No abstract available.
Embryonic Development* ; Female ; Humans* ; Pregnancy ; Serum Albumin*

The pressure of cervical spine using artificial spiral cord in experimental trauma was studied to investigate the relationship between cervical canal size and the severity of spondylosis of spine. Twelve human cadaveric cervical spine preparations were evaluated based upon their severity of degeneration and canal size was measured in all, and large diameter and small canals were defined. A drop mass assembly was constructed with different combinations of masses to produce 24 possible drop combinations for each preparation. Pressure was recorded with sensor transducer arrays beneath the artificial spinal cord in the cadaveric cervical spine. Although the cervical canal size of specimen does not correlate with the degree of degeneration, significant differences were observed between spondylotic cervical canal size and the pressures at experimental trauma in 12.5mm and developmental canal size in 14.3mm in C5 level(p<0.05). Also, there was statistical difference in the pressure at C5 level between the specimens in which Pavlov ratio were more and less than one. These result may indicated that small cervical canals may be correlated with more severe cord injury than large cervical canals in acute spinal injury.
Cadaver ; Humans ; Spinal Cord ; Spinal Injuries ; Spine* ; Spondylosis ; Transducers

No abstract available.
Stroke*

It is well known that moyamoya disease is often accompanied by an intracranial aneurysm. We present 3 patients, among total 40 patients with moyamoya disease over a recent 4-year period, in whom moyamoya disease and an intracranial saccular aneurysm were discovered simultaneously. In 2 of the 3 patients, the aneurysms were occluded endovascularly by Guglielmi detachable coils(GDC). Here, with review of pertinent literature, we discuss the clinical characteristics of an intracranial aneurysm associated with moyamoya disease and the benefits and drawbacks between two therapeutic options- direct surgery and endovascular treatment.
Aneurysm ; Humans ; Intracranial Aneurysm* ; Moyamoya Disease*

A series of 51 consecutive patients with 55 cerebral aneurysms of the vertebrobasilar system is presented. Thirty aneurysms had their origins at the basilar artery(BA) bifurcation, 7 at the origin of the superior cerebellar artery (SCA), 4 at the posterior cerebral artery(PCA), 4 at the BA trunk, 8 from the vertebral artery(VA) at the origin of the posterior inferior cerebellar artery(PICA), and two from the PICA. The patient population consisted of 31 women and 21 men, with a mean age of 50 years(range 30-70 years). The overall mortality and morbidity rates at 6 months were 17.6%(9/51) and 13.7%(7/51), respectively. The most common cause of death was rebleeding(55.6%, 5/9). Nineteen patients had underwent only conservative treatment due to aneurysms classified as inoperable(6 cases), fatal rebleeding(5 cases), refusal against surgery(5 cases), poor Hunt and Hess grade that did not improve(2 cases), and one aneurysm that spontaneously disappeared. Treatments consisted of neck clipping in 16 patients, wrapping in 6, and endovascular therapy in 10. All of these treatment modalities were carried out after 2 weeks from initial insult. Treatment outcome was evaluated with Glasgow Outcome Scale(GOS) at 6 months after initial insult. Patients with Hunt and Hess(H-H) Grades I and II at admission had good outcome in 70.6%, whereas only 60% of patients with H-H Grades III and IV showed good outcome. But there was no statistically significant difference. Five patients with aneurysms which were located proximally had better outcome than those with distal aneurysm(100% good outcome vs 66.7%). All of ten patients who were treated with endovascular therapy showed good outcome, whereas only 13 out of 22(59.1%) patients who underwent either clipping or wrapping showed good outcome. There was statistically significant difference(p<0.05). As for the comparison of outcome according to the size of aneurysm and age of patients, we found no statistically significant difference. These results indicated that the location of aneurysm was one of important prognostic factor in vertebrobasilar system. Endovascular treatment may be a promising treatment option and considering the very high mortality from rebleeding early management may contribute to reduce the mortality and morbidity in posterior circulation aneurysm.
Aneurysm ; Arteries ; Cause of Death ; Disulfiram ; Female ; Humans ; Intracranial Aneurysm* ; Male ; Mortality ; Neck ; Pica ; Subarachnoid Hemorrhage ; Treatment Outcome

Residual aneurysm is a challenging problem after clipping procedure for the aneurysms. The anthors describe one patient in whom endovascular treatment was sucessfully done to treat residual aneurysm after surgical clipping. We discussed the role of endovascular coil occlusion in case of incomplete surgical obliteration of aneurysms.
Aneurysm ; Humans ; Intracranial Aneurysm* ; Surgical Instruments

