STUDY DESIGN: A retrospective study was made of patients undergoing posterolateral fusion of the lumbar spine. OBJECTIVES: To compare the clinical outcomes of the patients who underwent posterolateral fusion of the lumbar spine with commercially available allogeneic bone graft with those patients in a similar consecutive control group who underwent posterolateral fusion of the lumbar spine with autogenic bone graft and to determine whether the commercially available allogeneic bone is useful for postero-lateral fusion of the lumbar spine. SUMMARY OF LITERATURE REVIEW: Major differences exist in the ability of an allogeneic bone graft to regenerate a viable cellular network as compared to an autogenic bone graft. This is related to the immunologic response of the host to the foreign bone. The fusion rate of deep freezing allogeneic bone graft was reported as 80-100%. MATERIALS AND METHODS: Seventy-nine patients with spondylolisthesis treated with decompression, fixation with pedicle screws and posterolateral fusion were retrospectively reviewed. Nineteen patients (group 1) were treated with commercially available allogeneic bone (Tutoplast) graft mixed with autogenic bone and the remaining 60 patients (group 2) were treated with autogenic bone graft. Operating time, amount of transfusion, duration of hospital stay, symptom improvement, fusion rate, duration of fusion, and complications were studied. RESULTS: There were no significant differences between the two groups in terms of duration of hospital stay, amount of transfusion, symptom improvement, and complications . However, there were significant differences between the allogeneic and autogenic groups in terms of operating time (212.3 versus 230.9 minutes), fusion rate (36.8% versus 98.3%), and duration of fusion (10.2 versus 6.4 months), respectively. CONCLUSIONS: Commercially available allogeneic bone is less useful for posterolateral fusion of the lumbar spine.
Decompression ; Freezing ; Humans ; Length of Stay ; Retrospective Studies ; Spine* ; Spondylolisthesis ; Transplants

PURPOSES: This study examined the relationship between risk behaviors and sexual knowledge, sexual attitudes, and sexual experiences of male high school students. METHOD: A cross-sectional, descriptive study was conducted. Data were collected from 2 male high schools in metropolitan Gwangju. Five hundred forty-eight boys were enrolled in this study. Descriptive statistics, factor analysis, t-test or ANOVA, and Pearson's correlation were used for data analysis. RESULTS: The mean sexual knowledge and sexual experience scores were relatively low, 0.60 out of 1 point, and 0.75 out of 4 points, respectively. Three attitude types of the students were identified: permissible, conservative and pleasure seeking attitude. The score of the permissible type was affected by the subjects' exposure to pornographic material. The score of the conservative type was affected by alcohol consumption and acquaintances with a heterosexual friend. The score of the pleasure seeking type was affected by their exposure to pornographic material, alcohol consumption, smoking, going to a video-room, and acquaintances with a heterosexual friend. There was a negative correlation between the permissible type and sexual knowledge, and a positive correlation between the conservative and pleasure seeking types and sexual experience. CONCLUSION: Male high school students who have been exposed to risk behaviors have a higher likelihood of indulging in sexual activity, and the pleasure seeking type appears to be related to sexual experience. An educational program may be needed to prevent risky behaviors and sexual experiences in male high school students considering their sexual attitude type.
Alcohol Drinking ; Friends ; Gwangju ; Heterosexuality ; Humans ; Male* ; Pleasure ; Risk-Taking* ; Sexual Behavior ; Smoke ; Smoking ; Statistics as Topic

STUDY DESIGN: A retrospective study was performed in obese and nonobese patients undergoing lumbar spine surgery. OBJECTIVES: To report perioperative complications and surgical outcomes in obese patients who underwent lumbar surgery compared with a similar consecutive control group to determine whether obesity is a predictor of poor outcome as well as a factor associated with perioperative complications in lumbar spine surgery. SUMMARY OF LITERATURE REVIEW: Perioperatiye challenges in managing the obese patient include anesthesia considerations related to impaired preoperative cardiac and respiratory function, technical difficulties associated with incubation, positioning, and gaining venous and arterial access for monitoring and administering medications. Obesity has also been implicated in delayed wound healing and thrombophlebitis. MATERIALS AND METHODS: One hundred twenty seven patients with spondylolisthesis treated with decompression and fusion were retrospectively evaluated. Forty four patients were obese and remaing eighty three patients were nonobese. The operation time, amount of transfusion, duration of hospital stay and clinical outcomes were studied. RESULTS: There were no significant differences between the obese and control groups in terms of duration of surgery (224 versus 200 min), amount of transfusion (2.6 versus 2.2 pint), duration of hospital stay (21.3 versus 19.7 days), and symptom improvement (74fo versus 73fo). CONCLUSIONS: Obesity is not a predictor of poor outcome as well as a factor associated with high perioperative complication rate in lumbar spine surgery.
Anesthesia ; Decompression ; Humans ; Length of Stay ; Obesity* ; Retrospective Studies ; Spine* ; Spondylolisthesis ; Thrombophlebitis ; Wound Healing

