No abstract available.
Genomic Library* ; Helicobacter pylori* ; Helicobacter*

OBJECTIVE: Epidural fibrosis and adhesion are the main reasons for post-laminectomy sustained pain and functional disability. In this study, the authors investigate the effect of irradiated freeze-dried human amniotic membrane on reducing epidural adhesion after laminectomy on a rat model. METHODS: A total of 20 rats were divided into two groups. The group A did not receive human amniotic membrane implantation after laminectomy and group B underwent human amniotic membrane implantation after laminectomy. Gross and microscopic findings were evaluated and compared at postoperative 1, 3 and 8 weeks. RESULTS: The amount of scar tissue and tenacity were reduced grossly in group of rats with human amniotic membrane implantation (group B). On a microscopic evaluation, there were less inflammatory cell infiltration and fibroblast proliferation in group B. CONCLUSION: This experimental study shows that implantation of irradiated freeze-dried human amniotic membrane reduce epidural fibrosis and adhesion after spinal laminectomy in a rat model.
Amnion ; Animals ; Cicatrix ; Failed Back Surgery Syndrome ; Fibroblasts ; Fibrosis ; Humans ; Laminectomy ; Rats

OBJECTIVE: Recurrent herniation following disc excision has been reported in 5-15% of patients. There have been numerous studies of recurrent disc herniation, but these have analyzed mixed patient populations. We designed this study to analyze the factors that influencing the clinical results, and efficiency of repeat discectomy for recurrent lumbar disc herniation occurring at the same level and on the same side after primary discectomy. METHODS: Between 1990 and 2011, a total of 52 patients who underwent repeat discectomy for recurrent lumbar disc herniation were retrospectively analyzed. Clinical outcomes were measured with Macnab criteria and visual analog scale (VAS score). Clinical parameters were also analyzed for influencing factors for outcome. RESULTS: Based on Macnab criteria, an excellent surgical outcome was achieved in 28 cases (54%), a good outcome in 22 cases (42%), a fair outcome in 1 case (2%), and a poor outcome in 1 case (2%). Based on VAS score, 47 of 52 patients (90%) showed more than 4 score improvement. Age, sex, diabetes mellitus, smoking, time interval between repeat and primary discectomy, duration of recurrent symptoms, and extent of disc herniation did not significantly affect Macnab criteria and VAS score. However, a traumatic event showed less VAS score improvement whereas not affecting on Macnab criteria. CONCLUSION: Conventional open lumbar discectomy performed as repeat surgery for recurrent herniation showed satisfactory results. Based on the results of this study, repeat discectomy can be recommended for the management of recurrent lumbar disc herniation. Further study is needed to evaluate factors related to the outcomes of repeat discectomy.
Diabetes Mellitus ; Diskectomy ; Humans ; Reoperation ; Retrospective Studies ; Smoke ; Smoking

The omentum has been used over the years for a variety of clinical problems. Recently it has shown that placing the omemtum on the brain and spinal cord can lead to an extensive development of vascular connections at the omental/CNS interface. Success with omental transposition to the human brain has led to increasing intreast in placing the omentum onto the human spinal cord. One paraplegic patient was chosen to enter into a feasibility study to see if omental transposition to their spianl cord might result in clinical benefit. The length of time from injury was about 21 months respecively. This patient had little, if any, motor and sensory function below umbilicus level. The operation required surgical lengthening of the pedicled omentum followed by its placement into a subcutaneous tunnel created backward along the lateral chest wall up to T-10, 11 level. An extensive thoracic laminectomy was then performed followed bya wide opening of the dura. In our case the cord showed segmental shrinkage of the spinal cord consistent with previous trauma. The omentum was laid directly onto the underlying spinal cord. Our observation for five months has shown that placement of the omentum onto the chronically injured spinal cord allowed for subsequent improvement in neuroelectrical activity, as manifested by reproducible somatosensory evoked potentials, and, more importantly, in moter function. It is considered that placing the omentum directly upon the brain or spinal cord may have the effect of either improving local vascular perfusion or, possibly, exerting some biochemicals(neurotransmitter), or as yet unknown, influence. But further observation is warranted to determine whether this improvement will be continued and will be observed in another cases.
Brain ; Evoked Potentials, Somatosensory ; Feasibility Studies ; Humans* ; Laminectomy ; Neurotransmitter Agents ; Omentum ; Perfusion ; Sensation ; Spinal Cord ; Spinal Cord Injuries ; Thoracic Wall ; Umbilicus

