• Title/Summary/Keyword: Spinal lesion

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Comparison of the Activity of Cortical Neurons According to Muscle Contraction Type between Post Stroke Hemiplegic Subjects and Healthy Subjects (뇌졸중 환자와 정상인의 근 수축 유형에 따른 피질 신경원의 활성도 비교)

  • Yang, Ga-Ae;Kim, Su-Hyon;Lim, Yong-Eun;Lee, Dong-Geol;Kim, Tae-Youl
    • The Journal of Korean Physical Therapy
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    • v.21 no.1
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    • pp.73-80
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    • 2009
  • Purpose: In order to examine difference in the activity of potential of spinal neurons and cortical neurons according to muscle contraction type in post stroke hemiplegic subjects and healthy subjects, the present study conducted an experiment as follows. Methods: The subjects in the experimental group were 17 left-side hemiplegic subjects (9 female, 8 male; mean age, 63.41$\pm$9.86 years) with the right hand as the dominant hand selected among post stroke hemiplegic subjects, and 17 age matched healthy control subjects (10 female, 7 male; mean age, 64.12$\pm$12.07 years). Movement-related cortical potentials (MRCPs) were measured using surface electromyography and electroencephalography while concentric and eccentric movements were made alternately. Results: As to the pattern of the activity of MRCP, which indicates the activity of motor cortical neurons, we found that the amplitude is high (p<0.01), the length of excitement is short (p<0.01) and the ascending gradient of amplitude to the peak increases (p<0.05) in post stroke hemiplegic subjects' lesion sites different from healthy subjects. Conclusion: The activity of cortical neurons was no difference in activity according to contraction type was observed in post stroke hemiplegic subjects' lesion sites. This suggests that there is no distinction in the activity of cortical neurons between concentric contraction and eccentric contraction. Accordingly, if post stroke hemiplegic subjects' activity of motor cortex is analyzed by measuring MRCPs, it is considered useful in research on neural plasticity or as a ground of clinical effects in the area of physical therapy for the central nervous system.

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Simultaneous occurrence of an Odontogenic Myxoma and a Squamous Cell Carcinoma of the Mandible (편평세포암종과 병발한 치성점액종)

  • Kim Bong-Su;Lee Sang-Rae;Hwang Eui-Hwan;Lee Byung-Do
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.1
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    • pp.341-355
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    • 1999
  • Squamous cell carcinoma is the most common type of oral cancer and odontogenic myxoma is relatively uncommon benign tumor of mesenchymal origin. There are, to our knowledge, no prior reports of simultaneously occurring squamous cell carcinoma and odontogenic myxoma of the jaw bones. In this case, at first, the plain films and computed tomograms revealed a large expansile multilocular radiolucent lesion on left mandible and marked expansion of cortical plate. In addition this radiograms revealed also infiltrative bony destruction of anterior and medial border of ascending ramus of left mandible and alveolar bone of left maxilla, floating teeth on left lower molar area and metastatic enlargement of left submandibular, jugular digastric and spinal accessory lymphnodes. Magnetic resonance imaging of this patient revealed infiltrative growth of tumor on alveolar bone of left maxilla, left retromolar fat pad. left masseter and left medial pterygoid muscle. Intraoral presurgical biopsy presented typical features of squamous cell carcinoma. After chemotherapy with radiation therapy during 6 months. this central lesion was diagnosed as odontogenic myxoma by the postsurgical biopsy. After 3 months, this patient presented multiple metastatic signs at lumbar spines, rib and liver. Consequently, our case is simultaneous occurrence of squamous cell carcinoma and odontogenic myxoma.

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Treatment of large sized cystic lesion of the jaws with specific appliance for decompression:cases report (악골 내 거대 낭종성 병소의 감압술을 위해 고안된 장치를 이용한 치험례: 증례보고)

  • Jang, Chang-Su;Kim, Ju-Won;Yang, Seung-Bin;Yim, Jin-Hyuk;Kim, Jwa-Young;Yang, Byoung-Eun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.2
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    • pp.133-136
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    • 2011
  • Cystic lesions on the jaws with expansion can invade the adjacent anatomical structure, infiltrate and expand the jaws, cause facial deformity, etc. There is great potential for pathologic fractures after cyst enucleation, and damage to the major structures like the nerve, artery. For these reasons, marsupialization and decompression are commonly used to reduce the cystic size. In 1947, Thomas first mentioned decompression that reduces the osmotic pressure in a cyst by making a hole in the cyst and insert a drain. In our cases, a large sized cystic lesion was treated with a specific device made from an orthodontic band and spinal needle. This device is easy and effective for applications and self irrigation.

