Harrington Instrumentation and Spinal Fusion to treat the unstable fracture and fracture-dislocation of the thoraco-Iumbar spine is a very effective method. This method not only decompresses the spinal cord and nerve roots by anatomical reduction and preserves spinal stability, but also makes possible early rehabilitation and prevention of complications. A clinical study was made of twelve patients who were hospitalized and treated at the Department of Orthopaedic Surgery, Chung-Nam National University Hospital from Oct. 1978 to J une 1980. The following results were obtained: 1. Of twelve patients, five(42%) had a flexion-compression fracture, four(33.3%) had a shear fracture-dislocation, two(16.7%) had a flexion-rotational fracture, and one(8.3%) had a bursting fracture. 2. Seven(58%) had a complete neural deficit and five (42%) had an Incomplete neural deficit. Two (28%) of the seven patients with complete neural deficit showed slight neurological recovery, but two patients(40%) with incomplete neural deficit gained complete recovery. 3. Correction of the kyphotic deformity was 16 degrees on the average, and the displacement was completely corrected in five of the six patients. 4. During the follow-up period, there was a final loss of about five degrees (range 3-16 degree) of kyphotic correction In our patients and there was no difference in loas of correction between laminectomy group and control group. 5. After an average of 18 postoperative days, ambulation was started, and acute hospital days were 77 days on the average. 6. There was no difference in spinal fusion rate between brace-wearing group (4 cases) and cast Immobilized group (8 cases). 7. Two cases (16.6%) of the twelve cases showed spontaneous interbody fusion.
Clinical Study ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Laminectomy ; Loa ; Methods ; Rehabilitation ; Spinal Cord ; Spinal Fusion ; Spine ; United Nations ; Walking

PURPOSE: To evaluate the radioloic findings of malignant retroperitoneal fibrosis. MATERIALS AND METHODS: Post-contrast CT (n=9) and urographic (n=7) findings of nine patients with malignant retroperitoneal fibrosis were retrospectively analyzed. Primary tumors were found to be advanced gastric cancer (n=6), early gastric cancer (n=1), breast cancer (n=1), and cervical cancer (n=1). We analyzed CT findings with regard to the site of soft tissue lesion, ureteral involvement, the presence or absence of hydronephrosis, and distant metastasis. The level and length of ureteral involvement, presence or abscence of ureteral stenosis, and ureteral displacement as seen on urography, were analyzed. RESULTS: On CT scans, enhanced soft tissue lesions (mass, 5 cases; plaque, 4 cases) encircling the abdominal aorta and IVC were noted in all cases. Thickening of the ureteral wall (n=8), hydronephrosis (n=9), and enlarged lymph node (n=5) were also seen. On urography, irregular stenosis and medial displacement of ureters from level L2 to S2 were noted in all cases. The length of ureteral involvement was 4-6.5cm. CONCLUSION: The common CT findings of malignant retroperitoneal fibrosis were enhanced soft tissue lesion encircling the abdominal aorta and IVC, hydronephrosis, and thickening of the ureteral wall. On urography, ureteral stenosis and medial displacement were seen.
Aorta, Abdominal ; Breast Neoplasms ; Constriction, Pathologic ; Humans ; Hydronephrosis ; Lymph Nodes ; Neoplasm Metastasis ; Retroperitoneal Fibrosis* ; Retrospective Studies ; Stomach Neoplasms ; Tomography, X-Ray Computed ; Ureter ; Urography ; Uterine Cervical Neoplasms

PURPOSE: Patients with gallbladder cancer tend to have advanced, unresectable tumor at the time of presentation and they face a dismal prognosis in the absence of a standard chemotherapy regimen. This study was performed to evaluate the outcomes of patients with gallbladder cancer and who underwent postoperative gemcitabine-based chemotherapy. METHODS: From March of 2001 to February of 2008, a total of 27 patients underwent operation for gallbladder cancer. They underwent two types of gemcitabine-based chemotherapy. One type of regimen was the combined administration of gemcitabine 1,000 mg/m2 and 5-fluorouracil 200 mg/m2. The other one was combined administration of gemcitabine 1,000 mg/m2 and cisplatin 70 mg/m2. RESULTS: Among the 27 patients, 15 patients were treated with gemcitabine-based chemotherapy and 12 patients were treated with many kinds of the best supportive care without chemotherapy. The median survival was 29.1+/-2.7 months and 15.7+/-2.8 months, respectively. The median survival and disease free survival for the gemcitabine based chemotherapy group who received curative resection was 31.6+/-2.5 and 15.7+/-3.2 months, respectively. The median survival and disease free survival for the patients without chemotherapy after curative resection was 16.3+/-2.9 and 15.7+/-3.2 months, respectively. CONCLUSION: Patients with gallbladder cancer and who received adjuvant gemcitabine-based chemotherapy had a relatively favorable prognosis. Especially, gemcitabine-based combination chemotherapy could be effective and acceptable for the treatment of gallbladder cancer patients who have undergone curative resection.
Cisplatin ; Deoxycytidine ; Disease-Free Survival ; Drug Therapy, Combination ; Fluorouracil ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Prognosis

