Stabilization of the unstable spine created by the posterior decompression is as important as the decompression itself in the treatment of spinal stenosis. The purpose of this study is to evaluate the effectiveness of C-D pedicle screw fixation in stabilization after lumbar decompression, in reduction of spondylolisthesis and in restoration of the lumbar sagittal curvature. C-D pedicle screw fixation was performed in 102 spinal stenosis patients after posterior lumbar decompression and fusion during the period from March 1987 to December 1988. Their age ranged from 15 to 72 years with an average of 49.1 years. There were 34 males and 68 females. The follow up was from 6 to 21 months with an average of 12.5 months. The causes of spinal stenosis were degenerative in 50 patients, spondylolisthesis in 39, iatrogenic in 9 and degenerative lumbar scoliosis in 4. Objective clinical results showed significant improvement of claudication, SLR limitation, motor weakness, sensory and DTR changes in most patients. Following results were obtained from the study of C-D pedicle screw fixation after posterior decompression in lumbar spinal stenosis.1. C-D pedicle screws provide the secure fixation that allows early ambulation and shorter hospital stay. 2. C-D pedicle screws enable the reduction of spodylolisthesis at the time of posterior stabilization. 3. C-D pedicle screw fixation is successful in the restoration and maintenance of sagittal curvature of the lumbar spine. 4. C-D pedicle screw fixation enables the correction of scoliosis at the time of posterior decompression.
Decompression ; Early Ambulation ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Pedicle Screws ; Scoliosis ; Spinal Stenosis ; Spine ; Spondylolisthesis

No abstract available.
Down Syndrome* ; Myeloproliferative Disorders*

No abstract available.
Tuberculosis, Miliary*

No abstract available.
Scoliosis* ; Syringomyelia*

Bacterial keratitis is a common ophthalmic disease. In certain cases of pseudomonas keratitis, the corneal perforation may occur within 24-48 hours of the onset. Soa suitable, massive antibiotic should be promptly used in these cases. Intensive topical therapy with fortified aminoglycoside antibiotics is a current mainstay in the treatment of bacterial keratitis because insufficient antibiotic concentrations may not inhibit bacterial growth. In 1985, Glasser and associates reported the effect of longer dosing intervals on corneal gentamicin levels with using topical fortified gentamicin solutions in rabbits. We compared peak and trough antibiotic levels achieved in the rabbit cornea by various topical administrations of tobramycin which was prepared in a concentration of 13.6mg/ml by fortifying commercially available ophthalmic tobramycin solution with injectable drug. A loading dose consists of one drop given every minute for five minutes. 1. Eyes receiving one drop every hour(Group 1) and three drops every two hours(Group 5) showed little conjunctival hyperemia. Eyes given one drop every 30 minutes(Group 2) developed minimal inflammatory responses, as did eyes given a single loading dose followed by one drop each hour(Group 4). The moderate inflammatory response occurred in eyes receiving sequential loading doses(Group 3). Abnormalities in the cornea and the iris were not seen in all studied groups. 2. Gentamicin peak level in sequential loading doses group(Group 3) was significantly higher than those achieved by one drop every hour(Group 1) or one drop every 30 minutes(Group 2). At two hours of gentamicin administration, sequential loading doses(Group 3) produced remarkably high concentrations: than those produced in Group 1, Group 2, or three drops every two hours(Group 5). During the first four hours, Group 3 represented high antibiotic levels than those produced in Group 1, Group 2, Group 5, or a single loading dose followed by one drop each hour(Group 4). There were no significant differences between trough levels with on drop every hour(Group 1) and three drops every two hours(Group 5).
Administration, Topical* ; Anti-Bacterial Agents ; Cornea ; Corneal Perforation ; Gentamicins ; Hyperemia ; Iris ; Keratitis ; Pseudomonas ; Rabbits* ; Tobramycin*

