STUDY DESIGN: This is a retrospective study analyzing 76 patients treated by decompression, pedicle screw instrumentatin and fusion for spondylolytic spondylolisthesis with symptomatic spinal stenosis. OBJECTIVES: This is to verify the advantages of adding posterior lumbar interbody fusion (PLIF) to the usual posterolateral fusion (PLF) with pedicle screw instrumentation. SUMMARY OF BACKGROUND DATA: Stabilization after decompression of spondylolytic spondy- lolisthsis is difficult due to insufficiency of fusion base, gap between the bases and incompetent anterior disc support. PLIF offers anterior support, reduction and a broad fusion base. METHODS: Forty patients were treated with PLF and 36 were treated with additional PLIF. They were compared for union, reductin of the deformity and clinical results. RESULTS: The patients were followed up for more than 2 years (mean: 4.6 years). Nonunion was observed in 3 PLF cases (7.5%) and none in PLIF. Reduction of slippage was 28.3% in PLF and 41.6% in PLIF (p < 0.05). In PLF group, 8 patients (20%) had recurrence of deformity with loss of reduction more than 50%. Hardware failures occurred in 2 with PLF. There was no major neurologic complications in both groups. Both groups had a few difference in the satisfactory results, but some difference in the excellent result by Kirkaldy-Willis criteria. Excellent result was 45% in PLF and 75% in PLIF. CONCLUSIONS: Addition of PLIF to PLF following a complete decompression and pedicle screw flxation is a recommendable procedure for the treatment of spondylolytic spondylolisthesis with spinal stenosis.
Congenital Abnormalities ; Decompression ; Humans ; Pedicle Screws ; Recurrence ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis

No abstract available.
Diaphragm* ; Rupture*

From 1981 to 1993, one hundred and thirty eight patients had been treated by free flap or island flap, for the tissue defects of the extremities. Among these 138 patients, vascularized bone graft was 29 cases, soft tissue free flap 40, replantation 22, local island flap 45, and lymphovenous shunt 2. Average age at the time of operation was 27 years(1-66 years), and men were 110, women 28. Average duration of follow-up was 2 years and 8 months(4 months-11 years and 8 months). Twenty nine cases of vascularized bone graft was consisted of fibular graft in 15 patients, ilium 8, joint transplantation 4, thumb reconstruction using big toe 1, and rib 1. Four of them were failed. Among 40 patients of soft tissue free flap, latissimus dorsi flap was 12 cases, dorsalis pedis flap 11, scapular flap 8, wraparound procedure 7 and gracilis flap 2. Seven of them were failed. The levels of replantations were both lower extremities in one patient, leg 1, arm 2, distal forearm 2, and finger(s) 16. In six patients, replantation was nor successful. Among 45 patients of local island flap, lateral supramalleolar island flap was performed in 8 patients, dorsalis pedis flap 2, Chinese flap 10, reverse ulnar artery flap 4, reverse posterior interosseous artery flap 3, neurovascular island flaps for fingers 14, and others 4. Two of them were failed. Two cases of lymphovenous shunt for the treatment of lymphedema were successful. As a whole, 119 cases were successful(86%) among 138 cases including local island flap 45 cases.
Arm ; Arteries ; Asian Continental Ancestry Group ; Extremities ; Female ; Fingers ; Follow-Up Studies ; Forearm ; Free Tissue Flaps ; Hallux ; Humans ; Ilium ; Joints ; Leg ; Lower Extremity ; Lymphedema ; Male ; Replantation ; Ribs ; Superficial Back Muscles ; Surgical Flaps ; Thumb ; Transplants ; Ulnar Artery

In Korea, all domestic made test systems for detecting antibodies in HIV-1 contain the antigens from human immunodeficiency type 1 (HIV-1) subtype B. However, because HIV-1 subtype O is significantly different in amino acid sequences from all other subtypes of HIV-1, there has been a need for developing a test for detecting antibodies in subtype O. For this purpose, the entire nucleotide sequence corresponding to the extracellular domain of the transmembrane glycoprotein of HIV-1 subtype O was synthesized with consideration of Escherichia coli cordon usage. Various regions of the extracellular domain were cloned into E. coli expression vectors and tested for levels of protein production. The nucleotide sequence, named ECTM, that can encode a 129 amino acid-long peptide, was found to be expressed at a high level in E. coli. The protein of approximately 17 kDa specifically reacted with sera from individuals infected with HIV-1 subtype O. The ECTM protein was purified to near homogeneity by the CM-T gel chromatography, using concentrated, denatured inclusion bodies. In Western blot analysis, the purified viral antigen reacted with sera from individuals infected with subtype O more efficiently than subtype B. The enzyme linked immunoabsorbent assay (ELISA) system was developed using the subtype O viral protein and compared with the commercially available kit lacking the antigens from subtype O. The ELISA kit containing the subtype O antigen ECTM alone efficiently reacted with sera from individuals infected with subtype O. The subtype O antigen-containing kit produced a positive absorbence even when sera were diluted 512-fold, suggesting a high sensitivity. The commercially available kit also reacted with subtype O sera, but produced a negative result at a dilution of 8-fold. Our results suggest that the currently available kit may not be able to efficiently detect subtype O sera and that the viral protein developed in this study may be added to the current system to maximize the detection of sera from individuals infected with subtype O.
Amino Acid Sequence ; Antibodies ; Base Sequence ; Blotting, Western ; Chromatography, Gel ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Glycoproteins ; HIV* ; HIV-1* ; Humans* ; Inclusion Bodies ; Korea ; O Antigens

BACKGROUND/AIMS: Planned endoscopic submucosal dissection with snaring (ESD-S) is thought to shorten operating time spent on submucosal dissection, but may lead to uncertainty of en bloc resection or to a possible increase in tumor-positive margins. The purpose of the present study is to investigate the feasibility of ESD-S as a planned procedure for gastric adenoma. MATERIALS AND METHODS: The medical records of 99 patients who underwent ESD-S or ESD for gastric adenoma between May 2011 and May 2012 were retrospectively reviewed. We analyzed the differences between the ESD-S and the ESD groups, focusing on rates of en bloc resection and pathologic complete resection, mean operation time, and complications. RESULTS: The mean operation time was significantly lower in the ESD-S group than in the ESD group (19.9+/-11.2 vs. 33.8+/-19.9, P=0.012). Cases with an operation time under 30 minutes were more frequent in the ESD-S group (88.9% vs. 48.1%, OR=8.615, 95% CI=2.949~25.168). There were no significant differences in en bloc resection, histologic complete resection, or complication rates between the two groups. CONCLUSIONS: ESD-S has a time advantage over ESD with a comparable compete resection rate. ESD-S can be considered a planned method for available early gastric adenoma.
Adenoma* ; Endoscopy ; Focus Groups ; Humans ; Medical Records ; Retrospective Studies ; SNARE Proteins* ; Uncertainty

Seventy-five patients with moyamoya disease were admitted at Kyung Hee University Hospital from 1978 to 1993. Of these, we followed up fourty-five cases who had been treated conservatively for the study of the natural history of moyamoya disease. Seven operated cases and six dead patients during admission were excluded in this study and sixteen cases were lost to follow-up. There were 16 males and 29 females. The hemorrhagic group was twenty-three cases and the non-hemorrhagic group was twenty-two cases. On angiographic findings, the typical type was twenty-eight cases and the atypical type was seventeen cases. Twenty-one cases(91%) of the hemorrhagic group were over twenty years old and sixteen cases(73%) of the non-hemorrhagic group were under twenty years old. The mean follow-up period was 66 months(range 6 months to 15 year 4 months). Nineteen cases had reattack, but most of them had good result except only two cases who died due to huge intracerebral hematoma. Of the sixteen cases, who were under twenty years old and manifested as transient ischemic attack, fifteen cases were improved only with conservative management. The good result of fourty-one cases out of fourty-five with conservative management. suggests that spontaneous collateral circulation had developed well to restore the function of ischemic brain in the natural course of moyamoya disease. Moyamoya disease seems to be not so worse in natural course than expected and further study about natural history will be necessary.
Brain ; Collateral Circulation ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Ischemic Attack, Transient ; Lost to Follow-Up ; Male ; Moyamoya Disease* ; Natural History*

