Among the many causes producing lower back pain herniated nucleus pulposus and bulging disk have occupiedlarge percentaages and uniformly showed defect on lateral aspect of contrast filled thecal sac. But it isessential to differentiate each conditions from the other because of their different treatment methods.differentiation at metrizamide myelography between a diffusely bullging disk(unlikely to cause nerve rootcompression) and a herniated disk is based on the curature, extent, and multipllicity of the extradural deformityof the anterolateral margin of the contrast filled sac and o hte presence of fusiform widening of the most distalpart of the affected nerve root. The deformities caused by a bullging disk are round, usually symmetrical(aothoughoccasionally more prominent on one side), do not extend above or below the disk space, and can show multiple levelinvolvement; the nerve root is uniform in caliber and normal in size(although some of severe bulging show fusiformwidening of the most distal part of the affected nerve root). The deformities caused by a herniated disk isangular and extends cephalad and/or caudal to the level of the disk space; the affected nerve root is usuallywidened in its most distal visible part. A consecutive series of 50 patients with low back pain and no pasthistory of back surgery who did metrizamide myelography underwent spine CT and /or laminectomy. Using the criterialisted above for differentiation of bulging from herniated disk on metrizamide myelography, the myelographicdiagnosis was correct in 32(22 patients) of 34(24 patients) (95%) surgically and/or computed tomographicallyconfirmed bulging disks and in all 26 (100%) surgically and/or computed tomographically confirmed herniated disks.
Clothing ; Congenital Abnormalities ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Low Back Pain ; Metrizamide ; Myelography ; Spine

A patient with extraskeletal cervical epidural Ewing's sarcoma who presented with cervical radiculopathy is reported. A 58-year-old woman presented with right posterolateral neck pain and upper extremity radiculopathy. The computed tomography myelography showed epidural and paravertebral masses on right side, with widening of the ipsilateral neural foramina at the C2-C3 level. On magnetic resonance images, the mass was isointense to soft tissue on T1-weighted images, hyperintense on T2-weighted images, and showed diffuse enhancement on GdTA enhanced T1-weighted images. The staged, combined posterior and anterior approach were done and the tumor mass was subtotally removed. During postoperative adjuvant chemotherapy with Cytoxane, Adriamycin, Vincristine, Prednisolone regimen, the patient died of severe compression of upper cervical cord by recurrent, extended tumor mass in the spinal canal.
Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Middle Aged ; Myelography ; Neck Pain ; Prednisolone ; Radiculopathy ; Sarcoma, Ewing* ; Spinal Canal ; Upper Extremity ; Vincristine

Sixty four leprous claw hands had been operated on for intrinsic replacement extensor-extensor many tailed at the Department of Orthopedic Surgery, Kyungpook National University Hospital during the period from 1966 to 1970. The follow up study was carried out for fourty-one hands from one year to four years and nine months after operation, and evaluated by the following assessments. 1. Fully open hand assessment 2. Lumbrical position assessment 3. Hook position assessment 4. Closed fist assessment 5. Mechanics of closing 6. Separate finger movement in lumbrical position The results obtained were as follows: 1. The most of the cases were median-ulnar palsy. 2. The majority of them were in third decade young men. 3. Satisfactory result was 63.5% in appearance, 70.8% in function, 62.8% according to the patients statement, and 61.1% in overall total assessment. 4. As complication two cases of severe adhesion of the grafted tendons and significant lateral deviation on nine fingers were noted. 5. Preoperative and postoperative physiotherapy contributed a important roll in the end results.
Animals ; Fingers ; Follow-Up Studies ; Gyeongsangbuk-do ; Hand ; Hoof and Claw ; Humans ; Male ; Mechanics ; Orthopedics ; Paralysis ; Tail ; Tendons ; Transplants

PURPOSE: Although influenza is regarded as one of the major causes of morbidity and mortality in children with cancer, the actual vaccine coverage remains poor. We conducted evaluation of immunogenicity and safety of influenza vaccine in children with cancer. METHODS: In this study, 25 children with cancer who received influenza vaccine (SK influenza IX vaccine(R)) at the Korea Cancer Center Hospital between October and December 2009 were analyzed. Blood samples of patients were collected twice (at the beginning of this study and at 30th day after vaccination) and their antibody titers were measured using the hemagglutination-inhibition (HI) assay. Immunogenicity of the influenza vaccine was assessed by seroprotection rate on days 0 and 30, seroconversion rate on day 30, and mean fold increase (MFI) of geometric mean titer (GMT) of HI between days 0 and 30. RESULTS: Any of the subjects in our study did not experienced serious adverse events after influenza vaccination. Seroprotection rates were 68% for H1N1, 40% for H3N2, and 36% for B. Seroconversion rates were 12% for H1N1, 16% for H3N2, and 20% for B. MFIs were 0.9 for H1N1, 1.2 for H3N2, and 1.8 for B. CONCLUSION: In the study, we found a limited protective immune response to influenza vaccine, among subjects with cancer. However, some subjects showed seroconversion, and there were no severe adverse events among all subjects, supporting the recommendation of annual influenza vaccination in children with cancer.
Child ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Vaccination

