Osteoporosis causes a decrease in bone mineral density. To overcome the decrease in fixation strength, a variety of techniques and devices have been developed, including cement augmentation of pedicle screws. Polymethyl methacrylate (PMMA), is commonly known as bone cement, and is widely used for implant fixation in various orthopaedic and spine surgery. In general, PMMA augmentation of pedicle screws is simple and safe if performed with technical precautions. PMMA is a safe agent, but it may rarely lead to significant foreign body reactions. In this report, we present a patient who developed bone cement-related epidural space foreign body granuloma
Osteoporosis

OBJECTIVE: We analyzed the clinical features of amniotic fluid embolism confirmed by autopsy or clinical dicision for making a plan of rapid diagnosis and intensive emergency care. STUDY DESIGN: We experienced 2 clincal cases in Ewha Mokdong Hospital and Severance Hospital at 1995, and reviewed the medical record & autopsy report of 15 cases in National Institute of Scientific Investigation from Jan, 1991 to Dec, 1995. RESULTS: The mean maternal age was 31+/-3 years. The mean gestational age was 40+/-1 weeks. The number of delivery were 1.4+/-0.8. The number of abortion history. were 2.6+/-2. The sexuality of fetus were six males (35 %), five females (29%), and unknown six cases (35 %) and the fetal mortality rate was 29 % (5 cases). The initial clinical symptoms and signs were hypotension (12 patients, 71%), vaginal bleeding(ll patients, 65%), cardiac arrest (6 patients, 35 %), dyspnea (5 patients, 29 %), and seizure (2 patients, 12%). In the case of normal spontaneous vaginal delivary (NSVD), the symptoms occurred during induction in 3 (18%), during delivery in 1 (6%), and after delivery in 9 (53%). In the case of Cesarean section, the symptoms occurred during section in 2 (12%), and after section in 1 (6%). There are one case whose symptoms occurred during 3rd gestational period. CONCLUSIONS: We should alert for the amniotic fluid embolism in the clinical findings of acute collapse and vaginal bleeding, respiratory symptoms, and seizure at any peripartum. With eary suspicion of this disease and aggressive intensive care we can reduce amniotic fluid embolism mortality rate and it's legal problem.
Abortion, Induced ; Amniotic Fluid* ; Autopsy ; Cesarean Section ; Diagnosis ; Dyspnea ; Embolism, Amniotic Fluid* ; Emergency Medical Services ; Female ; Fetal Mortality ; Fetus ; Gestational Age ; Heart Arrest ; Humans ; Hypotension ; Critical Care ; Male ; Maternal Age ; Medical Records ; Mortality ; Peripartum Period ; Pregnancy ; Seizures ; Sexuality ; Uterine Hemorrhage

No abstract available.
Pneumonia* ; Radiography, Thoracic* ; Thorax*

Carotid endarterectomy is superior to medical treatment in preventing secondary stroke in patients with symptomatic high grade carotid stenosis. Transluminal angioplasty is a promising procedure as an alternative treatment for these patients. We report two cases of carotid angioplasty with Palmaz-Schatz stent in patients with carotid artery occlusive disease. One patient presented with decreased right visual acuity because of retinal arterial embolism. The angiogram demonstrated a discrete tight stenosis of right internal carotid artery carotid stenting with Palmaz-Schatz coronary stent was performed without any significant complications. The other patient presented with recurrent episodes of cerebral infarction, for which he had undergone left carotid erdarterectomy 3-years ago. The carotid angiogram demonstrated tight stenoses of both internal carotid arteries. Carotid artery stenting was performed at left and right internal carotid arteries without any complications. We suggest that stenting may be an effective and safe therapeutic alternative to surgical treatment in some selected patients with carotid artery occlusive disease.
Angioplasty* ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Cerebral Infarction ; Constriction, Pathologic ; Embolism ; Endarterectomy, Carotid ; Humans ; Retinaldehyde ; Stents* ; Stroke ; Visual Acuity

