OBJECTIVE: The goal of study is the evaluation of clinicofunctional outcomes and fusion success rates of unilateral posterior lumbar interbody fusion(PLIF) using cages. METHODS: The authors conducted retrospective study of 81 patients who underwent unilateral PLIF using cages. The outpatient notes, standard hospital charts, and pre-and postoperative imaging studies were analyzed. In this study pre-and postoperative back pain, radiating pain, fusion success rates, pseudoarthrosis, clinicofunctional outcome, and complications were evaluated. Follow-up duration ranged from 3 to 8 years. RESULTS: Eighty-one patients underwent unilateral PLIF using 98 cages(TFC:37, CH cage:25, Novus cage 36). Two-level fusion was performed in 17 patients. There were 48 men(59%) and 33 women(41%). Seventh decade was most common(47%). The most common site of PLIF was at L4-5 space(69.4%) and left side(58%) was prevalent. Fusion was successful in 91 out of 98 levels(92.8%) and pseudoarthrosis was observed in five patients(7 level, 7%). The clinicofunctional results by Prolo scale were as follows:good(score 8-10):80.3%, moderate(score 6-7):14.8%, poor(score 5 or less 5):4.9%. Device migration was observed in six cases:5(20%) of 25 CH cages and 1(2.8%) of 36 Novus cages. CONCLUSION: Unilateral PLIF using cage is one of method to decrease the rates of iatrogenic complications in patient of unilateral symptomatic spinal instability while preserving normal anatomic structures with good fusion success rates and clinicofunctional results after surgery.
Back Pain ; Follow-Up Studies ; Humans ; Outpatients ; Pseudarthrosis ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Transient evoked otoacoustic emission (TEOAE) has an increasingly signficant role in pediatric otological practice such as screening hearing in newborn babies. To assess the potential applicability of the TEOAE measurements on the sequential monitoring of pediatric patients with middle ear effusion (MEE), we investigated the effects of MEE on the TEOAE responses. MATERIALS AND METHODS: TEOAE responses were recorded from 33 patients (56 ears) before and after ventilation tube insertion. RESULT: In the 37 cases with MEE, we found that the average band reproducibility below 2 kHz was recovered significantly after the tube placement, although the band reproducibility at 5 kHz was diminished. In the 19 cases without MEE, no significant changes in echo amplitude and band reproducibility were noted in the postoperative TEOAE measurements compared to the preoperative measurements. CONCLUSION: The results of this study suggest that an improvement in echo response and band reproducibility less than 2 kHz in serial TEOAE measurements may indicate the resolution of MEE in children with OME.
Child ; Hearing ; Humans ; Infant, Newborn ; Mass Screening ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Ventilation

BACKGROUND: It has been speculated that many factors including age, hemoglobin serum albumin level and socioeconomic factors are closely related with the mortality and morbidity of patients with end-stage renal disease (ESRD). Optimal management of the patients with pre-dialysis chronic kidney disease has been thought to be very important for the prognosis of end-stage renal disease patients on dialysis. METHODS: In order to evaluate the clinical impact of referral pattern of chronic renal failure patients to nephrologist, 217 patients (male 129, female 88) who initiated hemodialysis from Jan. 1998 to Jul. 2002 in Chungnam National University Hospital were included in this retrospective analysis. Patients were defined as early referral (n=129) when hemodialysis was initiated at least 90 days after the first visit to nephrologist and as late referral (n=88) when hemodialysis was performed within 90 days after the first visit to nephrologist. RESULTS: Male gender and medical aid coverage were significantly more prevalent in late referral than early referral group (p<0.05, p<0.05, respectively). Late referral group had more combined medical problems than those of early referral group (p<0.05). Serum albumin level of early referral group was significantly higher than that of late referral group at the initiation of hemodialysis (p<0.001). At the initiation of hemodialysis, temporary central catheter for the blood access was needed in 85.2 % of late referral group. However, only 41.6% of early referral group needed such temporary catheter (p<0.001). One year after initiation of hemodialysis treatment, early referral group showed significantly lower mortality rate than that of late referral group (p<0.001). CONCLUSION: The early referral of chronic renal failure patients to nephrologist has beneficial effects including higher one-year survival after beginning of hemodialysis.
Catheters ; Chungcheongnam-do ; Dialysis ; Female ; Humans ; Kidney Failure, Chronic* ; Male ; Mortality ; Prognosis ; Referral and Consultation* ; Renal Dialysis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Serum Albumin ; Socioeconomic Factors

