No abstract available.
Carcinoma, Renal Cell* ; Humans

One hundred and twenty patients with symptomatic lumbar disc herniation were treated with automated percutaneous lumbar discectomy(APLD) from June 1988 to October 1989 in Seoul National University Hospital. Among them, 95 patients were followed up for more than 6 months. Number of male patients was 58 and female 37. Age ranged from 15 to 57 years with average 28 years. L4-L5 was the most commomly involved level comprising 80%, and 2 level involvement was 9%. Average duration of procedure was 38 minutes, and average amount of tissue aspirated was 5.2 grams and average hospital stay was 2.4 days. The average follw up was 10.8 months. Eighty seven percent of patients were satisfactory and 13% unsatisfactory and there was no major complication. There was no significant disc space narrowing in all the cases and the size of herniation revealed no significant change in all the patients, even the patient had a satisfactory result. APLD was compared with chemonucleolysis performed during 1988 in terms of clinical results, disc space narrowing on plain films and herniation size change on follw up CT. Chemonucleolysis also had satisfactory result in 89% with reduction of herniation size in 41% but induced significant disc space narrowing in 84%. Authors experienced some special cases, which are generally considered poor indication for percutaneous discectomy. Those were degenerative, calcified and possibly ruptured discs. Satisfactory results were obtained in 10 of 14 these patients.
Diskectomy ; Diskectomy, Percutaneous ; Female ; Humans ; Intervertebral Disc Chemolysis ; Length of Stay ; Male ; Seoul

OBJECTIVES: To determine changes in the incidence and pattern of eclampsia in Il Sin Christian Hospital over a 46-year period. METHODS: Information was collected from medical records of the 1910 eclamptic patients among 233,613 deliveries in Il Sin Christian Hospital from Jan. 1 1953 to Dec. 31 1998. Incidence, presentation, and management of eclampsia were reviewed retrospectively, and maternal mortality rate and perinatal mortality rate were calculated. Statistical analysis was done by Chi-squared and Fisher's exact test through two by two tables looking at relative changes between each study period. RESULTS: The overall incidence of eclampsia was 81.8 per 10,000 deliveries. The incidence of eclampsia had increased from 137.3/10,000 in 1953-1962 to 278.4/10,000 in 1963-1972, but the rate had reduced to 6.5/10,000 in 1993-1998. There was a statistically significant fall in the rate of eclampsia every decade between 1973 and 1992, but there has been steady decrease in the last study period. Convulsion occurred antepartum in 54% of patients, intrapartum in 29% and postpartum in 17%. With the reduction in the proportion of antepartum eclampsia, there has been a relative increase in that of intrapartum and postpartum eclampsia. Maternal death occurred in 59 cases among eclampsia, and maternal mortality rate was 3.1%. Maternal mortality rate had significantly decresed from 11.1% in 1953-1962 to 3.8% in 1963-1972, and there has been no maternal death from eclampsia since 1986. Postpartum eclampsia had increased death risk compared with antepartum or intrapartum eclampsia. There were 280 cases of perinatal death and overall perinatal mortality rate was 144.1 per 1000 deliveries. There was a significant decrease in the rate from 243.2/1000 in 1953-1962 to 141.5/1000 in 1963-1972, but the rate has risen steadily since 1983. CONCLUSIONS: With the improvement in antenatal care and management of eclampsia, the incidence of eclampsia and its associated maternal mortality has decreased over the last 46 years. But eclampsia still remains a significant complication of pregnancy with high maternal and perinatal mortality.
Eclampsia* ; Female ; Humans ; Incidence ; Maternal Death ; Maternal Mortality ; Medical Records ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Seizures

No abstract available.

No abstract available.
Adenocarcinoma* ; Appendix*

Glanzmann's thrombasthenia is a rare autosomal recessive hemorrhagic disorder characterized by prolonged bleeding time, ad deficient or absent clot retraction in the presence of normal platelet count. The major underlying abnormality in this disease is grossly defective first-phase aggregation of platelet, which are unresponsive to ADP or other platelet agonists such as epinephrine, collagen, thrombin in any concentration. This disability is caused by a decrease or absence of the platelet membrans glycoprotein IIb-IIIa complex, a member of the integrin family of adhesive receptors involved in cell-cell and cell-matrix fibronectin, and vitronectin On the development of surface labeling technique, a variety of biochemical techniques such as radioimmunoassay, crossed immunoelectrophoresis and SDS-PAGE have been used to study the structure and the function of platelet membrane glycoproteins, and to detect the platelet functional defect. But all of these techniques demand a relatively large amount of homogeneous paletelet population that requires manipulation through isolation and washing procedures before analysis. In order to eliminaste such an intricate procedure, we have applied method for analyzing platelet surface components in whole blood using monoclonal antibody and flow cytometry to recognize the absence of severe reduction of platelet membrane glycoprotien llb-llla complex. Platelet analysis by flow cytometry is a successful alternative rapid diagnostic technique for Glanzmann's thrombasthenia patients as well as well as for carriers of this disease. Fow cytometry technique provides a sensitive tool for investigating platelet functional defects caused by altered expression or deficiency of platelet surface proteins.
Adenosine Diphosphate ; Adhesives ; Bleeding Time ; Blood Platelets* ; Clot Retraction ; Collagen ; Electrophoresis, Polyacrylamide Gel ; Epinephrine ; Fibronectins ; Flow Cytometry* ; Glycoproteins ; Hemorrhagic Disorders ; Humans ; Immunoelectrophoresis, Two-Dimensional ; Membrane Glycoproteins* ; Membrane Proteins ; Membranes* ; Platelet Count ; Platelet Membrane Glycoproteins ; Radioimmunoassay ; Thrombasthenia* ; Thrombin ; Vitronectin

