Most patients who have spondylolysis dont's need surgical treatment. However, for the patients who have no response to conservative treatment, surgical treatment may be indicated. In 1970, Buck reported the operative technique that the used two screws between the pars defect and lamina followed by bone graft. In patients who have spondyloysis, pain in the back seems to be due to instability and irritation of nerve root by the abnormal motion of the loose neural arch and granulation tissue. For period of 7 years from May, 1984 to March, 1991, twelve patients with spondyloysis who had no response to conservative treatment were treated with Buck's operation and were analyzed. Following results were obtained: 1. The age of the patients was 24 years in average ranging from 14 to 40 years. 2. The level of the lesion was L5 in 10 cases, L4 in 2 cases. 3. Preoperative clinical feature included low back pain in 12 cases, refered pain in 2 cases. 4. Clinical sympotoms were improved in 83%, and the follow up result of the operation: excellent 16.7%, good 66.6% and poor 16.7%.
Follow-Up Studies ; Granulation Tissue ; Humans ; Low Back Pain ; Spondylolysis ; Transplants

Ectopic pancreas is commonly located at stomach, duodenum and jejunum. It is a relatively rare entity and is usually of no clinical importance which especially is a very rare source of massive upper gastrointestinal bleeding. We have recently experienced a case of an ectopic pancreas in the second portion of the duodenum which was proven to be a source of massive gastrointestinal bleeding by duodenoscopy and was confirmed by surgical exploration.
Duodenoscopy ; Duodenum* ; Esophagus* ; Hemorrhage* ; Intestines* ; Jejunum ; Pancreas* ; Stomach*

Solitary fibrous tumors (SFTs) are rare mesenchymal tumors mainly originating in the pleura. Since complete resection is the most important prognostic factor, typical surgical approach has been open laparotomy. In this report, we present a unusual case of large retropancreatic SFT that was successfully treated via laparoscopic resection. A 22-year-old female was diagnosed with a 8×7 cm-sized well-demarcated mass with multiple loculating and enhancing solid portions on the left adrenal fossa. The mass showed no definite invasion of adjacent organs and laparoscopic resection was planned. Using blunt dissection and individual vessel ligation, the operation was successful. The operative time was 220 minutes, and the amount of intraoperative blood loss was estimated to be within 100 ml. The patient recovered without complications. Laparoscopic excision of large retroperitoneal SFTs can be safe and feasible if there is no evidence of local invasion or malignancy on preoperative radiologic images.
Female ; Humans ; Laparotomy ; Ligation ; Minimally Invasive Surgical Procedures ; Operative Time ; Pleura ; Retroperitoneal Neoplasms ; Solitary Fibrous Tumors* ; Young Adult

No abstract available.

No abstract available.

BACKGROUND: The p16INK4a (p16) tumor suppressor gene is frequently inactivated in human non-small cell lung cancers (NSCLCs), predominantly through homozygous deletion or in association with aberrant promotor hypermethylation. Death-associated protein kinase (DAPK) gene influences interferon γ-induced apoptotic cell death and has important role in metastasis of lung cancer in animal model. Hypermethylation of promoter region of DAP kinase gene may suppress the expression of this gene. METHODS: This study was performed to investigate the aberrant methylation of p16 or DAP kinase in 35 resected primary NSCLCs by methylation-specific PCR (MSP), and demonstrated frequency, diagnostic value and clinical implication of aberrant methylation of two genes. RESULTS: Thirty-two cases were male patients, and 3 cases were female patients with an average age was 57.8±10.5 years. The histologic types of lung cancer were 22 of squamous cell carcinoma, 12 of adenocarcinoma, 1 of large cell carcinoma. Pathologic stages were 11 cases of stage I(1 IA,10 IB), 13 cases of stage II (1 IIA, 12 IIB), and 11 cases of stage III(9 IIIA, 2 IIIB). Regarding for the cancer tissue, p16 aberrant methylation was noted in 13 case of 33 cases (39.4%), DAP kinase in 21 cases of 35 cases (60%). Age over 55 year was associated with p16 aberrant methylation significantly (p<0.05). Methylation status of two genes was not different by smoking history, histologic type, size of tumor, lymph node metastasis and disease progression of lung cancer. There was no correlation between p16 and DAP kinase hypermethylation. CONCLUSION: This investigation demonstrates that aberrant methylation of p16 tumor suppressor gene or DAP kinase showed relatively high frequency (74.3%) in NSCLCs, and that these genes could be a biologic marker for early detection of lung cancer.
Adenocarcinoma ; Biomarkers ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Cell Death ; Death-Associated Protein Kinases ; Disease Progression ; DNA Methylation ; Female ; Genes, Tumor Suppressor* ; Humans ; Interferons ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Male ; Methylation* ; Models, Animal ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Protein Kinases* ; Smoke ; Smoking

Sacrococcygeal teratoma is a rare tumor, it occurs once in every 40,000 live births. Most of the reported cases appear in female infant (M:F=1:4). They deserve clinical attention because they are potentially malignant and are curable if diagnosed and treated early. The patients may have associated congenital anomalies. This patient has spina bifida cystica in lower sacrum. Brief review of related literature is included in the report.
Female ; Humans ; Infant ; Infant, Newborn* ; Live Birth ; Sacrum ; Spina Bifida Cystica* ; Spinal Dysraphism* ; Teratoma*

