We reviewed clinically the 56 patients, who had anterior interbody fusion of the cervical spine due to various causes, from 1975 to 1984. The result of the studies are as follows; 1. Inawaisting sign of the grafted level is the one of the most important prognostic factors which indicates the favorable fusion. 2. The mechanism of the inwaisting sign is not confirmed, however plausible explanation is the flexure drift law, which cause the inwaisting phenomena. 3. The time of clinical, radiological union and the appearance of the inwaisting sign of the grafted bone in the fusion of the lower cervical spine are displayed earlier than in the upper cervical spine. 4. Fusion at the one level is obtained one or two weeks earlier than the two level fusion. At the two level fusion, one large bone block operation achieved the earlier bony union than the two separate bone blocks fusion; it could shorten the fusion time by 4 weeks radiologically, although there were no significant difference in clinical aspect and inwaisting sign. 5. In the anterior interbody fusion of the cervical spine, clinical fusion took place in 6–7 weeks, and radiological one in 10-14 weeks after the fusion operation. And it was not influenced by the type of injury or neurological complications. The inwaisting sign appeared from the 4th to 7th week postoperatively. 6. There are no problems in the case of posterior instability initially. The reason is that we have performed the cervical traction and absolute bed rest for 4 to 6 weeks before the anterior interbody fusion in order to take the healing of the poterior ligament complex.
Bed Rest ; Clinical Study ; Humans ; Jurisprudence ; Ligaments ; Spine ; Traction ; Transplants

Melorheostosis is a rare disease entity of bone with an etiology and pathogenesis. It cause pain and stiffness in an affected limb, and dense bone formation along the side of bone resembles the flow of candle dripping. Two cases of the disease involving left hand and wrist, and right lower leg are reported with the review of literature.
Extremities ; Hand ; Hyperostosis ; Leg ; Melorheostosis ; Osteogenesis ; Rare Diseases ; Wrist

No abstract available.
Adenoma*

Pure lipoma, originating from the trachea is a very rara disease entity A-37-ycar-old-male patient had suf'leered from intermittent episodes of dyspnea and has been treated under the diagnosis of bronchial asthma for 6 months. On chest CT scan and bronchofiberscopic examination, a round mass with the pedunculated neck was found in the mid-portion of the membranous portion of the intrathoracic trachea. Under the guide of fiberoptic bronchoscope, the mass was extirpated using polypectomy w re loop and eletrocauterization. He was discharged without any events on third postoperative day of operation and has been well without recurrence for 6 months.
Asthma ; Bronchoscopes ; Diagnosis ; Dyspnea ; Humans ; Lipoma* ; Neck ; Recurrence ; Tomography, X-Ray Computed ; Trachea

No abstract available.
Female ; Gonadotropin-Releasing Hormone* ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

PURPOSE: More than a few patients revisit Emergency Departments (EDs) with the same complaint. It is generally assumed that a revisit within a short period happens due to an inadequate evaluation during the previous visit, which creates a quality problem in emergency care. The purpose of this study is to analyze patient's revisiting the ED within 48 hours after being discharged and to use this information as a tool for quality assurance in the ED. METHODS: We carried out a chart review of patients who have revisited the ED within 48 hours between March 1, 2000 and February 28, 2002. We divided the patients into three groups according to their age. Disease variables were analyzed according to the age groups and admission rates. RESULTS: A total of 78,182 patients visited the ED during the period. Of these, 66,974 patients were discharged from the ED and the others were admitted. Of these discharged, 1,012 patients revisited the ED with the same complaints within 48 hours. The common disease or complaint of the short-term revisiting patients in order were acute abdomen, acute pharyngotonsilitis, ureter stones, respiratory problems, etc. Admissions of revisiting patients were due to acute abdomen, acute gastroenteritis, acute appendicitis, intussucception, panperitonitis, ileus, etc. There were significantly different admission rates according to initial symptoms, diseases and the age group of the revisiting patient. CONCLUSION: For quality improvement of emergency care, we need to standardize a management protocol, and the guidance for patient care provided in this paper might be recommended. A short -stay unit in the ED may be useful in some cases.
Abdomen, Acute ; Appendicitis ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital ; Gastroenteritis ; Humans ; Ileus ; Patient Care ; Quality Improvement ; Ureter

Anterior papillary muscle rupture caused by occlusion of the first diagonal branch is reported to be very rare. A 66-year-old woman was transferred to our hospital for acute myocardial infarction and cardiogenic shock. Echocardiography and angiography revealed severe mitral regurgitation caused by rupture of the anterior papillary muscle and the complete occlusion of the first diagonal branch. In an emergent setting, she had been successfully treated by mitral valve replacement and coronary artery bypass grafting. She was discharged on postoperative twelfth day without any event.
Aged ; Angiography ; Coronary Artery Bypass ; Echocardiography ; Female ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Myocardial Infarction ; Papillary Muscles* ; Rupture* ; Shock, Cardiogenic

PURPOSE: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model. MATERIALS AND METHODS: Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MRI, and US at 1 day, 3 day, and 1 week after operation. RESULTS: US was superior to MRI or spiral CT in diagnosis of diaphragmatic rupture(P<0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitively of MRI and spiral CT increased as the size of laceration were larger, but no statistical significant was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase. US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spinal CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05) In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05). CONCLUSION: This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.
Animals ; Delayed Diagnosis ; Diagnosis* ; Diaphragm ; Hemothorax ; Hernia ; Humans ; Lacerations ; Magnetic Resonance Imaging ; Models, Animal ; Mortality ; Pleural Effusion ; Rabbits ; Rupture* ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Ultrasonography* ; Viscera

BACKGROUND: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma. METHODS: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013. RESULTS: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis. CONCLUSION: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.
Adenocarcinoma* ; Carcinoembryonic Antigen* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lung* ; Lymph Nodes ; Medical Records ; Multivariate Analysis ; Neoadjuvant Therapy ; Pathology ; Prognosis ; Recurrence ; Sensitivity and Specificity ; Smoke ; Smoking

PURPOSE : In a recent study of Wilms' tumors, a new X chromosome gene, Wilms' tumor gene on the X chromosome (WTX), was discovered that was found to harbor small deletions and point mutations. The WTX protein negatively regulates Wnt/beta-catenin signaling, and is considered to be a tumor suppressor gene. One of the questions about the WTX gene is whether the genetic alterations of the WTX gene are specific only to Wilms' tumors. The aim of this study was to explore whether the WTX gene mutation is a characteristic of human non-small cell lung cancer (NSCLC). MATERIALS AND METHODS : In the current study, we analyzed the part of the WTX gene encoding the N-terminal of WTX, where most of the WTX point mutations have been detected in Wilms' tumors. Forty-eight NSCLC tissues were analyzed by a single-strand conformation polymorphism assay and DNA sequencing. RESULTS : SSCP analysis revealed no evidence of somatic mutations in the DNA sequences encoding the N-terminal of the WTX gene in the 48 NSCLC tissues. CONCLUSION : The data presented here indicate that the WTX gene may not be somatically-mutated in human NSCLCs, and suggest that NSCLCs may not utilize mutational events of the WTX gene in the process of pathogenesis
Base Sequence ; Carcinoma, Non-Small-Cell Lung ; Genes, Tumor Suppressor ; Humans ; Point Mutation ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Wilms Tumor ; X Chromosome