• Journal of Veterinary Clinics
• /
• v.31 no.2
• /
• pp.152-155
• /
• 2014

An 11-year-old castrated Schnauzer presented with paraplegia for the last two weeks, initially developed pelvic limb ataxia 6 months ago and left pelvic limb paresis 3 months ago. On neurological examination, paraplegia and postural reaction deficits were noted in the pelvic limbs with no deep pain sensation, and the dog showed exaggerated spinal reflexes and involuntary urination. Magnetic resonance (MR) images of thoracolumbar spinal cord were obtained with a 0.3 Tesla magnet. A mass with a broad base to the dorsal and left dural margins was identified at the level of L2, causing marked spinal cord compression. The mass showed isointensity to the spinal cord on T1-weighted (T1W) precontrast images, hyperintensity on T2-weighted images, marked homogeneous contrast enhancement with well-defined margins and the "dural tail" sign on T1W postcontrast images. An intradural-extramedullay tumor was considered, most likely, meningioma was highly suggestive. Left-sided hemilaminectomy and dorsal laminectomy were performed. An intradural mass partially adherent to dura mater was compressing the spinal cord, and the mass was completely removed with the attached dura mater. A histopathologic diagnosis of angiomatous subtype meningioma was made.

• The Korean Journal of Rehabilitation Nursing
• /
• v.3 no.1
• /
• pp.27-42
• /
• 2000

The purpose of this study was to identify the degree of sexual adjustment and quality of life in married men with spinal cord injuries and to furnish primary data to sexuality rehabilitation nursing practice which can lead to ideal sexual life and quality of life those men with SCI. Seventy married men with SCI were conveniently sampled in Kwangju, Suncheon, Mokpo and Seoul for responding the questionnaire, which was based on this research. With the research scale, SIS (Sexual interest and satisfaction) by Siosteen et al.(1990) and SB(Sexual behaviour) by Kreuter et al.(1996) were used for the measurement of sexual adjustment. And, for measuring quality of life was used SCI QL-23(Spinal cord injury of life-23) scale by Lundqvist et al.(1997). Data were collected from January 20 to March 20, 1999, using a structured questionnaire. A hundred volumes of questionnaire were used. and 85 volumes were collected, 70 volumes were used as research data after excluding 15 volumes unsuitable to data analysis. The obtain data were analysed using percentage, t-test, ANOVA, Duncan test, and Pearson's correlation by SAS PC+ program. The results were as follows: 1. The mean score of sexual interest and satisfaction of the subjects was 8.42. out of 18. The ways of their sexual behavior after spinal cord injuries were embracing and caressing (62.9%), kissing(58.6%), caressing breast with hands (55.7%), caressing breast with hands (52.9%), caressing genitals with hands (37.2%), caressing genitals with mouth(30.0%) and sexual intercourse (18.6%). The mean score of quality of life was 52.53 out of 100. 2. Age(F=3.24, p=.045) and caregiver (F=4.02, p=.022)were major variables which reveals significant differences in terms for sexual interest and satisfaction. The later results on Duncan's test showed that subjects who were in their 30s or 40s were significant higher than subjects whose age were in their 50s in their sexual interest and satisfaction. Also subjects with their spouse's care or mother's care were higher than those with other's care. 3. Subjects with incomplete paraplegia were higher than those with the complete paraplegia in sexual interest and satisfaction (F=3.01, p=.036). 4. Variables that showed the significant differences in the quality of life were education(t=2.860, p=.007) and period of marriage(t=2.125, p=.037). and occupational status(t=-2.161, p=.034). High school graduates, those who married before spinal cord injuries and those who didn't have occupation were higher than the other subjects. 5. Variables that revealed significant differences in the quality of life were time passage after spinal cord injuries(F=8.72, p=.001) and injured level of spinal cord(F=3.32, p=.042). Duncan's test showed that subjects who had lived for less than 4 years were higher those with time passage of 5-9 years and 10 years. Also subjects with lumbar injuries were higher than those with thoracic injuries in terms of quality of life. 6. There was negatively correlated between sexual interest and satisfaction and quality of life(r=-.256, p<.05). As a result of these findings sexuality rehabilitation for individuals with SCI was very important issue for their quality of life. Thus, registered nurses who care clients with SCI should activily participate in the client's sexual needs. Also, various sexual behaviors as well as sexual intercourse should be encouraged for the sexual adjustment of client's with SCI.

