Patients with lumbar spinal stenosis may exhibit symptoms such as back pain, radiating pain, and neurogenic claudication. Although long-term outcome of treatments manifests similar results for both nonsurgical and surgical treatments, positive effects such as short-term improvement in symptoms and decreased fall risk may be expected with surgery. Surgical treatment is basically decompression, and a combination of treatments can be added depending on the degree of decompression and the accompanying instability. Recently, minimally invasive surgery has been found to result in excellent outcomes in the treatment of lumbar spinal stenosis. Therefore, better treatment effects can be anticipated with an approach aimed at understanding the overall pathophysiology and treatment methods of lumbar spinal stenosis.

PURPOSE: The TransAtlantic Inter-Society Consensus offers the proper guidelines for the treatment of peripheral arterial disease (PAD). Many new devices and surgical techniques have been introduced to the medical field and these have been aggressively used to manage the patients with PAD. We performed this study to evaluate the current status of endovascular therapy based on the literature and we review the efficacy and safety of the new devices used in the field. METHODS: A search of the literature was performed in the PubMed and science websites. The keywords were "chronic total occlusions", "superficial femoral artery revascularization", "peripheral arterial disease" and "endovascular therapy". RESULTS: The variation of the results was large according to the studies. The rough technical success rate was 80~90% and the 1 year clinical success rate, the primary patency rate and the limb salvage rate for chronic total occlusions were approximately 50~70%, 50% and 80~90%. The efficacy and safety of the new devices used in the field were acceptable. CONCLUSION: Further refinement of the guidewires and sheaths and the development of adjunctive devices have allowed traversal of even the long lesions and this has increased the technical success. Although surgery remains the principal treatment for patients with lower limb ischemia, surgeons must now assess the benefits and risks associated with various treatment options, including endovascular therapy.
Consensus ; Femoral Artery ; Humans ; Ischemia ; Limb Salvage ; Lower Extremity ; Peripheral Arterial Disease ; Peripheral Vascular Diseases ; Risk Assessment

The increasingly successful results of hair restoration surgery in the last years have developed the interest and the confidence of patients and it is the most frequently performed esthetic surgery among male patients. Currently, various kinds of techniques for hair restoration surgery including hair transplantation, scalp reduction, and scalp flaps are performed in our clinic. Among these, hair transplantation is the basic and the most popular procedure, which can be performed not only by itself but also in conjunction with other procedures. 123 consecutive cases of hair transplantations were peformed from Jan. 1995 to Feb. 1996 for male pattern baldness, traumatic alopecia, and female pattern baldness under out patient base. The authors introduced a new classification for male pattern baldness, which are the type M, O, C, U, M-O, and C-O after alphabet to make simple and easy for clinical application. The ancillary procedures were scalp reduction, preauricular flap, and scalp expansion. An ellipsis of hair bearing scalp taken from the occipital area was sliced into slit-, mega-, mini-, and micro-grafts. The survival rate of the grafts was over 90% with minimal complications. This hair transplantation technique enabled us to achieve a good density and more natural looking hair with avoidance of cobble stoning and apparent scar.
Alopecia* ; Cicatrix ; Classification ; Hair* ; Humans ; Male* ; Scalp ; Surgery, Plastic ; Survival Rate ; Transplants

No abstract available.
Angioplasty* ; Carotid Artery, Internal* ; Carotid Stenosis*

