The surgical intervention for secondary developmental cervical spinal stenosis that results in myelopathy and radiculopathy has been modified by technical improvement to obtain more reliable enlargement of the cervical spinal canal. The authours have experienced good results with the modified open door expansive laminoplasty, so we report this article. The patients were treated by surgical intervention during the period from October 1989 to February 1991. The results obtained were as follows : 1) The average age was 54.7 years, and the sex distribution ratio of female to male was 2 : 8. 2) In clinical symptoms and symptoms of both myelopathy and radiculopathy. 3) In morphological analysis of lesions, all patients except one case had lesions over 3 levels, The lesions were spondylosis, spondylosis combined with soft disc herniation, spondylosis combined with OPLL, spondylosis combined with OPLL and soft disc herniation, OPLL and OYL in the order of frequency. 4) The operation method was as follows : after the patient was positioned in modified Concorde position, open door lamina was anchored to faced joint capsule and surrounding tissue with nylon sutures. And then the raw epidural space was covered with Lyodura by the modified Hirabayashi method. By this method, reclosure of widened spinal canal was prevented. 5) The outcomes were evaluated by JOA score difference between preoperation and post operation times. The outcome of recovery rate was 100% in five cases. Therewere no aggravated or unimproved cases. The results were excellent 8 cases, good 1 case, unchanged 0 case, poor 0 case and expired 1 case.
Epidural Space ; Female ; Humans ; Joint Capsule ; Male ; Nylons ; Radiculopathy ; Sex Distribution ; Spinal Canal ; Spinal Cord Diseases ; Spinal Stenosis* ; Spondylosis ; Sutures

OBJECTIVES: Group psychotherapy is known to be an effective treatment program for adolescents who attach importance to peer relationship, but it is not activated in Korea. Therefore, researchers performed weekly the closed, homogeneous, time-limited (10 sessions), outpatient group psychotherapy for adolescents with conduct disorder. Objectives of this study were as follows: first, we practiced the group psychotherapy for adolescents with conduct disorder and evaluated its effectiveness: second, we examined the therapeutic factors which were used by participants: third, we intended to settlee down the group psychotherapy for adolescents with CD as an effective and efficient treatment modality. METHODS: This study was performed two times from October to December in 1998 and from April to June in 1999. It was sponsored by Youth Counselling Center in H city. The case group were composed of 15 female students who were second grade in H high school, and 4 students were dropped out. The control group were composed of 18 female students who were same grade in H high school and 3 students were dropped out. Before and after this program, self-report delinquency scale, aggression scale and impulsivity scale were asked to them. And just after each session, Yalom 13 therapeutic factors scale and satisfaction questionnaire for group psychotherapy were asked to them. And at last meeting, total assessment questionnaire was asked to them. RESULTS: We compared the change of therapeutic factors between the former half sessions(1-5) and the later half sessions (6-10), and the results were as follows: in the former half, the upper ranks of therapeutic factors were existential factor, universality, catharsis, identification with leader, and identification with members in order. And in the later half, the upper ranks of therapeutic factors were catharsis, existential factor, identification with leader, identification with members, and guidance of members in order. The rank of catharsis and guidance of members went upward and the rank of universality went downward when we compared the ranks in the former half to those in the later half. Altruism and family enactment were the lowest ranked in both half. The satisfaction questionnaire for group psychotherapy showed to be helped by participants at the rate of 45.7% in former half, 83.3% in later half. The total assessment questionnaire showed the willingness of re-participation at the rate of 85.7% if future opportunity of group psychotherapy is given for them. CONCLUSIONS: The time-limited group psychotherapy for adolescents diagnosed by conduct disorder was very effectively practiced and the participants reported high level of the satisfaction. The outpatient group psychotherapy for adolescents would be expanded and practiced though there are several accompanied problems including the difficulty of structuring, the deficit of motivation, and financial problem.
Adolescent* ; Aggression ; Altruism ; Catharsis ; Conduct Disorder* ; Female ; Humans ; Impulsive Behavior ; Korea ; Motivation ; Outpatients* ; Psychotherapy, Group* ; Surveys and Questionnaires

In the treatment of fractures of the thoracolumbar junctiion area, surgical intervention was performed when posterior part of veretbral body, posterior structure supporting ligaments were involved and body compression more than 40%. Number of cases satisfying above criteria were seven between Aug. 1990 and Jun. 1991. Age distribution ranged from 15 to 57 years. Sex ratio was 4:3(F:M). Four patients presented with nerve root sign, one patient with cauda equina signs, and two patients were normal neurologically. In all cases, spinal canal decompression, internal instrument fixation, and bone fusion with iliac bone were performed via anterolateral approach. After surgical treatment, neurological deficits disappeared and kyphotic angle returned to normal range of thoracolumbar junction area in all cases. Percentage of body compression was improved from preop. 55% to postop. 21% in average. According to above results, we concluded that anterior instrumental fixation combined with bone fusion using iliac bone was supperior to posterior approach in providing biomechanical stability and decompression of protruding ventral bone fragments.
Age Distribution ; Cauda Equina ; Decompression ; Humans ; Ligaments ; Reference Values ; Sex Ratio ; Spinal Canal

Thyroid hemiagenesis is considered to be a rare congenital anomaly, but its incidence is propabley underestimated because the diagnosis is usually incidental. The left lobe is absent four times as often as the right and women are about three times more likely to have this developmental defect. Many of these patients are hyperthyroid or medical attention. We present the case of a 14-year-old women with right thyroid hemiagenesis associated without other thyroid disorders. The diagnosis of hemiagenesis was established by isotope imaging and thyroid ultrasound. In most of the clinical reports on thyroid hemiagenesis, an association with other thyroid disorders was found such as hyperthyroidism, multinodular goitre, hypothyroidism, benign adenama, Graves' disease, acute and subacute thyroiditis, and carcinoma. Even if morphology and function of thyroid gland is normal on diagnosis, a follow-up survey should be recommended.
Adolescent ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Thyroid Gland* ; Thyroiditis, Subacute ; Ultrasonography

Thyroid hemiagenesis is considered to be a rare congenital anomaly, but its incidence is propabley underestimated because the diagnosis is usually incidental. The left lobe is absent four times as often as the right and women are about three times more likely to have this developmental defect. Many of these patients are hyperthyroid or medical attention. We present the case of a 14-year-old women with right thyroid hemiagenesis associated without other thyroid disorders. The diagnosis of hemiagenesis was established by isotope imaging and thyroid ultrasound. In most of the clinical reports on thyroid hemiagenesis, an association with other thyroid disorders was found such as hyperthyroidism, multinodular goitre, hypothyroidism, benign adenama, Graves' disease, acute and subacute thyroiditis, and carcinoma. Even if morphology and function of thyroid gland is normal on diagnosis, a follow-up survey should be recommended.
Adolescent ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Thyroid Gland* ; Thyroiditis, Subacute ; Ultrasonography

BACKGROUND: Perfusion scintigraphy with dipyridamole have been reported to be useful for diagnosis of coronary artery disease and the assessment of the presence and extent of myocardium at ischemic risk, especially in patients who can not undergo dynamic exercise testing. Dipyridamole, pharmacologic coronary vasodilator, also induces fall in blood pressure and rise in heart rate. The purpose of this study was to answer the question if dipyridamole induced peripheral hemodynamic responses were related to chest pain, ST changes on EKG, scintigraphic defect or extent of coronary stenosis. METHODS: Dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 43 subjects who were suspected to have coronary artery disease. The peripheral hemodynamic response was graded as absent(group 0) if there was a < or =10mm fall in systolic blood pressure (SBP) and/or < or =10 beats/min rise in geart rate(HR) ; moderate(group 1) if there was >10 but < or =20mm fall in SBP and/or >10 but < or =20 beats/min rise in HR ; and marked (group 2) if there was >20mm fall in SBP and/or >20 beats/min rise in HR. RESULTS: The overall diagnostic sensitivity and specificity for coronary artery disease of dipyridamole perfusion scintigraphy were 68%, 83% while per vessel sensitivity and specificity for coronary artery disease were 66%, 97%. The numbers of induced chest pain and ischemic ST changes among hemodynamic subgroups, were 40%, 40% in group 0, 33%, 27% in group 1 and 50%, 40% in group 2 without significant difference in each hemodynamic subgroups. Either the numbers of diseased coronary arteries or the numbers of patients demonstrationg reversible scintigraphic defects were not statically different among each subgroups. CONCLUSION: Although the peripheral hemodynamic response dose not always correlate with its central coronary effect but dipyridamlole 99mTc-MIBI myocardial perfusion scintigraphy is an useful test for diagnosis of coronary artery disease.
Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis ; Dipyridamole* ; Electrocardiography ; Exercise Test ; Heart Rate ; Hemodynamics* ; Humans ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion Imaging ; Sensitivity and Specificity

