STUDY DESIGN: Ninty eight patients with multilevel spinal stenosis who were treated with posterior decompression and instrumented posterolateral fusion were reviewed retrospectively. All patients were divided two groups by pathologic level and surgery level. One is complete level decompression group (whole pathologic levels were decompressed) and the other is limited level decompression group (less than pathologic levels were decompressed). SUMMARY OF BACKGROUND DATA: Many patients with spinal stenosis haute multilevel pathology, which is very difficult problem to make surgical strategy for determination of decompression level. METHOD: Patients were reviewed using combination of clinical records, follow-up examinations and radiographs. Posterior decompression and instrumented posterolateral fusion were performed in all patients using pedicle screw fixation (TSRH 49 cases, Diapason 37 cases, CCD 12 cases) and either autogenous bone graft alone or autograft with allograft. The average follow-up period was 19.7 months. RESULTS: In the clinical results by the criteria of Kirkalldy-Willis, there was no difference between complete level decompression group and limited level decompression group. By the bone graft mothorts, fusion rate was no difference between autograft alone group and autograft with allograft group, but fusion periods were more shorter in autograft alone group than in autograft with allograft group(P>0.05). CONCLUSION: In multilevel spinal stenosis, the segments that associated with neurologic symptoms or seyeie stenosis on radiograph must be decompressed but the segments that not associated with neurologic symptoms and mild stenosis on radiograph do not need preventive decompression.
Allografts ; Autografts ; Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Pathology ; Retrospective Studies ; Spinal Stenosis* ; Transplants*

PURPOSE: To demonstrate the effectiveness of the conservative treatment which was introduced to the extraarticular triplane fractures of the distal tibia. MATERIALS AND METHODS: We reviewed radiographs and medical records of eight patients with extraarticular triplane fractures of the tibia. Four patients were treated with closed reduction and internal fixation and the others with closed reduction and plaster. RESULTS: In all patients, the union of fractures was obtained. Although the physes were closed early, there was no angular deformity or leg length discrepancy. CONCLUSION: In case of extraarticular triplane fracture, except for open fracture or failure of closed reduction, conservative treatment yield good result.
Child* ; Congenital Abnormalities ; Fractures, Open ; Humans ; Leg ; Medical Records ; Tibia*

BACKGROUND AND OBJECTIVES: Auricular masses are growths on the outer ear that have not been well characterized clinically. We assessed the clinical nature and treatment of auricular benign masses in patients at our institution. SUBJECTS AND METHODS: We retrospectively identified 63 patients with auricular benign masses who underwent excision and biopsy from May 1970 to April 2011. We determined the site, cause, size, pathology and postoperative results of these auricular masses. RESULTS: Auricular benign masses occurred most commonly on the lobule (44.4%), followed by the tragus (20.6%), crus of helix (11.1%), triangular fossa (6.3%), crus of antihelix-antitragus (3.1%) and scapha (1.5%). Pathologically, the most common type of auricular mass was epidermal cysts (25.3%), followed by hypertrophic scar (12.6%), fibrous tissue-accessory ear (9.5%), chronic inflammation-nevus (7.9%), keloid (6.3%), hemangioma (4.7%), and skin tag-seborrheic keratosis (3.1%). CONCLUSIONS: The most common site of auricular benign masses is the lobule and most common pathology is an epidermal cyst.
Biopsy ; Cicatrix, Hypertrophic ; Ear ; Ear, External ; Epidermal Cyst ; Hemangioma ; Humans ; Keloid ; Keratosis ; Retrospective Studies ; Skin