BACKGROUND: The purpose of this study was to investigate the mechanism of endothelium-dependent and independent responses to endothelins (ETs) in porcine coronary artery. METHODS: The vascular rings of left anterior descending artery or left circumflex artery from 7 pigs were suspended in conventional organ chambers for the measurement of isometric force. To evaluate relaxation responses, vascular rings with endothelium were exposed to ET-1 and ET-3. To evaluate contraction responses, vascular rings with and without endothelium were exposed to ET-1 and ET-3 in the presence or absence of BQ 123 (ET(A) receptor antagonist) or TAK-044 (ET(A) and ET(B) receptor antagonist). RESULTS: Transient relaxation responses of vascular rings occurred after exposure of ET-1 and ET-3. These transient responses disappeared after preincubation with N-nitro-L arginine. There was an increased contractions of vascular rings according to increasing concentration of ET-1 and ET-3. The initial responses were enhanced in vascular rings without endothelium in ET-1 and ET-3. In vascular rings with endothelium, the contraction responses were more reduced in vascular rings with preincubation of BQ 123 than in vascular rings without BQ 123 in ET-1. In vascular rings without endothelium, the contraction responses were more reduced in vascular rings with preincubation of TAK-044 than in vascular rings without TAK-044 in ET-1. CONCLUSION: ET(B) receptor on the endothelium might mediate the transient vasodilator responses to ET-1 and ET-3 through release of nitric oxide in porcine coronary artery. ET(A) and ET(B) receptor on vascular smooth muscle cells might mediate vasoconstrictor responses to ETs.
Arginine ; Arteries ; Coronary Vessels* ; Endothelins* ; Endothelium ; Muscle, Smooth, Vascular ; Nitric Oxide ; Receptors, Endothelin ; Relaxation ; Swine

BACKGROUND: Although the precise pathogenesis of the Behçet's disease is not yet undertween the severity of Behçet's disease and the serum cytokine level. development of cytokine research has made it possible to find out if there is an association between the severity of Behçet's syndrome and the serum cytokine level. OBJECTIVE: Our purpose was to elucidate whether the immunopathological mechanism is associated with the serum tumor necrosis factor (TNF) and interleukin-1β (I1,1β) which are predominantly produced by monocytes/macrophages, and mterleukm-6 (IL-6). METHOD: Sixty seven patients of Behçet's disease and ten healthy adults as a control group were studied. Serum TNF and IL-6 levels were detected by enzyme immunoassay and serum IL-lβ levels by radioimmunoassay. RESULTS: There were no statistically significant differences in the serum levels of TNF, IL-1β, TL-6 compared with the control group. CONCLUSION: These data suggest that the immunopathological reactions of the Behçet's disease are not associated with a monocyte/macrophage dependent mechanism, possibly due to other immunocompetent cells.
Adult ; Humans ; Immunoenzyme Techniques ; Interleukin-6* ; Methods ; Necrosis* ; Radioimmunoassay ; Tumor Necrosis Factor-alpha

