To report two cases of type 1.5 split cord malformation (SCM), a subtype of SCM with combined characteristics of types I and II and to review the relevant literature and propose a new possible pathogenetic theory for type 1.5 SCM. A 52-year-old woman had hemicords within a single dural sac with a dorsal bony septum at the L5 level. A 9-year-old boy had hemicords within a single dural sac with a ventral bony septum and fibrous extension at the L3 level. Both patients underwent microsurgical treatments for removing the bony septum, detethering the spinal cord, and sectioning the filum terminale. The surgical procedure revealed an extradural partial bony septum and hemicords within an intact single dural sac in each patient. Both patients were discharged from the hospital without de novo nerve dysfunction. Published cases have validated that types I and II SCM can overlap. We recommend recent type 1.5 SCM as a normative terminology for this overlapping SCM and report two rare cases of this SCM. We propose an associated pathogenesis consisting of uneven distribution and regression to explain type 1.5 SCM. Furthermore, we postulate that the amount of condensing meninx primitiva might determine whether the left bony septum has fibrous extensions to the opposite dura in type 1.5 SCM.
Objectives: Sciatica is a musculoskeletal pain sensed in the leg along with the distribution of the sciatic nerve, which is sometimes accompanied by low back pain and is most commonly caused by a disc herniation. In the Unani system of Medicine, Irq-un-Nasa (Sciatica) is defined as the pain which starts from the hip joint and descends towards the foot. It is a type of Waja-ul-Mafasil which is developed due to the accumulation of Khilt-e-Dam or Khilt-e-Balgham ghaleez in the hip joint. The conventional system of Medicine offers several medications and surgeries to manage sciatica with limited clinical evidence of effectiveness. These cases aim to provide insight into the effects of Fasd (Venesection) in Irq-un-Nasa. Case Presentation: Fasd was performed in the saphena minor vein of two clinically diagnosed patients with sciatica after the initial assessment. Two sittings of Fasd, once a week in each patient, were performed, followed by telephonic assessments for two months. The intensity of sciatic pain reduced with subsequent sittings of Fasd, and there was no recurrence of any symptoms and signs again during complete follow-up. Conclusion: Based on the results of the present case report, it appears that such cases of Irq-un-Nasa can be managed with Fasd, and the quality of life of such patients can also be improved.
Parvalbumin occurs in various types of cells in the retina. We previously reported parvalbumin distribution in the inner nuclear layer of bat retina. In the present study, we identified the parvalbumin-immunoreactive neurons in the ganglion cell layer of the retina of a bat, Rhinolophus ferrumequinum, and investigated the distribution pattern of the labeled neurons. Parvalbumin immunoreactivity was found in numerous cell bodies in the ganglion cell layer. Quantitative analysis showed that these cells had medium to large-sized somas. The soma diameter of the parvalbumin-immunoreactive cells in the ganglion cell layer ranged from 12.35 to 19.12 ${\mu}m$ (n=166). As the fibers in the nerve fiber layer were also stained, the majority of parvalbumin-immunoreactive cells in the ganglion cell layer should be medium to large-sized retinal ganglion cells. The mean nearest neighbor distance of the parvalbumin-immunoreactive cells in the ganglion cell layer of the bat retina ranged from 59.57 to 62.45 ${\mu}m$ and the average regularity index was 2.95 ${\pm}$ 0.3 (n=4). The present results demonstrate that parvalbu-min is expressed in medium to large-sized retinal ganglion cells in bat retina, and they have a well-or-ganized distributional pattern with regular mosaics. These results should be important as they are applicable to a better understanding of the unsolved issue of a bat vision. This data will help to provide fundamental knowledge for the better understanding of the unique behavioral aspects of bat flight maneuverability.
