The result of interference with the conductibility of the spinal cord is one of the most disabling and distressing complications of splnal tuberculosis. This fact was recognized as early as in 1779, when Pott published. The antituberculous drugs and improved surgical treatment have made possible a more effective treatment than before and improved the prognosis but not solved all problems completely. The following results were shown by analysis of 63 cases of spinal tuberculosls with neurological symptom experienced in the Department of Orthopedic Surgery, Seoul National University in the past 9.5 years from Jan. 1970 to Jun. 1979. 1. Number of cases In child was 15. (29%). 2. Pulmonary and other tuberculous diseases were manifested in 29 cases (46%). 3. Regions of the spine inovolved were most common In thoracic spine (43 cases), especially lower thoracic spine. 4. There were 49 early and 14 late paraplegia 5. There were 24 complete and 39 incomplete paraplegia. 6. Spastic type was more common than flaccid type. 7. Anterior fusion was done in 55 cases and costotransversectomy in 8. 8. There were 36 cases (57%) of complete recovery and 8 of fallure. 9. The prognosis for recovery from paraplegia appeared to depend on age, duration, type and onset of paraplegia.
Child ; Humans ; Muscle Spasticity ; Orthopedics ; Paraplegia ; Prognosis ; Seoul ; Spinal Cord ; Spine ; Tuberculosis ; Tuberculosis, Spinal

PURPOSE: Vesicoureteral reflux (VUR) is the major cause of urinary tract infection (UTI) in children. Prolonged untreated UTI associated with VUR may result in serious complications, such as renal scarring, renal atropy, and decreased renal function. Therefore, follow up must be continued until UTI is cured completely, to prevent of serious complication. The authors conducted this study to evaluate results of the follow-up of UTI associated with VUR. METHODS: During the period from March 1991 to July 1996, we had 47 children with urinary tract infection associated with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Presbyterian Medical Center. The patients were managed medically or surgically. RESULTS: 1) There were no differences in sex distribution in the 47 cases with VUR. The intensity of 67 refluxing ureters, classified by the International Reflux Study Committee, grade I, 10 cases; grade II, 11 cases; grade III, 20 cases; grade IV, 17 cases; grade V, 9 cases. 2) The most common causative agent in UTI was E. coli. Fourty-six cases underwent ultrasonography and 24 showed abnormal findings. Fourty-four cases underwent a 99mTc-DMSA renal scan, and 25 showed abnormal findings. The incidence of renal scarring showed a direct correlation with the severity of VUR. 3) The incidence of urinary tract infection during follow-up did not differ between the groups medical management versus surgical management. 4) Fourty-four refluxing ureters were treated primary medically and 38 of them were followed up. Twenty-five of the 38 ureters were disappeared or improved, and 9 persisted. The rest showed aggravation of reflux. Twenty-five of the 32 refluxing ureters showed disappearance or improvement of reflux before 5 years of age, The spontaneous cure rate of vesicoureral reflux seemed to be higher in the cases with a milder grade of reflux. 5) Although refluxing ureter disappeared completely on VCUG, we found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG. 6) Thirty-three refluxing ureters were treated surgically and one of them was stationary on follow-up VCUG, while the others were cleared. CONCLUSIONS: As a result of follow-up the 47 patients with VUR, the incidence of urinary tract infection did not differ between the groups medical versus surgical management. Rates of disappearance of VUR in medical and surgical management were 66%, 97%, respectively. The spontaneous cure rate of VUR seemed to be higher in the cases with a milder grade of reflux and before 5 years of age. We found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG.
Child ; Cicatrix ; Follow-Up Studies* ; Humans ; Incidence ; Pediatrics ; Protestantism ; Sex Distribution ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Urology ; Vesico-Ureteral Reflux*

PURPOSE: Vesicoureteral reflux (VUR) is the major cause of urinary tract infection (UTI) in children. Prolonged untreated UTI associated with VUR may result in serious complications, such as renal scarring, renal atropy, and decreased renal function. Therefore, follow up must be continued until UTI is cured completely, to prevent of serious complication. The authors conducted this study to evaluate results of the follow-up of UTI associated with VUR. METHODS: During the period from March 1991 to July 1996, we had 47 children with urinary tract infection associated with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Presbyterian Medical Center. The patients were managed medically or surgically. RESULTS: 1) There were no differences in sex distribution in the 47 cases with VUR. The intensity of 67 refluxing ureters, classified by the International Reflux Study Committee, grade I, 10 cases; grade II, 11 cases; grade III, 20 cases; grade IV, 17 cases; grade V, 9 cases. 2) The most common causative agent in UTI was E. coli. Fourty-six cases underwent ultrasonography and 24 showed abnormal findings. Fourty-four cases underwent a 99mTc-DMSA renal scan, and 25 showed abnormal findings. The incidence of renal scarring showed a direct correlation with the severity of VUR. 3) The incidence of urinary tract infection during follow-up did not differ between the groups medical management versus surgical management. 4) Fourty-four refluxing ureters were treated primary medically and 38 of them were followed up. Twenty-five of the 38 ureters were disappeared or improved, and 9 persisted. The rest showed aggravation of reflux. Twenty-five of the 32 refluxing ureters showed disappearance or improvement of reflux before 5 years of age, The spontaneous cure rate of vesicoureral reflux seemed to be higher in the cases with a milder grade of reflux. 5) Although refluxing ureter disappeared completely on VCUG, we found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG. 6) Thirty-three refluxing ureters were treated surgically and one of them was stationary on follow-up VCUG, while the others were cleared. CONCLUSIONS: As a result of follow-up the 47 patients with VUR, the incidence of urinary tract infection did not differ between the groups medical versus surgical management. Rates of disappearance of VUR in medical and surgical management were 66%, 97%, respectively. The spontaneous cure rate of VUR seemed to be higher in the cases with a milder grade of reflux and before 5 years of age. We found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG.
Child ; Cicatrix ; Follow-Up Studies* ; Humans ; Incidence ; Pediatrics ; Protestantism ; Sex Distribution ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Urology ; Vesico-Ureteral Reflux*

