, Gyu Bock Choi, Duk Hee Kang, Kyun Il Yoon Acute bilateral renal cortical necrosis is a rare cause of acute reanl failure, occuring in about 2% of patients and it's prognosis is fatal. The pathophysiology of this condition is complex, but ultimately leads to the destruction of the renal cortex with sparing of the renal medulla and a thin tissue rim of under the capsule.
In this report we describe a 23-year-old female patient in whom the diagnosis was made using MR imaging during the acute initial phase of the disease. On T1-weighted images, the signal intensity of the renal cortex was increased, but the signal intensity of the renal cortex was demarcated by a rim of low signal intensity in the region of the corticomedullary junction. MR imaging is useful, noninvasive, and specific modality for an early diagnosis of acute bilateral renal cortical necrosis.
Spinal stenosis is one of the degenerative diseases of spine, and frequently involves several segments. However, symptom may be provided by pathology in only one or two segments. Therefore, it is very important to select symptomatic segments when we treat patients with multilevel stenosis surgically. Decompression may be done limitedly to prevent high morbidity and complications associated with extensive decompression and posterolateral fusion. The purpose of this study is to evaluate the effectiveness of limited decompression of selective segments in spinal stenosis. From September, 1993 to August, 1996, 21 patients who underwent limited decompression of only symptomatic segments, were followed up for more than 1 ysar, and the results were assessed according to the criteria of Kim & Kim. The indications of surgery were definite neurologic symptoms, failure of conservative treatments, and no instability. The segments for operation were chosen by symptom, physical examination and radiographic study, and sometimes root block or electromyography were done in case of necessity. The results were followed as: 4 excellent(19%), 13 good(62%), 3 fair(14%), and 1 poor(5%). 1 superficial wound infection developed and was treated without suquelae. Conclusively, limited decompression of selective segments in multilevel spinal stenosis is considered to be useful if selection of level and extent of decomperssion are carefully determined.
, Kyu-Man Shin, Jun-Hyeok Song The assessment of the cerebral vasoreactivity provides information regarding to the reserve capacity of the cerebral circulation in patients with cerebrovascular disease, which has important therapeutic consequencies because it allows for the diagnosis of impending ischemia and for the control of the effect of initiated correcitive measures.
The author performed transcranial doppler study to measure the CO2 reactivity to the entire basal cerebral arteries in 30 cases of control group and 10 cases of disease group between 3rd and 7th day after insult. The control persons involved 10 cases of 3rd decade, 10 cases of 5th, 10 cases of 7th, and the diasease persons involved 10 cases of spotanenous subarachnoid hemorrhages. All disease patients were examined by single photon emission computed tomography and their results were compared to Doppler CO2 reactivities.
In control group, the mean blood flow velocity and pulsatility index increased with age, but the CO2 reactivity decreased. In patient group, MBFV, PI index, MI ratio were not correlated to the presence of disease, but only CO2 index was decreased than the same age group of normal control. The regions showing abnormal ROI by SPECT well corresponded with the regions showing decreased CO2 reactivity. There was no close correlation between ROI(Region of Interest) index and CO2 index, but the CO2 reactivity was remarkably decreased in the region which showed abnormal regional cerebral blood flow in SPECT findings(p=0.04). In the relationship between the various prognostic factors, ROI increased as the clinical status worse(r=-0.05, p=0.0008), the acute prognosis(3Mo) had positive correlation with CO2 omdex(r=0.32, p=0.04) or clinical status, and negative correlation with ROI index(r=0.40, p=0.0094).
Transcranial doppler CO2 testing in patients with spotanenous subarachnoid hemorrhage provides useful information regarding hemodynamic state, prognosis and determination of beneficial effects specific therapy. In the various TCD parameters, CO2 index was correlated well with the acute prognosis.
, Jin Han Cha For coverage of sacral pressure sore, the gluteus maximus musculocutaneous flap had been used commonly. We covered these sacral defect with the gluteus maximus fasciocutaneous flap. Forty three parients with relatively large(average 8×8cm) sacral grade IVpressure sores underwent bilateral gluteus maximus fasciocutaneous flap and donor site was closed as a V-Y advancement. The mean postoperative follow up was 32 months, with a range of 4 to 53months. Using this technique, we achieved uniformly good results and minimal complication. There is no recurrance in our cases. We believe that the V-Y advancement technique using the fasciocutaneous unit has some major advantages for repair of large sacral defects. It is a safe, simple, and less invasive method. The purpose of this presentation is to demonstrate our encouraging experience with this surgical modality.