BACKGROUND/AIMS: This study was conducted to develop an optimal strategy to achive long-term survival after liver resection for hepatocellular carcinoma. METHODS: Between July 1975 and March 1995, 109 patients who underwent liver resection for hepatocellular carcinoma at Inje University Seoul Paik Hospital were analyzed retrospetively. RESULTS: 38 patients (34.9%) survived longer than 5 years after the operation. Prognostic factors of statistical significance were the diagnostic clue, ICG R15, TNM stage, extent of tumor, intrahepatic metastasis, portal vein thrombosis, serosal infiltration, tumor grade, resection margin, Glissonian approach, radicality of operation, cancer recurrence and disease free interval. For the 63 cases with no intrahepatic metastasis, there was no survival difference between the lobectomy group and the segmentectomy/subsegmentectomy group(36.8% vs. 50.0%). In those cases with satellite nodules in one segment of the liver, 66.7% of the lobectomy group lived longer than 5 years while 17.6% of lessthan- lobectomy group survived long-term(p=0.025). CONCLUSION: For long-term survival, a systemic segmentectomy/ subsegmentectomy is adquate for those tumors without intrahepatic metastasis, while the presence of satellite nodules in one segment mandates a standard hepatic lobectomy.
Carcinoma, Hepatocellular* ; Humans ; Liver* ; Neoplasm Metastasis ; Recurrence ; Seoul ; Survivors* ; Venous Thrombosis

PURPOSE: To introduce mini-open rotator cuff repair using the anterolateral approach and evaluate its clinical outcomes and effectiveness. MATERIALS AND METHODS: 59 consecutive cases of rotator cuff tearing which were treated with mini-open repair utilizing the anterolateral approach were evaluated. The population comprised 39 men and 20 women, with an average age of 56.6 years. An average follow-up time period was 26 months. Clinical outcomes were analyzed based on VAS, ADL, and ASES scores. RESULTS: The average respective VAS, ADL, and ASES scores improved from 7.04, 12.37, and 35.32 preoperatively to 1.02, 27.20, and 90.08 postoperatively (p=0.000). There were 41 excellent, 11 good, 2 fair, and 5 poor results. There were satisfactory results in 52 cases (88.1%). There were no statistically significant differences between the final ASES scores and age, sex, duration of symptoms, tear size, and preoperative stiffness (p>0.05). CONCLUSION: Mini-open rotator cuff repair using the anterolateral approach effective in providing better visualization.
Activities of Daily Living ; Female ; Follow-Up Studies ; Humans ; Male ; Rotator Cuff

The correlation between facial pain and/or headache in patients with chronic sinusitis and localized findings on paranasal sinus omputed tomography (CT) are poorly understood. So we prospectively evaluated the relationship of paranasal sinus pain symptoms with CT imaging. Fifty eight patients with headache and/or facial pain rated their pain in 9 areas at the time of CT scanning and 2 months after endoscopic sinus surgery (ESS). We scored the degree of air-fluid level, mucosal thickening, and mucus retention cysts using a grade scale of severity. The ostiomeatal unit, middle meatus and nasofrontal duct were also evaluated for patency. Bivariate analysis was performed to evaluate the relationship between patients' pain, that was improved after ESS and CT findings. Among 58 patients who had facial pain and/or headache at the time of CT scan, the pain improved in 51 patients after ESS. Bivariate analysis failed to show any relationship between pain symptoms and CT findings in 51 patients. This study suggests that findings on CT do not routinely correlate with the patients' symptoms of facial pain or headache. CT should therefore be reserved for delineating the anatomy and degree of sinus disease before surgical intervention.
Facial Pain ; Headache ; Humans ; Korea* ; Mucus ; Prospective Studies ; Sinusitis ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: It has become increasingly clear that immunotherapy with a specific aeroallergen extract is an effective treatment for allergic rhinitis. The fear of side reactions has led to strict regulation preventing a more widespread use of specific immunotherapy. The aim of this study is to investigate incidence of local and systemic side reactions in patients who received immunotherapy. SUBJECTS AND METHOD: Subjects were 139 patients with perennial allergic rhinitis. All patients with allergic rhinitis were diagnosed by history and positive allergic skin test or MAST. All patients received injections of Dermatophagoides farinae or cockroach extracts. Retrospective study was conducted to investigate the incidence of local and systemic side reactions. RESULTS: Ninety-nine patients (71.2%) experienced more than a side reaction. Eighty-seven patients (62.6%) experienced local side reactions and 41 patients (29.5%) experienced systemic reactions. The frequency of side reaction in each age group was different but not statistically significant. The side reactions were developed in 66.8% of patients during buildup phase and in 42.4% of patients during maintenance phase. All patients who experienced systemic reactions were recovered after appropriate managements. CONCLUSION: Immunotherapy is a relatively safe treatment for allergic rhinitis patients in spite of frequent reaction rate, because most of reactions are local reactions and patients with systemic reactions are treated completely.
Cockroaches ; Dermatophagoides farinae ; Humans ; Immunotherapy* ; Incidence ; Retrospective Studies ; Rhinitis* ; Skin Tests

