OBJECTIVE: The direct repair of the pars interarticularis defect using a lag screw with bone grafting(Buck operation) is an anatomical, less invasive surgical treatment preserving motion segment. This paper reports the methods and long-term results of the direct screw repair of the pars interarticularis defect and fusion in symptomatic lumbar spondylolysis using a cannulated lag screw. METHODS: Ten patients with symptomatic spondylolysis nonresponsive to medical treatment more than 6 months underwent this operation. Eight patients(6 men and 2 women) were followed for longer than 24 months after surgery. Mean age at the time of surgery was 28.3(18-43) years. The involved lumbar vertebra were L5 in 6 cases, L3 in 1 case and L4 in 1 case. All patients except 1 case had bilateral lesion. All patients underwent preoperative magnetic resonance(MR) image and plain radiographs including functional view. Patients with slippage, instability, moderate to severe intervertebral disc degeneration on preoperative MR image at the affected segment and isthmus defect more than 4mm in length were contraindications to this procedure. Surgical outcome was evaluated with visual analogue scale(VAS), Macnab classification, and functional rating index(FRI). Postoperative plain radiographs were taken 4 weeks, 3 months. 6 months, 12 months, 18 months, 24 months after surgery and postoperative computed tomography scan was performed between 12-24 months after surgery. RESULTS: The average length of inserted screws were 42mm(35-45mm). Three cases experienced Excellent outcome, Good in 5 cases according to Macnab classification 6months after operation. Preoperative mean FRI scrore is 86.0%(34.4points) and postoperative 24months is 32.8%(13.1points). DeltaFRI is 0.62. There was no operation related complication including implant related complication(eg. screw fracture, screw malposition). One case with unilateral pars defect showed fusion as early as 6 months. CONCLUSION: These results indicate that Buck operation is a reliable and safe operation for symptomatic lumbar spondylolysis. Long-term data are needed for further evaluation for fusion.
Classification ; Humans ; Intervertebral Disc Degeneration ; Male ; Spine ; Spondylolysis*

Signet ring cell carcinoma has been previously described in many organs, most frequently in the stomach, and rarely in the colon, rectum, gallbladder, pancreas, breast, nadsal cavity, prostate, urinary bladder and ureter. Signet ring cell carcinomas in the lung, especially, when examined by small biopsies, are generally believed to be metastatic. This case was diagnosed by bronchoscopic biopsy. We also examined various organs by noninvasive method, including UGI series, barium enema and abdomen CT scarf, but all studies were nomal. Patient received cisplatin and etoposide combination chemotherapy followed by local radiotherapy ai a primary non-small cell lung cancer. Patient died of his disease 6 months after diagnosis. Now we report a case of primary signet ring cell carcinoma of the lung.
Abdomen ; Barium ; Biopsy ; Breast ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Signet Ring Cell* ; Cisplatin ; Colon ; Diagnosis ; Drug Therapy, Combination ; Enema ; Etoposide ; Gallbladder ; Humans ; Lung Neoplasms ; Lung* ; Pancreas ; Prostate ; Radiotherapy ; Rectum ; Stomach ; Ureter ; Urinary Bladder

One hunderd and ten patients who had undergone surgery for lumbar spinal stenosis between March, 1988 and March, 1991 were evaluated in terms of radiological findings, classification, clinical features, coexisting disease and postoperative results. The overall mean age was 60 years, and patients with lateral stenosis were, an average, 11years younger than those with central canal stenosis. There was a high incidence of coexisting disease but its effect on symptoms and disease progression was statistically not significant. Characteristic radiological features were disc height decrease, facet joint hypertrophy, facet joint arthrosis, diffuse bulging disc, and ligamentum flavum hypertrophy, but no significant difference between the sexes was seen Nor were there differences between the symptoms of patients with lateral and central stenosis, though claudication was found mainly in patients with multiple level stenosis. The relief of symptoms by decompressive surgery more significantly successful in lateral than in central stenosis, and the surgical success rate was 74%.
Classification ; Constriction, Pathologic ; Disease Progression ; Humans ; Hypertrophy ; Incidence ; Ligamentum Flavum ; Spinal Stenosis* ; Zygapophyseal Joint

