Study design. This retrospective study analyzes the influence of lumber rotation on fusion extent in King type III AIS treatment by CD instrumentation. Objectives. To establish a guideline for fusion in King type III AIS Summary Study of background data. Rotational characteristics of the lumber curve may significantly affect the postoperativ e behavior of uninstrumented lumbar curve thus calling for a different lumbar rotation. Methods. Sixteen King type III AIS treated with CD were divided into two groups by the direction of lumbar curve rotation. It was opposite direction (OD) to the rotation of the major curve in 9 and same direction (SD) in 7. In OD, 6 were treated by selective thoracic fusion (TF) and 3 were fused to the stable vertebra (SV). In SD, 6 were treated by TF and 1 was fused to the SV. They were evaluated for balance, major and fractional curve correction after a minimum follow up of 2 years. Result. In OD, all curves were balanced regardless of the fusion extent with satisfactory curve correction. In SD-TF, all were clinically balanced with major curve correction of 75%, but all the fractional curve were overcorrected, adding on the major curve. In SD-SV, the curve was balanced with stable lumbar curve. Conclusion. In King type III curve with lumbar curve rotated to the opposite direction, selective thoracic fusion is sufficient. However, when the fractional curve is rotated in the same direction, fusion to the stable vertebra may be a safer choice.
Adolescent* ; Follow-Up Studies ; Humans ; Retrospective Studies ; Scoliosis* ; Spine

Congenital lobar emphysema (CLE) is an overinflation of infantile pulmonary lobe caused by air trapping within the affected area. This is usually diagnosed on radiological findings postnatally. Most cases present in the neonatal period with signs of acute or chronic respiratory distress. There are only a few reports of CLE in the literature with prenatal sonographic feature documented. The routine use of prenatal sonography has helped to find fetal anomalies, such as fetal lung mass, that pose a challenge to early diagnosis, appropriate counselling, postnatal follow-up, and better outcome. A boy with CLE was detected by prenatal sonogram. He had a uniformly echogenic right lung with mediastinal shift to the left which was suspected type III congenital cystic adenomatoid malformation prenatally. He showed no evidence of respiratory distress at birth, but experienced progressive tachypnea and chest retraction. He had right middle lobectomy on the seventh postnatal day and pathologic diagnosis of CLE had been made. We report this rare case with brief review of literature. This is the first domestic case which was detected prenatally and confirmed pathologically after lobectomy.
Cystic Adenomatoid Malformation of Lung, Congenital ; Diagnosis ; Early Diagnosis ; Emphysema* ; Follow-Up Studies ; Humans ; Lung ; Male ; Parturition ; Tachypnea ; Thorax ; Ultrasonography

PURPOSE: The purpose of this study is to understand and analyse the actual education environment of the subject, life science, and how it is taught in high school, and thereby make a realistic assessment of whether a medical life science experience program is necessary. METHODS: The test method to assess the actual curriculum was developed by Life Science teachers, medical school faculty and education specialists. The subject was divided into 4 areas consisting of 6 items each. Our survey was mailed out. The analysis consisted of frequency analysis, chi-square analysis, correlation analysis, and variance analysis using SPSS 13.0 for Windows. RESULTS: Over 90% of Life Science class teachers agreed that teaching should be done through lectures and lab experiments in parallel. However, currently the class is heavily lecture-oriented due to the lack of lab facilities, the lack of budget and the difficulty of organizing lab courses. Due to the nature of the subject, lab experiments are crucial. Therefore, it is recommended that a biomedical science experience program be included in the curriculum. This program should be offered during vacation and geared toward high school freshmen and sophomore students. CONCLUSION: This research clearly showed the need to develop a high school biomedical science experience program. In order for the program to be successful, one must take into consideration the safety of experiments, the capability of the instructors, the development of a variety of experiments, the accessibility of the location of the lab, securing interest in education at a community level and the compilation of an experience program at every educational level.
Biological Science Disciplines* ; Budgets ; Curriculum ; Education* ; Humans ; Lectures ; Postal Service ; Schools, Medical ; Specialization

STUDY DESIGN: An in vitro experiment. OBJECTIVES: To assess the effect of pulsed sinusoidal EMF on human intervertebral disc (IVD) cells. LITERATURE REVIEW SUMMARY: Electromagnetic field (EMF) is known to modify some relevant physiological parameters of cells cultured in vitro, such as proliferation, synthesis, secretion of growth factors and transcription. EMF induces bone formation in delayed, non union and spinal fusion models. Also, the exposure of EMF has been shown to protect against the hazardous effect of smoking in the rabbit IVD. MATERIALS AND METHODS: Human IVD cells were three-dimensionally cultured in alginate beads and exposed to a 650 omega, 1.8millitesla magnetic flux density, 60Hz sinusoidal wave of EMF. The cultures were divided into the control and EMF groups, with various exposure times. The cytotoxicity, and DNA and proteoglycan syntheses were measured by the MTT assay, and [3H]-thymidine and [35S]-sulfate incorporation, respectively. RT-PCRs were performed for aggrecan, and collagen types I and II mRNA expressions. RESULTS: There was no recognizable cytotoxicity in the EMF group, but cellular proliferation was stimulated (p<0.05). Newly synthesized proteoglycan, normalized by DNA synthesis, was decreased in the EMF group (p<0.05) as were the expressions of aggrecan (48hour exposure) and type II collagen (72 hours exposure) mRNA compared to the control group. CONCLUSIONS: EMF seems to be hazardous in the synthesis of the chondrogenic matrix, while marginally beneficial in the cellular proliferation of human IVD cells.
Aggrecans ; Cell Proliferation ; Collagen ; Collagen Type II ; DNA ; Electromagnetic Fields* ; Humans* ; Intercellular Signaling Peptides and Proteins ; Intervertebral Disc* ; Magnets* ; Osteogenesis ; Proteoglycans ; RNA, Messenger ; Smoke ; Smoking ; Spinal Fusion

