OBJECTIVE: Acute vertebral burst fractures warrant extensive fixation and fusion on the spine. Osteoplasty (vertebroplasty with high density resin without vertebral expansion) has been used to treat osteoporotic vertebral compression fractures. We report our experiences with osteoplasty in acute vertebral burst fractures. METHODS: Twenty-eight cases of acute vertebral burst fracture were operated with osteoplasty. Eighteen patients had osteoporosis concurrently. Preoperative MRI was performed in all cases to find fracture level and to evaluate the severity of injury. Preoperative CT revealed burst fracture in the series. The patients with severe ligament injury or spinal canal compromise were excluded from indication. Osteoplasty was performed under local anesthesia and high density polymethylmethacrylate(PMMA) was injected carefully avoiding cement leakage into spinal canal. The procedure was performed unilaterally in 21 cases and bilaterally in 7 cases. The patients were allowed to ambulate right after surgery. Most patients discharged within 5 days and followed up at least 6 months. RESULTS: There were 12 men and 16 women with average age of 45.3(28-82). Five patients had 2 level fractures and 2 patients had 3 level fractures. The average injection volume was 5.6cc per level. Average VAS (Visual Analogue Scale) improved 26mm after surgery. The immediate postoperative X-ray showed 2 cases of filler spillage into spinal canal and 4 cases of leakage into the retroperitoneal space. One patient with intraspinal leakage was underwent the laminectomy to remove the resin. CONCLUSION: Osteoplasty is a safe and new treatment option in the burst fractures. Osteoplasty with minimally invasive technique reduced the hospital stay and recovery time in vertebral fracture patients.
Anesthesia, Local ; Female ; Fractures, Compression ; Humans ; Laminectomy ; Length of Stay ; Ligaments ; Magnetic Resonance Imaging ; Male ; Osteoporosis ; Retroperitoneal Space ; Spinal Canal ; Spine ; Vertebroplasty

No abstract available.

BACKROUND/AIMS: It has been thought that in many of those who complain of "epigastric soreness," their symptom is actually "heartburn" secondary to gastroesophageal reflux disease (GERD). This study was undertaken to determine the incidence of GERD in patients who complain of epigastric soreness and to evaluate the effect of cisapride tartrate on their symptoms. METHODS: A total 107 patients who visited tertiary referral hospitals and complained of epigastric soreness were enrolled. We evaluated their symptoms and performed esophagogastroduodenoscopies (EGD). In 53 of the 107 patients who showed a normal EGD, gastroesophageal reflux studies (24 hour ambulatory pH monitoring, Bernstein test, modified Bernstein test) were performed. RESULTS: Of the 107 patients, 36 had organic gastroduodenal diseases, 18 had reflux esophagitis, and 53 showed a normal EGD finding. Of these 53 patients, the gastroesophageal reflux studies were normal in 23 patients and abnormal in 30. Forty eight (44.9%) of 107 patients showed reflux-associated epigastric soreness. There was no difference in demographic characteristics among reflux-associated, gastroduodenal, and functional epigastric soreness groups. Among clinical characteristics of the 3 groups, the only difference found was the time of the symptoms during a day. In the reflux-associated epigastric soreness group, the symptoms were more severe during daytime. After cisapride tartrate administration for 4 weeks, symptom scores of reflux-associated and functional epigastric soreness groups improved from 9.2+/-3.9 and 10.4+/-3.9 to 4.0+/-3.8 and 3.8+/-2.2, respectively. CONCLUSIONS: We found a great number of patients having GERD among those complaining of "epigastric soreness." Cisapride tartrate was effective in relieving epigastric soreness in reflux-associated and functional epigastric soreness groups.
Cisapride* ; Endoscopy, Digestive System ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Incidence* ; Tertiary Care Centers

BACKGROUND: DNA of epidermodysplasia verruciformis(EV)-associated human papillomaviruses (HPVs) has been detected in benign and malignant skin tumors and other proliferative diseases of epithelial origin. The objective of this study was to determine the association of EV-associated HPV DNA in nongenital seborrheic keratoses(SK) in Korean patients. SUBJECTS AND METHODS: Forty biopsy specimens were collected from patients with nongenital SK and cutaneous SCC and controls. All tissue samples were examined by PCR. RESULTS: By polymerase chain reaction(PCR), EV-associated HPV DNA was detected in 15 of 40 nongenital SK(37.5%) compared with 1 of 40 cutaneous squamous cell carcinomas(SCC) samples and 3 of 40 healthy controls. Detected viruses in SK included HPV 20(n=6), HPV 23 (n=2). The rest tested positive for HPV 5, 16, 17, 22, 25, 37, and RTRX4. CONCLUSION: Our findings suggest that EV-associated HPV may be involved in the pathogenesis of nongenital SK of Asian skin.
Asian Continental Ancestry Group ; Biopsy ; DNA* ; Humans* ; Keratosis, Seborrheic* ; Papilloma* ; Polymerase Chain Reaction ; Skin*

