No abstract available.
Adrenoleukodystrophy*

Tumors of the sacrum are relatively uncommon. The diagnosis is difficult, especially in the early phase of the disease, because the clinical manifestations are nonspecific, the clinical signs may be vague and the radiologic changes are needed to differentiate from intestinal gas shadow. The clinical features are sacral pain, sensory change on perineum, urination difficulty, constipation, and sciatica. Seven cases of sacral tumor were treated at the Department of Orthopaedic Surgery, Kyung Hee University, from October 1981 to October 1992, and the results were as follows: 1. Because of the variability of the sacral tumor, we cannot define the most common tumor. 2. There is difficult in early diagnosis of the tumor, because the symptoms of tumor are similar to that of lumbar disc herniation and the radiologic findings are subtle. 3. CT and MRI are very effective methods to detect the tumor in the sacrum. 4. Curettage, excision, resection, sacrectomy and internal fixation were done according to the kinds of tumors and the amount of bony destruction.
Constipation ; Curettage ; Diagnosis ; Early Diagnosis ; Magnetic Resonance Imaging ; Perineum ; Sacrum ; Sciatica ; Urination

STUDY DESIGN: Prospective study of 87 patients OBJECTIVES: To identify the natural course of the prevertebral soft tissue swelling after a one- or two-level anterior cervical discectomy and fusion (ACDF) and to help prevent potentially lethal airway complications after an ACDF. SUMMARY OF LITERATURE REVIEW: Airway complication after anterior cervical surgery is rare but potentially lethal. MATERIALS AND METHODS: Eighty-seven patients who underwent a one- or two-level ACDF with a plate and screws were examined. Cervical spine lateral radiography was taken preoperatively, on the immediate postoperative day, 1st, 2nd, 3rd, 4th and 5th day after surgery. Prevertebral soft tissue was measured from C2 to C6 on the cervical spine lateral radiography. RESULTS: Prevertebral soft tissue swelling occurred postoperatively and increased markedly on the second day after surgery. The peak prevertebral soft tissue swelling was observed on the second and third day after surgery. The prevertebral soft tissue swelling was decreased gradually from the 4th day after surgery. Prominent swelling of the prevertebral soft tissue was found at the 2nd, 3rd and 4th cervical spine. There were no significant differences in the prevertebral soft tissue swelling between the one-level and two-level ACDF group. Only one patient required reintubation (1.1%) CONCLUSIONS: The peak prevertebral soft tissue swelling was observed on the second and third day after surgery. Therefore, maintaining intubation for 3 or 4 days after surgery would be helpful in high-risk patients.
Diskectomy* ; Humans ; Intubation ; Prospective Studies ; Radiography ; Spine

A patient with squamous carcinoma of Bartholin gland including transitional component is reported and the literature related to this disease is reviewed. Carcinoma of the Bartholin gland is rare, comprising less than 1% of female genital tract cancer. This report was summurized a clinical experience of a 53 year old women with Bartholin gland carcinoma, FIGO Stage II. Histologically, this tumor is characterized by poorly differentiated squamous cell carcioma, individually cellular keratinizationa and transitional component. This patient was treated by modified radical vulvectomy with ipsilateral lymph node dissection and neoadjuvant chemotherapy(4 courses) and followed by radiation therapy.
Carcinoma, Squamous Cell* ; Cellular Structures* ; Female ; Humans ; Lymph Node Excision ; Middle Aged

