STUDY DESIGN: This is a retrospective study analyzing 73 patients treated by decompression, pedicular screw instrumentation and posterior lumbar interbody fusion (PLIF) for lumbosacral spondylolithesis and symptomatic spinal stenosis. we used laminected laminar and spinous process instead of iliac bone. OBJECTIVES: This is to evaluate fusion rate and clinical results of PLIF with laminected laminar and spinous process. MATERIALS AND METHODS: PLIF in 73 patients with lumbosacral disorders who carried out at Pohang St. Mary's Hospital from March 1994 to January 1996. Fusion rate was evaluated by simple X-ray and dynamic view. Clinical effect was evaluated by Kirkaldy-Willis criteria. RESULTS: The solid fusion was achieved at 67 cases(91.8%) and the average period of fusion was 6.4 months. Complications were 2 cases of superficial skin infection and 3 cases of root irritation. The functional results by Kirkaldy-Willis were as follows ; excellent 40 cases, good 23 cases, fair 9 cases and poor 1 case. CONCLUSIONS: This PLIF procedure combined with transpedicular instrumentation showed sufficient fusion rate and excellent clinical results and improvement in vertebral alignment.
Decompression ; Gyeongsangbuk-do ; Humans ; Retrospective Studies ; Skin ; Spinal Stenosis

PURPOSE: The aim of the study is to determine whether late preterm infants from normal oral GTT (glucose tolerance test) but positive GCT (glucose challenge test) mothers are associated with adverse postnatal outcome. METHODS: A retrospective study was performed from singleton infants who were born at 34(+0)-36(+6) weeks between January 2008 and December 2012 and prenatally checked at CHA Gangnam Medical Center. Infants were categorized into three groups according to the results of 50 g oral GCT and 100 g oral GTT; NG group (normal glucose tolerance group, n=603) vs. GIG group (gestational impaired glucose tolerance group; infants of normal oral GTT but positive GCT mothers, n=77) vs. GDM group (gestational diabetes group, n=52). Neonatal outcomes were compared among the three groups. RESULTS: GIG group showed significantly increased incidence of jaundice compared to NG group (9.6% vs. 19.5%, P=0.031). The number of old mothers (> or =35 years at delivery) was significantly higher in GIG group compared to NG group (27.5% vs. 33.8%, P=0.006). After stratification by maternal age, GIG group showed significantly increased respiratory diseases compared to NG group (44% vs. 65.4%, P=0.04). Hypocalcemia and feeding problem increased across the groups (NG vs. GIG vs. GDM; 13.3% vs. 26.9% vs. 32.0%, P= 0.024; 6.0% vs. 11.5% vs. 20.0%, P=0.05, respectively). CONCLUSION: Late preterm infants of normal oral GTT but positive GCT mothers, especially in older mother, have increased risk of postnatal morbidities such as respiratory distress, jaundice, hypocalcemia or feeding intolerance. Thus, careful follow up may be needed in this group since antepartum period.
Diabetes, Gestational* ; Diagnostic Tests, Routine* ; Female ; Follow-Up Studies ; Glucose ; Glucose Intolerance ; Humans ; Hypocalcemia ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Jaundice ; Mass Screening* ; Maternal Age ; Mothers* ; Pregnancy ; Retrospective Studies

We would like to correct the author affiliations.

Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys are frequently involved. Clinical diagnosis of SLE is based on the criteria of American Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria but were antinuclear antibody (ANA)-negative have been reported. It was reported that critical factor in ANA positivity is the choice of substrate. It is generally accepted that the cultured cell of human origin, especially HEP-2 cell, is better than tissue section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE patients when human tissue culture cells are used as substrate. We report a 25-year-old man admitted to our hospital because of generalized edema. He was found to have active lupus nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody were positive.
Adult ; Animals ; Antibodies, Antinuclear ; Autoimmune Diseases ; Cells, Cultured ; Diagnosis ; DNA ; Edema ; Humans ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Pancytopenia ; Rheumatic Diseases

Angiogenesis is a fundamental biological process including endothelial cell adhesion, migration, invasion and tube formation. Integrin receptors of endothelial cells play important roles in angiogenesis. They mediate cell-cell contact and cell adhesion to extracellular matrix. Roles of integrins have been described for a number of cell types. ECV304 endothelial cells were known to overexpress alpha3beta1 integrin and to form tube like structure in 3-D Matrigel culture. However the function of alpha3beta1 integrin in endothelial cells remains to be determined. Therefore, we have investigated morphological characteristics of ECV304 cells and roles of alpha3beta1 integrin in angiogenesis. To elucidate several characteristics, ECV304 endothelial cells were compared with HUVEC in the aspect of morphology, localization of integrins, angiogenesis pattern. In addition, role of alpha3beta1 integrin were analyzed in the aspect of endothelial cell binding, migration, invasion and tube formation on Matrigel. The result showed that alpha3beta1 integrin overexpressed ECV304 endothelial cells showed strong adhesiveness to extracellular matrix proteins, and high migration and invasion activities. Furthermore, expression of alpha3beta1 integrin was increased according to time course during in vitro culture and was continuously strong in ECV304 cells on 3-D Matrigel culture. These results indicate that alpha3beta1 integrin is able to be a critical component in control of angiogenesis by regulation of cell adhesion, migration, invasion and tube formation of ECV304 endothelial cells.
Adhesiveness ; Biological Processes ; Cell Adhesion ; Endothelial Cells* ; Extracellular Matrix ; Extracellular Matrix Proteins ; Integrin alpha3beta1* ; Integrins

