Open discectomy is one of usual treatment for herniated intervertebral disc. We may expect the reduction of height of intervertebral disc due to decreased volume by partial resection of herniated disc. But the effect of decreased height of intervertebral disc space to posterior joint and spinal canal has not been identified, and the correlation between the amount of reduced height and the changes of range of motion has been undetermined. Thus, we analyzed radiologic changes of disc height and segmental motion by the flexion-extension view in 20 patients who had undergone discetomy for prolapsed intervertebral disc from June 1989 to January 1991 who could be followed up for 3 years or more. As a result, lumbar discetomy associates with 1) significant decrement of disc height (average 14%), 2) decreased disc motion of involved segment without hypermobility (average 34%), 3) hypermobility of adjacent segment, 4) and posterior facet overriding consistent with recurred low back pain.
Diskectomy ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Joints ; Low Back Pain ; Range of Motion, Articular ; Spinal Canal

Acrodynia is caused by chronic mercury poisoning and/or mercury, hypersensitivity occuring in infants and children only. Ingestion or inhalation of mercury contained in some house paints, calomel ingestion, the use of mercury ointments and other mercurial preparations can be the causes of acrodynia. We herein report a 3-year-old boy with typical acrodynia after expoaure to house paints and lacquer for 2 months. His hands and feet were erythematous and edematous vesiculo-bullous lesion with acral dark bluish discoloration. Mercury levels of blood and urine were significantly incresed by 61. 2ug/dl and 264ug/L (normal; below 30ug/dl and 100ug/L).
Acrodynia* ; Child ; Child, Preschool ; Eating ; Foot ; Hand ; Humans ; Hypersensitivity ; Infant ; Inhalation ; Lacquer ; Male ; Mercury Poisoning ; Ointments ; Paint

Tumors of the sacrum are relatively uncommon. The diagnosis is difficult, especially in the early phase of the disease, because the clinical manifestations are nonspecific, the clinical signs may be vague and the radiologic changes are needed to differentiate from intestinal gas shadow. The clinical features are sacral pain, sensory change on perineum, urination difficulty, constipation, and sciatica. Seven cases of sacral tumor were treated at the Department of Orthopaedic Surgery, Kyung Hee University, from October 1981 to October 1992, and the results were as follows: 1. Because of the variability of the sacral tumor, we cannot define the most common tumor. 2. There is difficult in early diagnosis of the tumor, because the symptoms of tumor are similar to that of lumbar disc herniation and the radiologic findings are subtle. 3. CT and MRI are very effective methods to detect the tumor in the sacrum. 4. Curettage, excision, resection, sacrectomy and internal fixation were done according to the kinds of tumors and the amount of bony destruction.
Constipation ; Curettage ; Diagnosis ; Early Diagnosis ; Magnetic Resonance Imaging ; Perineum ; Sacrum ; Sciatica ; Urination

OBJECTIVE: This study was designed to establish the treatment strategy on postoperative persistent pain of endometriosis. METHODS: During a 12-month period from March 2000 to February 2001, 62 patients had postoperative persistent pelvic pain. 62 patients of them were treated with GnRH analogue for 6 months. If they were not responsive to those treatment, It were recommended high dose progesterone treatment for 6 months after trigger point injection to differentiate from trigger point pain. and then for remained pain, Nonsteroidal antiinflammatory drugs (NSAIDs) and tricyclic antidepressants (TCAs) were supplied for 6 months. Finally, contineously remained pelvic pain was treated by mistletoe extract. RESULTS: 62 patients had a postoperative persistent pelvic pain. GnRH analogue were supplied to 62 patients, and then 23 patients had persistent pain. These 23 patients undertook lidocaine injection on trigger point to differentiate from trigger point pain. Two patients were responsive to injection. Remained 21 patients were treated with high dose progesterone for 6 months. Thereafter unresponded 14 patients were supplied with NSAIDs and TCAs. Finally, remained 5 patients that were uncontrolled with previous treatments were injected with mistletoe extract. Three patients were controlled with mistletoe extract. CONCLUSION: Most of persistent pain after laparoscopic operation of endometriosis were successfully controlled by sequential treatment of GnRH analogue, trigger point injection, high dose progesterone, NSAIDs and TCAs, and mistletoe extract injection.
Anti-Inflammatory Agents, Non-Steroidal ; Antidepressive Agents, Tricyclic ; Endometriosis* ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Lidocaine ; Mistletoe ; Pelvic Pain ; Progesterone ; Trigger Points

Management of the impalpable testis is one of the controversial issues in cryptorchidism. So we studied to evaluate the usefulness of laparoscopy and surgical methods for impalpable testis. From January 1992 to December 1993, a total of 36 patients with impalpable cryptorchid was admitted to Seoul National University Children's Hospital. All the patients were examined by laparoscopy under general anesthesia. According to laparoscopic finding, in 15 patients with high abdominal testis, we performed 5 microscopic testicular autotransplantations and 10 testicular vessels transsections(Fowler-Stephens method). In other cases, We performed 9 standard orchiopexies and 6 orchiectomies. Complication of laparoscopy was not experienced. During mean follow up period of 12 months, success rate was 80% in microscopic testicular autotransplantation, 80% in testicular vessels transsection and 91% in standard orchiopexy. Therefore, we think that laparoscopy can be used safely to assess the accurate location of impalpable testis and that surgical methods including testicular autotransplantation are acceptable to high abdominal testis.
Anesthesia, General ; Autografts ; Cryptorchidism ; Follow-Up Studies ; Humans ; Laparoscopy ; Male ; Orchiectomy ; Orchiopexy ; Seoul ; Testis*