BACKGROUND: The aim of the present study was to determine the frequency of six efflux pump genes in Acinetobacter clinical isolates collected from South Korean hospitals. METHODS: In this study, we used a total of 339 Acinetobacter strains, comprising 279 Acinetobacter calcoaceticus–Acinetobacter baumannii (ACB) complex and 60 non-ACB complex strains. We performed specific PCR assays to detect adeG, adeB, adeE, adeY, abeM, and adeJ, transporter genes of the multidrug efflux pumps AdeFGH, AdeABC, AdeDE, AdeXYZ, AbeM, and AdeIJK, respectively. RESULTS: Frequencies of six efflux pump genes varied according to the species of Acinetobacter. Frequencies of adeE, abeM, and adeJ between A. baumannii group and A. nosocomialis group were found to be significantly different. Significant differences were found in the frequencies of adeB, adeE, adeY, and adeJ among the susceptible A. baumannii (SAB), multidrug-resistant A. baumannii (MDRAB), and extensively drug-resistant A. baumannii (XDRAB) groups within the 154 strains of A. baumannii. The frequencies of efflux pump genes in imipenem-susceptible and imipenem-nonsusceptible groups were significantly different for adeB, adeY, and adeJ. The frequencies of efflux pump genes in ciprofloxacin-susceptible and ciprofloxacin-nonsusceptible groups were significantly different for adeB and adeY. No significant difference was found in the frequency of efflux pump genes among groups sampled from different regions of Korea, across 86 strains of A. baumannii collected in 2012. CONCLUSIONS: The frequencies of six efflux pump genes obtained in this study demonstrate the fundamental epidemiological feature of efflux pump genes in Korean Acinetobacter clinical isolates.
Acinetobacter ; Gene Frequency ; Genes, MDR ; Korea ; Polymerase Chain Reaction

Background/Aims: A poor prognostic factor for Crohn’s disease (CD) includes perianal fistulizing disease, including perianal fistula and/or perianal abscess. Currently, a tool to assess perianal symptoms in patients with CD remains nonexistent. This study aimed to develop a perianal fistulizing disease self-screening questionnaire for patients with CD. Methods: This prospective pilot study was conducted at three tertiary referral centers between January 2019 and May 2020. We formulated questions on perianal symptoms, including tenesmus, anal discharge, bleeding, pain, and heat. A 4-point Likert scale was used to rate each question. Patients with CD completed a questionnaire and underwent pelvic magnetic resonance imaging (MRI). Results: Overall, 93 patients were enrolled, with 51 (54.8%) diagnosed with perianal fistulizing disease, as determined by pelvic MRI. The Spearman correlation findings demonstrated that anal pain (p = 0.450, p < 0.001) and anal discharge (p = 0.556, p < 0.001) were the symptoms that most significantly correlated with perianal disease. For anal pain and discharge, the area under the receiver operating characteristic curve of the scores was significantly higher than that of the combined score for all five symptoms (0.855 vs. 0.794, DeLong’s test p = 0.04). For the two symptoms combined, the sensitivity, specificity, and positive predictive and negative predictive values were 88.2, 73.8, 80.4, and 83.8%, respectively, with 81.7% accuracy for detecting perianal fistulizing disease. Conclusions This study indicates that simple questions regarding anal pain and discharge can help accurately identify the presence of perianal fistulizing disease in patients with CD.

