DESIGN: A retrospective study was performed in isthmic and degenerative spondylolisthesis patients who had undergone posterolateral fusion (PLF) only (group I) or posterolateral fusion (PLF) with posterior lumbar interbody fusion (PLIF) (group II). OBJECTIVES: The objective of this study was to help in the selection of a surgical treatment option for spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Irrespective of whether group Ior group II, satisfactory results have been reported in the surgical treatment of spondylolisthesis. However, isthmic and degenerative types have not been investigated in terms of outcome. MATERIALS AND METHODS: We analyzed 112 patients (Isthmic: group I(32), group II(22), Degenerative: group I(37), group II(21)) who underwent surgical treatment for spondylolisthesis between April 1995 and December 2000. Kirkaldy-Willis criteria, radiologic union state, reduction ratio of slippage, change of disc space and change of segmental angle were analyzed as indicators of outcome. RESULTS: We found the following by radiologic analysis: In isthmic spondylolisthesis, group IIwas better than group Iin terms of reduction ratio of slippage (reduction loss:3.38% vs. 2.3%, P=0.15), change of segmental angle (reduction loss : 2.11 degrees vs. 1.6degrees, P=0.15), bone union (83% vs. 92%, P=0.45) and change of disc space (reduction loss : 2.83 mm vs. 1.9 mm, P=0.02). In the degen-erative spondylolisthesis, group IIdid not show significant difference from group Iin terms of reduced slippage (reduction loss: 3.8% vs. 3.85%, P=0.47), change of segmental angle (reduction loss: 2.73 degrees vs. 2.64 degrees, P=0.43), bone union (80% vs. 87%, P=0.72) or disc height (reduction loss: 3.2 mm vs. 3.14 mm, P=0.45). In terms of clinical outcome, group II was better than groups Iin cases of isthmic spondylolisthesis (fair < or =:85% vs. 93%, P=0.72), however, groups IIwas not better than groups Iin cases of degenerative spondylolisthesis (fair < or =:83% vs. 85%, P=0.23). CONCLUSIONS: In the degenerative spondylolisthesis patient, no significant difference was found between group Iand group II, but in the isthmic spondylolisthesis patient, group I and group II were found to be significantly different in terms of the reduction ratio of the disc heights.
Humans ; Retrospective Studies ; Spine* ; Spondylolisthesis*

PURPOSE: The purpose of this study is to compare CO2 DSA and nonionic contrast media angiography in respect to the quality of the opacification of collaterals and incidence of side-effects in peripheral occlusive arterial disease. MATERIALS AND METHODS: Sixteen patients who were suspected to have peripheral occlusive arterial disease were performed angiography with nonionic contrast media and CO2 at the same location with the same catheter. The causes of the lesions were atherosclerosis(n=7) and Buerger's disease(n:9). CO2 DSA was compared with nonionic contrast media angiography in respect to the quality of image in the diagnosis of the lesions, opacifications of collaterals and side-effects. RESULTS: In atherosclerosis;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 6 patients and was poor in 1 patient;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 5 patients and was poor in 2 patients. In Buerger's disease;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 2 patients and was poor in 7 patients;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 1 patient and was poor in 8 patients. Leg pain was the only side-effect after CO2 injection occuring in 4 out of 16 patients. CONCLUSION: CO2 could be used as safe contrast media in patient with risk factors for nonionic contrast media and for diagnosis of the atherosclerosis in lower extremity. For the procedures such as vascular intervention reguiring large amount of contrast media CO2 could effectively replace nonionic contrast media.
Angiography* ; Atherosclerosis ; Catheters ; Contrast Media ; Diagnosis ; Humans ; Incidence ; Leg ; Lower Extremity* ; Risk Factors

Endoscopic variceal ligation (EVL) is effective for the management of bleeding esophageal varices, and its use is widespread now. EVL necessitates the use of overtubes. Two primary techniques have been used for overtube placement; one is with endoscope, and the other is with bougie dilator. Overtube placement with endoseope is not without risk. There are reportd of esophageal or pharyngeal laceration or perforation. Overtube placement with bougie dilator circumvents this risk, but it is rather cumbersome to use. The authors devised a safe and easy method for overtube placement, and applied it to a number of patients to test its safety and convenience. First, overtube-dilator assembly was prepared as follows. A Rigiflex achalasia dilator (balloon 30mm OD, 10cm length; Microvasive Co) was lubricated and inserted into the overtube. A tenth of the balloon tip was protruded out of the overtube, then the balloon was insufflated with air at 10-15 psi. Second, standard endoscopy was performed, followed by placement of guide wire in the stomach. Overtube-dilator assembly was lubricated and introduced over the wire as a rail. Once the overtube was properly positioned, the balloon was deflated, and the balloon and wire were removed as a whole, which completed overtube placement. For 65 patients with esophageal variceal bleeding, 82 procedures of EVL were performed using the new technique. Overtube-dilator assembly was easy to prepare and handle. This technique added little time to the procedure and minimizes patients discomfort. No patient suffered major complications such as bleeding, laceration or perforation. This novel method for overtube placement was safe and convenient for use in EVL. It can also be applied to other procedures using overtube such as endoscopic foreign body removal.
Endoscopes ; Endoscopy ; Esophageal Achalasia ; Esophageal and Gastric Varices ; Foreign Bodies ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Stomach

