PURPOSE: To compare the pullout strength and insertion torque of proximally tapered screw (PT) with fully tapered screw (FT) and to investigate the correlation between the pullout strength and bone mineral density, morphology of pedicle, and insertion torque of the screw in osteoporotic lumbar spine. MATERIALS AND METHODS: Fifteen osteoporotic lumbar vertebrae from four white human cadavers were used. Bone mineral density, pullout strength and insertion torque were measured by dual energy x-ray absorptiometry, MTS and torque screw driver individually. RESULTS: The FT screw provided greater pullout force and insertion torque than the PT screw in 12 of 15 vertebrae tested (p<0.01). Pullout strength was correlated with insertion torque in PT (r=0.666, P=0.0006) and FT (r=0.464, P=0.19) screws. CONCLUSIONS: Results of this study indicate that the FT screws provide higher pullout strength and insertion torque than PT screws in osteoporotic lumbar spine and suggest that the development of tapered minor diameter may lead to an improved pedicle screw with high pullout strength and insertion torque. Nevertheless, further study is needed to investigate the effect of tapering the minor diameter on the mechanical bending strength of the screw.
Absorptiometry, Photon ; Bone Density ; Cadaver ; Humans ; Lumbar Vertebrae ; Spine* ; Torque

Spinal epidural hematomas can often result from a spinal tap, trauma, pregnancy, bleeding diathesis, vascular malformations, hypertension, etc. However, a spontaneous spinal epidural hematomas (SSEH) without any risk factors are relatively rare clinical entities and the clinical suspicion is very difficult in an acute setting. The outcome for patients with SSEH usually is determined by the speed of the diagnosis and the initiation of the appropriate treatment. We present a good surgical outcome of a rare case of acute SSEH without any risk factors. The patient presented initially with paresis of both upper and lower extremities, upper thoracic and neck pain and mild headache. We report the diagnosis and treatment method of SSEH in this case with a review of the relevant literature.
Diagnosis ; Disease Susceptibility ; Headache ; Hematoma* ; Hematoma, Epidural, Spinal ; Hemorrhage ; Humans ; Hypertension ; Lower Extremity ; Neck Pain ; Paresis ; Pregnancy ; Risk Factors* ; Spinal Puncture ; Spine* ; Vascular Malformations

This erratum is being published to correct the printing error on page 286 of the article entitled 'Panton-Valentine leukocidin positive Staphylococcus aureus isolated from blood in Korea' by Kim JS, Park JS, Song W, Kim HS, Cho HC, Lee KM, Kim EC in Korean J Lab Med 2007;27:286-91. DOI 10.3343/kjlm. 2007.27.4.286 as follows. The heading of the right column of the Table 1 was misprinted as methicillin-resistant, so it should be corrected to methicillin-susceptible.
Adult ; Amino Acid Substitution ; Brain Neoplasms/radiotherapy/surgery ; Breast Neoplasms/diagnosis/radiotherapy/surgery ; Female ; *Genetic Counseling ; Genetic Predisposition to Disease ; *Germ-Line Mutation ; Humans ; Li-Fraumeni Syndrome/*diagnosis/genetics/therapy ; Mutation, Missense ; Pedigree ; Tumor Suppressor Protein p53/*genetics

Primary pulmonary hypertension is a rar, incurable, and progressive clinical entity. When associated with pregnancy, the prognosis of primary pulmonary hypertension is worsened with maternal mortality rates of at least 50%. The patient was a 29-year-old mother in her 2nd pregnancy, with previous uncomplicated gestation, 5 years ago. She had been well until the 28th week of present gestation when she was admitted because of increasing dyspnea on exertion. She was a housewife with no remarkable family and past histories. We have experienced a patient with primary pulmonary hypertension in pregnancy. She was treated with an oral calcium-channel blocker and low-molecular-weight heparin and was delivered vaginally with good maternal and fetal outcome. So we report a case of primary pulmonary hypertension associated with pregnancy and review literature.
Adult ; Dyspnea ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary* ; Maternal Mortality ; Mothers ; Pregnancy* ; Prognosis

PURPOSE: To determine if MR myelography (MRM) improves the interpretation of the severity of stenosis in patients with a multi-level lumbar stenosis. MATERIALS AND METHODS: Among the patients referred for MRI with MRM prospectively, 100 patients over 50 years old with multiple lumbar stenosis were enrolled in this study. The most severe stenotic level and the degree of stenosis at that level according to the extent of the remaining subarachnoidal space (1: normal to 50%, 2: over 50% but not a total block, 3: total block) were evaluated in a blinded manner by two observers. Conventional MRI (class A), MRM (class B) and MRI+MRM (class C) was evaluated independently and the interobserver and intraobserver reliability were assessed. RESULTS: In the selection of the most severe level and degree of stenosis, both observers showed a higher level of consensus with classes B and C than classes A and C. The interobserver k average values for the selection of the most severe level in classes A, B and C were 0.649, 0.782 and 0.832, respectively. In terms of the degree of stenosis, the average in classes A, B and C were 0.727, 0.771 and 0.784, respectively. The intraobserver k values for the above two items were the highest in class (B), followed by (C) and (A) in all observers and within the range of "almost perfect" (0.81< or =k< or =1) except for the selection of the level of one observer in clause A. CONCLUSION: MRM when used in routine practice can help improve the observer reliability in assessing the severity of stenosis in multiple lumbar stenosis.
Consensus ; Constriction, Pathologic* ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Myelography ; Prospective Studies