PURPOSE: We investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency. MATERIALS AND METHODS: Eighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels. RESULTS: The subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels. CONCLUSIONS: Serum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise.
Abdominal Fat ; Body Composition ; Electric Impedance ; Erectile Dysfunction* ; Exercise ; Exercise Test ; Humans ; Male ; Physical Fitness ; Testosterone*

BACKGROUND AND OBJECTIVES: To investigate whether taste thresholds, as determined by electrogustometry (EGM) and chemical taste tests, differ by age and the severity of facial palsy in patients with Bell's palsy. SUBJECTS AND METHODS: This study included 29 patients diagnosed with Bell's palsy between January 2014 and May 2015 in our hospital. Patients were assorted into age groups and by severity of facial palsy, as determined by House-Brackmann Scale, and their taste thresholds were assessed by EGM and chemical taste tests. RESULTS: EGM showed that taste thresholds at four locations on the tongue and one location on the central soft palate, 1 cm from the palatine uvula, were significantly higher in Bell's palsy patients than in controls (p<0.05). In contrast, chemical taste tests showed no significant differences in taste thresholds between the two groups (p>0.05). The severity of facial palsy did not affect taste thresholds, as determined by both EGM and chemical taste tests (p>0.05). The overall mean electrical taste thresholds on EGM were higher in younger Bell's palsy patients than in healthy subjects, with the difference at the back-right area of the tongue differing significantly (p<0.05). In older individuals, however, no significant differences in taste thresholds were observed between Bell's palsy patients and healthy subjects (p>0.05). CONCLUSIONS: Electrical taste thresholds were higher in Bell's palsy patients than in controls. These differences were observed in younger, but not in older, individuals.
Bell Palsy* ; Facial Paralysis* ; Healthy Volunteers ; Humans ; Palate, Soft ; Taste Threshold* ; Tongue ; Uvula

PURPOSE: Several studies indicate that nonsteroidal anti-inflammatory drugs including aspirin and sulindac reduce the risk of colon cancer. Futhermore, nonsteroidal anti-inflammatory drugs that inhibit the cyclooxygenase (COX) are shown to inhibit the development colon cancer in animal models of carcinogenesis. COX-1 is constitutively expressed to fulfill its beneficial housekeeping roles. COX-2 is not constitutively expressed by most normal tissues, but it is rapidly induced by certain inflammatory cytokines, tumor promoters, growth factors and oncogenes. The purpose of this study is to evaluate the role of COX-2 in colorectal carcinoma development and the correlation between COX-2 expression and tumor angiogenesis and p53 overexpression. METHODS: Immunohistochemical analyses using antibodies against COX-2, factor VIII-related antigen, vascular endothelial growth factor (VEGF) and p53 were carried out on archival specimens of 15 colorectal adenoma and 41 adenocarcinoma. RESULTS: COX-2 expression was increased in 5/15 (33.3%) adenomas and 24/41 (58.5%) adenocarcinomas. COX-2 expression in adenocarcinoma was nearly significantly higher than in adenoma (P=0.050). In adenocarcinoma, COX-2 expression was increased in early cancer (TNM stage) (P=0.028) and well differentiated tumor (P=0.029). COX- 2 expression was not correlated with VEGF expression, microvessel density and p53 overexpression. CONCLUSIONS: These findings indicate that enhanced expression of COX-2 occurs early during colorectal cancer progression. However, further investigations are needed to evaluate the relationship of COX-2 and tumor angiogenesis using other laboratory methods.
Adenocarcinoma* ; Adenoma ; Antibodies ; Aspirin ; Carcinogenesis ; Carcinogens ; Colonic Neoplasms ; Colorectal Neoplasms ; Cyclooxygenase 2* ; Cytokines ; Housekeeping ; Intercellular Signaling Peptides and Proteins ; Microvessels ; Models, Animal ; Oncogenes ; Prostaglandin-Endoperoxide Synthases ; Sulindac ; Vascular Endothelial Growth Factor A ; von Willebrand Factor