Bronchial Asthma could be developed by occupational origin. 4-16% of bronchial asthmas are known to be related to occupational exposure. However, occupational asthma has not been reported from the periodic occupational health examination, but reported through case report from clinicians. The authors analysed hospital records to find out work-related bronchial asthma and their occupational characteristics at a university hospital in Jnchon. All records which were confirmed as bronchial asthma in adult by an allergist from June, 1996 to May, 1998 were selected. Through record reviewing, any suspected work related asthma was selected and the interview was done by phone or at the out-patient clinic. The possible cases were confirmed by additional tests including specific bronchial provocation test. Sixteen(3. 9%) out of 411 bronchial asthma were confirmed as work-related asthma. Eight cases out of 16 worked at furniture industry, three worked at dye manufacturing and two worked at musical instrument manufacturing industry. Others worked at farm and machinary industry. The confirmed asthmogen were toluene diisocyante(8), reactive dye(3), and grain dust(1). None of the cases was detected as work-related asthma in the periodic health examination. Twelve out of sixteen occupational asthma patients discontinued their work. The results suggested that many patients with occupational asthma were not reported and the periodic health examination was not an effective system for detecting the workrelated asthma. Thus, setting up the surveillance system involving allergist or pulmonologist would be important to detect and prevent occupational asthma.
Adult ; Asthma* ; Asthma, Occupational ; Bronchial Provocation Tests ; Cereals ; Hospital Records ; Humans ; Incheon* ; Interior Design and Furnishings ; Music ; Occupational Exposure ; Occupational Health ; Outpatients ; Toluene

Many of the thoracolumbar spine fracture may be managed conservatively by postural reduction. But postural reduction alone cannot treat all the patient with thoracolumbar spine fracture properly. Recently, more patients with thoracolumbar spine fracture are managed surgically with the advance of surgical technique and instrument. Surgery may be performed by either anterior or posterior approach according to many factors. Generally initial management of patient with thoracolumbar spine fracture is conservative and surgery is delayed for spinal fusion, but early surgery with decompression of spinal cord and fusion of the vertebral body seems to be more proper in unstable fracture with compression of spinal cord by bony fragment and incomplete neurological deficit. Authors analyzed 52 cases of thoracolumbar spine fracture and made a proper management plan and proper surgical approach.
Decompression ; Humans ; Spinal Cord ; Spinal Fusion ; Spine*

Meningeal melanocytoma is a rare benign melanotic tumor arising from melanocytic cells in the leptomeninges. Preoperative differential diagnosis of meningeal melanocytoma from other melanotic tumors is difficult based on magnetic resonance imaging (MRI). Definitive diagnosis of meningeal melanocytoma from other melanotic tumors is done on the basis of histopathological and immunohistochemical analyses. The prognosis of this tumor is not always favorable with occasional local recurrence, especially in cases of subtotal gross resection. The authors report on a case of a 58-year-old man who presented with a melanocytoma located at the T7-8 level. The patient underwent on a total surgical excision for successful control of the tumor. During a follow-up period of 2 years, the patient presented no signs of recurrence. We emphasize the importance of discrimination of meningeal melanocytoma from other melanotic tumors to facilitate appropriate treatment. Complete resection is the treatment of choice for spinal melanocytoma. Radiation therapy should be reserved for those cases in which complete resection is not possible or in which there is recurrence.
Diagnosis, Differential ; Discrimination (Psychology) ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Prognosis ; Recurrence