PURPOSE: To report the clinical findings and results of the surgical treatment of the spinal pseudarthrosis in ankylosing spondylitis patients. MATERIALS AND METHODS: We reviewed 24 destructive vertebral lesions in 15 patient with ankylosing spondylitis who underwent pseudarthrosis repair and/or correction of kyphotic deformity. We assessed the clinical, laboratory, pathological and radiological findings. We performed anterior interbody fusion with or without Smith-Petersen osteotomy (SPO) at the level of pseudarthrosis. Pedicle subtraction osteotomy (PSO) was performed additively at lumbar spine in severe kyphotic patients. Clinical outcomes and complications were assessed. RESULTS: Traumatic history and inflammatory reaction were not universal findings. Histopathological specimens showed fibrous degeneration with sclerotic bony spicules and mild chronic inflammation. We performed AIF with SPO in 12 kyphotic patient with additional PSO in 6 patients. Posterior interbody fusion was performed in non-kyphotic patients. Radiolographic results demonstrated solid union of pseudarthrosis at average 4.2 months after operation and sagittal imbalance was improved from 24 cm to 4.2 cm at follow up. The subjective satisfactions of the patients at the last follow up were excellent or good in all of the cases. CONCLUSION: The principal etiology of pseudarthrosis in ankylosing spondylitis thought to be a mechanical weakness of unfused segment. Most of patients have had good clinical results by surgical stabilization of destructed anterior column with or without correction of deformity in combination with SPO and PSO.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Inflammation ; Osteotomy ; Pseudarthrosis* ; Spine ; Spondylitis, Ankylosing*

OBJECTIVES: The goal of operation for degenerative lumbar diseases is to relieve radiculopathy and low back pain and to prevent further degeneration. The authors analyzed the surgical results of posterior lumbar interbody fusion(PLIF) and 360degrees fixation to evaluate the proper treatment policy in spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. MATERIAL AND METHODS: The authors performed PLIF on 92 patients and 360degrees fixation on 138 patients with spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. We retrospectively studied clinical outcomes and subjective satisfaction of these patients by several criteria such as visual analog scale(VAS), Prolo's economic and functional outcome scale, medication usage after operation and questionaire for overall outcome. RESULT: Pre- and postoperative VAS on back pain and leg pain showed decrease of pain from 6.5, 6.7 to 2.2, 2.4 in PLIF group and from 7.0, 7.2 to 2.5, 2.7 in 360degrees fixation group. Excellent and good outcomes on Prolo's scale were 81.5% in PLIF group and 82.6% in 360degrees fixation group. Medication usage after operation was reduced in 79.3% of PLIF group and in 78.3% of 360degrees fixation group. Patients' self-reported overall success of their procedure showed 82% in PLIF group and 84% in 360degrees fixation group. CONCLUSION: Both PLIF and 360degrees fixation showed good outcomes and provided biomechanically stable fusion in spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. Therefore, only PLIF seems necessary and considered a proper surgical treatment for these disorders.
Back Pain ; Humans ; Leg ; Low Back Pain ; Radiculopathy ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis

PURPOSE: This study was performed to investigate the indications, yield, and complications of flexible bronchoscopy for respiratory disease in children compared to earlier domestic studies and to examine if any differences existed in comparison to international studies. METHODS: The medical records of 100 cases of flexible bronchoscopy that were performed in 76 patients at the Department of Pediatrics of The Catholic University of Korea, Seoul St. Mary's Hospital from June 16, 2010 to August 6, 2013 were reviewed. RESULTS: A total of 76 patients (50 males and 26 females) were included in the study. The most common indication of flexible bronchoscopy was persistent pneumonia or pneumonia in immunocompromised patients (53 cases). The object of flexible bronchoscopy was accomplished in 65 of 100 cases, and, the treatment was changed in 24 of 65 cases. The most common abnormal finding was tracheomalacia that was found in 18 cases. In 67 cases where bronchoalveolar lavage was performed, bacteria were identified in 47 cases, fungi in 9 cases, and viruses in 22 cases. Complications occurred in 8 cases. CONCLUSION: Compared to earlier domestic studies, there was no significant change in diagnostic approaches and therapeutic improvement. However, this study showed that flexible bronchoscopy appears to be safe in patients with hemato-oncologic disease. Compared to international studies, the occurrence of complications due to flexible bronchoscopy was relatively low.
Bacteria ; Bronchoalveolar Lavage ; Bronchoscopy* ; Child* ; Fungi ; Humans ; Immunocompromised Host ; Korea ; Male ; Medical Records ; Pediatrics ; Pneumonia ; Seoul ; Tracheomalacia

