Cervical spine injuries are increasing recently due to increasing traffic accidents. Many patients have been treated with cervical laminectomy but stabilization of the cervical spine has been neglected as a part of the treatment. 30 patients with cervical spine injuries who were admitted to our hospital from January 1, 1973 to December 31, 1978 were evaluated. The following observations were made: 1. The ratio between male and female was 2:1 and the majority(43%) were found in the 4th decades. 2. The common causes of cervical spine injuries were traffic accident(40%) and falls(33.3%). The most common site of the lesion was the 5th and 6th cervical spine level (33.3%). 3. Among 30 cases, 10 cases(33.3%) had complete paralysis, 12 cases(40%) incomplete paralysis, 6 cases (20%) had nerve root injury and no neurological change is 2 cases. 4. The mechanisms of cervical injuries were classified morphologically and flexion-rotation injuries (55.5%) were the most common. 5. We evaluated the results of treatment neurological & radiographically. In complete paralysis, there was no neurological improvement and cervical kyphosis increased after laminectomy. In incomplete paralysis and nerve root injury, anterior fusion showed slight neurological recovery but mild cevical kyphosis and displacement of the graft were observed. In posterior fusion or cast immobilization, we had a satisfactory result with a high fusion rate and normal cervical curvature. 6. lt is impossible to compare anterior interbody fusion with posterior fusion for neurological recovery. For early mobilization and rehabilitation, we emphasize early stabilization by anterior or posterior fusion according to the mechanism of injury.
Accidents, Traffic ; Clinical Study ; Early Ambulation ; Female ; Humans ; Immobilization ; Kyphosis ; Laminectomy ; Male ; Paralysis ; Rehabilitation ; Spine ; Transplants

Nocturia is usually considered to be just one of the symptoms included with lower urinary tract symptoms (LUTS) and is treated with therapy based on LUTS. Recent research suggests, however, that nocturia is not merely a simple symptom of LUTS but is a multifactorial condition with many contributing etiological factors. The causes of nocturia can be classified into bladder storage problems, increased urine output, sleep disturbance problems, and other potential diseases. The frequency-volume chart (FVC) is very important in evaluating and diagnosing nocturia. Patients usually record the volume and timing of voids for a period of 1 to 3 days on the FVC. The FVC data can provide information on voiding patterns and clues about the etiology and treatment of nocturia. It is doubtful that alpha-blockers will have clinical significance for treatment because the difference in nocturia episodes between treatment with alpha-blockers and placebo is too small. Antimuscarinics also exert no effect on nocturnal polyuria, and the evidence supporting the efficacy of antimuscarinics for the treatment of nocturia is limited. However, several randomized placebo-controlled trials have shown the efficacy of oral desmopressin in the treatment of adults with nocturia. Short-acting hypnotics may be helpful for patients with sleep disturbances. Although surgical or interventional therapy is not indicated for nocturia, transurethral resection of the prostate appears to confer a greater improvement in benign prostatic hyperplasia symptoms including nocturia. The management of nocturia may require a team approach by making optimal use of multidisciplinary expertise.
Adult ; Deamino Arginine Vasopressin ; Humans ; Hypnotics and Sedatives ; Lower Urinary Tract Symptoms ; Muscarinic Antagonists ; Nocturia ; Polyuria ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder

No abstract available.
Bandages*

Abdominal pregnancy is very rare and potentially life-threatening variation of ectopic pregnancy. Early diagnosis is very difficult. In the last several decades prenatal care has improved and noninvasive procedures such as ultrasound scanning and fetal cardiotocography have led to us a better assessment of fetal and maternal disorders. In the last 30 years an increase of diagnosed ectopic pregnancies has been noted and attributed to the greater frequency of pelvic inflammatory disease. Although the incidence of ectopic pregnancy is rising, the incidence of abdominal pregnancy, which is primarily a sequel of a missed ruptured ectopic pregnancy, remains low. We presented a case of secondary abdominal pregnancy in 14 wks with its review of literature.
Cardiotocography ; Early Diagnosis ; Female ; Incidence ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic ; Prenatal Care ; Ultrasonography

