No abstract available.
Aneurysm* ; Carotid Artery, Internal*

Over the past few decades, interest in minimally invasive spine surgery (MISS) has increased tremendously due to its core principle of minimizing approach-related injury while providing outcomes similar to traditional open spine procedures. With technical and technological advancements, MISS has expanded its utility not only to simple spinal stenosis, but also to complex spinal pathologies such as metastasis, trauma, or adult spinal deformity. In this article, we review the techniques and technology in MISS and discuss the indications, benefits, and limitations of MISS.

BACKGROUND: The antitumor effects of herpes simplex virus thymidine kinase(HSV-tk) and ganciclovir(GCV) strategies for cancer gene therapy have a the following advantages:1) a direct cytotoxicity to HSV-tk modified cancer cells by GCV 2) a cell death by the local transfer of toxic metabolites from the HSV-tk modified cells to nearby unmodified tumor cells(bystander effect), and 3) in vivo bystander effect such as antitumor-immunity. Retroviral and adenoviral sequences can silence transgene expression in cells and mice. In this study, we investigated the above described advantages of HXV-tk/GCV strategy in Lewis lung cell and mouse lung cancer model using retroviral vector and adenoviral vector. Also, we observed whether the expression of a silenced gene can be reactivated by treating cell with butyrate. METHODS: Retrovirus-HSV-tk and adenovirus-HSV-tk vectors were used for the transduction of Lewis lung carcinoma(LLC) cells. The change of HSV-tk expression by butyrate was measured by Western blot.The antitumor activities containing bystander effect were observed in vivo(by MTT assay) and in vivo tumor models of various combinations of LLC and LLC-tk. RESULTS: 1. Butyrate induced the enhancement of HSV-tk expression from adenovirally transduced cells but not from retrovirally transduced cells. 2. Both retrovirus-HSV-tk and adenovirus-HSV-tk vectors with GCV treatment were effective for killing of tumor cell in vitro and suppression of LLC tumorigenicity. Bystander effect was responsible for killing of mixture of LLC-tk and LLC in vitro and in vivo-tumorigenicity model. CONCLUSION: Butyrate could augment adenoviral vector seems to be an effective approach for lung cancer therapy.
Adenoviridae ; Animals ; Butyrates ; Bystander Effect ; Carcinoma, Lewis Lung* ; Cell Death ; Genes, Neoplasm ; Genetic Therapy* ; Herpes Simplex* ; Homicide ; Lung ; Lung Neoplasms ; Mice* ; Phosphotransferases* ; Retroviridae ; Simplexvirus* ; Thymidine ; Transgenes ; Zidovudine*

Nephrotic syndrome has been considered a hypercoagulable state because thromboembolic events of the venous or the arterial circulations occur on occasion. There are various risk factors for thromboembolism in patients with nephrotic syndrome (membranous nephropathy, severe hypoalbuminemia, hemoconcentration and medications such as steroid and diuretics). As thromboembolism is often fatal, early detection and proper management are important. Although anticoagulation is the preferred therapy, thrombolysis may be considered for an extensive thrombosis, for inferior vena cava (IVC) thrombosis, for recurrent pulmonary thromboembolism and for bilateral renal vein thrombosis in conjunction with acute renal failure. We report here on a case of renal vein and IVC thrombosis in a 24-year-old male with nephrotic syndrome, and this patient was treated with intravenous thrombolytics rather than anticoagulation and local thrombolytic infusion. He complained of left flank pain and his CT scan revealed left renal vein thrombosis and IVC thrombosis. After urokinase infusion, his thrombi were resolved successfully without bleeding complications.
Acute Kidney Injury ; Flank Pain ; Hemorrhage ; Humans ; Hypoalbuminemia ; Male ; Nephrotic Syndrome* ; Pulmonary Embolism ; Renal Veins* ; Risk Factors ; Thromboembolism ; Thrombosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator ; Vena Cava, Inferior* ; Young Adult

PURPOSE: Spontaneous subarachnoid hemorrhage(S-SAH) is a relatively rare disease with good clinical course and prognosis. The purpose of this study is to evaluate the cisternal blood distribution on CT in patient with S-SAH. MATERIALS AND METHODS: Out of 406 patients with subarachnoid hemorrhage on brain CT scan, 11 patients confirmed to be S-SAH by angiography and clinical follow-up were examined. We analysed the CT findings of these 11 cases retrospectively. RESULTS: Five patients had only perimesencephalic distribution of hemorrhage:the prepontine, the interped- uncular, and the suprasellar cisterns were involved in 4 cases each, the basal sylvian cistern in 3 cases, and the ambient cistern in 2 cases. The quadrigeminal and a portion of the lateral sylvians were also involved in 1 case each. Six patients revealed cisternal hemorrhage extending beyond the perimesencephalic cistern into the ventricles, cortical sulci, and lateral sylvian fissure. Intraventricular hemorrhage was noted in 3 cases of these 6 patients. CONCLUSION: Our study suggests that uncomplicated clinical course and normal anglographic finding are more important than CT distribution of cisternal hemorrhage in diagnosing S-SAH.
Angiography ; Brain ; Follow-Up Studies ; Hemorrhage ; Humans ; Prognosis ; Rare Diseases ; Retrospective Studies ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