Studies About the Effect of Excitatory Amino Acid Receptor Antagonist on Traumatic Spinal Cord Injury (척수신경손상에 대한 흥분성 아미노산 수용체 길항제의 효과에 대한연구)

  • Kim Jong-Keun
    • The Korean Journal of Pharmacology
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    • v.31 no.1 s.57
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    • pp.1-9
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    • 1995
  • The slow development of histopathological changes and long period required for stabilization of lesions have suggested that secondary injury processes exacerbate the effect of initial mechanical insult after traumatic spinal cord injury (SCI). The importance of glutamate receptors in the normal functions of spinal cord, in concert with the large body of evidence that points to their involvement in neurotoxicity due to both ischemic and traumatic insults to the CNS, suggested a probable role of glutamate receptors in secondary injury process after traumatic SCI. In order to investigate the involvement of excitatory amino acid in the secondary injury process after SCI, this study examined the effect of dextrorphan, a noncompetitive NMDA receptor antagonist, on the recovery of hindlimb function and the residual tissue at injury site following SCI. Locomotor function was assessed using open field test (21 point scale). At 8 weeks spinal cord tissue was examined using quantitative histopathologic technique. Prior to surgery female Long-Evans rats were adapted to the test environment. Rats received laminectomies (T9/T10), and spinal cord contusions (NYU impactor) were produced by a 10 gm weight dropped 25 mm. DXT (15 or 30 mg/kg, i.p.) or saline was injected 15 min before contusion. Behavioral testing resumed 2 days post-injury and continued twice a week for 8 weeks. No differences between DXT and saline groups were found for hindlimb function and sparing tissue at the lesion site. These results suggest that NMDA receptor might not be involved in secondary injury processes after traumatic SCI.

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Role of Peripheral Glutamate Receptors to Mechanical Hyperalgesia following Nerve Injury or Antidromic Stimulation of L5 Spinal Nerve in Rats with the Previous L5 Dorsal Rhizotomy (제5효후근을 절단한 백서에서 제5요척수신경의 신경손상이나 전기자극에 의한 기계적 과민통 생성에 있어서 말초 글루타민산 수용기의 역할)

  • Jang, Jun Ho;Nam, Taick Sang;Yoon, Duck Mi;Leem, Joong Woo;Paik, Gwang Se
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.33-44
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    • 2006
  • Background: Peripheral nerve injury leads to neuropathic pain, including mechanical hyperalgesia (MH). Nerve discharges produced by an injury to the primary afferents cause the release of glutamate from both central and peripheral terminals. While the role of centrally released glutamate in MH has been well studied, relatively little is known about its peripheral role. This study was carried out to determine if the peripherally conducting nerve impulses and peripheral glutamate receptors contribute to the generation of neuropathic pain. Methods: Rats that had previously received a left L5 dorsal rhizotomy were subjected to a spinal nerve lesion (SNL) or brief electrical stimulation (ES, 4 Hz pulses for 5 min) of the left L5 spinal nerve. The paw withdrawal threshold (PWT) to von Frey filaments was measured. The effects of an intraplantar (i.pl.) injection of a glutamate receptor (GluR) antagonist or agonist on the changes in the SNL- or ES-produced PWT was investigated. Results: SNL produced MH, as evidenced by decrease in the PWT, which lasted for more than 42 days. ES also produced MH lasting for 7 days. MK-801 (NMDAR antagonist), DL-AP3 (group-I mGluR antagonist), and APDC (group-II mGluR agonist) delayed the onset of MH when an i.pl. injection was given before SNL. The same application blocked the onset of ES-induced MH. NBQX (AMPA receptor antagonist) had no effect on either the SNL- or ES-induced onset of MH. When drugs were given after SNL or ES, MK-801 reversed the MH, whereas NBQX, DL-AP3, and APDC had no effect. Conclusions: Peripherally conducting impulses play an important role in the generation of neuropathic pain, which is mediated by the peripheral glutamate receptors.

