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

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

BACKGROUND: Systemic anticoagulation therapy has been recommended to prevent subacute thrombosis after intracoronary stening. Recent data, however, suggest that antiplatelet therapy might be an effective alternative to anticoagulation therapy. We evaluated the effect of antithrombotic regimens on subacute thrombosis and short-term clinical course after successful implantation of Cordis coronary stent, which is a flexible, balloon expandable, radiopaque tantalum stent. METHOD: Two hundred and seventy-five consecutive patients with 290 lesions were treated with 356 Cordis stents implantation. According to post-stent antithrombotic regimen, patients were divided into three groups ; 165 patients with 175 lesions received aspirin 200mg/day, ticlopidine 500mg/day and warfarin for one month(Group 1), 66 patients with 69 lesions received aspirin and ticlopidine(Group 2) and 44 patients with 46 lesions received aspirin alone(Group 3) after successful Cordis stenting. RESULTS: The overall procidural success rates were 97.7% in group 1, 98.6% in group 2 and 100% in group 3. More than 65 percents of the patients were eligible for elective stenting aspirin, ticlopidine and warfarin, 0% in patients with aspirin and ticlopidine, and 6.8% in patients assigned to the treatment with aspirin alone. CONCLUSION: The Cordis coronary stent is an effective endovascular stent in various clinical indications including unstable angina and acute myocardial infarction. Antiplatelet therapy using aspirin and ticlopidine after successful Cordis coronary stenting is promising alternative to anticoagulation therapy to overcome the drawbacks of stenting. However, post-stent antithrombotic therapy with aspirin alone is associated with significant rate of stent thrombosis.
Angina, Unstable ; Aspirin ; Coronary Artery Disease ; Humans ; Korea* ; Myocardial Infarction ; Stents* ; Tantalum ; Thrombosis ; Ticlopidine ; Warfarin

Subcutaneous granuloma pyogenicum (SGP) is a rare variant of granuloma pyogenicum. In general, it appears as a single subcutaneous nodule with a slight tenderness. We report herein an unusual case of SGP arising from the left palm of an 11-year-old girl. Two mild-tender bean-sized reddish or flesh colored subcutaneous nodules on the lateral border of the left palm, and medial side of 5th left finger, respectively, were noted on physical examination. Histopathologic examination revealed the findings of lobular capillary hemangioma, characterized by localized proliferation of capillary lined by a single endothelial cell layer. Intralesional injection of triamcinolone acetonide (TA) were performed for the treatment. However two new erythematous nodules developed at another area of the left palm, which disappeared without any treatment.
Capillaries ; Child ; Endothelial Cells ; Female ; Fingers ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Injections, Intralesional ; Physical Examination ; Recurrence* ; Triamcinolone Acetonide

The Epstein-Barr virus(EBV) is known to play a causal role in oncogenesis and to be associated with endemic Burkitt's lymphomas, B cell lymphomas in immunocompromised patients, and nasopharyngeal carcinomas. More recently, EBV has also associated with Hodgkin's disease, B cell lymphomas in non-immunocompromised patients, and T-cell lymphomas. Twenty eight cases of a non-Hodgkin's lymphoma of gastrointestinal tract were investigated to determine both the immunophenotype by using immunohistochemical staining and the incidence of the EBV nuclear antigen by using the polymerase chain reaction. Twenty-four of the 28 cases(85.7%) were B-cell type, and 4 of the 28 cases(14.3%) are of T-cell type. The EBV nuclear antigen was detected in three of the 28 cases(10.7%), including two cases of B-cell lymphoma of the stomach and one case of T-cell lymphoma of the small bowel. The EBV nuclear antigen was more frequently found in malignant lymphomas arising in the intestine(1/4) than in stomach(2/16). EBV positivity (25%) in T-cell NHLs was rather higher than EBV positivity (8.3%) in B-cell NHLs. Further expanded evaluations on the role of EBV in the tumorigenesis of a gastrointestinal malignant lymphomas are necessary because the cases of gastrointestinal lymphomas examined were very limited.
B-Lymphocytes ; Burkitt Lymphoma ; Carcinogenesis ; Gastrointestinal Tract* ; Herpesvirus 4, Human* ; Hodgkin Disease ; Humans ; Immunocompromised Host ; Incidence* ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin* ; Lymphoma, T-Cell ; Polymerase Chain Reaction ; Stomach ; T-Lymphocytes

