No abstract available.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Porokeratosis*

The introduction of microdiscectomy in lumbar spine surgery has resulted in a significant decrease in postoperative pain and length of hospital stay. Intraoperative application of long-acting local anesthetic agents and corticosteroids during lumbar discectomy have been used for the management of postoperative pain. However, the efficacy of local anesthetic agents and corticosteroids has not been reported. This study evaluated 30 patients undergoing lumbar microdiscectomy. These patients were divided into three groups. Group I(10 patients) received intramuscular Depomedrol and intravenous Solumedrol at the start of the operation. A gelfoam soaked with Depomedrol was placed over the affected nerve root following discectomy. In addition, bupivacaine was infiltrated into the paraspinal musculature at the skin incision and during closure. Group II(10 patients) received intramuscular bupivacaine and used a saline-soaked gelfoam. Group III(10 patients) acted as a control group without corticosteroids and bupivacaine. Patients in Group I had a statistically significantly shorter hospital stay(8.9 days) compared to the control group(14.9 days). Patients in Group I required less postoperative narcotic analgesia than the other groups. A larger percentage of patients in Group I reported reduction of lower back pain and radicular pain until #POD 3 compared to other groups. These results indicate that the combination of long-acting local anesthetic agents and corticosteroids can reduce postoperative discomfort and hospital stay.
Adrenal Cortex Hormones* ; Analgesia ; Anesthetics ; Bupivacaine* ; Diskectomy ; Gelatin Sponge, Absorbable ; Humans ; Length of Stay ; Low Back Pain ; Methylprednisolone Hemisuccinate ; Pain Management* ; Pain, Postoperative ; Skin ; Spine

No abstract available.
Leukemia*

This 32 year-old man sustained crush injury and resultant in paraplegia. Lumbar MRI was taken and revealed fracture and dislocation between L2 and L3 vertebrae bodies. On the day of the injury, he underwent a surgical intervention of posterolateral fixation and bone graft from L1 to L4 vertebrae. He was transferred to Rehabilitation Medicine Department of Asan Medical Center where patient was subsequently found to have an unexpected neurologic finding of decreased sensation below T5 dermatome on right and below T6 on left. Accordingly we took a thoracic MRI which showed features consistent with arachnoiditis at thoracic and lumbar cord segment. A dermatomal somatosensory evoked potential study was performed with finding of abnormal somatosensory pathway below mid thoracic dermatome. We reported an unusual case of thoracic arachnoiditis occurred after the surgical fixation of the lumbar vertebral fracture and dislocation.
Adult ; Arachnoid* ; Arachnoiditis* ; Chungcheongnam-do ; Dislocations ; Evoked Potentials, Somatosensory ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Paraplegia ; Rehabilitation ; Sensation ; Spine ; Transplants

The objectives of the present study were to (1) determine the susceptibility of Anopheles sinensis to Korean isolates of Plasmodium vivax, (2) establish a method to collect large quantities of P. vivax sporozoites for use as antigen in seroepidemiological studies, and (3) investigate the characteristics of Korean isolates of P. vivax sporozoites. Females of Anopheles sinensis were collected at non-epidemic area, Seokwha-ri, Cheongwon-gun and Chungcheongbuk-do using tent-trap methods coupled with dry ice. The females were artificially infected with gametocytes of P. vivax using blood obtained from P. vivax malaria patients. Individual mosquitoes were infected using either a parafilm-covered glass feeding apparatus or were allowed to feed on naturally infected volunteers. Mosquitoes were sacrificed between 16 and 18 days post-feeding and an enzyme-linked immunosorbent assay (ELISA) was used to detect sporozoites. Four (33.4%) of 12 mosquitoes, which were fed on naturally infected volunteers directly, were positive for sporozoites. In cases, the mosquitoes allowed to feed on whole blood which were extract from three different patients with heparin treated vacuutainers using a parafilm-covered glass apparatus. Two of 55 (3.6%) were positive which blood sample was maintained at room temperature for 8 hours, 1 of 68 (1.5%) was positive which blood was maintained at 4 degrees C for 24 hours and 1 of 47 (2.3%) was positive at 4 degrees C for 48 hours. The mean number of sporozoites was estimated about 818 (n = 8; range of 648-1,056) based on optical density values of ELISA.
Animals ; Anopheles/*parasitology ; Enzyme-Linked Immunosorbent Assay ; Human ; Korea ; Plasmodium vivax/isolation & purification/*pathogenicity ; Support, Non-U.S. Gov't

