Although anterior fusion has several advantages in the management of fracture-dislocations of cervical spine than posterior methods, it has not been used in common. Because, it does not give sufficient stability to prevent the dislodgment of the graft and angular deformity and it requires prolonged rigid external immobilization. In order to promote the stability and to reduce the external support, authors have fixed with plate and screws in anterior spine fusion for various type of fracture-dislocations of cervical spine, and report the results of 29 consecutive cases. Minimum follow-up period was 6 months (Av. 12mos.). Two level fixation after anterior decompression by corpectomy was done in 7 cases. Ambulation was started from the day after operation with aid of orthosis, regardless of the neurological status. Bone union was observed in all, but one expired case, within 2–3 months. There was no failure in fixation and no worsening in neurology. Improvement of neurological status were observed in 17 patient during and follow up periods of treatment, among 23 patient with neurological symptoms on arrival. The observed complications of hoarseness(2 csses), dysphagia(2 cases) and Horner's syndrome(1 case) were improved later, but the patient with pneumonia was expired one month after operation. It is concluded that the procedure is a safe and better alternative for the fracture-dislocations including flexion injury between C2-T1, because it provides good stability, rapid union, short external support and possibility of neural decomprssion.
Congenital Abnormalities ; Decompression ; Dislocations ; Follow-Up Studies ; Humans ; Immobilization ; Neurology ; Orthotic Devices ; Pneumonia ; Spine ; Transplants ; Walking

Dextran is a macromolecular polymer of dextrose. Dextran is used as a plasma expander with reduction in blood viscosity and disruption of red cell aggregates. It also inhibits platelet aggregation and prothrombin activation. It has been reported that a hemostatic defect characterized by a prolonged bleeding time in subject receiving large amount of dextran. The present study was undertaken to observe the effect of dextran on bleeding time and platelet aggregation by increasing volume. In this study, bleeding time was checked and sampling was done at before infusion, after 5 ml/kg, 10 ml/kg and 15 ml/kg infusion of dextran in 15 patients with spinal or regional anesthesia. The results were as follows: 1) There was prolonged bleeding time by increasing volume of dextran 40, but within nonnal limit. 2) There was no platelet aggregation with 15ml/kg of dextran.
Anesthesia, Conduction ; Bleeding Time ; Blood Platelets* ; Blood Viscosity ; Dextrans* ; Glucose ; Humans ; Plasma ; Platelet Aggregation ; Polymers ; Prothrombin

Penile amputation during circumcision is a quite rare event. So far, replantation generally requires microsurgical techniques. Yet herein, we report on the successful replantation of a completely amputated penis; the amputation occurred during the circumcision of a 9-year-old boy, and we did not use microsurgical technique for the replantation.
Amputation ; Child* ; Circumcision, Male* ; Female ; Humans ; Male ; Penile Diseases ; Penis* ; Replantation*

OBJECTIVE: Our previous study demonstrated that the placental GnRH and GnRH mRNA did not parallel the time course of hCG secretion, though it is thought to be one of the potential paracrine regulators of hCG secretion from the trophoblasts. The present study was designed to examine the potential variation in GnRH-receptor mRNA expression in the placenta, which may account for the GnRH-mediated action of hCG secretion during pregnancy. METHODS: Human placentas in firt, second, and third trimester of normal pregnancy were obtained. These placentas were fixed with 4% paraformaldehyde and embedded in OCT compound, and sectioned by cryostat. For in situ hybridization, S labeled RNA probes were used and followed by autoradiography. RESULTS: The GnRH-receptor mRNA signals were present in both cytotrophoblast and syncytiotrophoblast cell layers. Signal intensities varied with gestational ages and were abundant at 6-7 weeks, peaked at 9-12weeks, declined at 14 and 24 weeks, and were barely detectable at term. The present study demonstrates that GnRH-receptor mRNA exhibits changes paralleling the time course of hCG secretion during pregnancy CONCLUSION: These data provide mechanistic understanding that the paracrine/autocrine regulation of hCG secretion by placental GnRH is mediated through an increase followed by a decline in GnRH-receptor mRNA expression from the first trimester to term placenta.
Autoradiography ; Female ; Gestational Age ; Gonadotropin-Releasing Hormone ; Humans ; In Situ Hybridization ; Placenta* ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Pregnancy* ; RNA Probes ; RNA, Messenger* ; Trophoblasts

PURPOSE: To describe the abnormal signal intensity seen on MRI of the brain in Wilson disease. MATERIALS AND METHODS: Eight patients (7 male and 1 female, 10 to 33 years of age ) with Wilson disease were studied with a 0.5TMRI system. Patients were divided into symptomatic and asymptomatic groups, and MR imaging was compared withclinical data. RESULTS: In 93 lesions, signal intensity was abnormal ; there was involvement of the pallidus(24lesions, 26%), the midbrain (20, 22%), the pons(14, 15%), the putamen (13, 14%), the thalamus(6, 7%), thepituitary gland (4, 4%), the caudate nuclei (4, 4%), the internal capsule (4, 4%), and the dentate nucleus (4,4%). In the putamen, all lesions but one were bilateral, and there was symmetric distribution. The four patientswith neurologic symptoms had 69 lesions and the remaining four without such symptoms had 24 lesions. OnT2-weighted images, high signal intensity was seen in all lesions but two, and on T1-weighted images, this wasseen in 24 lesions. All lesions of the pituitary gland showed high signal intensity on T1-weighted images.CONCLUSION: Lesions were frequently seen in the globus pallidus, midbrain, pons and putamen, and were more commonin patients with neurologic symptoms.
Brain* ; Cerebellar Nuclei ; Female ; Globus Pallidus ; Hepatolenticular Degeneration* ; Humans ; Internal Capsule ; Magnetic Resonance Imaging* ; Male ; Mesencephalon ; Neurologic Manifestations ; Pituitary Gland ; Pons ; Putamen

