• Title/Summary/Keyword: Entry lesions

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Inferolateral Entry Point for C2 Pedicle Screw Fixation in High Cervical Lesions

  • Lee, Kwang-Ho;Kang, Dong-Ho;Lee, Chul-Hee;Hwang, Soo-Hyun;Park, In-Sung;Jung, Jin-Myung
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.341-347
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    • 2011
  • Objective : The purpose of this retrospective study was to evaluate the efficacy and safety of atlantoaxial stabilization using a new entry point for C2 pedicle screw fixation. Methods : Data were collected from 44 patients undergoing posterior C1 lateral mass screw and C2 screw fixation. The 20 cases were approached by the Harms entry point, 21 by the inferolateral point, and three by pars screw. The new inferolateral entry point of the C2 pedicle was located about 3-5 mm medial to the lateral border of the C2 lateral mass and 5-7 mm superior to the inferior border of the C2-3 facet joint. The screw was inserted at an angle $30^{\circ}$ to $45^{\circ}$ toward the midline in the transverse plane and $40^{\circ}$ to $50^{\circ}$ cephalad in the sagittal plane. Patients received followed-up with clinical examinations, radiographs and/or CT scans. Results : There were 28 males and 16 females. No neurological deterioration or vertebral artery injuries were observed. Five cases showed malpositioned screws (2.84%), with four of the screws showing cortical breaches of the transverse foramen. There were no clinical consequences for these five patients. One screw in the C1 lateral mass had a medial cortical breach. None of the screws were malpositioned in patients treated using the new entry point. There was a significant relationship between two group (p=0.036). Conclusion : Posterior C1-2 screw fixation can be performed safely using the new inferolateral entry point for C2 pedicle screw fixation for the treatment of high cervical lesions.

Clinical and Pathological Aspects of Filarial Lymphedema and Its Management

  • Shenoy, R.K.
    • Parasites, Hosts and Diseases
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    • v.46 no.3
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    • pp.119-125
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    • 2008
  • Lymphatic filariasis, transmitted by mosquitoes is the commonest cause of lymphedema in endemic countries. Among 120 million infected people in 83 countries, up to 16 million have lymphedema. Microfilariae ingested by mosquitoes grow into infective larvae. These larvae entering humans after infected mosquito bites grow in the lymphatics to adult worms that cause damage to lymphatics resulting in dilatation of lymph vessels. This earliest pathology is demonstrated in adults as well as in children, by ultrasonography, lymphoscintigraphy and histopathology studies. Once established, this damage was thought to be irreversible. This lymphatic damage predisposes to bacterial infection that causes recurrent acute attacks of dermato-lymphangio-adenitis in the affected limbs. Bacteria, mainly streptococci gain entry into the lymphatics through 'entry lesions' in skin, like interdigital fungal infections, injuries, eczema or similar causes that disrupt integrity of skin. Attacks of dermato-lymphangio-adenitis aggravates lymphatic damage causing lymphedema, which gets worse with repeated acute attacks. Elephantiasis is a late manifestation of lymphatic filariasis, which apart from limbs may involve genitalia or breasts. Lymphedema management includes use of antifilarial drugs in early stages, treatment and prevention of acute attacks through 'limb-hygiene', antibiotics and antifungals where indicated, and physical measures to reduce the swelling. In selected cases surgery is helpful.

Morphometric Relationship between the Cervicothoracic Cord Segments and Vertebral Bodies

  • Kim, Ji Hoon;Lee, Chul Woo;Chun, Kwon Soo;Shin, Won Han;Bae, Hack-Gun;Chang, Jae Chil
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.384-390
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    • 2012
  • Objective : The objective of this study was to investigate the morphologic characteristics between the vertebral body and the regions of the cervical and thoracic spinal cords where each rootlets branch out. Methods : Sixteen adult cadavers (12 males and 4 females) with a mean age of 57.9 (range of 33 to 70 years old) were used in this study. The anatomical relationship between the exit points of the nerve roots from the posterior root entry zone at each spinal cord segment and their corresponding relevant vertebral bodies were also analyzed. Results : Vertical span of the posterior root entry zone between the upper and lower rootlet originating from each spinal segment ranged from 10-12 mm. The lengths of the rootlets from their point of origin at the spinal cord to their entrance into the intervertebral foramen were 5.9 mm at the third cervical nerve root and increased to 14.5 mm at the eighth cervical nerve root. At the lower segments of the nerve roots (T3 to T12), the posterior root entry zone of the relevant nerve roots had a corresponding anatomical relationship with the vertebral body that is two segments above. The posterior root entry zones of the sixth (94%) and seventh (81%) cervical nerve roots were located at a vertebral body a segment above from relevant segment. Conclusion : Through these investigations, a more accurate diagnosis, the establishment of a better therapeutic plan, and a decrease in surgical complications can be expected when pathologic lesions occur in the spinal cord or vertebral body.

Microsurgical DREZotomy for Treatment of Intractable Central Pain in Patient with Spinal Cord Injury (척수 손상 환자의 중추성 통증에 대하여 시행한 Microsurgical DREZotomy의 효과)

  • Lee, Zee-Ihn;Kim, Seong-Ho;Ahn, Sang-Ho;Jang, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.49-54
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    • 2002
  • The central pain in patient with spinal cord injury is a common and disabling sequela. The microsurgical DREZ(Dorsal Root Entry Zone)otomy is a surgical procedure effective in the treatment of intractable pain and spasticity in spinal cord injured patients. It consists of a microsurgical lesions performed in the ventrolateral region of the dorsal root entry zone at the selected levels. This report presents one case with incomplete paraplegia patient, who had chronic central neuropathic pain ineffective to many conservative treatments in bilateral T10 and right T11 segments and both lower extremities, is relieved from the pain after microsurgical DREZotomy. In conclusion, microsurgical DREZotomy is one method of effective treatments for spinal cord injured patients with intractable central neuropathic pain.

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Cerebral Infarction Mimicking Skeletal Metastases on Tc-99m MDP Bone Scintigraphy

  • Lim, Seok-Tae;Park, Soon-Ah;Sohn, Myung-Hee;Yim, Chang-Yeol
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.433-435
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    • 2000
  • A 6000-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the ether represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.$^{1-4)}$ A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.$^{4)}$ Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.

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A Case of Tugerculoma in Cerebrum with Brain Edema (뇌부종(腦浮腫)을 동반한 대뇌(大腦)의 결핵종(結核腫) 1례(例))

  • Son, Dong-Hyug;Yu, Kyung-Suk;Jang, In-Soo;Lee, Young-Goo;Yun, Hee-Sik;Byun, Duck-Si;Lee, Jin-Goo
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.529-533
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    • 2000
  • Intracranial tuberculoma is very rare nowadays. It is very difficult to differentiate tuberculoma from other space-occupying lesions. CT and MRI and intensive systemic review is very useful to diagnose intracranial tuberculoma. This case of patient had several symptoms of hemiparesis, headache. And we supposed that his symptoms were due to cerebrovascular accident at entry. But he was diagnosed as tuberculoma with brain edema in cerebrum. After treating him with mannitolization, acupuncture and herb medicine, his symptoms were remarkably improved. So we report this case of tuberculoma in cerebrum.

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Corrected transposition of the great arteries associated with severe tricuspid insufficiency: one case report (삼첨판막 폐쇄부전을 동반한 선천성 교정형 대혈관전위증치험 1례 보)

  • Kim, Chi-Gyeong;Na, Beom-Hwan;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.362-370
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    • 1984
  • The term corrected transposition of great arteries [hereafter referred to as corrected TGA] of the heart in which there is both a discordant atrio-ventricular relationship and transposition of the great vessels. Usually situs solitus is present, while the ventricles are inverted showing an l -loop. The great vessels are transposed and in the l-position so that the pulmonary artery arises from the right-sided morphological left ventricle and the anteriorly l- transposed aorta arises from the left-sided morphological right ventricle yielding an SLL pattern. In the majority of cases, associated lesions are common. The most frequent are ventricular septal defect, obstruction to the pulmonary outflow tract, tricuspid valve incompetence and atrio-ventricular conduction abnormalities. In the rare cases, no associated conditions are present and hemodynamic pathways are normal. In the report, we present one case of a 20 year-old male having corrected TGA associated with severe tricuspid valve incompetence, was corrected by tricuspid valve replacement, directly developed a supra-ventricular tachycardia but was controlled by calcium-entry blocker, verapamil, successfully.

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Study on The Herbs and Forms of Oriental Applications to Treat Mycoses (진균증을 치료하는 한방외용약의 제형과 약물 분류)

  • Kim, Yong-Chan;Kang, Jung-Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.5
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    • pp.1126-1134
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    • 2006
  • Human fungal infections are uncommon in normally healthy persons, being confined to conditions such as candidiasis (thrush) and dermatophyte skin infections such as athlete's foot. However, in the immunocompromised host, a variety of normally mild or nonpathogenic fungi can cause potentially fatal infections. Furthermore, the relativeease with which people can now visit 'exotic' countries provides the means for unusual fungal infections to be imported into this country. Mycoses appear in many different forms and areas. Fungal infections or mycoses are classified depending on the degree of tissue involvement and mode of entry into the host. These are Cutaneous, Subcutaneous, Systemic, and Opportunistic. Cutaneous mycoses specially appears symptoms on the skin. They are treated by amphotericinB, nystatin, grycelfulvin, micronazole and ketaconazole, etc, but these medicines are been careful about using, because most of them have serious side effects and toxicities. So, on the purpose of finding safe novel medicines, we have researched oriental medicines and search them to treat mycoses. In oriental medicines treating mycoses, we pay attention to orient applications that directly have an effect on disorder lesions. Oriental applications consists of various herbs and have a lot of forms, so we try to classify them as herbs and forms

TLR9 Expression in Uterine Cervical Lesions of Uyghur Women Correlate with Cervical Cancer Progression and Selective Silencing of Human Papillomavirus 16 E6 and E7 Oncoproteins in Vitro

  • Hao, Yi;Yuan, Jian-Ling;Abudula, Abulizi;Hasimu, Axiangu;Kadeer, Nafeisha;Guo, Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5867-5872
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    • 2014
  • Background: Cervical cancer is listed as one of high-incidence endemic diseases in Xinjiang. Our study aimed to evaluate the expression of TLR9 in uterine cervical tissues of Uyghur women and examine associations with clinicopathological variables. We further characterized the direct effects of TLR9 upon the selective silencing of human papillomavirus (HPV) E6 and E7 oncoprotein expression in HPV 16-positive human cervical carcinoma cells treated with siRNA in vitro. Materials and Methods: Immunohistochemistry was applied to evaluate TLR9 expression in 97 formalin-fixed paraffin-embedded cervical samples from Uyghur women; 32 diagnosed with cervical squamous cell carcinomas (CSCC), 14 with low-grade cervical intraepithelial neoplasias (CINI), 10 medium-grade (CINII), 24 high-grade (CINIII), and 17 chronic cervicitis. $BLOCK-iT^{TM}$ U6 RNAi Entry Vector $pENTR^{TM}$/U6-E6 and E7 was constructed and transfected the entry clone directly into the mammalian cell line 293FT. Then the HPV 16-positive SiHa human cervical carcinoma cell line was infected with RNAi recombinant lentivirus. RT-PCR and Western blotting were used to determine the expression of TLR9 in both SiHa and HPV 16 E6 and E7 silenced SiHa cells. Results: Immunohistochemical staining showed that TLR9 expression was undetectable (88.2%) or weak (11.8%) in chronic cervicitis tissues. However, variable staining was observed in the basal layer of all normal endocervical glands. TLR9 expression, which was mainly observed as cytoplasmic staining, gradually increased in accordance with the histopathological grade in the following order: chronic cervicitis (2/17, 11.8%)

$BBPY^{(R)}$ graft for periodontal intrabony defects and molar furcation lesions: Case Report (다양한 치주 골내낭과 이개부 병변의 처치를 위한 $BBP^{(R)}$ 이식재의 임상적 효과)

  • Kim, Myung-Jin;Lee, Ju-Youn;Kim, Sung-Jo;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
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    • v.38 no.1
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    • pp.97-102
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    • 2008
  • Purpose: Periodontal intrabony defects have great deal of importance since they contribute to the development of periodontal disease. Current treatment regimens for intrabony defects involve grafting of numerous bony materials, GTR using biocompatible barriers, and biomodification of root surface that will encourage the attachment of connective tissue. Xenograft using deproteinized bovine bone particles seems to be very convenient to adjust because it doesn't require any donor sites or imply the danger of cross infections. These particles are similar to human cancellous bone in structure and turned out to be effective in bone regeneration in vivo. We here represent the effectiveness of grafting deproteinized bovine bone particles in intrabony defect and furcation involvements that have various numbers of bony walls. Materials and methods: Open flap debridement was done to remove all root accretions and granulation tissue from the defects within persisting intrabony lesions demonstrating attachment loss of over 6mm even 3 months after nonsurgical periodontal therapy have been completed. Deproteinized bovine bone particles($BBP^{(R)}$, Oscotec, Seoul) was grafted in intrabony defects to encourage bone regeneration. Patients were instructed of mouthrinses with chlorohexidine-digluconate twice a day and to take antibiotics 2-3 times a day for 2 weeks. They were check-up regularly for oral hygiene performance and further development of disease. Probing depth, level of attachment and mobility were measured at baseline and 6 months after the surgery. The radiographic evidence of bone regenerations were also monitored at least for 6 months. Conclusion: In most cases, radio-opacities increased after 6 months. 2- and 3-wall defects showed greater improvements in pocket depth reduction when compared to 1-wall defects. Class I & II furcation involvements in mandibular molars demonstrated the similar results with acceptable pocket depth both horizontally and vertically comparable to other intrabony defects. Exact amount of bone gain could not be measured as the re-entry procedure has not been available. With in the limited data based on our clinical parameter to measure pocket depth reduction following $BBP^{(R)}$ grafts, it was comparable to the results observed following other regeneration techniques such as GTR.