No abstract available.
Submandibular Gland* ; Tuberculosis*

Degenerative lumbar spondylolisthesis requires fusion of the involved segments and decompression laminectomy because it is mechanically unstahle and usually associated with stenosis of the spinal canal. Transabdominal retroperitoneal approach through small longitudinal pararectal skin incision provides easy and safe access to L3-4 and L4-5 disc spaces with less bleeding. We thought that anterior interbody fusion enable us to restore the disc space and to reduce partially the listhesis with less hleeding and less harvest of graft hone compared to posterolateral fusion, and also without the risk of neural or dural damage which could he occurred in posterior lumbar interbody fusion 4.15.16.17). Thus, authors performed the same-day anterior and posterior spinal surgery (APSS) in 28 patients (30 disc spaces) from 1992 to 1996 and analyzed the clinical and radiological results. The most common site of involvement was L4-5 level (82.1%). The mean follow-up period was 2 years and 2 months (from l2 months to 4 years). Fusion was ohtained at 29 disc spaces (96.7%) within 24 weeks (average, I 6 weeks). The anterior displacement was corrected up to the average of 65.4% (5.8mm) postoperatively and the average of 60.7% (5.2mm) correction remained at last follow-up. The intervertebral disc space was restored up to the average of 96.9% (7.5mm) postoperatively and the average of 86.0% (6.2mm) restoration remained at last follow-up. Twenty-five out of 28 patients (89.2%) showed excellent or good clinical results hy the criteria of Kim, et al6). In conclusion, the same-day procedure of successive anterior interbody fusion, decompression laminectomy and posterior pedicular instrumentation for the degenerative lumbar spondylolisthesis associated with spinal stenosis was thought to be a good method of treatment.
Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Hemorrhage ; Humans ; Intervertebral Disc ; Laminectomy ; Skin ; Spinal Canal ; Spinal Stenosis ; Spondylolisthesis* ; Transplants

No abstract available.
Adult* ; Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

The ESHAP regimen, a combination of the chemotherapeutic drugs etoposide, methylprednisolone (solumedrol), high-dose cytarabine (ara-C), and cisplatin, has been shown to be active against refractory or relapsed non-Hodgkin's lymphoma (NHL) in therapeutic trials. We undertook this study to determine whether this regimen would be effective and tolerable in Korean patients. A total of 40 patients with refractory or relapsed NHL (8 indolent and 32 aggressive) were enrolled in this study. The overall response rate was 70% (95% confidence interval; 59.8-89.7%); 22.5% of patients achieved a complete response and 47.5% a partial response. The median survival duration was 12 months (95% confidence interval; 5.9-18.1 months) and the median duration of progression-free survival was 9 months (95% confidence interval; 1.1-16.9 months). The median survival duration of patients with relapsed NHL was longer than that of patients with refractory lymphoma (15 months vs 4 months, p=0.02). Myelosuppression was the most frequent complication and treatment-related mortality was noted in two patients. These results suggest that the ESHAP regimen is effective in patients with relapsed NHL who have a sensitive disease. The role of ESHAP chemotherapy in discriminating patients who are more likely to benefit from a subsequent transplant should be evaluated in the future.
Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/adverse effects ; Bone Marrow/drug effects ; Cisplatin/*administration & dosage/adverse effects ; Cytarabine/*administration & dosage/adverse effects ; Disease-Free Survival ; Drug Tolerance ; Etoposide/*administration & dosage/adverse effects ; Female ; Humans ; Lymphoma, Non-Hodgkin/*drug therapy ; Male ; Methylprednisolone/*administration & dosage/adverse effects ; Middle Aged ; Recurrence ; Retrospective Studies ; Salvage Therapy

