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

To evaluate the several clinicopathological factors and the expression of P-glycoprotein that influence the survival rate of the patients with colorectal cancer, 168 patients with colonic adenocarcinoma, who were operated in Wonkwang University Hospital from January, 1982 to July 1992 were reviewed. The staging of the tumors were performed according to Astler Coller modification of Dukes classification of colon carcinoma. Immunohistochemical staining for P-glycoprotein test was performed with the specimen of Dukes B2 and C of patient who were received postoperative chemotherapy(ACNU+5FU intravenously or oral 5FU) and/or immunotherapy(PSK or OK-432) over 4 months. P-glycoprotein positive was defined when the tumor cells more than 20% showed red dot in the cytoplasm. Statistical analyses were carried out using SPSS for windows and cumulative survival rate was calculated using the Kaplan-Meier method. 1) Age: under 60 years(n=76) 80.2%, over 60 years(n=61) 72.8%(P>0.05). 2) Sex: male (n=67) 83.2%, female(n=70) 70.7%(P>0.05). 3) The duration of symptoms: under 3 months(n=67) 74.9%, over 3 months(n=70) 79.0% (P>0.05). 4) The location of tumor: left colon(n=45) 85.7%, right colon(n=33) 75.5%, rectum(n=59) 71.7%(P>0.05). 5) The histologic types: well differentiated(n=116) 77.0%, poor differentiated(n=21) 76.2%(P>0.05%). 6) Lymph node metastasis: negative nodes(n=98) 82.7%, positive nodes(n=39) 62.2%(P<0.05). 7) Depth of invasion: below muscular layer(n=29) 82.1%, over subserosal layer(n=108) 75.7% (P>0.05). 8) Chemotherapy +/- Immunotherapy: In stsge B2, receiving group(n=47) 82.6%, not receiving group(n=17) 74.3%(P>0.05). In stage C, receiving group(n=27) 65.8%, not receiving group (n=11) 53%(P>0.05). 9) P-glycoprotein: In stage B2 and C1, positive expression(n=15) 66.7%, negative expression (n=26) 84.6%(P>0.05). Multivariate analysis indicated that the positive lymph node was independendently correlated with survival. We think that the prognosis of colonic adenocarcinoma are related with lymph node metastasis and the further prospective study are needed for evaluation of the relationship between the prognosis and p-glycoprotein expression.
Adenocarcinoma ; Classification ; Colon ; Colorectal Neoplasms ; Cytoplasm ; Drug Therapy ; Humans ; Immunotherapy ; Lymph Nodes ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; P-Glycoprotein ; Prognosis* ; Survival Rate

Prune belly syndrome is a rare anomaly complex associated with absence of abdominal muscle combined with urinary tract abnormalities. We have encountered stillbirth female with severely distended abdomen without external genitalia end anus who was Finally confirmed as prune belly syndrome by an autopsy. Herein we report a case with review of literature.
Abdomen ; Abdominal Muscles ; Anal Canal ; Autopsy ; Female ; Genitalia ; Humans ; Prune Belly Syndrome* ; Stillbirth ; Urinary Tract

We experienced a case of transureteroureterostomy in a single kidney with multiple distal ureteral strictures. The patient had received nephrectomy due to staghorn calculi 14 years ago. We have utilized the abandoned ureter from the transureteroureterostomy with stenting. We have confirmed good drainage through the anastomosed ureter by radiological imaging. No other complications were observed except Pseudomonas urinary tract infection. Thereby we report this unique procedure of transureteroureterostomy using the 14-year-age abandoned ureter.
Calculi ; Constriction, Pathologic ; Drainage ; Humans ; Kidney ; Nephrectomy ; Pseudomonas ; Stents ; Ureter ; Urinary Tract Infections

