The coexistence of spinal stenosis and scoliosis in lumbar spines is becoming a more frequent problem in elderly persons. Decreased bone mass in most of these patients also complicates their management. Recently, the pedicle screw instrumentation systems offer the way to solve these difficult problems. Most of the cases with degenerative scoliosis itself don't require surgical intervention. However, the case with severe clinical manifestations need surgery. From Jan. 1988 to Oct. 1993, authors had treated operatively for 15 cases of spinal stenosis with degenerative lumbar scoliosis. After adequate posterior decompression, pedicular instrumentation was carried out and correction of scoliotic deformity was attempted. Cotrel-Dubousset instrumentation was used in six patients, Graf instrumentation in three patients, and combined(Steffee and Graf) instrumentation in six patients. Follow up was obtained at an average of 20.4 months(Range; 10
Aged ; Animals ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Lordosis ; Methods ; Pedicle Screws ; Scoliosis ; Spinal Stenosis ; Spine

From September 1987 to June 1994, the authors had performed posterolateral fusion in one patient, anterior spinal fusion alone in four patients, anterior spinal fusion after posterior augmentation with Rectangle Luque and posterolateral fusion in four patients of tuberculosis of the lumbosacral junction. The purpose of this study was evaluated the reliability of the posterior augmentation with Rectangle Luque and posterolateral fusion. We divided into two groups: the study group was anterior spinal fusion after posterior augmentation with Rectangle Luque in four patients, the control group was anterior spinal fusion alone in four patients. The average follow up was obtained at 16 months(12 to 20 months) in study group, at 42.7 months in control group. Results were as follows: 1. Clinical results according to Moskowitz criteria were 2 patients with grade I. 2 patients with grade II in the study group; one patient with grade I, one patient with grade II, one patient with grade III, one patient with grade IV in the control group. Hypolordosis(less than 10 degree) at the lumbosacral junction was associated with a higher incidence of back pain. 2. Radiographically well consolidated anterior fusion was noted in all patients within average 6 months (5-7 months) in the study group and 7.2 months (5-10 months) in the control group. 3. Radiologically the lumbosacral saggital angle was corrected after operation and the mean angle was 16.5 degrees(12 to 20 degrees) in the study group, 7.2 degrees(3 to 20 degrees) in the control group. The mean loss of angular correction was 5 degrees(1 to 8 degrees) in the study group, 6.2 degrees(1 to 13 degrees) in the control group at postoperative one year follow up. In conclusion, this results suggest that the anterior spinal fusion concomitant with the posterior augmentation with Rectangle Luque is the recommendable methods for tuberculosis of the lumbosacral junction in adults.
Adult ; Back Pain ; Follow-Up Studies ; Humans ; Incidence ; Spinal Fusion ; Tuberculosis

Postoperative rhabdomyolysis with acute renal failure (ARF) is a rare complication of laparoscopic urologic surgery. It is associated with lateral decubitus surgical position, long operative time, and increased body mass. We report a case of a 49-year-old-man with right renal cell carcinoma who underwent a laparoscopic right radical nephrectomy for 7 hours in left decubitus position and was complicated by ARF due to postoperative rhabdomyolysis. Laparoscopic renal surgery is performed in many surgical renal diseases and heightened suspicion may help early recognition of postoperative rhabdomyolysis. Vigorous hydration and hemodialysis are also helpful in treating ARF secondary to rhabdomyolysis
Acute Kidney Injury ; Carcinoma, Renal Cell ; Laparoscopy ; Nephrectomy ; Operative Time ; Renal Dialysis ; Rhabdomyolysis

We sought to determine whether early amniocentesis is a safe and acceptable method of genetic evaluation in early pregnancy. During the 20-month period from February 1994 to September 1995, 80 consecutive early amniocentesis were performed transabdominally at 12(+3)-14(+6) weeks of gestation and 305 consecutive mid-second-trimester transabdominal amniocenteses were performed at 16(+0)-18(+0) weeks of gestation. All amniotic fluid samples were cultured using flask method. There were no significant differences between the early and mid-second-trimester amniocenteses in failed sampling, ambiguous results, pregnancy loss within 4 weeks after the procedure, pregnancy loss from 4 weeks after procedure to 28 weeks of gestation, preterm birth, and perinatal death. We may conclude that early amniocentesis is a safe and acceptable method for prenatal diagnosis.
Amniocentesis* ; Amniotic Fluid ; Female ; Pregnancy ; Premature Birth ; Prenatal Diagnosis