Spinal intradural extramedullary teratoma is a rare condition that develops more commonly in children than in adults and may be associated with spinal dysraphism. We report a rare case of adult-onset intradural extramedullary teratoma in the thoracolumbar spinal cord with no evidence of spinal dysraphism and without the history of prior spinal surgery. The patient was a 38-year-old male whose chief complaint was urinary incontinence. X-ray images of the thoracolumbar spine showed the widening of the interpedicular distance and posterior marginal erosion of the vertebral bodies and pedicles at the T11, T12, and L1 level. Magnetic resonance imagings of the lumbar spine showed a lobulated inhomogeneous high signal intradural mass (87x29x20 mm) between T11 and L1 and a high signal fluid collection at the T11 level. Laminectomy of the T11-L1 region was performed, and the mass was subtotally excised. The resected tumor was histopathologically diagnosed as a mature cystic teratoma. The patient's symptom of urinary incontinence was improved following the surgery.
Adult ; Child ; Humans ; Laminectomy ; Magnetic Resonance Spectroscopy ; Male ; Spinal Cord ; Spinal Cord Neoplasms ; Spinal Dysraphism ; Spine ; Teratoma ; Urinary Incontinence

We present a case of a 68-year-old female with an atypical form of spinal tuberculosis, which involved posterior elements with multiple foci in two noncontiguous vertebral levels. The lesions caused spastic paraparesis and urinary hesitation. There was no evidence of pulmonary or other extrapulmonary tuberculous disease. Based on clinical and radiographic findings, this atypical spinal tuberculosis was preoperatively misdiagnosed as metastatic spine tumor. The histopathologic finding confirmed tuberculosis and the patient was treated successfully with surgery and antituberculous therapy. In case of a spinal lesion of unknown origin, it is important to be aware that atypical spinal tuberculosis can mimic metastatic spine tumor and tuberculosis should always be considered.
Aged ; Female ; Humans ; Paraparesis, Spastic ; Spine* ; Tuberculosis ; Tuberculosis, Spinal*

OBJECTIVE: Hydrocephalus is a common sequelae of aneurysmal subarachnoid hemorrhage (SAH) and patients who develop hydrocephalus after SAH typically have a worse prognosis than those who do not. This study was designed to identify factors predictive of shunt-dependent chronic hydrocephalus among patients with aneurysmal SAH, and patients who require permanent cerebrospinal fluid diversion. METHODS: Seven-hundred-and-thirty-four patients with aneurysmal SAH who were treated surgically between 1990 and 2006 were retrospectively studied. Three stages of hydrocephalus have been categorized in this paper, i.e., acute (0-3 days after SAH), subacute (4-13 days after SAH), chronic (> or =14 days after SAH). Criteria indicating the occurrence of hydrocephalus were the presence of significantly enlarged temporal horns or ratio of frontal horn to maximal biparietal diameter more than 30% in computerized tomography. RESULTS: Overall, 66 of the 734 patients (8.9%) underwent shunting procedures for the treatment of chronic hydrocephalus. Statistically significant associations among the following factors and shunt-dependent chronic hydrocephalus were observed. (1) Increased age (p < 0.05), (2) poor Hunt and Hess grade at admission (p < 0.05), (3) intraventricular hemorrhage (p < 0.05), (4) Fisher grade III, IV at admission (p < 0.05), (5) radiological hydrocephalus at admission (p < 0.05), and (6) post surgery meningitis (p < 0.05) did affect development of chronic hydrocephalus. However the presence of intracerebral hemorrhage, multiple aneurysms, vasospasm, and gender did not influence on the development of shunt-dependent chronic hydrocephalus. In addition, the location of the ruptured aneurysms in posterior cerebral circulation did not correlate with the development of shunt-dependent chronic hydrocephalus. CONCLUSION: Hydrocephalus after aneurysmal SAH seems to have a multifactorial etiology. Understanding predisposing factors related to the shunt-dependent chronic hydrocephalus may help to guide neurosurgeons for better treatment outcomes.
Aneurysm ; Aneurysm, Ruptured ; Animals ; Cerebral Hemorrhage ; Hemorrhage ; Horns ; Humans ; Hydrocephalus ; Meningitis ; Prognosis ; Retrospective Studies ; Subarachnoid Hemorrhage ; Ventriculoperitoneal Shunt