BACKGROUND: Microscopic examination of sputum smears for acid-fast bacilli (AFB) is the most important and rapid diagnostic test for pulmonary tuberculosis. However, the AFB observed on the smear may represent either M. tuberculosis or nontuberculous mycobacteria (NTM). This study examined the clinical usefulness of a polymerase chain reaction test for M. tuberculosis (TB-PCR) for the differentiation of pulmonary tuberculosis and NTM lung disease in patients with smear-positive sputums in a tertiary hospital in Korea. MATERIAL AND METHODS: From January, 2003 to December, 2003, 826 AFB smear-positive and culture-positive sputum specimens were collected from 299 patients. RESULTS: NTM were recovered from 26.6% (220/826) of the smear-positive sputum specimens and 23.4% (70/299) of the patients with smear-positive sputum. All the patients with isolated NTM had clinically significant NTM lung disease; 38 patients (54.3%) had M. avium and 26 patients (37.1%). had M. abscessus. In the patients with pulmonary tuberculosis, 78.7% of the patients (74/94) showed TB-PCR positivity, and all the patients with NTM lung disease showed negative results on the TB-PCR test (p<0.001). A positive result of the TB-PCR test on the sputum or bronchial washing fluid specimens was able to predict pulmonary tuberculosis with 88.4% sensitivity, 100% specificity, a 100% positive predictive value and a 79.7% negative predictive value for the patients with smear-positive sputum. CONCLUSION: The TB-PCR test for sputum specimens or bronchial washing fluid specimens could be useful for differentiating pulmonary tuberculosis and NTM lung disease for the patients with smear-positive sputum in Korea.
Diagnostic Tests, Routine ; Humans ; Korea ; Lung Diseases* ; Lung* ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Polymerase Chain Reaction* ; Sputum* ; Tertiary Care Centers ; Tuberculosis* ; Tuberculosis, Pulmonary*

A 44-year-old woman diagnosed with idiopathic chronic kidney disease was subjected to living related renal transplantation from her brother. Immunosuppressant consisted of cyclosporine, mycophenolate mofetil, and prednisolone. On the day 2 after transplantation, her serum level of BUN and creatinine (Cr) were normalized to 13.4 mg/dL and 1.06 mg/dL respectively. Urine output was also well maintained. On day 9, her body temperature was 39degrees C, serum level of BUN and Cr were increased to 20.8 mg/dL and 1.54 mg/dL respectively and urine output was decreased with weight gain. Her serum cyclosporine trough level was 118 ng/dL. DTPA renal scan and Doppler sonography suggested acute rejection. So, antirejection treatment was started with methylprednisolone pulse therapy under the cover of empirical broad spectrum antibiotics. On day 11, graft biopsy was done and the biopsy was compatible with acute interstitial nephritis. The relationship between the time of renal dysfunction and drug medication was analyzed; trimethoprim-sulfamethoxazole (TMP-SMZ) and omeparzole were suspected as causative drugs. So, TMP-SMZ and omeprazole were discontinued. Her serum Cr was slowly increased to 2.32 mg/dL until day 15. And afterward, her serum Cr decreased and normalized We suggest that acute interstitial nephritis should be considered among the many causes of early renal allograft dysfunction when using TMP- SMZ and omeprazole.
Adult ; Allografts ; Anti-Bacterial Agents ; Biopsy ; Body Temperature ; Creatinine ; Cyclosporine ; Female ; Humans ; Kidney Transplantation* ; Methylprednisolone ; Nephritis, Interstitial* ; Omeprazole* ; Pentetic Acid ; Prednisolone ; Renal Insufficiency, Chronic ; Siblings ; Transplants ; Trimethoprim, Sulfamethoxazole Drug Combination* ; Weight Gain

Objective: To investigate the effects of Gastrodiae rhizoma, a dried root of Gastrodia elata Blume, on proliferation and differentiation of human NSCs derived from embryonic stem cells. Methods: A 70% ethanol extract of Gastrodiae rhizoma (EEGR) was estimated with 4-hydroxybenzyl alcohol as a representative constituent by HPLC. Results: MTT assay showed that the treatment with EEGR increased the viability of NSCs in growth media. Compared to control, EEGR increased the number of dendrites and denritic spines extended from a differentiated NSC. Whereas EEGR decreased the mRNA expression of Nestin, it increased that of Tuj1 and MAP2 in NSCs grown in differentiation media. Immunocytochemical analysis using confocal microscopy also revealed the increased expression of MAP2 in dendrites of EEGR-treated NSCs. Furthermore, EEGR decreased mRNA expression of Sox2 in NSCs grown even in growth media. Conclusions: In conclusion, our study demonstrates for the first time that EEGR induced proliferation and neuronal differentiation of NSCs, suggesting its potential benefits on NSC-based therapies and neuroregeneration in various neurodegenerative diseases and brain injuries.