BACKGROUND: The purpose of this study was 1) to review the length of an adequate period of conservative treatment and the appropriate surgical indications for herniated lumbar disc(HLD), 2) to collate the scientific evidences on surgeries for HLD, and 3) to collect expert opinions on HLD. METHODS: We searched for articles in PubMed, the Cochrane Library and KoreaMed up to 1 October 2008, and these articles were concerned with the natural history of HDL, systemic reviews of HDL and expert opinions on HLD. We also searched for meta-analyses and randomized or quasi-randomized controlled trials(RCTs or QRCTs) of surgery for HLD. We performed a meta-analysis using the Cochrane method. The survey consisting of 21 questions was delivered to all the members of the Korean Spinal Neurosurgery Society(KSNS) via E-mail. RESULTS: A total of 59 articles were included in this study. There were 16 articles concerning the period of conservative management and the surgical indications. Among the 33 articles on surgery for HLD, there were 4 meta-analyses, 27 RCTs, and 2 QRCTs. Among the 938 members of the KSNS, 72 responded to the survey. A minimum of 1 to 3 months of conservative management was the most preferred answer(58%), followed by a conservative management period of less than 1 month(33%). Percutaneous endoscopic discectomy was more preferred by the hospitals that specialized in spinetreatment than by the university hospitals(p<0.05). CONCLUSION: Conservative management for a minimum of 2 weeks to 3 months is recommended for patients with tolerable pain only. The patients with neurological compromise or intolerable pain should be considered for surgery. There is strong evidence on the relative effectiveness of surgical discectomy versus chemonucleolysis versus placebo. There is no scientific evidence on the effectiveness of any other form of minimally invasive procedure.
Diskectomy ; Electronic Mail ; Evidence-Based Medicine ; Expert Testimony ; Humans ; Intervertebral Disc Chemolysis ; Natural History ; Neurosurgery

In order to evaluate the efficiency of serological typing of A. baumannii in practical application, a total of 63 strains of A. baumannii and 234 strains of Gram-negative, lactose non-fermenting bacteria were tested with polyclonal rabbit immunized sera (RIS) against heat-killed A. baumannii strains by slide agglutination tests. Six typing sera of RIS were finally obtained after the checkerboard agglutination test and reciprocal cross-absorption. Species identification of sixty-three strains of A. baumannii were confirmed by ribotyping. Forty-seven (74.6%) of the 63 strains of A. baumannii showed strong positive reaction by slide agglutination tests. Thirty-nine strains could be serotypable and thus classified into 6 distinct serovars of A. baumannii, but 8 strains were unable to classify into specific serovar. Serovar 4 was the most frequent arbitrary serovar and included 17 strains among the 39. When slide agglutination tests were performed with 50-fold diluted pooled polyclonal RIS, there was no cross-reactions except one of E. coli strain among 234 strains of various Gram-negative lactose non-fermenting. Although each profile of LPS-gel electrophoresis of A. baumannii appeared to be unrelated with serovar, the patterns of western-blot of LPS after immunostaining with homologous RIS showed serovar-specificity. Several fractions of low molecular weight LPS showed cross-reaction with antisera of other serovars. In conclusion, the sensitivity and specificity of serological identification of A. baumannii strains were 74.6% and 99.6%, respectively. This result suggests that serotyping is a useful method for the identification of A. baumannii strains as well as is the epidemiological tool to trace back the source of the nosocomial outbreaks.
Acinetobacter baumannii* ; Acinetobacter* ; Agglutination Tests ; Bacteria ; Disease Outbreaks ; Electrophoresis ; Immune Sera ; Lactose ; Molecular Weight ; Ribotyping ; Sensitivity and Specificity ; Serotyping

No abstract available.
Gastroschisis* ; Prenatal Diagnosis*

DNA binding compounds were previously shown to bind to the right-handed DNA forms and hybrid B-Z forms in a highly cooperative manner and indicate that structural specificity plays a key role in a ligand binding to DNA. In this study, the modes of binding and structural specificity of agents to unusual DNA are examined by a variety of fluorescence techniques (intensity, polarization and quenching, etc.) to explore a reliable method to detect the association environment of ligands to deoxyoligonucleotides initially containing a B-Z junction between the left-handed Z-DNA and right-handed B-DNA. The results of fluorescence energy transfer measurement demonstrated that the ligand molecules bind to the allosterically converted DNA structures by intercalation. In the absence of high-resolution structural data, this fluorescence energy transfer measurement allowed reliable measures and infer the binding environment of ligands to the allosteric DNA structures.
Allosteric Regulation ; Circular Dichroism ; DNA/*chemistry/*metabolism ; Energy Transfer ; Ethidium/*metabolism ; Exodeoxyribonucleases/metabolism ; Ligands ; Motion ; Nucleic Acid Conformation ; Oligodeoxyribonucleotides/*metabolism