• Journal of Chest Surgery
• /
• v.49 no.4
• /
• pp.232-241
• /
• 2016

Background: Paraplegia is a devastating complication following operations on the thoracoabdominal aorta. We investigated whether histidine-tryptophan-ketoglutarate (HTK) solution could reduce the extent of ischemia/reperfusion (IR) spinal cord injuries in a rat model using a direct delivery method. Methods: Twenty-four Sprague-Dawley male rats were randomly divided into four groups. The sham group (n=6) underwent a sham operation, the IR group (n=6) underwent only an aortic occlusion, the saline infusion group (saline group, n=6) underwent an aortic occlusion and direct infusion of cold saline into the occluded aortic segment, and the HTK infusion group (HTK group, n=6) underwent an aortic occlusion and direct infusion of cold HTK solution into the occluded aortic segment. An IR spinal cord injury was induced by transabdominal clamping of the aorta distally to the left renal artery and proximally to the aortic bifurcation for 60 minutes. A neurological evaluation of locomotor function was performed using the modified Tarlov score after 48 hours of reperfusion. The spinal cord was harvested for histopathological and immunohistochemical examinations. Results: The spinal cord IR model using direct drug delivery in rats was highly reproducible. The Tarlov score was 4.0 in the sham group, $1.17{\pm}0.75$ in the IR group, $1.33{\pm}1.03$ in the saline group, and $2.67{\pm}0.81$ in the HTK group (p=0.04). The histopathological analysis of the HTK group showed reduced neuronal cell death. Conclusion: Direct infusion of cold HTK solution into the occluded aortic segment may reduce the extent of spinal cord injuries in an IR model in rats.

• Journal of Chest Surgery
• /
• v.35 no.4
• /
• pp.255-260
• /
• 2002

Paraplegia remains unresolved as the most dreaded operative complication with surgical treatment of descending thoracic and thoracoabdominal aortic diseases. In this study, the neuroprotective effect of trimetazidine that has been used clinically for ischemic heart disease was investigated in a rabbit spinal cord ischemia model. Material and Method: Thirty-three New Zealand white rabbits were randomized as follows: control group undergoing abdominal aortic occlusion but receiving no pharmacologic intervention(Group 1, n= 17); TMZ group(Group 2, n= 16) receiving 3 mg/kg trimetazidine intravenously before the occlusion of the aorta. Ischemia was induced by clamping the abdominal aorta just distal to the left renal artery for 30 minutes. Neurologic status was assessed at 2, 24, and 48 hours after the operation according to the modified Tarlov scale, then the lumbosacral spinal cord was processed for histopathologic examinations 48 hours after the final assessment. Result: The average motor function score was significantly higher in the TMZ group(3.20 $\pm$ 0.77 vs 1.13 $\pm$ 1.25 at 2 hours, 3.50 $\pm$ 0.76 vs 1.45 $\pm$ 1.57 at 24 hours, and 3.91 $\pm$ 0.30 vs 1.86 $\pm$ 1.86 at 48 hours after operation; p value$\leq$0.05). Histologic observations were correlated with the motor scores. Conclusion: The results suggested that trimetazidine reduced spinal cord injury during aortic clamping and that it may have clinical utility for the thoracoabdominal aortic surgery:

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.12
• /
• pp.208-212
• /
• 2017