OBJECTIVE: Incidence of chronic subdural hematoma (CSDH) is gradually increasing in young adults for several reasons. In this study, we aimed to identify features of CSDH noted in young adults that distinguish the disease from CSDH diagnosed in the elderly. METHODS: One hundred eighty-two patients with CSDH who underwent a total of 218 surgical procedures between January 2003 and February 2010 were retrospectively reviewed with regard to clinical presentation, radiographic results and prognosis including recurrence. To compare younger patients with the elderly, patients were divided into three groups on the basis of age (Group A: < or =40, Group B: 41-64, Group C: > or =65 years). RESULTS: Group A showed a male predominance (p=0.0001), lower rate of recurrence (p=0.0012), shorter symptom duration (p=0.035), and fewer leading signs such as hemispheric symptoms (p=0.005) compared to Groups B and C. Radiologic findings such as maximal hematoma thickness (p<0.0001) and degree of midline shift (p=0.028) were less severe in Group A than Groups B and C. Alcoholism was the most prevalent illness in all three groups. When exempting infants with hematologic malignancy, non-recurrence, previous trauma history, headache as leading symptom, and no mortality were all common in younger adults (all p<0.05). CONCLUSION: Young adults with CSDH show less severe clinical and radiologic features as well as fewer recurrences than noted in the elderly population. Even if a clinician's index of suspicion of CSDH in young adults complaining of headache is not high, meticulous radiologic surveillance could find CSDH, leading to satisfactory results including less frequent recurrence.
Adult ; Aged ; Alcoholism ; Headache ; Hematologic Neoplasms ; Hematoma ; Hematoma, Subdural, Chronic ; Humans ; Incidence ; Infant ; Male ; Prognosis ; Recurrence ; Retrospective Studies ; Young Adult

BACKGROUND: Previously developed diagnostic assays to detect antibodies against HIV have difficulties in diagnosing the infected blood prior to seroconversion. Various 3.5 generation HIV diagnostic assays developed in the Republic of Korea also have the same problem. Newly developed LG HIV Ag-Ab Plus (LG Life Science, Seoul, Korea) is the product to overcome this limitation. METHODS: Sensitivity of both LG HIV Ag-Ab Plus and Enzygnost HIV Integral (Dade Behring, Marburg, Germany) were evaluated by using 82 anti-HIV 1 positive samples, 2 anti-HIV 1 group O positive samples (Vital products, Boynton Beach, FL, USA), 25 anti-HIV 2 positive samples, 5 anti-HIV panels (Boston Biomedica, Inc., MA, USA). Specificity of both product were evaluated using 1081 Anti-HIV negative samples (1000 healthy donors, 13 alcoholics sera, 20 end-stage renal disease sera, 20 HBsAg positive sera, 22 anti-HBs antibody positive sera, 6 anti-HCV positive sera). Seroconversion window was evaluated by using 4 seroconversion panels. Intrapersonal and interpersonal reproducibility of the test were also evaluated. RESULTS: Sensitivity of LG HIV Ag-Ab Plus to sera of healthy donor was 99.9% and that to sera of patients with other underlying diseases was 100%. Sensitivity of both LG HIV Ag-Ab plus and Enzygnost HIV integral assays to sera of HIV infected patients was 100%. Sensitivity of LG HIV Ag-Ab Plus to BBI panel was comparable or better than that of Enzygnost HIV Integral. Analysis of window period using seroconversion panels showed no difference between both tests. CONCLUSION: Sensitivity and specificity of LG HIV Ag-Ab Plus was comparable to that of Enzygnost HIV Integral. It also had an excellent result in analysis of window period using seroconversion panels. So, newly developed LG HIV Ag-Ab Plus assay, by using it in screening donated blood, may provide significant contribution in safety of donated blood.
Alcoholics ; Antibodies ; Biological Science Disciplines ; Hepatitis B Surface Antigens ; HIV* ; Humans ; Kidney Failure, Chronic ; Mass Screening ; Republic of Korea ; Sensitivity and Specificity ; Seoul ; Tissue Donors