BACKGROUND: Ondansetron is a specific 5-hydroxytrypamine (HT3) receptor antagonist, sodium channel blocker and mu-opioid receptor agonist. Prophylactic intravenous administration of ondansetron has an antiemetic effect in general and epidural anesthesia. This study is designed to evaluate the antiemetic effect of intravenous ondansetron in patient-controlled epidural analgesia (PCEA) patients. METHODS: Sixty ASA physical status I-II patients undergoing elective cesarean section under epidural anesthesia using 0.75% ropivacaine and fentanyl 50microgram were received intravenous fentanyl 50microgram plus ondansetron 2 mg (group 2 mg: n = 20), 4 mg (group 4 mg: n = 20) or 8 mg (group 8 mg: n = 20) after delivery of baby. PCEA was started using 0.15% ropivacaine and 50microgram/ml butorphanol (total volume: 300 ml, 4 ml of bolus dose, and 10 min of lockout interval). The intraoperative and postoperative incidence and severity of nausea and vomiting were recorded using 4 point scale (0: none, 1: mild, 2: moderate, 3: severe) for postoperative 24 hours. RESULTS: There were no significantly lower incidence and severity of nausea and vomiting in group 8 mg (10%, 5%) than group 2 mg (25%, 10%), and group 4 mg (20%, 10%) during postoperative 24 hours. CONCLUSIONS: Prophylactic intravenous ondansetron 8 mg injection with PCEA drug has no superior antiemitic effect than 2 mg or 4 mg in cesarean section patients under PCEA without significant side effects.
Administration, Intravenous ; Analgesia, Epidural* ; Anesthesia, Epidural ; Antiemetics ; Butorphanol ; Cesarean Section* ; Female ; Fentanyl ; Humans ; Incidence ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting* ; Pregnancy ; Sodium Channels ; Vomiting

This report describes a case of spinal nerve root compression due to an acute inflammatory granuloma after lumbar surgery. A 39 year-old man with a history of increasing back pain with a 3-week duration was diagnosed with a herniated intervertebral disc (HIVD). The diagnosis of a HIVD was confirmed by magnetic resonance imaging (MRI) with indications for surgery. A discectomy and a partial laminectomy was performed and the symptoms were alleviated immediately after surgery for a five-day period. However, a slowly progressing pain was subsequently noted along a different dermatome. There was no pain relief despite the patient being given pharmacological treatments, combined with an epidural steroid injection. The follow up MRI images showed severe compression of the nerve roots by a epidural lesion. Another procedure was performed 17 days after the initial operation. The lesion responsible for the compression of the nerve roots was found to be an acute inflammatory granuloma. The pain was relieved after the second procedure and there were no other symptoms or neurological problems. This case is remarkable in that a granuloma formed relatively quickly and grew to such a size that it was able to severely compress the surrounding nerve roots.
Adult ; Back Pain ; Diagnosis ; Diskectomy ; Follow-Up Studies ; Granuloma* ; Humans ; Intervertebral Disc ; Laminectomy ; Magnetic Resonance Imaging ; Spinal Nerve Roots* ; Spinal Nerves* ; Spine*

No abstract available.
Empyema* ; Gastroenteritis* ; Salmonella* ; Urinary Bladder*

A 60-year-old woman has experienced of right upper quadrant abdominal discomfort. This partient took cholecytectomy due to gall stone 15 years ago. At that time microscopic finding the neck of gallbladder showed well differentiated papillary adenocarcinoma confined to superficial part of musele layer. 3 years before admission she took T-tube drainage due to obstructive jaundice. The microscopic finding af distal common bile duct showed well differentiated adenocarcinoma. Recently she complained of pain and discomfort on T-tube site and so we perforrned endoscopic retrograde biliary drainage after removal of T-tube. The computed tomogram showed no mass in liver or lymph node enlargement. 4 months after procedure of ERBD; we changed to the new catheter for the prevention of cloggiag of prosthesis. We report here a case of longterm survival over 15 years after the diagnosis of cancer of extrahepatic bile duct.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Bile Ducts, Extrahepatic ; Catheters ; Common Bile Duct* ; Diagnosis ; Drainage ; Female ; Gallbladder* ; Gallstones ; Humans ; Jaundice, Obstructive ; Liver ; Lymph Nodes ; Middle Aged ; Neck ; Prostheses and Implants

No abstract available.
Pneumonectomy* ; Radiography, Thoracic* ; Thorax*

A fabrication method of inner and outer crown using CAD/CAM is presented. The information of abutment teeth is transferred to a computer through a 3-dimensional scanner. A Konus inner and outer crown is designed on a computer and a real crown is machined based on this design using CAM. This method can save laboratory time and reduce inaccuracies compare to conventional casting procedure. A stone model with six prepared abutment teeth from a patient was used in this study. Three dimensional information from the model was transferred to a computer using a contact type 3dimensional scanner with a 25micrometer accuracy. All margins were identified on a computer image where there is a change in surface taper of a model. To provide a cement space, the image of a inner surface of a Konus inner crown was duplicated 25micrometer apart from the surface of a prepared abutment teeth image. The cement space was 20micrometer at the cervical margin. All Konus crowns were machined with a 10micrometer accuracy. It was concluded that this method can reduce working-time for the laboratory process and increase accuracy. A further research is required to make a simplified process for a more complex prosthesis.
Computer Graphics* ; Crowns* ; Humans ; Prostheses and Implants ; Tooth