Hemangiopericytoma is a rare vascular tumor derived from the pericyte and usually occures in the lower extremities and the retroperitoneum. Complete excision is treatment of choice. Regular follow up is strongly recommended due to its potential malignancy which is recurrence and metastasis. We experienced surgical excision of metastatic pulmonary hemangiopericytoma from retroperitoneal hemangiopericytoma completely excised 10 years ago.
Hemangiopericytoma* ; Lower Extremity ; Lung Neoplasms ; Neoplasm Metastasis ; Pericytes ; Recurrence

BACKGROUND: Complete surgical resection is the most effective treatment for stage IB non-small cell lung cancer (NSCLC). Recurrence accounts for the disappointing survival rates after resection. There has been renewed interest in adjuvant therapy after complete resection. Appropriate selection of effective adjuvant therapy will depend on the prognostic factors for recurrence. MATERIAL AND METHOD: The study included 114 patients with completely resected stage IB NSCLC. The variables selected for the study were gender, age, the type of resection, cell type, the degree of differentiation, the tumor size and the presence of visceral pleura invasion. The Kaplan-Meier method was used to estimate the survival and disease-free survival rate. The results were compared using the log rank test. Multivariate analysis was performed by Cox's proportional hazard model. Two-sided p-valves <0.05 were considered to be statistically significant. RESULT: The 3-year overall survival and the disease-free survival rates were 87.0% and 79.4%, respectively. The degree of differentiation showed a significant influence on disease-free survival according to the univariate analysis. According to the multivariate analysis, a poor grade of differentiation was a significant poor prognostic factor. CONCLUSION: These results demonstrate that poor differentiation may be a poor prognostic factor for patients with completely resected IB NSCLC. Therefore, the patients with a poor grade of differentiation may require adjuvant therapies.
Carcinoma, Non-Small-Cell Lung* ; Disease-Free Survival ; Humans ; Lung ; Multivariate Analysis ; Neoplasm Staging ; Pleura ; Proportional Hazards Models ; Recurrence* ; Risk Factors* ; Survival Rate

BACKGROUND: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. MATERIAL AND METHOD: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. RESULT: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. CONCLUSION: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.
Diaphragm ; Emergencies ; Hospital Mortality ; Humans ; Hypotension ; Intubation ; Multiple Trauma ; Postoperative Complications ; Prognosis ; Rupture ; Vital Signs

BACKGROUND: It is doubtful that aging causes deteriorated glucose metabolism and insulin resistance of skeletal muscle. Some researchers had different results about it. So we have studied the mechanism responsible for the abnormal glucose tolerance associated with aging in rapidly growing and matured rats. MATERIALS AND METHODS: Animals were used S.D. rats. Growing rats were 7 weeks old (BW: 160-190 gm) and matured rats were 28 weeks old (BW: 420-525 gm). RESULTS: Fasting blood glucose and plasma insulin levels were significantly elevated in matured rat compared with growing rats. And during oral glucose tolerance test the glucose level was also significantly elevated in matured rats. These results confirmed an insulin resistant state of aging. Insulin levels at 30 minutes of oral glucose tolerance test was significantly elevated in growing rat. But at 120 minutes it was maintained at higher level in matured rats than in growing rats. It suggested the possibility of increased insulin secretion by initial stimulation of beta-cells in growing rats, and increased secretion and decreased catabolic rate of insulin in matured rats. Glucose uptake rate of soleus muscle in matured rats was lower than that of growing rats, but the difference was not statistically significant. The dose(insulin)- responsive (glucose uptake) curve of soleus muscle was only slightly deviated to the right side. CONCLUSION: Glucose metabolism of rat skeletal muscle was worsened by aging. The data of glucose uptake experiments suggested the possibility of insulin resistance of skeletal muscle in matured rats, but the mechanism of insulin resistance of skeletal muscle need further studies.
Aging ; Animals ; Blood Glucose ; Fasting ; Glucose Tolerance Test ; Glucose* ; Insulin ; Insulin Resistance ; Metabolism* ; Muscle, Skeletal* ; Plasma ; Rats*

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections