acute leukemia or chronic granulocytic leukemia were treated with total body irradiation using 6 MV linear accelerator before bone marrow transplantation at the Division of Therapeutic Radiology, department of Radiology, St. Mary's Hospital, catholic University Medical College from August 1987 to September 1988. Among 20 patients, 8 patients received 6 fractions of 200 cgy (total 1200 cgy), 10 patients received a single 850 cgy radiation, 1 patient received 4 fractions totaling 850 cgy (200, 200, 200, 250), and 1 patient received 1100 cgy in 2 fractions (850, 250). 17 patients received allogenic grafts, 2 patients received autologous grafts, and only one patients received one locus mismatched graft. 13 patients are still alive and 7 patients died. The complications induced by total body irradiation were nausea and vomiting, diarrhea, skin eruption, mucositis, and pneumonitis.
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Humanos , Trasplante de Médula Ósea , Diarrea , Leucemia , Leucemia Mielógena Crónica BCR-ABL Positiva , Mucositis , Náusea , Aceleradores de Partículas , Neumonía , Oncología por Radiación , Piel , Trasplantes , Vómitos , Irradiación Corporal TotalRESUMEN
We have experienced 56 cases of posterior fossa tumors which were diagnosed with clinical symptoms, angiography, brain computerized tomography scan and/or operative and pathologic findings at the department of neurosurgery of Catholic University Medical College from January 1983 to December 1987. The results were summarized as follows: 1) Cerebellar astrocytomas were the most common posterior fossa tumors(21%). 2) The male to female ratio of posterior fossa tumors was equal. The astrocytoma and hemangioblastoma were frequent in male, but brain stem glioma, acoustic neuroma and meningioma were more frequent in female. 3) The posterior fossa tumors were more frequent in younger persons. 4) The most common duration symptoms were within 3 months(39%) and the common clinical features were headache(73%), nausea and vomiting(48%). In neurological examination, cerebellar signs were present in most cases(63%). 5) In brain computerized tomography scan, low density(46%) and contrast enhancement(63%) were common features and in vertebral angiography, mass effect(93%) in posterior fossa tumors. 6) The most postrior fossa tumors showed relatively good prognosis(61%) but mortality rate was high(30%).
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Femenino , Humanos , Masculino , Angiografía , Astrocitoma , Encéfalo , Tronco Encefálico , Glioma , Hemangioblastoma , Neoplasias Infratentoriales , Meningioma , Mortalidad , Náusea , Examen Neurológico , Neuroma Acústico , NeurocirugiaRESUMEN
We have experienced 56 cases of posterior fossa tumors which were diagnosed with clinical symptoms, angiography, brain computerized tomography scan and/or operative and pathologic findings at the department of neurosurgery of Catholic University Medical College from January 1983 to December 1987. The results were summarized as follows: 1) Cerebellar astrocytomas were the most common posterior fossa tumors(21%). 2) The male to female ratio of posterior fossa tumors was equal. The astrocytoma and hemangioblastoma were frequent in male, but brain stem glioma, acoustic neuroma and meningioma were more frequent in female. 3) The posterior fossa tumors were more frequent in younger persons. 4) The most common duration symptoms were within 3 months(39%) and the common clinical features were headache(73%), nausea and vomiting(48%). In neurological examination, cerebellar signs were present in most cases(63%). 5) In brain computerized tomography scan, low density(46%) and contrast enhancement(63%) were common features and in vertebral angiography, mass effect(93%) in posterior fossa tumors. 6) The most postrior fossa tumors showed relatively good prognosis(61%) but mortality rate was high(30%).
