Refractory deformity in ankylosing spondylitis is caused by loss of normal lordotic curvature in lumbar spine. For the correction of deformity, monosegmental osteotomy, intracorporal decancellation and multisegmental osteotomy are used. Among them, multisegmental osteotomy is reported to be safe because of its small correction amount at each level. Since 1989, authors treated 5 cases of ankylosing spondylitis with severe kyphotic deformity by multisegmental osteotomy and transpedicular instrumentation. All were young males between 22 and 35 years of age. Preoperative kyphotic deformity was 80°, 105°, 72°, 35°, 55° (Av. 70°) and amount of correction was 55°, 105°, 72°, 20°, 40° (Av. 58°) respectively. Levels for osteotony were 4 to 8 segments and correction at a level was 5° to 13° (Av. 8.3°). Normal standing upright posture and vision for straight forward were obtained in all. Instrumentation was Zielke in three Cotrel-Dubousset in two. One case of Zielke instrumentation showed rod failure. However, all showed solid bony union without any loss of correction or pseudoarthrosis. From the above experience, multisegmental osteotomy for the treatment of kyphotic deformity in ankylosing spondylitis was believed to be a safe and effective method of treatment.
Congenital Abnormalities ; Humans ; Male ; Methods ; Osteotomy ; Posture ; Pseudarthrosis ; Spine ; Spondylitis, Ankylosing

The face and notably the lips are important structures not only of aestheticvalue but also for expression, vibrancy and vitality. Sometimes we are encountered with the functional and aesthtetic lip problems especially in the patients with mandibular prognathism, such as excessive vermilion exposure, lip incompetence and hyperactivity of mentalis muscle. The etiologic factors are usually related to excessive anterior facial height, secondary to the abnormal development of perioral muscle, salivary gland and the swelling of lymphatic gland. Sometimes orthognathic surgery (mandibular setback osteotomy) alone is not accepted regarding to aesthetic value, there is likely to be a corresponding interest in adjunctive procedures such as genioplasty and soft tissue procedures. This article urges the incorporation of reduction cheiloplasty. It is a relatively minor procedure that can be easily reproducible and yields excellent, predictatable results with few complications. We treated two patients who have excessive vermilion exposure and marked abnormal lip eversion using reduction cheiloplasty combined with mandibular setback osteotomy, followed by improved facial harmony and patients were pleased.
Genioplasty ; Humans ; Lip ; Orthognathic Surgery ; Osteotomy* ; Prognathism ; Salivary Glands

We analyzed the results of the prostate biopsies of 64 patients with elevated serum PSA (>4ng/ ml) at Kangbuk Samsung Hospital from March 1993 to February 1996. Of 64 patients, 11 patients (17%) had prostate cancer and 53 patients (83%) were diagnosed as benign prostatic hyperplasia. Among the patients with prostate cancer, 1 patient had serum PSA between 4.1 to 10.0ng/ml, 2 patients between 10.1 to 20.0ng/ml and 8 patients above 20ng/ml The detection rates of prostate cancer in each serum PSA levels were 3%, 15% and 36% respectively. Two of 17 patients with both negative DRE and TRUS were diagnosed as prostate cancer Two of 21 patients with positive TRUS and negative DRE had prostate cancer but none of 8 patients with positive DRE and negative TRUS had prostate cancer. Seven of 18 patients with both positive TRUS and DRE had prostate cancer. The sensitivity, specificity, positive predictive value and overall accuracy of DRE and TRUS in patients with elevated PSA (>4ng/m1) were 64%, 64%, 27%, 64% and 82%, 43%, 23%, 50% respectively in patients with elevated serum PSA (>4ng/ml). In conclusion, these results suggest that prostate biopsy in early diagnosis of prostate cancer would be needed for the patients with elevated serum PSA (>4ng/ml) regardless of the results of DRE and TRUS.
Biopsy* ; Early Diagnosis ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Sensitivity and Specificity

BACKGROUND: Skin surtice lipids increase and decrease in tints with acne vulgaris and in patients with atopic dermatis, respectively. Notably, hydratior. in decreased in patients with atopic dermatitis. Clinically it is common for the two diseases to occur together. OBJECTIVE: We would like to find out the rate, clinical cteristics, and hydration and lipid levels when acne vulgaris and atopic dermatitis concur. METHODS: We classific the clinical levels and measured the hydration and lipid levels of the face and forearm area of patients with acne vulgaris, patients phatopic dermatitis, and patients with both diseases, who visited the Youngdong Severance Hospital. RESULTS: 1) 13.8% (14/102) of patients with acne vulgaris had at, epidermatitis. 31.1% (14/45) of patients with atopic dermatitis had acne vulgaris. 2) Patients with acne vulgaris had increased lipid levels and normal hydration levels. 3) Patients with atopie dermatitis had decreased lipid and iylration levels. 4) Patients withoth cnevulgaris and atopic dermatitis a no severe grade of acne vulgaris, and showed decreased hydration but normal lipid levels. CONCLUSION: In patients with both arne vulgaris and atoic dermatitis, clinically acne vulgaris was not severe and hydation levels were lower than normal controls.
Acne Vulgaris* ; Dermatitis ; Dermatitis, Atopic* ; Forearm ; Humans ; Skin

No abstract available.
Adenocarcinoma* ; Rectum*

PURPOSE: To evaluate the cilinical results of transjugular intrahepatic portosystemicshunt(TIPS) for the control of variceal bleeding. MATERIALS AND METHODS: TIPS creation was attempted in 23 patients with endoscopically confirmed variceal bleeding. Most patients had multiple episodes of bleeding in the past and have been treated with multiple endoscopic sclerotherapies. Pre- and post-procedural hepatic and portal vein pressures were measured. After creation of TIPS patients were followed up at regular intervals. RESULTS: TIPS has been successfully accomplished in 22 of 23 patients using Wallstent(n=21 ) and Strecker stent(n=1 ). Immediate bleeding control was achieved in all patients with shunt creation. No procedure-related complication was noted. Portal vein pressure was reduced from 30.7+/-5.8 mmHg to 20.8+/-4.7 mmHg. The mean pressure gradient of portosystemic shunt dropped from 22.8+/-6.0 prior to TIPS to 12.2+/-4.1 immediately after. During the follow-up period (6-556 days, mean; 10months), seven patients died; progressive hepatic failure (n=4), variceal rebleeding(n=2), and respiratory failure(n=1). Hepatic encepha-Iopathy after TIPS was noted in 7 patients(31.8%). Variceal rebleeding occurred in 3 patients(13.6%). The remaining 15 patients have survived an average of 11 months. CONCLUSION: This results suggest that TIPS is a safe and effective method for lowering portal pressure and controlling variceal bleeding. Furthermore if these initial results are encourged by further long-term observation, TIPS could replace endoscopic and risky surgical intervention.
Esophageal and Gastric Varices ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver Failure ; Portal Pressure ; Portal Vein ; Portasystemic Shunt, Surgical* ; Sclerotherapy

No abstract available.
Dermatitis, Allergic Contact* ; Fusidic Acid* ; Sodium*

No abstract available.
Humans ; Urethra* ; Urinary Bladder* ; Urinary Incontinence*

No abstract available.
Humans ; Urethra* ; Urinary Bladder* ; Urinary Incontinence*

No abstract available.
Calcium* ; Child* ; Humans