STUDY DESIGN: A retrospective analysis was performed on 40 patients who had had previous lux bar spine surgeries. OBJECTIVE: To determine what factors most influenced surgical outcome and to analyze results in a series of revision lumbar surgeries. SUMMARY OF BACKGROUND DATA: Satisfactory surgical outcome of the revision lumbar surgery range from 28% to 82% and are rarely comparable to primary surgery. Many factors predicting outcome from repeat lumbar surgery haute been listed. METHODS: Forty patients were analyzed who had had previous lumbar surgeries. The patients were classified into 5 groups according to diagnosis: 3 Infection,5 instability,8 nonunion, 14 HNP and 10 spinal stenosis. of 40 patients,33 patients(82.5%) underwent fusion with instrumentation for repeat surgery. Their clinical course was followed for a minimum of 1 year. The number of surgery on each mpatient was 1.3 times on an average. RESULTS: Overall, 80% of patients had a satisfactory result. Obviously extruded or sequestrated HNP in MRI findings, complete block of contrast with severe radiculopathy and/or myelopathy in spinal stenosis, complete decompression, neurolysi s and fusion with instrumentation, and longer than 6 month pain relief after precious surgery were correlated with satisfactory outcome. However, the number of precious operation, age, repair of pseudarthrosis , no abnormality at surgery and combined multiple degenerative joint disease were significantly correlated with poor surgical outcome. The most common complication during repeat surgery was dural tear in 5 cases(12.5%). CONCLUSIONS: Success rate of revision surgery was low as compared to primary operation. Therefore, erroneous diagnosis and faulty surgical technique understandably lead to failure, and precise attention to preoperative and intraoperative detail can minimize these sources of error.
Decompression ; Diagnosis ; Humans ; Joint Diseases ; Magnetic Resonance Imaging ; Pseudarthrosis ; Radiculopathy ; Reoperation ; Retrospective Studies ; Spinal Cord Diseases ; Spinal Stenosis ; Spine* ; Tears

The non-surgical treatment for the fresh humeral shaft fracture would appeared to be not sufficient in respect of immobilization and maintenance of the contact surface of the fracture ends, which have had stimulated surgeons to perform internal fixation. This might be one of the reasons to produce non-union of humeral shaft fracture, supplemented by increasing incidence of fractures due to car and machinary accident. Authors have experienced 18 cases of non-union of humeral shaft fracture and accomplished solid union in all cases by osteosynthesis accompanied by autogenous bone graft. In detail: 1. Non-union was prevalent in the agr group of 20 to 40 and mostly in male. Site of non-union was found mostly at the lower 2/3. 2. The cause of the fracture was mainly due to the car and machinary accident. Initial treatments were surgical in 14 out of 18 cases, and 12 cases of this surgically treated group were treated within 2 days after the injury. 3. On retrospective analysis of medical records and X-ray films, probable cause of the non-union were supposed to be too early performed inadequate internal fixation and post-operative infection in the operated cases, whereas distraction of fracture ends due to poor external fixation and infection in the cases treated conservatively. 4. 16 cases of established non-union were treated by authors with rigid internal fixation and additional bone graft, and 1 case with bone graft only. 5. Authors have utilized shoulder spica or long arm cast post-operatively for 1 to 4 months. 6. Union was obtained in all cases. Developed transient radial nerve palsy in 4 cases; and neighbouring joints contracture in 2 cases, which required considerable time of physical therapy.
Arm ; Contracture ; Humans ; Immobilization ; Incidence ; Joints ; Male ; Medical Records ; Paralysis ; Radial Nerve ; Retrospective Studies ; Shoulder ; Surgeons ; Transplants ; X-Ray Film

No abstract available.
Child* ; Humans ; Plasma* ; Renal Veins* ; Renin* ; Veins*

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Mass Screening*

No abstract available.
Child* ; Heart Defects, Congenital* ; Humans ; Plasma* ; Renal Veins* ; Renin* ; Veins*

Fiberglass, as a substitute of asbestos, is used for more than 60 years as a insulator material. Health hazards including irritation of skin, mucosa and respiratory system associated with use of fiberglass is reported. Many studies on the fibrogenicity and carcinogenicity of fiberglass was conducted but evidence is not sufficient to confirm the carcinogenicity or fibrogenicity. Authors studied the health hazards among 152 inhabitants(71 men and 81 women) from 32 households living around the fiberglass factory which produced the fiberglass insulators and glasswool panels for 20 years. Questionnaire survey on household and persons, examination of underground water, pathologic examination of subcutaneous tumors and examination of fiberglass in tumor tissues were done. The results are as follows; 1. Fiberglass concentration of underground water sampled from 33 households in the study area was 13. 7-95. 9 fiber/cc with the diameter to length ratio more than 1:20. 2. Prevalence of dermatosis among study subjects was 23.0 % (35 cases). Prevalence was not associated with the distance from the factory nor duration of exposure. 3. There were 15 cases of subcutaneous tumor with prevalence of 9. 9 %. Age of subcutaneous tumor cases was all above 30 year-old except one cases, who was 5 year old child, who lived in the surveyed area since he was born. Prevalence of subcutaneous tumor was significantly high in area A(42.9 %) than area B(4.6 %, p<0.01). Prevalence of subcutaneous tumor was higher in long-term exposed inhabitants, but was not statistically significant. 4. Pathologic examination exhibits partly encapsulated fat tissue masses and cut surfaces were pale yellow with gritty sensation. The masses consist of mature fat cells showing variation in size and shape. On polarizing microscope, the peripheries of tumors include small irregular threads of doubly refractile material probably represent glass fibers in fibrocollagenous tissue. Concentration of fiberglass in tissue was 5.1-10.2 fiber/rag wet tissue in case 1, 25.8-184.9 fiber/mg wet tissue in case 2 and 40.8-126.5 fiber/mg wet tissue in case 3. Length of fiberglass was shorter than that in underground water. 5. Cases of malignant tumor among inhabitants since last 10 years were 4, 3 of whom was developed in a same household just near the factory. Diagnoses of malignancy cases were stomach cancer, stomach and esophageal cancer, oral cavity cancer, and stomach cancer with liver metastasis. On review examination of tissues of endoscopic biopsy specimen from a case of stomach cancer, there was adenocarcinoma with no evidence of fiberglass materials. Authors concluded there is evidences that fiberglass was strongly associated with the development of the health hazards including dermatosis and benign subcutaneous tumor. However, the association of fiberglass exposure with the development of malignant tumor was not clear, although strongly suggested. For the prevention of development of further health hazards, it is recommended that under ground water source should be closed and further experimental study to confirm the mechanism of the tumorigenesis and follow up survey on the inhabitants should be conducted.
Adenocarcinoma ; Adipocytes ; Adult ; Asbestos ; Biopsy ; Carcinogenesis ; Child ; Child, Preschool ; Diagnosis ; Epidemiologic Studies* ; Esophageal Neoplasms ; Family Characteristics ; Glass* ; Groundwater ; Humans ; Liver ; Male ; Mouth ; Mucous Membrane ; Neoplasm Metastasis ; Prevalence ; Respiratory System ; Sensation ; Skin ; Skin Diseases ; Stomach ; Stomach Neoplasms ; Surveys and Questionnaires

