In the March 2009 edition of the Journal of Korean Neurosurgical Society, we published an article entitled "Unilateral Lumbosacral Facet Interlocking without Facet Fracture" (Volume 45, pages 182-184). Fig. 1B on page 183 was supposed to be printed in color, but it was printed in black by mistake. We apologize to the authors and readers of JKNS for any inconvenience.

We encountered a case of neonatal altoimmune thrombocytopenia(NAIT) due to anti-HLA-B7+B60+B61. Bilateral cephal hematoma and umbilical hematoma were noted at the time of birth. Purpura developed at the third day. Platelet count was 110,000 at birth and decreased to 66,000/micro liter at the day 4. Prothrombin time and partial prothrombin time were within normal limit. The mother's platelet count was 220,000/micro liter and she had no history of abnormal bleeding. Platelet antibody tests empolying mixed passive hemagglutination and immunofluorescence revealed that the mother's serum was reactive against the platelets from the father and the neonate, but was not reactive with her own platelets. Platelets from eight volunteer group 0 donors were tested with the mother's serum; seven were reactive and one was negative. The positive reactions were lost after chloroquine treatment of platelets. Antigen capture ELISA(ACE) and modified antigen capture ELISA employing monoclonal antibodies against platelet glycoproteins In, IIa, IIb, and IIIa were negative. Mother's serum was tested for lymphocytotoxicity against 49 donor ]ymphocytes and the specificity was found to be anti-HLA-B7+B60+B61. At the 9th day, one unit of platelet concentrate from the mother was transfused and the platelet count of the neonate rose up to 340,000/micro liter. The neonate was discharged at the day of sixteenth and the platelet count remained high thereafter.
Antibodies, Monoclonal ; Blood Platelets ; Chloroquine ; Enzyme-Linked Immunosorbent Assay ; Fathers ; Fluorescent Antibody Technique ; Hemagglutination ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Membrane Glycoproteins ; Prothrombin Time ; Purpura ; Sensitivity and Specificity ; Thrombocytopenia* ; Tissue Donors ; Volunteers

No abstract available.
Peritoneum*

Diffuse pulmonary meningotheliomatosis (DPM) is an extremely rare condition. We herein report a unique case of DPM in a 54-year-old woman with a previous history of hepatocellular carcinoma. A chest computed tomography showed diffuse bilateral nodular infiltration, suggesting miliary spread of metastatic hepatocellular carcinoma. The patient underwent a video-assisted thoracoscopic surgery for diagnostic purposes. The cut surface of the lung specimen showed multiple dispersed small nodules, consisting of variably sized nests or whorls of bland epithelioid cells often along the walls of alveolar septa or in a perivascular network within the alveolar interstitium. The tumor cells showed immunoreactivity for epithelial membrane antigen, vimentin, and progesterone receptor. DPM should be included in the differential diagnosis of diffuse multiple small nodules or a reticular pattern in the radiologic studies.
Carcinoma, Hepatocellular ; Diagnosis, Differential ; Epithelioid Cells ; Female ; Humans ; Lung ; Lung Neoplasms ; Meningioma ; Middle Aged ; Mucin-1 ; Receptors, Progesterone ; Thoracic Surgery, Video-Assisted ; Thorax ; Vimentin

OBJECTIVE: Although several prior works showed the white matter (WM) integrity changes in amnestic mild cognitive impairment (aMCI) and Alzheimer's disease, it is still unclear the diagnostic accuracy of the WM integrity measurements using diffusion tensor imaging (DTI) in discriminating aMCI from normal controls. The aim of this study is to explore diagnostic validity of whole brain automated probabilistic tractography in discriminating aMCI from normal controls. METHODS: One hundred-two subjects (50 aMCI and 52 normal controls) were included and underwent DTI scans. Whole brain WM tracts were reconstructed with automated probabilistic tractography. Fractional anisotropy (FA) and mean diffusivity (MD) values of the memory related WM tracts were measured and compared between the aMCI and the normal control groups. In addition, the diagnostic validities of these WM tracts were evaluated. RESULTS: Decreased FA and increased MD values of memory related WM tracts were observed in the aMCI group compared with the control group. Among FA and MD value of each tract, the FA value of left cingulum angular bundle showed the highest area under the curve (AUC) of 0.85 with a sensitivity of 88.2%, a specificity of 76.9% in differentiating MCI patients from control subjects. Furthermore, the combination FA values of WM integrity measures of memory related WM tracts showed AUC value of 0.98, a sensitivity of 96%, a specificity of 94.2%. CONCLUSION: Our results with good diagnostic validity of WM integrity measurements suggest DTI might be promising neuroimaging tool for early detection of aMCI and AD patients.
Alzheimer Disease ; Anisotropy ; Area Under Curve ; Brain ; Diffusion Tensor Imaging ; Humans ; Memory ; Mild Cognitive Impairment* ; Neuroimaging ; Sensitivity and Specificity ; White Matter