PURPOSE: Radical gastrectomy and lymph node dissection is the treatment of choice for gastric cancer but the efficacy of surgical treatment of recurrent gastric cancer has been debated. We evaluated the efficacy of surgical treatment for recurrent gastric cancer. METHODS: We collected the data on 108 recurrent gastric cancer patients who underwent radical gastrectomy and lymph node dissection for gastric cancer and analyzed the clinicopathologic data, the patterns of recurrence of gastric cancer, and the strategies of treatment for recurrent gastric cancer. RESULTS: The patterns of recurrence were 32 locoregional, 26 hematogenous, 24 peritoneal, and 26 mixed recurrences. The strategies of treatment for recurrent gastric cancer were the combination of surgical treatment and chemotherapy in 31 cases (28.7%), chemotherapy alone in 49 cases (45.4%), and conservative treatment in 28 cases (25.9%). The morbidity and mortality in reoperation group were 35.5% and 9.7%, respectively. The mean survival after recurrence was 25.4, 12.7, and 4.9 months in reoperation group, chemotherapy group and conservative treatment group, respectively. In multivariate analysis, the differentiation of primary tumor, patterns of recurrence, and the strategies of treatment for recurrent gastric cancer were related with survival after recurrence of gastric cancer. CONCLUSION: Our data suggested that the more aggressive and intensive treatment such as surgical treatment could improve the survival rate for recurrent gastric cancer. Therefore, if the patients' conditions are tolerable and there is resectability, surgical treatment may be an applicable strategy for recurrent gastric cancer in terms of long-term survival.
Gastrectomy ; Humans ; Lymph Node Excision ; Multivariate Analysis ; Recurrence ; Reoperation ; Stomach Neoplasms ; Survival Rate

BACKGROUND: Amplifications of the HER-2/neu oncogene and the Topoisomerase II-alpha gene are important determiners of the response to chemotherapy in the breast cancer. For detecting HER-2/neu amplification, fluorescent in situ hybridization and immunohistochemistry are currently regarded as standard methods. Chromogenic in situ hybridization (CISH) is investigated as a new modification of in situ hybridization. The purpose of this study is to compare the efficacy of CISH and immunohistochemistry (IHC) in detecting HER-2/neu oncogene amplification and to investigate the prognostic significance of the HER-2/neu oncogene and the Topoisomerase II-alpha gene in breast cancer. METHODS: Using CISH and IHC the amplifications and protein expressions of the HER-2/neu oncogene were studied on paraffin sections of 43 infiltrating duct carcinomas. The expression of the Topoisomerase II-alpha gene was studied immunohistochemically. RESULTS: Of the 43 infiltrating duct carcinomas, amplifications of the HER-2/neu oncogene by CISH were observed in 8 cases (18.6%), and the HER-2/neu protein was deemed overexpressed by IHC in 9 cases (20.9%). The amplifications of the HER-2/neu oncogene showed a statistically significant correlation with tumor size, histological grade, and the Topoisomerase II-alpha index. The Topoisomerase II-alpha index showed a statistically significant correlation with tumor size, lymph node status, stage, histologic grade, and estrogen receptor status. CONCLUSIONS: CISH is a useful alternative for determining HER-2/neu amplification, especially for confirming the immunohistochemical staining results. HER-2/neu amplification and the Topoisomerase II-alpha gene index may be prognostic factors of breast cancer.
Animals ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Estrogens ; Immunohistochemistry ; In Situ Hybridization* ; In Situ Hybridization, Fluorescence ; Lymph Nodes ; Mammary Neoplasms, Animal ; Oncogenes* ; Paraffin

OBJECTIVE: To investigate the relationship between umbilical plasma erythropoietin(epo) concentrations and umbilical cord pH in high risk pregnancies. METHODS: We measured epo concentrations and gas in 103 cases of cord blood obtained from 88 cesarean section (15 of twin) composed of 39 cases of normal control (12 of normal twins), 45 cases of high risk pregnancies and 4 cases of unclassified group using an RIA kit from december,1998 to December, 1999. Statistical analysis was performed using the student's t test and regression analysis. P values less than 0.05 were considered statistically significant. RESULTS: Umbilcal plasma epo concentrations revealed significant inverse correlation (P<0.05) with umbilical acidosis and cord blood epo levels, and it were significantly higher in GDM and IUGR than normal pregnancies (control: 1.60 1.15, n=39 versus GDM: 7.78 7.18, n=11 versus IUGR: 64.77 90.57 n=10, p<0.05), but 11 cases of fetal distress and 13 cases of preeclampsia did not differ significantly from umbilical plasma epo of normal control. CONCLUSIONS: Elevated epo concentrations in cord blood indicate fetal hypoxia and It is significantly increased in IUGR and GDM, these findings show that cord blood epo may serve as a clinically useful marker for chronic fetal hypoxia.
Acidosis ; Cesarean Section ; Erythropoietin* ; Female ; Fetal Blood* ; Fetal Distress ; Fetal Growth Retardation ; Fetal Hypoxia ; Hydrogen-Ion Concentration ; Plasma ; Pre-Eclampsia ; Pregnancy* ; Umbilical Cord

