STUDY DESIGN: A retrospective follow-up study comparing soft disc cervical myelopathy (Group A) and spondylotic bar cervical myelopathy (Group B). OBJECTIVES: To analyze different factors by comparing preoperative radiological and clinical data of Group A with that of Group B. SUMMARY AND LITERATURE REVIEW: The different causes of cervcal myelopathy resulted in different symptoms and prognoses. MATERIALS AND METHOD: A clinical and radiological analysis of the data in 31 patients who underwent an anterior cervical decompression and fusion was performed to assess the different factors between two groups. The patients were classified into two groups; 20 in Group A and 11 in Group B. Comparisons between the two groups were made in regard to the physical findings, radiological and clinical evaluation. RESULTS: The duration of myelopathy was 3 months in Group A and 8.7months in Group B. Of all cases, 5 cases (25.0%) in group A and 4 cases (36.4%) in group B had myelopathy associated with radiculopathy. Of the 20 cases in group A with myelopathy, 7 cases had a median compression and 13 cases had a paramedian compression on MRI. Of the 11 cases in group B with meylopathy, 9 cases had a median compression and 2 cases had a paramedian compression on MRI. The follow-up MRI of the 14 cases (73.7%) in group A and 2 cases (20.0%) in group B showed spontaneous regression of the T2 WI high signal intensity. CONCLUSION: In degenerative disc disease, the different causes of cervcal myelopathy result in different symptoms and prognoses. However, the treatment of choice in both groups is a one level anterior decompression and fusion.
Decompression ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Radiculopathy ; Retrospective Studies ; Spinal Cord Diseases*

Patients with ankylosing spondylitis are susceptible to fractures, which usually occur in the cervical spine. However, upper spinal fractures, particularly dens fracture-nonunion complicating ankylosing spondylitis, are quite rare. We encountered one such case. The patient was treated with posterior fusion followed by a halovest, which resulted in good conditions.
Humans ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Echocardiography*

Dermatomyositis is a disorder of unknown etiology characterized by an inflammatory myopathy involving striated skeletal muscle and associated characteristic skin lesions. In recent years, there has been increased the awareness of the association of malignant tumor with this disorder. But the relations between dermatomyositis and malignant tumors remains controversial. Comparing to other countries, the incidence rate may be said to be low in Korea. However, we suggest that our concerning makes it's associated malignant tumors discovered. The cutaneous necrosis, elevated erythrocyte sedimentation rate, older age, or acute onset of symptoms proved to have the predictive value of cancer in dermatomyositis. Therefore, we think that more detailed diagnostic workups for malignant neoplasms are recommended in the patient with this criterion. Here we reported a case.of dermatomyositis accompaning by lung cancer with brief review of literatures.
Blood Sedimentation ; Dermatomyositis* ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Muscle, Skeletal ; Myositis ; Necrosis ; Skin ; Small Cell Lung Carcinoma*