PURPOSE: To determine the effect of intravitreal bevacizumab injection before panretinal photocoagulation (PRP) in clinically significant macular edema (CSME) patients. METHODS: A total of 91 eyes (70 patients) having severe nonproliferative diabetic retinopathy with CSME requiring PRP were enrolled in the present study; the medical records were retrospectively reviewed and analyzed. The eyes were divided into the regular PRP group (51 eyes) and PRP with preinjection of bevacizumab (1.25 mg) group (combination group, 40 eyes) and compared. Best corrected visual acuity (BCVA) and central macular thickness (CMT) at pretreatment and 1, 3, 6, and 12 months after PRP was evaluated. RESULTS: BCVA (logarithm of the minimum angle of resolution, Snellen visual acuity in parentheses) at pretreatment and 1, 3, 6, and 12 months after PRP was 0.24 (0.575), 0.27 (0.537), 0.28 (0.525), 0.28 (0.525), and 0.30 (0.501) (p = 0.13, 0.15, 0.56 and 0.79) in the regular PRP group and 0.32 (0.479), 0.25 (0.562), 0.26 (0.549), 0.27 (0.537), and 0.36 (0.436) (p = 0.02, 0.04, 0.02 and 0.13) in the combination group, respectively. CMT (microm) at pretreatment and 1, 3, 6, and 12 months after PRP was 257.66, 285.16, 282.21, 289.65, and 309.85 (p = 0.00, 0.00, 0.00 and 0.00) in the regular PRP group and 349.39, 312.17, 331.15. 353.30, and 333.55 (p = 0.04, 0.94, 0.79 and 0.06) in the combination group, respectively. CONCLUSIONS: Pretreatment of anti-vascular endothelial growth factor injection before PRP affected the decrease of macular thickness for 3 months after PRP and improved visual acuity for 6 months after PRP when compared with PRP alone in patients with CSME.
Diabetic Retinopathy ; Endothelial Growth Factors ; Humans ; Light Coagulation* ; Macular Edema* ; Medical Records ; Retrospective Studies ; Visual Acuity ; Bevacizumab

PURPOSE: Polyarteritis nodosa (PAN) is the necrotic vasculitis affecting middle and small-sized arteries throughout the body including ocular tissue. We report an atypical PAN case of unilateral central retinal artery occlusion in which the ocular involvement occurred before systemic symptoms. CASE SUMMARY: A 58-year-old male visited the ophthalmology department due to abruptly decreased visual acuity. Best corrected visual acuity (BCVA) was 0.05 (in the right eye) and 1.0 (in the left eye) basedon the Snellen chart. He complained of acute decreased vision occurring ten days prior and intermittent migraine on the right side with no underlying diseases, such as hypertension or diabetes mellitus. Relative afferent pupillary defect was observed in the right eye. Generalized edema was found around the optic disc and fovea on fundus examination and optical coherence tomography. The patient was diagnosed with central retinal artery occlusion (CRAO) based on a fluorescein angiography. Subsequently, PAN was diagnosed based on clinical features, laboratory test results and imaging studies. The treatment was started with an immunosuppressive agent. One month later, the BCVA was 0.05 based on the Snellen chart. CONCLUSIONS: In PAN patients, decreased vision can occur as a first symptom due to CRAO. If the patient visits the ophthalmology clinic, history taking and laboratory tests for PAN can aid in early diagnosis and treatment, as well as preventing additional complications of PAN.
Arteries ; Diabetes Mellitus ; Early Diagnosis ; Edema ; Fluorescein Angiography ; Humans ; Hypertension ; Male ; Middle Aged ; Migraine Disorders ; Ophthalmology ; Polyarteritis Nodosa* ; Pupil Disorders ; Retinal Artery Occlusion ; Tomography, Optical Coherence ; Vasculitis ; Visual Acuity

Subacute thyroiditis is a frequent benign thyroid disease associated with previous viral upper respiratory tract infection. Known complications of this disease are long-standing subclinical hypothyroidism, persistent anterior neck pain and rarely Graves disease. In general, thyroid abscess is an uncommon disease because of anatomic isolation of the gland and its rich system of drainage for blood and lymph. Especially, development of thyroid abscess in subacute thyroiditis is extremely rare phenomenan, but significant bad outcomes can be resulted. Its clinical BACKGROUND containes immune-suppressed state, anatomic defect, presence of underlying other thyroid disease and of non-thyroidal infectious foci. We experienced a case of subacute thyroiditis complicated with streptococcal thyroid abscess during glucocorticoid therapy. The patient was a 19-year-old female who was admitted due to anterior neck pain for 1 month. Typical subacute thyroiditis was suggested from initial laboratory findings including CBC, erythrocyte sedimentation rate, serum T3, T4, TSH levels, thyroid scan & thyroid uptake. But during oral prednisolone therapy, unexpected bacterial thyroid abscess was developed. We report this unusual case with review of literatures.
Abscess ; Blood Sedimentation ; Drainage ; Female ; Graves Disease ; Humans ; Hypothyroidism ; Neck Pain ; Prednisolone ; Respiratory Tract Infections ; Thyroid Diseases ; Thyroid Gland* ; Thyroiditis, Subacute* ; Young Adult