OBJECTIVE: Although anterior cervical discectomy and fusion (ACDF) is the standard treatment for degenerative cervical disc disease, concerns regarding adjacent level degeneration and loss of motion have suggested that arthroplasty may be a better alternative. We have compared clinical and radiological results in patients with cervical disc herniations treated with arthroplasty and ACDF. METHODS: We evaluated 53 patients treated for cervical disc herniations with radiculopathy, 21 of whom underwent arthroplasty and 32 of whom underwent ACDF. Clinical results included the Visual Analogue Scale (VAS) score for upper extremity radiculopathy, neck disability index (NDI), duration of hospital stay and convalescence time. All patients were assessed radiologically by measuring cervical lordosis, segmental lordosis and segmental range-of-movement (ROM) of operated and adjacent disc levels. RESULTS: Mean hospital stay (5.62 vs. 6.26 days, p<0.05) and interval between surgery and return to work (1.10 vs. 2.92 weeks, p<0.05) were significantly shorter in the arthroplasty than in the fusion group. Mean NDI and extremity VAS score improved after 12 months in both groups. Although it was not significant, segmental ROM of adjacent levels was higher in the fusion group than in the arthroplasty group. And, segmental motion of operated levels in arthroplasty group maintained more than preoperative value at last follow up. CONCLUSION: Although clinical results were similar in the two groups, postoperative recovery was significantly shorter in the arthroplasty group. Although it was not significant, ROM of adjacent segments was less in the arthroplasty group. Motion of operated levels in arthroplasty group was preserved at last follow up.
Animals ; Arthroplasty ; Convalescence ; Diskectomy ; Extremities ; Follow-Up Studies ; Humans ; Length of Stay ; Lordosis ; Neck ; Radiculopathy ; Return to Work ; Upper Extremity

PURPOSE: A study was performed to compare the detectability of extrahepatic duct stones between nonenhanced and enhanced computed tomography(CT). MATERIALS AND METHODS: Consecutive 30 patients with extrahepatic duct stones were analyzed with special attention to the detectability of stones between nonenhanced and enhanced CT. The extrahepatic duct was further divided into two segments, one above(suprapancereatic) and the other in(intrapancreatic) the head of the pancreas. Conspicuity of the stone was graded as "visible", "suspicious", and "invisible". Three radiologists reviewed the CT images without prior information and determined the location of stone and grade of their conspicuity. RESULTS: The stones were located at the suprapancreatic common duct in 5 patients, intrapancreatic common duct, in 15 patients and both portion of the duct in 10 patients. There was no difference in the detection rate of stones between the two images at suprapancreatic common duct, and was 93%, However, the rate at intrapancreatic common duct was 95% and 64% on nonenhanced and enhanced CT scans, respectively. The overall detection rate was 95% on nonenhance CT and 75% on enhanced CT. CONCLUSION: We concluded that nonenhanced CT was prerequisite to evaluate the extrahepatic duct stones in addition to enhanced CT.
Head ; Humans ; Pancreas ; Tomography, X-Ray Computed

Leiomyoma is a neoplasm of smooth muscle relatively common in the stomach, but very rare in the duodenal location. Recurrent bouts of severe melana remain the most frequent presenting symptom for leiomyoma. A 69-year-old man presented to us with a 4-day history of melena. Endoscopy revealed norinal mucosa covered ovoid elevated lesion with central linear depression and ulcer at the second portion of duodenum. Endoscopic biopsy showed chronic inflammation only. Duodenal mass was excised through a duodenotomy. Pathological diagnosis was leiomycena.
Aged ; Biopsy ; Depression ; Diagnosis ; Duodenum ; Endoscopy ; Esophagus* ; Hemorrhage* ; Humans ; Inflammation ; Intestines* ; Leiomyoma* ; MART-1 Antigen ; Melena ; Mucous Membrane ; Muscle, Smooth ; Stomach* ; Ulcer

The purpose of this study is to investigate the spectra of a magnetic resonance spectroscopy (MRS) in accordance with the variance of TE and the volumes of metabolites in a localized voxel for the quality assurance using a designed single voxel spectroscopy QA phantom. Because a cone-shape phantom is designed as the volume of metabolite in a localized voxel is changeable, we try to analyze the peaks of each metabolite (NAA, Cr, Cho, Lac, etc.) in accordance with metabolite volume in a localized voxel as well as echo time (TE). All data were obtained using a 3T MRI/MRS machine and analyzed using jMRUI(R). The results of this study show that TE is in inverse proportion to the noise of MRS and the longer TE and the less metabolite volume in the localized voxel, the peak intensities of each metabolite decrease. In case of the lactate, its peak was observed on the all TE only if the greatest metabolite is included in the localized voxel. Then, the intensity of a metabolite is more sensitive to the metabolite volume in the localized voxel than the TE. These obtained in vitro MRS data is provide the guideline that is important for in vivo metabolite quantification. But, in the edge of cone-shape vial air bubbles were observed and spectrum could not obtained. Therefore our cone-shape MRS phantom needs to be modified in order to solve these problems.
Lactic Acid ; Magnetic Resonance Spectroscopy ; Noise ; Spectrum Analysis

The purpose of this study is to identificate root canal system including ideal access placement, root curvature, canal configuration, incidence of isthmus in mandibular incisors for success of endodontic treatment. 200 mandibular incisors were selected. The ideal access placement was determimed as follows. The teeth were radiographed from mesiodistal and buccolingual views using intraoral dental film. The image was divided into coronal, middle and apical third using the proximal film. Straight line access was determined by measuring the faciolingual canal width and placing points at midway point between the buccal and lingual wall at the junction of the middle and apical third and at the juntion of coronal and middle third of the root canal. A line was drawn connecting these two points extending through the crown of the tooth. The point at which the line crossed the external crown surface was recorded as facial, incisal, lingual. Degree of root curvature was determined by Schneider Protractor Method. Both section method and clearing method were used in this study. By section method, 100 mandibular incisors were embedded in clear resin and transeverse serial sectioned at 0.5, 1.0, 2.0, 3.0, 4.0, 5.0mm level from root apex. The resected surfaces were stained by methylene blue and examined under x40 magnification with a stereomicroscope. By clearing method, 100 mandibular incisors were cleared in methysalicylate after decalcification with 10% nitric acid and evaluated under x18 magnification with a stereomicroscope. The results were as follows ; 1. 29% had the center of the plotted straight-line access facial to incisal edge, whereas 71% had straight-line access at the incisal edge. When incisal wear classified as extensive, the straight-line access was plotted on the incisal edge 95.5%. When incisal wear classified as slight/none, the straight-line access was plotted on the facial 65.9%. 2. Degree of curvature of main canal was straight or almost straight, and only 10% in buccolingual direction had a degree of curvature greater than 20 degrees and 5.5% in mesiodistal direction had. 3. In section method, canal configuration analysis showed that 51% of the specimen classified as type I, 27% as type II, 12% as type III, 10% as type IV. For thoses setions with two canals, the incidence of an isthmus was 26.7%, 64.3%, 79.2%, 96.3%, 97.4%, 97.6% at each level and highest in 3~5mm sections. 4. In clearing method, canal configuration analysis showed that 74% of the specimen classified as type I, 11% as type II, 6% as type III, 9% as type IV. These results suggested that traditional access from lingual should be moved as far toward the incisal as possible to locate and debride the lingual canal and root canal system should be cleaned, shaped completely and obturated three dimensionally for successful endodontic treatment.
Crowns ; Dental Pulp Cavity ; Incidence ; Incisor ; Methylene Blue ; Nitric Acid ; Tooth