BACKGROUND: The cell-mediated immune response plays an important role in tuberculosis. After being activated by mycobacterial antigens, T lymphocytes express a high affinity receptor (IL-2R) for interleukin-2 (IL-2) on their own surface and release a soluble fraction of the IL-2 receptor (sIL-2R) from the cell membrane into the circulation. Neopterin is a metabolite of guanosine-triphosphate, which is produced by stimulated macrophages under the influence of IFN-gamma with a T lymphocyte origin. Therefore, the utility of sIL-2R, IFN-gamma and the neopterin levels as immunologic indices of the cell-mediated immune response and severity of disease in patients with pulmonary tuberculosis was assessed. METHOD: The serum sIL-2R, IFN-gamma and neopterin levels were measured in 39 patients with pulmonary tuberculosis, 6 patients with tuberculous lymphadenitis prior to treatment and 10 healthy subjects. The serum and pleural sIL-2R, neopterin and ADA levels were measured in 22 patients with tuberculous pleurisy. The patients with pulmonary tuberculosis were divided into a mild, moderate and severe group according to the severity by ATS guidelines. To compare the results from these patients with those of the pretreatment levels, the sIL-2R, IFN-gamma and neopterin levels were measured in 36 of the 39 patients(1 patient, expired; 2 patients were referred to a sanitarium) with pulmonary tuberculosis after 2 months of treatment. RESULTS: 1) The serum sIL-2R and IFN-gamma levels were elevated in patients with tuberculosis when compared to those of healthy subjects (0.05). The neopterin concentration in the serum was significantly lower in patients with pulmonary tuberculosis(2967+/-2132.8 pg/ml) than in healthy controls(4949+/-1242.1 pg/ml)(p<0.05). 2) In the pulmonary tuberculosis group, the serum sIL-2R and IFN-gamma levels were higher in patients with severe disease than those in patients with mild and moderate disease. However, the neopterin levels declined as the pulmonary tuberculosis became more severe (p<0.01). 3) The mean serum sIL-2R and IFN-gamma levels declined from 1071+/-1139.4 U/ml to 1023+/-1920.9 U/ml(p>0.05), 41 52.8 pg/ml to 22+/-23.9 pg/ml(p<0.05), respectively, after 2 month of treatment. The mean serum neopterin levels increased from 3158+/-2272.6 pg/ml to 3737+/-2307.5 pg/ml(0.05) after a 2 month of treatment. These findings were remarkable in the severe group of pulmonary tuberculosis with a clinical correlation. 4) In the patients with tuberculous pleurisy, the serum sIL-2R and ADA were significantly higher than those in the pleural fluid, However, the neopterin levels in the sera and pleural effusion were similar. CONCLUSION: On the basis of this study, sIL-2R, IFN-gamma and neopterin measurements may not only provide an insight into the present state of the cell-mediated immune response, but also serve as parameters monitoring of the prognosis of the disease, particularly in patients with severe pulmonary tuberculosis. In addition, an assay of the pleural sIL-2R levels might signal a stimulated local immunity including T cell activation in the tuberculous pleural effusion.

There have been paucity of reports on atlas hypoplasia, and as a result this condition is not clearly defined, nor well understood. The authors reported three cases of atlas hypoplasia that were found in adults who presented with myelopathic symptoms. On radiographic examination, it was found that the anterior-posterior diameter of the atlas was remarkably narrower in all three cases in comparison with normal persons. The MRI in all three cases also revealed intramedullary high signal lesions at the levels where severe spinal cord compression was present. This led to our diagnosis of atlas hypoplasia causing myelopathy.
Adult* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Spinal Cord Compression ; Spinal Cord Diseases*

PURPOSE: Estrogen receptor (ER) is the key therapeutic target in breast cancer. ERbeta has recently been identified to be distinct from ERalpha. In contrast to ERalpha, the functions of ERbeta in breast cancer are still unclear. We sought to determine whether the expression of ERbeta can be used as a predictive marker for endocrine therapy for patients with ERalpha-negative breast cancer. METHODS: Formalin-fixed, paraffin-embedded tumor specimens from 52 patients with ER-/PR+ invasive breast cancer were immunostained for their ERbeta expression. These patients were treated with adjuvant tamoxifen. The results were correlated with various clinicopathological variables and the follow-up data. The expressions of p53 and HER-2/neu were also analyzed and correlated with the ERbeta status. RESULTS: An ERbeta expression was observed in 53.8% (28/52) of the breast cancer samples. There was no correlation between the ERbeta expression and the other clinicopathologic factors (age, tumor size, histologic type, nodal status, histological grade, stage, therapeutic modality, progesterone receptor (PR) expression, p53 expression and HER-2/neu expression). Recurrence was present in 7.7% (2/26) of the patients whose tumors had an ERbeta expression, as compared to the presence of recurrence in 36.4% (8/22) of the patients whose tumors had no ERbeta expression (p<0.05). The patients with ERbeta negative-tumors revealed lower disease free survival rate than those with ERbeta positive-tumors (p<0.05). Of the 52 patients, 10 (19.2%) were p53 positive, and 11 (21.2%) were HER-2/neu positive. No significant correlations were observed between ERbeta and p53 or HER-2/neu. CONCLUSION: These results suggest that ERbeta might be a predictive marker of a response to endocrine therapy in patients with ER-/PR+ invasive breast cancer, although this needs to be confirmed by additional studies.
Breast ; Breast Neoplasms ; Disease-Free Survival ; Estrogen Receptor alpha ; Estrogen Receptor beta ; Estrogens ; Follow-Up Studies ; Humans ; Progesterone ; Receptors, Progesterone ; Recurrence ; Tamoxifen

