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

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

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

The most common cause of chronic cutaneous sinus tract in the face and neck is chronically draining dental infection. The diagnosis is easily confirmed by dental examination and dental roentgenogram of the involved area, but this disease is frequently misdiagnosed and incorrectly treated in dermatologic department. We report four cases of cutaneous sinus tract of dental origin. First patient had a painful nodule with chronically draining pus and a dimple on the left cheek. Second patient had a dimple with draining bloody fluid on the right chin. Third patient had a pea-sized papule with draining serous fluid on the left chin. Fourth patient had a fluctuant erythematous plaque with draining pus and a dimple on the left buccal area. In all four patients radiologic examination of the maxillary and mandibular regions demonstrated radioluency at the apex of tooth consistent with periapical abscess.
Cheek ; Chin ; Diagnosis ; Humans ; Neck ; Periapical Abscess ; Suppuration ; Tooth

Purpura is discoloration of the skin and mucous membranes due to extravasation of red blood cells and may be due to a variety of factors, but it is sometimes difficult to identify the exact cause. Some forms of purpura can frighten the patient and puzzle the physician. Mask phenomenon is an unusual purpura of the relatively loose tissues of the face and neck occuring after prolonged coughing, vigorous vomiting, valsalva's maneuver, parturition, or any other exertion that raises intrathoracic or abdominal pressure. This occurs with acute onset and fades within twenty-four to seventy-two hours spontaneously. A work-up for a coagulation or platelet defect is usually not required. We herein describe five cases of mask phenomenon(unusual facial purpura).
Blood Platelets ; Cough ; Erythrocytes ; Humans ; Masks* ; Mucous Membrane ; Neck ; Parturition ; Purpura* ; Skin ; Valsalva Maneuver ; Vomiting

Purpura is discoloration of the skin and mucous membranes due to extravasation of red blood cells and may be due to a variety of factors, but it is sometimes difficult to identify the exact cause. Some forms of purpura can frighten the patient and puzzle the physician. Mask phenomenon is an unusual purpura of the relatively loose tissues of the face and neck occuring after prolonged coughing, vigorous vomiting, valsalva's maneuver, parturition, or any other exertion that raises intrathoracic or abdominal pressure. This occurs with acute onset and fades within twenty-four to seventy-two hours spontaneously. A work-up for a coagulation or platelet defect is usually not required. We herein describe five cases of mask phenomenon(unusual facial purpura).
Blood Platelets ; Cough ; Erythrocytes ; Humans ; Masks* ; Mucous Membrane ; Neck ; Parturition ; Purpura* ; Skin ; Valsalva Maneuver ; Vomiting

Spinal block procedures are useful methods that reduce the need for surgical treatment. In addition to their therapeutic aspects of pain relief, in many patients, they are also used for diagnostic purposes to distinguish from symptoms originating from extra-spinal areas. Therefore, these procedures are the most basic technique for orthopedic surgeons dealing with diseases from limbs and spine. On the other hand, despite the simplicity of the instruments and drugs used, the overall understanding of them and the lack of knowledge of the possible side effects and complications can cause serious harm to the patient at the beginning of the trial. Therefore, it is necessary to understand the types of drugs used in the spinal block procedures, pharmacokinetic properties, and the side effects of each drug. In addition, efforts should be made to identify their indications, as well as advantages and disadvantages of each procedure to avoid possible complications. The purpose of this review was to provide basic knowledge and skills necessary for lumbar spinal block procedures as well as provide the reader with the ability to perform themselves.