Glutathione S-Tanaferase (GST) is tripeptide, which plays a central role in the detoxification of electrophilic xenobioticas, including cytotoxic drugs and carcinogens, by conjugation with redueed glutathione. There are four major claases af human GST : pi, alpha, mu and rnicrosomal, They are propoaed as a marker for human and experimental neoplasia iincluding liver, kidney, lung,colon, uterine cervix, etc. Expression of pi, alphn, mu form of GST in control (15 cases), CIN (14 cases), invasive carcinoma (28 cases) of human uterine cervix was investigated immunohistochemically. They were selected fram September, 1992, to,June, 1992, in the department of Obstetrics and Gynecology, Yonsei university College of medicine. In nucleus, the expresaion of GST pi was increased statistically significant in case of CIN and invasive Ca. of Cx. compared to control(p=0.018, p=0.002). But expression of GST alpha, mu has no significant difference in each case. In cytoplasms, the expvession of GST pi was increased statistically significani, in case of CIN and invasive Ca. of Cx. (p=0.001, p<0.001). But expreasion of GST alpha, mu has no significant differenrce in each case. There was no statistically significant diHerence in expression of GST isoenzymes oC each nucleua and cytoplasm according to stage and cell type in Ca. oC Cx. The further evaluation of survival and expression of GST pi in Ca. of Cx. in order to establish new prognostic factor in Ca. of Cx.
Carcinogens ; Cervix Uteri* ; Cytoplasm ; Female ; Glutathione Transferase* ; Glutathione* ; Gynecology ; Humans ; Isoenzymes* ; Kidney ; Liver ; Obstetrics

To assess the efficacy of 2 different mitral balloon valvotomy (PMV) techniques, PMV was performed using Inoue balloon (I) in 35 pts and double balloon (D) in 33 pts with mitral stenosis (male 27, female 41, mean age 42+/-12 years). The success rate of PMV was 89%(31/35 pts) in I group and 97%(33/33 pts) in D group. Mitral valve area after dilation increased equally effectively in both groups (I and D) from 0.9+/-0.2 and 0.8+/-0.2 to 1.9+/-0.2 and 1.9+/-0.3cm2 respectively (p<0.0001). There were no differences in degree of improvement of cardiac output, mitral gradient, left atrial pressure, pulmonary artery pressure and various doppler echocardiographic findings in both groups, but EF slope was more improved from 13+/-7 to 48+/-16 mm/sec in D group than those (from 15+/-6 to 39+/-15mm/sec) of I group. Increments of long and short diameters of mitral valve orifice by 2D-echocardiogram were 1.1+/-0.6 and 0.3+/-0.3cm in D group and 0.9+/-0.5, 0.4+/-0.3cm in I group. The ratio of long and short diameter increase was significantly larger in D than that of I group (long/short 2.8+/-0.7 vs 2.4+/-0.7, p<0.05) and short diameter of orifice after dilation was more improved in I than that of D group (1.1+/-0.2 vs 1.0+/-0.2cm p<0.05). Complications included deflation failure of Inoue balloon in 2, and cerebral embolic episode in 1 (D). Incidence of increased mitral regurgitation was 50% in D and 45% in I, development of ASD (Qp/Qs>1.2) was 20% in D, 13% in I group respectively and mean amount of left to right shunt (Qp/Qs) was 1.7+/-0.3 in D and 1.5+/-0.1 in I group. Total procedure and fluoroscopic time were 84+/-24 and 25+/-11 min. in D and 56+/-20 and 16+/-6 min. In I, which had statistically significant differences (p<0.002). Thus we concluded PMV using Inoue or double balloons was equally effective in selected patients. Total procedure and fluoroscopic time of Inoue balloon technique were significantly shorter than those of double balloons. Double balloon technique had more tendency of longitudinal splitting of the commissures.
Atrial Pressure ; Balloon Valvuloplasty* ; Cardiac Output ; Echocardiography ; Female ; Follow-Up Studies* ; Humans ; Incidence ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Pulmonary Artery

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis*

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