No abstract available.
Pneumothorax, Artificial* ; Treatment Failure* ; Tuberculosis, Pulmonary*

STUDY DESIGN: A prospective study. OBJECTIVE: To compare the derotational effect of the two methods and to determine the effect of the position of axis of the rotation on derotation of the apical vertebrae. SUMMARY OF BACKGROUND DATA: Vertebral derotation about z-axis following a posterior instrumentation and its relation to the position of the rotational axis is still controversial. Rod derotation(RD) method rotates the vertebrae about the axis of the rod curvature located relatively anterior position whereas the vertebrae to rod(VTR) method, reducing the vertebrae to the contoured rod, rotates the vertebrae about the posteriorly located axis. MATERIALS AND METHODS: Eleven consecutive thoracic idiopathic scoliosis subjected to segmental pedicle screw instrumentation were analysed. Six were treated by RD and five by VTR. Average preoperative curve was 46.6 delta in RD and 51 delta in VTR with flexibility of 69% and 71% respectively (p>0.05). Mean preoperative relative apical vertebral rotation(RAVR) measured by computerized tomography were 11.2 delta in RD and 13.8 delta in VTR(p>0.05). RESULTS: Average postoperative curve magnitudes were 11.5 delta in RD and 12 delta in VTR with correction rates of 77% and 74% respectively (p>0.05). Postoperative relative apical vertebral rotation(RAVR) were 3.6 delta in RD and 6.1delta in VTR with correction rates of 68% and 56% respectively (p>0.05). The mean instrumentation time per vertebral segment instrumented was 4.7 minutes in RD and 8.5 minutes in VTR (p<0.05). Screw pullout during operative procedure in 8/51 screws(15%) in VTR and none(0/60) in RD. CONCLUSION: RD and VTR methods were not significantly different, both enabling a significant apical z-axis derotation and frontal curve correction. However, RD was more efficient than VTR with less operative time and intraoperative screw loosening. The position of the axis of rotation did not significantly influence the apical derotation effect of segmental pedicle screw instrumentation.
Axis, Cervical Vertebra ; Operative Time ; Pliability ; Prospective Studies ; Scoliosis* ; Spine* ; Surgical Procedures, Operative

No abstract available.
Heterotaxy Syndrome*

We report a case of ARC syndrome with arthrogryposis multiplex congenita, renal tubular insufficiency and cholestasis. The Patient presented in the early neonatal period with micrognathia, low set ears, high arched palate, multiple joint contracture, conjugated hyperbilirubinemia and failure to thrive. He died at the age of 1 month despite medical therapy. Findings of renal tubular insufficiency included persistent renal tubular acidosis, glucosuria, aminoaciduria, and proteinuria. Liver biopsy revealed intracellular and canalicular cholestasis, ballooning degeneration and giant cell formation of hepatocyte. Kidney sonography revealed medullary nephrocalcinosis. This association was first reported in 1973 by Lutz-Richner and Landolt and again in another family by Nezelof et al in 1979. Until now, 13 cases were reported worldwide. Except one case, all children died in infancy. Autosomal recessive inheritance is the most likely mode of transmission. We have experienced a case of ARC syndrome in a male neonate with signs and symptoms of lethargy, poor oral intake, direct hyperbilirubinemia, acidosis, and multiple joint contracture.
Acidosis ; Acidosis, Renal Tubular ; Arthrogryposis* ; Biopsy ; Child ; Cholestasis* ; Contracture ; Ear ; Failure to Thrive ; Giant Cells ; Hepatocytes ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Joints ; Kidney ; Lethargy ; Liver ; Male ; Nephrocalcinosis ; Palate ; Proteinuria ; Wills

Crohn's disease is an acute or chronic inflammatory disorder, characteristically non- specific granuloxaatous neerotiziag, cicatrical low grade inflammation, occuring in various portions of the entire oro-gastraintestinal tract. The etiology is not clearly defined and rather uncertain. The disease is a heterogenous & dubious entity with multiple systemic manifestations. The incidence of the disease is geographically unequal in world wide distrihution. And male and female are equally involve. In June, 1985, a case of 17-year-old female patient, who was diagnosed by clinico-micro- scopic examination at Han Yang Univ. hospital. And then, we report with a review of world literatare.
Adolescent ; Crohn Disease* ; Female ; Humans ; Incidence ; Inflammation ; Male

No abstract available.

