The surgical intervention for secondary developmental cervical spinal stenosis that results in myelopathy and radiculopathy has been modified by technical improvement to obtain more reliable enlargement of the cervical spinal canal. The authours have experienced good results with the modified open door expansive laminoplasty, so we report this article. The patients were treated by surgical intervention during the period from October 1989 to February 1991. The results obtained were as follows : 1) The average age was 54.7 years, and the sex distribution ratio of female to male was 2 : 8. 2) In clinical symptoms and symptoms of both myelopathy and radiculopathy. 3) In morphological analysis of lesions, all patients except one case had lesions over 3 levels, The lesions were spondylosis, spondylosis combined with soft disc herniation, spondylosis combined with OPLL, spondylosis combined with OPLL and soft disc herniation, OPLL and OYL in the order of frequency. 4) The operation method was as follows : after the patient was positioned in modified Concorde position, open door lamina was anchored to faced joint capsule and surrounding tissue with nylon sutures. And then the raw epidural space was covered with Lyodura by the modified Hirabayashi method. By this method, reclosure of widened spinal canal was prevented. 5) The outcomes were evaluated by JOA score difference between preoperation and post operation times. The outcome of recovery rate was 100% in five cases. Therewere no aggravated or unimproved cases. The results were excellent 8 cases, good 1 case, unchanged 0 case, poor 0 case and expired 1 case.
Epidural Space ; Female ; Humans ; Joint Capsule ; Male ; Nylons ; Radiculopathy ; Sex Distribution ; Spinal Canal ; Spinal Cord Diseases ; Spinal Stenosis* ; Spondylosis ; Sutures

The purpose of the present study is to consider its effect on the childbirth of a woman. This is a quasi-experimental study with nonequivalent control group post-test design. The subjects of this study are 60 primiparas (30 in the control, and another 30 in the experimental group) who have had a regular prenatal care from February 5 to March 20, 2002, in an outpatient obstetrics and gynecology of S university medical center located in Seoul. The result is as follows: 1. The hours of labor pains in the entire delivery period: the average hours are 7 hr. 9 min. in the experimental group, and 10 hr. 39 min. in the control group. The hours of labor pains are shorter in the woman with a family delivery experience in LDR. The difference is statistically significant (t=-3.34, p=.001). 2. The degree of pains in the entire delivery period: the average degree is 7.38 in the experimental group, and 7.68 in the control group. The degree of labor pains are lower in the woman with a family delivery experience in LDR. But, the difference is statistically insignificant (t=-0.86, p=.396). 3. The perceptions of the delivery experience: the average score of the perception is 73.63 in the experimental group, and 63.57 in the control group. The women with a family delivery experience in LDR have more positive perception of the delivery procedure, and, the difference is statistically significant (t=4.65, p=.000). In summary of the above result, a family- participated delivery in LDR is proved to be an effective nursing intervention that shortens the hours spent in the delivery procedure and promotes positive perceptions of the delivery experience.
Academic Medical Centers ; Delivery Rooms* ; Female ; Gynecology ; Humans ; Labor Pain ; Nursing ; Obstetrics ; Outpatients ; Parturition* ; Pregnancy ; Prenatal Care ; Seoul

Gorham's syndrome is a rare disorder involing a proliferation of vascular channels associated with extensive loss of bony matrix. It starts in bone, but it may secondarily involve soft tissue and adjacent bones. Although the osteolysis usuakky arrests spontaneously, its biologic behavior is difficult to predict. The mechanism of steolysis is unkown, and the role of osteoclasts is controverwial We have experienced one case of Gorham's syndrome affecting the scapula and clavicle, which is reported in this paper with brief review of literature.
Clavicle ; Osteoclasts ; Osteolysis ; Scapula

A clinical and radiological study was done on 96 cases of spontaneous pneumothorax, encoutered in the Dept. ofRadiology, Busan National University Hospital during last 3 years from March. 1979 to March 1982. The results weresummarized as follows; 1. In the age distribution, the ages between 20 and 39 years were most highest, as 54 cases(56.3%). In the sex distribution, the ratio of male to female was 5:1 in male predominance. 2. The underlyingpathology of the total 96 cases of spontaneous pneumothorax were of tuberculous origin in 33.3% andnon-tuberculous origin in 66.7%. And below 20 years, most were of non-tuberculous origin. 3. In the cases of lungcollapse over 2/3, non-tuberculous origin was more than tuberculous origin and had characteristics of significantmediastinal shifting, in contrast to lower percentage of fluid level by chest radiography. 4. The rupture of blebsor bullae was the main immediate causes of spontaneous pneumothorax, independent of the underlying pathology. 5.In only 27 cases (28.1%) among total 96 cases, bullae or blebs could be detected on the chest radiography. 6. Intreatment of spontaneous pneumothorax, the closed thoracotomy with under water seal drainage is accepted to be thegeneral method of treatment. But open thoracotomy is considered as the best useful therapeutic procedure toprevent the recurrence, whenever bullae of blebs are found on the chest radiography. 7. In the cases of closedthoracotomy, the recurrent rate was 25.0% and most cases were found at the ipsilateral side of the first attack.8. Within a week, the collpased lung were well expanded in most cases of total 96 cases, after closed thoracotomy.
Age Distribution ; Blister ; Busan ; Drainage ; Female ; Humans ; Lung ; Male ; Methods ; Pathology ; Pneumothorax ; Radiography ; Recurrence ; Rupture ; Sex Distribution ; Thoracotomy ; Thorax ; Water

PURPOSE: To evaluate the clinical characteristics of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures and assess the surgical outcomes of a novel, closed intramedullary nailing surgical approach designed to minimize fixation failure. MATERIALS AND METHODS: Between May 2013 and April 2017, 31 patients with intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures treated with closed intramedullary nailing or long proximal femoral nail antirotation (PFNA) were enrolled in this study. Preoperative data included age, sex, injury severity score, body mass index, location of shaft fracture, injury mechanism, accompanying traumatic injury, walking ability before injury, and surgical timing. Perioperative outcomes, including follow-up period, types of intramedullary nails, number of blocking screws used, operation time, and blood loss were assessed. Radiologic outcomes, including union rate, time from surgery to union, and femoral shortening, and clinical outcomes, including hip flexion, walking ability, and Harris hip score were also evaluated. RESULTS: A total of 29 unions (93.5%) were achieved. The time to union was 16.8 months (range, 11–25 months) for hip fractures (15.7 weeks for intertrochanteric fractures and 21.7 weeks for subtrochanteric fractures) and 22.8 months for femoral shaft fractures. There were no significant differences in surgical outcomes between the two groups except for type of intramedullary nail. CONCLUSION: Closed intramedullary nailing in the treatment of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures may be a good surgical option. However, fixation of femoral shaft fractures might not be sufficient depending on the implant design.
Body Mass Index ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Fractures ; Humans ; Injury Severity Score ; Walking

PURPOSE: To report a patient with ocular syphilis, who showed variable ocular manifestations, including optic neuritis and chorioretinitis in both eyes over a short time period. CASE SUMMARY: A 44-year-male visited our clinic for central scotoma in the left eye. The visual acuity was 20/25 in the right eye and 20/40 in the left eye. The fundus of the left eye showed a slightly hyperemic optic disc and multiple yellowish deposits. One week later, visual acuity and fundus lesion improved to 20/20 without a definitive treatment. However, 1 month later, he reported a new deterioration of vision in his right eye to 20/40. The right eye had a relative afferent pupillary defect and the fundus examination showed a blurred optic disc margin. Serological work-up was recommended but the patient refused. He returned 3 weeks later with an improvement in the right eye vision (20/25) and a worsening in the left eye (20/200). The examination revealed an improvement of the previously blurred disc margin in the right eye and newly developed chorioretinitis with vasculitis in the left eye. A serological test was performed. The venereal diseases research laboratory titer was 1:32. The fluorescent treponemal antigen absorbance test as positive for IgG and IgM. He was diagnosed with ocular syphilis and referred to the infectious disease department. He was treated with antibiotics. Six months later, the visual acuity was 20/20 in both eyes and the previous fundus lesions had disappeared. CONCLUSIONS: Ocular syphilis should be considered in patients with atypical and variable clinical course.
Anti-Bacterial Agents ; Chorioretinitis* ; Communicable Diseases ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Optic Neuritis* ; Pupil Disorders ; Scotoma ; Serologic Tests ; Sexually Transmitted Diseases ; Syphilis* ; Vasculitis ; Visual Acuity

In the treatment of fractures of the thoracolumbar junctiion area, surgical intervention was performed when posterior part of veretbral body, posterior structure supporting ligaments were involved and body compression more than 40%. Number of cases satisfying above criteria were seven between Aug. 1990 and Jun. 1991. Age distribution ranged from 15 to 57 years. Sex ratio was 4:3(F:M). Four patients presented with nerve root sign, one patient with cauda equina signs, and two patients were normal neurologically. In all cases, spinal canal decompression, internal instrument fixation, and bone fusion with iliac bone were performed via anterolateral approach. After surgical treatment, neurological deficits disappeared and kyphotic angle returned to normal range of thoracolumbar junction area in all cases. Percentage of body compression was improved from preop. 55% to postop. 21% in average. According to above results, we concluded that anterior instrumental fixation combined with bone fusion using iliac bone was supperior to posterior approach in providing biomechanical stability and decompression of protruding ventral bone fragments.
Age Distribution ; Cauda Equina ; Decompression ; Humans ; Ligaments ; Reference Values ; Sex Ratio ; Spinal Canal

BACKGROUND: Inflammatory bowel disease(IBD) such as ulcerative colitis or Croln's disease is often related with varied diseases including pyoderma gangrenosum, erythema nodosum, ankylosing arthritis and psoriasis. To date, however, a cIinical observation of IBD accompanied by psoriasis has been sparcely accomplished although an immunogenetic mechanism explaining a coexistence of IBD and psoriasis has been proposed. OBJECTIVE: We estimated the prevalence of IBD in patients with psoriasis in Korea and investigated the clinical characteristics of IBD accompanied by psoriasis. METHODS: 92 psoriatic patients and 389 non-psoriatic control subjects were enrolled in this study. Colonoscopic biopsy and barium series were performed in 47 psoriatic patients and 110 control subjects showing irritative intestinal symptoms. RESULTS: 1. The prevalence of IBD in psoriatic patients(14.1%) was significantly greater than in the control group(1.0%). 2. In the temporal relationship, psoriasis developed several years prior to the onset of IBD in 84.6% of psoriatic patients. 3. The frequency of arthropathies in the psoriatic patients possessing IBD(84.6%) was significantly higher than that of non-psariatic counterparts with IBD(25.0%) or that of psoriatics without lBD(2.5%), 4. The psoriatir. patients with IBD demonstrated much more frequently diffuse colonal extension than in non-psoriatic subjects with IBD. CONCLUSION: Our findings of an increased prevalence of IBD in the psoriatic population present further evidence of an association between IBD and psoriasis. In the psoriatic patients showing acute or chronic gastrointestinal symptoms, colonoseopic evaluation might be mandatory for the evaluation of IBD.
Arthritis ; Barium ; Biopsy ; Colitis, Ulcerative ; Colon ; Erythema Nodosum ; Humans ; Immunogenetics ; Inflammatory Bowel Diseases* ; Korea ; Prevalence ; Psoriasis* ; Pyoderma Gangrenosum

Food irradiation has been steadily increasing in many countries in line with increasing international trade and concerns about naturally occurring harmful contaminants in food. Although irradiation provides an excellent safeguard for the consumer by destroying almost 100% of harmful bacteria, it is necessary to ensure the safety of irradiated foods. This study was performed to investigate the effect of an irradiated diet on lipid peroxidation in the plasma, liver, small intestinal mucosa, and lymphocyte DNA damage in mice. Eight-week old ICR mice were assigned to two groups to receive either non-irradiated or irradiated (10 kGy) diets containing 20.38% fish powder and 6.06% sesame seeds for 4 weeks. The resulting changes in the degrees of lipid peroxidation were evaluated based on the level of plasma and liver thiobarbituric acid reactive substance (TBARS), transmission electron micrograph of jejunal mucosa, and free radical-induced oxidative DNA damage in lymphocytes, as measured by alkaline comet assay (single cell gel electrophoresis). The peroxide values of the gamma irradiated diet were measured every week, and the sample for comet assay was taken at the end of the four week experimental period. There was no significant difference in food efficiency ratio between the two groups. The peroxide values of the diet were immediately increased to 35.5% after gamma irradiation and kept on increasing during storage. After 4 weeks, no differences in tissue or plasma TBARS value were observed between the two groups, but epithelial cells of jejumum showed osmiophillic laminated membranous structures, considered as myelin figures,. The oxidative DNA damage expressed as tail moment (TM) increased 30% in the blood lymphocytes of the mice fed the irradiated diet. In conclusion, the comet assay sensitively detected differences in lymphocyte DNA damage after feeding with the irradiated diet for 4 weeks. However, in order to ensure the safety of irradiated foods, it would be more useful to conduct a long-term feeding regimen using an irradiated diet and examine the level of lipid peroxidation and the state of oxidative stress in a greater range of organs.
Animals ; Bacteria ; Comet Assay ; Diet* ; DNA Damage* ; DNA* ; Epithelial Cells ; Food Irradiation ; Intestinal Mucosa ; Lipid Peroxidation ; Liver ; Lymphocytes* ; Mice* ; Mice, Inbred ICR ; Mucous Membrane ; Myelin Sheath ; Oxidative Stress ; Plasma* ; Sesamum ; Thiobarbituric Acid Reactive Substances

BACKGROUND AND OBJECTIVES: Since allergic fungal sinusitis (AFS) has been described in 1983, only a few cases have been reported in the domestic scientific journals. This leads to alleviate the strict criteria because many patients with allergic mucin and fungal hyphae reveal negative results of allergic skin test or serologic tests for fungal antigens. To classify these patients, the term `eosinophilic fungal rhinosinusitis (EFS)' was first coined in 1999. The objective of this study was to evaluate the clinicopathological features of EFS. SUBJECTS AND METHOD: The authors retrospectively reviewed medical records of 21 patients who had been diagnosed as EFS between June 2002 and November 2003 at the department of otolaryngology, Asan medical center. RESULTS: Chief complaints at first visits were in the order of nasal obstruction, postnasal drip, headache, foul odor, and rhinorrhea. Nasal endoscopic findings showed nasal polyp, purulent discharge, and fungal debris. 14.2% of patients revealed no abnormal findings. All patients had increased intrasinus attenuation at non-contrast media-enhanced CT. 47.6% of patients had complete opacification of maxillary sinus predominantly. No patients had the evidence of type I hypersensitivity for fungal antigens. Twenty patients had undergone endoscopic sinus surgery and surgical specimens proved to have allergic mucin with fungal hyphae. Postoperatively, four patients (20%) had recurrent symptoms and polypoid mucosal changes, which showed responses to short term oral steroid therapy. CONCLUSION: EFS is a frequent type of fungal sinusitis if surgical specimens are carefully examined histologically. Out of patients who received endoscopic sinus surgery, bi-meatal approach for the maxillary sinus lesions, and local steroid therapy, 80% were cured with no sign of relapse. The existence of eosinophilic infiltration and allergic mucin leads us to believe that focal allergic reaction occurs inside the sinus.
Antigens, Fungal ; Chungcheongnam-do ; Eosinophilia ; Eosinophils* ; Headache ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Hyphae ; Maxillary Sinus ; Medical Records ; Mucins ; Nasal Obstruction ; Nasal Polyps ; Numismatics ; Odors ; Otolaryngology ; Paranasal Sinus Diseases ; Recurrence ; Retrospective Studies ; Serologic Tests ; Sinusitis ; Skin Tests