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*

Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*

Dermatitis herpetiformis is a chronic, intensely itchy, papulovesicular skin disorder of unknown cause, which is usually symmetrically distributed on extensor surface. Most patients have an associated gluten-sensitive enteropathy which is usually asymptornatic. We report six cases of dermatitis herpetiformis diagnosed by direct immunofluorescence studies. The patients have had characteristic features of dennatitis herpetiformis, such as vesicles, erythernatous papules, urticaria-like plaques, and hypopigmentation or hyperpigmentation, dispersed on the neck, back, and arms. None of the patients had subjective symptoms associated with gluten-sensitive enteropathy. Clinicians should be aware of the clinical features of this disease to avoid possible misdiagnosis, and to provide better therspeutic approaches in time.
Arm ; Celiac Disease ; Dermatitis Herpetiformis* ; Dermatitis* ; Diagnostic Errors ; Fluorescent Antibody Technique, Direct ; Humans ; Hyperpigmentation ; Hypopigmentation ; Neck ; Skin

To evaluate the relationships among the c-erbB-2 oncogene expression, DNA ploidy and other prognostic factors, an immunohistochemical study of the c-erbB-2 oncogene product and flow cytometric analysis of DNA ploidy were performed in paraffin sections of 42 cases of ovarian carcinomas. The results were as follows: 1) The positive reaction for c-erbB-2 oncogene product was observed mainly along the cytoplasmic membrane, and occasionally within the cytoplasm of the tumor cells. 2) Overall the positivity of c-erbB-2 oncogene expression was 45.2% of the ovarian carcinomas. By the histological types, the positivity was 35.7% in serous carcinoma, 80.0% in mucinous carcinoma, and 45.2% in endometrioid carcinoma; by the degree of differentiation, 57.1% in well differentiated carcinoma, 40.0% in moderately differentiated, and 27.3% in poorly differentiated; by the nuclear grading, 58.3% in grade I, 52.6% in grade II, and 18.2 % in grade III; and by the clinical staging, 57.1% in stage I, 42.8% in stage II, and 35.0% in stage III. The expression of the c-erbB-2 oncogene in the ovarian carcinomas was higher in the tumors of good differentiation, of the lower nuclear grade and of the lower clinical stage. 3) The incidence of DNA aneuploidy in the cases positive for the c-erbB-2 oncogene expression(47.3%) was higher than that in the negative cases(31.4%). From the above results, therefore, it is suggested that the c-erbB-2 oncogene may be involved in the early stage of ovarian carcinogenesis. Also suggested is that ovarian carcinomas positive for the c-erbB-2 oncogene in the early stages may have higher probability of having a DNA aneuploid cell line during the progress of the tumors.
Adenocarcinoma, Mucinous ; Aneuploidy ; Carcinogenesis ; Carcinoma, Endometrioid ; Cell Membrane ; Cytoplasm ; DNA* ; Incidence ; Oncogene Proteins ; Oncogenes ; Paraffin ; Ploidies*

A retrospective study was made of 10 consecutive patients who underwent mandibular reconstruction with PCBM from December 1994 to July 1996. Free autogenous iliac bone in the from of particulate cancellous bone and marrow was densely packed into the crib that was adapted to bridge the mandibular discontinuity defect. Frozen-treated autogenous mandibular bone, splitted autogenous rib, and titanium mesh(Dumbach, Leibinger) were used as cribs carrying the PCBM. All ten cases underwent successful healing with the formation of a continuous bony union with the remaining mandible. The rate of resorption was assessed by sequential panoramic radiographs. The mean horizontal dimension of the madibular defects was 44mm and the mean vertical dimension of the reconstructed segments was 23mm. The bony height of the reconstructed segments retained about 90% of the bony height of over a 1-year period. We confirmed that PCBM grafts were the most successful and predictable grafts in mandibular discontinuity reconstruction.
Bone Marrow* ; Humans ; Infant Equipment ; Mandible ; Mandibular Reconstruction* ; Retrospective Studies ; Ribs ; Titanium ; Transplants ; Vertical Dimension

All ceramic restorations have had a more limited life expectancy than metal ceramic crowns because of their lower strength. The relatively lower strength has limited the use of all-ceramic crowns to the areas where occlusal loads are lower. Therefore many researches have been done to increase the strength of all-ceramic crowns. IPS Empress 2 is a new type of lithium disilicate glass-ceramic with enhanced physical characteristics which has been in use clinically since 1998. Previous researches reported that the flexural strength of all-ceramic material was greater than 300MPa, and all-ceramic crowns can be used in staining or layering technique. The objective of this study was to investigate the influence of the thickness of IPS Empress 2 ceramic on fracture strength. Both staining technique and layering technique was investigated. Vita VMK was used as control. For all three groups, five specimens each of 0.8mm, 1.0mm, 1.4mm, 1.8mm, and 2.2mm thickness (a total of 75 specimens) were prepared. Control group: Vita VMK Porcelain specimens were prepared with dentine ceramic and liquid glazing was done. Group I: IPS Empress 2 were prepared with staining technique and stained twice and glazed once. Group II : IPS Empress 2 were prepared with layering technique and glazed after wash firing. The thickness and diameter of the specimen were measured and controlled after specimen preparation. Biaxial Flexure Test (ASTM Standard F394-78) was adopted as this test method produces results least affected by the edge condition of the specimens. Fracture strength was measured with Instron Universal Testing Machine. Conclusions are as follow : 1. The fracture strength was increase in order of control group, test group I, test group II. 2. Fracture strength of the group I(Empress 2 Staining) was 65.54 N in 0.8mm, 155.2 N in 1.0mm, 233.5 N in 1.44mm, 434.5 N in 1.8mm, and 600.1 N in 2.2mm. 3. Fracture strength of the group II (Empress 2 Layering) was 190.0 N in 0.8mm, 283.5 N in 1.0mm, 437.2 N in 1.4mm, 732.0 N in 1.8mm, and 1115.0 N in 2.2mm. 4. No statistical difference was found in flexural strengths according to thickness in a specified group(p>0.05).
Ceramics* ; Crowns ; Dental Porcelain ; Dentin ; Fires ; Life Expectancy ; Lithium

Renal vein thrombosis is usually a complication of multiple underlying renal disease rather than primary process. High incidence of renal vein thrombosis in patients with nephritic syndrome, which suggest the nephrotic syndrome play a paramount role in the genesis of renal vein thrombosis or thromboembolic phenomena. But these are likely to relationship of “egg and chicken”, and then we cannot determine what is primary of these. Recently authors experienced a case that was questioned renal vein thrombosis with nephrotic-syndrome clinically, laboratory and preliminary radiologically, and this case in confirmed by selective left renal venography. Here we report a case of renal vein thrombosis with nephrotic syndrome which successfully managed with oral anticoagulants and reviewed literatures.
Anticoagulants ; Humans ; Incidence ; Nephrotic Syndrome* ; Phlebography ; Renal Veins* ; Thrombosis

No abstract available.
Cell Line* ; Chromosome Aberrations* ; Cytogenetics* ; Humans* ; Neuroblastoma*

No abstract available.
Spina Bifida Occulta*

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