Concurrent use of instrumentation has been shown to increase fusion rates and satisfactory results for surgical treatment of the lumbar stenosis. The objectives of the present study were to evaluate clinically and radiologically two groups of lumbar stenosis who were surgically treated with pedicular screw fixation system and posterior lumbar interbody or posterolateral autogenous bone graft following complete posterior decompression. One group was degenerative type and the other group was spondylolisthetic type spinal stenosis. We analyzed the results of 39 cases of lumbar stenosis who underwent pedicular screw and rod fixation system and posterior lumbar interbody or posterolateral autogenous iliac bone fusion following complete posterior decompressive operation during the period from May 1988 to December 1992. There were 27cases of degenerative type and 12 cases of spondylolisthetic type lumbar stenosis. The were 25 women and 14 men. Their age was ranged 20 to 76 years old with an average of 51.7 years old. The follow up period was the interval from 18 months to 6 years with an average of 3.2 years. The radiologic union rate was average 94.9% and 96.3%(26cases) in degenerative spinal stenosis and 91.7%(11 cases) in spondylolisthetic spinal stenosis. The clinical success rate was average 92.3%(36 cases), 88.9%(24 cases) in degenerative spinal stenosis and 100%(12 cases) in spondylolisthetic spinal stenosis. The patients with spondylolytic spinal stenosis showed better result in their life than the patient with degenerative spinal stenosis.
Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Humans ; Male ; Pedicle Screws ; Spinal Stenosis ; Transplants

Kimura's disease is an uncommon, chronic inflammatory disorder of unknown etiology that is seen in an endemic form in the Orient. It usually presents as a mass in the subcutaneous tissue of the head and neck region or the major salivary glands, and is often associated with a regional lymphadenopathy. The patients have peripheral blood eosinophilia and elevated IgE levels but are otherwise usually healthy. We encountered the case of a 33-year-old man who had a soft tissue mass in his left distal arm which was diagnosed as being Kimura's disease.
Adult ; Arm* ; Eosinophilia ; Head ; Humans ; Immunoglobulin E ; Lymphatic Diseases ; Neck ; Salivary Glands ; Subcutaneous Tissue

Eosinophilia-myalgia syndrome(EMS) is a systemic illness that occurred as an epidemic by ingestion of over-the counter L-tryptophan preparation in the United States in October 1989. We report a Korean case of EMS not associated with the ingestion of either L-tryptophan or other nutritional supplements such as lysine and niacin.
Eating* ; Eosinophilia-Myalgia Syndrome* ; Lysine ; Niacin ; Tryptophan ; United States

Idiopathic atrophoderma of Pasini and Pierini(IAPP) is an uncommon condition of unknown etiology and typically affects persons in the second and third decades of life. IAPP consists of asymptomatic grey to brown depressed lesions with "cliff drop" borders, which are usually bilateral and located on the trunk. A 40-year-old woman visited our department because of unilateral atrophic lesions on the abdomen, right arm, and posterior aspect of right thigh for 20 years. Laboratory evaluations were normal and histologic examination revealed significantly decreased thickness in dermis. We report an unusual case of idiopathic atrophoderma of Pasini and Pierini presenting unilateral distribution.
Abdomen ; Adult ; Arm ; Dermis ; Female ; Humans ; Thigh

Injection medialization laryngoplasty is a procedure that has many advantages in treating vocal fold paralysis; however, undesired complications can occur. We experienced a case of a pulmonary embolism, suspected in a patient who had undergone an injection laryngoplasty with calcium hydroxylapatite (CaHA). The patient suffered dyspnea after undergoing the injection laryngoplasty. Chest embolism computed tomography (CT) scan revealed a new lesion of enhancing materials at the pulmonary vasculature in the right upper lobe. The CaHA embolism was suspected, and the patient was treated with warfarin for 12 months. The patient's symptom of dyspnea nearly disappeared and a follow up chest embolism CT scan revealed no signs of the previous lesion. Thus, we would like to report this rare case along with a review of the literature.
Calcium* ; Durapatite* ; Dyspnea ; Embolism ; Follow-Up Studies ; Humans ; Laryngoplasty* ; Paralysis ; Pulmonary Embolism* ; Thorax ; Tomography, X-Ray Computed ; Vocal Cord Paralysis ; Vocal Cords ; Warfarin

Malposition of the extracorporeal membrane oxygenation (ECMO) venous cannula in the azygos vein is not frequently reported. We hereby present such a case, which occurred in a neonate with right-sided congenital diaphragmatic hernia. Despite ECMO application, neither adequate flow nor sufficient oxygenation was achieved. On the cross-table lateral chest radiograph, the cannula tip was identified posterior to the heart silhouette, which implied malposition of the cannula in the azygos vein. After repositioning the cannula, the target flow and oxygenation were successfully achieved. When sufficient venous flow is not achieved, as in our case, clinicians should be alerted so they can identify the cannula tip location on lateral chest radiograph and confirm whether malposition in the azygos vein is the cause of the ineffective ECMO.
Azygos Vein* ; Catheters* ; Extracorporeal Membrane Oxygenation* ; Heart ; Hernias, Diaphragmatic, Congenital* ; Humans ; Infant, Newborn* ; Oxygen ; Radiography, Thoracic