PURPOSE: This study aimed to evaluate the cancer detection rate in a Korean population with prostate-specific antigen (PSA) levels greater than or equal to 20.0ng/mL. MATERIALS AND METHODS: A total of 174 men 50 to 79 years old (median 69) included in the study. The median prostate volume of the patients was 44.8mL (range 14.1 to 210.0) and their serum PSA ranged from 20.0 to 9725.0ng/mL (median 44.8). RESULTS: Of 174 men 141 (81.0%) were diagnosed with prostate cancer on initial biopsy. In the total number of patients, the positive predictive value (PPV) was 62.9% for PSA 20 to 29.9, 72.7% for PSA 30 to 39.9 and 100% for PSA 40 to 49.9 ng/mL. In patients with an abnormal digital rectal examination (DRE), the values for these PSA ranges increased to 89.5%, 91.7% and 100%, respectively. The PPV was 81.0% for PSA cutoff of 20, 89.2% for a cutoff of 30, 95.4% for a cutoff of 40, and 94.7% for a cutoff of 50 ng/mL. In conjunction with an abnormal DRE, the values for these PSA cutoffs increased to 95.9%, 98.1%, 100%, and 100%, respectively. CONCLUSION: Our data suggest the ability to predict the presence of prostate cancer reliably on initial biopsy when PSA threshold is greater than or equal to 50ng/mL. This PSA threshold may be lowered to 40ng/mL in the presence of an abnormal DRE. In Korean men with high PSA, the detection rate of prostate cancer on biopsy appears to be comparable to that for American men.
Aged ; Biopsy ; Cohort Studies ; Digital Rectal Examination ; Humans ; Korea ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate/pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis/metabolism/pathology

PURPOSE: To investigate whether the preoperative prostatic biopsy values predict the tumor stage in radical retropubic prostatectomy (RRP) specimens. MATERIALS AND METHODS: We reviewed the prostatic needle biopsy findings in 69 patients, diagnosed with clinical organ confined prostate cancer, and who underwent a RRP between December 2003 and November 2004. The biopsy specimens were assessed for the number and maximal tumor length of positive cores and for the Gleason score. The preoperative serum prostate-specific antigen (PSA) level and prostate volume were measured using transrectal ultrasonography (TRUS). TRUS guided biopsies of 13.7 2.2 sites were performed. The preoperative values were compared with the pathological stage of the RRP specimens. RESULTS: Of the 69 patients, 53 (76.8%) had organ confined cancer and 16 (23.2%) had extraprostatic extension (pathologic T2 and T3 or greater, respectively), with mean ages of 65.6 and 65.1 years, respectively. The mean PSA levels were 8.0 and 13.0ng/ml and the prostate volumes were 38.3 and 33.8ml, respectively. The age, prostate volume, biopsy Gleason score and preoperative PSA level were not significant factors for predicting the pathological stage inform a multivariate analysis (p>0.05). The number (p=0.007) and maximal tumor length of positive cores (p=0.046) were significantly higher in those with an extraprostatic stage than in the organ confined cancer group. The optimal maximal tumor length and number of positive cores for the detection of extraprostatic cancer were 7.5mm and 6.5, respectively. CONCLUSIONS: The number and maximal tumor length of positive cores were strong predictors of the pathologic stage in the RRP specimens.
Biopsy* ; Biopsy, Needle ; Humans ; Multivariate Analysis ; Neoplasm Grading ; Pathology ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms ; Ultrasonography

PURPOSE: In the era of shock wave lithotripsy (SWL) and ureteroscopy, the majority of ureter stones are successfully managed with these less invasive treatment modalities. However, open ureterolithotomy still has a role in special situations. The efficacy of a laparoscopic retroperitoneal ureterolithotomy for large impacted ureter stones indicated for open ureterolithotomy is reported. MATERIALS AND MTHODS: Between February 1998 and December 1999, laparoscopic retroperitoneal ureterolithotomy for proximal ureter stones was performed in 5 patients who required an open ureterolithotomy. The mean size of the stones was 15mm, all of which were tightly impacted in the ureteral lumen and were associated with marked hydronephrosis. RESULTS: All but the initial operation was performed successfully via the retroperitoneal approach. Open conversion was needed in the first patient because of inexperience and the lack of anatomic perception. The mean operation time and estimated blood loss was 122 minutes and < or =50ml, respectively. A transfusion was not needed in any of the patients. Postoperative pain was well controlled with 175mg of Ketoprofen. The mean postoperative length of hospital stay was 6.3 days. There were no significant intraoperative or postoperative complications. CONCLUSIONS: A laparoscopic retroperitoneal ureterolithotomy can be considered as an alternative to conventional ureterolithotomy when open surgery is indicated.
Humans ; Hydronephrosis ; Ketoprofen ; Laparoscopy ; Length of Stay ; Lithotripsy ; Pain, Postoperative ; Postoperative Complications ; Shock ; Ureter ; Ureteroscopy