In gliomas, the most frequently studied tumor suppressor gene is the p53 gene which has been found to be mutated in a considerable fraction of astrocytomas and glioblastomas. Mutations that alter the function of the p53 gene product are thought to play a critical role in glial tumorigenesis. The murine double minute 2(MDM2) gene has been shown to code for a cellular protein that forms a complex with the p53 tumor suppressor gene product and inhibits its function. The fact that MDM2 can negatively regulate p53 suggests MDM2 could function as an oncogene when overexpressed. We investigated the expression of p53, MDM2 and proliferative activity of the tumor cells in 71 cases of gliomas(17 cases of differentiated astrocytomas. 25 cases of anaplastic astrocytomas and 29 cases of glioblastomas). Their paraffin-embedded tissue sections were immunostained with monoclonal antibody(p53 and PCNA, proliferating cell nuclear antigen) and polyclonal antibody(MDM2) for detection of p53, MDM2 and PCNA respectively. The results were as follows: The p53 staining was positive in 28 cases(39.4%) and MDM2 staining in 5 cases(7.0%) of 71 gliomas. The p53 positive-staining was detected in 2 cases(11.8%) of 17 differentiated astrocytomas, 9 cases(36.0%) of 25 anaplastic astrocytomas and 17 cases(58.6%) of 29 glioblastomas. The p53 expression was associated with malignancy grade(p<0.005) and proliferative activity was strongly associated with malignancy grade(p=0.0001). The p53 expression was closely associated with proliferative activity : p53-positive tumors had significantly higher median PCNA-labeling index than p53-negative tumors(40.6+/-10.1% versus 19.6+/-15.0%)(p=0.0001). But, MDM2 expression was not associated with proliferative activity(p=0.4575). The proportion of p53 immunoreactivity had significant association with proliferaive activity: the more the proportion of p53 immunoreactivity increased, the higher PCNA-labeling index elevated(p=0.0001). None of the tumors with MDM2 expression showed immunoreactivity for p53. These results suggest that the mutation of p53 gene plays a critical role in malignant transformation in glioma and it could be the prognostic factor for histologically same grade gliomas and that a subset of human gliomas escapes from p53-regulated growth control by amplification and overexpression of MDM2. Therefore gene study targeting these genes may be useful for the management of human glioma as a diagnostic modality.
Astrocytoma ; Carcinogenesis ; Genes, p53 ; Genes, Tumor Suppressor ; Glioblastoma ; Glioma* ; Humans ; Oncogenes ; Proliferating Cell Nuclear Antigen ; Proto-Oncogene Proteins c-mdm2 ; United Nations

The role of cerebral revascularization in the treatment of ischemic stroke has been incompletely investigated. Ten patients with middle cerebral artery occlusion or stenosis and four patients with internal carotic artery occlusion or stenosis underwent superficial temporal artery-middle cerebral artery(STA-MCA) bypass surgery in the setting of acute neurological deficits, crescendo transient ischemic attacks(TIA'S), or recent completed stroke(CS). Early STA-MCA anastomosis was remarkably helpful in the setting of acute cerebral ischemia and crescendo TIA'S for their symptomatic relief. In addition, low flow revascularization were performed safely and also contributed to stabilization or slight reduction of the neurological deficit enen in CS. However, further controlled randomized studies are indicated.
Arteries ; Brain Ischemia ; Cerebral Revascularization ; Constriction, Pathologic ; Humans ; Infarction, Middle Cerebral Artery ; Stroke*

OBJECTIVES: We investigated the parenting stress and depressive mood of mothers with developmentally-delayed children and the effects of participation in a mother-child development promotion program on same. METHODS: Subjects were the mothers of 20 developmentally-delayed children. The severity of the mothers' parenting stress was evaluated via the Korean version of the Parenting Stress Index, Short Form (K-PSI-SF) and the severity of their depressive symptoms were evalueted by the Korean version of the Beck Depression Inventory (K-BDI). RESULTS: The mean K-PSI-SF score and mean K-BDI score for these mothers were 93.35 (SD=10.47) and 23.25 (SD=10.42), respectively. These scores correspond to high parenting stress and moderate depression. The mothers who participated in a mother-child attachment- promotion program showed significant decreases in their K-PSI-SF and KBDI scores. CONCLUSION: Our data suggest that a mother-child attachment promotion program with emphasis on child development is effective in reducing parenting stress and depressive mood in mothers of developmentally-delayed children.
Child ; Child Development ; Depression ; Humans ; Mothers ; Parenting ; Parents