BACKGROUND: The authors report the results of preserving the infrapatellar branch of the saphenous nerve during unicompartmental knee arthroplasty to prevent lateral skin numbness. METHODS: All 100 cases had medial compartmental osteoarthritis and a minimally invasive technique had been used. The mean follow-up duration was two years and eight months (range, 24 to 42 months). RESULTS: The classification according to the location of this nerve was observed as either Mochida Type I with 76 cases (76%), Type II with 16 cases (16%), and unclassified type with 8 cases (8%). In Type I, the nerve was saved in 62 cases (82%), but could not be preserved in Type II because of the surgical procedure. These results showed that the mean distance from the joint line to the nerve of Type I was 9.13 mm (range, 4 to 15 mm) and the nerve passed inferiorly. CONCLUSIONS: This study showed the location of this nerve can be predicted ahead of the procedure, which will help preserve it during the surgery.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects/*methods ; Female ; Humans ; Hypesthesia/etiology/*prevention & control ; *Knee Prosthesis ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery ; Skin/*innervation

To evaluate the differences between current and past surgical treatment of intussusception, the medical records of 48 intussusception patients who underwent surgical treatment over 4 years (1975-1978, Group A) were reviewed and compared to the medical records of 75 intussusception patients who underwent surgical treatment over 4 years (1995-1998, Group B). Sex ratio is male predominant in both group (2.7:1 vs 1.6:1) and mean age of operation is 6.7+/-5.0 month (Group A) and 8.1+/-7.0 month (Group B). Major symptoms and signs of both groups are vomiting, hematochezia and irritability. White blood cell count of peripheral blood in both groups had no significant difference (12,417+/-4,446/mm3 vs 12,297+/-4,531/mm3). In operation methods, group A had significantly higher bowel resection rate over group B (31.3% vs 14.7%, p<0.05). In group A, 2 patients were died after operation, but group B have no operative mortality. Admission period after operation is significantly short in Group B (7.5+/-2.7 day vs 5.4+/-2.1 day, p<0.01). These results suggest there were no significant difference in characters of patients between Group A and B. But surgical treatment of intussusception in 1990s was more conservative than that in 1970s. We expect that recent surgical treatment lead early recovery from operation and early discharge from hospital.
Gastrointestinal Hemorrhage ; Humans ; Intussusception* ; Leukocyte Count ; Male ; Medical Records ; Mortality ; Sex Ratio ; Vomiting

PURPOSE: This study was designed to evaluate characteristics of foot pressure distribution with or without partial prosthetic foot in transmetatarsal amputee. MATERIALS AND METHODS: The subjects were 9 transmetatarsal amputees. Foot pressures were measured at hallux, the 1st-5th metatarsal head (MTH), mid-foot, condyle area by F-scan system in amputated or contralateral foot during active walking. RESULTS: In amputated foot, mean peak pressure was greatest in midfoot without prosthetic foot but it was greatest in hindfoot with prosthetic foot. In unaffected foot, although mean peak pressure was higher in hallux, and 1-5th MTH compared to amputated foot, it was greatest in hind foot both with and without prosthetic foot. However, in unaffected foot, mean peak pressure significantly decreased in hallux and 5th MTH after wearing the prosthetic foot. There was a significant difference in mean peak pressure in hallux and 5th MTH between amputated and unaffected foot after wearing prosthetic foot. However, other region had no significant difference with or without prosthetic foot between feet. CONCLUSIONS: The use of partial prosthetic foot tends to shift weight bearing from the heel area to forefoot and could significantly reduce hind foot peak pressure and redistributed to peak pressure. The partial prosthetic foot can also offer the peak pressure to reduction both amputated foot and unaffected foot and help to toe off during walking.
Amputees ; Foot ; Hallux ; Head ; Heel ; Humans ; Metatarsal Bones ; Prostheses and Implants ; Toes ; Weight-Bearing

The goal of surgical stone management is to achieve maximal stone clearance with minimal morbidity to the patient. Because of its efficacy, efficiency and low morbidity, extracorporeal shock wave lithotripsy(ESWL) is the first-line treatment for almost all urinary calculi. However, stone clearance after ESWL has been shown to be affected by the stone burden, location, chemical composition and kidney anatomy. Especially, the success rate for ESWL is reduced in lower pole stone(LPS). Percutaneous nephrolithotomy(PNL) and retrograde ureteroscopic intrarenal surgery(RIRS) are alternative treatment options for stones refractory to ESWL such as LPS. Although effective, PNLsubjects the patient to increased morbidity compared to ESWL and RIRS. Because of its low morbidity and relatively high success rate, RIRS for LPS is an attractive treatment modality in selective patients. We report a case of multiple renal pelvis and lower calyceal stones treated with ureteroscopy.
Humans ; Kidney ; Kidney Calculi ; Kidney Pelvis* ; Shock ; Ureteroscopy ; Urinary Calculi