Because additive effects of inhaled corticosteroids and long-acting anticholinergics are unclear, we undertook this study to compare the efficacy of tiotropium alone and tiotropium plus budesonide in patients with chronic obstructive pulmonary disease. The study subjects were randomized to receive either tiotropium 18 microgram once daily with or without budesonide 200 microgram twice daily for 6 weeks. The efficacy variables were changes in trough forced expiratory volume in one second (FEV1), St. George's Respiratory Questionnaire (SGRQ), 6-minute walk distance (6MWD), and use of rescue medication. One hundred patients were randomized and 81 completed the study. The mean age was 64.0 yr, and the mean FEV1 was 39.7% predicted. Compared with tiotropium alone (N=40), the tiotropium/budesonide combination (N=41) was related to an improvement in the SGRQ total score (tiotropium -2.8 units and tiotropium/budesonide -5.6 units, p=0.003). 6MWD was improved by 13.5 m in the tiotropium group and by 22.5 m in the tiotropium/budesonide group (p=0.031). Changes in trough FEV1 and the use of rescue medication were similar between two groups. In conclusion, compared with tiotropium alone, the tiotropium/ budesonide combination was related to an improved health-related quality of life. These data support that low-dose budesonide may enhance the efficacy of tiotropium.
Aged ; Bronchodilator Agents/*administration & dosage ; Budesonide/*administration & dosage ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Models, Statistical ; Pulmonary Disease, Chronic Obstructive/*drug therapy ; Quality of Life ; Questionnaires ; Scopolamine Derivatives/*administration & dosage ; Spirometry/methods ; Treatment Outcome

PURPOSE: Intimal hyperplasia (IH) due to vascular smooth muscle cell proliferation is a leading cause of late vascular graft failure. Transforming growth factor-beta1 (TGF-beta1), known to influence smooth muscle cell growth in vascular wall has been subjected for experimental research as a cause of IH. It has been also showed that IH can be mediated by local renin-angiotensin system in vascular intimal injury. Under the assumption that TGF-beta1 and local angiotensin II (ANG II) have a major role as a cause of IH, we carried out this study to see if there are any relationship between intimal hyperplasia and TGF-beta1 mRNA expression, and effect of angiotensin-converting enzyme inhibitor (ACEI) on IH. METHODS: 14 New Zealand White rabbits were subjected for this experiment. The right carotid arteries of 14 rabbits had been bypass grafting with polytetrafluoroethylene. 14 rabbits were allocated into two groups: 7 rabbits had bypass grafting only (graft only) and the other 7 rabbits had bypass grafting with ACEI (graft with ACEI). The rabbits, graft with ACEI were on Captopril (10 mg/kg/day PO) from day of operation to 8 weeks when to harvest. There were patent 9 carotid bypass grafts at harvest, and the studies were performed in patent grafts. Intimal hyperplasia was defined by the intima to media height ratio (IMHR). The mRNA expression of TGF-beta1 was determined by semiquantitative RT-PCR. RESULTS: IMHR of graft with ACEI was lower than that of graft (p<0.05). The mRNA expression of TGF-beta1 in graft with ACEI was lower than that in graft only (p<0.05). In summary, there was evidence that TGF-beta1 is closely related with intimal hyperplasia and there is also relationship between ANG II and TGF-beta1. CONCLUSION: ANG II and TGF-beta1 may mediate intimal hyperplasia of vascular graft, and ACE inhibitor may be a armamentarium for inhibition of intimal hyperplasia in vascular graft procedures.
Angiotensin II ; Captopril* ; Carotid Arteries* ; Cell Proliferation ; Hyperplasia ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Polytetrafluoroethylene* ; Rabbits ; Renin-Angiotensin System ; RNA, Messenger* ; Transforming Growth Factor beta1* ; Transplants*

