No abstract available.

No abstract available.
Spinal Cord Diseases* ; Spinal Cord*

There are many factors affecting surgical results of cervical spondylotic myelopathy. Age, duration of symptom, neurologic status, and direction of surgical approach are side to have prognostic implications. Also a high signal intensity on T2 weighted magnetic resonance imaging(HSI on T2WI) is insisted as a poor prognostic factor. We analyzed these factors in 56 patients treated over a 10-year period retrospectively. Statistical analysis was done using chi square, Mantel-Haenszel. Cochran-Mantel-Haenszel, Wilcoxon, and logistic procedure. We preferred anterior decompression when compressive lesions existed ventrally. However posterior decompression was performed in a 4 or more level stenosis. Age ranged from 22 to 74 year(mean : 50.8). 25 patients underwent the anterior procedure, 33 patients the posterior procedure, and 2 both procedures. Neurologic status was graded both preoperatively and at follow-up using the Nurick grading system from 1 to 5. The preoperative Nurick grade was 2.75+/-0.16(mean+/-SE). Mean follow-up period was 13.8 months(SE 0.14). The follow-up Nurick grade was 2.125+/-0.14, and these was noted an improvement of 0.63+/-0.12. The amount of improvement was equivalent between the anterior and the posterior approaches(0.52 vs. 0.73 respectively, p=0.67). There was no mortality. Uni- and multivariant analysis demonstrated that age, duration of symtom and HSI on T2WI had no significant effect on either follow-up Nurick grade or amount of improvement, but the preoperative Nurick grade had a significant effect(p<0.000). Comparable results can be obtained with either approaches if chosen properly. Only the preoperative Nurick grade has the prognostic value.
Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Humans ; Mortality ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Spinal Cord Diseases ; Spondylosis

No abstract available.
Humans ; Urinalysis*

The author analysed clinical effect of surgical decompression and stabilization on spinal cord dysfunction in 20 cases of atlantoaxial dislocation. Of 20 cases, 10 cases were related with trauma(either recent or remote), 4 with bony anomalies, 3 with inflammatory processes and remaining 3 of unknown etiologies. 9 cases had reducible dislocations and 11 cases were not reduced preoperatively. All cases were decompressed if necessary and stabilized via ventral transoral or posterior approaches. All cases except one, neurological symptoms and sings were improved or stabilized after operations. One patient who had been bedridden and had high preoperative CO2 retention, died 2 months after operation due to respiratory complications. In 3 of 10 ventrally decompressed cases, pharyngeal wounds were disrupted and it took more than 3 months of admission to heal. In 3 of 17 posterior fusion, solid bony fusion could be achieved by second operations. In conclusion, atlantoaxial dislocations can be cured by systematic decompression and fusion, but complication can be serious and troublesome.
Decompression ; Decompression, Surgical* ; Dislocations* ; Humans ; Spinal Cord* ; Wounds and Injuries

Thoracic disc herniation is so uncommon that only four cases have been literally reported to Korean Neurosurgical Journal Since 1972. Authors report here another 7 cases of thoracic disc herniation and analyse clinical findings and surgical outcome of 11 cases including 4 cases previously reported from other hospitals. Results are as follows: 1) Male dominancy in incidence was quite evident(10 : 1), and most patients were middle aged(30-50). 2) About a half of the patients had sudden onset of spinal cord compression symptoms, and the remaining half had insidious onset. 3) In 7 of 11 patients, diagnosis could be done by myelography alone, but in 4 of 11 cases, myelographic findings were equivocal and contrast CT scan were required for confirmation. 4) Thoracic disc herniations were more frequent in mid-thoracic discs(T5-T8 disc). 5) Considering the direction and location of disc herniations, 7 cases were paramedian, 2 cases central and 1 case was posterolateral. 6) Transthoracic transpleural approach were adequate for central or paramedian disc herniations, and posterolateral or transpedicular approach for lateral herniations.
Diagnosis ; Humans ; Incidence ; Male ; Myelography ; Spinal Cord Compression ; Tomography, X-Ray Computed

The 5 year survival rate after surgical resection for stage III non-small cell lung cancer(NSCLC) remains short, only 10-19%. Radiotherapy seems to show some benefit for local control, but it does not reflect to prolongation of survival, as distant metastasis prevails. Vinblastine is one of the most active agent against NSCLC. 5-Fluorouracil(5-FU) and cisplatin are synergistic in anti-cancer activity in adenocarcinoma of gastrointestinal tract and squamous cell cancer of head and neck. We initiated a phase II trial for advanced NSCLC to determine the effect of FVP regimen in response rate, survival and toxicities. The therapy consisted of 5-FU 500mg/m2/12 hours continious IV infusion for 36 hours from day 1, vinblastine 3mg/m2 IV bolus day 1 and 2, cisplatin 75mg/m2 IV infusion over 2 hours day 1 and it was repeated every 3 weeks. Among the 45 patients entered into this study, 40 patients were evaluable for response. The objective response rate was 50%(CR;1/40, 2.5% PRi19/40, 47.5%). The median survival of all the patients was 42.9 weeks(8.4+ - 140.6 weeks); the responding patients survived longer than the non-responders(mediansurvival; 54.4 weeks vs 29.7 weeks, p<0.05). The toxicities of this regimen were acceptable but 1 patient died of pneumonia associated with granulocytopenia. We concluded that the FVP regimen is effective in the treatment of advanced non-small cell lung cancer and a prospective randomized trial and long- term follow up is warranted.
Adenocarcinoma ; Agranulocytosis ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Dronabinol* ; Drug Therapy ; Drug Therapy, Combination* ; Fluorouracil* ; Follow-Up Studies ; Gastrointestinal Tract ; Head ; Humans ; Lung ; Neck ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Pneumonia ; Radiotherapy ; Survival Rate ; Vinblastine

Intradural extramedullary (IDEM) tuberculoma of the spinal cord is uncommon entity and moreover, few reports have been documented on concurrent IDEM and intracranial tuberculomas. Authors report a case of IDEM spinal tuberculoma having intracranial lesion simultaneously. A 49-year-old woman suffered from paraparesis and urinary incontinence while being given medical treatment for tuberculous meningitis. Magnetic resonance imaging (MRI) revealed an IDEM mass lesion between the T1 and T2 spinal levels, and multiple intracranial tuberculous granulomas. Surgical resection of the IDEM tuberculoma followed by anti-tuberculous medication resulted in good outcome.
Brain/radiography ; Case Report ; Female ; Follow-Up Studies ; Human ; Magnetic Resonance Imaging ; Middle Age ; Mycobacterium tuberculosis/isolation & purification ; Spinal Cord Diseases/radiography* ; Tuberculoma/surgery ; Tuberculoma/radiography ; Tuberculoma/drug therapy ; Tuberculoma/complications* ; Tuberculosis, Meningeal/surgery ; Tuberculosis, Meningeal/radiography ; Tuberculosis, Meningeal/drug therapy ; Tuberculosis, Meningeal/complications*

No abstract available.
Fracture Fixation, Intramedullary*