Microinvasive carcinoma of the uterine cervix(FIGO stage IA) has been reported as highly curable disease even with conservative surgery such as conization and simple hysterectomy. Nevertheless, the surgical management for microinvasive carcinomas has been proposed varying from conservative surgery to radical hysterectomy with pelvic nodes dissection according to different diagnostic criterias for microinvasive carcinoma. We reviewed 512 patients who had been diagnosed as microinvasive carcinoma of the uterine cervix at the Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center from Jan. 1988 to Dec. 1995. Among them, 376 patients were included in this study satisfying guided criterias such as proper management and follow up more than at least one year, and they were analyzed retrospectively based on the clinicopathologic characteristics, pattern of surgical management and postoperative status. (continue)
Cervix Uteri* ; Conization ; Delivery of Health Care ; Diagnosis* ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies

Abiotrophia defectiva, a nutritionally variant streptococci can cause bacteremia, brain abscess, septic arthritis and in rare cases, infective endocarditis, which accounts for 5-6% of all cases. A. defectiva is characteristically difficult to diagnose and the mortality, morbidity and complication rates are high. Here, we discuss a case of infective endocarditis caused by A. defectiva. A 62-year-old female had previously undergone prosthetic valve replacement 6 years prior to admission. She developed infective endocarditis after tooth extraction. Her endocarditis was successfully treated with antimicrobial therapy and mitral valve replacement surgery. This is the first case of infective endocarditis caused by A. defectiva reported in Korea. This case shows that A. defectiva could be considered as a causative organism of infective endocarditis in Korea.
Abiotrophia* ; Arthritis, Infectious ; Bacteremia ; Brain Abscess ; Endocarditis* ; Female ; Humans ; Korea* ; Middle Aged ; Mitral Valve ; Mortality ; Tooth Extraction

PURPOSE: Over the last 30 years, Serratia marcescens (S. marcescens) has emerged as an important pathogen, and a common cause of nosocomial infections. The aim of this study was to identify risk factors associated with mortality in patients with S. marcescens bacteremia. MATERIALS AND METHODS: We performed a retrospective cohort study of 98 patients who had one or more blood cultures positive for S. marcescens between January 2006 and December 2012 in a tertiary care hospital in Seoul, South Korea. Multiple risk factors were compared with association with 28-day all-cause mortality. RESULTS: The 28-day mortality was 22.4% (22/98 episodes). In a univariate analysis, the onset of bacteremia during the intensive care unit stay (p=0.020), serum albumin level (p=0.011), serum C-reactive protein level (p=0.041), presence of indwelling urinary catheter (p=0.023), and Sequential Oran Failure Assessment (SOFA) score at the onset of bacteremia (p<0.001) were significantly different between patients in the fatal and non-fatal groups. In a multivariate analysis, lower serum albumin level and an elevated SOFA score were independently associated with 28-day mortality [adjusted odds ratio (OR) 0.206, 95% confidential interval (CI) 0.044-0.960, p=0.040, and adjusted OR 1.474, 95% CI 1.200-1.810, p<0.001, respectively]. CONCLUSION: Lower serum albumin level and an elevated SOFA score were significantly associated with adverse outcomes in patients with S. marcescens bacteremia.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy/microbiology/*mortality ; Cross Infection/mortality ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Multiple Organ Failure ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Serratia Infections/diagnosis/drug therapy/*mortality ; Serratia marcescens/drug effects/*isolation & purification ; Severity of Illness Index ; Survival Rate ; Time Factors ; Treatment Outcome