Fifty-seven cases of non-union examined and treated at Department of Orthopedic Surgery, Seoul National University Hospital during the period of 1968 to 1979 were observed and analysed. The results were summarized as follows: 1. Of the 57 cases,there were 43 male and 14 female patients. This result showed marked predominence of male over female patients. 2. Non-unions most commonly occured between 21 and 40 of age. 3. The causes of the fractures consisted of 22 traffic accidents, 20 fallings, 7 machinery injuries, 6 direct blows, and 2 chronic osteomyelitis. 4. Of the 57 cases, there were 20 open fractures and 37 closed fractures. 5. The sites of nonunion were lower extremities in 41 cases and upper extremities in 16 cases. The femur, 31 cases, was most commonly involved. 6. The mean duration from fracture to diagnosis of non-union was 14.8 months. 7. Prior to admission to this hospital, one received no treatment at all, 23 were treated conservatively, and the remaining 33 treated operatively. 8. Probable causes of the nonunions were unsatisfactory immobilization in 26 cases, operative complications in-24, infections in 3, interpositions of the soft tissues in 3, and separations of fragments in 1. 9. All patients received surgical operations, which were successful in 87.7%.
Accidents, Traffic ; Diagnosis ; Female ; Femur ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Lower Extremity ; Male ; Orthopedics ; Osteomyelitis ; Seoul ; Upper Extremity

Chordomas are maligaant tumors which arise in the remnants of the embryonic notochord, and exhibit a definite predilection for the extremes of the spinal axis, the great majority arising either in the basioccipital or in the sacrococcy geal regions. Particularly, complete surgical removal is almost impossible, therefore, local recurrence after the surgical removal of this tumor is common or rule. This report describes a csse of chordoma arising sacrococcygeal region treated with block resection.
Chordoma ; Notochord ; Recurrence ; Sacrococcygeal Region

Pelvic inflammatory disease can induce tubo-ovarian abscess, peritonitis, perihepatitis as sequelae. It can result in an associated hydroureteronephrosis or ureteral obstruction. We experienced a case of ureteral obstruction with urinoma in a 22-year old woman who had tubo-ovarian abscess, presented with fever, chills and left flank pain. She was treated with ureteroureterostomy and urinoma excision.
Abscess* ; Chills ; Female ; Fever ; Flank Pain ; Humans ; Pelvic Inflammatory Disease ; Peritonitis ; Ureter* ; Ureteral Obstruction* ; Urinoma* ; Young Adult

PURPOSE: Laparoscopic surgery has been generalized for the treatment of localized renal cell carcinoma(RCC). Recently, laparoscopic radical nephrectomy for an RCC over the pT2 stage has gained rapid momentum as an effective surgery for treatment. We evaluated the possibility of the use of laparoscopic surgery for a large RCC, using the surgical results according to tumor size. MATERIALS AND METHODS: Between June 2003 and June 2007, a total of 46 patients that under underwent a laparoscopic radical nephrectomy for RCC were divided into three groups according to tumor size: group 1 (n=16, tumor size 7cm). The surgical outcomes and perioperative morbidities were evaluated retrospectively, and were compared for each group. RESULTS: The transfusion rate for group 3 patients was higher than for the other groups(group 1: 0%, group 2: 13.3%, group 3: 26,7%). However, the mean operative time(group 1: 154.3 minutes, group 2: 158.4 minutes, group 3: 197.9 minutes), postoperative initiative time to ambulate(group 1: 1.88 days, group 2: 2.00 days, group 3: 1.87 days) postoperative initiative time to diet(group 1: 1.38 days, group 2: 1.53 days, group 3: 1.53 days), total hospital stay(group 1: 7.94 days, group 2: 8.47 days, group 3: 8.20 days) and complication rate(group 1: 12.5%, group 2: 13.3%, group 3: 13.3%) were similar for patients in the three groups. Pathological results indicated that all cases showed a renal cell carcinoma with a negative surgical margin. CONCLUSIONS:There were no differences in the operative and postoperative results of the performance of laparoscopic radical nephrectomy according to tumor size, except for the transfusion rate. If the use of the technique and experience accumulate, laparoscopic radical nephrectomy will be feasible for all localized RCC regardless of tumor size.

