Pneumocystis carinii is a pulmonary pathogen of immunocompromised humans or other mammals. Its infection results from activation of organisms involved in latent infection or from new infection through the air. Almost all children are known to be infected within 2 to 4 years of birth, though prenatal transplacental transmission has not yet been demonstrated. In this study we observed experimental P. carinii infection in neonatal rats, thus investigating the possibility of transplacental vertical transmission by Diff-Quik staining of the lung impression smears and in-situ hybridization for lung sections. The positive rate of P. carinii infection in immunosuppressed maternal rats was 100%, but that in normal maternal rats was 0%. Cystic forms of P. carinii were observed in three of six 1-week old neonatal rats born of heavily infected mothers, but none of them was positive by in-situ hybridization. Five weeks after birth, cystic forms were detected in four neonatal rats. In the lobes of the lungs, no predilection site of P. carinii was recognized. Counts of cystic forms on smears and the reactivity of in-situ hybridization in the lungs of neonatal rats were significantly lower than in maternal rats. The present findings suggest that P. carinii is rarely transmitted through the placenta and proliferates less successfully in the lungs of neonatal rats than in mothers.
Animal ; Animals, Newborn/microbiology* ; Disease Transmission, Vertical* ; Female ; Immunocompromised Host ; Lung/microbiology ; Male ; Opportunistic Infections/transmission* ; Opportunistic Infections/complications ; Pneumocystis carinii/isolation & purification ; Pneumonia, Pneumocystis carinii/transmission* ; Pneumonia, Pneumocystis carinii/complications ; Pregnancy ; Rats ; Rats, Wistar

Mandibular prognathism was defined by Johe Hunter as follows : 'The lower jaw projecting too far forwards so that the foreteeth pass before those of upper jaw, therefore disfigurement and malocclusion are the two of facial main characteristics.' Mandibular ramus osteotomy by vertical osteotomy or sagittal splitting osteotomy recently has come into more common use. Although preoperative and postoperative orthdontic management is indispensable in surgery of this type, we occasionally encounter patients who are intolerant to a long duration of orthodontic treatment and intermaxillary fixation. We describe surgical refinement accomplishing mandibular anterior segmental osteotomy, recession genioplasty by horizontal osteotomies and decortication of the anterior portion of the bony bar for a minor degree of mandibular prognathism. In results, the amount of setback is limited to 4 to 5mm, no intermaxillary fixation is required and no orthodontic treatment, in this operation, is needed. This procedure can obtain a rapid aesthetic improvement. We used this preocedure in 8 patients (3 males and 5 females) with a mild mandibular prognathism. No major complications occurred throughout the follow-up period except transient paresthesia of the mental nerves, otherwise all patients were satisfied with the result.
Follow-Up Studies ; Genioplasty* ; Humans ; Jaw ; Male ; Malocclusion ; Osteotomy* ; Paresthesia ; Prognathism*

The purpose of this study was to observe the additive effect of halothane anesthesia and propranolol, and also the effect of atropine and isoproterenol on the heart rate and the blood pressure after propranolol during halothane anesthesia in human-volunteers. The results were as follows: 1) In conscious patients, 10 minutes after intravenous administration of 1.0mg propranolol the heart rate was slower but there was no significant change in the blood pressure. 2) Twenty-thirty minutes after halothane anesthesia, the heart rate was slower by 6 to 8 beats per minute: systolic and diastolic blood pressure was lower by 20.4 torr and 10.5 torr, respectively. 3) 10 minutes after intravenous administration of 1.0mg propranolol during halothane anesthesia, the heart rate was decreased by 7.8, 7.0 per minute: systolic and diastolic blood pressure decreased by 6.7, 5.7 torr and 3.0, 3.9 torr in the atropine and isoproterenol group, respectively. 4) One minute after intravenous administration of atropine 0.5mg after propranolol 1.0mg during halothane anesthesia, the heart rate increased by 12.1 per minute and persisted so far 10 minutes, but the blood pressure did not increase. 5) One minute after intravenous administration of isoproterenol 0.025mg after propranolol 1.0mg during halothane anesthesia, the heart rate had markedly increased by 35, but normalized 10 minutes later. The systolic blood pressure was increased by 13.4 torr but normalized 10 minutes later. 6) The above results indicate: Atropine increases the heart rate which has been slowed with propranolol during halothane anesthesia: isoproterenol increases the heart rate and blood pressure but the duration of action was short. Therefore, authors considered that atropine is useful for the maintenance of heart rate, and continuous administration of isoproterenol for maintenance of blood pressure and heart rate after propranolol during halothane anesthesia.
Administration, Intravenous ; Anesthesia* ; Atropine* ; Blood Pressure* ; Halothane* ; Heart Rate* ; Heart* ; Humans ; Isoproterenol* ; Propranolol*