BACKGROUND: Niacin supplementation improves dyslipidemia and lowers serum phosphorus levels in patients with chronic kidney disease (CKD). We evaluated whether low-dose niacin supplementation can improve dyslipidemia, lower serum phosphorus levels, and be administered with a low frequency of adverse effects in patients with CKD. METHODS: We retrospectively analyzed the clinical records of patients with CKD who had taken niacin from January 2009 to June 2011. We excluded patients with CKD stage 1 and 5. We then enrolled 31 patients with CKD who had taken niacin at a fixed dose of 500mg/day for 6 months. We also randomly selected 30 patients with CKD who had been taking statin for 9 months as a control group. RESULTS: Among the 34 patients with CKD who were prescribed niacin, five (14%) complained of adverse effects, and three (8%) discontinued niacin. The proportion of patients in the niacin group who had been taking a statin or omega-3 fatty acids was 67.7% and 48.8%, respectively. In the niacin group, high-density lipoprotein cholesterol level was significantly increased and triglyceride level was significantly decreased at 12 and 24 weeks compared with baseline levels (P < 0.05). In the niacin group, phosphorous level (P < 0.05) was significantly decreased, and glomerular filtration rate (GFR) was significantly increased (P < 0.05) at 24 weeks compared with baseline values. CONCLUSION: Low-dose niacin had a low frequency of adverse effects and also improved dyslipidemia, lowered serum phosphorus level, and increased GFR in patients with CKD. Further studies are needed to evaluate the long-term effects of low-dose niacin for renal progression of CKD.
Cholesterol ; Dyslipidemias ; Fatty Acids, Omega-3 ; Glomerular Filtration Rate ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipoproteins ; Niacin ; Phosphorus ; Renal Insufficiency, Chronic ; Retrospective Studies

BACKGROUND: Niacin supplementation improves dyslipidemia and lowers serum phosphorus levels in patients with chronic kidney disease (CKD). We evaluated whether low-dose niacin supplementation can improve dyslipidemia, lower serum phosphorus levels, and be administered with a low frequency of adverse effects in patients with CKD. METHODS: We retrospectively analyzed the clinical records of patients with CKD who had taken niacin from January 2009 to June 2011. We excluded patients with CKD stage 1 and 5. We then enrolled 31 patients with CKD who had taken niacin at a fixed dose of 500mg/day for 6 months. We also randomly selected 30 patients with CKD who had been taking statin for 9 months as a control group. RESULTS: Among the 34 patients with CKD who were prescribed niacin, five (14%) complained of adverse effects, and three (8%) discontinued niacin. The proportion of patients in the niacin group who had been taking a statin or omega-3 fatty acids was 67.7% and 48.8%, respectively. In the niacin group, high-density lipoprotein cholesterol level was significantly increased and triglyceride level was significantly decreased at 12 and 24 weeks compared with baseline levels (P < 0.05). In the niacin group, phosphorous level (P < 0.05) was significantly decreased, and glomerular filtration rate (GFR) was significantly increased (P < 0.05) at 24 weeks compared with baseline values. CONCLUSION: Low-dose niacin had a low frequency of adverse effects and also improved dyslipidemia, lowered serum phosphorus level, and increased GFR in patients with CKD. Further studies are needed to evaluate the long-term effects of low-dose niacin for renal progression of CKD.
Cholesterol ; Dyslipidemias ; Fatty Acids, Omega-3 ; Glomerular Filtration Rate ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipoproteins ; Niacin ; Phosphorus ; Renal Insufficiency, Chronic ; Retrospective Studies

We report on a 64-year-old man with leptomeningeal metastasis (LM) from an epidermal growth factor receptor (EGFR)-mutated adenocarcinoma of the lung. He was treated with paclitaxel, cisplatin. After completion of chemotherapy, he complained of headache, nausea, and vomiting. EGFR-mutated tumor cells were identified from the cerebrospinal fluid (CSF). Second-line therapy with gefitinib, methotrexate was started. After receiving gefitinib for 4 weeks, he had no more headaches or vomiting. Eleven months after initiation of gefitinib, he developed headache and nausea. Chest computed tomography showed aggravation of bone metastasis. Third-line therapy was started with gemcitabine and carboplatin. Two weeks later, he experienced disorientation. After a fourth relapse within the central nervous system, the therapy was switched to erlotinib and significant improvement of LM was achieved. This case shows that LM can be diagnosed by detecting EGFR mutation in CSF and EGFR tyrosine kinase inhibitors are effective for LM from EGFR mutant non-small cell lung cancer.
Adenocarcinoma ; Carboplatin ; Carcinoma, Non-Small-Cell Lung ; Central Nervous System ; Cerebrospinal Fluid ; Cisplatin ; Drug Therapy ; Epidermal Growth Factor* ; Erlotinib Hydrochloride ; Headache ; Humans ; Lung Neoplasms* ; Lung* ; Methotrexate ; Middle Aged ; Nausea ; Neoplasm Metastasis* ; Paclitaxel ; Phosphotransferases* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor* ; Recurrence ; Thorax ; Vomiting

