Between January 1992 and December 1995, 23 patients with chronic lower back pain involving lumbar disc degeneration and spinal stenosis underwent decompression and posterior lumbar interbody fusion. Two groups of patients were studied, and clinical symptoms, neurological signs and clinical results were compared. With regard to mechanical back pain and clinical results, posterior lumbar interbody fusion was superior to decompression, but as regards leg pain and neurologic signs, the two groups were similar. Posterior lumbar interbody fusion was of considerable benefit to patients with chronic lower back pain.
Back Pain ; Decompression* ; Humans ; Intervertebral Disc Degeneration ; Leg ; Low Back Pain* ; Neurologic Manifestations ; Spinal Stenosis*

No abstract available.
Animals ; Cloning, Molecular* ; Interleukin-2* ; Mice*

PURPOSE: To assess the value of gray-scale stimulated acoustic emission in differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma. MATERIALS AND METHODS: Twenty-four cases of epatocellular carcinoma (HCC) in 23 patients and 26 cases of metastatic adenocarcinoma in 14 patients were prospectively examined using the pulse-inversion harmonic technique after intravenous SH U 508A administration. Gray-scale stimulated acoustic emission (SAE) was measured 5 mins after bolus injection of a contrast agent (4g, 400 mg/ml). The presence or absence of SAE signals at internal and marginal areas of the tumor and the appearance (smooth or irregular) of its border were compared. In addition, the SAE index [SAE (parenchyma) - SAE (tumor)/ SAE (parenchyma)] was histographically determined using a computerized program (PiView TM ; Mediface, Seoul, Korea). The statistics were analysed using student'st test. RESULT: Of the 24 HCC cases, 20 (83%) showed internal SAE signals, while 23 (96%) marginal signals were emitted. Of the 26 cases of metastatic adenocarcinoma, one (4%) showed internal SAE signals, while in five (19%), these signals were marginal. The tumoral border was irregular in 19 HCC lesions (79%) and smooth in 23 metastatic lesions (88%). For HCC and metastatic tumors, the mean SAE index was 0.38 +/-0.15 and 0.60 +/- 0.08, respectively (p < 0.001). CONCLUSION: Gray-scale stimulated acoustic emission can be a useful tool in differential diagnosis between heatocellular carcinoma and metastatic adenocarcinoma.
Acoustics* ; Adenocarcinoma* ; Carcinoma, Hepatocellular* ; Diagnosis, Differential* ; Humans ; Liver Neoplasms ; Microbubbles ; Prospective Studies ; Seoul

No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal*

No abstract available.
Animals ; Cell Line* ; Mice* ; Polymerase Chain Reaction ; Stem Cells*

No abstract available.
Tibial Fractures*

Objective: : To evaluate the stent apposition of a low-profile visualized intraluminal support (LVIS) device in distal internal carotid artery (ICA) aneurysms, examine its correlation with clinical and angiographic outcomes, and determine the predictive factors of ischemic adverse events (IAEs) related to stent-assisted coiling. Methods: : We retrospectively analyzed a prospectively maintained database of 183 patients between January 2017 and February 2020. The carotid siphon from the cavernous ICA to the ICA terminus was divided into posterior, anterior, and superior bends. The anterior bends were categorized into angled (V) and non-angled (C, U, and S) types depending on the morphology and measured angles. Complete stent apposition (CSA) and incomplete stent apposition (ISA) were evaluated using unsubtracted angiography and flat-panel detector computed tomography. Dual antiplatelet therapy with aspirin 200 mg and clopidogrel 75 mg was administered. Clopidogrel resistance was defined as fewer responders (≥10%, <40%) and non-responders (<10%) based on the percent inhibition (%INH) of the VerifyNow system. These were counteracted by a dose escalation to 150 mg for fewer responders or substitution with cilostazol 200 mg for non-responders. IAEs included intraoperative in-stent thrombosis, transient ischemic attack, cerebral infarction, and delayed in-stent stenosis. A multivariate logistic regression analysis was used to determine the predictive factors for ISA and IAEs. Results: : There were 33 ISAs (18.0%) and 27 IAEs (14.8%). The anterior bend angle was narrower in ISA (-4.16°±25.18°) than in CSA (23.52°±23.13°) (p<0.001). The V- and S-types were independently correlated with the ISA (p<0.001). However, treatment outcomes, including IAEs (15.3% vs. 12.1%), aneurysmal complete occlusion (91.3% vs. 88.6%), and recanalization (none of them), did not differ between CSA and ISA (p>0.05). The %INH of 27 IAEs (13.78%±14.78%) was significantly lower than that of 156 non-IAEs (26.82%±20.23%) (p<0.001). Non-responders to clopidogrel were the only significant predictive factor for IAEs (p=0.001). Conclusion : The angled and tortuous anatomical peculiarity of the carotid siphon caused ISA of the LVIS device; however, it did not affect clinical and angiographic outcomes, while the non-responders to clopidogrel affected the IAEs related to stent-assisted coiling.

No abstract available.
Catheters ; Stents

OBJECTIVES: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. METHODS: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. RESULTS: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I=1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). CONCLUSIONS: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.
Emergencies* ; Epidemiology ; Female ; Friends ; Gyeonggi-do ; Humans ; Korea ; Logistic Models ; Methods ; Psychology ; Referral and Consultation* ; Suicide*

No abstract available.
Meconium* ; Peritonitis* ; Ultrasonography*