BACKGROUND/AIMS: The therapeutic strategy between endoscopic piecemeal mucosal resection (EPMR) and endoscopic submucosal dissection (ESD) for large laterally spreading tumors (LSTs) has not been clearly defined. The aim of this study was to compare the clinical outcomes between EPMR and ESD in patients with large LST. METHODS: From July 2006 to September 2010, 106 patients who underwent endoscopic resection for large (>20 mm) LSTs were included in our retrospective analysis. RESULTS: Baseline characteristics of the patients and tumors were not different between two groups except for location (EPMR-right colon, ESD-rectum). The en bloc resection rate and complete resection rate were significantly higher in the ESD group than those in the EPMR group (EPMR vs. ESD, 53.5% vs. 88.6, P<0.01, 45.1% vs. 71.4%, P=0.01, respectively). However, total procedure time was significantly shorter in the EPMR group (21.3 min vs. 44.4 min, P<0.01). Furthermore, the rates of complication including perforation and bleeding were significantly lower in the EPMR group than those in the ESD group (perforation, 1.4% vs. 11.4%, P=0.02; bleeding, 4.2% vs. 17.1%, P=0.03, respectively). During 19.9 months of follow-up, no significant difference was observed in terms of recurrence (1.5% vs. 3.2%). Non-granular, pseudo-depressed type (LST-PD) showed a significantly higher presence of adenocarcinoma and deeper submucosal invasion than other types of LSTs. CONCLUSIONS: The therapeutic strategy for choosing between EPMR and ESD for large LST lesions should be determined based on the macroscopic findings of their subtype. En bloc resection with ESD should be applied to LST-PDs due to their higher rate of submucosal invasion.
Adenocarcinoma ; Colon ; Follow-Up Studies ; Hemorrhage ; Humans ; Recurrence ; Retrospective Studies

PURPOSE: The critical pathway (CP) is to standardize the clinical practice of specialists working to optimize care. The objective of this study was to develop a critical pathway for the surgical treatment of patients with colorectal or gastric cancer and to evaluate the results of the CP. METHODS: Twenty-one patients with colorectal cancer, who were managed according to the CP between August 2005 and November 2005, were compared with 18 patients for whom this pathway had not been used between June 2004 and September 2004. Forty-eight patients with gastic cancer, who were managed according to the CP between June 2005 and September 2005, were compared with 49 patients for whom this pathway had not been used daring the same period in 2004. The length of stay and the cost per patients were compared between the CP group and the non-CP group. RESULTS: For patients with colorectal cancer, the postoperative hospital length of stay in the CP group was significantly shorter (9.0 vs. 12.3 days, P<0.001), but for patients with gastric caner, there was no difference (10.6 vs. 11.4, P=0.134). The mean hospital charges were won5,037,816 and won5,263,508 for colorectal cancer and for gastric cancer, respectively, and won4,808,602 and won4,674,329, for the CP and the non-CP groups, respectively, but these differences were not significant. CONSLUSIONS: The critical pathway in colorectal and stomach surgery decreased the length of stay and might regulate hospital charges. Such a pathway could be easily designed and implemented at hospitals and could standardize clinical practice.
Colorectal Neoplasms ; Critical Pathways* ; Hospital Charges ; Humans ; Length of Stay ; Specialization ; Stomach ; Stomach Neoplasms*

Primary malignant lymphoma is very rare and represents less than 1.5% of all intracranial neoplasms. The authors have experienced a case of primary malignant lymphoma of the brain in a 66 year-old woman who presented with presistent headache, nausea and generalized weakness. Brain CT scan demonstrated typical deep seated tumor masses in the right temporal and left frontal lobes with strong contrast enhancement. We obtained a good result after surgery followed by radiation and chemotherapy and report our case with review of the articles.
Aged ; Brain Neoplasms ; Brain* ; Drug Therapy ; Female ; Frontal Lobe ; Headache ; Humans ; Lymphoma* ; Nausea ; Tomography, X-Ray Computed

Here in this study, we investigated the lifespan-extending effect and underlying mechanism of methanolic extract of Moringa olelifa leaves (MML) using Caenorhabditis elegans (C. elegans) model system. To define the longevity properties of MML we conducted lifespan assay and MML showed significant increase in lifespan under normal culture condition. In addition, MML elevated stress tolerance of C. elegans to endure against thermal, oxidative and osmotic stress conditions. Our data also revealed that increased activities of antioxidant enzymes and expressions of stress resistance proteins were attributed to MML-mediated enhanced stress resistance. We further investigated the involvement of MML on the aging-related factors such as growth, food intake, fertility, and motility. Interestingly, MML significantly reduced growth and egg-laying, suggesting these factors were closely linked with MML-mediated longevity. We also observed the movement of aged worms to estimate the effects of MML on the health span. Herein, MML efficiently elevated motility of aged worms, indicating MML may affect health span as well as lifespan. Our genetic analysis using knockout mutants showed that lifespan-extension activity of MML was interconnected with several genes such as skn-1, sir-2.1, daf-2, age-1 and daf-16. Based on these results, we could conclude that MML prolongs the lifespan of worms via activation of SKN-1 and SIR-2.1 and inhibition of insulin/IGF pathway, followed by DAF-16 activation.
Caenorhabditis elegans* ; Caenorhabditis* ; Eating ; Fertility ; Longevity ; Methanol ; Moringa oleifera* ; Moringa* ; Osmotic Pressure

