The authors analyzed 52 patients with traumatic cervical fracture and dislocation admitted to the department of neurosurgery, Gyeongsang National University Hospital between July, 1989 and December, 1993. The most common age group was 21-30 years old, and 46 were male. The most frequent cause of injury was motor vehicle accident. High cervical injuries were 11 cases and mid-low cervical injuries were 41 cases. 34 cases had surgical intervention by anterior approach with bone graft only(5), anterior approach with bone graft and instrumentation(9), posterior approach with wiring and bone graft(18) and total laminectomy(2). The others had conservative treatment and immobilized by traction(9), Halo-vest(8) or neck collar(1). The average post of immobilization of conservatively treated patients was 9.7weeks, anterior approach without instrumentation was 9 weeks and posterior approach was 5.4 weeks, but patients who treated by anterior approach with instrumentation keep soft collar only. At final follow-up, no significant differences were noted between surgically and conservatively treated group but initial neurologic state correlates with prognosis, independent of modality of treatment. Thus the surgical intervention does not significantly influence the prognosis of the patient but shortens the duration of postoperative immobilization.
Dislocations* ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Motor Vehicles ; Neck ; Neurosurgery ; Prognosis ; Transplants

Digital infrared thermographic imaging system is noninvasive, easy to reading, objective and physiologic instrument by measuring and imaging infrared energy emitted from skin surface. The authors present the result of digital infrared thermographic images of 83 patients of operated lumbar disc herniation from October, 1990 to March, 1991. 46 patients have received discectomy and the other 37 patients have received chemonucleolysis. We have done digital infrared thermographic imaging preoperatively and postoperatively. In preoperative digital infrared thermographic imaging, diagnostic sensitivity is about 76%, In postoperative digital infrared thermographic imaging, clinical results were well correlated in discectomy group. But in chemonucleolysis group, clinical results were not correlated with digital infrared thermographic images.
Diagnostic Imaging ; Diskectomy ; Humans ; Intervertebral Disc Chemolysis ; Skin

Background and Objectives: The aim of this study was to determine the clinical effectiveness of parotid gland (PG) massage for the prevention of PG dysfunction after administration of radioiodine (I-131) therapy for treatment of differentiated thyroid cancer (DTC). Materials and Methods: One hundred patients with DTC with planned high-dose I-131 therapy were enrolled in the clinical trial and randomized into two groups (massage and non-massage group). Serum amylase values were obtained before and 24 h after I-131 therapy, and salivary gland scintigraphy (SGS) were taken before and at eight months after the I-131 therapy. Additional SGS (addSGS) were taken when the patients complained symptoms related to salivary gland dysfunction. Questionnaire surveys were performed before and until two years after I-131 therapy. Results Ninety-five of 100 patients finished the study protocol. Changes in survey scores tended to be higher in the non-massage group. The non-massage group had more severe symptoms related to salivary gland dysfunction. Among 32 patients who underwent addSGS, 27 had normal 8-month SGS. Of these 27 patients, 18 (66.7%) had salivary gland dysfunction on the addSGS. Amylase values were significantly increased in patients with normal 8-month SGS but abnormal addSGS, as compared to patients who were normal on both 8-month SGS and addSGS (p=0.046). Amylase difference values were a significant predictor of abnormal addSGS (p=0.002). Conclusion: PG massage reduced symptoms related to salivary gland dysfunction. The PG massage may be helpful in preventing damage to salivary glands caused by I-131 therapy.

Radioactive iodine (RAI) therapy for differentiated thyroid cancer has been successfully used for more than 70 years. However, there is still plenty of controversy surrounding the use and doses of radioiodine. There is insufficient evidence to answer the questions. Recent American Thyroid Association (ATA) guidelines seem to favor low-dose RAI, based on recent clinical trials and meta-analyses. However, long-term follow-up data remains limited, and there are additional factors we should consider that might affect the efficacy of RAI therapy. Therefore, until sufficient data are available, it is necessary to remain cautious about determining RAI doses by considering multiple patient-specific variables.
Follow-Up Studies ; Iodine ; Thyroid Gland ; Thyroid Neoplasms