A lumbar juxtafacet cyst is a rare disease that causes low back pain, radiculopathy and neurological claudication by compressing the nerve roots. A 34-year-old male complained of severe low back pain and radicular pain in the right lower extremity. Magnetic resonance images revealed a cyst at the lateral recess of the spinal canal between the L3-4 disc and posterior facet joint that extended to the L4 body level. Under the guidance of an image intensifier, needle aspiration of the cyst was performed, which extracted 1.5 ml of serous, yellowish colored fluid. After the aspiration, the symptoms subsided dramatically. The follow-up magnetic resonance images showed no recurrence of the cyst. To the best of the author’s knowledge, there are no reports of lumbar juxtafacet cyst treated with needle aspiration in Korea. This case is reported with a review of the relevant literature.

OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

PURPOSE: This study was tried to evaluate the effect of the partial body fractionated irradiation on the frequency of chromosomal aberration. MATERIALS AND METHODS: In three patients with uterine cervix carcinoma, chromosomal aberrations were analyzed during fractionated external beam radiotherapy. Radiation field included whole pelvis and total dose was 5040 cGy in 28 fractions. RESULTS: The values of the frequency of dicentrics and rings (Ydr) in pre- irradiated peripheral lymphocytes in three patients were 0.0060, 0.0000, and 0.0029, respectively. The frequency of dicentrics and rings, estimated during the course of radiotherapy, increased with radiation dose and best fitted to the linear equation, Ydr=7.31x10(-5) D(cGy)+1.45x10(-2). The frequency of dicentrics and rings among the cells with dicentric and/or ring (Qdr) also showed increasing tendency and best fitted to the linear equation, Qdr= 1.01x10(-4) D(cGy)+1.04. CONCLUSION: Ydr increased linearly with radiation dose in the dose range of our study, and Qdr showed increasing tendency with dose.
Cervix Uteri ; Chromosome Aberrations* ; Female ; Humans ; Lymphocytes ; Pelvis ; Radiotherapy*

PURPOSE: This study was tried to evaluate the effect of the partial body fractionated irradiation on the frequency of chromosomal aberration. MATERIALS AND METHODS: In three patients with uterine cervix carcinoma, chromosomal aberrations were analyzed during fractionated external beam radiotherapy. Radiation field included whole pelvis and total dose was 5040 cGy in 28 fractions. RESULTS: The values of the frequency of dicentrics and rings (Ydr) in pre- irradiated peripheral lymphocytes in three patients were 0.0060, 0.0000, and 0.0029, respectively. The frequency of dicentrics and rings, estimated during the course of radiotherapy, increased with radiation dose and best fitted to the linear equation, Ydr=7.31x10(-5) D(cGy)+1.45x10(-2). The frequency of dicentrics and rings among the cells with dicentric and/or ring (Qdr) also showed increasing tendency and best fitted to the linear equation, Qdr= 1.01x10(-4) D(cGy)+1.04. CONCLUSION: Ydr increased linearly with radiation dose in the dose range of our study, and Qdr showed increasing tendency with dose.
Cervix Uteri ; Chromosome Aberrations* ; Female ; Humans ; Lymphocytes ; Pelvis ; Radiotherapy*

For more than 80% of body weight is transmitted through the anterior and middle column, the interbody gap produced by operative reduction of spondylolisthesis is potential risk factor for redisplacement, implant failure, pseudoarthrosis and kyphosis. In biomechanical aspect, augmentation of the anterior column support by interbody fusion is desirable to prevent above problems in surgical treatment of spondylolisthesis. Recently, circumferential fusion is recommended in high-grade spondylolisthesis (grade III, IV, or V ), but there is some controversy about additional interbody fusion in posterior instrumentation for low-grade spondylolisthesis (grade I or II ). So, the purpose of this retrospective study was to compare the segmental sagittal angle in 35 patients of low-grade spondylolisthesis who was performed posterior instrumentation with or without posterial lumbar interbody fusion (PLIF) and to find out the risk factors of the loss of segmental sagittal angle in cases of posterior instrumentation without posterial lumbar interbody fusion (PLIF).
Body Weight ; Humans ; Kyphosis ; Pseudarthrosis ; Retrospective Studies ; Risk Factors ; Spondylolisthesis*

The anterior decompression and anterior interbody fusion have been the choice of surgical treatment for spinal tuberculosis since 1960. But, multi-level spinal tuberculosis involved more than three vertebrae resulted in large post-debridement defect and spinal instability. So, failure of the graft was very common & postoperative maintenance of the kyphotic angle correction was very difficult. In part of such cases as multi-level spinal tuberculosis, we performed supplementary anterior instrumentation in a single-stage procedure. The authors analyzed total 39 surgical cases of multi-level tuberculosis of the thoracolumbar spine from January 1985 to June 1992. The patients treated only with a strut graft were designated as group I(n=23) and the patients added by anterior instrumentation as group II(n=16). Mean age of 39 cases was 33.1 years, and mean follow-up period was 31.6 months. The purpose of this study was to compare the postoperative results of group I with those of group II by measuring the angular kyphosis on serial lateral roentgenograms, and to provide an aid in selecting method of surgery before treatment of multi-level spinal tuberculosis with high risk of progression of kyphosis. The results were as follows: 1. There were 16 cases of thoracolumbar, 14 cases of thoracic, 9 cases of lower lumbar lesions, and numbers of vertebrae involved were 4.2 in mean. 2. By standard Cobb lateral measurement, mean preoperative angle of segmental kyphosis was 32.5° in group I, and 45.1° in group II, and group II proved as more kyphotic. After operation, mean angle of segmental kyphosis was 24.7° in group I and 32.4° in group II. 3. On final F/U, mean angle of segmental kyphos was 32.7° in group I, and 37.3° in group II, and final loss of correction was 8.0° in group I, 4.9° in group II. 4. There were 8 patients(34.8%) of graft-related complications in Group I, and 2(12.5%) in group II. And graft failure in group I resulted in severe loss of correction of segmental kyphosis, but graft failure in group II did not, through graft protection by anterior instrumentation. 5. There were 3 patients(18.8%) of implant-related problems in group II; two during and one after union. In these former two cases, bony union was obtained without loss of correction by prolonged application of brace. No cases of group II was associated with persistence or recurrence of infection after instrumentation. In our opinion, anterior interbody fusion and combined anterior instrumentation can be effective and safe one of methods in surgical treatment for multi-level tuberculosis of the spine which has been considered as the most important determinant of the result by its extensive vertebral involvement with resulting large post-debridement defect to be struted.
Braces ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Methods ; Recurrence ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Vertebral stabilization using transpedicular screw fixation device is widely used in the surgical treatment of degenerative lumber diseases such as spinal stenosis, pseudospondylolisthesis, and spinal instability. The use of transpedicular screw fixation devices provides substantial advantages with regard to an increase of the rate of solid arthrodesis, early rehabilitation, short segment spinal fusion, and restoration of sagittal lumbar lordosis. The authors analyzed 11 patients showing definite postoperative loss of the lumbar sagittal lordosis in a total of 110 surgical cases of degenerative lumbar diseases who underwent segmental spinal fusion using transpedicular screws from January 1981 to December 1993. The purpose of this study was to analyze the causes of loss of lumbar sagittal lordosis in the instrumented segments and to present some precautions in transpedicular screw fixation for surgical patients with degenerative lumbar spines to maintain corrected lumbar sagittal lordosis. The results from this study were as follows: 1. By standard Cobb lateral measurements, eleven cases in a total of 110 patients showed definite loss of lumbar sagittal lordosis more than 4 degrees. 2. The period reflecting loss of lordosis was roughly within postoperative four months which were critical fusion time of the grafted bone mass, which lasted an average of 4.8 months in this study. 3. The implants led to loss of lordosis consisted of 6 cases in 53 Diapasons, 4 cases in 32 Wiltses, and a case in 15 Steffee plate systems. Diapason & Steffee plate systems were classified as a rigid type and Wiltse system as a flexible one. 4. The causes of postoperative loss of lordosis were recognized as 2 cases of screw toggling, 5 cases of screw-rod locking failure and 4 cases of rod bending. 5. The group resulted in more loss of lordosis in degrees was related to significant change between preoperative and postoperative lordosis, distraction of disc space during operation, extensive discectomy, and reduction of degenerative spondylolisthesis which were the cases of the anterior column deficiency.
Animals ; Arthrodesis ; Diskectomy ; Humans ; Lordosis ; Rehabilitation ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Transplants