We traced median nerve somatosensory evoked potential(SSEP) in 57 patients with putaminal hemorrhage from February, 1986 to January, 1991 for evaluation of relationship between SSEP findings and Glasgow outcome scale. 1) All patients with normal SSEP, prolonged central condution time and low ampulitude of cortical wave at affected side with small sized putaminal hemorrhage had good recovery to grade I. 2) Nine out of 25 patients with flat cortical wave of SSEP in small sized putaminal hemorrhage recovered to grade I. 3) All patients with moderate or large sized putaminal hemorrhage had flat cortical wave at affected side, none of them improved to grade I. It suggested that SSEP tracing in putaminal hemorrhage seemed to be valuable for evaluation of prognosis.
Evoked Potentials, Somatosensory* ; Glasgow Outcome Scale ; Hemorrhage* ; Humans ; Median Nerve ; Prognosis ; Putaminal Hemorrhage

Cognitive evoked potential(CEP) is the result of endogenous brain response following cognitive stimulus. There are several kinds of waves, including N1, P2, P3 and slow, but only P3 has wide clinical application. In order to obtain normal data, we studied CEP in 174 normal Koreans using the odd-ball paradigm, and our results concerning the latencies and amplitudes of P3 waves, and their relation to age., were were as follows: 1) The average latency of P3 waves of Fz, Cz and Pz was 332.95, 333.34 and 333.66 msec, respectively, in those aged over 60, P3 latency was more delayed than in other age groups. 2) Among teenager, the average latency of P3 waves of Fz, Cz and Pz decreased by 8.35, 9.58 and 9.58msec/year, respectively, but among those aged over 20, increased by 0.87, 0.90 and 0.91msec/year, respectively. 3) The average amplitude of P3 waves of Fz, Cz and Pz was 14.41, 15.37 and 15.12uV, respectively, and in those aged over 60, P3 amplitude showed a greater decrease. 4) The average amplitude of P3 waves of Fz, Cz and Pz decreased by 0.31, 0.32 and 0.23 uV/year in those aged under 29, decreased by 0.65, 0.63 and 0.67uV/year in those over 50, but was stationary in those aged 30 to 49. 5) Due to wide variation and poor constancy, the amplitude of P3 waves does not appear to be especially useful for initial evaluation of cognitive function; it may, however, be useful for follow-up evaluation of a single subject. For each age group, relatively constant P3 latency data can be obtained, and for the evaluation of cognitive function, P3 waves could therefore be useful.
Adolescent ; Brain ; Evoked Potentials* ; Follow-Up Studies ; Humans ; Reference Values*

Persistent primitive trigeminal artery is relatively rare cerebrovascular anomaly, usually observed on angiography or at autopsy. We reported two cases of persistent primitive trigeminal artery. One is associated with spontaneous subarachnoid hemorrhage and the other intraventricular hemorrhage with scanty subarachnoid hemorrhage after minor head trauma. We reviewed the persistent primitive trigeminal artery and it's clinical significance. It's clinical significance seemed to be followed; 1) Formation of intracranial aneurysm due to increased arterial blood flow. 2) pathway for microemboli from carotid system to basilar system. 3) probable cause hemodynamic cerebral ischemia. 4) unexpected finding during surgical procedure.
Aneurysm ; Angiography ; Arteries* ; Autopsy ; Brain Ischemia ; Craniocerebral Trauma ; Hemodynamics ; Hemorrhage ; Intracranial Aneurysm ; Subarachnoid Hemorrhage ; Trigeminal Ganglion

Aneurysmal bone cyst of the rib is a rare benign tumor which resembles the giant cell tumor or fibrous dysplasia of the bone. It rarely develops in the rib although it affects the metaphysis of the long bone and facial bone. We have treated a 14 year old male patient who had the aneurysmal bone cyst in the legt 4th. rib. Wide surgical resection of the affected rib was carried out with good clinical result. He is well 16 months after the resection.
Adolescent ; Aneurysm* ; Bone Cysts* ; Facial Bones ; Giant Cell Tumors ; Humans ; Male ; Ribs*