We report here two cases of foreign body granulomas that arose from the pelvic wall and liver, respectively, and simulated recurrent colorectal carcinomas in patients with a history of surgery. On contrast-enhanced CT and MR images, a pelvic wall mass appeared as a well-enhancing mass that had invaded the distal ureter, resulting in the development of hydronephrosis. In addition, a liver mass had a hypointense rim that corresponded to the fibrous wall on a T2-weighted MR image, and showed persistent peripheral enhancement that corresponded to the granulation tissues and fibrous wall on dynamic MR images. These lesions also displayed very intense homogeneous FDG uptake on PET/CT.
Adult ; Aged ; Colorectal Neoplasms/pathology/*surgery ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Fluorodeoxyglucose F18/diagnostic use ; Granuloma, Foreign-Body/complications/*diagnosis ; Humans ; Hydronephrosis/etiology ; Image Enhancement/methods ; Liver/pathology/radionuclide imaging ; Liver Neoplasms/*diagnosis/secondary ; Magnetic Resonance Imaging ; Male ; Pelvic Neoplasms/*diagnosis/secondary ; Pelvis/pathology/radiography ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed

Giant cell granuloma is an uncommon bony lesion in the head and neck region that most commonly affects the maxilla and mandible. Although it is a benign disease process, it can also be locally destructive. The most common treatment for giant cell granuloma is surgery, ranging from simple curettage to resection. More recently, nonsurgical treatments have been reported. Systemic calcitonin and intralesional glucocorticosteroids have shown varying degrees of success and, when successful, have reduced the necessity for major reconstructive surgery, thus preventing any large surgical defects. We report a case of giant cell granuloma of the maxilla that responded favorably to treatment with surgical excision, followed by intralesional injection of steroid.
Calcitonin ; Curettage ; Follow-Up Studies ; Giant Cells ; Granuloma, Giant Cell ; Head ; Injections, Intralesional ; Mandible ; Maxilla ; Maxillary Sinus ; Neck ; Steroids

Purpose: To investigate the presence of fusion and suppression in patients with unilateral idiopathic epiretinal membrane (ERM). Methods: Thirty-five patients with unilateral idiopathic ERM received a full ophthalmologic exam including best corrected visual acuity (BCVA). Patients were divided into suppression and non-suppression groups according to the results of 4 Prism Dioptre Base-out Test and Worth 4 Dot test. Age, symptoms, duration of ERM, BCVA, average M-chart score, results of Titmus test and optical coherence tomography parameters were compared between the two groups. Factors associated with suppression were also evaluated. Results: Eleven (31%) of 35 patients had suppression. The BCVA (0.18 ± 0.12 vs. 0.29 ± 0.12 p = 0.019) and stereopsis (2.25 ± 0.27 vs. 2.66 ± 0.62, p = 0.009) were significantly lower in the suppression group than the non-suppression group. Median age was older (63.21 ± 9.64 vs. 70.82 ± 6.80, p = 0.013) and duration of ERM (7.86 ± 3.69 vs. 18.54 ± 14.92 months, p = 0.004) was longer in the suppression group than the non-suppression group. Average M-chart score was higher in the suppression group. However, not all the patients suffered from metamorphopsia, including the suppression group when using binocular vision. Conclusions Unilateral suppression is common in unilateral idiopathic ERM and influences the patient’s stereopsis. Suppression was significantly correlated with age, duration of symptoms and metamorphopsia.