BACKGROUND: Lumbar transforaminal epidural injections (LTEIs) have been utilized in the treatment of radicular pain, and LTEIs have the advantage of target-specificity. However, there have not been enough studies on the contrast patterns in LTEIs with using fluoroscopy. The purpose of this study was to evaluate the spreading epidural contrast patterns that are seen during real-time fluoroscopic guided LTEIs. METHODS: A total of 131 patients who underwent fluoroscopic guided LTEIs were studied. The inclusion criteria were those patients with low back pain and/or lower extremity pain that was caused by a herniated nucleus pulposus, lumbar spinal stenosis, failed back surgery syndrome, and herpes zoster-associated pain. We classified the contrast patterns in regard to the contrast flow spreading to the nerve root and/or the unilateral, bilateral or cylinderic type of epidural spreading on the AP view of the fluoroscopy and the ventral or dorsal epidural filling on the lateral view. In addition to the pattern analysis, we evaluated the range of contrast spreading from the cranial to the caudal epidural filling and the incidence of an intravascular flow pattern. RESULTS: Epidural spreading was seen in 126 cases (96.2%) of the total patients through the nerve root. Ventral spreading occurred in 120 cases (95.2%). On the AP view, a nerve root with unilateral, bilateral and cylinderic epidural filling was noted for 108 (85.7%), 9 (7.1%) and 9 (7.1%) cases, respectively. The contrast spreading to vertebral segments was smaller for the patients with lumbar spinal stenosis and failed back surgery syndrome than for the other groups (P < 0.0083). The incidence of intravascular injection was 11.1% (14/126). CONCLUSIONS: LTEIs using fluoroscopic visualization provided excellent assessment of the ventral epidural filling as well as nerve root filling. However, unilateral epidural spreading was prominent for the LTEIs.
Failed Back Surgery Syndrome ; Fluoroscopy ; Humans ; Imidazoles ; Incidence ; Injections, Epidural ; Low Back Pain ; Lower Extremity ; Nitro Compounds ; Spinal Stenosis

Removal of blunt esophageal foreign bodies using Foley catheter under a fluoroscopic guidance is a well-recognized procedure. However, since this procedure is rather cumbersome and uncomfortable to the patient, the authors tried to find an easier and more convenient modified technique. For 10 patients with esophageal foreign body, we tried the method to the patients who is lying in the right lateral decubitus position and 3 assistants hold head. arms, trunk and legs of the patients without tilting the table and without using immobilizer. Foley catheter is inserted through nostril, nasal cavity and pharynx to esophagus. In order to identify the Foley catheter in esophagus, 0.025 inch short wire was inserted in the Foley catheter. The balloon of a Foley catheter was inflated by 10cc of air, and the syringe was kept attached to the Foley catheter during the procedure. After passage of the foreign body through the upper esophageal sphincter, the balloon was deflated immediately and the foreign body was removed through the mouth. We successfully removed in removing all the blunt esophageal foreign body with ease. This modified method is also fast, safe and efficient.
Arm ; Catheters* ; Deception ; Esophageal Sphincter, Upper ; Esophagus ; Foreign Bodies* ; Head ; Humans ; Leg ; Methods* ; Mouth ; Nasal Cavity ; Pharynx ; Syringes

Basal cell carcinoma(BCC) is the most common human malignancy. It involves the face and neck most frequently. However, BCC can very rarely occur on external glenitalia such as scrotum and vulva. We report two cases of serotal and vulvar BCCs in a 67 year old imale and a 43 year old female. He suffered from well defineril erythematous to violet colored plaque with central erosion on the left scrotum for 5 years. She had a brown black colored plaque on the left vulva for 8 years. They did not show any metastatic foci from g!rimary cutaneous lesions, and underwent surgical excision and curettage respectively.
Adult ; Aged ; Carcinoma, Basal Cell* ; Curettage ; Female* ; Genitalia* ; Humans ; Male* ; Neck ; Scrotum ; Viola ; Vulva

