• Journal of Korean Neurosurgical Society
• /
• v.46 no.5
• /
• pp.468-471
• /
• 2009

Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.8
• /
• pp.1037-1042
• /
• 2000

Objective : The goal of this study was to recognize the clinical feature and associated risk factors in spinal epidural abscess(SEA), and to improve the outcome accordingly. Methods : A retrospective study was performed in 14 patients with SEA who underwent surgical intervention at our hospital between 1990 and 1999. Results : After a mean follow-up period of 10.2 months(range, 1-57 months), 8 patients had no or minimal deficits, 4 patients had severe paresis or plegia and/or bowel/bladder dysfunction, and 2 patients died due to medical complications. Staphylococcus aureus was the predominant pathogen, isolated in 9 patients(64.3%). Cervical and thoracic spinal epidural abscesses showed a tendency to develop rapidly and were associated with severe neurological deficits. Conclusion : Thoracic spinal epidural abscesses were associated with a poorer prognosis than those in other regions. Therefore, it should be treated more aggressively. Good neurological recovery can be obtained despite severe neurologic deficit when treated by early diagnosis and prompt surgical intervention.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.3243-3254
• /
• 2013

It is well known that increased incidences of lung, skin, and bladder cancers are associated with occupational exposure to PAHs. Animal studies show that certain PAHs also can affect the hematopoietic and immune systems and can produce reproductive, neurologic, and developmental effects. As a consequence, several studies have been attempted to investigate the fate of PAHs in atmospheric environment during the past decades. However, there is still a lack of information in regard to the atmospheric concentration of PAHs during the "Bon Fire Night". In this study, twenty-three polycyclic aromatic hydrocarbons and twenty-eight aliphatics were identified and quantified in the $PM_{10}$ and vapour range in Birmingham ($27^{th}$ November 2001-$19^{th}$ January 2004). The measured concentrations of total particulate and vapour (P+V) PAHs were consistently higher at the BROS in both winter and summer. Arithmetic mean total (P+V) PAH concentrations were $51.04{\pm}47.62$ ng $m^{-3}$ and $22.30{\pm}19.18$ ng $m^{-3}$ at the Bristol Road Observatory Site (BROS) and Elms Road Observatory Site (EROS) respectively. In addition arithmetic mean total (P+V) B[a]P concentrations at the BROS were $0.47{\pm}0.39$ ng $m^{-3}$ which exceeded the EPAQS air quality standard of 0.25 ng $m^{-3}$. On the other hand, the arithmetic mean total (P+V) aliphatics were $81.80{\pm}69.58$ ng $m^{-3}$ and $48.00{\pm}35.38$ ng $m^{-3}$ at the BROS and EROS in that order. The lowest average of CPI and $C_{max}$ measured at the BROS supports the idea of traffic emissions being a principle source of SVOCs in an urban atmosphere. The annual trend of PAHs was investigated by using an independent t-test and oneway independent ANOVA analysis. Generally, there is no evidence of a significant decline of heavier MW PAHs from the two data sets, with only Ac, Fl, Ph, An, 2-MePh, 1+9-MePh, Fluo and B[b+j+k]F showing a statistically significant decline (p<0.05). A further attempt for statistical analysis had been conducted by dividing the data set into three groups (i.e. 2000, 2001-2002 and 2003-2004). For lighter MW compounds a significant level of decline was observed by using one-way independent ANOVA analysis. Since the annual mean of $O_3$ measured in Birmingham City Centre from 2001 to 2004 increased significantly (p<0.05), it may be possible to attribute the annul reduction of more volatile PAHs to the enhanced level of annual average $O_3$. By contrast, the heavier MW PAHs measured at the BROS did not show any significant annual reduction, implying the difficulties of 5- and 6-ring PAHs to be subject to photochemical decomposition. The deviation of SVOCs profile measured at the EROS was visually confirmed during the "Bonfire Night" festival closest to the $6^{th}$ November 2003. In this study, the atmospheric PAH concentrations were generally elevated on this day with concentrations of Fl, Ac, B[a]A, B[b+j+k]F, Ind and B[g,h,i]P being particularly high.