An 8-month-old 3.15 kg female Cocker-spaniel with history of ataxia referred to the Veterianary Medical Teaching Hospital, Chungnam National University. There were no abnormalities in CBC and serum chemical analysis. Agenesis of dens was found on dorsoventral view in cervical radiography. Compressed cervical spinal cord and enlarged cerebral ventricle were observed in magnetic resonance imaging. It was diagnosed as atlantoaxial instability with hydrocephalus. For conservative therapy, neck brace was applied and diuretics and prednisolone were administered. The dog's ataxia became better gradually.
Ankylosing spondylitis (AS) is a chronic inflammatory disease presenting progressive spinal stiffness and sacroiliitis. Cervical spine fracture combined with AS should be treated with operation, but it is closely related with increased rates of surgical site infection, which are associated with an elevated erythrocyte sedimentation rate and elevated C-reactive protein. We report a case of delayed postoperative infection appeared in cervical paravertebral space, which was masked by laboratory findings and clinical characteristics represented in this rheumatic disease. A 53-year-old man who had medical history of AS got operation after cervical spine fracture. During hospitalization, he experienced aching pain originating from left posterior neck to shoulder, which was revealed out to be delayed postoperative infection, diagnostically obscured by elevated values of inflammatory markers. This case emphasizes detailed evaluation considering symptoms and comorbidity of the patient should be performed to apply proper management.
In November 2012, a 4-month-old foal with anorexia, neurologic signs with ataxia and death was submitted for necropsy to the diagnostic laboratory of Jeju Self-Governing Provincial Veterinary Research Institute. Grossly, yellowish-white fibrinous materials were seen on the ventral cerebrum, cerebellum, medulla oblongata and cervical spinal cord of the foal. Histologically, severe fibrino-purulent meningitis characterized by the infiltration of neutrophils and fibrionous exudates with bacterial colonies were presented in cerebrum, cerebellum, brain stem and cervical spinal cord. In the bacterial isolation using meningeal exudate, the small white colonies on blood agar plate with ${\beta}$-hemolysis were observed. Isolated bacteria were Gram-positive cocci and confirmed as Streptococcus (S.) equi subsp. zooepidemicus by VITEK 2 system. Based on the histopathological features and the bacterial test, this case was diagnosed as meningitis associated with S. equi subsp. zooepidemicus infection in a foal. In our best knowledge, this is the first report for fibrino-purulent meningitis caused by S. equi subsp. zooepidemicus infection in Jeju.
Yang, Jae Hyun;Jang, Young Joo;Ahn, Se Jin;Kim, Hye-Ryoun;Kim, Cheol Hyeon;Koh, Jae Soo;Choe, Du Hwan;Lee, Jae Cheol
Tuberculosis and Respiratory Diseases
/
v.67
no.6
/
pp.574-576
/
2009
An intramedullary spinal cord metastasis (ISCM) rarely develops in systemic cancer but is indicative of a poor prognosis. A 56-year-old man was admitted due to weakness of the lower extremities. He had received radiotherapy 3 months prior for a brain metastasis that had developed 1 year after achieving a complete response from chemotherapy for extended stage small cell lung cancer. Although the brain lesion had improved partially, ISCM from the cervical to lumbar-sacral spinal cords, which was accompanied by a leptomeningeal dissemination, was diagnosed based on magnetic resonance imaging of the spine and cerebrospinal fluid cytology. Finally, he died of sudden cardiac arrest during treatment. This is the first case of ISCM involving the whole spinal segments. Physicians should be aware of the subsequent development of ISCM in lung cancer patients with a previously known brain metastasis who present with new neurological symptoms.
Caglar, Yusuf Sukru;Ozgural, Onur;Zaimoglu, Murat;Kilinc, Cemil;Eroglu, Umit;Dogan, Ihsan;Kahilogullari, Gokmen
Journal of Korean Neurosurgical Society
/
v.62
no.2
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pp.209-216
/
2019
Objective : Hydatid cyst disease is caused by the parasite Echinococcus granulosus. It is rarely seen in the vertebral system, occurring at a rate of 0.2-1%. The aim of this study is to present 12 spinal hydatid cyst cases, and propose a new type of drainage of the cyst. Methods : Twelve cases of spinal hydatid cysts, surgical operations, multiple operations, chronic recurrences, and spinal hydatic cyst excision methods are discussed in the context of the literature. Patients are operated between 2005 and 2016. All the patients are kept under routine follow up. Patient demographic data and clinicopathologic characteristics are examined. Results : Six male and six female patients with a median age of 38.6 at the time of surgery were included in the study. Spinal cyst hydatid infection sites were one odontoid, one cervical, five thoracic, two lumbar, and three sacral. In all cases, surgery was performed, with the aim of total excision of the cyst, decompression of the spinal cord, and if necessary, stabilization of the spinal column. Mean follow up was 61.3 months (10-156). All the patients were prescribed Albendazole. Three patients had secondary hydatid cyst infection (one lung and two hepatic). Conclusion : The two-way drainage catheter placed inside a cyst provides post-operative chlorhexidine washing inside the cavity. Although a spinal hydatid cyst is a benign pathology and seen rarely, it is extremely difficult to achieve a real cure for patients with this disease. Treatment modalities should be aggressive and include total excision of cyst without rupture, decompression of spinal cord, flushing of the area with scolicidal drugs, and ensuring spinal stabilization. After the operation the patients should be kept under routine follow up. Radiological and clinical examinations are useful in spotting a recurrence.