PURPOSE: The purpose of this study was to evaluate the usefulness of CT-guided percutaneous needle aspiration(PCNA) of paraaortic and pelvic lymph nodes in patients with uterine cervical carcinoma. MATERIALS AND METHODS: CT-guided PCNA was performed in 18 patients with treated cervical carcinoma. initial clinical stages were CIS in one, lb in three, lib in ten, and IIIb in four cases. We used 20 gauge Westcott needles for aspiration. Mean depth from skin to lymph nodes was 10.0cm in paraaortic group (n=13) and was 7.9cm in pelvic group (n=5). The size of lymph nodes ranged 1.0-3.0cm (mean :1.8) and 1.5-5.0cm (mean :2.6cm), respectively. RESULTS: All cases with paraaortic lymph node enlargement were proved to be metastatic lymphadenopathy. In five cases with pelvic lymph node enlargement, three were proved to be malignancy and two were negative. Among 16 cases with metastatic lymphadenopathy, eight patients were treated with chemotherapy, five with radiation therapy, and three with chemotherapy and radiotherapy. In two cases with negative results lymph nodes were disappeared or unchanged on follow up CT scans. No complications were encountered during CT-guided PCNA procedure. CONCLUSION: CT-guided PCNA of paraaortic and pelvic lymph nodes is a useful method in determining metastasis from cervical carcinoma and in planning further treatment.
Biopsy, Fine-Needle* ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Lymphatic Diseases ; Needles ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen ; Radiotherapy ; Skin ; Tomography, X-Ray Computed

Hyperacute liver failure from mushroom intoxication in children is rare and has a low survival rate. We report a case of hyperacute liver failure from mushroom intoxication in a 29-month-old boy. The patient ingested a mushroom about three days prior to presentation. He was admitted to the hospital with vomiting, abdominal pain, seizures, and hematemesis. During the hospitalization the patient developed hepatic encephalopathy (stage IV-a), and a coagulopathy. He recovered fully with specific medication, Penicillin GK and N-acetylcysteine.
Abdominal Pain ; Acetylcysteine ; Agaricales ; Child ; Hematemesis ; Hepatic Encephalopathy ; Hospitalization ; Humans ; Liver ; Liver Failure ; Penicillins ; Preschool Child ; Seizures ; Survival Rate ; Vomiting

Hyperacute liver failure from mushroom intoxication in children is rare and has a low survival rate. We report a case of hyperacute liver failure from mushroom intoxication in a 29-month-old boy. The patient ingested a mushroom about three days prior to presentation. He was admitted to the hospital with vomiting, abdominal pain, seizures, and hematemesis. During the hospitalization the patient developed hepatic encephalopathy (stage IV-a), and a coagulopathy. He recovered fully with specific medication, Penicillin GK and N-acetylcysteine.
Abdominal Pain ; Acetylcysteine ; Agaricales ; Child ; Hematemesis ; Hepatic Encephalopathy ; Hospitalization ; Humans ; Liver ; Liver Failure ; Penicillins ; Preschool Child ; Seizures ; Survival Rate ; Vomiting

No abstract available.
Alopecia* ; Hair* ; Humans ; Male* ; Tissue Expansion*

No abstract available.
Paraplegia* ; Spondylitis, Ankylosing*

PURPOSE: CEA, CA19-9, and CA72-4 are the most commonly used tumor markers in stomach cancer. This clinical study was performed to evaluate the diagnostic value of these tumor markers in stomach cancer patients. MATERIALS AND METHODS: A retrospective analysis of 170 stomach cancer patients who had undergone curative gastrectomy between January 1991 and December 1996 at the Department of Surgery was performed. The preoperative and postoperative serum levels of these tumor markers were measured in 170 patients. RESULTS: The preoperative positive cases were 28 cases (16%) in CEA, 15 (9%) in CA19-9, and 24 (14%) in CA72-4. The postoperative positive cases among 48 recurrences were 21 cases (44%) in CEA, 10 (21%) in CA19-9, and 10 (21%) in CA72-4. The combination of CEA with CA19-9 or CA72-4 had higher positivity rate (58%) than single tumor marker. The highest positivity rate was found in CEA at recurrences of anastomotic site, in CA19-9 at recurrences of lymph node, in CA72-4 at peritoneal seeding and distant metastasis. In multivariate analysis, these tumor markers were not independent prognostic factors. CONCLUSION: CEA, CA19-9, and CA72-4 have proved unhelpful in initial diagnosis of stomach cancer because of their low positivity rate. And the combination of 3 tumor markers was the useful method for raising positivity rate in diagnosis of recurrences.
Diagnosis ; Gastrectomy ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Stomach* ; Biomarkers, Tumor*