We have analysed 13 patients with malignant obstructive jaundice due to metastasis who were treated with local radiation therapy to the area of porta hepatis at the Radiation Therapy Department of Paik hospital attached to the Inje University between 1984 and 1988. A good response was observed in 6 out of 7 evaluable paitens receiving a total radiation dose ranging from 2600 to 5480 cgy in 2.6 to 6 weeks. A complete response was noted in 5 patients, a partial response in 1 patient, and no response in 1 patient. The overall median survival for 13 patients was 3 months. But two patients lived more than a year without recurrence of jaundice. Moderate dose, localized field radiation therapy appears to the beneficial in relieving obstructive jaundice and gives a good symptomatic relief.
Humans ; Jaundice ; Jaundice, Obstructive* ; Neoplasm Metastasis ; Recurrence

OBJECTIVES: To determine if unilateral pedicle screw fixation is comparable to bilateral fixation in one-or two-segment lumbar spinal fusion. METHODS: Eighty-eight patients with spinal stenosis or spondylolisthesis were assigned to either unilateral or bilateral pedicle screw instrumentation groups. Demographic variables, preoperative diagnosis, number of fusion segments, and kinds of instrumentation used were similar between the two treatment groups. RESULTS: There were no significant differences between the two groups in terms of blood loss, clinical results, time at which fusion was complete, fusion rate, and complication rate. There were significant differences between the two groups in terms of duration of operating time, duration of hospital stay, medical expenses. The number of fusion segments or kinds of instrumentation did not affect the fusion rate, time at which fusion was complete, or clinical outcomes. Metal failure rate of unilateral fixation was higher in patients with spondylolytic spondylolisthesis than in patients with spinal stenosis. CONCLUSIONS: Unilateral pedicle screw fixation was as effective as bilateral pedicle screw fixation in lumbar spinal fusion independent of the number of fusion segments (one or two segments) or pedicle screw systems. Unilateral pedicle screw fixation is not recommended for spondylolytic spondylolisthesis patients who were treated with Gill' s decompression.
Decompression ; Diagnosis ; Humans ; Length of Stay ; Spinal Fusion* ; Spinal Stenosis ; Spondylolisthesis

An increase in the dose of chemotherapy enhances the response of many experimental and clinical cancers, but the extent of chemotherapy dose escalation and repeated use is often limited by myelosuppression. The side effects of chemotherapy including bleeding and infection due to myelosuppression have resulted in delayed therapy and a reduction in the therapeutic dose, therefore it is necessary to overcome myelosuppression especially leukopenia in patients with gynecologic malignancies who recieved chemotherapy. This study is undertaken to investigate the clinical effects of rhG-CSF(recombinant human Granulocyte-colony stimulating factor) in 29 patients with gynecologic malignancy who recieved chemotherapy. It was given at a dose of 100 microgram bid/day subcutaneously until significantly increase of leukocyte count in leukopenic patient. The results showed, the rhG-CSF has significantly increased the number and function of leukocyte. The use of rhG-CSF was effective and useful to treat chemotherapy induced leukopenia and to accelerate the recovery from this complications.
Drug Therapy* ; Hemorrhage ; Humans* ; Leukocyte Count ; Leukocytes ; Leukopenia*