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis*

Since after first report of percutaneous transluminal coronary angioplasty in 1977, improved operator technique and advanced equipment designs have resulted in an increase in primary success rate from 67% to 92% in recent days. Despite these improvement, acute closure and restenosis remain as serious limitations to both the short and long-term success of PTCA. Coronary artery stents have been proposed as a method of treating acute closure and preventing restenosis. We implanted 21 balloon expandable Palmaz-Schatz Stent in selected 21 Patients(mean age 62+/-8 years, M/F : 16/5) with atherosclerotic coronary artery disease. The indications were elective stenting in 17, acute dissection postangioplasty in 2 and restenosis following angioplasty in 2. The clinical diagnosis of the subjects was unstable angina in 12 pts(57%), stable angina in 1, and post infarction angina in 8 including 6 acute myocardial infarction. The target vessel was right coronary artery In 12(57%), left anterior descending artery in 6(29%) and left circumflex in 3(14%). The size of implanted stent was 3mm in 15, 3.5mm in 5 and 4.0mm in 1. The morphology of attempted lesion was AHA/ACC classification type A in 1, type B in 17(B1 ; 1, B2 ; 16) and type C in 3. Angiographic findings were 1-vessel disease in 16 patients, 2-vessel disease in 4 and 3-vessel disease in 1. Coronary artery stenting wast technically successful in 21 all patients(100%) and complications included subacute total occlusion 1 week after stenting in 1, which was recanalized successfully by repeat PTCA without myocardial infarction, prolonged sinus arrest after stenting due to microembolism in 1 and puncture site bleeding requiring transfusion in 1. CONCLUSION: Coronary artery stenting was a safe and effective procedure to obtain adequate coronary blood flow in selected patients but long-term efficacy of primary elective coronary stenting should be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary ; Arteries ; Classification ; Coronary Artery Disease ; Coronary Vessels* ; Diagnosis ; Equipment Design ; Hemorrhage ; Humans ; Infarction ; Myocardial Infarction ; Punctures ; Stents

Since after first report of percutaneous transluminal coronary angioplasty in 1977, improved operator technique and advanced equipment designs have resulted in an increase in primary success rate from 67% to 92% in recent days. Despite these improvement, acute closure and restenosis remain as serious limitations to both the short and long-term success of PTCA. Coronary artery stents have been proposed as a method of treating acute closure and preventing restenosis. We implanted 21 balloon expandable Palmaz-Schatz Stent in selected 21 Patients(mean age 62+/-8 years, M/F : 16/5) with atherosclerotic coronary artery disease. The indications were elective stenting in 17, acute dissection postangioplasty in 2 and restenosis following angioplasty in 2. The clinical diagnosis of the subjects was unstable angina in 12 pts(57%), stable angina in 1, and post infarction angina in 8 including 6 acute myocardial infarction. The target vessel was right coronary artery In 12(57%), left anterior descending artery in 6(29%) and left circumflex in 3(14%). The size of implanted stent was 3mm in 15, 3.5mm in 5 and 4.0mm in 1. The morphology of attempted lesion was AHA/ACC classification type A in 1, type B in 17(B1 ; 1, B2 ; 16) and type C in 3. Angiographic findings were 1-vessel disease in 16 patients, 2-vessel disease in 4 and 3-vessel disease in 1. Coronary artery stenting wast technically successful in 21 all patients(100%) and complications included subacute total occlusion 1 week after stenting in 1, which was recanalized successfully by repeat PTCA without myocardial infarction, prolonged sinus arrest after stenting due to microembolism in 1 and puncture site bleeding requiring transfusion in 1. CONCLUSION: Coronary artery stenting was a safe and effective procedure to obtain adequate coronary blood flow in selected patients but long-term efficacy of primary elective coronary stenting should be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary ; Arteries ; Classification ; Coronary Artery Disease ; Coronary Vessels* ; Diagnosis ; Equipment Design ; Hemorrhage ; Humans ; Infarction ; Myocardial Infarction ; Punctures ; Stents

Interest in the prevalence of patent foramen ovale(PFO) and its relation to embolic stroke has increased with the sophistication of methods for noninvasive cardiac assessment. The effect of foramen ovale closure on the risk for subsequent strokes is promised. A 22-year old woman was presented with sudden onset of cerebral infarct. She had a patent formen ovale, and right to left shunt during the Valsalva maneuver, which was diagnosed by transesophageal contrast echocardiography. Transcatheter closure of PFO was performed with Rashkind PDA umbrella under the guidance of transesophageal echocardiography. Transcatheter closure of PFO can be accomplised with little morbidity and may reduce the risk of embolic episode.
Echocardiography ; Echocardiography, Transesophageal* ; Female ; Foramen Ovale ; Foramen Ovale, Patent* ; Humans ; Prevalence ; Stroke* ; Valsalva Maneuver ; Young Adult