PURPOSE: Recent studies have shown that interferon-gamma-inducible protein of 10 kDa (IP-10/CXCL10) levels is increased in acute bronchiolitis and asthma. The aim of this study was to examine the levels of IP-10 in children with wheezing and whether it correlates with other clinical variables. METHODS: A total of 62 subjects children were hospitalized for lower respiratory tract infection with wheezing and visited the Emergency Department due to an acute exacerbation of asthma. IP-10 levels were measured using enzyme-linked immunosorbent assay in the serum collected at admission. Serum IP-10 levels were evaluated for the relationships with age, sex, blood eosinophils counts, acute phase reactant, allergic sensitization, history of wheezing, and chest X-ray findings. RESULTS: Age showed a significant negative correlation with serum IP-10 levels (P=0.002). The serum levels of IP-10 were also significantly increased in patients with pneumonic infiltration on X-rays compared to those with normal or hyperinflation (P<0.009). There was no significant difference in the serum IP-10 level according to the other factors, including allergic sensitization. CONCLUSION: Serum IP-10 is significantly associated with inflammation of the lung and age, but not with allergic inflammation.
Asthma ; Bronchiolitis ; Chemokine CXCL10* ; Child* ; Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Humans ; Inflammation ; Lung ; Respiratory Sounds* ; Respiratory Tract Infections ; Thorax

PURPOSE: This study aimed to have a deeper insight into the clinical spectrum of foreign body aspiration in children and to prospect the further clinical implications of early diagnosis. METHODS: We conducted a retrospective medical chart review of 48 children with foreign bodies at The Catholic University of Korea, Seoul St. Mary's Hospital, between January 2009 and December 2013 in terms of age, sex, symptoms and signs, radiologic findings, and clinical courses. Patients were divided into 2 groups according to the time from aspiration to a definite diagnosis. The 2 groups were compared for clinical courses, radiologic findings, and the length of hospitalization. RESULTS: Approximately 85% of patients were 3 years of age or younger. About one-fifth of patients had no history of foreign body aspiration. Cough and coarse breathing sounds were the most common symptoms and signs. The most frequent radiologic finding was pulmonary air trapping (33.3%). The mostly commonly aspirated foreign body was peanut and detected in left main bronchus. Cough, sputum, and absence of aspiration history were more common in the delayed diagnosed group than in the early diagnosed group. CONCLUSION: Our results suggest that the number of accidents associated with foreign body aspiration can be reduced by keeping infants with nut formula under close observation and by conducting assertive bronchoscopic examination on children with delayed recovery from respiratory infections. After removal of foreign bodies, close monitoring and expectation of possible complications can prevent patients from a long hospital stay.
Bronchi ; Bronchoscopy ; Child* ; Cough ; Diagnosis ; Early Diagnosis ; Foreign Bodies* ; Hospitalization ; Humans ; Infant ; Korea ; Length of Stay ; Nuts ; Respiratory Sounds ; Respiratory Tract Infections ; Retrospective Studies ; Seoul ; Sputum

The incidence of overall cancer has increased over time. The incidence of top-ranking cancers has changed in the 1990s and the 2000s. However, few studies have evaluated the trends in metastatic skin cancers during this period. We evaluated the recent trends in incidence, peak age and location of metastatic skin cancers from 1991 to 2010. This 20-yr survey was divided into two decades to determine the trends by comparing the statistics. Out of 694,466 outpatients (1991-2010), 174 (0.025%) were diagnosed with metastatic skin cancer. The incidence of metastatic skin cancer increased significantly from 20.64 per 100,000 outpatients in the 1990s to 28.70 per 100,000 outpatients in the 2000s (P = 0.030). The peak age of skin metastasis shifted from the 40s to the 50s in women, and from the 50s to the 60s in men. The percentage of metastatic skin cancers originating from intra-abdominal organs increased from 10% in the 1990s to 23.1% in the 2000s (P = 0.027). The percentage of metastatic skin cancers located on the abdomen increased from 7.1% in the 1990s to 15.4% in the 2000s (P = 0.011). The higher proportion of metastatic skin cancers located on the abdomen may be related to the increase in skin metastases from intra-abdominal organs.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Registries ; Republic of Korea/epidemiology ; Skin Neoplasms/*epidemiology/*secondary ; Young Adult