Marfan syndrome is a hereditary disorder of connective tissue fibers, involving skeleton, eye and cardiovascular system. The cardiovascular complications, directly related to the cause of death, are associated with about 90% of the Marfan syndrome. The cardiovascular complications are aortic and mitral insufficiency, mitral valvular prolapse, bacterial endocarditis, arrhythmia and aneurysm of interatrial septum and aorta. Among the cardiovascular complications, bacterial endocarditis is unusual. The aortic valve, though commonly abonormal in Marfan syndrome, was rarely involved by endocarditis. In contrast the mitral valve was the favoured site of infection in these patients. The low incidence of aortic valve involvement remains unexplained. There is extreme mortality in Marfan patients affected by endocarditis. A 22-year-old man was admitted to Wallace Memorial Baptist Hospital because of intermittent fever with chill, dyspnea and orthopnea. He had characteristic Marfanoid features such as a slender body with sparsity of subcutaneous fat, arachnodactly and disproprtionate long extremities, axial myopia as well as suspicious family history. Three blood cultures produced a slowly growing gamma-hemolytic streptococcus sensitive to penicillin. Chest X-ray revealed increased C-T ratio and generalized congested lung parenchyme and increased lung markings with multiple dense, horizontal lines, so called Kerley's B lines. Echocardiogram showed thickened bicuspid arotic valve with vegetation and enlarged left ventricular cavity, grade 3/4 mitral and aortic regurgitation. The authors have experienced a rare case of Marfan syndrome with subacute infective endocarditis.
Aneurysm ; Aorta ; Aortic Valve ; Aortic Valve Insufficiency ; Arrhythmias, Cardiac ; Bicuspid ; Cardiovascular System ; Cause of Death ; Connective Tissue ; Dyspnea ; Endocarditis ; Endocarditis, Bacterial ; Endocarditis, Subacute Bacterial* ; Estrogens, Conjugated (USP) ; Extremities ; Fever ; Humans ; Incidence ; Lung ; Marfan Syndrome* ; Mitral Valve ; Mitral Valve Insufficiency ; Mortality ; Myopia ; Penicillins ; Prolapse ; Protestantism ; Skeleton ; Streptococcus ; Subcutaneous Fat ; Thorax ; Young Adult

PURPOSE: The subareolar area is often difficult to evaluate ultrasonographically due to tissue shadowing, which obscures visualization of ducts and parenchymal tissue. The purpose of this study is to determine if real-time compound imaging improves evaluation of normal subareolar tissue and solid nodules in subareolar area compared to conventional ultrasonography. METHODS: 190 images of the subareolar area were obtained from 135 patients from March 2001 to July 2002. Thirty-three of 190 images showed solid nodules, extraductal nodules in 30 and intraductal nodules in three. We scanned both conventional and compound imaging with a stationary probe, to maintain an identical projection and tissue pressure. We used two compound techniques; survey mode (S) is made by 3 coplanar images and target mode (T) by 9 coplanar images. The evaluating points were 1) reduction in the density of shadowing, 2) resolution of duct wall, 3) resolution of duct lumen, 4) margin of nodule, and 5) internal echoes of nodule. In a blinded fashion, three radiologists graded the quality of images on a 5-point scale. RESULTS: For reviewer 1/2/3, S showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.1 0.6/0.5+/-0.5), 2) resolution of duct wall (0.9+/-0.2/1.5+/-0.6/1.0+/-0.5), 3) resolution of duct lumen (0.9+/-0.2/1.6 +/-0.6/0.7+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.5/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/- 0.5/1.2+/-0.4) and T showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.2+/-0.6/0.7+/-0.7), 2) resolution of duct wall (1.0+/-0.3/1.5+/-0.6/1.1+/-0.5), 3) resolution of duct lumen (0.9+/-0.3/1.6+/-0.6/0.8+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.6/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/-0.6/1.3+/-0.4). In all evaluating points, two modes of real-time compound imaging were superior to conventional imaging (P<0.05). There was no significant difference between two modes of compound imaging. CONCLUSION: Real-time compound imaging improves evaluation of normal subareolar tissue and subareolar solid nodules compared to conventional ultrasonography by reducing shadowing and increasing anatomic resolution of ducts.
Breast ; Humans ; Shadowing (Histology) ; Ultrasonography*