BACKGROUND: Catheter-related exit site infection is a major risk factor for the development of peritonitis and can contribute to failure of treatment maintenance in peritoneal dialysis (PD) patients. Although povidone-iodine can be used for exit site care, the irritation induced by the local application of povidone-iodine could lead to secondary infection. Therefore, we evaluated the clinical effectiveness of normal saline compared with povidone-iodine as a method of exit site care in chronic PD patients. METHODS: In all, 126 patients undergoing PD treatment for>46 months between January 2006 and December 2009 were enrolled. Data were retrospectively analyzed for the incidence of exit site infection and peritonitis for 2 years prior to and after December 2007. In addition, we identified the incidences of catheter- related infections during follow-ups from January 2010 to December 2013. RESULTS: The participants' mean age was 58.87+/-12.9 years. The incidences of exit site infection and peritonitis were one episode per 64.6 patients-months and one episode per 40.4 patients-months in the povidone-iodine group, respectively, whereas these were one episode per 57.5 patients-months and one episode per 45.6 patients-months in the normal saline group, respectively. Whereas Gram-positive bacteria most frequently caused catheter-related infections in both groups, culture-negative infections were dominant in the normal saline group. CONCLUSION: Exit site care using normal saline did not increase the incidence of exit site infection and peritonitis. Therefore, normal saline may be an alternative treatment for exit site care in patients receiving PD.
Catheter-Related Infections ; Coinfection ; Follow-Up Studies ; Gram-Positive Bacteria ; Humans ; Incidence* ; Peritoneal Dialysis* ; Peritonitis* ; Povidone-Iodine* ; Retrospective Studies ; Risk Factors

Anaplastic lymphoma kinase (ALK) rearrangement, is a kind of driver mutation, accounts for 3%-5% of non-small cell lung cancer (NSCLC). NSCLC patients harboring ALK fusion genes have distinct clinical features and good response to ALK inhibitors. Metastasis from lung cancer to the ovary has rarely been known. We report a case of a 54-year-old woman with bilateral ovarian metastases from ALK rearranged NSCLC. She underwent bilateral salpingo-oophorectomy for ovary masses, which were progressed after cytotoxic chemotherapy although primary lung mass was decreased. Histopathological examination of the ovary tumor showed characteristic adenocarcinoma patterns of the lung and ALK rearrangement.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Female ; Humans ; Lung ; Lung Neoplasms ; Lymphoma ; Middle Aged ; Neoplasm Metastasis* ; Ovary ; Phosphotransferases

A series of 61 cases of primary hemifacial spasm have been evaluated by means of blink reflex and needle electromyography and their result compared with unaffected site. The R1 and R2 response and late acti-ity. After activity in blink reflex. And electrical activity in EMG at rest were observed. The results of study were as in the followings: 1) The arnplitude of large R1 and R2 responses were increased in affected side in contrast to unaffected side. 2) late activity(72.2%) and after activity(83.6%) were observed in only affected side at rela-ti-ely Iong duration, as well as regular interval spontaneous repetivive discharges in EMG at rest. This result of large R1 and R2 responses could be compatible with ephaptic ransmission, but late activity, after activity, and spontaneous repetitive MUPs could be explained hyperexcitability of the facial motor nucleus rather than autoexcitation of peripheral facial nerve. Additionally the authors thought that the use of conventional blink reflex as well as specialized blink reflex tests could be very useful for the diagnosis of hemifacial spasm and for the evaluation of it's course.
Blinking* ; Diagnosis ; Electromyography* ; Facial Nerve ; Hemifacial Spasm* ; Needles