No abstract available.

STUDY DESIGN: We studied retrospectively the comparison of the clinical and radiologic results of surgical treatment between additional posterior lumbar interbody fusion group and posterolateral fusion with transpedicular screw fixation alone group for spondylolisthesis with segmental instability. OBJECTIVES: To evaluate the efficacy of additional PLIF group using threaded cage in surgical treatment of spondylolisthesis with instability. SUMMARY OF LITERATURE REVIEW: The interbody gap produced by operative reduction of spondylolisthesis is potential risk factors for redisplacement, implant failure and pseudarthrosis. There have been many reports regarding surgical treatment of spondy-lolisthesis for preventing postoperative redisplacement or complication. However, there have been controversies, which was most effective procedure for maintenance of surgical correction of spondylolisthesis. MATERIAL AND METHOD: A fourteen patients with spondylolisthesis who underwent PLIF using threaded cage in addition to PLF from August 1998 to June 1999(Group A) were compared to twenty-one patients who underwent PLF alone from January 1993 to May 1995(Group B). We assessed the radiologic results of slip reduction(SR), sagittal angle correction(SAC) and disc height restoration(DHR) on preoperative, postoperative and last follow-up lumbar sagittal view and clinical outcomes according to Kirkaldy-Willis criteria. RESULTS: The Group A / Group B showed postoperative mean SR 13.2%/9.9%, SAC 3.7 degrees /2.3 degrees and DHR 24.1%/6.3%. At last follow up, the Group A / Group B showed mean SR loss 1.0/7.3%, SAC loss 1.2 degrees /5.4 degrees and DHR loss 1.5%/11% respectively. The clinical results were analyzed as 100%/81%(Group A/B) of excellent to good results. CONCLUSIONS: Additional posterior lumbar interbody fusion with threaded cage was more effective in reduction & maintenance of reduction and showed better clinical results than posterolateral fusion in spondylolisthesis with instability.
Follow-Up Studies ; Humans ; Pseudarthrosis ; Retrospective Studies ; Risk Factors ; Spondylolisthesis*

STUDY DESIGN: Retrospective. OBJECTIVE: To define the preoperative risk factors for postoperative deep wound infection of instrumented spine and to analyze treatment modality and its result. SUMMARY OF LITERATURE REVIEW: When there have been postoperative deep wound infection after pedicular screw fixation of lumbar spine. there have been controversies, which was appropriate time of implants removal. MATERIALS AND METHODS: From January 1991 to December 1997, we performed 582 cases of posterior instrumentation using pedicular screws. We reviewed retrospectively seven cases who had suffered from postoperative wound infection in our hospital, and three referral cases from other hospitals. RESULTS: Six of ten cases have been exposed significant preoperative risk factors(i. e., diabetes, old age, malnutrition, concomitant infection, obesity, etc.). Infections was diagnosed at an average of 12.3 days after operation with fever & wound drainage as the most common presenting feature. Patients underwent prompt incision & drainage, susceptible antibiotics, multiple debride-ments(average: 1.77, range: 1-3). Seven of ten cases underwent removal of implant finally. At follow up evaluation, all cases except one had no recurrence of infection. But five cases showed pseudarthrosis. Four (80%) of them underwent removal of implant within 1 year after operation. Clinical results by criteria of Kirkaldy-Willis were 2 Good's, 7 Fair's and 1 Poor. CONCLUSION: Postoperative deep wound infection after pedicular screw fixation of lumbar spine leads to poor result. Especially early removal of implant within 1 year after operation was followed by pseudarthosis.
Anti-Bacterial Agents ; Drainage ; Fever ; Follow-Up Studies ; Humans ; Malnutrition ; Obesity ; Pseudarthrosis ; Recurrence ; Referral and Consultation ; Retrospective Studies ; Risk Factors ; Spine* ; Surgical Wound Infection ; Wound Infection* ; Wounds and Injuries*

No abstract available.
Malignant Atrophic Papulosis*

STUDY DESIGN: Retrospective study. OBJECTIVES: To analyze the clinical results of patients who were treated by pedicle screw fixation in osteoporotic spine and suggest the methods for preventing a loss of fixation strength. SUMMARY OF THE LITERATURE REVIEW: There are some methods to decrease failure rate and increase fixation strength in the osteoporotic spine: use bicortical screw, cement augmentation and supporting anterior column by interbody fusion using cages. MATERIALS AND METHODS: Forty-four patients treated by spinal instrumentation using pedicle screw from 2004 to 2011 were followed for at least 12 months. Five men and 39 women were diagnosed as osteoporotic spine (T score <-3.0). Two hundred forty eight pedicle screws were included and statistically analyzed the correlation between the use of bicortical screw, cement augmentation, anterior column support and fixation loss of the pedicle screw. Radiologic results were evaluated to find out the mechanical complications, like loosening of the screw, fixation failure, and nonunion. RESULTS: There were 9 complications associated with mechanical strength, loosening of pedicle screws in 7, sinking down of cage in 4, and nonunion in 4 cases. Using bicortical pedicle screw, cement augmentation and anterior column support were significantly correlated with the increasing fixation strength (P=0.001, P=0.047, P=0.014). In addition, these three factors contribute to stabilize the instrumentation (Linear by linear association, P=0.012). CONCLUSIONS: These 3 methods, using bicortical pedicle screw, cement augmentation and supporting anterior column, are effective to enhance the fixation strength and prevent loss of holding power in the osteoporotic spine.
Female ; Humans ; Male ; Osteoporosis ; Retrospective Studies ; Spine