Axin is a negative regulator of the Wnt/beta-catenin pathway and is involved in the regulation of axis formation and proliferation. Involvement of Axin in the regulation of other signaling pathways is poorly understood. In this study, we investigated the involvement of Akt in growth regulation by Axin in L929 fibroblasts stimulated by EGF. Akt activity was increased by EGF treatment and Ras activation, respectively. Both the EGF- and Ras-induced Akt activations were abolished by Axin induction, as revealed by both Western blot and immunocytochemical analyses. The proliferation and Akt activation induced by EGF were decreased by Axin induction, and the effects of EGF were abolished by treatment of an Akt-specific inhibitor. Therefore, Axin inhibits EGF-induced proliferation of L929 fibroblasts by blocking Akt activation.
Animals ; Cell Line ; Cell Nucleus/metabolism ; Cell Proliferation ; Epidermal Growth Factor/*pharmacology ; Fibroblasts/drug effects/physiology ; Mice ; Proto-Oncogene Proteins c-akt/antagonists & inhibitors/*metabolism ; Repressor Proteins/genetics/*physiology ; Signal Transduction ; ras Proteins/biosynthesis/genetics

The purpose of our study was to evaluate children who underwent hepatic resection for primary malignant hepatic tumor in the period from January 1994 to December 2001. A total of 8 patients, seven with hepatoblastoma (HB) and one with hepatocellular carcinoma (HCC). were studied. One HCC was respectable at the initial diagnosis, but five cases of unresectable HB received two cycles of transarterial chemoembolization (TACE) before operation. One patient with an unresectable HB with bone marrow metastasis was operated after one cycle of TACE and one cycle of systemic chemotherapy based on CCG-823F protocol. All 6 patients who underwent TACE and neoadjuvant chemotherapy showed marked redcuction in tumor volume and a clear outline of the lesion. Major complication was not noticed. Mean alpha-fetoprotei (alpha-FP) level at diagnosis, after neoadjuvant chemotherapy and after postoperative chemotherapy was 9,818 (42-35,350), 664, and 10.1 ng/mL, respectively. Half life of the alpha-FP after complete resection was 5.1 days (3.0-8.7 days). Median follow up period was 57.1 months (10-97 months) and all the patients are alive with NED. In conclusion, preoperative chemotherapy, especially TACE, is effective, safe, and useful to treat initially unresectable hepatoblastoma, and serial level of the serum alpha-FP is a useful tumor marker for diagnosis and monitoring therapeutic responses.
Bone Marrow ; Carcinoma, Hepatocellular ; Child ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Half-Life ; Hepatoblastoma ; Humans ; Neoplasm Metastasis ; Tumor Burden

Parathyroid cysts are an uncommon cause of neck masses, which are rarely suspected before surgery. Although several theories of their origin have been proposed, none has been proven satisfactorily to the exclusion of the others. We experienced a 33-year-old euthyroid woman presenting with a mass on the jugular notch. She complained of throat discomfort. An ultrasound of the mass in the neek suggested a thyroglossal duct cyst. Treatment consisted of a neck exploration and the removal of a 4x3x3 cm cystic mass. The cystic mass contained a clear fluid with a high level of parathyroid hormones in excess of 11.4 ng/ml. The pathological diagnosis revealed a benign parathyroid cyst. This report reviews current knowledge of parathyroid cysts as well as the relevant literature.
Adult ; Diagnosis ; Female ; Humans ; Neck ; Pharynx ; Thyroglossal Cyst ; Ultrasonography

Pulmonary hypertension is an uncommon but serious complication of systemic lupus erythematosis (SLE).Usually its outcomes are ominous and may progress to heart failure and even sudden death.The pathophysiology is still unknown, but several mechanisms,such as pneumonitis,vasculitis,thromboembolism or thrombosis in situ have been proposed.There is no definitive therapy for this condition.Although supportive measures with vasodilators remain the mainstay of treatment,the responses are generally disappointing. We describe a case of improvement of pulmonary hypertension in SLE treated with cyclophosphamide pulse therapy as documented by hemodynamic data. Immunosuppressive treatment with cyclophosphamide was effective in this condition,suggested an immune mediated pathogenesis.
Cyclophosphamide* ; Heart Failure ; Hemodynamics ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Thrombosis ; Vasodilator Agents