A study was carried out in order to obtain the status of student sickness and medical care in University Health Service, Ewha Womans University. This study was based on the clinical records of University Health Service and hospitals 'for student insurance pay claims during the year of 1981. And the findings from the study were as follows; 1. A total number of student patients cared at University Health Service in 1981 was 9,822 and the incidence rate of primary cared was 773 per 1,000 students. 2. A total number of student patients cared at hospitals was 393 and the incidence rate of secondary cared was 31 per 1,000 students and 5 student out of 31 per 1000 was cared under the haspitalization. 3. The evacuation rate of student patients from University Health Service to hospital was 393 out of 9,822 student primary cared or 4.0 percent. 4. The order of 5 major diseases of primary cared in University Health Service was respiratory system diseases (36.6%), Digestive system diseases (17.4%), Skin and subcutaneous tissue diseases (16.0%), Symptoms and undetermined diagnosis (13.7%) and Nerve and sensory organ diseases (12.0%) respectively. 5. The disease order of student patients(333) cared in hospitals as out-patients was Skin and subcutaneous tissue diseases (40.3%), Nervous and Sensory organ disease (19.2%), Digestive system diseases (10.8%) respectively. 6. The disease order of student patients (60) cared in hospitals as in-patients was Digestive system diseases (35.0%), Respiratory system diseases (13.3%), Nerve and sensory organ diseases (10.0%), Infectious and parasitic diseases (10.0%), and Symptom and Undetermined diagonsis (10.0%) respectively. 7. The evacuation rate of student patients in University Health Service to hospital was varied according to disease groups; the lowest rate was the diseases evacuated to Internal Medicine Department 1.5% or 75 out of 5,072 patient primary cared and the highest rate was Neuropsychiatry department 63.7% or 7 out of 11 patients. 8. The monthly distribution of student patients in University Health Service was the highest in September (17.9%) and April (15.5%) each semester. 9. The monthly number of student patients treated in hospitals was the range 20 to 40 in out patients and 2 to 9 in in-patients. 10. The hospital ill days per case were $4.3{\pm}5.0$ days in out-patients and $9.7{\pm}9.5$ days in in-patients.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.30
no.4
/
pp.271-281
/
2004
Adenoid cystic carcinoma is malignant tumor in salivary gland, and its behavior is very invasive. Of all malignant tumor adenoid cystic carcinoma is occured in frequency of 4.4% in major salivary gland, and 1.29% in minor salivary gland. Histopathologically, adenoid cystic carcinoma is characterized by a cribriform appearance, and tubular form and solid nest type tumor can be seen. The tumor cell structure composed of modified myoepithelial cell, and basaloid cell. Extracellular matrix of this tumor cell contains variable ground substance with basement membrane component. Basement membrane matrix composed of collagen fibers, glycoproteins, proteoglycans, and its function is well known that it participate in differentiation, proliferation, and growth of tumor cell. Basement membrane molecule is essential for invasion of peripheral nerve, blood vessel, skeletal muscle in tumor cell of adenoid cystic carcinoma. In many studies, the tumor cell of adenoid cystic carcinoma containing modified myoepithelial cell participate in synthesis of proteoglycan. In this study, tissue sample of adenoid cystic carcinoma of human salivary gland were obtained from 15 surgical specimen, and all specimen were routinely fixed in 10% formalin and embedded. Serial $4-{\mu}m$ thick sections were cut from paraffin blocks. the histopathologic evaluation was done with light microscopy. And, the immunohistochemical staining, characteristics of glycosaminoglycan were observed. For biochemical analysis of glycosaminoglycan, isolation of crude glycosaminoglycan from tumor tissue and Western bolt analysis were carried out. With transmission electomicroscopy, tumor cell were observed. Biologic behavior of adenoid cystic carcinoma was observed with distribution and expression of basement membrane of glycosaminoglycan in tumor cells, The results obtained were as follows: 1. In immunohistochemical study, chondroitin sulfate is postively stained in tumor cell and interstitial space, dermatan sulfate is weakly stained in ductal cell. But keratan sulfate is negatively stained. 2. In immunohistochemical study, heparan sulfate is strong positive stained in tumor cell and basement membrane, especially in invasion area to peripheral nerve tissue. 3. In transmission electromicroscpic view, the tumor cells are composed modifed myoepithelial cells, and contains many microvilli and rough endoplasmic reticulum. 4. In Western blot analysis, the expression of glycosaminoglycan is expressed mostly in heparan sulfate. From the results obtained in this study, tumor cell of adenoid cystic carcinoma is composed modified myoepithelial cell, and glycosaminoglycan of basement membrane molecule of heparan sulfate and chondroitin sulfate mostly participate in the development and invasiveness of adenoid cystic carcinoma by immunohistochemical study and western blot analysis.
Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.
The main purpose of this work is the study on the etiology and pathology of the anorexia in oriental and western medicine. An appetite is stimulated by the need of supply of nutrition for life and the physical desire of hunger which appeared as the alternative of taste. In this paper, I investigated the anatomical and the physiological function system, the Piwei functional system and meridian distribution, and the differentiation of the disease according to the Zangfu(internal organs) in association with the anorexia. And conclusion could be summarized as follows : 1. The tongue, one of the Piwei functional system(脾胃機能系), is connected with Pi(脾), Xin(心), Gan(肝) and Shen(腎) meridian. Especially Pi and Xin meridian have the close relations with taste. 2. The appetite has the close relations with Piwei. The appetite and digestion is influenced by the function of smoothing and regulating and bloodflow of Ki(肝主疏泄), warming the Shen to activate the function of Pi(腎主溫養), cleansing the inspired air and keeping the Ki flowing downward(肺主肅降). 3. The cause of anorexia is the insufficiency of Ki of Piwei(脾胃氣虛), the attack of Wei by hyperactive Gan Ki(脾氣犯胃), the insufficiency of Wei Yin(胃陰不足), the declination of the fire from the vital gate(命門火衰) and the retention or stagnancy of undigested food (飮食停滯). Especially, the main cause of anorexia is the insufficiency of Ki of the Piwei(脾胃氣虛). 4. Recently the attack of Wei by hyperactive Gan Ki(脾氣犯胃) is raised by the main cause of anorexia. 5. The mental function of anorexia, which is induced by the unbalance of Pi, is directly associated with Xin(心) and Xin meridia(心經). 6. The goal of the treatment of the anorexia is dependent on the recovery of the weakness of the Pi. And for this goal, the disorders of the other organs is also treated. 7. In the point of the anatomy and physiology, the main cause of anorexia is the loss of function of the autonomic nerve system and the vagus nerve.