No abstract available.
Child* ; Fatty Liver ; Humans ; Hypercholesterolemia ; Incidence* ; Obesity

Although cysticercosis is the most common parasitic disease affecting the central nervous system, spinal cysticercosis is rare. A rare form of spinal cysticercosis involving the whole spinal canal is presented. A 45-year-old Korean male had a history of intracranial cysticercosis and showed progressive paraparesis. Spinal magnetic resonance scan showed multiple cysts compressing the spinal cord from C1 to L1. Three different levels (C1-2, T1-3, and T11-L1) required operation. Histopathological examination confirmed cysticercosis. The patient improved markedly after surgery.
Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurocysticercosis/diagnosis/*pathology/surgery ; Spinal Canal/*parasitology ; Treatment Outcome

No abstract available.
Ascites* ; Female ; Ovary*

PURPOSE: To compare the clinical and radiological results between the anterior and posterior screw fixation for the treatment of talar neck fracture. MATERIALS AND METHODS: Among 30 patients who received surgical treatment for talar neck fracture from 2001 to 2008. Twenty-seven patients with a follow-up period of more than 1 year were divided into two groups. Twelve patients were treated with anterior screw fixation and 15 patients with posterior approaches. We analyzed preoperative, postoperative and follow-up radiographs. Clinical results were evaluated by Hawkins criteria. RESULTS: The posteriorly inserted screws were placed across the more central portion of the talar neck and perpendicular to the plane of fracture (p<0.05). There were no difference in clinical results, the duration of union, and complications including avascular necrosis between two groups. However, 2 patients complained of pain around the talonavicular joint in the anterior insertion group. CONCLUSION: Although the clinical results were good irrespective of insertion methods, the posterior approach of screw fixation for talar neck fractures allows for a better mechanical advantage than anterioly placed screws. This may allow early motion with a reduced risk of failure of fixation or of displacement of the fracture.
Displacement (Psychology) ; Follow-Up Studies ; Humans ; Imidazoles ; Joints ; Neck ; Necrosis ; Nitro Compounds ; Talus

PURPOSE: To evaluate the anatomic and functional outcome of retrograde intramedullary single wire fixation for metacarpal shaft fractures of the little finger. MATERIALS AND METHODS: hirty one consecutive patients with closed metacarpal shaft fractures of the little finger who have been treated with retrograde intramedullary single wire fixation were evaluated. Fracture union and angulation were analyzed radiologically, and clinical evaluations were performed including range of motion, DASH score and complications. RESULTS: Fracture union was achieved in all cases and callus formation was obvious at postoperative 41 days. Average angulation of fracture site was 3degrees in the coronal plane and 1.2degrees in the sagittal plane at the last follow up and no measurable metacarpal shortening was observed. Mean TAM was 253degrees and DASH score was 2.6. There were two cases of pin migration as intermediate complications. CONCLUSION: Closed reduction with subsequent percutaneous retrograde K-wire fixation produced good radiological and functional results. We recommend this minimally invasive technique which provides adequate fixation of displaced little finger metacarpal shaft fractures with good functional results and low morbidity.
Bony Callus ; Fingers ; Follow-Up Studies ; Humans ; Range of Motion, Articular

Popliteal artery injury in blunt trauma of knee joint is not common but poses high rate of amputation due to anatomical characteristics or delayed diagnosis and treatment. The aim of the present study is to review the authors' experiences with this condition and identify factors contributing to disability. We reviewed 7 cases of popliteal artery injury in trauma around knee. Injury mechanism, type of vessel damage, associated injuries, mangled extremity severity scores (MESS), ischemic time and additional treatments were analyzed. Tibial fracture, distal femoral fracture and serious soft tissue defect were combined. Mean MESS was 9.9 point and mean time of revascularization was 7.1 hours. Transfemoral amputation was performed in 2 cases due to vascular insufficiency and devastating infection, and 4 patients were able to walk without any support at the last follow up. Age, the severity of soft tissue injury, ischemic time and MESS are thought to be related to prognosis, and young patients with short ischemic time show best results, but authors experienced one exceptional case. We have to consider multiple factors related to the prognosis in popliteal artery injury with fractures around knee, and careful decision is needed regarding to early amputation.
Amputation ; Delayed Diagnosis ; Extremities ; Femoral Fractures ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Knee ; Knee Joint ; Popliteal Artery ; Prognosis ; Soft Tissue Injuries ; Tibial Fractures