STUDY DESIGN: An in vitro experiment. OBJECTIVES: To assess the effect of pulsed sinusoidal EMF on human intervertebral disc (IVD) cells. LITERATURE REVIEW SUMMARY: Electromagnetic field (EMF) is known to modify some relevant physiological parameters of cells cultured in vitro, such as proliferation, synthesis, secretion of growth factors and transcription. EMF induces bone formation in delayed, non union and spinal fusion models. Also, the exposure of EMF has been shown to protect against the hazardous effect of smoking in the rabbit IVD. MATERIALS AND METHODS: Human IVD cells were three-dimensionally cultured in alginate beads and exposed to a 650 omega, 1.8millitesla magnetic flux density, 60Hz sinusoidal wave of EMF. The cultures were divided into the control and EMF groups, with various exposure times. The cytotoxicity, and DNA and proteoglycan syntheses were measured by the MTT assay, and [3H]-thymidine and [35S]-sulfate incorporation, respectively. RT-PCRs were performed for aggrecan, and collagen types I and II mRNA expressions. RESULTS: There was no recognizable cytotoxicity in the EMF group, but cellular proliferation was stimulated (p<0.05). Newly synthesized proteoglycan, normalized by DNA synthesis, was decreased in the EMF group (p<0.05) as were the expressions of aggrecan (48hour exposure) and type II collagen (72 hours exposure) mRNA compared to the control group. CONCLUSIONS: EMF seems to be hazardous in the synthesis of the chondrogenic matrix, while marginally beneficial in the cellular proliferation of human IVD cells.
Aggrecans ; Cell Proliferation ; Collagen ; Collagen Type II ; DNA ; Electromagnetic Fields* ; Humans* ; Intercellular Signaling Peptides and Proteins ; Intervertebral Disc* ; Magnets* ; Osteogenesis ; Proteoglycans ; RNA, Messenger ; Smoke ; Smoking ; Spinal Fusion

PURPOSE: To diagnose soft tissue tumor, such as lipoma and Schwannoma, magnetic resonance imaging (MRI) is sufficient in most cases. However, various characteristics are found in MRI images of Schwannoma, thus other type of tumors are often misdiagnosed as Schwannoma with MRI images. In this study, we evaluate the diagnostic value of specific MRI findings of Schwannoma. MATERIALS AND METHODS: From January 2002 to May 2013, 104 patients who are suspected as Schwannoma rith MRI images are included in data, and the final diagnosis is confirmed with biopsy. Patients are divided into group 1 and group 2 who are confirmed as Schwannoma and other disease with biopsy, respectively. RESULTS: 92 patients were diagnosed as Schwannoma (group 1) and 12 patients were diagnosed as other disease (group 2). We investigate the diagnostic value of specific MRI findings of Schwannoma. 41 patients of group 1 (45%) and 0 patients of group 2 (0%) showed target sign, 47 patients of group 1 (51%) and 2 patients of group 2 (17%) showed fascicular sign, 44 patients of group 1 (48%) and 5 patients of group 2 (42%) showed fat split sign, 28 patients of group 1 (30%) and 1 patients of group 2(9%) showed nerve entering and exiting sign, and 8 patients of group 1 (9%) and 6 patients of group 2 (50%) showed none of four specific findings on their MRI images. 52 patients of group 1 (57%) and 5 patients of group 2 (42%) have tumors on the pathway of nerve. Target sign could be considered as the best diagnostic value of the sign we investigate (p<0.05). CONCLUSION: Although specific MRI findings have powerful diagnostic value, patients are often misdiagnosed as Schwannoma with MRI findings. Therefore, if patients who are suspected as Schwannoma based on MRI findings have no target sign on their MRI images, we should consider the possibility of other disease.
Biopsy ; Diagnosis ; Humans ; Lipoma ; Magnetic Resonance Imaging* ; Neurilemmoma*

