A total of 236 anterior cervical interbody fusion has been performed. In 76 cases mostly Cloward's original method has used. During these operations several technical modifications were made. With these technique 159 cases were operated and showed marked beneficial results. 1. For widening of the interspace, a halter traction was better than the vertebra spreader. 2. Extension of the cervical spine when drilling of the vertebral bodies prevented the post-operative flexion deformity of the neck. 3. The dowel size, 2mm. In diameter larger than the drill hole was used and the cortical end plate of the dowel was fixed st the anterior edges of the vertebral bodies. 4. It was safe to leave the posterior edges of the vertebral bodies when drilling. 5. If the dowel was too thin, 2 pieces of the graft were packed. 6. Post-operative pain on the dornor bone site and walking difficutly wer minimized when the dowel was obtained from the inner aspect of the ileum. when the dowel was obtained from the inner aspect of the ileum. Many technical fitfalls of this type of operation were analyzed and discussed the improved surgery.
Congenital Abnormalities ; Ileum ; Neck ; Spine ; Traction ; Transplants ; Walking

Most intussusceptions occur in children and no etiologic factor can be determined in most cases. In contrast, adult intussusception is rare and many cases in adults are generally related to neoplasm such as lymphoma, carcinoid tumor, malignant tumor, sarcoma, benign tumor and congenital abnormalities. Intussusception in adults that's due to primary malignant lymphoma of the terminal ileum is a rare clinical condition. We describe here two cases of ileo- colonic-type intussusception that were due to primary malignant lymphoma of the terminal ileum. The clinical, radiographic and pathologic finding are described along with a brief review of the literature.
Adult* ; Carcinoid Tumor ; Child ; Congenital Abnormalities ; Humans ; Ileum* ; Intussusception* ; Lymphoma* ; Sarcoma

Alimentary tract duplications are uncommon congenital abnormalities that usually have an anatomical connection with some part of the gastrointestinal tract and have a common blood supply with the adjacent segment of intestine. A completely isolated duplication cyst (CIDC) is a very rare type of gastrointestinal duplication that does not communicate with the normal bowel segment and possesses its own exclusive blood supply. Only 5 CIDC cases in adults have been reported in the English medical literature. Additionally, only 1 case of mucinous cystadenoma from an infected CIDC of the ileum has been reported. This report describes a 52-year-old male patient with a peritoneal CIDC, which upon curative excision was found to have given rise to an adenocarcinoma. The latter was lined internally with malignant glandular cells and contained a smooth muscular outer layer as determined by microscopic examination of the tissue. We believe that this is the first reported case of an adenocarcinoma originating from a CIDC in an adult.
Adenocarcinoma* ; Adult* ; Congenital Abnormalities ; Cystadenoma, Mucinous ; Gastrointestinal Tract ; Humans ; Ileum ; Intestines ; Male ; Mesentery* ; Middle Aged

Radilogic findings in 30 patients with intestinal tubeculosis and 10 patients with intestinal Behcet'sdiseases, who had been diagnosed at seoul National University Hospital during the recent 5 years, were analysedretrospectively to evaluate the radiologic differential diagnosis of the two diseases. Intestinal tuberculosisseverely involved the cecum, the ileocecal valve, the distal ileum and colons, but Behcet's disease mainlyinvolved th distal ileum and infrequently the ileocecal valve and the cecum. The ulcers in tuberculosis wereusually multiple small barium collected areas among psuedopolyps on the contrary, those in Behcet's disease weremultiple, discrete, well marginated, geographic, ring-like deep penetrating or collar-button shaped. Intestinaltuberculosis tended to involved long segments of intestines, with severer mucosal irregularity and deformity ofthe ileocecal valve and the ascending colon in comparison with Behcet's disease. Mesenteric and/or peritonealinvolvment were accompanied in 1/3 cases of intestinal tuberculosis,a nd active pulmonary tuberculosis or pleuraleffusion also in 1/3 cases of intestinal tuberculosis.
Barium ; Cecum ; Colon ; Colon, Ascending ; Congenital Abnormalities ; Diagnosis, Differential ; Humans ; Ileocecal Valve ; Ileum ; Intestines ; Seoul ; Tuberculosis ; Tuberculosis, Pulmonary ; Ulcer

BACKGROUNDThe surgical management of the absence of the vagina is a complex problem and constitutes a significant technical challenge. As the laparoscopy has been an important tool for the treatment of uterovaginal anomalies, we evaluated the feasibility of laparoscopic vaginoplasty using an ileal segment retrospectively.

