The effects of hyperbaric oxygen on radiation cystitis have been reported in patients with radiation-induced hemorrhagic cystitis refractory to conventional therapy. Cessation of gross hematuria and reversal of cystoscopic bladder changes were seen in response to a series of hyperbaric oxygen therapy of 3 atmosphere absolute pressure for 2 hours. We report the experience of 2 cases of hyperbaric oxygen therapy for radiation-induced cystitis.
Atmosphere ; Cystitis* ; Hematuria ; Humans ; Hyperbaric Oxygenation ; Oxygen* ; Urinary Bladder

The septum formation(web) of bile duct is an uncommon disease. Its rarity and vague symptoms result in delayed diagnosis. However, the increased use of endoscopic retrograde cholangiopancreatography(ERCP) and percutaneous transhepatic cholangiography(PTC) have resulted in greater awareness of this entity and understanding of its natural history as well as an increased frequency of diagnosis. We have experienced 4 cases of common bile duct web, which were associated with stones in the bile duct, confirmed by operation.
Bile Ducts ; Common Bile Duct* ; Delayed Diagnosis ; Diagnosis ; Natural History

BACKGROUND: Thalium 201(TI-201) has been a widely applied myocardial perfusion agent for the detection of coronary artery disease. however its low emission energy and long half-life make this agent suboptiomal for the examination of coronary artery disease. To circumvent the physical limitation of TI-201, a group of technetium 99m-labeled isonitril complex has been developed. Our study was done to examine the value of SPECT with 99mTc-HexaMIBI in estimating myocardial perfusion in patients with myocardial infarction. METHODS: We evaluated the sensitivity of SPECT with 99mTc-HexaMIBI in 29 patients with acute myocardial infarction. We also compared the severity and vascular territory of abnormal perfusion on SPECT scanning with severity of coronary artery stenosis, values of serum enzyme and sites in ECG. RESULTS: 1) There were 26 patients(90%) who showed perfusion defect, and 3 patients(10%) who showed normal perfusion in myocardial SPECT. The 3 patients with normal perfusion demonstrated non Q-wave infarction of ECG. 2) Among 23 patients performed coronary argiography, there were 19 patients(82%) who showed positive findings on myocardial SPECT and luminal narrowing above 50% on coronary angiogram, and there were 3 patients(13%) who showed significant coronary artery stenosis in spite of negative myocardial SPECT. 3) The grade of perfusion defect showed no significant difference between groups undergone thrombolytic therapy and groups not undergone thrombolytic therapy. 4) There was good correlation between the site of perfusion defect on SPECT and the site of infarction on ECG. CONCLUSION: We conclude that SPECT with 99mTc-HexaMIBI is a promising non invasive test for simultaneous diagnosis of myocardial infarction and evaluation of perfusion defect.
Coronary Artery Disease ; Coronary Stenosis ; Diagnosis ; Electrocardiography ; Half-Life ; Humans ; Infarction ; Myocardial Infarction* ; Perfusion ; Phenobarbital ; Technetium ; Technetium Tc 99m Sestamibi* ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon*

Far lateral disc herniation(FLDH) with compression of the nerve root as it exits through the foramen has been a recognized entity for a number of years. Failure to diagonose and precisely localize these herniations can lead to unsuccessful surgical exploration or exploration of the innocent interspace. If these herniation are diagnosed, they often cannot be adequately exposed by the classic minline hemilaminectomy approach. A partial or complete unilateral facetectomy to expose these herniations can lead to vertebral instability or contribute to continued postoperative back pain. The authors present 5 patients who were diagnosed as having far lateral lumbar disc herniations from 1988 to 1990. Two of these were at L4-5 level, two at L5-S1 level and one at L3-4 level and all were over 60 years old. High resolution CT scan appeared to be the best study and the paramedian muscle splitting microsurgical approach, done in 3 cases, was found to be the most direct and favorable anatomical route to FLDH for vertebral stability and minimal postoperative back pain.
Back Pain ; Humans ; Middle Aged ; Tomography, X-Ray Computed

Anterior cervical discectomy and fusion (ACDF) is currently the standard treatment for cervical disc disease. Some patients wish to be treated with a less invasive method, because of their social/physical situations. Here we present one method of treatments for socially/physically active patients. Three patients had triceps weakness and mild posterior neck pain. The offending lesions were at the C6-7 level. All were middle-aged soldiers with families. If conventional ACDF were performed, they would have to retire from the military according to the regulation. They had to be able to perform military drills after the treatment if they were going to be able to keep their jobs. Because of their social/physical situations, all wanted to choose method with that they could treat the disease and keep their jobs. For these reasons, the posterior cervical endoscopic discectomies were performed. Ruptured fragments were successfully removed in all. The arm pain improved by more than 90% in two patients by 7 days and in the other patient by 2 months, respectively (excellent outcome by Macnab's criteria). None of the operations caused instability. All of the patients are currently able to successfully perform their military drills without difficulty. The posterior cervical endoscopic discectomy may be a promising alternative for the physically/socially active patients.
Adult ; Cervical Vertebrae/radiography/*surgery ; *Diskectomy ; Endoscopy ; Humans ; Intervertebral Disk/radiography/surgery ; Magnetic Resonance Imaging ; Male ; Severity of Illness Index ; Tomography, X-Ray Computed ; Treatment Outcome

No abstract available.

