STUDY DESIGN: The indications of the lumbosacral spinal fusion has been very controversial. The posterior lumbar interbody fusion has the popularity of the spinal fusion: coaption of large surface areas of cancellous bone without shear forces, anatomic restoration and maintenance of more normal dimensions of the joint space, total discectomy as preparation for the fusion, and the accomplishment of better neural decompression without creating instability of the spine. OBJECTIVES: To evaluate the long-term results of the surgical management of degenerative lumbar disease by the modified transdiscal posterior lumbar interbody fusion technique using cancellous chip graft were analyzed. SUMMARY OF LITERATURE REVIEW: The disadvantages of classical posterior lumbar interbody fusion has a injury of nerve root by extensive retraction with the insertion of peg grafts into the disc space, compression of root by graft retropulsion, inadeguate removal of annulus fibrosus and end plates from excessive bleeding from venous plexus of spinal canal and from vertebral cancellous bone. MATERIALS & METHOD: Author's 43 cases who had transpedicular instrumentation and modified transdiscal PLIF using cancellous chip graft since 1989 in the Department of Orthopedic Surgery, Korea University Hospital were analyzed, retrospectively. After preparation of the interspace has been complete by total discectomy, removal of the cartilaginous end plates and perforation of the cortical plates using the ring curette, cancellous chip grafts are inserted into the interspace with the Funnel technique. The structural success of each fusion was documented by sequencial radiographs. The criteria for fusion included: homogenous amalgamation of the fusion mass and vertebral bodies, trabeculation, mass configuration, and no motion demonstrable by hyperflexion studies. The results obtained were as follows: 1. Stable fusion was obtained in 39 patients(91%) at post-operative 6 months. 2. Clinically no patient developed neurologic deficit after fusion and 41 patients (95.3%) had good results by Gill's criteria. 3. No significant complications influencing operative result were observed except minor complications such as paralytic ileus, transient dysuria and superficial infection. 4. In conclusion, modified transdiscal PLIF procedure using cancellous chip graft showed excellent clinical and radiological results to achieve spinal fusion and the procedure is technically feasible and should be considered more widely employed.
Decompression ; Diskectomy ; Dysuria ; Hemorrhage ; Humans ; Intestinal Pseudo-Obstruction ; Joints ; Korea ; Neurologic Manifestations ; Orthopedics ; Retrospective Studies ; Spinal Canal ; Spinal Fusion ; Spine ; Transplants*

No abstract available.
Female ; Humans ; Insemination* ; Pregnancy*

Successful percutaneous transluminal angioplasty (PTA) of an internal mammary artery graft was performed in a 40 year old male patient who had recurrent angina soon after bypass surgery. Coronary angiography showed total occlusion of proximal portion of the left anterior descending artery and normal right coronary artery. Angiography of the left internal mammary artery graft revealed a tight stenosis (90% diameter narrowing) in the mammary artery at its insection into the left anterior descending artery.Angiography after the angioplasty demonstrated a widely patent graft (residual stenosis 10%) and translesional pressure gradient was 10 mmHg.
Adult ; Angiography ; Angioplasty* ; Arteries ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Vessels ; Humans ; Insects ; Male ; Mammary Arteries* ; Transplants*

Epidermal cyst in the fibroadenoma of the breast is very rare. A 29-year-old woman presented with a lump in the upper outer quadrant of the right breast. Clinically it was a fibroadenoma and the excisional specimen showed an encapsulated, firm lobulated lesion with a cystic area on cut surface. The cystic area showed squamous metaplasia of the ductal epithelium and keratinous cyst formation in the fibroadenoma. We report this unusual case with review of literatures.
Adult ; Breast ; Epidermal Cyst* ; Epithelium ; Female ; Fibroadenoma* ; Humans ; Metaplasia

No abstract available.
Bartter Syndrome*

No abstract available.

A case of fibrocalcifying pseudotumor occuring at a very unusual site, the intraosseous region of axis, is presented. Previous reports of similar lesions in skull base, intracranial parenchyme, soft tissue around spine, mediastinum, and pleura have been described under the designation 'fibro-osseouslesions' and 'calcifying pseudoneoplasm' The etiology, pathogenesis and natural course of the lesion are still unknown. Bvt the lesion is probably benign nature and reactive lesion rather than neo-plastic. Authors performed resection of lamina, spinous process, and a portion of pedicles and occipitocervical fusion to prevent spinal cord compression due to cortical expansion or fracture. Microscopically, amorphous, basophilic, hyaline, and chondroid calcifying masses were rimmed by palisading histiocytes and foreign body-type giant cells. No evidence of malignancy was found.
Axis, Cervical Vertebra* ; Basophils ; Giant Cells, Foreign-Body ; Histiocytes ; Hyalin ; Mediastinum ; Pleura ; Skull Base ; Spinal Cord Compression ; Spine

Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

A clinical trial was done to evaluate the antihypertensive efficacy and side effects of manidipine, a new calcium antagonist, in 30 patients with mild to moderate essential hypertension. 1) The study patients consisted of 19 men and 11 women, and the mean age was 51.8 years. 2) Blood pressure dropped significantly in 2 weeks and in 4 weeks, and well maintained throughout the study period. The mean-pressure drop was 26.2/14.9mmHg after 10 weeks. 3) Heart rate did not change significantly with manidipine therpy. 4) Optimal dose for effective pressure-drop was between 10 and 20 mg in 86% of patients. Overall good antihypertensive effect was achieved in 83% of patients. 5) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change, but serum calcium increased from 9.2% mg/dl (p=0.001) in 10 weeks. 6) Side effects were mild in nature(palpitation in 3, dry mouth in 1, weakness in 1 and impotence in 1 patient). In conclusion, manidipine monotherapy with 10 to 20 mg once a day regimen is effective and well tolerated in the patients with mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Chemistry ; Electrolytes ; Erectile Dysfunction ; Female ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth

There have been so many methods described for the correction of the deviated noses but it is difficult to get satisfactory results and recurrence rate is high. There is no exact explanation why the recurrences are so high and no estabished guides for techniques according to the surgical pathology. We found the classical swinging door technique effective in cases where the caudal septum deviated from the midline. However, where the caudal septum and the tip stay in the midline, scoring or submucosal resection do not work well enough to cortet them. We used the reverse swinging door technique of our own. After elevation of mucoperichonodrium, we did sagittal section in the posterior septum and moved the septum to the midline on the pivot point of the caudal septum and. The gap created in the posterior portion of the septum were filed with bone grafts, cartilage grafts or Medopor, which were sutured to the septum, We did this technique with or without osteotmies in 56 deviated noses for last 5 years. The results were very satisfactory and there was no complication.
Cartilage ; Nose* ; Pathology, Surgical ; Recurrence ; Transplants