Autoimmune insulin syndrome is characterized by insulin autoantibody, hyperinsulinemia, and fasting hypoglycemia without previous insulin immunization. This syndrome shows discordant levels between immunoreactive insulin and C-peptide. Negative results of an anatomic study of the pancreas and an inability to reproduce hypoglycemia during a prolonged fast may be helpful in excluding insulinoma. Symptomatic hypoglycemia usually develops during an oral glucose tolerance test. This syndrome is a self-limited disorder. Recently, we experienced one case that developed symptomatic hypoglycemia during both the fasting & oral glucose tolerance test, and another that developed symptomatic hypoglycemia during the oral glucose tolerance test but not the fasting test. Hereby, we present these cases with a review of the literature.
C-Peptide ; Fasting ; Glucose Tolerance Test ; Hyperinsulinism ; Hypoglycemia* ; Immunization ; Insulin* ; Insulinoma ; Pancreas

PURPOSE: To compare satisfaction after laser in situ keratomileusis (LASIK) with satisfaction after wavefront guided customized LASIK. METHODS: One hundred fifty-nine patients were included in this randomized, comparative, clinical trial. A myopia-specific Quality of Life Questionnaire was used to evaluate postoperative satisfaction. RESULTS: Overall questionnaire scores improved after both procedures. Wavefront LASIK showed higher satisfaction scores with respect to "Difficulty in visiting others", "Need a lot of help from others", and "Improvement of quality of life". But, most of the questionnaires did not show differences in actual visual satisfaction of daily living. CONCLUSIONS: Conventional and wavefront LASIK improved the visual satisfaction of patients. However, for the most part there was no difference in improvement of daily living between the two procedures.
Humans ; Keratomileusis, Laser In Situ* ; Patient Satisfaction* ; Quality of Life ; Surveys and Questionnaires

BACKGROUND: Cell cycle deregulation plays a major role in chemical multistage carcinogenesis.Therefore, the evaluation of cell cycle proteins is important. METHODS: In order to induce carcinogenesis in the rat urinary bladder, 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)was administered to male Sprague-Dawley rats for 30 weeks. Expressions of cyclin D1, A, E, and B1 were examined by immunohistochemical stainings. RESULTS: Urothelial cell hyperplasia appeared at 5 weeks, followed by papilloma at 10 weeks. Superficial carcinoma was observed at 20 weeks, and invasive carcinoma developed in 40% (4/10) of the rats at 30 weeks. Expressions of cyclin D1 and A increased sequentially from normal mucosa throughhyperplasia, papilloma, and carcinoma (p<0.01). Expressions of cyclin D1, B1 and cyclin Ewere higher in invasive carcinomas than in superficial carcinomas (p<0.01). In contrast, therewas no significant difference in the expression of cyclin B1 between hyperplasia, papillomaand superficial carcinoma. CONCLUSIONS: The present results indicate the important roles of cyclin D1 and A in the development of BBN-induced urothelial carcinoma of rats. Aberrantexpression of cyclin B1 and E may contribute to the progression from superficial to invasivebladder cancer rather than tumorigenesis.
Animals ; Carcinogenesis* ; Cell Cycle ; Cell Cycle Proteins ; Cyclin B1 ; Cyclin D1 ; Cyclins* ; Humans ; Hyperplasia ; Male ; Mucous Membrane ; Papilloma ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder*

A 75-year-old man was referred to our hospital with intestinal obstruction caused by intussusception. Abdominal computed tomography (CT) revealed seven polypoid masses in the small intestine, while chest CT revealed a mass in the right lower lobe. Preoperative laboratory tests showed white blood cell (WBC) and neutrophil differential counts of 63,630/mm3 and 95%, respectively. The serum granulocyte colony-stimulating factor (G-CSF) was 114 pg/mL, which was elevated (normal range, <18.1 pg/mL). After resection of the small bowel, the WBC count decreased to 20,510/mm3. The pathology showed a poorly differentiated carcinoma with sarcomatous components confirmed by positive immunostaining of cytokeratin (AE1/AE3) and vimentin in the small intestine. Furthermore, immunohistochemistry with specific monoclonal antibodies against G-CSF was positive. A lung biopsy revealed the same histological findings as the small intestine lesion. Therefore, the patient was diagnosed as having a G-CSF producing sarcomatoid carcinoma of the lung with metastasis to the small intestine.
Aged ; Antibodies, Monoclonal ; Biopsy ; Carcinosarcoma ; Granulocyte Colony-Stimulating Factor ; Granulocytes ; Humans ; Immunohistochemistry ; Intestinal Obstruction ; Intestine, Small ; Intussusception ; Keratins ; Leukocytes ; Lung ; Neoplasm Metastasis ; Neutrophils ; Thorax ; Vimentin