OBJECTS: 99mTc-lactosylated human serum albumin (LSA) is a newly synthesized radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically presented on the hepatocyte membrane. Hepatic uptake and blood clearance of LSA were evaluated in rat with acute hepatic injury induced by dimethylnitrosamine (DMN) and results were compared with corresponding findings of liver enzyme profile and these of histologic changes. MATERIALS AND METHODS: DMN (27 mg/kg) was injected intraperitoneally in Sprague-Dawley rat to induce acute hepatic injury. At 3 (DMN-3), 8 (DMN-8), and 21 (DMN-21) days after injection of DMN, LSA injected intravenously, and dynamic images of the liver and heart were recorded for 30 minutes. Time-activity curves of the heart and liver were generated from regions of interest drawn over liver and heart area. Degree of hepatic uptake and blood clearance of LSA were evaluated with visual interpretation and semiquantitative analysis using parameters (receptor index : LHL3 and index of blood clearance : HH3), analysis of time-activity curve was also performed with curve fitting using Prism program. RESULTS: Visual assessment of LSA images revealed decreased hepatic uptake in DMN treated rat, compared to control group. In semiquantitative analysis, LHL3 was significantly lower in DMN treated rat group than control rat group (DMN-3: 0.842, DMN-8: 0.898, DMN-21: 0.91, Control: 0.96, p< 0.05), whereas HH3 was significantly higher than control rat group (DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, Control: 0.473, p< 0.05). AST and ALT were significantly higher in DMN-3 group than those of control group. Centrilobular necrosis and infiltration of inflammatory cells were most prominent in DMN-3 group, and were decreased over time. CONCLUSION: The degree of hepatic uptake of LSA was inversely correlated with liver transaminase and degree of histologic liver injury in rat with acute hepatic injury.
Animals ; Asialoglycoprotein Receptor ; Dimethylnitrosamine* ; Heart ; Hepatocytes ; Humans ; Liver* ; Membranes ; Necrosis ; Radionuclide Imaging* ; Rats* ; Rats, Sprague-Dawley ; Serum Albumin*

Pylephlebitis is defined as an inflammation of the portal system, which is a rare but dreaded complication of intra-abdominal inflammatory processes. In the past it was observed as a sequela of neglected or complicated appendicitis. With earlier diagnosis, modern surgical technique and antibiotics, the incidence has declined even further. In addition, thrombosis in portal system (pylethrombosis) can complicate the pylephlebitis, followed by obstruction of the portal system, leading to portal hypertension in the late stage. Proper recognition of early thrombosis and an accompanying intra-abdominal inflammatory process should arouse the suspicion of septic thrombophlebitis and lead to the early institution of adequate therapy to prevent the almost universally fatal outcome. We report the case of woman who had pylephlebitis and presented with fever of unknown origin, probably associated with acute appendicitis.
Anti-Bacterial Agents ; Appendicitis ; Diagnosis ; Fatal Outcome ; Female ; Fever of Unknown Origin* ; Fever* ; Humans ; Hypertension, Portal ; Incidence ; Inflammation ; Portal System ; Portal Vein* ; Thrombophlebitis* ; Thrombosis

The demand for medical care and welfare for patients with disabilities is expanding, and healthcare professionals are also increasingly interested in the need for medical care for patients with disabilities. The purpose of this study was to evaluate the competency of disabled patients' management and the education experience of dental hygiene students, who are the main players of oral health care for disabled patients. A total of 196 students in the dental hygiene department and 3rd and 4th grade students were surveyed using questionnaires. As a result, most of the students had a positive awareness of disabled patients; 84.7% answered with the need to train dental hygienists in specializing in handicapped patients, 76.5% were willing to attend seminars related to disabled patients after graduation, and 71.4% of the students provided dental treatment for patients with disabilities in curriculum and comparative curriculum. The students who provided treatment for disabled patients showed that their competence in most areas of knowledge of disabled patients, oral health education, and oral disease prevention was highly evaluated as significant. The competence of respondents who answered that the theoretical education was sufficient was significantly higher. Based on this, institutional support for the education of dentistry for disabled patients is needed, and sufficient theoretical education and practical training should be offered to foster personnel capable of contributing to the improvement in the oral health of patients with disabilities. In addition, in-depth discussions on the training of dental hygienists specialized in handicapped patients should be conducted.
Clinical Competence* ; Curriculum ; Delivery of Health Care ; Dental Care for Disabled ; Dental Hygienists ; Disabled Persons ; Education ; Humans ; Mental Competency ; Oral Health ; Oral Hygiene* ; Surveys and Questionnaires