METHODSTotally 86 patients who underwent laparoscopic vaginoplasty using an ileal segment in Beijing Anzhen Hospital during February 2004 to July 2007 were enrolled in this study. Of the 86 patients, 70 (81.4%) underwent primary operations and 16 (18.6%) secondary operations. Nineteen (22.1%) patients underwent total laparoscopic vaginoplasty and 67 (77.9%) patients underwent laparoscope-assisted vaginoplasty. The operation time, cost of hospitalization, and hospital duration were compared between the two laparoscopic groups. The Student's t test and the Mann-Whitney test were used to examine the differences.

RESULTSAll the surgeries were successfully completed with no any intraoperative complication. There were three major surgical complications in the postoperative period: one case of intra-abdominal hemorrhage, one case of meatal stenosis, and one case of intestinal obstruction. The mean follow-up period of this series was 18 months. Seventy-eight patients were satisfied with their sexual lives after the surgeries except 5 women complaining of vaginal stenosis and 3 with no sexual partner during the follow-up. Significant differences were obtained between total laparoscopic and laparoscope-assisted vaginoplasty groups, such as the operation time, cost of hospitalization, and hospital duration (P < 0.01). There were no significant differences in sexual function between the two groups.

CONCLUSIONSThe laparoscopic vaginoplasty using an ileal segment is satisfactory for cosmetic, functional, and anatomic results. Vaginoplasty with an ileal segment, performed by either total laparoscopic or laparoscope-assisted techniques, has a high success rate for a functional vagina.

Adult ; Female ; Gynecologic Surgical Procedures ; methods ; Humans ; Ileum ; transplantation ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Transsexualism ; surgery ; Treatment Outcome ; Vagina ; abnormalities ; surgery ; Young Adult

Duplication is a rare congenital abnormality and may occur in any region of the gastrointestinal tract. A 19-year-old woman was admitted due to lower abdominal pain. Abdomino-pelvic CT scan showed a cystic mass interpreted as mesenteric cyst or duplication cyst. On the operation finding, it seemed to be arised from mesentery but attached to the ileum. Microscopically, the cystic wall was lined by non-keratinizing squamous, ciliated pseudostratified columnar epithelium, and ectopic gastric mucosa with two distinct muscular layers and a serosa. We report the first case of ileal duplication cyst lined by squamous and ciliated columnar epithelium in Korea.
Cilia/pathology ; Cysts/*congenital/pathology/radiography ; Epithelium/pathology ; Female ; Humans ; Ileal Diseases/*diagnosis/pathology/radiography ; Ileum/*abnormalities/pathology ; Tomography, X-Ray Computed ; Young Adult

We report on an exceptional vascular cause of gastrointestinal hemorrhage. A 30-yr-old man was admitted because of recurrent hematochezia. Colonoscopy showed circumferential, erythematous, and nodular vascular distensions with hematocystic spots in the terminal ileum resembling varicosis and subsequent computed tomography with 3-dimensional angiographic reconstruction revealed a vascular architecture around the terminal ileum. No other potential source of bleeding was identified. The patient was treated by ileocecectomy and the final diagnosis was of an arteriovenous malformation confined to the terminal ileum. He has been followedup without a further hemorrhagic episode.
Adult ; Arteriovenous Malformations/complications/*pathology ; Diagnosis, Differential ; Gastrointestinal Hemorrhage/etiology/*pathology ; Humans ; Ileum/*abnormalities ; Intestines/*blood supply ; Male ; Recurrence ; Varicose Veins/etiology/*pathology