Despite its low incidence, stent thrombosis (ST) is one of the most dreaded complications of percutaneous coronary intervention. Endeavor (Medtronics Europe SA) is a new zotarolimus-eluting stent (ZES) with a favorable safety profile that was reported in early and ongoing trials. However, few lethal stent thromboses related to this new drug eluting stent (DES) have been reported. We experienced a case of simultaneous subacute ZES thromboses, 6 days after stent implantations in the proximal left anterior descending artery and the proximal right coronary artery (RCA).
Arteries ; Coronary Vessels ; Drug-Eluting Stents ; Europe ; Incidence ; Percutaneous Coronary Intervention ; Sirolimus ; Stents ; Thrombosis

BACKGROUND: Chemically induced epidermal carcinogenesis is usually divided into two stages, the initiation and promotion. The initiation involves conversion of some epidermal cells into latent neoplastic cells and the promotion is proliferation of the transformed cells. Ethyl carbamate (EC) has been identified at low microgram quantities in various fermented beverages, distilled products and tobacco smoke. It has been known as a initiator of tumor. Oxidation of the ethyl group of EC is followed by dehydration to yield the carcinogen vinyl carbamate (VC). This is further oxidized to vinyl carbamate epoxide (VCO). VC and VCO proved to be much more carcinogenic than EC. OBJECT: This study is attemped to investigate the skin tumor and non-skin tumor in hairless mice induced by application of 12-0-tetradecanoyl-phorbol-13-acetate (TPA) on the skin initiated with VCO and its relationship with calcium gradient and epidermal lipid. METHODS: In this experiment, the tumor induction was performed by painting the mouse skin once a week for five weeks with VCO solution, and then 12-0-tetradecanoyl-phobol-13-acetate (TPA) was treated in the same manner twice a week for 40 weeks. We biopsied the skin at 5, 10, 25, 30, 35 and 40 weeks and stained the specimens with hematoxylin-eosin, Ru04 postfixation and ion capture cytochemistry for calcium staining. RESULTS: The results are summerized as follows 1. Cellular proliferation, hyperkeratosis and dysplasia of the epidermis were more prominent in skin tumors than non-skin tumors. Papillomas were developed at 8 weeks after application of VCO- TPA but not TPA alone. The occurrence of keratoacanthoma and squamous cell carcinoma was 33 and 39 weeks, respectively. 2. Calcium gradient was distorted in the only TPA treatment group but normal in the control group. Calcium deposition was increased through all layers of epidermis and the calcium gradient was disappeared in the epidermis of tumors in the VCO-TPA treatment group. These findings were similar to papilloma, keratoacanthoma and squamous cell carcinoma. 3. Fragmented, incomplete lipid bilayer formation, dilated intercellular spaces and multiple lacunar domains were prominent in the VCO-TPA and TPA treatment groups but not in the control group. The VCO-TPA treatment group has shown more epidermal lipid damage than that of the only TPA treatment group. 4. Diploid DNA histogram patterns were observed in all the control and TPA treatment groups. But aneuploidy was observed in 1 of 3 keratoacanthomas and 3 of 3 squamous cell carcinomas. CONCLUSION: From the above results, it is concluded that various skin tumors, such as papilloma, keratoacanthoma and squamous cell carcinoma or non-skin tumor were produced by VCO. Skin tumors showed various, distinctive light microscopic or electron microscopic changes compared to the non-skin tumor. It is thought that intercellular lipid change and calcium gradient disappearance in the epidermis have an important role in the carcinogenesis.
Aneuploidy ; Animals ; Beverages ; Calcium* ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Proliferation ; Dehydration ; Diploidy ; DNA ; Epidermis ; Extracellular Space ; Histocytochemistry ; Keratoacanthoma ; Lipid Bilayers ; Mice ; Mice, Hairless* ; Paint ; Paintings ; Papilloma ; Skin* ; Smoke ; Tobacco ; Urethane

BACKGROUND/AIMS: Mirocam(R) capsule endoscopy has been widely used in Korea; however, data with respect to Mirocam(R) capsule endoscopy is lacking. We have assessed the factors affecting complete small bowel studies and diagnostic yield in Mirocam(R) capsule endoscopic studies. METHODS: We retrospectively analyzed 103 cases that were assessed with Mirocam(R) capsule endoscopy between June 2007 and February 2010 at Guro Korea University Hospital. RESULTS: The mean age of the 103 cases was 55.47 years (range, 16-99 years) and 67 cases (65%) were male. The indications for capsule endoscopy were hematochezia/melena (77 cases, 74.8%), anemia (8 cases, 7.8%), abdominal pain (12 cases, 11.7%), and miscellaneous (weight loss and chronic diarrhea; 6 cases, 5.8%). The mean stomach transit time was 59.9+/-88.3 minutes (range, 1-630 minutes) and the mean small bowel transit time was 396.0+/-131.7 minutes (range, 117-708 minutes). The rate of successfully performing a complete small bowel study was 82.5% (85 cases), and the stomach transit time was a significant factor for a complete small bowel study (OR=0.991, 95% CI=0.984-0.998, P=0.012). The diagnostic yield was 51.5% (53 cases); visual quality was a significant factor in determining the diagnostic yield (OR=6.776, 95% CI=1.32-34.70, P=0.022). CONCLUSIONS: In a Mirocam(R) capsule endoscopic study, short stomach transit time was a significant factor affecting completion of the small bowel study. Achieving excellent visual quality by good bowel preparation was a significant factor for improving the diagnostic yield.
Abdominal Pain ; Anemia ; Capsule Endoscopy ; Humans ; Korea ; Male ; Retrospective Studies ; Stomach