PURPOSE: The N-myc amplification is one of well known poor prognostic markers in neurblastoma. Because the traditional detection method, Southern blot, is expensive, labor-intensive and time-consuming, the detection of N-myc amplification is not routinely performed in Korea. The purposes of this study are to develop polymerase chain reaction (PCR) for detecting N-myc amplification in neuroblastoma tumor tissue, and to elucidate the clinical significance of N-myc amplification. METHODS: The clinical data and paraffin embedded tumor specimen of 54 neuroblastoma cases were collected from 10 medical centers in Korea. We have developed semiquantitative method of estimating gene copy number that uses differential PCR. N-myc gene primers (RC N-myc, N-myc 7-1) are amplified together with primers from a single-copy internal control gene (beta-globin). After ethidium bromide-stained agarose gel electrophoresis, the ratio of the two PCR products, which stands for N-myc amplification, is determined. Kaplan-Meier survival analysis was performed to evaluate the prognostic significance of N-myc amplification. RESULTS: The differential PCR was very effective, less expensive, less labor-intensive, and simple detection method for N-myc amplification. The percentage of N-myc amplification was higher in the patients older than 1 year old (34.1%: 14/41), when they were compared to the patients younger than 1 year old (16.7%: 2/12). The percentage of N-myc amplification was higher in the patients who have primary tumor at adrenal gland (40.9%: 9/22) than who have primary tumor at retroperitoneum (17.6%: 3/17) or at mediastinum (16.7%: 2/12). In Stage I, II, and III patients, the mean survival time of N-myc amplified group was 18 months and that of N-myc umamplified group was 64 months (Log Rank 4.35, P=0.037). CONCLUSION: The differential PCR was very effective, less expensive, less labor-intensive, and simple detection method for N-myc amplification. The N-myc amplification is one of poor prognostic indicators in Neuroblastoma.
Adrenal Glands ; Blotting, Southern ; Electrophoresis, Agar Gel ; Ethidium ; Gene Dosage ; Genes, myc ; Humans ; Korea ; Mediastinum ; Neuroblastoma* ; Paraffin ; Polymerase Chain Reaction* ; Prognosis ; Survival Rate

Background: Hodgkin's lymphoma (HL) constitutes 10%–20% of all malignant lymphomas and has a high cure rate (5-year survival, around 90%). Recently, interest has increased concerning preventing secondary complications (secondary cancer, endocrine disorders) in long-term survivors. We aimed to study the epidemiologic features and therapeutic outcomes of HL in children, adolescents, and young adults in Korea. Methods: We performed a multicenter, retrospective study of 224 patients aged < 25 years diagnosed with HL at 22 participating institutes in Korea from January 2007 to August 2016. Results: A higher percentage of males was diagnosed at a younger age. Nodular sclerosis histopathological HL subtype was most common, followed by mixed cellularity subtype.Eighty-one (36.2%), 101 (45.1%), and 42 (18.8%) patients were classified into low, intermediate, and high-risk groups, respectively. Doxorubicin, bleomycin, vinblastine, dacarbazine was the most common protocol (n = 102, 45.5%). Event-free survival rate was 86.0% ± 2.4%, while five-year overall survival (OS) rate was 96.1% ± 1.4%: 98.7% ± 1.3%, 97.7% ± 1.6%, and 86.5% ± 5.6% in the low, intermediate, and high-risk groups, respectively (P = 0.021). Five-year OS was worse in patients with B-symptoms, stage IV disease, highrisk, splenic involvement, extra-nodal lymphoma, and elevated lactate dehydrogenase level.In multivariate analysis, B-symptoms and extra-nodal involvement were prognostic factors for poor OS. Late complications of endocrine disorders and secondary malignancy were observed in 17 and 6 patients, respectively. Conclusion This is the first study on the epidemiology and treatment outcomes of HL in children, adolescents, and young adults in Korea. Future prospective studies are indicated to develop therapies that minimize treatment toxicity while maximizing cure rates in children, adolescents, and young adults with HL.

PURPOSE: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. MATERIALS AND METHODS: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. RESULTS: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. CONCLUSION: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.
Academies and Institutes ; Acute Pain ; Analgesics ; Female ; Fentanyl* ; Humans ; Male ; Nausea ; Prospective Studies ; Quality of Life ; Radiotherapy* ; Sleep Initiation and Maintenance Disorders ; Transdermal Patch*