A vitelline duct (VD) anomaly is a relatively common congenital abnormality of the umbilical area. The anomalies include patent vitelline duct (PVD), cyst, fistula or sinus. The incidence is approximately 2% of the populations, but development of symptoms is rare. Recently, we experienced two cases; PVD accompanied by a smallomphalocele and intestinal volvulus due to mesenteric band between Meckel's diverticulum and the mesentery. Thereafter,we evaluated the data of vitelline duct anomalies for 27 years. From 1980 to 2006, 18 cases of VD anomalies were reviewed based on the hospital records retrospectively. There were 15 boys and 3 girls and age ranged from 2 days to 15 years. Among the 18 cases, 15 cases were symptomatic and consisted of Meckel's diverticulum (10 cases), PVD (4 cases) and umbilical polyp (1 case). Three asymptomatic cases of Meckel's diverticulum were found incidentally were and were observed without resection. Ten cases of Meckel's diverticulum were presented with intestinal bleedings (4 cases), intestinal obstructions (5 cases) and perforation (1 case). Wedge resections and segmental resections of ileum were performed in 8 patients and 2 patients, respectively. Postoperative complications were adhesive ileus (1 case) and wound seroma (1 case). Small omphaloceles were accompanied in two of 4 PVD patients. There was 1 small omphalocele case which was accompanied by a prolapse of ileum. In summary, VD anomalies were more common in male and more than half of them were found in patients less than 1 year of age. PVD was diagnosed most frequently in neonates. Meckel's diverticulum presented with intestinal obstruction more frequently than bleeding.
Adhesives ; Child* ; Congenital Abnormalities ; Female ; Fistula ; Hemorrhage ; Hernia, Umbilical ; Hospital Records ; Humans ; Ileum ; Ileus ; Incidence ; Infant, Newborn ; Intestinal Obstruction ; Intestinal Volvulus ; Male ; Meckel Diverticulum ; Mesentery ; Polyps ; Postoperative Complications ; Prolapse ; Retrospective Studies ; Seroma ; Umbilicus ; Vitelline Duct* ; Vitellins* ; Wounds and Injuries

Paget bone disease(PBD) is usually focal, but can be wide spread disorder of the skeletal remodeling characterized by greatly increased osteoclast size and activity. It has extremely variable prevalence worldwide, being common in England and northern European countries and areas populated by their descendants, but strikingly uncommon in Asia, the middle east, Africa and Scandinavia. It's occurrence also shows familial clustering, some postulates autosomal dominant inheritance. Many studies have shown that paramyxoviruses may play a critical role in the etiology of this disorder. However, the precise etiology of PBD remains unknown.We describe a kindred with PBD in 3 successive generations. The propositus, a 55-year-old man, has panostotic PBD and giant cell reparative granuloma of pagets disease involving his head, mandible, abdomen and ileum, rare tumorous complication of Paget's disease. Bowed limbs were first noticed at age 25 years, and progressed for 20 years. Giant cell reparative granuloma began manifesting at age 45 years, and responded dramatically to high-dose dexamethasone therapy. His pretreatment biochemical finding were remarkable for elevated serum ALP, 765(normal 66-220 u/L) and osteocalcin, 154(normal 6.3-30.7 mg/ml), but normal serum calcium, phosphorous, 250HD and PTH. A nondecalcified iliac crest specimen demonstrated classic histopathologic 25OHD and PTH. A nondecalcified iliac crest specimen demonstrated classic histopathologic changes of PBD on light microscopy. His decreased father had a similar degree of bony deformities beginning at age 20 years, but had not been examined. His two asymptomatic daughters, 20 and 24-year-old, were both found to be affected with widespread PBD by bone scan, radiographic study, and their serum ALP levels, 939 and 435U/L, respectively. This is the first report of familial occurance of PBD and a case of giant cell reparative granuloma of Paget's disease in Korea, where PBD is very rare.
Abdomen ; Africa ; Asia ; Bone Diseases ; Calcium ; Congenital Abnormalities ; Dexamethasone ; England ; Extremities ; Family Characteristics ; Fathers ; Giant Cells ; Granuloma ; Head ; Humans ; Ileum ; Korea ; Mandible ; Microscopy ; Middle Aged ; Middle East ; Nuclear Family ; Osteocalcin ; Osteoclasts ; Pedigree ; Prevalence ; Scandinavian and Nordic Countries ; Wills ; Young Adult