OBJECTIVE: This study was undertaken to evaluate the usefulness of laparoscopic myomectomy after hormone replacement therapy in postmenopausal women with uterine myoma. METHODS: The total number of patients with uterine myoma in a postmenopausal women from March 1999 to December 2002 in Department of Obstetrics and Gynecology in Chonnam University Hospital was 137. Patients underwent laparoscopic myomectomy are 12 (Group B) and only hormone replacement therapy without operation are 83 (Group A). The others are not undertaken any treatment (Group C). The number and size of myoma and the development of estrogen-dependent tumor periodically followed up. RESULTS: There were significant differences among three groups with respect to myoma dimension, number. And the risk of developing of estrogen dependent tumor is not increased with Hormone replacement therapy in postmenopausal women. So, laparoscopic myomectomy in a postmenopausal patients would be performed carefully. CONCLUSION: We are not sure whether HRT increases the number and size of the myoma and malignant change when compared with untreated with postmenopausal women. So, laparoscopic myomectomy in a postmenopausal patients would be performed carefully. Further prospective studies with larger groups and a long-term would be helpful in deciding which treatment modality would be appropriate in a postmenopausal patient with myoma.
Estrogens ; Female ; Gynecology ; Hormone Replacement Therapy* ; Humans ; Jeollanam-do ; Leiomyoma* ; Myoma ; Obstetrics ; Postmenopause

Hydrogen peroxide is considered to be a dose- and time-dependent mediator in apoptotic and necrotic death. In this study, we examined the signaling of the E6 and E7 proteins with respect to apoptosis or necrosis after H2O2 injury using an in vitro model with overexpressed E6 or E7 genes. For this purpose, the E6 and E7 gene expressing astrocytes were exposed to 0.01 mM and 0.2 mM H2 O2 solutions. Twenty- four hours after treatment with the lower dosage(0.01 mM H2O2), control, E6-expressing cells suffered about 45% injury and LXSN-expressi ng cells decreased by 67% as assessed by LDH release. However, E7-expressing cells showed less injury, resulting in 20-30% of LDH release. Astrocytes expressing E6, E7, LXSN and mock-infected cells showed a typical apoptotic death patter n on the DNA gel after treatment with a low-dose of H2O2 (0.01 mM), however the y died from necrotic death after a high-dose (0.2 mM) H2O2. Overexpression of HPV-E7 genes protected the cells from apoptotic death after a low-dose of H2O2 and from necrotic death after a high-dose of H2O2, while the overexpression of E 6 genes from the necrotic death. E7 expressing astrocytes showed higher catalas e activity and the levels of E2F protein surged more than 100-folds compared with the control astrocytes. We believe that the activity of E7 protein to protect astrocytes from H2O2 injury was at least partly due to increased catalase, a scavenger protein.
Animal ; Apoptosis/*physiology ; Astrocytes/*drug effects/pathology/*physiology ; Cells, Cultured ; Hydrogen Peroxide/*pharmacology ; Mice ; Necrosis ; Oncogene Proteins, Viral/*genetics/*physiology ; Oxidants/*pharmacology ; Signal Transduction/physiology

No abstract available.
Female* ; Human Growth Hormone* ; Humans*

The prevalence of intervertebral disc herniation (IDH) of the thoracic spine is rare compared to the cervical or lumbar spine. In particular, IDH of the upper thoracic spine is extremely rare. We report the case of T1-2 IDH and its treatment, with a literature review. A 37-year-old male patient visited our hospital due to radiating pain at the left upper extremity and weakness of grip power. In cervical spine magnetic resonance images, T1-2 disc space showed herniated disc material and compressed T1 root was identified. Laminoforaminotomy was performed with a posterior approach. The radiating pain and weakness of grip power improved immediately after the surgery. Of patients who show radiating pain or numbness at the medial aspect of forearm, or weakness of intrinsic muscle of hand, can be suspected to have T1 radiculopathy. A detailed physical examination and a radiologic evaluation including this area should be required for the T1 radiculopathy.
Adult ; Forearm ; Hand ; Hand Strength ; Humans ; Hypesthesia ; Intervertebral Disc ; Intervertebral Disc Displacement ; Laminectomy ; Magnetic Resonance Spectroscopy ; Male ; Muscles ; Physical Examination ; Prevalence ; Radiculopathy ; Spine ; Thoracic Vertebrae ; Upper Extremity

Cutaneous metastases from follicular thyroid carcinoma are extremely rare. A 59-year-old woman presented with a 1 month history of a slowly enlarging scalp nodule. Ten years earlier, the patient had been received total thyroidectomy for anterior neck mass, and diagnosed as poorly differentiated follicular thyroid carcinoma. The patient had developed pulmonary metastases 4 years after the initial surgery and concurrent chemotherapy. A biopsy from the scalp nodule showed an intradermal tumor composed of mostly thyroid follicular structures with colloid material. The tumor cells were monomorphic with scant pale cytoplasm and uniform nuclei, and stained positive for thyroid transcription factor-1 and thyroglobulin. We report a cutaneous metastasis from the follicular thyroid carcinoma as a rare case.
Adenocarcinoma, Follicular ; Biopsy ; Colloids ; Cytoplasm ; Female ; Humans ; Middle Aged ; Neck ; Neoplasm Metastasis ; Scalp ; Thyroglobulin ; Thyroid Gland ; Thyroidectomy