A urinary calculus in the urethra is rarely seen and usually encountered in men with a urethral stricture or diverticulum. Herein, we report a rare case of a giant calculus in the urethra of a 42-year-old male patient with paraplegia after spinal cord injury due to car accident 20 years ago. A recent urologic consultation from the emergency room was performed since the patient had multidisciplinary symptoms during the day without any urination and presented with urinary difficulties due to hematuria and pain symptoms occurring with a mass in the bottom of the testicles. Abdomen and pelvic computed tomography (CT) was performed to examine the tumor mass, which was found to be absent. In addition, urethral stones were observed in the CT. Cystostomy was performed after the first urethroplasty, and the stone was removed from the urethra. Two weeks later, the patient was subjected to urethrography to remove the Foley catheter. No specific finding in voiding was detected. Giant urethral stones sometime require differentiation from tumor status. Treatment may vary according to size and location, requiring careful examination.

• Journal of Chest Surgery
• /
• v.32 no.6
• /
• pp.532-535
• /
• 1999

Background: The purpose of this study was to evaluate and analyze the surgical techniques and postoperative complications in patients undergoing operations for descending thoracic aortic aneurysms. Material and Method: The data of 22 major operations between March 1987 and August 1997 were retrospectively reviewed. Result: There were 18 men and 4 women with a mean age of 49 years (range 33 years to 82 years). The cause of the aneurysm was aortic dissection in 13 patients, atherosclerosis in 3, mycotic in 3, trauma in 2 and uncertain in 1. The operative techniques were resection and graft replacement in 16, axillofemoral bypass graft in 2, femorofemoral bypass graft in 2, exclusion, aneurysmorrhaphy in 1 and transfemoral stent insertion in 1. During the operation, 16 cases were performed under total aortic clamp. Among the 16 patients, femorofemoral bypass was used in 14 cases and previously made shunt in 2 cases. The mean total aortic clamp time was 91 minutes and the mean extracorporeal circulation time was 116 minutes. One death occurred in an excluded patient on the 52 postoperative day due to a rupture of the aneurysm. Postoperative complications were paraplegia in 1 case, acute renal failure in 1 case and acute respiratory failure in 1 case. Conclusion: Although surgical treatment of the descending thoracic aneurysm has many postoperative complications, good surgical results can be achieved with a proper patient selection and fine surgical techniques.

• Journal of Chest Surgery
• /
• v.37 no.9
• /
• pp.774-780
• /
• 2004

Although traumatic thoracic aortic rupture is potentially a fatal condition requiring surgical attention, the presence of concomitant injury involving other parts of the body may greatly increase the risk of cardio-pulmonary bypass. We report our experience of treating associated injuries prior to the thoracic aortic rupture in these patients. Material and Method: From 1997 to 2003, the medical records of 24 traumatic aortic rupture patients were retrospectively reviewed and checked for the presence of associated injury, surgical method, postoperative course, and complications. Surgical technique comprised thoracotomy with proximal anastomosis under deep hypothermic circulatory arrest followed by side arm perfusion to reestablish cerebral circulation. CSF drainage was performed to prevent lower extremity paraplegia. Result： Major concomitant injuries (n=83) were noted in all of the reviewed patients, Of these, there were 49 thoracic injuries, 18 musculoskeletal injuries, and 13 abdominal injuries, Operations for associated injuries (n=16) were performed in 12 patients on mean 7.6$\pm$12.6 days following the injury. The diagnosis of aortic rupture at the time of injury was detected in only 18 patients. Delayed surgery of the thoracic aorta was performed on average 695$\pm$1350 days after injury and there were no deaths or progression of rupture in any of these patients during the observation period. There were no operative deaths and no major postoperative complications. Conclusion: Treating concomitant major injuries prior to the aortic injury in traumatic aortic rupture may reduce surgical mortality and morbidity.