The best treatment modality for spontaneous intracerebral hemorrhage still remains to be controversial. Stereotactic surgery can be performed safely and easily but its indication and optimal timing of operation have to be determined. We treated 80 patients with spontaneous intracerebral hemorrhage by stereotactic surgery from October 1994 to December 1997. We investigated clinical status of the patients before and after surgery, amount of hematoma, evacuation rate, timing of operation, transcranial Doppler sonography(TCD), and computerized tomography(CT) findings. The results were as follows: 1) The outcome of early surgery(within 24 hours of bleeding) was better than that of late surgery(after 24 hours of bleeding)(p=0.034). 2) The outcome was better in the patient with higher evacuation rate(p=0.014). 3) TCD monitoring showed beneficial effect of surgery on hemodynamic status. We conclude that the early surgery within 24 hours after bleeding is correlated with the better outcome, and TCD monitoring is useful for evaluation of perioperative hemodynamic change.
Cerebral Hemorrhage* ; Hematoma ; Hemodynamics ; Hemorrhage ; Humans

BACKGROUND: To meet the need for a subspecialized skin type system, the Baumann skin type (BST) system was proposed. OBJECTIVE: To evaluate the distribution of BST types and influencing factors among Korean women. METHODS: BST questionnaires were administered to 1,000 Korean women. The possible responses were as follows: oily (O) or dry (D), sensitive (S) or resistant (R), pigmented (P) or non-pigmented (N), and wrinkled (W) or tight (T). The correlations of the BST with the subjects' age, location, ultraviolet (UV) ray exposure, drinking and smoking habits, and blood type were assessed. RESULTS: The OSNT, DSNT, DRNT, and OSNW skin types were the most common skin types (55.3%). The O, S, P, and W types accounted for 46.6%, 68.8%, 23.2%, and 31.9%, respectively. The proportion of the O and S type was the highest in Gyeongsangbuk-do (55.0%) and Seoul (77.2%). The proportion of the P and W type was the highest in Gyeongsangbuk-do (33.0%) and Chungcheong-do (39.0%). The O type decreased in the higher age group, whereas the P and W type showed a reversed tendency. In smokers, the proportion of W type was significantly higher than in the non-smokers (66.3% vs. 24.1%, p<0.05). CONCLUSION: The 4 most common BST types were OSNT, DSNT, DRNT, and OSNW. In the comparison across the 4 BST parameters according to the age, region, smoking and drinking habits, occupation, blood type, and UV exposure, significant differences were observed. Individualized and customized skin care is required according to the personal skin type.
Drinking ; Female* ; Gyeongsangbuk-do ; Humans ; Occupations ; Seoul ; Skin Care ; Skin* ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND/AIMS: Recent studies have shown that serum interferon gamma-inducible protein-10 (IP-10) concentration decreased after pegylated interferon and ribavirin therapy, and was associated with a sustained virologic response (SVR). The aim of this study was to investigate the clinical significance of the pretreatment IP-10 level and change in serum IP-10 level between 1 month before and after treatment and its association with various virologic responses in patients having chronic hepatitis C (CHC) with genotype 1 undergoing pegylated interferon and ribavirin therapy. METHODS: Thirty-six patients having CHC with genotype I undergoing pegylated interferon and ribavirin therapy who had available stored sera 1 month before and after treatment were enrolled retrospectively. Serum IP-10 levels were measured by ELISA. Serum HCV RNA was measured by RT-PCR (detection limit<50 IU/mL). RESULTS: The mean age of patients (n=36; 21 men) was 53.5 years, and the mean of pretreatment HCV RNA levels was 5.7 log10 IU/mL. The serum IP-10 level at 1 month after treatment significantly decreased from 432.2 to 306.5 pg/mL (p=0.033). The rate of rapid virologic response (RVR), early virologic response (EVR), end-of-treatment response (ETR), and SVR were 58%, 83%, 74%, and 57%, respectively. No significant difference in pretreatment IP-10 levels was observed between the patients with (RVR, EVR, ETR, and SVR) and without various virologic responses (p>0.05). The change in serum IP-10 between 1 month before and after treatment had no clinical meaning based on various virologic responses (p>0.05). CONCLUSIONS: The level of pretreatment IP-10 and change in IP-10 level between 1 month before and after treatment were not predictive factors of a SVR. Additional large-scale studies to determine the SVR-predicting role of serum IP-10 levels in patients with CHC are needed.
Enzyme-Linked Immunosorbent Assay ; Genotype ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferons ; Retrospective Studies ; Ribavirin ; RNA