Descending necrotizing mediastinitis (DNM) is one of the most lethal form of mediastinitis originating from an oropharyngeal infection. It requires an early and aggressive sugical treatment, but the operative approach and optimal form of mediastinal drainage remains controversial. We report a case of DNM in a 45-year-old male who underwent right cervicomediastinotomy to drain the deep neck space, upper mediastinum and anterior mediastinal drainage was accomplished through a subxiphoid approach. After this procedure, he steadily improved and was dischrged on hospital day 36. We report this case with a brief review of the literature.
Drainage ; Humans ; Male ; Mediastinitis* ; Mediastinum ; Middle Aged ; Neck

PURPOSE: The purpose of this study is to describe the findings of the transligamnetous type of the herniated lumbar disc (HLD) with magnetic resonance MR imaging. MATERIALS AND METHODS: We retrospectively analyzed the MR images of surgically proven 20 cases of transligamentous type of HLD from January 1, 1992 to August 20, 1992. The MR imaging was performed with 1. 0T MR unit, using sagittal spin echo (SE) and axial gradient echo (GE) techniques. RESULTS: The results were as follows;1) the interruption of black line of the posterior longitudinal ligament (PLL) was identified in 19 levels and 17 levels in sagittal SE and axial GE images, retrospectively;2) the widening of adjacent epidural fat space was demonstrated in 16 cases of central or posterolateral HLD. The herniated disc material, as compared with the parent intervertebral disc, showed intermediate signal intensity (SI) in 19 and low SI in 1 level on T1WI, high SI in 10, intermediate SI in 7, low SI in levels on T2WI, and high SI in 10, intermediate SI in 9, low SI in 1 level on GE images. CONCLUSION: The most important sign of the transligamentous type HLD on MRI was the interruption of the black line with additional finding of the widening of adjacent epidural fat space. The MR signal intensity of the herniated disc was variable. Axial GE image was valuable for the evaluation of the direction of HLD and it relationship with neural structure, but had no addiational information for the degree and biochemical change of HLD over SE image.
Financial Management* ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Parents ; Retrospective Studies

No abstract available.
Brain* ; Hemangioendothelioma* ; Lung* ; Mediastinum*

PURPOSE: To evaluate the clinical usefulness of PAP in staging and monitoring of patient with prostate cancer, we performed a comparative study with PSA, retrospectively. METHODS: We evaluated 72 patients with prostate cancer. Of these patients 11 had stage A, 6 stage B, 10 stage C, 5 stage D1 and 40 stage D2 prostate cancer. Serum PAP level was measured in all 72 patients and serum PSA level was measured concomitantly in 42 patients. RESULTS: The mean initial PAP value was 13.40+/- 7.00 U/L. But only 40 (55.6%) had elevated PAP value above 1.5U/L at presentation. Of 55 advanced cases (stage C, D), 39 (76.9%) had elevated PAP values. Of the 42 patients, who underwent longitudinal PSA assessment, the mean initial PSA value was 178.0 +/- 33.3 ng/ml. Forty (95.2%) had elevated PSA value above 4 ng/ml at presentation. Of 41 advanced cases (stage C, D1, D2), 33 (80.5%) exceeded 50 ng/ml. None of the patient had elevated PAP value with normal PSA value at presentation. Among 42 patients, who had followed with longitudinal serum PSA and PAP, progression of the disease to the bone, lung, and rectum occurred in 26 patients; in all PSA was the first indicator of progression and in none of them PAP anticipated PSA elevation. CONCLUSIONS: Although PAP value usually reflects advanced prostate cancer (70.9%), serum PSA also reflects it (80.5%). Serum PSA monitoring is superior to serum PAP monitoring in predicting disease progression. The use of PSA and PAP jointly to stage and monitor prostate cancer did not appear to enhance the clinical utility over that of PSA alone.
Acid Phosphatase* ; Disease Progression ; Humans ; Lung ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Rectum ; Retrospective Studies