PURPOSE: To evaluate the early clinical results of lumbar microdiscectomy using minimally invasive tubular retractor (METRx-MD system, Medtronic Sofamor Danek, Memphis, TN), and to validate the merits of minimally invasive spinal surgery. MATERIALS AND METHODS: From April, 2003 to April 2004 we retrospectively studied a consecutive series of 45 patients who underwent lumbar microdiscectomy using minimally invasive tubular retractor. In all cases, minimally invasive approach using the tubular retractor were performed with a 2 cm sized paramedian incision. The following data were collected: clinical outcomes, operative time, intraoperative blood loss, need for blood replacement, time needed before ambulation, length of hospital stay, and complications. The clinical outcomes were assessed by the modified MacNab criteria. RESULTS: Minimally invasive tubular microdiscectomy was performed in 45 patients over a 12-month period with an average follow-up of approximately 8 months. The clinical outcomes assessed by MacNab criteria were excellent in 33 patients (73%), good in 10 patients (22%). The average operative time was 63 minutes (range, 35 to 95 minutes). The average blood loss was 62 mL (range, 50 to 110 mL). None of the patients needed blood replacement. With the exception of 2 patients, all patients could walk at the day of surgery. The average hospital stay was 2.3 days. None of the patients had dural tear, wound problem, or other complications. CONCLUSION: Lumbar microdiscectomy using tubular retractor can offer a useful modality for the treatment of lumbar herniated disc with the merits of minimally invasive spinal surgery. Further long-term, randomized, prospective investigations are needed to fully evaluate the impact of this technique.
Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Length of Stay ; Operative Time ; Wounds and Injuries

Histological findings in corpus cavernosum were retrospectively evaluated in 36 patients with erectile impotence. Biopsies were obtained during insertion of penile prosthesis from both corpora. The most prominent histological findings were fibrosis(63.9%) and hyalinization(50%). Peyronie`s disease was not clinically diagnosed in any patient. Our findings suggest that clinical penile cavernosal fibrosis is common and may be a significant etiologital factor in patients with erectile impotence.
Biopsy ; Erectile Dysfunction* ; Fibrosis* ; Humans ; Male ; Penile Prosthesis ; Retrospective Studies

No abstract available.

Neuroleptic malignant syndrome is a rare, but potentially life-threatening adverse event associated with the use of neuroleptic agents. We describe the case of a 47-year-old schizophrenic woman who was treated with clozapine for years. The patient developed acute renal failure with pulmonary edema, and underwent mechanical ventilation and hemodialysis.
Acute Kidney Injury ; Antipsychotic Agents ; Clozapine* ; Female ; Humans ; Middle Aged ; Neuroleptic Malignant Syndrome* ; Pulmonary Edema ; Renal Dialysis ; Respiration, Artificial ; Rhabdomyolysis

No abstract available.
Knee ; Ligaments* ; Magnetic Resonance Imaging

Sporotrichosis is a chronic infection that follows accidental implantation of the fungus Sporothrix schenckii into the skin. The infection begins with skin trauma under conditions when conidia may be present. A 48-year-old woman presented with a 5-year history of an 8X 12 cm sized, centrally depressed, erythematous plaque on the left wrist. She had been treated with antifungal agents at an other hospital for about 6 months but there was no improvement. The histopathological findings showed an infiltration of mononuclear cells and tuberculoid structures on the whole dermis and subcutis. According to the histopathological findings and clinical manifestations, she was diagnosed as having lupus vulgaris. There was much improvement of the lesion after antituberculous therapy. However, 2 months later she developed asymptomatic multiple erythematous papules around the lesion of lupus vulgaris and along the lymphatic drainage of the left arm. The histopathological findings of the newly developed lesion showed a granulomatous reaction and an infiltrate of acute and chronic inflammatory cells. Moist and creamy colonies were changed into brown-to-black ones with a leathery appearance with age. This appearance and clinical manifestations confirmed the diagnosis of lymphocutaneous sporotrichosis. This clinical appearance reflects that the sporotrichosis developed on the ulcerative lesion or biopsy site of lupus vulgaris.
Antifungal Agents ; Arm ; Biopsy ; Dermis ; Diagnosis ; Drainage ; Female ; Fungi ; Humans ; Lupus Vulgaris* ; Middle Aged ; Skin ; Spores, Fungal ; Sporothrix ; Sporotrichosis* ; Ulcer ; Wrist