Between December 1983 and December 1989, twenty-five breast carcinoma patients were treated with surgical resection and postoperative radiotherapy at Inje University Seoul Paik Hospital. Twenty-three of 25 were evaluable and there were 7 patients with stageII, 14 patients with stageIII, and 2 patients with stageIV. Twenty-one patients were treated with modified radical mastectomy and the remained 2 patients with simple mastectomy. The follow-up period ranged from 2 to 8 years. The local control rate was 83c13 for the entire group. The local control rates for each stage were 100%(6/6) for stage II, 73%(l1/15) for stageIII, and 100%(2/2) for stageIV. The number of metastatic axillary nodes was a good predictor of locoregional cotrol. It was 100% for the patients with 0-3 metastatic nodes and 72% for more than 4 nodes, respectively. The 5-year overall survival rate for the entire group was 59%, and the disease-free survival rate was 32%. The 5-year survival rates for each stageII,III and IV was 83%, 59% and 50%, respectively. The distant metastasis occurred in 10 out of 23 patients and the most common site was bone. The results indicate that postoperative radiotherapy continues to play an important role in the primary mangement of the high-risk breast cancer patients.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Simple ; Neoplasm Metastasis ; Radiotherapy* ; Seoul ; Survival Rate

PURPOSE: To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. METHODS AND MATERIALS: The study involved a retrospective review of outcome in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median : 97 months). Seventeen were men and 10 were women. The numbers of functioning and non-functioning pituitary adenoma were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy (median : 5040cGy) were deliverd over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. RESULTS: For radiation therapy alone, the 5YSR was 100% and progression free survival rate was 85.8%. The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy, the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose, radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statistically significant (P > 0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluable patients with hyperprolactinoma achived normalization in 4 and decrement in 5 patients. Only 2 patients developed mild degree of panhypopituitarism. CONCLUSION: The radiotherapy appears to be effective in controlling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherapy was comparable. There was a trend toward high recurrence rate in patients with nonfunctioning or prolactin secreting tumor and larger radiation field sizes.
Disease-Free Survival ; Female ; Humans ; Male ; Multivariate Analysis ; Pituitary Neoplasms* ; Prolactin ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Visual Fields

No abstract available.
Binding Sites* ; Gonadotropins* ; Humans* ; Ovarian Neoplasms*

PURPOSE: To describe clinical and MRI findings of growth hormone-secreting pituitary adenoma, to determine ifthere are any characteristic MRI findings different from those of other pituitary adenomas, to evaluate the relationship between tumor size and serum growth hormone level, and to assess the results of immunohistochemical study. MATERIALS AND METHODS: We retrospectively analysed clinical and MRI findings of 29 patients with growth hormone-secreting pituitary adenoma confirmed by serum growth hormone level and surgery. We also evaluated the relationship between the tumor volume and serum growth hormone level, and the results of immunohistochemical study. Coronal and sagittal T1-weighted MR images in all patients and gadolinium enhanced T1-weighted MR images in28 patients were obtained with 2.0 T(24 cases) and 0.5 T(5 cases) MR imagers. The images were analyzed in terms oftumor size, signal intensity, degree of contrast enhancement, extent of tumor growth and the presence or absenceof cystic change, hemorrhage and calcification. RESULTS: Clinical manifestations included facial feature changeand soft tissue swelling of hands and feet(n=29), headache(n=12), impaired visual acuity(n=9), symptoms of hyperprolactinemia(n=8), visual field defect(n=5), and others(n=6). On MR images, all of the 29 cases were seen tobe macroadenomas and the size of the tumors averaged 2.2cm(1-5.2 cm). Supra- and infrasellar extensions were seenin 21 and 22 patients, respectively. Cavernous sinus invasion was noted in seven, and in one this was bilateral.Signal intensity was isointense with cortical grey matter in 26 cases(90%). Cystic change or necrosis was seen ineight cases(28%), hemorrhage in four(14%), and calcification in two(7%). After enhancement, most(25/28) of the tumors enhaned less than mormal pituitary in degree. There was no correlation between serum growth hormone level and tumor size. Immunohistochemical study showed positive growth hormone-secreting cells in only 69%(11/16). CONCLUSION: Clinical findings in patients with growth hormone-secreting pituitary adenomas were various and included acromegaly, headache, visual impairment, and symptoms of hyperprolactinemia, for example. On T1-weightedMR images, all tumor were macroadenoma, and there were no characteristic findings different from those of other pituitary tumors. The volume of a tumor did not correlate with serum hormone level. Immunohistochemical study showed positive growth hormone-secreting cells in a limited number of cases.
Acromegaly ; Cavernous Sinus ; Growth Hormone ; Growth Hormone-Secreting Pituitary Adenoma* ; Hand ; Headache ; Hemorrhage ; Humans ; Hyperprolactinemia ; Magnetic Resonance Imaging* ; Necrosis ; Pituitary Neoplasms ; Retrospective Studies ; Tumor Burden ; Vision Disorders ; Visual Fields