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Femenino , Humanos , Masculino , Angiografía , Astrocitoma , Encéfalo , Tronco Encefálico , Glioma , Hemangioblastoma , Neoplasias Infratentoriales , Meningioma , Mortalidad , Náusea , Examen Neurológico , Neuroma Acústico , NeurocirugiaRESUMEN
Electrical monitoring of the nervous system offers the potential for the detection of injury, intraoperatively. The relationship of MEP(Motor Evoked Potential) and SEO(Sensory Evoked Potential) taken in 30 rats before and after spinal cord injury is reported. MEP was obtained from distal portion to the site of spinal cord injury by electrical stimulation of the cerebral motor cortex after insertion of a ball electrode in the cerebral motor cortex. SEP was collected at the cerebral somatosensory cortex during the sciatic nerve stimulation. Experimental animals were divided into a 20 gcm spinal cord-trauma group and a 50 gcm spinal cord-trauma group. Changes of cardiopulmonary function after cerebral motor cortex stimulation and pre-and post-injury MEP and SEP were obtained at constant time interval. The results were follows : 1) Significant changes in blood pressure, pulse rate, and respiratory rate were noted to be elevated after stimulation of cerebral motor cortex and these were returned to normal in 10 minutes after stimulation. 2) MEP in control group showed that the latency was 8.6+/-1.54 msec and the amplitude was 20.60+/-3.2 microV. In MEP of 20 gcm spinal cord trauma group, the latency was increased to 30% (11.26+/-2.76 msec) compared to control group at 10 minutes after the injury and the amplitude was decreased to 29% (14.60+/-1.99 microV). The latency was slowly decreased with the passage of time, to 21% increase. (10.42+/-1.84 msec) at 1 hour after injury but the amplitude was not changes. In 50 gcm spinal cord-trauma group the latency was decreased to 75% (4.9+/-1.52 microV) compared to control group. With the passage of time. no change was revealed in latency but amplitude was decreased. The amplitude was decreased to 80% (4.00+/-1.49 microV) compared to control group. Change of MEP was marked in 50 gcm spinal cord-trauma group. With the passage of time MEP was slightly improved in 20 gcm spinal cord-trauma group but deteriorated in 50 gcm spinal cord-trauma group. 3) The latency of SEP in control group was 12.22+/-0.7 msec and the amplitude of those was 20.00+/-2.21 microV. No significant statistical change was recorded in the SEP of each spinal cord-trauma group compared to control group. MEP might be more important indicator than SEP in estimation and evaluation of the functional change of spinal cord injury.
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Animales , Ratas , Presión Sanguínea , Estimulación Eléctrica , Electrodos , Potenciales Evocados , Frecuencia Cardíaca , Corteza Motora , Sistema Nervioso , Frecuencia Respiratoria , Nervio Ciático , Corteza Somatosensorial , Traumatismos de la Médula Espinal , Médula EspinalRESUMEN
Electrical monitoring of the nervous system offers the potential for the detection of injury and diagnosis of disease. Existing evoked potentials monitor one or another sensory modality, but no generally usable motor monitor exists. Recovery rates of motor function in rats with spinal cord injury were comparetively observed by MEP (Motor Evoked Potential) recorded in 20 spinal cord injured rats and 10 control from distal portion of the injury during stimulation of the cerebral motor cortex. Experimental animals were divided into 10 control and 20 spinal cord injury group which were 10 rats received 20 gcm using weight drop method injury and 10 rats received 50 gcm injury to the spinal cord injury. The relationship of changes in MEQ measured pre-and post-injury respectively and a recovery rats of motor function was analysed and obtained the following results. 1) In postinjury MEP by 20gcm spinal cord-injury rats, 28% latency increase (11.4+/-1.33 msec, control : 8.25+/-1.01 msec) and 14% amplitude decrease (17.77+/-7.7 microV, control 20.70+/-2.71 microV) were noted in the recording at 1 week after the injury. However, with the passage of time MEP showed improvement in latency and amplitude. In 50 gcm spinal cord-injury group, 76% latency increase (14.49+/-1.48 msec) and 65% amplitude decrease (6.70+/-2.21 microV) were observed and the latency and amplitude were not improved with the passage of time. 2) A recovery rate of motor function in the injury group was noted to be slowly increased after injury to the spinal cord in 20 gcm spinal cord-injury group, however there was no recovery of motor function in the 50 gcm spinal cord-injury group. 3) Histological examination demonstrated that ecchymotic hemorrhage was found in less than 25% of the cord in 20 gcm spinal cord-injury group, however, approximately 50% of the cord was noted to have ecchymosis and distruption of the neural tissue in 50 gcm spinal cord-injury group. MEP is probably sensitive in the detection of motor dysfunction after spinal cord injury, and clinically whenever MEP showed an improvement, recovery of motor function was followed. MEP might be clinically an important indicator for the prediction of motor function recovery in the patients with spinal cord injury.
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Animales , Humanos , Ratas , Diagnóstico , Equimosis , Potenciales Evocados , Potenciales Evocados Motores , Hemorragia , Corteza Motora , Sistema Nervioso , Recuperación de la Función , Traumatismos de la Médula Espinal , Médula EspinalRESUMEN
The Peutz-Jeghers syndrome is a familial disesse charaeterized by mucocutaneaus pigmentation, gastrointestinal polyposis, and transmission of autosomal dominant trait. This syndrome is clinically important becuase of the coreplieation caused by the polyp, leading to abdominal pain, gastrointestinal bleeding, and intussusception. Authors experienced a case of Peutz-Jeghers syndrome admitted to Walace Memorial Baptist Hospital who was complained of recurrent abdominal pain, melanin pigmentation of lips, oral mucosa, and digits. UGI series, small bowel series, colon cnema, gastrofiberscopy, and colonoseopy revealed multiyle intestinal polyps. Pathologic findings on endoseopic polypectomy showed hamartomatous polyp.