OBJECTIVE: The purpose of this study is to assess the survival and prognostic factors of surgically treated metastatic spine tumors. METHODS: A retrospective review of 68 patients who underwent the surgical treatment of metastatic spine tumors from 1988 to 2001 was conducted. The survival of each patient was confirmed on Feb 2002. The survival rates were calculated and several variables were examined for prognostic factors. RESULTS: Postoperative mean survival time was 21.1 months. Three month and 2 year cumulative survival was 70.3% and 21.4%, respectively. The patients who survived less than 3 months after operation were 23(33.8%). The significant prognostic factors were the category of primary tumors, postoperative ambulation, preoperative functional status, and the interval between initial diagnosis and spine metastasis. CONCLUSION: The postoperative survival was related with the biologic behavior of primary tumor and general physical condition. High mortality rate in postoperative three months suggests that more sophisticated selection criterion is needed.
Diagnosis ; Humans ; Mortality ; Neoplasm Metastasis ; Retrospective Studies ; Spine* ; Survival Analysis* ; Survival Rate ; Walking

For the experimental study of neural tube defect (NTD), a surgical model has advantages over other models in a few aspects. It causes less functional derangement of cells and the NTDs can be made selectively by surgery. The authors planned to use the surgical model for the experimental study of NTD. As the first step for the studies, the chronological changes of morphology during the early postoperative period were investigated using postincubation 3-day chick embryos. The objectives of this study are (1) the morphological evaluation of the surgical model as a method for studies of open NTD, and (2) the observation of morphological changes for the first 24 hours after surgery which include 'overgrowth' appearance and the continuity between the surface ectoderm and the neuroectoderm. The morphological changes were observed by light microscope and scanning electron microscope. Immediately after surgery, typical open NTDs were observed. Morphologically they were very similar to the appearance of spontaneous (non-surgical) open NTDs. The opened neural tubes were everted progressively and they looked rather flat at 24 hours after surgery. Cellular hyperplasia ('overgrowth' appearance) was noted within 24 hours after surgery and became more prominent during the 24 hours. There was increasing continuity between the surface ectoderm and the neural tissue until 24 hours after surgery when the continuity looked almost complete. In conclusion, surgically induced NTDs are morphologically very similar to spontaneous NTDs.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals ; Chick Embryo ; *Disease Models, Animal ; Evaluation Studies as Topic ; Neural Tube Defects/etiology/*pathology ; Postoperative Period

To determine the effects and its complications of ventral cervical and selective spinal accessory nerve rhizotomy in the spasmodic torticollis, 14 patients who had undergone surgery between 1989 and 1997 were reviewed retrospectively. In overall twenty four operations were performed. The ventral cervical rhizotomy with spinal accessory nerve rhizotomy were performed in nine patients and the ventral cervical rhizotomy without spinal accessory nerve rhizotomy were done in two patients. Five cases of sternocleidomastoid myotomy with or without peripheral accessory neurectomy, and the five cases of peripheral accessory neurectomy were also performed. In two patients, the selective peripheral denervations were performed. In overall thirteen patients(93%) showed improvement in their condition. Of the eleven patients with the ventral cervical rhizotomy and spinal accessory nerve rhizotomy, nine patients(82%) improved. Five patients suffered from dysphagia or dysphonia postoperatively for several months, but one patient is having more than two years. Of these six patients, five patients had undergone the bilateral upper cervical rhizotomy and bilateral accessory nerve rhizotomy. Therefore to reduce the postoperative dysphagia or dysphonia, the authors recommend to save the unilateral cervical ventral roots or unilateral accessory nerve root. The authors also stress that the selective peripheral denervation would be the choice of operation in cases with the spasmodic torticollis because of its effectiveness and rarity of complications.
Accessory Nerve ; Deglutition Disorders ; Denervation ; Dysphonia ; Humans ; Retrospective Studies ; Rhizotomy* ; Spinal Nerve Roots ; Torticollis*

OBJECTIVE: To describe the underlying causes, surgical results, and prognostic factors in thoracic stenosis causing myelopathy, retrospective analysis for 28 cases of thoracic stenosis with surgery was performed MATERIALS AND METHOD: Twenty-eight patients(male, 15; female, 13) who underwent decompressive surgery for thoracic stenosis between 1987 and 1997 were analyzed. The mean age was 49 and the mean follow-up was 30.6 months. Statistical analysis with SPSS(r) was performed. Chi-square test was used for the analysis of relationship between subjects and multivariate analysis with general linear model was used to find prognostic factors. RESULT: Degenerative spondylosis was the most common cause, and three cases were associated with systemic diseases. Decompressive laminectomy was done in 23 cases, anterior decompression in four cases, and combined decompression in one case. Ossification of ligamentum flavum was found in 18 cases, facet hypertrophy in 13, ossification of posterior longitudinal ligament in six, and ventral spur in four. Postoperatively, 16 patients improved functionally and 4 patients worsened. The group of which initial symptom duration was less than two years showed better result(p=0.003). The group with sufficient decompression and no additional proximal stenosis had better outcome(p=0.002, p=0.001). CONCLUSION: Chronic myelopathy caused by thoracic stenosis can be reversible with appropriate decompression.
Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Humans ; Hypertrophy ; Laminectomy ; Ligamentum Flavum ; Linear Models ; Multivariate Analysis ; Ossification of Posterior Longitudinal Ligament ; Retrospective Studies ; Spinal Cord Diseases ; Spinal Stenosis* ; Spondylosis