BACKGROUND: Although a number of visual evoked potentials (VEPs) studies have been performed to elucidate the pathophysiology of migraines, their results have been controversial. We studied the pattern-reversal visual evoked potentials (PRVEPs) during long periods of stimulation to show whether or not PRVEPs in migraines are abnormal. METHODS: Patients were divided into two groups; Group 1 (migraine with aura; MWA, n=29) and Group 2 (migraine without aura ; MOA, n=32) according to the International Headache Society criteria. PRVEPs were performed in both groups and in healthy volunteers (n=62). PRVEPs were averaged in 100 responses for a total duration of 10 minutes after an initial 3 minutes during stimulation and were analysed in terms of latencies and peak to peak amplitudes of N1-P1 and P1-N2 peaks. RESULTS: Amplitudes of PRVEPs in migraines showed significant increases compared to normal subjects (p<0.001), and amplitudes of PRVEPs in MWA showed significant increases compared to those in MOA (p<0.05). CONCLUSIONS: These results are explained by cortical hypoexcitability and hyper-responsiveness in migraine and by additional cortical hyper-responsiveness (another hyper-responsiveness) in MWA compared to MOA. We suggest that serotonergic and noradrenergic hyperactivity could be responsible for cortical hypoexcitability and hyper-responsiveness in a migraine brain. Another hyper-responsiveness in MWA could also be thought of as some evidence for cortical neuronal abnormality in MWA in addition to serotonergic and noradrenergic hyperactivity in a migraine brain. (J Korean Neurol Assoc 19(3):239~244, 2001)
Brain ; Epilepsy ; Evoked Potentials ; Evoked Potentials, Visual ; Headache ; Healthy Volunteers ; Humans ; Migraine Disorders* ; Neurons*

PURPOSE: To estimate the prevalence of cataracts based on screening test results and statistical estimation methods. METHODS: Between June 1994 and September 2005, 85,505 persons aged 20 years and older were screened at a health promotion center for a general health care screen. We assumed that all subjects had complete screening results; however some subjects had an unknown disease status. A 2x3 table form could be generated from this data set. To estimate cataract prevalence, we used a maximum likelihood estimation method to reconstruct a 2x2 table including probabilities for each cell. RESULTS: The overall estimated cataract prevalence was 13.98% (95% confidence intervals, 13.75% to 14.21%). We estimated the prevalence of cataracts to be 15.29% in men (95% confidence intervals, 14.95% to 15.63%) and 12.97% in women (95% confidence intervals, 12.65% to 13.29%). In addition, we found that the cataract prevalence distinctly increased in people aged 60 years or older. CONCLUSIONS: We found that these estimated cataract prevalences were not considerably different from study results obtained in other countries. Therefore, our method may be considered to be appropriate for estimating prevalence. Our results indicate that cataract prevalence in our study population increases with age and highlight the need for early detection and early interventions.
Cataract* ; Dataset ; Delivery of Health Care ; Early Intervention (Education) ; Female ; Health Promotion ; Humans ; Male ; Mass Screening* ; Prevalence*

Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors that arise in the wall of the gastrointestinal tract. We report a case of obscure gastrointestinal bleeding due to a GIST of the jejunum successfully documented by videocapsule endoscopy (VCE) and single-balloon enteroscopy (SBE). A 36-year-old man with hematochezia was referred for further evaluation of no evidence of bleeding focus on esophagogastroduodenoscopy and colonoscopy. A VCE showed a suspicious ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion. SBE revealed a nonbleeding 4x2 cm mass with an ulcer at the proximal jejunum. The patient underwent laparoscopic resection without complication. Histological examination revealed a well circumscribed, dumbbell-shaped firm mass comprised of spindle cells. Immunohistochemical staining for CD 117 was diffusely positive, whereas staining for S-100, CD 34 and MIB-1 was all negative. It was confirmed to be a low-grade GIST at the proximal jejunum.
Capsule Endoscopy ; Colonoscopy ; Endoscopy ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Jejunum ; Ulcer

Sunitinib an inhibitor of the vascular endothelial growth factor receptor, is highly effective against renal cell carcinoma and is now widely used in patients with metastatic disease. Gastroesophageal reflux disease (GERD) is rarely reported as a side effect of sunitinib. We report two cases of GERD with upper gastrointestinal bleeding related to sunitinib administration. Both cases responded well to conservative management. Microscopic findings in both cases showed cellular atypia such as hyperchromasia, increases in nuclear size, and multinucleation. The cellular atypia of the squamous mucosa appears to be associated with reparative processes.
Carcinoma, Renal Cell ; Esophagitis, Peptic ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Indoles ; Mucous Membrane ; Pyrroles ; Receptors, Vascular Endothelial Growth Factor

Eosinophilic pancreatitis is a rare disorder that frequently accompanies peripheral eosinophilia and/or eosinophilic gastroenteritis. Eosinophilic pancreatitis can mimic a pancreatic neoplasm by forming a pancreatic mass with focal pancreatic eosinophilic infiltration. Because eosinophilic pancreatitis responds well to steroid treatment, it is important to distinguish eosinophilic pancreatitis from pancreatic neoplasm. Thus, fine needle aspiration biopsy (FNAB) should be considered in patients with a pancreatic mass accompanied by peripheral eosinophilia and/or eosinophilic gastroenteritis. We describe a case of eosinophilic pancreatitis with annular pancreas that was diagnosed by FNAB. This is the first reported case of eosinophilic pancreatitis with annular pancreas diagnosed by FNAB.
Biopsy ; Biopsy, Fine-Needle ; Enteritis ; Eosinophilia ; Eosinophils* ; Gastritis ; Gastroenteritis ; Humans ; Pancreas* ; Pancreatic Diseases ; Pancreatic Neoplasms ; Pancreatitis*