To develop a proper electrophysiologic techniques for examining the rat femoral nerve.
10 Sprague Dawley rats were use to perform the electrophysiologic study of the exposed femoral nerves by surgical incision. Needle electrodes were used to stimulate the nerves and to obtain the compound nerve action potentials of those nerves.
The normal conduction velocity of femoral nerve in this method is 35.4±5.6m/sec and the mean amplitudes of compound nerve action potentials were 40.6±32.8µV. The data of conduction velocity was quite reliable with narrow ranges of standard deviations. But the compound nerve potentials amplitudes data showed wide ranges of variations among individual rats.
The techniques and resultion data of femoral verve conduction of rats are described in this article. Even though this technique needs surgical incision exposing the noninvasiveness and rapid healing of the surgical wound in the rats.
This verve conduction study method of examining femoral nerve in rats is relatively easy, accurate and repeatable techniques that permits visual and microscopic observation of the exposed nerves during the nerve conduction study.
, Jee-Hyang Chung, Eun-Kyoung Cho, Jee-Young Oh, Seung-Hee Chae, Kee-Duck Park, Kyoung-Gyu Choi , Young Chul Kim This study was performed to examine personailty characteristics in patients with panic disorder and to assess the links between personailty characteristics and duration, frequency, and severity of panic symptoms.
Thirty-six patients meeting DSM-IV criteria for panic disorder(patient group) and thirty-six normal controls were assessed by the PDQ-R and EPQ.
1) Panic parients were more likley to show avoidant(p<0.05), obsessive-compulsive(p<0.01), histrionic(p<0.01), borderline(p<0.001) and paranoid(p<0.05) personality scales than controls. The scores of total PDQ-R(p<0.01), cluster B(p<0.001) and cluster C(p<0.01) personality disorder and traits in panic patients were significantly higher than controls.
2) Panic patients showed significantly higher scores than controls on the EPQ factors of N(p<0.01) and significantly lower scores than controls on the EPQ factors of E(p<0.05).
3) The frequency of panic attack and severity of panic symptoms in panic patients were sinificantly correlated with cluster A personality disorder(p<0.05) and schizotypal personaity disorder(p<0.01), respectively.
The above results revealed that panic patients were more avoidant, obsessive-compulsive, histrionic, borderline, and paranoid than controls. The author also noted that panic patients were more introverted and neurotic than controls. Some clinical features of panic support the previous findings that where was a possible kink between panic disorder and personality disorder.
Endometrial hyperplasia(EH) and endometrial carcinoma(EC) very in their biologic potential, which may be correlated with the histologic grade. Evaluation of cellular kinetics, which may prove to be another measure of predicting biologic behavior. Accessments of AgNORs and PCNA(proliferative cell nuclear antigen) indeces in 33 cases of EH including 16 cases of simple hyperplasia(SH), 8 of complex hyperplasia(CH), and 9 of atypical hyperplasia(AH), and 28 of EC including 7 of grade I, 12 of grade II, and 6 of grade III were performed. The results were as follows :I, 12 of grade II, and 6 of grade III were performed. The results were as follows : 1. AgNOR counts per glandular cells(Mean SD) were 2.7±0.2 in normal proliferative and 2.3±0.2 in secretory endometrium, and increased to 3.2±0.3 in SH, 3.5±0.3 in CH, to 5.4±0.4 in AH, and finally 6.9±0.5 in endometrioid carcinoma(grade I: 5.8±0.7, grade II: 6.7±0.6, grade III: 8.4±0.9). 2. PCNA indeces(percentages of nuclear positive cells of total cells of glands) were 16±14.2 in normal proliferative endometrium and 12±8.1 in secretory endometrium, and increased to 18.4±14.7 in SH, 21.6±17.8 in CH, 36.4±27.4 in AH, and finally 42.1±31.3 in EC(grade I: 38.3±23.2,grade II: 39.4±25.4, and grade III: 58.4±35.3). 3. DNA aneuploidy was detected in 4 cases of EC(40%), and tended to be more frequently found in poorer histologic grade. This data suggest that cell kinetic evaluation of EH and EC using AgNORs and PCNA is well correlated with histologic grade. And with the aspect of biologic potential, AH could be regarded as well differentiated EC.
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