No abstract available.
Cervix Uteri* ; Female

To maintain an adequate airway in a patient with tracheobronchial narrowing coming from various causes, prosthetic tracheobronchial stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. After insertion, precious reported complications were granuloma formation, dysphagia, suction catheter entrapment and fatal massive hemoptysis. We report a case of complication associated with expandible metallic scent with endobronchial stenosis due to tuberculosis.
Catheters ; Constriction, Pathologic* ; Deglutition Disorders ; Granuloma ; Hemoptysis ; Humans ; Palliative Care ; Stents* ; Suction ; Tuberculosis

The treatment of massive bone and soft tissue defect in the lower leg has a high complication rate of nonunion, chronic infection, and amputation without well-vascularized tissue coverage of the open fracture. Despite adequate free soft tissue coverage, massive skeletal defect may result in segmental bone defects, angulation deformity, and limb length discrepancies. In the last decade, major advances have occurred in the Ilizarov method of distraction osteogenesis in lower leg salvage as a delayed procedure or simultaneous distraction after free-tissue transfer. The authors have performed Ilizarov transport in conjunction with muscle and musculocutaneous flap coverage in nine cases of lower leg salvage. The flaps consist of rectus, gracilis, latissimus dorsi, parascapular, and serratus muscle or musculocutaneous fashioning using ipsilateral or contralateral pedicle in consideration of vessel condiation. Revision, recorticotomy and flap elevation were also used as a secondary procedure for satisfactory results. The conclusions, were as follows: 1) Multidisciplinary team approach with conjoining departments at the time of preoperative evaluation, postoperative care and rehabilitation care; 2) Muscle flap covered with split-thickness skin graft was preferred to musculocutaneous flap; 3) To reduce the total reconstructive period, simultaneous free tissue transfer with Ilizarov distraction should be considered.
Amputation ; Congenital Abnormalities ; Extremities ; Fractures, Open ; Ilizarov Technique ; Leg* ; Myocutaneous Flap ; Osteogenesis* ; Osteogenesis, Distraction ; Postoperative Care ; Rehabilitation ; Skin ; Superficial Back Muscles ; Transplants

Symptomatic diffuse idiopathic skeletal hyperostosis (DISH) is not common. Gelfoam is one of the most commonly used topical hemostatic agents. But, in the partially moistened state, air retained in its pores may result in excessive expansion on contact with liquid. The onset of swallowing difficulty after anterior cervical spine surgery due to appling gelfoam is a rare complication. A 77-year-old man with swallowing difficulty was admitted to our hospital and we diagnosed him as DISH confirmed by radiological study. After removing the DISH, patient's symptom was relieved gradually. However, on postoperative day (POD) 7, the symptom recurred but lesser than the preoperative state. We confirmed no hematoma and esophageal perforation on the operation site. We observed him closely and controlled the diet. Three months later, he had no symptom of swallowing difficulty, and was able to be back on a regular diet, including solid foods. We present a complication case of swallowing difficulty occurring by gelfoam application.
Deglutition ; Diet ; Esophageal Perforation ; Gelatin Sponge, Absorbable ; Hematoma ; Hyperostosis, Diffuse Idiopathic Skeletal ; Spine

Human papillomavirus(HPV) has implicated in the development of cervical cancer. Several studies has suggested a strong correlation between HPV 16, 18 and cervical intraepithelial neoplasia(CIN). For detecting and typing HPV DNA in cervical tissues, recently the chemiluminescent molecular hybridization assay method has been widely used. This study was performed to determine the usefulness of hybrid capture assay for detecting high-risk HPV in cervical epithelial cells, and to compare the correlation among cervical cytology, biopsy finding and HPV infection, and to determine whether the addition of the hybrid capture assay to cytologic test would improve the ability to identify significant lesions. This study included 267 patients who visited the colposcopic clinic of the department of obstetrics and gynecology, Chonbuk University Hospital from May, 1997 to October 199S. Pap smears hybrid capture assays, and colposcopically directed biopsy were performed concurrently on al1 women. The results obtained were as follow; l. Using hybrid capture assay, the detection rate of high-risk HPV of all patients was 37.1%(99/267). There was no statistical significance in the detection rate of HPV between the age groups. 2. The false negative rate of Pap Smear was 53.3% and showed significant discrepancies between the cytologic and histologic diagnosis. 3. According to the cytologic diagnosis, the detection rates of high-risk HPV were 7.1% in normal, 25.3% in ASCUS or LSIL, and 61.6% in HSIL. In each cytologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 4. According to the histologic diagnosis, the detection rates of high-risk HPV were 0.1% in normal, 11.1% in CIN I, and 72.7% in CIN II or CIN III. In each histologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 5. According to the comparison of histologic diagnosis between positive and negative results of high-risk HPV test due to each cytology, there was no statistical significance in the incidence rate of cervical neoplasia, Above results suggest that high-risk HPV test using hybrid capture assay may be a useful method in supplement the pitfalls of cervical cytology. This test might also have prognostic value in the management of patients with CIN.
Biopsy ; Diagnosis ; DNA ; Epithelial Cells* ; Female ; Gynecology ; Human papillomavirus 16 ; Human Papillomavirus DNA Tests* ; Humans ; Incidence ; Jeollabuk-do ; Obstetrics ; Uterine Cervical Neoplasms