BACKGROUND: Childhood obesity is becoming more prevalent, associated with a variety of adverse consequences which leads to adulthood obesity. Although diagnosis is usually made by body mass index, there is neither a cutoff point for the percentage body fat nor abdominal circumference. The aim of this study was to identify each cutoff point for both measures. METHODS: The measurement of height, weight, abdominal circumference and percentage body fat was performed through manual assessment and bioelectrical impedance analysis for 4,242 subjects aged 11 in Gunpo City, South Korea. The cutoff point for body fat percentage and abdominal circumference is set to maximize the sum of sensitivity and specificity for detecting obesity and overweight using the Receiver Operating Characteristics (ROC) curve. RESULTS: The mean percentage body fat was 13.6+/-6.9% for boys and 19.4+/-5.3% for girls. The mean abdominal circumference of boys was 68.0+/-9.1 cm, and that of girls was 64.3+/-7.7 cm. The cutoff point of percentage body fat for obesity was 21.8% in boys and 24.5% in girls. The prevalence of obesity was 15.2%, 16.7% for males and females, respectively. The abdominal circumference cutoff for obesity was 76.9 cm in boys and 70.7cm in girls. Based on that, the prevalence of obesity was 19.7% for boys and 20.0% for girls, which was higher than what was identified by body mass index, as in the case of body fat percentage. CONCLUSION: The cutoffs of body fat percentage and abdominal circumference in one city of Gyeonggi Province were lower than those suggested in the previous studies.
Adipose Tissue ; Aged ; Body Mass Index ; Electric Impedance ; Female ; Humans ; Male ; Obesity ; Overweight ; Prevalence ; Republic of Korea ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Depression increases the risk of cardiovascular risk factors in adults. However, the association between depression and cardiovascular risk factors was not well evaluated in South Korea. Our study was done to evaluate the association between depression and cardiovascular risk factors in workers. METHODS: The study population was selected among adults working in several industries that had more than 50 employees. They had received their medical examinations at the Health Promotion Center of Hallym University Sacred Heart Hospital between March and November 2005. We estimated the odds ratio to determine whether depression (Korean Center for Epidemiologic Studies Depression Scale score > or =21) was associated with each cardiovascular risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity). RESULTS: The prevalence of depression was 15.5%. Depression was significantly associated with hypertension (P<0.001), obesity (P=0.03) and hypercholesterolemia (P=0.004). The adjusted odds ratio for hypertension and hypercholesterolemia were 1.41 (95% CI 1.04~1.91) and 1.59 (95% CI 1.05~2.40), respectively. The association between depression and obesity was eliminated after adjustment (1.25, 95% CI: 0.97~1.61). CONCLUSION: Depression was significantly associated with hypertension and hypercholesterolemia in workers. Further long-term study on the association of depression with cardiovascular risk factors is necessary.
Adult ; Cardiovascular Diseases ; Depression ; Diabetes Mellitus ; Epidemiologic Studies ; Health Promotion ; Heart ; Humans ; Hypercholesterolemia ; Hypertension ; Obesity ; Odds Ratio ; Prevalence ; Republic of Korea ; Risk Factors

The authors reviewed 102 cases of craniopharyngiomas with primary onset, which had occurred during a recent 15-year period. Among the 42 women and 60 men, 34 patients were children(aged 15 or less) and 68 were adults. The children showed clinical characteristics different from those of adults. With regard to initial presentation, headache was the most frequent chief complaint in children, while visual disturbance was most common in adults. The incidence of growth hormone deficiency was high in children, while in adults, adrenal corticosteroid deficit was most common. As seen on CT or MRI, the tumor was larger and calcification was more abundant in children than in adults. Gross total resection(GTR) was achieved in 46 cases. The main causes for incomplete removal were severe adhesion to the hypothalamus(31.3%) and the midbrain(18.8%), and heavy calcification(20.8%). The extent of surgery showed no significant influence on the Karnofsky Performance Score(KPS) on discharge, and in 82.4% of patients the results were good(KPS 80 or more). Postoperative endocrinological disturbances requiring hormonal replacement therapy were more common in the GTR group(p<0.01). In 22 recurrent cases, the median time from initial operation to recurrence was 18.5 months. Among patients who did not undergo postoperative radiation therapy, the recurrence rate was lower in those who had undergone GTR(p<0.05). An analysis of histological characteristics revealed that the adamantinomatous-type tumor recurred more frequently than the squamous papillary type. In conclusion, it is suggested that there is a difference in the growth pattern and clinical behavior of the tumor between adult and childhood craniopharyngioma. The authors recommend that unless expected postsurgical complications are detrimental to the patients, radical total resection should be attempted during the first operation, especially in patients who are under 15 and whose craniopharyngioma is of the adamantinomatous type. Radiation therapy should be considered for patients with a residual tumor and the treatment should be tailored to the individual.
Adult ; Child ; Craniopharyngioma* ; Female ; Growth Hormone ; Headache ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Neoplasm, Residual ; Recurrence