Background: Since the global coronavirus disease 2019 (COVID-19) pandemic, nonpharmacological interventions (NPIs) such as extensive and comprehensive hand hygiene, mask-wearing, and social distancing have been implemented globally. This study aimed to investigate changes in respiratory viruses other than severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that occurred following the implementation of these NPIs. Methods: From January 2018 to December 2021, influenza-like illness patient specimens and specimens from the Korea Influenza and Respiratory Viruses Surveillance System were analyzed at the Incheon Metropolitan City Institute of Public Health and Environment.Oropharyngeal or nasopharyngeal swab samples from respiratory infection patients were transferred in a virus transport medium at 4°C. After RNA or DNA extraction, respiratory virus-specific genes for human influenza virus (IFV), adenovirus (ADV), parainfluenza virus (PIV), respiratory syncytial virus (RSV), human rhinovirus (hRV), human coronavirus, human bocavirus, and human metapneumovirus were detected by individual real-time reverse transcription polymerase chain reaction. Results: A total 3,334 samples were collected. After NPI was implemented, the detection of respiratory viruses other than SARS-CoV-2 decreased overall. The yearly detection rate of respiratory viruses was decreased from 69.5% (399/574) in 2018 and 73.3% (505/689) in 2019 to 19.8% (206/1,043) in 2020 and 34.9% (365/1,028) in 2021. The epidemic was more prominent in respiratory viruses such as IFV and RSV, which were considered dominant viruses, especially those with viral envelopes. Among viruses that were not considered dominant, hRV showed no clear change before and after NPI, while PIV showed a rapid increase compared to the existing dominant viruses between October–December 2021, after the increase in the number of gatherings started at the end of September and the “Relaxing COVID19 and mitigation policy,” which was implemented on November 1. Conclusion NPI seems to have influenced the isolation and transmission of respiratory viruses in South Korea. In the future, additional studies focusing on the isolation and transmission patterns of respiratory viruses following NPI are needed.

Lindera obtusiloba has been widely used as a traditional medicine for the treatment of lots of diseases, including abdominal pain, bruise, and hepatocirrhosis. Here in this study, we elucidated the lifespan-extending effect of methanolic extract of Lindera obtusiloba (MLO) using Caenorhabditis elegans model system. We found that MLO has potent lifespan extension activities under normal culture condition. Then, we determined the protective effects of MLO on the stress conditions such as osmotic, thermal and oxidative stress. To reveal possible mechanism of MLO-mediated lifespan, we further investigated the effect of MLO on the antioxidant enzyme activities and intracellular ROS levels. Our results demonstrated that superoxide dismutase and catalase activities were significantly up-regulated by MLO treatment, resulted in reduced intracellular ROS levels. In this work, we also tested whether MLO-mediated longevity activity was associated with aging-related factors such as food intake and growth. Our data revealed that both of pharyngeal pumping rate and body length were significantly shifted by MLO treatment, indicating these factors were involved in MLO's lifespan-extension effects. Although MLO induces reduction in food intake, the body movement of MLO-fed aged worms was not decreased, compared to untreated control worms, indicating MLO might extend lifespan without affecting healthspan.
Abdominal Pain ; Caenorhabditis elegans* ; Caenorhabditis* ; Catalase ; Contusions ; Eating ; Lindera* ; Longevity ; Medicine, Traditional ; Methanol ; Oxidative Stress ; Superoxide Dismutase

Although various endoscopic treatments, such as laser photocoagulation, electrocoagulation, heater probe, injection have been used for treatment of arteriovenous malformation (AVM), associated complications also have been reported. In order to avoid the complications, elastic band ligation has recently been used as an alternative method for endoscopic treatment of gastric AVM. A 58-year-old man was admitted due to hematemesis and melena. A gastroscopy revealed AVM with vessel exposure and active bleeding at the greater curvature of fundus, and we performed arteriography for emergency embolization, but, we do not find the bleeding vessel. Endoscopic band ligation therapy was performed as an alternative method for control of bleeding. 2 months later, follow-up endoscopy showed disappearance of AVM and no evidence of hemorrhage.
Angiography ; Arteriovenous Malformations* ; Electrocoagulation ; Emergencies ; Endoscopy ; Follow-Up Studies ; Gastroscopy ; Hematemesis ; Hemorrhage ; Humans ; Ligation* ; Light Coagulation ; Melena ; Middle Aged