Convex-probe endobronchial ultrasound-guided transbronchial needle aspiration (CP-EBUS-TBNA) has emerged as a new diagnostic modality that allows ultrasound-guided, real-time needle aspiration of mediastinal and hilar lymph nodes. Mediastinoscopy has been the reference standard for neoplastic staging in the mediastinum, but it is invasive and requires general anesthesia. Considering recent prospective studies and clinical guidelines, a needle technique such as EBUS-TBNA and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) should be performed first for the mediastinal nodal staging of non-small lung cancer. Combining EBUS-TBNA and EUS-FNA will replace more invasive methods such as mediastinoscopy. CP-EBUS-TBNA can also be used for the restaging after neoadjuvant therapy, the diagnosis of recurrent lung cancer and central lung parenchymal lesion which abuts trachea or bronchi. In the era of personalized medicine, good-quality and sufficient tissues need to be obtained for the molecular testing and treatment guidance. EBUS-TBNA has the ability to obtain satisfactory material for the detection of EGFR mutation, KRAS mutation, and EML-ALK fusion gene.
Anesthesia, General ; Bronchi ; Diagnosis* ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Mediastinoscopy ; Mediastinum ; Methods ; Needles ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Trachea ; Precision Medicine

BACKGROUND: Intimal hyperplasia due to vascular smooth muscle cell proliferation is a leading cause of late vascular graft failure. Transforming growth factor-beta1 (TGF-beta1), known to influence smooth muscle cell growth in vascular wall has been the subject of experimental research as a cause of this intimal hyperplasia. Under the assumption that TGF-beta1 has a major role as a cause of intimal hyperplasia, we carried out this study to see if there were any relationship between intimal hyperplasia and TGF-beta1 mRNA expression in vascular bypass graft. METHODS: 21 New Zealand white rabbits were used for this experiment. The right carotid arteries of the 21 rabbits had been bypass grafted with polytetrafluoroethylene (PTFE graft), and the contralateral carotid arteries received sham operations (Control group). The 21 rabbits were allocated into three groups according so that the carotid artery grafts could be harvested at 1, 8, and 14 weeks, respectively. There were 14 patent carotid bypass grafts at harvest (4, 5, and 5 cases according to the postoperative period), and the studies were performed on those patent grafts. Intimal hyperplasia was defined by the intima-to- media height ratio (IMHR). The mRNA expression of TGF-beta1 was determined by semiquantitative RT-PCR. RESULTS: The IMHR in the PTFE graft groups increased as time went by from 1 to 14 weeks (p<0.01). The mRNA expressions of TGF-beta1 in PTFE grafts were higher than those in the controls at 1 and 8 weeks (p<0.05). According to sequential changes in the PTFE grafts, the expressions of TGF-beta1 were highest at 8 weeks and lowest at 14 weeks (p<0.05). CONCLUSIONS: There is evidence that TGF-beta1 is closely related with intimal hyperplasia in vascular bypass graft until 8 weeks after PTFE graft anastomosis.
Carotid Arteries* ; Cell Proliferation ; Hyperplasia* ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Polytetrafluoroethylene* ; Rabbits ; RNA, Messenger* ; Transforming Growth Factor beta1* ; Transplants*

Acute traumatic spondylolisthesis at L5-S1 level is a rare condition, almost exclusively the result of major trauma, frequently associated with transverse process fractures and severe neurologic deficits. Recently, open reduction and internal fixation with posterior stabilization has been the method of treatment most frequently reported. We report a rare case of traumatic L5-S1 pondylolisthesis with a unilateral facet locking with a review of literatures.
Neurologic Manifestations ; Spondylolisthesis