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.

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

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

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

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

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.
Paraplegia* ; Spondylitis, Ankylosing*

PURPOSE: This study was designed to investigate the significance of preoperative serum CA 19-9 level as a prognostic factor and postoperative serum CA 19-9 level as an indicator for recurrence in gastric adenocarcinoma patients. MATERIALS AND METHODS: 328 patients, who received curative resection of stomach for gastric cancer from 1989 to 1996 and followed up successfully, were analyzed retrospec- tively. Median follow-up period was 24 months (range: 11-38 months). The cut off level of serum CA 19-9 was 37 U/ml. The relationships between preoperative serum CA 19-9 status and prognostic parameters, recurrence and survival rate were analyzed. Multivariate analysis using Cox proportional hazards regression analysis was performed to evaluate as an independent prognostic factor. The relationship between postoperative serum CA 19-9 level and recurrence was investigated. RESULTS: Out of 328 cases, 29 cases (8.8%) showed elevated preoperative serum CA 19-9 level. The preoperative serum CA 19-9 level was correlated with the degree of depth of invasion and the status of lymph node metastasis (p<0.05). Patients with positive pre- operative serum CA 19-9 status showed higher incidence of recurrence (p<0.05) and poorer survival rate (p=0.00003) than patients with negative status. Preoperative serum CA 19-9 status (risk ratio: 3.4464, p=0.0039) revealed as an independent prognostic factor in multivariate analysis. Postoperative serum CA 19-9 status revealed as a useful predictor for recurrence in patients with positive preoperative serum CA 19-9 status. CONCLUSION: Preoperative serum CA 19-9 determination in patients with gastric cancer was valuable for predicting tumor progression and prognosis. Preoperative serum CA 19-9 status may be helpful to predict recurrence earlier than other diagnostic tools, especially in the patients with positive preoperative serum CA 19-9 status.
Adenocarcinoma* ; Follow-Up Studies ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Stomach ; Stomach Neoplasms ; Survival Rate