GRP was known as the modulator of Pain transmission in central nervous system and local effector to peripheral tissue causing vasodilation, increased blood flow, modulation of immune sysem, stimulation of endothelial cell proliferation, and stimulation of bone formation. Numerous study, therefore, were done to elucidate involvement of CGRP to tooth movement. To investgate the response of CGRP immunoreactive nerve cells according to cell size in trigeminal ganglion during tooth movement, immunohistochemical study was performed using rat. Experimental rats(9 weeks old, 210 gm) were divided as six groups(normal(n=6), 3 hour group(n=5), 12 hour group(n=4), 1 day group(n=5), 3 day group(n=5), 7 day group(n=5)), and were applied orthodontic force (approximately 30 gm) to upper right maxillary molar. After frozen sections of trigeminal ganglions were immunostained using rabbit antisera, the changes of CGRP immunoreactive cells in regard to cell size distribution(small cell(upto $20{\mu}m$), medium cell($20-35{\mu}m$), large cell(above $35{\mu}m$)) were observed. The results were as follows 1. The percentage of CGRP immunoreactive cells to all nerve cells in trigeminal ganglion was 33.0% in normal control group, was decreased to 24.5% in 1 day group, and was increased to 41.8% in 7 day group. 2. The percentage of small, medium, and large cells expressing CGRP immunoreactivity in normal trigeminal ganglion to all CGRP immunoreactive cells were 51.3%, 44.0%, 4.7%, respectively. 3. The percentage of small cells with CGRP immunoreactivity to all CGRP immunopositive cells was increased in 3 hour and 12 hour groups. 4. The percentage of medium cells with CGRP immunoreactivity was increaed in 3 day and 7 day groups. 5. The percentage of large cells with CGRP immunoreactivity was increaed in 7 day group. Conclusively, the small cells with CGRP immunoreactivity in trigeminal ganglion respond to orthodontic force during initial phase of tooth movement, and later the medium and large cells with CGRP immunoreactivity respond
We analyzed parasitic diseases diagnosed by tissue biopsy specimens at KyungHee Medical Center (KMC) from 1984 to 2005. The total number of parasite infection cases was 150 (0.07%) out of the total 211,859 biopsy specimens submitted for histopathological examinations. They consisted of 62 cysticercosis, 23 sparganosis, 16 paragonimiasis, 15 amebiasis, 11 anisakiasis, 11 clonorchiasis, 3 ascariasis, 2 scabies, 2 enterobiasis, 2 trichuriasis, 1 leishmaniasis, 1 taeniasis, and 1 thelaziasis. Out of 62 cysticercosis cases, 55 were detected in subcutaneous tissues or the central nerve system. Eighteen out of 23 sparganosis cases were involved in muscular and subcutaneous tissues. In most anisakiasis cases, the involved organ was the stomach. The lung and the pleura were the most common site of paragonimiasis. The incidence of parasitic diseases during the first 5 years (1984-1988) was the highest of all observed periods. After 1989, similar incidences were shown throughout the period. Whereas cysticercosis was diagnosed in 34 cases during 1984-1988, no case has been diagnosed since 2000. In the case of sparganosis, the chronological incidence was almost uniform throughout the period 1984-2005. Paragonimiasis showed a similar tendency to cysticercosis. In gender and age distribution of parasitic diseases, men showed higher incidence rates than females, and the age groups of the 40s or older indicated higher infection frequencies than other age groups. Therefore, these results are a significant report to appear the tendency of human parasitic disease diagnosed by tissue biopsy in association with parasitosis at KMC in Seoul.
Numb chin syndrome, is a rare neuropathy, characterized by facial and oral numbness restricted to the distribution of the mental nerve. Even though this neuropathy is uncommon, but this still has an important clinical meaning because it can be related with a malignancy. Because orofacial symptoms can even present the first clinical feature of a malignancy, dentists should pay careful attention to their meaning and importance to detect the malignant tumor early. Moreover, patients who present with a sudden numbness on chin should be investigated for the undiagnosed malignancy. In this report, we described a patient with stabbing orofacial pain and numbness of chin who was diagnosed with diffuse large B-cell lymphoma and placed the importance on the diagnosis of NCS.
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