Tuberculosis of the sigmoid colon is a rare disorder. An 80-year-old man visited Bongseng Memorial Hospital for medical examination. A colonoscopy was performed, and a lesion in the sigmoid colon that was suspected to be colon cancer was found. A biopsy was performed, and tuberculous enteritis with chronic granulomatous inflammation was diagnosed. Intestinal tuberculosis is most frequent in the ileocecal area, followed by the ascending colon, transverse colon, duodenum, stomach, and sigmoid colon, in descending order. Hence, we report a case of intestinal tuberculosis in the sigmoid colon, which is rare and almost indistinguishable from colon cancer.
Aged, 80 and over ; Biopsy ; Colon ; Colon, Ascending ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms ; Colonoscopy ; Duodenum ; Enteritis ; Humans ; Inflammation ; Stomach ; Tuberculosis ; Tuberculosis, Gastrointestinal

PURPOSE: The expression of the PIM-1 gene, which is a proto-oncogene that encodes a serine/threonine kinase, is associated with multiple cellular functions such as proliferation, differentiation, apoptosis and tumorigenesis. In particular, several studies have reported that the PIM-1 gene is associated with the development of lymphoma, leukemia and prostate cancer. Therefore, this study was conducted to evaluate the association between the single nucleotide polymorphisms in the PIM-1 gene and the risk of lung cancer occurrence in the Korean population. MATERIALS AND METHODS: To evaluate the role of the PIM-1 gene in the development of lung cancer, the genotypes of the PIM-1 gene were determined in 408 lung cancer patients and 410 normal subjects. RESULTS: We found that the T-C-T-C haplotypes of the PIM-1 gene (-1196 T>C, IVS4 +55 T>C, IVS4 +1416 T>A and +3684 C>A) were associated with an increased risk of lung cancer [adjusted odds ratio (aOR): 3.98; 95% CI: 1.24~12.75, p-value: 0.020]. In particular, these haplotypes showed an increased risk of lung cancer in males (aOR: 5.67; 95% CI: 1.32~24.30, p-value: 0.019) and smokers (aOR: 7.82; 95% CI: 1.75~34.98, p-value: 0.007). CONCLUSIONS: The present results suggest that the T-C-T-C haplotype of the PIM-1 gene could influence the risk of developing smoking-related lung cancer in the Korean population. Additional functional studies with an larger sample sized analysis are warranted to reconfirm our findings.
Apoptosis ; Cell Transformation, Neoplastic ; Genotype ; Haplotypes ; Humans ; Leukemia ; Lung ; Lung Neoplasms ; Lymphoma ; Male ; Odds Ratio ; Oncogenes ; Phosphotransferases ; Polymorphism, Single Nucleotide ; Prostatic Neoplasms ; Proto-Oncogenes

PURPOSE: Papillary thyroid cancer is the most common histological type of malignancy that originates from the thyroid. The disease has an excellent prognosis, despite characteristically being associated with lymph node metastases. According to the World Health Organization, a papillary thyroid microcarcinoma (PTMC) is defined as papillary carcinoma measuring ≤1 cm in the greatest dimension. We present the clinico-pathological features and investigate predictive factors related with lymph node metastases in patients with papillary thyroid microcarcinomas less than 5 mm in size. METHODS: Between January 2003 and June 2005, 75 patients underwent surgical treatment for thyroid papillary cancer less than 5 mm in size at the Department of Endocrine Surgery at our hospital. We analyzed the age of patients, gender, presence of symptoms, multifocality, combined thyroid disease, tumor size, capsular invasion, presence of a lymph node metastasis, tumor location, operative method and postoperative complications by use of Pearson's chi-squared test. RESULTS: Lymph node metastases most frequently occurred in patients with a lateral neck mass at presentation (p=0.004). Patients with capsular invasion of the thyroid showed a high rate of lymph node metastases (p=0.027). In patients with combined thyroid disease such as thyroiditis, more lymph node metastases were observed (p=0.018). CONCLUSION: Preoperative symptoms at presentation (especially a lateral neck mass) and tumors with capsular invasion had a high potential to cause lymph node metastases. Factors such as a lateral neck mass, capsular invasion, and combined thyroiditis may be predictive of a lymph node metastasis and are helpful in the determination of proper treatment.