Ko, Seok-Beom;Park, Hae Yean;Kim, Jong-Bae;Kim, Jung-Ran
Therapeutic Science for Rehabilitation
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v.7
no.1
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pp.63-77
/
2018
Objective : The purpose of this study was to investigate the effects of task-oriented training with functional electrical stimulation on hand function in incomplete cervical cord injury. Method : The subjects of the study were 3 adults diagnosed as incomplete cervical cord injury. The design of this study was ABA single-subject research design to compare dominant hand function of before and after intervention and detect individual effects. The experiment consisted of 30sessions, in which baseline process A1 and A2 were implemented 5 sessions each for 10sessions. Intervention B was implemented 20 sessions. The dependent variable was converted to the change of hand function every session, and Canadian Occupational Performance Measure (COPM), Jebsen-Taylor Hand Function Test(JTHFT), Wolf Motor Function Test(WMFT) were selected for outcome measurements. Result analysis was suggested through visual analysis using a graph and comparison of pre, post and follow-up intervention measurements. Results : As a result, the quality and quantity of dominant hand function increased during intervention B compared to the baseline A1 for all subjects. Baseline A2 was also maintained without training. Additionally, JTHFT, WMFT and COPM scores demonstrated improvement and maintain. The follow up JTHFT and WMFT showed increased required time on all subjects and decrease or maintain task performance and satisfaction in COPM. Conclusion : The task-oriented training with function electrical stimulation in this study has been positive effects on hand function and task performance and satisfaction.
Lee, Mi Geum;Lee, Hyo Min;Jo, Ji Yon;Choi, Yun Suk;Ku, Ui Kyoung;Lee, Chul Joong;Lee, Sang Chul;Kim, Yong Chul
The Korean Journal of Pain
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v.19
no.2
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pp.146-151
/
2006
Background: Spinal cord stimulation is a well-established method for the management of several types of chronic and intractable pain. This form of stimulation elicits a tingling sensation (paresthesia) in the corresponding dermatomes. The goal of this study was to establish a correlation between the spinal levels of the implanted epidural electrodes and the paresthesia elicited due to stimulation of the neural structures. Methods: Thirty five patients, who received trial spinal cord stimulation, were evaluated. After the insertion of the lead to the selected position, the areas of paresthesia evoked by stimulation were evaluated. Results: Seventy-one percent of cases showed paresthesia in the shoulder area when the tip of the electrode was located between the C2-C4 levels. At the upper extremities, paresthesia was evoked in 86-93% of cases, regardless of the location of the electrode tip within the cervical spinal segments. The most common tip placement of the leads eliciting hand stimulation was at the C5 level. The most common level of electrode tip placement eliciting paresthesia of the anterior and posterior thigh and the foot were at the T7-T12, T10-L1 and T11-L1 vertebral segments, respectively. Conclusions: Detailed knowledge of the patterns of stimulation induced paresthesia in relation to the spine level of the implanted electrodes has allowed the more consistent and successful placement of epidural electrodes at the desired spine level.
Acute delayed neurotoxicity of KH-502 [O.O-Diethyl O-(1-phenyyl-3-trifluoromethyl-5-pyrazoyl) thiophosphoric acid ester], an insecticide synthesized newly in Korea, was studied in White Leghorn hens. The doses were determined on the basis of preliminary $LD_{50}$ study. High, middle and low doses were determined to be 1123 mg/kg, 762 mg/kg and 518 mg/kg, respectively. The animals were pretreated with atropine (30 mg/kg) prior to administration of KH-502. The chemical was administrated at the first and 21st day of the study. As positive controls, animals were admlnistrated with triorthocresylphosphate (TOCP 1000 mg/kg and 500 mg/kg). Animals administrated with TOCP or KH-502 were sacrificed by perfusion-fixation at 21st and 42nd day of the study, respectively. The central and peripheral nerve tissues were routinely treated for microscopic observation. As results, eight, three, one, and one chickens died within 2 day after adminiatration with signs of cholinergic acute toxicity in high, middle low and TOCP dose-group (500 mg/kg), respectively. No abnormal clinical signs were observed in the survived chickens administrated with KH-502 in the duration of the study. The chickens in positive control groups showed ataxia and incoordination at the 14th day after administration of TOCP. From necropsy, macroscopic changes were not observed in all groups including positive control groups. Histopathologically, oxonal swelling with myelin loss, focal gliosis, distention around axonal space were observed in the spinal cords of the chickens administrated with TOCP 1000 mg/kg. The lesions were distinct in the dorsal and lateral funiculi of cervical spinal cord, in the lateral and ventral funiculi of thoracic spinal cord and in ventral funiculi of lumbosacral spinal cord. Axonal swelling and mlcrogliosis were infrequently observed in the chickens of other groups including negative control one. However, they were nonspecifically distributed in the spinal cords. In this study, we concluded that the new chemical, KH-502 did not have acute delayed neurotoxicity in White Leghorn hens.
Of 34 evaluated patients with primary spinal cord tumors, 32 were irradiated at our institution between 1969 and 1983. The results are reported of 32 patients, 16 with ependymoma and 16 with astrocytoma, who were treated with post-operative external beam radiotherapy following biopsy or subtotal resection Twenty-nine patients received $45\~55Gy$ megavoltage beam irradiation in $5\~6$ weeks and the remaining three patients received less than 40Gy. Spinal cord was in the irradiated field for six patients who received more than 50Gy. The minimum follow-up was five years. Five and ten year acturaial survival rates for entire group of patients were $73\%(22/30)\;and\;50\%(8/16)$, including three patients who were salvaged by surgery after radiation failures. Corresponding five and ten year relapse free survival rates were $60\%(18/30)\;and\;32\%(6/19)$, respectively. Of the 29 patients who recived more than 45Gy, relapse free survival at five years was $63\%(17/27)$. Treatment failed in 13 patients and all of those failures were in the irradiated portal. Patients with ependymomas have significantly better relapse free survival than those with astrocytomas, $80\%\;vs.\;40\%$ (p<0.05). There was significant difference in survival between patients with tumors involving the cervical spine and those with tumors in the other loactions, $45\%$ vs. $89\%(p<0.05)$. There was no significant differnece in survival between patients with cauda equina tumors and those with tumors at spinal cord, $100\%\;vs.\;68\%(p>0.05)$. No radiotherapy related neurological deficit was noted with a maximum 20 year follow-up. This study confirms that external beam radiotherapy is a safe and effective treatment modality for primary spinal cord tumors.
Kim, Jong-Ho;Jeong, Han-Seong;Park, Jong-Seong;Kim, Jong-Keun;Park, Sah-Hoon
The Korean Journal of Physiology and Pharmacology
/
v.2
no.1
/
pp.9-19
/
1998
The present study was primarily carried out to characterize the properties of the spinomesencephalic tract (SMT) neurons that project from the upper cervical spinal segments to the midbrain. It was also investigated whether these neurons received convergent afferent inputs from other sources in addition to cervical inputs. Extracellular single unit recordings were made from neurons antidromically activated by stimulation of midbrain. Recording sites were located in lamina $I{\sim}VIII\;of\;C1{\sim}C3$ segments of spinal cord. Receptive field (RF) and response properties to mechanical stimulation were studied in 71 SMT neurons. Response profiles were classified into six groups: complex (Comp, n=9), wide dynamic range (WDR, n=16), low threshold (LT, n=5), high threshold (HT, n=6), deep/tap (Deep, n=10), and non- responsive (NR, n=25). Distributions of stimulation and recording sites were not significantly different between SMT groups classified upon their locations and/or response profiles. Mean conduction velocity of SMT neurons was $16.7{\pm}1.28\;m/sec$. Conduction velocities of SMTs recorded in superficial dorsal horn (SDH, n=15) were significantly slower than those of SMTs recorded in deep dorsal horn (DDH, n=18), lateral reticulated area (LRA, n=21), and intermediate zone and ventral horn (IZ/VH, n=15). Somatic RFs for SMTs in LRA and IZ/VH were significantly larger than those in SDH and DDH. Five SMT units (4 Comps and 1 HT) had inhibitory somatic RFs. About half (25/46) of SMT units have their RFs over trigeminal dermatome. Excitabilities of 5/12 cells and 9/13 cells were modulated by stimulation of ipsilateral phrenic nerve and vagus nerve, respectively. These results suggest that upper cervical SMT neurons are heterogenous in their function by showing a wide range of variety in location within the spinal gray matter, in response profile, and in convergent afferent input.
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