An Intramedullary Neurenteric Cyst in the Conus Medullaris with Recurrent Meningitis

  • Park, Yeul-Bum;Kim, Seong-Ho;Kim, Sang-Woo;Chang, Chul-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.130-133
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    • 2007
  • Neurenteric cysts are rare congenital lesions of the spine that are lined with endodermal epithelium. Their most common location is the cervico-dorsal region, and the mass usually lies ventral to the spinal cord. However the conus medullaris area location is an uncommon location. Neurenteric cysts are best treated by decompression and as near total excision of cyst membrane as possible. We report a case of a 7 year-old-girl with a neurenteric cyst in the conus medullaris. The patient had a history of meningitis and a gait disturbance. Magnetic resonance imaging [MRI] showed an intramedullary mass lesion in the conus medullaris with syringomyelia. There was no associated bone or soft-tissue anomaly. The mass was subtotally removed through a posterior approach. However 4 months later, meningeal irritation signs developed and MRI showed recurrence of the cyst. At the second operation, the cystic membrane was totally removed and the patient's neurological symptoms improved postoperatively. We reports a case of recurred neurenteric cyst occurred in unusual location with the review of literature.

Surgical Resection of Intralobar Pulmonary Sequestration Misconceived of the Lung Abscess -1 Case Report- (폐농양으로 오인한 폐엽내형 폐격리증 수술 치험 1례)

  • Kim, Jae-Ryeon;Im, Jin-Su;Choe, Hyeong-Ho
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.797-800
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    • 1995
  • Pulmonary sequestration is an uncommon congenital pulmonary malformation characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries - descending thoracic aorta or abdominal aorta, subclavian artery, innominated artery and internal mammary artery, etc. In our country, 39 cases were reported previously. The patient was a 40 years old woman and admitted due to productive cough for 1 year. The chest X-ray and chest C-T showed a dense mass containing a large cavity with air-fluid level and multiple radiolucent cysts in the right lower lung field. On the operative field, we could identify an aberrant large artery [ $\phi$7mm which arose directly from the descending thoracic aorta at eighth thoracic spinal level and fed the sequestrated portion of the right lower lobe. The aberrant artery was double ligation after division. Only sequestrated lobe on the superolateral lesion of the right lower lobe was resected because of nonseparated lobes in all the right lobes. An abnormal vein and bronchiole were ligated with black silk. The patient`s postoperative course was unevenful.

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Herpes Zoster Meningitis Confirmed by Detection of Varicella-Zoster Virus DNA Using the Polymerase Chain Reaction -A case report- (중합효소 연쇄반응을 이용한 Varicella-Zoster Virus DNA 검출로 확인된 대상포진 수막염 -증례 보고-)

  • Heo, Hu Man;Choi, Yu Sun;Park, Seong Kyu
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.210-213
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    • 2005
  • Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.

Metastatic Brain Neuroendocrine Tumor Originating from the Liver

  • Lee, Guk Jin;Jo, Kwang Wook;Kim, Jeana;Park, Il Young
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.550-553
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    • 2015
  • A 67-year-old male presented with left temporal hemianopsia and left hemiparesis. A contrast-enhanced magnetic resonance image revealed a $4.5{\times}3.5{\times}5.0cm$ rim-enhancing mass with central necrosis and associated edema located in the left occipital lobe. Of positron emission tomography and abdominal computed tomography, a 9-cm mass with poor enhancement was found in the right hepatic lobe. Craniotomy and right hemihepatectomy was performed. The resected specimen showed histological features and immunochemical staining consistent with a metastatic neuroendocrine tumor (NET). Four months later, the tumors recurred in the brain, liverand spinal cord. Palliative chemotherapy with etoposide and cisplatin led to complete remission of recurred lesions, but the patient died for pneumonia. This is the first case of a metastatic brain NET originating from the liver. If the metastatic NET of brain is suspicious, investigation for primary lesion should be considered including liver.

Candida Parapsilosis Spondylodiscitis after Lumbar Discectomy

  • Cho, Kyun-Gil;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.295-297
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    • 2010
  • Candida is a relatively rare cause of spinal infections that commonly affects immunocompromised patients. A 70-year-old woman, who underwent a lumbar discectomy on L5-S1 two months earlier, was admitted to our department complaining of persistent back and leg pain. Magnetic resonance imaging showed irregular enhancing mass lesion in L5-S1 intervertebral space, suggest of pyogenic discitis with epidural abscess. The surgery was performed via retroperitoneal approach and the infected material at L5-S1 intervertebral space was removed. The histological examination of the specimen revealed chronic inflammation involving the bone and soft tissue, and a culture of the excised material was positive for Candida parapsilosis. The patient received intravenous fluconazole for 4 weeks after surgery and oral fluconazole 400 mg/day for 3 months after surgery. The patient made a full recovery with no symptoms 6 months after surgery. We present a rare case of spondylodiscitis after a lumbar discectomy due to Candida parapsilosis and discuss treatment option with a review of the literatures.