Background and Objectives: The aim of this study was to determine the clinical effectiveness of parotid gland (PG) massage for the prevention of PG dysfunction after administration of radioiodine (I-131) therapy for treatment of differentiated thyroid cancer (DTC). Materials and Methods: One hundred patients with DTC with planned high-dose I-131 therapy were enrolled in the clinical trial and randomized into two groups (massage and non-massage group). Serum amylase values were obtained before and 24 h after I-131 therapy, and salivary gland scintigraphy (SGS) were taken before and at eight months after the I-131 therapy. Additional SGS (addSGS) were taken when the patients complained symptoms related to salivary gland dysfunction. Questionnaire surveys were performed before and until two years after I-131 therapy. Results Ninety-five of 100 patients finished the study protocol. Changes in survey scores tended to be higher in the non-massage group. The non-massage group had more severe symptoms related to salivary gland dysfunction. Among 32 patients who underwent addSGS, 27 had normal 8-month SGS. Of these 27 patients, 18 (66.7%) had salivary gland dysfunction on the addSGS. Amylase values were significantly increased in patients with normal 8-month SGS but abnormal addSGS, as compared to patients who were normal on both 8-month SGS and addSGS (p=0.046). Amylase difference values were a significant predictor of abnormal addSGS (p=0.002). Conclusion: PG massage reduced symptoms related to salivary gland dysfunction. The PG massage may be helpful in preventing damage to salivary glands caused by I-131 therapy.

Background and Objectives: Even though most of the thyroid cancer shows good prognosis, de-differentiated thyroid cancer is still refractory to conventional treatments. Recently, kinase inhibitors including multi-kinase and BRAF inhibitors are widely used for treatment of de-differentiated thyroid cancers, but resistant to single kinase inhibitor treatment eventually encountered. Therefore, combination therapy may have better therapeutic effect than single therapy for thyroid cancer. In this study, we evaluated therapeutic effect of multi-kinase and BRAF inhibitor combination to anaplastic thyroid cancer cell lines with and without BRAF mutation. Materials and Methods: We used anaplastic thyroid cancer cell lines with BRAF V600E mutation (8505C) and with NRAS mutation (HTh7). Both cell lines were treated with various concentration of multi-kinase inhibitor (lenvatinib) and BRAF inhibitor (vemurafenib). And combination of various concentration of both kinase inhibitors were used to treat both cell lines. Cytotoxic effect was assessed with cell counting kit-8 and therapeutic effect of single kinase inhibitor therapy and the combination therapy was compared. Results: Anti-proliferative effect of vemurafenib on 8505C BRAF V600E -mutated cells was demonstrated from 0.25 μM concentration. However, HTh7 cells with NRAS mutation represented drug resistance up to 4 μM of vemurafenib. In case of lenvatinib treatment as a multi-kinase inhibitor, 8505C and HTh7 cells showed decreased cell viability dose-dependent manner. Combination treatment with vemurafenib and lenvatinib showed synergistic cytotoxic effect in BRAF mutated 8505C cell line, even at lower concentrations. Conclusion Combination treatment with multi-kinase inhibitor and BRAF inhibitor showed promising therapeutic results in BRAF mutated anaplastic thyroid cancer cell line.

Radioactive iodine (RAI) therapy for differentiated thyroid cancer has been successfully used for more than 70 years. However, there is still plenty of controversy surrounding the use and doses of radioiodine. There is insufficient evidence to answer the questions. Recent American Thyroid Association (ATA) guidelines seem to favor low-dose RAI, based on recent clinical trials and meta-analyses. However, long-term follow-up data remains limited, and there are additional factors we should consider that might affect the efficacy of RAI therapy. Therefore, until sufficient data are available, it is necessary to remain cautious about determining RAI doses by considering multiple patient-specific variables.

