Harrington Instrumentation to treat the unstable fracture (including the fracture dislocation) of the thraco-lumbar spine with neurologic deficits is a very effective method. This method provides rigid fixation and stability for thoracolumbar fracture, also offers the optimum condition for recovery of nerve roots, and decompresses the spinal canal with anatomical reduction. The principal advantage for this method of treatment is the early mobilization of the patient and enhanced rehabilitation. Authors, performed Harrington Instrumentation with a laminectomy experienced 20 cases of unstable thoraco-lumbar spine fracture(including the fracture-dislocation) with neurologic deficit from Aug. 1980 to Oct. 1984. The following results were obtained : 1) Of twenty patients, the patients at the age 20 to 49 were commonly injured and predominant cause of spinal injury was falling accident. 2) The thoraco-lumber fracure(including fracture-dislocation) were thoracolumbar junction, the commonest site among them was the lst lumber vertebra, and the commonest mechanism of spinal injury way flexon injury. 3) Most commonly, paraplegia was with twelve thoracic vertebra injury, and paraparesis was with lst lumbar vertebra. 4) Correction of the kyphotic deformity was 8 degree on the average, and the range of the correction was between 0 degree and 19 degree. 5) Neurological recoveries were gained from 14 patients(70%), and the 10 patients(50%) among them were completely recovered. 6) Average hospital periods were 78 days and after an average 21 postoperative days, ambulation was started. 7) In complication, three hook dislocations were occured. 8) Early operation (laminectomy for posterior decompression and Harrington Instrumentation for anterior decompression) was very effective in spinal cord injury.
Congenital Abnormalities ; Decompression ; Dislocations ; Early Ambulation ; Humans ; Laminectomy ; Neurologic Manifestations ; Paraparesis ; Paraplegia ; Rehabilitation ; Spinal Canal ; Spinal Cord Injuries ; Spinal Injuries ; Spine ; Walking

The intramedullary glioma of spinal cord has occupied 22.5% of intraspinal neoplasm, and is the most common among the intramedullary spinal cord tumor, and the first successful operative removal was performed in 1907 by Elsberg. The intramedullary astrocytoma has frequent incidence in the thoracic and cervical region of the spinal cord, which has more frequent grade I astrocytoma. We experienced a case of intramedullary grade II astrocytoma of the thoracolumbar region which has associated a paraplegia as neurological deficit. A 26 year old Korean female has admitted to our clinic because of paraplegia with incontinence for 2 years. On admission, the neurological examination revealed a paraparesis below T12 level with urinary and fecal incontinence and then local tenderness from T10 to L1 level. The simple X-ray film of the thracolumbar spine has showed erosion of both pedicle, widening of interpeduncular distance and scalloping change of posterior vertebral margin from T12 to L1, which were similar to the picture of intramedullary spinal cord tumor. We performed a myelography by pantopaque through the lumbar and cisternal puncture for accurate site of lesion, and found a complete block at L1 level and T10 level on myelogram. Then the immediate total laminectomy from T8 to L1 was applied. The operative finding was a intramedullary mass with cystic fluid, which has compressed the spinal cord. After aspiration of cystic fluid, we removed the tumor mass incompletely because of intermingling with spinal cord but the decompression was enough. The neurological defict was improved gradually for post-operative 4 weeks, thereafter improvement was stopped and remained the paraparesis. The post-operative pathological diagnosis was grade II astrocytoma, which composed of anaplastic cell and radiotherapy has followed.
Adult ; Astrocytoma* ; Decompression ; Diagnosis ; Fecal Incontinence ; Female ; Glioma ; Humans ; Incidence ; Iophendylate ; Laminectomy ; Myelography ; Neurologic Examination ; Paraparesis ; Paraplegia ; Pectinidae ; Punctures ; Radiotherapy ; Spinal Cord Neoplasms ; Spinal Cord* ; Spine ; X-Ray Film

Existence of Y derived chromosome in Turner patients is significant due to the risk of gonadoblastoma development, but cytogenetic analysis may fail to detect low levels of Y chromosomal materials. Recent studies using PCR based methods showed higher sensitivity to detect Y-specific sequences, in patients who were Y chromosome-negative cytogenetically. In this study PCR was performed on 44 Turner patients with no Y chromosome by cytogenetic analysis to detect the SRY, AMELY, ZFY, and DYZ1 sequences. Of seven patients whose karyotypes were 45,X/46,X,+mar, three patients were positive for SRY, ZFY, and AMELY. DYZ1 sequences was negative in them. And any of SRY, ZFY, AMELY, and DYZ1 sequences was detected in the remaining 37 patients. This result shows that PCR analysis for Y-specific sequences in Turner patients, especially in patients who have marker chromosome is a significant effort.
Cytogenetic Analysis ; Genes, sry ; Gonadoblastoma ; Humans ; Karyotype ; Polymerase Chain Reaction ; Turner Syndrome* ; Y Chromosome

OBJECTIVE: To explore the efficacy of serum CA19-9 determination for the detection of endometriosis. DESIGNS: A retrospective analysis. MATERIALS AND METHODS: Preoperative serum CA19-9 and CA125 concentrations were measured in 53 patients with surgically and/or histologically diagnosed endometriosis. The extent of disease was staged according to the revised American Fertility Society (1985) classification system. RESULTS: Serum CA19-9 levels were elevated (>or=37 U/ml) in 13 (24.5%) out of 53 patients with endometriosis and serum CA125 levels were elevated (>or=35 U/ml) in 13 (24.5%). Either CA19-9 or CA125 levels in serum were elevated in 18 (34.0%) patients. In patients with stage III or IV endometriosis, elevated CA19-9 levels were noted in 11 (31.4%) of 35 patients, while CA125 in 12 (34.3%). Either CA19-9 or CA125 levels in serum were elevated in 15 (42.9%) of 35 patients with stage III or IV. CONCLUSION: These results suggest that serum CA19-9, in addition to CA125, measurement could help in identifying patients with moderate to severe endometriosis.
Classification ; Endometriosis* ; Female ; Fertility ; Humans ; Retrospective Studies

OBJECTIVE: To evaluate the cumulative pregnancy rate(CPR) of in vitro fertilization and embryo transfer(IVF-ET) with intracytoplasmic sperm injection(ICSI). METHODS: Medical records of 260 infertile patients undergoing 519 cycles of IVF-ET with ICSI from January, 1994 to December, 1999 were retrospectively reviewed. The CPR beyond 12 weeks of gestation was estimated by Kaplan-Meier method. The CPRs were compared by log-rank test between groups divided by age of patients, indication of ICSI, and method of sperm retrieval for ICSI. RESULTS: As 70 patients achieved an on-going pregnancy after IVF-ET with ICSI, the PR was 26.9% per patient and 13.5% per cycle. The overall CPR was 54.9% after 6 cycles of IVF-ET with ICSI. As expected, age had a significant strong effect on the CPR; CPRs afer 4 cycles of ICSI were 61.8% in the age group of 30 years(n=81), 43.7% in 31-35 years(n=106), and 15.3% in 36 years(n=73). There was no significant difference in the CPR between abnormal semen analysis group(n=184) and prior low fertilization rate group(n=66). In abnormal semen analysis group, the CPR of surgically retrieved sperm subgroup(n=60) was not significantly different from that of ejaculated sperm subgroup(n=124). CONCLUSIONS: The CPR of IVF-ET with ICSI was presented, and it could be of much help in the clinical counseling of IVF-ET patients. ICSI technique could be used successfully for IVF-ET in infertile couples who had the male factor infertility or the past history of low fertilization rate in the previous cycles.
Cardiopulmonary Resuscitation ; Counseling ; Embryo Transfer* ; Embryonic Structures* ; Family Characteristics ; Fertilization ; Fertilization in Vitro* ; Humans ; Infertility ; Male ; Medical Records ; Pregnancy Rate* ; Pregnancy* ; Retrospective Studies ; Semen Analysis ; Sperm Injections, Intracytoplasmic* ; Sperm Retrieval ; Spermatozoa