A given facial type can be considered as a syndrome in which various features are aggregated, so a single parameter is not sufficient to accurately identify a given facial type. This study was designed to identify & characterize the skeletal types that blend under the headline-'Cl III,deepbite'. Cephalograms of thirty-four untreated mixed dentition patients, selected mainly on the basis of clinical impression of CI III with reduced lower face heights were studied. The following conclusion can be drawn. 1. CI III malocclusion with reduced lower face height could be classified into three types. 2. Subtype 1 was identified by the following features : strong ramus, more anteriorly positioned upper molars without alveolar hypoplasia, acutely reduced Mn. plane angle. 3. Subtype 2 was characterized by a short ramus, sharply reduced postrior alveolar height, and normal Mn. plane angle. In general, this type had hypoplasia tendency in the vertical dimension. 4. In subtype 3, the AUFH occupying more percentage than ALFH was a outstanding feature. Ramal height was in normal range, alveolar hypoplasia and slightly reduced Mn. plane angle was observed. 5. The features of the subtypes were reflected in certain indices, which can be regarded as discriminative index. LAFH: if reduced, regardless of subtypes, indicates reduced lower ant. face height consistently. FHR: when this ratio is increased, it indicates subtype 1. FHl: when this ratio is in normal range, it indicates subtype 2. FPI: if reduced greatly, it indicates subtype 3.
Ants ; Dentition, Mixed ; Humans ; Malocclusion* ; Molar ; Reference Values ; Vertical Dimension

No abstract available.
Acromioclavicular Joint* ; Acromion* ; Dislocations*

This study was carried out in order to find out the amount of tooth movement, the changes arch size and the changes in arch morphology following orthodontic treatment and to provide a guideline for to predict post-treatment arch morphology. The sample group for this study consists of 15 males and 22 females, totalling in 37 persons, who received orthodontic treatment at Orthodontic Department of DanKook Univ. Dental Hospital. They are classified into Extraction Class I treatment group (E I), Non-extraction Class I treatment group (N I), and Non-extraction Class III treatment group (N III), according to their pre-treatment malocclusion state and methods of treatment. Following conclusions and averaged dental arch form for each group were obtained by cephalometric linear measurements and dental arch measurements using pre- and post-treatment lateral cephalograms and plaster study models. 1. Intercanine width were reduced in max. of both EI and NI during the period of treatment. 2. Intermolar width were reduced in max. of EI and increased in max. of NI. Therefore although there was no difference between these two groups before the treatment, intermolar width of the max. of NI was wider than that of EI after the treatment. 3. PMV-incisor distance and PMV-canine distance were decreased in both max. and mand. of EI and that of NI, during the period of treatment. PMV-molar distance was decreased in both max. and mand. of NI and in mand. of NIII. 4. Items that showed stability during the treatment were: max. & mand. PMV-molar distance, mand. intercanine and intermolar width in EI; mand. intercanine and interrnolar width in NI; mand. & max. PMV-incisor distance, PMV-canine distance, max. PMV-molar distance and max. & mand. intercanine and intermolar width in NIII. 5. The differences in averaged canine and molar variances to post-treatment dental arch form were present only in EI and in NI. There was no variance between maxilla and mandible in each group.
Dental Arch* ; Female ; Humans ; Male ; Malocclusion ; Mandible ; Maxilla ; Molar ; Tooth Movement

OBJECTIVE: The aim of this study were to compare the effects of EG and PROH on cryopreservation of mouse and human embryos, and to find the optimal protocol for embryo freezing. METHODS: Human embryos derived from fertilized eggs showing 3 pronuclei (PN) and mouse embryos were divided into two groups respectively: dehydrated with 1.5 M EG+0.2 M sucrose or 1.5 M PROH+0.2 M sucrose using the slow freezing method. Moreover mouse embryos were controlled the exposure time of cryoprotectant during dehydration or rehydration steps. RESULTS: The survival rates of human embryos were 79.2% (84/106) in EG group and 77.9% (88/113) in PROH group. In mouse embryos, the survival and development rates up to blastocyst were 70.6% (245/347), 44.1% (123/279) in EG group and 62.1% (198/319), 45.1% (123/279) in PROH group, respectively. However, in EG group, partially damaged embryos after thawing were decreased compared to PROH group. In combination group, when the exposure time during dehydration and rehydration were reduced, the survival and embryonic developments were increased slightly, but not significant. CONCLUSION: Cryopreservation of mouse and human embryos at cleavage stage by using EG or PROH exhibited no statistical difference in the survival rate and/or developmental rate to blastocyst. However, the use of EG for cryopreservation of embryos might reduce the exposure time of the cryoprotectant because of a high permeation of EG and result in lessen its toxic effects.
Animals ; Blastocyst ; Cryopreservation ; Dehydration ; Embryonic Development ; Embryonic Structures ; Ethylene Glycol* ; Female ; Fluid Therapy ; Freezing ; Humans* ; Mice* ; Pregnancy ; Propylene Glycol* ; Sucrose ; Survival Rate ; Zygote

PURPOSE: Minimally invasive management of small renal tumors has become more common. We compared the results of partial nephrectomy by video-assisted minilaparotomy surgery (VAMS), open, and laparoscopic techniques. MATERIALS AND METHODS: We retrospectively compared clinicopathological, oncological, and functional outcomes in 271 patients who underwent partial nephrectomy for renal tumors at one institution from 1993 to 2007; including 138 by VAMS, 102 by open, and 31 by laparoscopic technique. RESULTS: Mean follow-up was 47.7+/-29.1 months. No statistically significant differences in the three groups were found in tumor size, tumor location, estimated blood loss, complication rate, preoperative glomerular filtration rate (GFR), and GFR at last follow-up. Ischemic time was shorter in the open (26.9 min) and VAMS (29.3 min) groups than in the laparoscopic group (31.0 min, p=0.021). Time to normal diet and hospital stay were shorter in the VAMS (1.8 days and 5.4 days) and laparoscopic (1.8 days and 4.7 days) groups than in the open group (2.4 days and 7.3 days, p=0.036 and p<0.001, respectively). Of 180 patients with cancer, positive surgical margins occurred in 2 of 82 patients (2.4%) in the VAMS group, none of 75 patients in the open group, and 3 of 23 patients (13.0%) in the laparoscopic group (p=0.084). In the VAMS, open, and laparoscopic groups, 5-year disease-free survival was 94.8%, 95.8%, and 90.3% (p=0.485), and 5-year cancer-specific survival was 96.3%, 98.6%, and 100%, respectively (p=0.452). CONCLUSION: Partial nephrectomy using VAMS technique provides surgical, oncologic, and functional outcomes similar to open and laparoscopic techniques.
Adult ; Aged ; Carcinoma, Renal Cell/mortality/*surgery ; Female ; Humans ; Kidney Neoplasms/mortality/*surgery ; Laparoscopy/instrumentation/*methods ; Laparotomy/instrumentation/*methods ; Male ; Middle Aged ; Nephrectomy/instrumentation/*methods ; Retrospective Studies ; Treatment Outcome ; Video-Assisted Surgery/instrumentation/*methods

PURPOSE: Our study aimed to determine whether obstructive sleep apnea (OSA) is common among branch retinal vein occlusion (BRVO) patients without systemic risk factors using a Watch PAT-100 portable monitoring device. METHODS: The study participants included consecutive patients with BRVO of less than 3 months duration without any risk factors known to be associated with OSA (diabetes, coronary artery disease, stroke, hematologic diseases, autoimmune disease, etc.) except for hypertension. All patients underwent full-night unattended polysomnography by means of a portable monitor Watch PAT-100 device. The apnea-hypopnea index (AHI) was calculated as the average number of apnea and hypopnea events per hour of sleep, and an AHI score of five or more events was diagnosed as OSA. RESULTS: Among 19 patients (6 males and 13 females), 42.1% (8 of 19) had an AHI reflective of OSA. In the 13 patients who had no concurrent illness, including hypertension, 30.8% (4 of 13) had positive test results for OSA; three of these patients were ranked as mild OSA, while one had moderate OSA. The OSA group had an average AHI of 12.3 ± 7.8, and the average AHI was 2.0 ± 0.9 in the non-OSA group. Although it was not statistically proven, we found that OSA patients experienced a more severe form of BRVO. CONCLUSIONS: We found a higher than expected rate of OSA in BRVO patients lacking concomitant diseases typically associated with OSA. Our findings suggest that OSA could be an additional risk factor in the pathogenesis of BRVO or at least a frequently associated condition that could function as a triggering factor.
Apnea ; Autoimmune Diseases ; Coronary Artery Disease ; Hematologic Diseases ; Humans ; Hypertension ; Male ; Polysomnography ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Risk Factors ; Sleep Apnea, Obstructive* ; Stroke

Precision medicine stands for 4Ps - precise, preventive, participatory, and personal; in which “precision” is important because the current modern medicine starts from “trial and error,” and “one does not fit all”. Current targeted therapies for cancer have changed treatment approaches and led the precision medicine; however, clinical use of liquid biopsy, using blood or other liquid specimens to characterize circulating tumor cells (CTC) or tumor genes instead of biopsies of tumor tissues, still awaits availability of more information regarding non-invasive cancer detection and characterization, prediction of treatment response, monitoring the disease course and relapse possibilities, identification of mechanisms of drug resistance, and newer pathogenesis. In this review, we will introduce the basic concept of CTC, circulating cell free DNA, and exosomes and their possible application for gastric cancer relevant with Helicobacter pylori infection.
Biopsy* ; DNA ; Drug Resistance ; Exosomes ; Helicobacter Infections* ; Helicobacter pylori ; Helicobacter* ; History, Modern 1601- ; Humans ; Neoplastic Cells, Circulating ; Precision Medicine ; Recurrence ; Stomach Neoplasms*