BACKGROUND: To determine the efficacy and safety of endoscopic resection and ablation of superficial varicosities using a powered vein resector, irrigated illuminator. MATERIAL AND METHOD: 83 consecutive patients were involved in the study. 103 limbs in 83 patients were treated using a minimal invasive, powered, vein resecting device with cutaneous transillumination and tumescent anesthesia technique. There were 51 women and 32 men. All patients were operated under general anesthesia or regional anesthesia. Operative time and patient satisfaction scores were recorded along with the number of incisions made. RESULT: 83 patients(51/61.4% female, 32/38.6% male, aged 25-78 years) had varicose vein. Average age at the time of operation was 45 years(range, 25 to 78 years). There were 63 unilateral procedures and 20 bilateral operations. Operative time ranged from 24 to 46 minutes (average 35.3 minutes) in the unilateral procedure. The number of incisions per limb averaged 2.7(range, 2 to 5). Postoperative complications occurred in 7(8.4%) patients. Patients were asked to describe their pain on an analog scale ranging from 1 to 10 with 1 representing no pain and 10 worst imaginable pain. Immediately postoperative pain score was 2.4. Postoperative pain score at 72 hours had a mean score of 2.0. Postoperative pain score at 1 months were 1. CONCLUSION: Varicose vein removal using Transilluminated Powered Phlebectomy(TIPP) is a safe and efficient procedure. The procedure saves time, is easy to perform, and gives direct visualization and a distinct endpoint of the removal of veins. It is also less tedious to perform and gives good cosmetic results with significant pain relief.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Extremities ; Female ; Humans ; Male ; Operative Time ; Pain, Postoperative ; Patient Satisfaction ; Postoperative Complications ; Surgical Procedures, Minimally Invasive ; Transillumination ; Varicose Veins* ; Veins

PURPOSE: Heat shock proteins (HSPs) are highly expressed during stress responses and cellular adaptation to environmental changes. One such protein is HSP27, a 27kDa protein that prevents cell death induced by many pro-apoptotic agents. Therefore, the aim of this study was to investigate the correlation between HSP27 expression and apoptosis induced by doxazosin treatment in prostate cancer cell line PC-3. MATERIALS AND METHODS: RT-PCR, Western blotting, and immunocytochemical staining were performed to determine whether HSP27 mRNA and protein are expressed in PC-3 cells. Next, to investigate the effects of doxazosin on apoptosis and HSP27 protein expression in PC-3 cells, the cells were stained using a TUNEL kit (to detect apoptotic cells) and with HSP27 antibody (to assess HSP27 protein expression) 6, 12, 24, and 48h after treatment with 25microM doxazosin. In addition, to determine whether HSP27 mRNA interference accelerates doxazosin-induced apoptosis of PC-3, we knocked down HSP27 with siRNA and then evaluated the rate of apoptosis after doxazosin treatment. RESULTS: HSP27 mRNA and protein were expressed in PC-3 cells. Furthermore, HSP27 mRNA and protein levels increased until 12 hours after 25microM doxazosin treatment, whereas the rate of apoptosis did not increased dramatically. After 12 hours, HSP27 expression decreased and then apoptosis was accelerated. In addition, siRNA-mediated knockdown of HSP27 induce higher apoptosis rate of PC-3 cells even before 12hrs after doxazosin treatment. CONCLUSIONS: By inhibiting apoptosis, HSP27 expression might play an important role in inhibiting progression to castration-refractory prostate cancer and resistance to anti-cancer treatment.
Apoptosis* ; Blotting, Western ; Cell Death ; Cell Line* ; Doxazosin ; Heat-Shock Proteins* ; Hot Temperature* ; HSP27 Heat-Shock Proteins* ; In Situ Nick-End Labeling ; Prostate* ; Prostatic Neoplasms* ; RNA, Messenger ; RNA, Small Interfering

Carcinoma of Gall bladder remains a terminal illness in most patients despite improved diagnostic capabilities, better perioperative care and a more aggresive surgical approch based on improved knowledge of this tumors natural histiory. Overall 5-year survival rates remain below 5%. This failure to significantly improve patient oucome is largely due to late recognition of gall badder cancer. Authors experienced 21 cases of gall bladder cancer confirmed by operation at the Kwang Ju Christian hospital from march 1983 to March 1991, and the results obtained were summarized as follows. (continue...)
Gallbladder Neoplasms ; Gwangju ; Humans ; Perioperative Care ; Survival Rate ; Urinary Bladder*

Replacement lipomatosis of the kidney is a rare disease. It is characterized by fatty replacement of destroyed or atrophic renal parenchyma which associated with inflammatory or noninflammatory renal disease. Herein we reported a case of replacement lipomatosis of the kidney with renal tuberculosis and calculus.
Calculi ; Kidney* ; Lipomatosis* ; Rare Diseases ; Tuberculosis, Renal

BACKGROUND: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigated the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. METHOD: 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. RESULT: Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure(PImax) was also significantly lower in the depleted group(p<0.05). CONCLUSION: We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.
Body Weight ; Electric Impedance ; Forced Expiratory Volume ; Humans ; Korea ; Mortality ; Nutritional Status* ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Residual Volume ; Total Lung Capacity ; Vital Capacity ; Weight Loss