No abstract available.
Contrast Media*

No abstract available.
Gelatin Sponge, Absorbable* ; Hemorrhage* ; Thrombin*

The authors analyzed 508 cases of geriatric anesthesia over 60 years of age out of 12, 153 cases of total anesthesia performed from January, 1970 to December, 1977 at our department of B.N.U.H. and the results were obtained as follows. 1) Of the total 12 153 cases508 cases (4. 2%) were over 60 years of age, and these were subdivided into 303 male(59.7%) and 205 female (40. 3%). 2) Among the 508 cases of geriatric patients, age distributions were 397 cases(78.2%) in the age group of 60-69,93(18.3%)in 70-79 and 18(3.5%) in over 80. 3) The techniques of anesthesia were 311 cases(61.0%) of general anesthesia, 188(37.2%) of spinal and 9(1.8%) of the combination of these two. 4) The anesthetics were halothane 182 cases(35. 8%), tetracaine 197(38. 8%), diethyl ether 78(15. 4%), nitrous oxide 34(6. 7%) and methoxyflurane 17(3. 3%). 5) In the section of surgery, 190 cases(37.4%) were General Surgery, 116(22.8) Urology, 53(10. 4%) OrthOpedic Sulgery, alld 42(8. 3%) Ophthalmology in order of numbers. 6) For the duration of anesthesia, 334 cases(65. 8%) were in 1 to 3 hours, 70(13. 8%) within 4 hours, 56(11. 0%) within 1 hour and 48(9. 4%) over 4 hours. 7) Operation on head-neck were 122 cases(24. 0%) chest-upper abdomen 150(29. 5%), lower abdomen 104(20.5%), perineum 81(15. 9%) and extremities 51(10.1%). 8) Elective operations(327 cases, 64.4%) versus emergency(181 cases, 35.6%) was about 1.8: 1.
Abdomen ; Age Distribution ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Clinical Study* ; Ether ; Extremities ; Female ; Halothane ; Humans ; Methoxyflurane ; Nitrous Oxide ; Ophthalmology ; Orthopedics ; Perineum ; Tetracaine ; Urology

As the development of the percutaneous renal surgery, Ureteropelvic junction obstruction can be treated with endourologic technique instead of open surgery. Precutaneous endopyelotomy has been used mainly for the treatment of secondary ureteropelvic junction obstruction. But it was also successful for treatment of primary ureteropelvic junction obstruction. Recently, we performed endopyelotomy for 3 cases of ureteropelvic junction obstruction a 39 years-old male who had renal pelvic stones combined with ureteropelvic junction, a 32 years-old male with ureteropelvic junction obstruction and a 23 years-old male who had horseshoe kidney combined with ureteropelvic junction obstruction and good results were obtained.
Adult ; Humans ; Kidney ; Male ; Young Adult

A percutaneous nephrostomy tract was used as a conduit to the kidney and upper ureter for extraction of calculi. We have performed percutaneous extraction of renal and upper ureter stones in 52 cases with the use of the percutaneous equipment and ultrasonic lithotrite. Overall success rate was 86.5% and average operating time was 90 minutes and mean hospitalization was 6.9 days. The advantage of this technique are that a skin incision of only 1 cm. is required to remove the stone, hospital days are fewer than with open procedures and postoperative morbidity is minimal. We conclude that percutaneous nephrolithotomy can be the primary choice of treatment in upper urinary tract stones.
Calculi ; Hospitalization ; Kidney ; Nephrostomy, Percutaneous* ; Skin ; Ultrasonics ; Ureter ; Urinary Calculi

Malignant growth of the small bowel accounts for approximately 1 to 3 percent of malignant tumors of the gastrointestinal tract. Leiomyosarcomas are the second most common primary tumor of the small bowel, their frequency being one-third to one-half of adenocarcinoma. The common clinical symptoms of leiomyosarcoma of the small intestine are hemorrhage and abdominal pain. Accurate diagnosis cannot be based on solely on the roentgenographic finding, although in certain situations the dignosis of leiomyosarcoma may be suggested strongly. We report a case of bleeding leiomyosarcoma located in the second portion of the duodenum which was first recognized by endoscopic examination and confirmed by explolaparotomy.
Abdominal Pain ; Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Hemorrhage ; Intestine, Small ; Leiomyosarcoma*

No abstract available.
Child* ; Humans ; Measles*