Brucellosis is a zoonotic infection that is usually transmitted from cattle to humans through ingestion of animal milk, direct contact with animal parts, or inhalation of aerosolized particles. In Korea, brucellosis seem to be transmitted through close contact with blood, fetus, urine, and placenta of domestic cow that has been infected by Brucella abortus, or inhalation of B. arbortus while examining or slaughtering cow. Brucella melitensis infection is rare in Korea and there have been no reported cases of B. melitensis originating from other countries until now. This report details a case of complicated brucellosis with infective spondylitis in a 48-year-old male construction worker recently returned from Iraq. Infection with B. melitensis was confirmed using 16s rRNA sequencing and omp31 gene analysis. The patient was successfully treated using a combination of rifampin, doxycycline, and streptomycin, in accordance with WHO guidelines. This is the first reported case of complicated brucellosis with infective spondylitis in Korea caused by B. melitensis originating from Iraq.
Animals ; Brucella abortus ; Brucella melitensis* ; Brucella* ; Brucellosis ; Cattle ; Doxycycline ; Eating ; Fetus ; Humans ; Inhalation ; Iraq ; Korea* ; Male ; Middle Aged ; Middle East ; Milk ; Placenta ; Rifampin ; Spondylitis ; Streptomycin ; Zoonoses

Brucellosis is a zoonotic infection that is usually transmitted from cattle to humans through ingestion of animal milk, direct contact with animal parts, or inhalation of aerosolized particles. In Korea, brucellosis seem to be transmitted through close contact with blood, fetus, urine, and placenta of domestic cow that has been infected by Brucella abortus, or inhalation of B. arbortus while examining or slaughtering cow. Brucella melitensis infection is rare in Korea and there have been no reported cases of B. melitensis originating from other countries until now. This report details a case of complicated brucellosis with infective spondylitis in a 48-year-old male construction worker recently returned from Iraq. Infection with B. melitensis was confirmed using 16s rRNA sequencing and omp31 gene analysis. The patient was successfully treated using a combination of rifampin, doxycycline, and streptomycin, in accordance with WHO guidelines. This is the first reported case of complicated brucellosis with infective spondylitis in Korea caused by B. melitensis originating from Iraq.
Animals ; Brucella abortus ; Brucella melitensis* ; Brucella* ; Brucellosis ; Cattle ; Doxycycline ; Eating ; Fetus ; Humans ; Inhalation ; Iraq ; Korea* ; Male ; Middle Aged ; Middle East ; Milk ; Placenta ; Rifampin ; Spondylitis ; Streptomycin ; Zoonoses

PURPOSE: Severe sepsis is associated with functional disability among patients surviving an acute phase of infection. Efforts to improve functional impairment are important. We assessed the effects of early exercise rehabilitation on functional outcomes in patients with severe sepsis. MATERIALS AND METHODS: A prospective, single-center, case-control study was conducted between January 2013 and May 2014 at a tertiary care center in Korea. Patients with severe sepsis and septic shock were enrolled and randomized to receive standard sepsis treatment or intervention. Intervention involved early targeted physical rehabilitation with sepsis treatment during hospitalization. Participants were assessed at enrollment, hospital discharge, and 6 months after enrollment. Functional recovery was measured using the Modified Barthel Index (MBI), Functional Independence Measure (FIM), and Instrumental Activities of Daily Living (IADL). RESULTS: Forty participants (21 intervention patients) were included in an intention-to-treat analysis. There were no significant differences in baseline MBI, FIM, and IADL between groups. Intervention yielded greater improvement of MBI, FIM, and IADL in the intervention group at hospital discharge, but not significantly. Subgroup analysis of patients with APACHE II scores ≥10 showed significantly greater improvement of physical function at hospital discharge (MBI and FIM) in the intervention group, compared to the control group (55.13 vs. 31.75, p=0.048; 52.40 vs. 31.25, p=0.045). Intervention was significantly associated with improvement of MBI in multiple linear regression analysis (standardized coefficient 0.358, p=0.048). CONCLUSION: Early physical rehabilitation may improve functional recovery at hospital discharge, especially in patients with high initial severity scores.
Activities of Daily Living ; APACHE ; Case-Control Studies ; Hospitalization ; Humans ; Korea ; Linear Models ; Prospective Studies ; Rehabilitation* ; Sepsis* ; Shock, Septic ; Tertiary Care Centers