A retrospective analysis of 219 mild head injured patients who were admitted to Chung-Ang University Hospital from January 1990 to December 1991 was made to correlate outcome to initial Glasgow coma scale(GCS) score, combined injuries and radiologic findings. The results were as follows: 1) The young males were most frequently affected. 2) The most common cause was motor vehicle accident followed by fall. 3) The most common combined injury was cervical sprain followed by subgaleal hematoma. 4) The skull fractures were shown in 29.2% but there was no correlation between outcome and skull fracture. 5) The most common abnormal CT finding was the subdural hematoma(20.3%). 6) The positive blood alcohol test was not correlated with the outcome. 7) The majority of the patients(91.8%) made a good recovery. 8) Thirteen patients(5.9%) were performed cranial operation under the diagnosis of epidural hematoma(5 patients), subdural hematoma(4 patients), contusion and FCCD.
Coma ; Contusions ; Craniocerebral Trauma* ; Diagnosis ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head* ; Hematoma ; Humans ; Male ; Motor Vehicles ; Prognosis ; Retrospective Studies ; Skull Fractures ; Sprains and Strains

Fournier's gangrene is a form of necrotizing fasciitis of the perineal, genital or perianal region due to perianal infection, urinary tract infection or local trauma. Even though many patients may present with minor skin lesions in the early stages of the disease, the natural course of this necrotizing disease is rapid progression of gangrene, eventually resulting in sepsis and death. Therefore, rapid and accurate diagnosis is the most important factor for a successful outcome. We report two cases of Fournier's gangrene in a 21-year-old and 24-year-old male, both of whom commonly presented with painful swelling and tenderness of the scrotum. Although one man showed a rapidly-spreading erythema and induration to the flank and lateral chest, they were both successfully treated with early antibiotic therapy and surgical drainage.
Diagnosis ; Drainage ; Erythema ; Fasciitis, Necrotizing ; Fournier Gangrene* ; Gangrene ; Humans ; Male ; Scrotum ; Sepsis ; Skin ; Thorax ; Urinary Tract Infections ; Young Adult

No abstract available.
R Factors* ; Shigella*

No abstract available.

Somatosensory evoked potential (SSEP) changes during cerebral aneurysm surgery and their relationship to postoperative neurologic complications have been studied on many occasions. However, it is still a matter of debate whether SSEP monitoring is really helpful in detecting or preventing neurologic complications. We studied 87 patients undergoing aneurysm surgery of the anterior cerebral circulation and SSEPs were monitored in 60 of these patients. All patients were grade 2 by the subarachnoid hemorrhage (SAH) grading system. Median nerve SSEP was monitored for middle cerebral or internal carotid artery aneurysms and posterior tibial nerve SSEP for anterior cerebral artery aneurysms. A decrease in the cortical amplitude of more than 50%, compared with control, was considered significant and interventions were then taken to reverse the SSEP. The pre- and postoperative neurologic deficits of each patient were evaluated immediately before and after surgery. No significant difference was found in the incidence of postoperative neurologic complications in the SSEP monitored (15% [9/60]) and unmonitored patients (22% [6/27]). In the SSEP monitored patients, the amplitudes of SSEPs decreased significantly in 14 patients and 4 of these showed neurologic complications. However, SSEP amplitudes were not significantly changed in 46 patients, and 5 of these showed neurologic complications. Significant changes in the amplitude of SSEP might represent neuronal injury, but the absence of change in the SSEP cannot guarantee patient safety. Our results suggest that SSEP monitoring may be useful for detecting the danger of neuronal injury, but that it does not reduce the incidence of neurologic complications in aneurysm surgery.
Adult ; Evoked Potentials, Somatosensory/physiology* ; Female ; Human ; Intracranial Aneurysm/surgery* ; Male ; Middle Age ; Monitoring, Physiologic* ; Nervous System Diseases/physiopathology ; Nervous System Diseases/etiology* ; Nervous System Diseases/diagnosis* ; Surgical Procedures, Operative/adverse effects*