Diphenylhydantoin(DPH) has been used intravenously as a drug of choice in conditions which seizure patients are incapable of oral feeding or in a state of status epilepticus. However, its clinical use has limitations because of its serious side effects of cardiac depression or systemic hypotension. In Western countries, the recently developed intravenous sodium valproate has been reported as safe and effective for seizure control in such patients. To assess the safety and effectiveness in seizure control, we investigated the serum levels of the drug at 24 hours, 48 hours, and 7 days after intravenous administration of sodium valproate(Depakine(R)), occurrence of seizures in the perioperative period, and the side effects of the drugs in 30 neurosurgical patients older than 3 years of age. The mean serum concentrations of valproic acid after bolus injection of 15mg/kg followed by continuous infusion with the rate of 0.5mg/kg/hour, were over 45.0 microgram/ml;45.0+/-16.3 microgram/ml at 24 hours, 50.4+/-21.0 microgram/ml at 48 hours, and 58.9+/-20.7 microgram/ml at 7 days after the start of the administration. All the patients whose serum valproic acid level was within the therapeutic range(40-100 microgram/ml), had never experienced an episode of seizure attack during the perioperative days. There was no evidence of elevated liver enzyme activity, but there were evidence of some tendency of decreased platelet count in the peripheral blood at 2 days after the administration of intravenous valproic acid. Four patients experienced episodes of mild nausea and/or vomiting. In conclusion, perioperative intravenous administration of valproic acids in neurosurgical patients was safe and effective in seizure control. However, it must be used precauciously in the patients with compromised coagulation system.
Administration, Intravenous ; Depression ; Humans ; Hypotension ; Liver ; Nausea ; Perioperative Period ; Platelet Count ; Seizures ; Sodium* ; Status Epilepticus ; Thrombocytopenia ; Valproic Acid ; Vomiting

Various functional activities have been reported for the fermented soybean products doenjang (DJ) and cheonggukjang (CGJ), although no systemic investigations of their immune functions have been conducted to date. We examined the effects of an experimental diet of DJ, CGJ, or a mixture of unfermented raw material for 4 weeks on overall immunity and immune safety in mice. No significant alterations were observed in peripheral or splenic immune cells among groups. Enhanced splenic natural killer cell activity was observed in the DJ and CGJ groups compared with the plain diet group. T helper type-1 (Th1)-mediated immune responses were enhanced in the DJ and CGJ groups with an upregulated production ratio of IFN-γ vs. IL-4 and IgG2a vs. IgG1 in stimulated splenic T and B cells, respectively. Resistance to Listeria monocytogenes infection was observed in the DJ and CGJ groups. Overall, the results of this study suggest that DJ and CGJ intake consolidates humoral and cellular immunity to Th1 responses.
Animals ; B-Lymphocytes ; Diet ; Immunity, Cellular ; Immunoglobulin G ; Interleukin-4 ; Killer Cells, Natural ; Listeria monocytogenes ; Mice* ; Soybeans*

OBJECTIVE: A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of Labb in surgical removal of petroclival meningiomas. MATERIALS AND METHODS: The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent and equal on both sides), Type B(confluent and non-dominant on tumor side), Type C(confluent and dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of Labb was analyzed with respect to its draining point and its collaterals to other superficial veins. RESULTS: Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of Labb, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. CONCLUSION: For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of Labb.
Brain Edema ; Colon, Sigmoid ; Constriction ; Drainage ; Humans ; Infarction ; Ligation ; Meningioma* ; Phlebography* ; Postoperative Hemorrhage ; Retrospective Studies ; Veins