BACKGROUND: There has been a nationwide increase in infections caused by Staphylococcus aureus resistant to multiple antimicrobial agents in Korea. Although nationwide antimicrobial resistance pro-files have been reported recently by analysing routine antimicrobial test results, a more extensive resistance profile survey including those agents that are not used routinely is required for the inferring the mechanism of antimicrobial resistance. We assessed the resistance profiles of a variety of antimicrobial agents on Korean nationwide collection of S. aureus strains and analyzed the profiles according to methicillin resistance. METHODS: We collected a total of 253 clinical isolates of S. aureus from 13 clinical laboratories over the country during a month in 2002. Antimicrobial susceptibility testings were performed with 21 antimicrobial agents by disk diffusion method. Methicillin-resistant S. aureus (MRSA) isolates were also confirmed by the PCR detection of mecA gene. RESULTS: More than 90% of MRSA strains were resistant to the following antimicrobial agents tested: -lactams (92.0-98.3%), gentamicin (92.5%), tobramycin (94.9%), erythromycin (96.6%), and cip-rofloxacin (94.3%). But only 0-29% of methicillin-susceptible S. aureus (MSSA) strains were resistant to those agents. MRSA and MSSA strains were respectively resistant to chloramphenicol in 4.0% and 2.5%, rifampin in 12.1% and 1.3%, trimethoprim-sulfamethoxazole in 22.4% and 1.3%, and amikacin in 51.7% and 3.8%. No isolates were resistant to vancomycin and teicoplanin. Falsely susceptible results against beta-lactams in MRSA ranged from 1.7-7.5%. No significant differences in susceptibility were noted against the agents within the same classes such as macrolide and fluoroquinolone. The PCR results of mecA gene correlated 100% with the results of oxacillin disk diffusion test. CONCLUSIONS: Methicillin resistance in S. aureus was an indication of resistance against beta-lactams, gentamicin, tobramycin, macrolide, and fluoroquinolone in Korea. However, MRSA still retained the susceptibility to chloramphenicol, rifampin, and trimethoprim-sulfamethoxazole. This study may provide antimicrobial resistance profiles necessary for the understanding of antimicrobial resistance mechanisms of S. aureus.
Amikacin ; Anti-Infective Agents ; beta-Lactams ; Chloramphenicol ; Diffusion ; Erythromycin ; Gentamicins ; Korea ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxacillin ; Polymerase Chain Reaction ; Rifampin ; Staphylococcus aureus* ; Teicoplanin ; Tobramycin ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin

BACKGROUND: Many methicillin-resistant Staphylococcus aureus (MRSA) isolates in Korea possess a specific profile of staphylococcal enterotoxins in that the toxic shock syndrome toxin gene (tst) coexists with the staphylococcal enterotoxin C gene (sec). Because the analysis of staphylococcal cassette chromosome mec (SCCmec), a mobile genetic element mecA gene encoding methicillin resistance, showed that majority of these are SCCmec type II, these MRSA isolates with tst and sec may be genetically related with each other. This study was performed to investigate the genetic relatedness of tstand sec-harboring MRSA strains isolated in Korea by using pulsed-field gel electrophoresis (PFGE). METHODS: A total of 59 strains of MRSA isolates of SCCmec type II possessing tst and sec were selected for PFGE and phylogenetic analyses. These isolates were collected from 13 health care facilities during nationwide surveillance of antimicrobial resistance in 2002. RESULTS: The 59 MRSA isolates were clustered into 11 PFGE types, including one major group of 26 strains (44.1%) isolated from 7 healthcare facilities. Seven PFGE types contained 2 or more isolates each, comprising 55 isolates in total. CONCLUSIONS: Most of SCCmec type II MRSA isolates containing tst and sec showed closely related PFGE patterns. Moreover, MRSA isolates collected from different healthcare facilities showed identical PFGE patterns. These findings suggested a clonal spread of MRSA strains possessing tst and sec in Korean hospitals.
Bacterial Toxins/*genetics ; Chromosomes, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Enterotoxins/*genetics ; Humans ; Methicillin Resistance/*genetics ; Phylogeny ; Staphylococcal Infections/epidemiology/microbiology ; Staphylococcus aureus/drug effects/*genetics/isolation & purification ; Superantigens/*genetics

The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary. It is the most common type of all virillizing ovarian tumors, accounting for less than 0.5% of all primary ovarian neoplasm. Recently, we experienced two cases of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.
Amenorrhea ; Female ; Ovarian Neoplasms ; Ovary* ; Sertoli-Leydig Cell Tumor* ; Sex Cord-Gonadal Stromal Tumors

The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary. It is the most common type of all virillizing ovarian tumors, accounting for less than 0.5% of all primary ovarian neoplasm. Recently, we experienced two cases of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.
Amenorrhea ; Female ; Ovarian Neoplasms ; Ovary* ; Sertoli-Leydig Cell Tumor* ; Sex Cord-Gonadal Stromal Tumors

Functional paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system that causes symptoms and signs of episodic catecholamine release. It has not been reported in Korea. We experienced a case of a 17 years old man with a history of diaphoresis and paroxysmal hypertension refractory to therapy since 14 years old. Urinary execretion of catecholamine and its metabolites were elevated. Computed tomography(CT) scan revealed high density mass located on the posterior mediastinum in the area of the right fifth intercostal space. At thoracotomy, a 3X3X4cm sized lesion was resected and confirmed as a paraganglioma.
Adolescent ; Humans ; Hypertension* ; Korea ; Mediastinum* ; Paraganglioma* ; Pheochromocytoma ; Thoracotomy