No abstract available.
Collagen* ; Interferons* ; Ureter* ; Ureteral Obstruction*

PURPOSE: Skin prick test and determination of allergen-specific IgE antibodies in serum are methods commonly used to diagnose allergies. Several studies indicate that skin test and specific IgE have roughly the same diagnostic precision, although discrepancies exist. The objective of this study was to evaluate the influence of total serum IgE on the relation between skin prick test and allergen-specific IgE antibody. METHODS: We performed skin prick tests using 14 major inhalant allergens and measured total IgE and specific IgE for two major allergens [Dermatophagoides farinae(D.f.) and Dermatophagoides pteronyssinus (D.p.)] in serum of 230 children with atopic asthma. RESULTS: Positivity of skin prick test was 92.2% for D.f., 89.6% for D.p., and 22.6% for cockroach. Allergen/Histamine(A/H) ratio and allergen-specific IgE score showed a positive correlation for D.f.(r=0.39, P<0.01), and for D.p.(r=0.38, P<0.01). Total serum IgE and allergen-specific antibody score showed a positive correlation for D.f.(r=0.50, P<0.01), and for D.p.(r=0.53, P<0.01). There was no correlation between total serum IgE and A/H ratio on skin prick test for the two allergens. However, total serum IgE had the tendency to increase according to the number of positive allergens on skin prick test. At each level of A/H ratio for D.f. and D.p. on skin prick test, patients with high total IgE had higher antigen-specific IgE scores than patients with low total IgE. CONCLUSION: Our results show that the relationship between skin prick test and antigen-specific IgE was influenced by the level of serum total IgE. This indicates that the level of serum total IgE should be taken into account when skin prick test and allergen-specific IgE are compared.
Allergens ; Antibodies ; Asthma* ; Child* ; Cockroaches ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Skin Tests ; Skin*

A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was bluish opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined cell borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Chest Pain ; Chondrosarcoma ; Chromatin ; Cytoplasm ; Diagnosis ; Dyspnea ; Eosinophils* ; Female ; Humans ; Mesothelioma ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Pleural Cavity ; S100 Proteins ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

PURPOSE: Central compartment reoperation for recurrent thyroid carcinoma is challenging to surgeons due to the scar tissues and adhesions and the distortion of the normal anatomic relationships. This study was carried out to investigate the central neck recurrence patterns and the surgical morbidity of reoperation for patients with papillary thyroid carcinoma. METHODS: The study population was comprised 68 papillary thyroid carcinoma patients (15 males and 53 females, median age: 50.8 years [range: 12~78 years]) who underwent reoperation for recurrent tumors in the central compartment of the neck between January 1999 and June 2007. All of the patients had undergone prior total thyroidectomy. RESULTS: Of the 68 patients, 21 recurrences occurred in the proper thyroid tissue of the thyroid bed, 43 in the central neck nodes and 4 in a combination of the central nodes and proper thyroid tissue. The common recurrent site from the proper thyroid tissue were at the berry ligaments and at the level of the upper one-third of the recurrent laryngeal nerves, while the common nodal recurrence sites were the lower-most portion of the paratracheal nodes and the right paraesophageal nodes (the lymph nodes posterior to the right recurrent laryngeal nerve). Eleven cases of transient hypocalcemia (17.5%, 11/63) and 3 cases of permanent hypocalcemia (4.3%, 3/63) were noted after reoperation. Recurrent laryngeal nerve injury occurred in 5 patients (8.1%, 5/62), but three of them were intentionally resected with the recurrent cancers. CONCLUSION: Reoperation for central neck recurrence of papillary thyroid carcinoma is associated with a higher complication rate. Meticulous surgical dissection of the central compartment based on the recurrent patterns is important to reduce injury to the recurrent laryngeal nerves and parathyroid glands.
Carcinoma ; Cicatrix ; Female ; Fruit ; Humans ; Hypocalcemia ; Intention ; Ligaments ; Lymph Nodes ; Male ; Neck ; Recurrence ; Recurrent Laryngeal Nerve ; Recurrent Laryngeal Nerve Injuries ; Reoperation ; Thyroid Gland ; Thyroid Neoplasms