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy

No abstract available.
Blood Transfusion, Autologous*

PURPOSE: To evaluate the effects of dexamethasone(D) on blood pressure(BP) in infants with bronchopulmonary dysplasia(BPD). METHODS: We retrospectively reviewed 10 infants with BPD(mean birth weight: 1,383+/-17 gm, mean gestational age: 29.0+/-1.7 weeks) treated with D at Wonkwang University Hospital from January 1994 to June 1998. D was started at 0.5 mg/kg/day intravenously for first week, followed by 0.3 and 0.1 mg/kg/day for second and third week, respectively. Changes in BP during pre-D, 1st wk(D1), 2ndwk(D2), 3rd wk(D3), and post-D periods were compared using Turkey Kramer multiple comparison test. RESULTS: Mean systolic pressure(sBP) significantly increased in Dl, D2, D3 compared to pre-D(63+1.3, P<0.01; 66+1.7, P<0.001; 683.4, P<0.001 vs 591.9 mmHg, respectively) but significantly decreased in post-D compared to D3(64+/-2.4 mmHg, P<0.05). Mean diastolic pressure(dBP) significantly increased in D2 and D3 compared to pre-D(42+/-1.1, P<0.001; 43+/-2.6, P<0.001, vs 382.1 mmHg, respectively). Mean dBP deed slightly in post-D(41+/-4.1 mrnHg, P>0.05). The sBP and dBP significantly increased from day 2 after initiation of D and were highest on day 17 and 17-18 of 3rd week, respectively. The number of hypertensive infants who were considered for antihypertensive medications were 2(20%) for sBP >or= 80-90 mmHg, 3(30%) for dBP >or= 50 mmHg and 1(10%) for dBP> or =60 mmHg. These infants, however, remained asymptomatic. CONCLUSION: Significant elevation of BP was observed during dexamethasone therapy for infants with BPD especially after 2nd day. However, BP elevation was transient, not requiring antihypertensive medications.
Birth Weight ; Blood Pressure* ; Bronchopulmonary Dysplasia* ; Dexamethasone* ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Retrospective Studies ; Turkey

This study was designed to investigate whether fibrosis of the corpus cavernoum(CC) induced by repeated intracavernous injection of papaverine HCl was related to pH of the drug. Forty-eight New Zealand White rabbits weighing 2.5kg-3.0kg were divided into 4 groups of 12 animals each. Group 1 received isotonic saline. Group 2; pH 2.0 papaverine HCl. Group 3; pH 3.0 papaverine HCl and Group 4; pH 4.0 papaverine HCl. The solution (0.1ml isotonic saline or 2mg. papaverine HCl of seeh pH) was injected intracorporeally twice every week for 6 months. Every one month since beginning of the injection, 2 animals of each group were sacrificed. the penis was observed with H and E and Masson`s lrichomme stain microscopically. No sign of Fibrosis was found in the CC of the group l even after 6months of injection. However, Group 2. 3 and 4 began to show focal of diffuse thin fibrotic changes after 2 months of injection. The fibrotic changes progressed more and more in accordance with the Frequency of papaverine HCl injection. After 4 months of injection. Group 2 showed diffuse thick fibrosis whereas Group 3 and 4 showed diffuse thin or focal thick fibrosis. In conclusion, intracavernous papaverine itself seems to play a main role to induce fibrosis of CC. However, the acidity of the papaverine HCl also might be responsible to development of the fibrosis when injected repeatedly for a long period.
Animals ; Fibrosis* ; Hydrogen-Ion Concentration ; Male ; Papaverine* ; Penis ; Rabbits