PURPOSE: In the era of shock wave lithotripsy (SWL) and ureteroscopy, the majority of ureter stones are successfully managed with these less invasive treatment modalities. However, open ureterolithotomy still has a role in special situations. The efficacy of a laparoscopic retroperitoneal ureterolithotomy for large impacted ureter stones indicated for open ureterolithotomy is reported. MATERIALS AND MTHODS: Between February 1998 and December 1999, laparoscopic retroperitoneal ureterolithotomy for proximal ureter stones was performed in 5 patients who required an open ureterolithotomy. The mean size of the stones was 15mm, all of which were tightly impacted in the ureteral lumen and were associated with marked hydronephrosis. RESULTS: All but the initial operation was performed successfully via the retroperitoneal approach. Open conversion was needed in the first patient because of inexperience and the lack of anatomic perception. The mean operation time and estimated blood loss was 122 minutes and < or =50ml, respectively. A transfusion was not needed in any of the patients. Postoperative pain was well controlled with 175mg of Ketoprofen. The mean postoperative length of hospital stay was 6.3 days. There were no significant intraoperative or postoperative complications. CONCLUSIONS: A laparoscopic retroperitoneal ureterolithotomy can be considered as an alternative to conventional ureterolithotomy when open surgery is indicated.
Humans ; Hydronephrosis ; Ketoprofen ; Laparoscopy ; Length of Stay ; Lithotripsy ; Pain, Postoperative ; Postoperative Complications ; Shock ; Ureter ; Ureteroscopy

Intrameduallary spinal hemangioblastoma is frequently associated with syringomyelia. It grows slowly and can be removed totally. Syringomyelia can be subcided by total removal of tumor and opening of syringomyelia. Two cases of intramedullary spinal hemangioblastomas associated with syringomyelia are reported. Intramedullary tumor and syrinx was easily diagnosed by magnetic resonance imaging(MRI). They are successfully managed by total removal of tumor and opening of syrinx. Patients showed improved neurological status after operations.
Hemangioblastoma* ; Humans ; Syringomyelia*

BACKGROUND: Acute lung injury (ALI) is a commonly encountered respiratory disease and its prognosis is poor when the treatment is not provided promptly and properly. However no specific pharmacologic treatment is currently available for ALI, although recently several supportive drugs have been under scrutiny. We studied anti-inflammatory effects of pentoxifylline (PF), a methylated xanthine, and ONO-5046, a synthetic neutrophil elastase inhibitor on lipopolysaccharide (LPS)-induced ALI in vitro. METHODS: To establish an in vitro model of LPS-induced ALI, primary rat alveolar macrophages and peripheral neutrophils in various ratios (1:0, 5:1,1:1,1:5,0:1) were co-cultured with transformed rat alveolar epithelial cells (L2 cell line) or vascular endothelial cells (IP2-E4 cell line) under LPS stimulation. Each experiment was divided into five groups-control, LPS, LPS+PF, LPS+ONO, and LPS+PF+ONO. We compared LPS-induced superoxide anion productions from primary rat alveolar macrophages and peripheral neutrophils in various ratios, and the resultant cytotoxxicity on L2 cells or IP2-E4 cells between groups. In addition we also compared the productions of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, monocyte chemotactic protein(MCP)-1, IL-6, and IL-10 as will as mRNA expressions of TNF-α, inducible nitric oxide synthetase(iNOS), and MCP-1 from LPS-stimulated primary rat alveolar macrophages between groups. RESULTS: (1) PF and ONO-5046 in each or both showed a trend to suppress LPS-induced superoxide anion productions from primary rat alveolar macrophages and peripheral neutrophils regardless of their ratio, except for the LPS+PF+ONO group with the 1:5 ratio, although statistical significance was limited to a few selected experimental conditions. (2) PF and ONO-5046 in each or both showed a trend to prevent IP2-E4 cells from LPS-induced cytotoxicity by primary rat alveolar macrophages and peripheral neutrophils regardless their ratio, although statistical significance was limited to a few selected experimental conditions. The effects of PF and/or ONO-5046 on LPS-induced L2 cell cytotoxicity varied according to expaerimental conditions. (3) PF showed a trend to inhibit LPS-induced productions of TNF-α, MCP-1, and IL-10 from primary rat alveolar macrophages. ONO-5046 alone didnot affect the LPS-induced productions of proinflammatory cytokines from primary rat alveolar macrophages but the combination of PF and ONO-5046 showed a trend to suppress LPS-induced productions of TNF-αand IL-10 PF and ONO-5046 in each or both showed a trend to increase LPS-induced IL-β and IL-6 productions from primary rat alveolar macrophages. (4) PF and ONO-5046 in each or both showed atrend to attenuate LPS-induced mRNA expressions of TNF-α and MCP-1 from primary rat alveolar macrophages but at the same time showed a trend increase iNOS mRNA expression. CONCLUSION: These results suggest that PF and ONO-5046 may play a role in attenuating inflammation in LPS-induced ALI and that further study is needed to use these drugs as a new supportive therapeutic strategy for ALI.
Acute Lung Injury* ; Animals ; Cytokines ; Endothelial Cells ; Epithelial Cells ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Interleukins ; Leukocyte Elastase* ; Macrophages, Alveolar ; Monocytes ; Neutrophils* ; Nitric Oxide ; Pentoxifylline* ; Prognosis ; Rats ; RNA, Messenger ; Superoxides ; Tumor Necrosis Factor-alpha ; Xanthine