Primary spontaneous cervical spondylolysis is a rare anomaly, and is often diagnosed as a traumatic lesion such as a fracture or a locked facet; alternatively, it may be overlooked. A literature review revealed one report that addresses the usefulness of three-dimensional reconstruction computed tomography (CT) imaging in the diagnosis of cervical spondylolysis. We have experienced two cases of subaxial cervical spondylolysis. One patient was transferred to our institute due to trauma, and the other patient was referred from a local hospital without trauma history. In this second patient symptoms occurred spontaneously and showed insidious progression. Both cases typically involved the right side of the C6 vertebra. The author utilized three-dimensional (3-D) reconstruction computed tomography (CT) for diagnosis and evaluation. Among those issued in Korea, this is the first report of primary subaxial cervical spondylolysis evaluated using 3-D CT.
Adult ; Cervical Vertebrae ; Female ; Humans ; Imaging, Three-Dimensional ; Korea ; Spine ; Spondylolysis

BACKGROUND: Negative U wave is frequent maker of systemic hypertension, aortic or mitral regurgitation and myocardial ischemia. This study was undertaken to determine the diagnostic significance of exercise-induced negative U wave in coronary artery stenosis. METHOD: 72 patients(46 men and 26 women ; 24~66 years of age) with chest pain were analysed with exercised-induced negative U wave and coronary angiographic finding. RESULT: Exercise-induced negative U wave was seen in 14 patients(19%). Among 14 patients with exercise-induced negative U wave, the predictive value of significant coronary artery stenosis(> or =75% stenosis of major coronary artery) was 71%, Exercise-induced negative U wave is more prevalent in patients with significant coronary artery stenosis(p<0.05). CONCLUSION: Exercise-induced negative U wave is a good marker of significant coronary artery stenosis.
Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Humans ; Hypertension ; Male ; Mitral Valve Insufficiency ; Myocardial Ischemia

BACKGROUND AND OBJECTIVES: Myocardial bridge is congenital coronary anomaly and cause myocardial ischemia by milking effect. The general study of myocardial bridge is to be weak, so we examined a clinical study of myocardial bridge. MATERIALS AND METHOD: This study included 36 bridge cases out of 1048 patients who underwent coronary angiography due to chest pain from Jan. 1993 to Jul. 1998. Angiographic film, medical records and interview by telephone were reviewed retrospectively. Total follow-up duration was mean 27 months (1 month to 62 months). RESULTS: Incidence of myocardial bridges diagnosed by angiography was 3.4%. Angiography showed normal in 32, 1 vessel disease in 3 and 2 vessel disease in one patient. Mean reference diameter was 2.97+/-0.36mm, bridge diameter was 2.75+/-0.33mm in diastole, 1.12+/-0.47mm in systole. Myocardial bridge length was 12.50+/-7.44mm, mean % diameter stenosis was 59.26+/-17.7%. Myocardial bridge location was 80.6% in mid LAD and 13.9% in mid & distal LAD and 5.5% in distal LAD. There was no statistically significant correlation with sex, risk factor of coronary heart disease, resting electrocardigraphy, treadmill test, diameter and angulation of coronary artery, clinical symptom in the severity of myocardial bridge. But the severity of myocardial bridge correlated with bridge length(r=.5033). CONCLUSION: Clinical outcomes of bridge patients were relatively good during the mean follow up periods of 27 months. Myocardial bridge was more severe in younger age and longer bridge length.
Angiography ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Diastole ; Exercise Test ; Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Milk ; Myocardial Ischemia ; Retrospective Studies ; Risk Factors ; Systole ; Telephone

BACKGROUND: Oxidative stress in primary aldosteronism (PA) is thought to worsen aldosterone-induced damage by activating proinflammatory processes. Therefore, we investigated whether inflammatory markers associated with oxidative stress is increased with negative impacts on heart function as evaluated by echocardiography in patients with PA. METHODS: Thirty-two subjects (mean age, 50.3±11.0 years; 14 males, 18 females) whose aldosterone-renin ratio was more than 30 among patients who visited Severance Hospital since 2010 were enrolled. Interleukin-1β (IL-1β), IL-6, IL-8, monocyte chemoattractant protein 1, tumor necrosis factor α (TNF-α), and matrix metalloproteinase 2 (MMP-2), and MMP-9 were measured. All patients underwent adrenal venous sampling with complete access to both adrenal veins. RESULTS: Only MMP-2 level was significantly higher in the aldosterone-producing adenoma (APA) group than in the bilateral adrenal hyperplasia (BAH). Patients with APA had significantly higher left ventricular (LV) mass and A velocity, compared to those with BAH. IL-1β was positively correlated with left atrial volume index. Both TNF-α and MMP-2 also had positive linear correlation with A velocity. Furthermore, MMP-9 showed a positive correlation with LV mass, whereas it was negatively correlated with LV end-systolic diameter. CONCLUSION: These results suggest the possibility that some of inflammatory markers related to oxidative stress may be involved in developing diastolic dysfunction accompanied by LV hypertrophy in PA. Further investigations are needed to clarify the role of oxidative stress in the course of cardiac remodeling.
Adenoma ; Chemokine CCL2 ; Cytokines ; Echocardiography ; Heart ; Heart Diseases ; Humans ; Hyperaldosteronism* ; Hyperplasia ; Hypertrophy ; Interleukin-6 ; Interleukin-8 ; Male ; Matrix Metalloproteinase 2 ; Oxidative Stress ; Tumor Necrosis Factor-alpha ; Veins