• Journal of Veterinary Clinics
• /
• v.30 no.4
• /
• pp.320-323
• /
• 2013

Spinal cord infarction is becoming recognized as an important cause of acute myelopathy in cats. Although the definitive diagnosis is confirmed through postmortem histopathologic examination, MR imaging features provide valuable informations for the diagnosis of spinal cord infarction. The aim of this report is to describe MR findings of acute spinal cord infarction in two cats and to evaluate usefulness of low field MRI (0.3Tesla) as a potential diagnostic tool of acute spinal cord infarction. A cat (unknown age, neutered male mixed breed cat) was referred one day after the acute onset of non-ambulatory spastic tetraparesis and the other cat (a 9-year-old, neutered female domestic short hair cat) was presented due to the acute onset of non-ambulatory paraparesis and one day later paraplegia. The lesions of the MR images were shown on the spinal cord parenchyma over C2 to C6 in case 1 and L2 to L5 in case 2. The MR images in these two cases were characterized by focal intramedullary lesions, mainly involving grey matter which were hyperintense T2 weighted and FLAIR images and hyperintense on DWI and hypointense on ADC map. The MR findings in both cases were highly suggestive of acute spinal cord infarctions, based upon previous reported small animal cases and human cases. In conclusion, based on MR features, together with the history and clinical examination findings, MRI modality can be used as an antemortem tool for the diagnosis of acute spinal cord infarction in cats.

• The Journal of Korean Physical Therapy
• /
• v.12 no.2
• /
• pp.255-265
• /
• 2000

The term 'myositis ossificans' encompasses four categories of clinicopathological disorders. The first, myositis ossificans progressive(fibrodysplasia ossificans progressive), is a rare genetic disease characterized by progressive heterotopic ossification involving skeletal muscle, tendon, ligaments, and fascia, with congenital malformation of the great toes, and usually microdactyly, monophalangism, and mal formed proximal phalanges. with valgus deformity of metatarsophalangeal joint. The ossification begins shortly after birth and may contribute to the patient's death. The second, heterotopic ossificans, can occur in patients with neuromuscular and chronic diseases such as paraplegia, poliomyelitis, polymyositis, bum, tetanus, and infection. But the lesions in these cases often lack the typical histologic features of myositis ossificans. The third, myositis ossificans traumatica, is the most common; it develops in response to soft tissue trauma such as a single severe injury, minor repetitive injures, fracture, joint dislocation, stab wound, or surgical incision. The forth, nontraumatic myositis ossificans, also designated :pseudomalignant osseous tumors of extraskeletal soft tissues' and 'psedomalignant myositis ossificans', occurs in persons repeated small mechanical injures or nonmechanical soft tissue injuries due to local ischemia, inflammation. or other factors cannot be ruled out in such cases.

• Journal of Chest Surgery
• /
• v.41 no.1
• /
• pp.49-54
• /
• 2008

Background: Aortic diseases tend to involve the entire aorta. Hence, there is the constant possibility of the need for a secondary operation at the remnant aorta. This study analyzed our cases of secondary aortic surgery in order to determine its characteristics and problems. Material and Method: Between April 2003 and June 2007, 12 patients (6 male and 6 female) underwent thoracoabdominal aortic replacement as a secondary aortic operation. Their clinical courses were analyzed. Four of the patients underwent lower thoracobadominal aortic replacement under the normothermic femorofemoral bypass, and the others underwent an entire thoracobdominal aortic replacement under deep hypothermic circulatory arrest. Result: There was no death or paraplegia. As local complications, there were 3 cases of wound infection and 2 cases of an immediate reoperation caused by bleeding and one case of delayed wound. revision for a contaminated perigraft hematoma. As a systemic complication, there was one case of renal insufficiency, which required hemodialysis and one case of respiratory insufficiency that needed prolonged ventilator care. The mean admission period was $30{\pm}21$ days. All the patients were followed up for $626{\pm}542$ days without reoperation or other problems. Conclusion: Using properly selected patients and a careful approach, thoracoabdominal aortic replacement can be performed safely as a secondary aortic surgery.