BACKGROUND/AIMS: Screening for hepatocellular carcinoma (HCC) is a common practice in the endemic countries but its exact role has not been fully investigated. The purpose of this study was to determine whether screening can achieve early diagnosis and survival benefits. METHODS: All HCC patients diagnosed at our hospital (September 1994~April 2000) were enrolled; They were divided into two groups; a surveilled group screened with alpha-fetoprotein (AFP) and ultrasound (US) for longer than 6 months before diagnosis and a non-surveilled group. We compared the tumor size, portal vein thrombosis, and stage at initial diagnosis and survival rate between the two groups. RESULTS: A total of 247 patients were enrolled. 64 were in the surveilled group and 183 were in the non-surveilled group. The tumor size at initial diagnosis in the surveilled group was smaller than in the non-surveilled group (2.6+/-2.0 cm vs. 5.7+/-4.1 cm, p<0.05). The percentages of patients with stage I, II, III, and IV were 42.2%, 20.3%, 14.1%, 23.4% in the surveilled group and 8.7%, 19.7%, 36.6%, 35.0% in the non-surveilled group. A significantly higher proportion in the surveilled group had earlier stage compared with the non-surveilled group (p<0.05). Portal vein thrombosis in the surveilled group was noticed as significantly less than in the non-surveilled group (9.4% vs. 26.8%, p<0.05). Among Child-Pugh A patients, the cumulative survival rate in the surveilled group was significantly higher than in the non-surveilled group (1 year; 91.4% vs. 70.7%, 2 year; 71.5% vs. 59.9%, p<0.05). CONCLUSIONS: Screening with AFP and US is a useful tool for early diagnosis of HCC, especially with improved survival in Child-Pugh A patients.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis/mortality/therapy ; Female ; Humans ; Liver Neoplasms/*diagnosis/mortality/therapy ; Male ; Middle Aged ; Survival Rate ; alpha-Fetoproteins/analysis

PURPOSE: Methemoglobinemia is a disorder caused by over accumulation of methemoglobin in the red blood cells of circulating blood, prohibiting adequate supply of oxygen to organs. The seriousness of its clinical symptoms and its treatment methods are determined by the blood methemoglobin level. Therefore, we revealed the clinical relation between the blood methemoglobin level and oxygen saturation on a pulse oximeter. Then we tried to indirectly measure the blood methemoglobin level by using their relation, instead of checking its level through blood sampling. METHODS: The medical records of 39 patients who were admitted to the Chonnam University Hospital Emergency Medical Center due to acute methemoglobinemia between January 1, 2001, and June 30, 2005, underwent a prospective analysis. RESULTS: Among the total of 39 cases, there were 25 males (64.1%) and 14 females (35.9%). There were 15 cases (38.5%) of dapsone overdosage, 18 cases (46.1%) of aniline- type pesticide intoxication, and 6 cases (15.4%) of aniline gas inhalation. As for the main symptoms for admission to the emergency center, there were 8 cases involving on altered mental state, 7 involving dizziness, 3 involving cyanosis, 7 involving dyspnea; and 14 cases were nonsymptomatic. Relational analyses of arterial blood gas analysis results, pulse oximetry saturation levels, and blood methemoglobin levels of the admitted patients revealed that only the pulse oximetry saturation level was related to the blood methemoglobin level (p<0.001). CONCLUSION: When in doubt about the possibility of acute methemoglobinemia, differences in the oxygen saturation level on the pulse oximeter level can be used instead of repeated co-oximetry examinations, can be used to judge treatment responses.
Blood Gas Analysis ; Cyanosis ; Dapsone ; Dizziness ; Dyspnea ; Emergencies ; Erythrocytes ; Female ; Humans ; Inhalation ; Jeollanam-do ; Male ; Medical Records ; Methemoglobin* ; Methemoglobinemia* ; Oximetry ; Oxygen* ; Prospective Studies

A primary leiomyoma in the neural foramen of the lumbar spine is a very rare condition. We examined a 23-year-old female presented with back and right flank pain. A plain radiography showed a well-defined, osteolytic lesion in the L3 body. In addition, MR images showed a mass lesion with intense enhancement, after intravenous injection with contrast material, in the right neural foramen at the L2/3 level. A histopathologic examination of the resected specimen revealed a benign leiomyoma.
Female ; Flank Pain ; Humans ; Injections, Intravenous ; Leiomyoma* ; Lumbar Vertebrae ; Radiography ; Spine* ; Young Adult