PURPOSE: We are going to establish the efficacy of endoscopic examinations in diagnosing and treating upper GI bleeding in full term neonates. METHODS: We retrospectively reviewed newborns who underwent endoscopic examination because of hematemesis from July 1998 to April 2001. RESULTS: Gestational ages were between 38 and 41weeks, and birth weights were between 2,730 and 3,400 gm. Total of 9 patients were reviewed. Endoscopic examination revealed gastric ulcer in 6 cases, multiple erosions in 2 cases and negative finding in 1 case. All 6 gastric ulcers were multiple and among them 2 patients endoscopic hemostatic therapy. No complication due to the procedure was noticed. Five patients recieved transfusions. All 9 cases were cured through conservative and endoscopic therapy without recurrence. CONCLUSION: The common cause of upper GI hemorrhage in newborns with no preceding disease turns out to be multiple gastric ulcers and the prognosis is good. The endoscopic approach is useful in diagnosing and treating upper GI bleeding in newborns.
Birth Weight ; Gestational Age ; Hematemesis ; Hemorrhage ; Humans ; Infant, Newborn* ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Ulcer

Malignant melanoma may show a predisposition for vulvar skin. Although 37% of all melanomas in women affect the vulva, the skin in this area accounts for only 12% of the total surface area of body. Malignant melanoma of the vulva presented as polypoid tumours in 35% of patients. The most common sites of disease were the clitoral area and the labia majora, which accounted for more than 60% of all lesions. Only 15% of tumours were located primarily in hair-bearing areas. Two women who were diagnosed vulvar melanoma in Uijongbu St. Mary's Hospital were evaluated. We reviewed their medical records. One woman underwent the radical vulvectomy with bilateral inguinal and femoral lymph node dissection, and the other underwent wide local excision with both inguinal lymph nodes dissection. We experienced 2 cases of vulvar melanoma, so we report it with a brief review of literature.
Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; Medical Records ; Melanoma* ; Skin ; Vulva

Food allergy is a disease caused by an abnormal immunological reaction to specific food proteins. Whole milk and soy beans are the most frequent causes of food allergy, some studies show that 2.2~2.8% of children aged between 1 and 2 year are allergic to milk. It can be classified to acute (urticaria, asthma, anaphylaxis) or chronic (diarrhea, atopic dermatitis) allergy according to clinical symptoms, or to IgE related or non IgE related allergy by an immunological aspect. Generally, allergies invading only the GI tract are mostly due to a non IgE related reaction. These hypersensitive, immunologic reactions of the GI tract, not related to specific IgE for food, present themselves in many ways such as food protein-induced enteropathy, food protein-induced enterocolitis syndrome (FPIES), celiac disease, food induced protocolitis, or allergic eosinophillic gastroenteritis. FPIES is one kind of non IgE related allergic reaction and is manifested as severe vomiting and diarrhea in infants between 1 week and 3 months. We report a case of FPIES in a 40-day old male infant presenting with 3 times of repeated events of watery diarrhea after cow's milk feeding.
Asthma ; Celiac Disease ; Child ; Diarrhea ; Enterocolitis* ; Eosinophils ; Food Hypersensitivity ; Gastroenteritis ; Gastrointestinal Tract ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Milk Proteins* ; Milk* ; Soybeans ; Vomiting

Administration of a subparalytic dose of a nondepolarizing muscle relaxant prior to intubating dose hastens the onset time of neuromuscular blockade. This study was designed to investigate the influence of a priming dose of vecuronium (0.015 mg/kg) and d-tubocurarine (0.05 mg/kg) on intubating dose of vecuronium (0.085 mg/kg). The authors measured TOF ratio using neuromuscular monitoring. This monitoring was carried out by stimulation of ulnar nerve at a frequency of 2Hz every 20 seconds using Datex relaxograph to measure the compound evoked electrographic response of hypothenar muscle. The patients were randomly divided into two groups as priming dose ; vecuronium and dtubocurarine (DTC) group respectively. Mixture of two different nondepolarizing muscle relaxant may produce synergism, although the reason for this synergism is unknown. It may be the results of the action of the drugs at different sites. In our study, we found the results as follows ;1) The rapid onset was occured with d-tubocurarine(0.05 mg/kg) as priming drug than vecuronium (0.015 mg/kg) 2) The duration was longer when d-tubocurarine was used (P<0.05) The authors conclude that the onset is more rapid and the duration is longer when other species of nondepolarizing muscle relaxant is used than same agent is used as priming drug.
Humans ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Neuromuscular Monitoring ; Tubocurarine* ; Ulnar Nerve ; Vecuronium Bromide*

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic*