This study was performed to analyze the clinical, radiological results of 70 patients with isthmic spondylolisthesis and 30 patients with degenerative spondylolisthesis who were underwent with wide decompression, reduction with transpedicular screw system and posterolateral fusion from Mar. 1990 to Dec. 1995. In this study we excluded posterior lumbar interbody fusion, circumferential fusion or decompression method for sondylolisthesis. The mean follow up duration was 29 months. The most common level was L5-Sl in isthmic group (36 patients, 51%), and L4-5 in degenerative group (23 patients, 77%). The clinical result were analyzed according to Kirkaldy-Willis criteria. The satisfactory result were obtained 90% in each group. Screw failure occured in unstable level with severe slip angle, so anterior column support may be recommended in this group. Pedicle screw fixation and wide decompression augmented with posterolateral bone graft is a satisfactory alternative method for degenerative and isthmic spondylolisthesis.
Decompression ; Follow-Up Studies ; Humans ; Spondylolisthesis* ; Transplants

STUDY DESIGN: We retrospectively reviewed the cervical myelopathy patients who underwent anterior or posterior surgery. OBJECTIVES: This study was undertaken to analyze the preoperative radiologic evaluation and the results of the treatment of cervical myelopathy. SUMMARY OF LITERATURE REVIEW: The surgical treatment of cervical myelopathy consisted of anterior/posterior or combined surgery according to lesion site, symptoms, number of involved sequents or prevalence of the surgeon. Material and METHODS: We reviewed the clinical and radiological aspects of 28 patients Preoperative plain radiographs and MRI were evaluated with clinical symptoms. Postoperative clinical evaluation was performed according to the Robinson's criteria. RESULTS: On plain lateral radiographs, spinal canal diameter were 13.4+/-2.6/12.5+/- 1.7mm, Pavlovratios were 0.78+/-0.09/0.66+/-0.08, spondylosis indices were 1.70/1.80mm, and the antero-posterior compression ration of spinal cord were 42.4+/-8/44.0+/-6% for anterior surgery and posterior surgery group each. The results of 15 patients who received anterior decompression and interbody fusion were excellent in 11, good in 2, and fair in 2 cases. The results of 13 patients who underwent laminoplasty were excellent in 9, good in 3, and fair in one case. CONCLUSIONS: The patients who have Pavlov ratio less than 0.8 and spondylosis index more than 1.5mm on plain radiograph are vulnerable to developing myelopathy. It is better to do anterior decom pression and interbody fusion in patients who have one or two segments involved and kyphotic deformity of the cervical spine. Otherwise, patients who involve more than 3 segments and narrow spinal canal can be managed using laminoplasty posteriorly.
Congenital Abnormalities ; Decompression ; Humans ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Spinal Cord Diseases* ; Spine ; Spondylosis

Dendritic cells (DCs) are the most potent antigen presenting cells that can activate naive T cells. Mature DCs exress high levels of MHC and costimulatory molecules on their surface and have capacity to produce IL-12, a 75 kDa heterodimeric cytokine composed of p35 and p40 subunit. IL-12 is currently thought to be one of most critical determinants for skewing the immune response towards Th1. Expression of IL-12 in dendritic cells seems to be regulated by various stimuli including CD40L. In the present study we investigated expression of IL-12 in mature DCs, which were cultured from bone marrow cells in the presence of GM-CSF. Maturity of the DCs was confirmed by morphologic characteristics, immunophenotypes, and allostimulatory activities. Exprssion levels of IL-12 p40 in the DCs were measured by semi-quantitative RT-PCR. Increases in IL-12 p40 expression were observed after treatment with lipopolysaccharide (LPS), an anti-MHC class II monoclonal antibody, or an anti-CD40 monoclonal antibody. The most remarkable increases, however, were observed in the DCs treated with an anti-CD40 monoclonal antibody. These results support a previous notion that signals through CD40/CD40L interaction may be important for the production of IL-12 by DCs. Moreover, results of this study show a possibility of using monoclonal antibodies against CD40 molecules for preparing DCs producing high amount of IL-12, which can be used for anti-tumor or anti-viral immunotherapy.
Animals ; Antibodies, Monoclonal ; Antigen-Presenting Cells ; Bone Marrow Cells ; CD40 Ligand ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Immunotherapy ; Interleukin-12* ; Mice* ; T-Lymphocytes

Intussusception in adults is not common unlike in pediatrics. It also differs from the pediatric intussusception in its origins, symptoms, and treatment. Since more than half of intussusception cases come from malignancy, laparotomy is considered to be the treatment of choice in most cases. This report deals with a patient who visited our hospital complaining of abdominal pain after colonoscopic polypectomy. The patient was diagnosed with colonic intussusception. After a conservative treatment regimen including antibiotics and fluid therapy, the intussusception was spontaneously reduced.
Abdominal Pain ; Adult ; Anti-Bacterial Agents ; Colon ; Colonoscopy ; Fluid Therapy ; Humans ; Intussusception ; Laparotomy ; Pediatrics

PURPOSE: Food allergies can affect the growth and nutritional status of children with atopic dermatitis (AD). This study was conducted to determine the association between the number of sensitized food allergens and the growth and nutritional status of infants and young children with AD. METHODS: We studied 165 children with AD, aged 5 to 47 months, and who visited the Atopy Clinic of the Seoul Medical Center. We recorded the birth weight, time at which food weaning began, scoring of atopic dermatitis (SCORAD) index, eosinophil counts in peripheral blood, and total serum IgE and specific IgE to six major allergens (egg white, cow's milk, soybean, peanut, wheat, and fish). The height and weight for age and weight for height were converted to z-scores to evaluate their effects on growth and nutritional status. Specific IgE levels > or =0.7 kUA/L, measured via the CAP assay, were considered positive. RESULTS: As the number of sensitized food allergens increased, the mean z-scores of weight and height for age decreased (P=0.006 and 0.018, respectively). The number directly correlated with the SCORAD index (r=0.308), time at which food weaning began (r=0.332), eosinophil counts in peripheral blood (r=0.266), and total serum IgE (r=0.394). Inverse correlations were observed with the z-scores of weight for age (r=-0.358), height for age (r=-0.278), and weight for height (r=-0.224). CONCLUSIONS: A higher number of sensitized food allergens was associated with negative effects on the growth and nutritional status of infants and young children with AD. Therefore, a thorough evaluation of both growth and nutritional status, combined with adequate patient management, is crucial in pediatric AD patients presenting with numerous sensitized food allergies.
Aged ; Allergens ; Birth Weight ; Child ; Dermatitis, Atopic ; Eosinophils ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Infant ; Milk ; Nutritional Status ; Soybeans ; Triticum ; Weaning

BACKGROUND/AIMS: The distribut ion of HCV genotypes varies with geographical area, and genot ypes can affect t he nat ur al course of HCV infection, but adequate genot yping data were not accumulat ed in Korea. This study was des igned to det ermine the pattern of distribution of HCV genotypes in Korea and it's clinical implications. METHODS: 100 cons ecut ive anti- HCV( +), RT-PCR(+) cases were recruited. Genotype specific oligonucleotide primers were made according to the sequence variation of NS5 region of HCV genome. Heminested PCR with mixed primersets was per formed, and genotype specific PCR products of different size were verified. Sequencing of cloned PCR products was done in cases with representative genotypes. Clinical profiles of genotype 1b and 2a were compared. RESULTS: Genotyping was done in 78 among 100 cases. Genotype 1b (48/ 78, 57.7%) and 2a (25/ 78, 32.1%) were most prevalent , and 1a (1/ 78, 1.3%) and mixed form (7/ 78, 9.0%) were also found. Milder cases with persistent normal ALT levels were more frequently seen in genotype 2a ( 9/ 25, 36.0%) than in genot ype 1b (3/ 45, 6.7%) (p< 0.01). CONCLUSIONS: Genotype 1b and 2a were major ones in anti- HCV( +) Korean adults, and the tendency of milder clinical course of genotype 2a was suggested.
Adult ; Clone Cells ; DEET ; DNA Primers ; Genome ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Korea ; Polymerase Chain Reaction*

A glomus tumor is a benign neoplasm of neuromyo-arterial glomus, composed of vascular channels surrounded by proliferating glomus cells and nerve fibers. Occasionally it displays unusual histopathologic features such as a large size, deep location, infiltrative growth, mitotic activity, nuclear pleomorphism, or necrosis. It can be diagnosed as an "atypical" glomus tumor, including malignant glomus tumor, glomus tumor of uncertain malignant potential, symplastic glomus tumor, or glomangiomatosis. Glomangiomatosis and symplastic glomus tumors reveal benign biologic behavior. We report a typical case of a symplastic glomus tumor, showing only marked nuclear atypia, compared with a classical glomus tumor.
Glomus Tumor* ; Necrosis ; Nerve Fibers

A 39-year-old hairdresser developed sodium bromate poisoning after drinking a cup of hair neutralizer in a suicide attempt. This is the first case of visual loss afteringestion of sodium bromate. Only few cases are as a cause of acute renal failure reported in medical literature. She presented 1 day later with anuria, required hemodialysis. Sensorineural hearing loss, often a characteristic finding, was developed.
Acute Kidney Injury* ; Adult ; Anuria ; Deafness* ; Drinking ; Hair ; Hearing Loss, Sensorineural ; Humans ; Poisoning* ; Renal Dialysis ; Sodium* ; Suicide

PURPOSE: A gonadotropin-releasing hormone stimulation test (GnRHST) is the gold standard in diagnosing central precocious puberty (CPP). The aim of this study was to investigate the diagnostic accuracy of basal gonadotropin levels for girls with suspected precocious puberty and to evaluate the factors affecting positive results of the GnRHST. METHODS: Korean girls with early pubertal development who visited the clinic during 2010-2012 were included. Auxological and biochemical tests were evaluated and a standard GnRHST was performed. A peak luteinizing hormone (LH) level of > or =5 IU/L was considered a positive response during the GnRHST. RESULTS: A total of 336 girls were included. The positive responses were observed in 241 girls (71.7%), and negative responses were found in 95 girls (28.3%). In the logistic regression analysis, the coefficient of the basal LH and basal LH/follicular stimulating hormone (FSH) ratio was 4.23 (P<0.001) and 21.28 (P<0.001), respectively. Receiver operating characteristic analysis showed that the basal LH/FSH ratio is a better predictor of the pubertal result after the GnRHST than the basal LH (area under the curve was 0.745 and 0.740, respectively; P=0.027). Among 189 girls with a basal LH of <0.1 IU/L, 105 (55.6%) had positive responses. CONCLUSION: An elevated level of the basal LH and basal LH/FSH ratio was a significant predicting factor of positive responses during the GnRHST. However a GnRHST was still necessary for diagnostic confirmation of CPP because more than half of the girls with a basal LH level below the detection limit revealed to have CPP.
Diagnosis* ; Female* ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Limit of Detection ; Logistic Models ; Lutein* ; Luteinizing Hormone* ; Puberty, Precocious* ; ROC Curve

PURPOSE: Management of cardiovascular risk factors is of major importance in renal transplant recipients to determine long-term outcomes. While calcineurin inhibitors improve the clinical course after kidney transplantation, they have been implicated in contributing to increased cardiovascular risk. This study investigated the influence of conversion from cyclosporine to tacrolimus on cardiovascular risks and graft function in renal allograft recipients with hyperlipidemia. METHODS: Twenty three adult renal recipients who were receiving cyclosporine-based regimen for more than one year after transplantation and had hyperlipidemia (serum total cholesterol > or =200 mg/dL) were enrolled. The effect of conversion from cyclosporine to tacrolimus was evaluated with blood pressure, fasting lipid profile, glucose and HbA1c. They were measured at baseline and at 1, 3, 6 and 12 months after conversion. The change in estimated glomerular filtration rate (eGRF) was also compared between before and after conversion. RESULTS: Though conversion from cyclosporine to tacrolimus did not cause significant differences in the serum triglyceride level, there was a noticeable decline in total cholesterol level (213.78+/-16.28 to 185.96+/-38.62 mg/dL, p<0.01). Conversion did not trigger new onset or worsening of diabetes mellitus with no meaningful differences in fasting blood glucose and HbA1c levels. The eGFR stabilized with Tacrolimus in comparison with the cyclosporine (-2.9+/-13.4 mL/min vs. -7.3+/-13.8 mL/min). CONCLUSION: Conversion to tacrolimus would be preferable to cyclosporine for maintenance immunesuppression in renal recipient with hyperlipidemia, as it meliorates hyperlipidemia and leads to stabilization of allograft function.
Adult ; Blood Glucose ; Blood Pressure ; Calcineurin ; Cardiovascular Diseases ; Cholesterol ; Cyclosporine ; Diabetes Mellitus ; Dyslipidemias ; Fasting ; Glomerular Filtration Rate ; Glucose ; Humans ; Hyperlipidemias ; Kidney Transplantation ; Risk Factors ; Tacrolimus ; Transplantation, Homologous ; Transplants