STUDY DESIGN: An in vitro experiment. OBJECTIVES: To evaluate the mRNA expressions of matrix components, and analyze the cellular proliferation and proteoglycan synthesis of human intervertebral disc cells in response to dexamethasone and TGF-beta1 SUMMARY OF LITERATURE REVIEW: Corticosteroids are responsible for the regulation of a diverse range of biological processes through modulation of the expression of target genes. The direct injection of methylprednisolone to the intervertebral disc (IVD) has been shown to cause degeneration and calcification of the disc in rabbits. Systemic administration of hydrocortisone induced degeneration of notochordal cells, which accelerated the aging process of the disc in mice. Transforming growth factor beta-1 (TGF-beta1) is known as a potent agent for the proliferation, differentiation and matrix synthesis of IVD. MATERIALS AND METHODS: IVD cells were isolated from ten patients, and subsequently cultured. Various doses of dexamethasone (DEX) and/or TGF-beta1 were administered to the IVD cultures. DNA and proteoglycan syntheses were measured by the incorporation of [3H]-thymidine and [35S]-sulfate, respectively. RT-PCRs were performed for the expressions of aggrecan, collagen types I and II, and osteocalcin mRNA. RESULTS: Cultures with DEX showed increased cellular proliferation and decreased proteoglycan synthesis (p<0.05). TGF-beta1 potentiated the proliferative effect of DEX, but failed to stimulate proteoglycan synthesis in the cultures containing DEX. There were no recognizable changes in the mRNA expressions of aggrecan, collagen types I and II, and osteocalcin in response to DEX and TGF-beta1. CONCLUSIONS: DEX demonstrated a proliferative effect on human IVD cells, with the combination of DEX and TGF-beta1 showing potentiation of the proliferative effect, while at high doses(100 and 1000nM, the DEX was shown to down-regulate the proteoglycan synthesis. Caution should be exercised in the use of corticosteroid in the therapeutic approaches for the treatment of disc disease or in the regenerative matrix of the IVD.
Adrenal Cortex Hormones ; Aggrecans ; Aging ; Animals ; Biological Processes ; Cell Proliferation ; Collagen ; Dexamethasone* ; DNA ; Humans* ; Hydrocortisone ; Intervertebral Disc* ; Methylprednisolone ; Mice ; Notochord ; Osteocalcin ; Proteoglycans ; Rabbits ; RNA, Messenger ; Transforming Growth Factor beta1 ; Transforming Growth Factors

Cerebral palsy (CP) usually arises in the prenatal period, interferes with normal development of the brain and presents as a disorder of motor dysfunction. It is a common cause of severe neurologic disability in children with incidence of 2 per 1000 live births in Canada. Presently, with the persistent increase in premature births and improved care in the perinatal period, the incidence of CP is strikingly augmented. According to neurologically impaired motor ability, they commonly have feeding difficulties, like swallowing, leading to frequent aspiration pneumonia and gastroesophageal reflux. Therefore, improvement of feeding techniques should be an urgent requirement to correct the risk of poor growth. We report a case of CP due to kernicterus who have recurrent pneumonia and growth failure, experience a jejunostomy to overcome the feeding problems.
Brain ; Canada ; Cerebral Palsy* ; Child ; Deglutition ; Gastroesophageal Reflux ; Humans ; Incidence ; Jejunostomy* ; Kernicterus ; Live Birth ; Pneumonia ; Pneumonia, Aspiration* ; Premature Birth

The purpose of the present study was to determine the potential relationships of glycemic control and use of metformin with non-muscle invasive bladder cancer characteristics. We reviewed data from 645 patients with non-muscle invasive bladder cancer between January 2004 and May 2015. We analyzed the association of pre and post-operative glycemic control and use of metformin with clinical characteristics of bladder tumors. We also analyzed the association of glycemic control and use of metformin with recurrence-free and progression-free survivals. Diabetes mellitus patients showed decreased recurrence-free survival (hazard ratio 1.42; 95% confidence interval 1.1-1.9; P = 0.021) and progression-free survival (hazard ratio 1.79; 95% confidence interval 1.1-2.8; P = 0.013). Diabetes mellitus patients with a HbA1c ≥ 7.0% demonstrated a higher rate of progression (P = 0.026). Kaplan-Meier analysis showed that progression-free survival rate was associated with poor baseline glycemic control (P = 0.026) and post-operative glycemic control (P = 0.025). However, use of metformin had no impact on the recurrence (P = 1.00) and progression (P = 0.282). In conclusion, poor baseline and post-operative glycemic control was related with shorter progression-free survival of patients with non-muscle invasive bladder cancer. Use of metformin had no impact on the recurrence and progression. Therefore, tight glycemic control and close follow-up for bladder tumor may be beneficial in patients with poor glycemic control.
Diabetes Mellitus* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Metformin* ; Recurrence* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Imperforate hymen is a rare congenital malformation, but it can make hematocolpometra and complications. In most cases definite finding is noticed after menarche as retention of menstrual flow results in abdominal pain, distension of the lower abdomen and often in acute urinary retention. A case of imperforate hymen associated with hematocolpometra at age of 12 was treated satisfactorily by simple crucial incision of hymen and drained of about 450 cc of tarry blood. We present a case of imperforate hymen with a brief review of literatures concerned.
Abdomen ; Abdominal Pain ; Female ; Hymen* ; Menarche ; Urinary Retention