Animal experiment was carried out to measure the physiologic changes of thoracic or thoracolumbar spine that occurred as a result of electrical stimulation, and to evaluate the usefulness of electrical stimulation as a possible treatment for scoliosis. Unilateral electrical stimulations were applied to the back muscle of immature rabbits.They were subgrouped into medial, intermediate, and lateral muscle stimulated groups in order to observe the effects of various electrode placements. The radiograms were taken every other week to observe the changes of the spinal curvatures for the period of 12 weeks. The histological studies of the muscles, which were obtained from the stimulated(right) and the nonstimulated(left) sides at the same level, also were carried out to determine the response of the muscles to the electrical stimulation. The results were as follows. l. A significant scoliotic curvature was observed two weeks after electrical stimulation, and those curvatures did not change more for the next six weeks in spite of prolonged stimulation. 2. Scoliotic curvature induced by electrical stimulation for eight weeks remained unchanged for another four weeks after stopping stimulation. 3. There were no statistical differences in the induced scoliotic curvature among the three groups stimulated at different sites of the medial, intermediate, and lateral regions respectively. 4. A prolonged unilateral electrical stimulation could induce the scoliosis, and may be used as a method for treatment of scoliosis.
Animal Experimentation ; Back Muscles ; Electric Stimulation ; Electrodes ; Methods ; Muscles ; Scoliosis ; Spinal Curvatures ; Spine

PURPOSE: Curcumin (Cur) has been reported to induce apoptosis in human renal carcinoma Caki cells. Dimethoxycurcumin (DMC), one of several synthetic Cur analogues, has been reported to have increased metabolic stability over Cur. We determined whether DMC, like Cur, induces apoptosis in Caki cells and also compared the apoptosis-inducing activity of DMC with that of Cur. MATERIALS AND METHODS: Caki cells were treated with DMC possessing four methoxy groups, Cur possessing two methoxy groups, or bis-demethoxycurcumin (BMC), which lacks a methoxy group. Cell viability was measured by using a methyltetrazolium assay. Flow cytometry and the caspase-3 activity assay were used to detect apoptosis. The release of cytochrome-c (Cyt c) was detected by Western blot analysis. The production of reactive oxygen species (ROS) was measured by flow cytometry. RESULTS: DMC, Cur, and BMC reduced cell viability and induced apoptosis, but the potency varied; DMC was the most potent compound, followed by Cur and BMC. ROS production, Cyt c release, and caspase-3 activity were increased, again in the order DMC>Cur>BMC. N-Acetylcysteine, a potent antioxidant, inhibited ROS production, Cyt c release, caspase-3 activation, and apoptosis induction in DMC-treated cells. CONCLUSIONS: These results indicate that DMC, like the original form of Cur, may induce apoptosis in human renal carcinoma Caki cells through the production of ROS, the release of mitochondrial Cyt c, and the subsequent activation of caspase-3. In addition, DMC is more potent than Cur in the ability to induce apoptosis.
Acetylcysteine ; Antineoplastic Agents ; Apoptosis ; Blotting, Western ; Carcinoma, Renal Cell ; Caspase 3 ; Cell Survival ; Chlorobenzenes ; Curcumin ; Cytochromes ; Cytochromes c ; Flow Cytometry ; Humans ; Reactive Oxygen Species

PURPOSE: To determine the feasibility and safety of robotic partial nephrectomy (RPN), we compared the operative outcomes of patients who had undergone RPN with those of patients who had undergone laparoscopic partial nephrectomy (LPN). MATERIALS AND METHODS: Between February 2009 and June 2010, 13 patients underwent transperitoneal RPN (group 1) and 14 patients underwent transperitoneal LPN (group 2) by a single surgeon. The operative outcomes of the 2 groups were compared by using Mann-Whitney U and Fisher's exact tests. RESULTS: All cases were completed successfully without conversion to open surgery. The mean operative time was 153.2+/-22.3 and 117.5+/-32.0 minutes in groups 1 and 2, respectively (p=0.003). The mean robotic console time of group 1 was 101.2+/-21.5 minutes, and the mean laparoscopic time of group 2 was 86.8+/-32.3 minutes (p=0.139). The mean warm ischemic time was 35.3+/-8.5 minutes and 36.4+/-6.8 minutes in groups 1 and 2, respectively (p=0.823). The mean estimated blood loss was 283.6+/-113.5 ml and 264.1+/-163.7 ml (p=0.382), respectively. The mean length of hospital stay was 6.1 and 5.3 days (p=0.290), respectively. The mean tumor size was 2.7+/-1.2 cm and 2.0+/-1.2 cm (p=0.035), respectively. The surgical margins were negative in all cases. CONCLUSIONS: Although the operative time of RPN was longer than that of LPN, there were no significant differences in operative outcomes including robotic console time and laparoscopic time between the procedures.
Conversion to Open Surgery ; Humans ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Nephrectomy ; Operative Time ; Warm Ischemia