OBJECTIVE: Unilateral percutaneous vertebroplasty is a widely accepted treatment for osteoporotic vertebral compression fractures (VCFs). However, bone cement may fail to fill both hemivertebra from the single needle. We assessed the radiographic and clinical outcome of hemivertebroplasty (HVP) and evaluated the factors that affect subsequent VCFs after HVP. METHODS: Fifty two patients who underwent HVP were reviewed. VCFs were identified based on clinical and radiological findings. The patients were grouped into two groups: 1) no subsequent VCFs, 2) subsequent VCFs. We evaluated the association between age, sex, body mass index (BMI) and bone mineral density (BMD) and subsequent VCFs. We also assessed the impact of location, type and grade of fracture, endplate fracture, burst fracture, bone cement volume on subsequent VCFs. We analyzed the compression ratio, wedge angle, kyphotic angle, and visual analogue scale (VAS) score in both groups. RESULTS: There were no significant differences in age, gender, BMI, and BMD between two groups. No significant difference was also found in pre-existing VCF, location, type and grading of fracture, endplate fracture, burst fracture, amount of bone cement, and radiological findings such as compression ratio, wedge angle, and kyphotic angle between two groups. The final mean VAS scores of patients with or without subsequent VCFs were 3.11 and 4.02, respectively. CONCLUSION: No major risk factors for the subsequent VCFs after HVP were found. However, we identified adjacent fractures, refractures, and remote fractures after HVP in chronological order. Therefore, long-term follow-up is necessary to evaluate the effectiveness of HVP to osteoporotic VCFs.
Body Mass Index ; Bone Density ; Follow-Up Studies ; Fractures, Bone ; Fractures, Compression ; Humans ; Needles ; Osteoporotic Fractures ; Risk Factors ; Vertebroplasty

No abstract available.
Endometrial Neoplasms* ; Female

urpose: Misonidazole is a radiosensitizer that binds in hypoxic cells. The purpose of this study was to find out the feasibility of I-131-Iodomisonidazole (IMISO) for imaging of tumor hypoxia. MATERIALS AND METHODS: Tosyl precursor was dissolved in acetonitrile and I-131-NaI was added to synthesize IMISO. Balb/c mice inoculated with CT-26 adenocarcinoma were injected with IMISO. Mice were sacrificed at 1,2,4,24 hr and % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy and MRI, mouse bearing CT-26 adenocarcinoma was administered with IMISO and imaging was performed 4 hr after. Then, mouse body was fixed and microtomized slice was placed on radiographic film for autoradiography. RESULTS: %ID/g of tumor was 1.64 (1h), 0.98 (2h), 0.85 (4h) and 0.20 (24h), respectively. At 24h, %ID/g of tumor was higher than that of all other tissues except thyroid. Tumor to muscle ratio increased with time and tumor to blood ratio also increased with time and reached 1.53 at 24 hr. On autoradiogram, tumor was well visualized as an increased activity in central hypoxic area of the tumor which corresponds to the area of high signal intensity on T2-weighted MR image. On scintigraphy, tumor uptake was visualized. CONCLUSION:: This RESULTS suggest that IMISO may have a potential for tumor hypoxia imaging in mouse model. However, further study is needed to improve it's localization in tumor tissue and to achieve acceptable images of tumor hypoxia.
Adenocarcinoma* ; Animals ; Anoxia* ; Autoradiography ; Magnetic Resonance Imaging ; Mice* ; Misonidazole ; Radionuclide Imaging ; Thyroid Gland ; X-Ray Film

Lymphangioleiomyomatosis(LAM) is defined as an abnormal proliferation of smooth muscles in the lung tissue throughout lymphatics, vascular and bronchial structure. A 52-year-old postmenopausal woman was admitted to our hospital for recurrent pneumothorax. She was treated for medroxyprogesterone by LAM 1 month ago. We performed operation of pulmonary partial resection and pleurodesis. The patient is receiving continuous medroxyprogesterone and Leuplin administration, and currently, 6 months after the operation, is still showing good results.
Female ; Humans ; Lung ; Lung Neoplasms ; Lymphangioleiomyomatosis* ; Lymphangioma ; Medroxyprogesterone ; Middle Aged ; Muscle, Smooth ; Pleurodesis ; Pneumothorax*

OBJECTIVE: Decompressive laminectomy is one of the most commonly used surgical methods for the treatment of spinal stenosis. We retrospectively examined the risk factors that induce spinal instability, including slippage (spondylolisthesis) and/or segmental angulation after decompressive laminectomy on the lumbar spine. METHODS: From January 1, 2006 to June 30, 2010, 94 consecutive patients underwent first-time single level decompressive laminectomy without fusion and discectomy. Of these 94 patients, 42 with a follow-up period of at least 2 years were selected. We measured the segmental angulation and slippage in flexion and extension dynamic lumbar radiographs. We analyzed the following contributing factors to spinal instability: age/sex, smoking history, disc space narrowing, body mass index (kg/m2), facet joint tropism, effect of the lordotic angle on lumbar spine, asymmetrical paraspinal muscle volume, and surgical method and level. RESULTS: Female patients, normal lordotic angle, and asymmetrical paraspinal muscle volume were factors more significantly associated with spondylolisthesis (p-value=0.026, 0.015, <0.01). Statistical results indicated that patients with facet tropism were more likely to have segmental angulation (p-value=0.046). Facet tropism and asymmetry of paraspinal muscle volume were predisposing factors to spinal instability (p-value=0.012, <0.01). CONCLUSION: Facet joint tropism and asymmetry of paraspinal muscle volume are the most important factors associated with spinal instability; therefore, careful follow-up after decompressive laminectomy in affected patients is necessary.
Body Mass Index ; Causality ; Decompression* ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Laminectomy ; Muscles ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Spinal Stenosis* ; Spine ; Spondylolisthesis ; Tropism ; Zygapophyseal Joint