For many years chemonucleolysis has been proven effective in the curative treatment of lumbar disc herniation. However, this technique is seldom popular in the herniated cervical disc. For several years microsurgery of the cervical disc has been effective in the treatment of refractory cervicobrachial neuralgia. To compete with this method which has been familiar to neurosurgeons, cervical nucleolysis using chymopapain for 1 year. Twenty two pateints(75%) had excellent outcomes, 5 pateints(15%) considered good while 3 sustained their symptom, but showed decreased intensity. The decision to intervene is made when the radiculagia is recurrent or resistant to medical treatment of several weeks duration, without myelopathy or bony abnormalities such as spondylosis or canal stenosis. The principal advantages of this method are : short stay in the hospital(3 days to 5 days on average), absence of general anesthesia, prompt resumption of previous activities, and long-term preservation of an intervertebral space. As a result, cervical nucleolysis has been shown to be an effective alternative to surgery for cervical soft disc herniations with refractory radicualgia.
Anesthesia, General ; Brachial Plexus Neuritis ; Chymopapain ; Constriction, Pathologic ; Intervertebral Disc Chemolysis* ; Microsurgery ; Spinal Cord Diseases ; Spondylosis

No abstract available.
Hepatolenticular Degeneration*

BACKGROUND: Inguinal hernia is one of the most common surgical diseases in pediatric patients. We reviewed pediatric inguinal hernia cases retrospectively to analyze the clinical characteristics. METHODS: We reviewed 200 herniorrhaphies in 194 patients who were under the age of 15 and who were operated on at Chungbuk National University Hospital from January 1992 to July 1997. RESULTS: 1) All of the cases were indirect inguinal hernias. Sliding hernias were noticed in 6 cases. High ligations were performed in all cases except 2 cases of Bassini operations. 2) Boys were affected 3.4 times more often than girls. 56.2% of the hernias occurred on the right side, 35.0% on the left side, and 8.8% bilaterally. Bilateral inguinal hernias occurred more often in girls (13.6%) than in boys (7.3%). 3) Hernias were noticed under the age of 1 year (47.9% of the cases). In most of those cases, operations were delayed. Especially, the operations were delayed more than 3 months for 82.1% of patients with hernias and under the age of 6 months. 4) On admission, most patients complained of inguinal or scrotal swelling and inguinal pain or discomfort. 5) Hospitalization occurred in 20.6% of the cases, 3 of which needed emergency operations. Hospitalization occurred in 47.5% of the cases under the age of 1 year; in those cases, hernias were noticed within the first 6 months, and in most of those cases, operations were delayed more than 3 months. 6) Postoperative complications occurred in 9 cases, i.e., 8 cases of scrotal swelling and 1 case of scrotal hematoma. There were no recurrent cases after operation (average follow-up of 33 months). 7) After unilateral inguinal hernia repairs, contralateral hernias developed in 10 patients including 4 patients who had had received their first hernia operations at other hospitals. The sex ratio was 9:1. Laterality of the first hernias were right in 5 cases and left in 5 cases. Contralateral hernias developed within an average of 4.8 months after the first operation; however, 6 cases developed within 6 months after the first operation. CONCLUSIONS: Education for early operation to prevent complications of hernias and careful evaluation of contralateral inguinal hernias in unilateral hernias are needed in the treatment of pediatric inguinal hernias.
Chungcheongbuk-do ; Education ; Emergencies ; Female ; Follow-Up Studies ; Hematoma ; Hernia ; Hernia, Inguinal* ; Herniorrhaphy ; Hospitalization ; Humans ; Ligation ; Postoperative Complications ; Retrospective Studies ; Sex Ratio

PURPOSE: To report the clinical data and visual outcomes after treatment of patients with dysthyroid optic neuropathy (DON). METHODS: We retrospectively reviewed the medical records and orbital images of 40 patients (65 eyes) with DON and analyzed the visual outcomes after treatment with intravenous steroids pulse therapy, radiotherapy and orbital decompression. RESULTS: The study included 21 men and 19 women, with 10 (25%) being diabetic patients. Visual field test results revealed defects in 88.7% of DON eyes; afferent pupillary defects in 63.2%; reduced color vision in 78.5%; and abnormal visual evoked potentials in 84%. Orbital imaging showed moderate to severe apical crowding in 95% of the orbits and intracranial fat prolapse in 24.2%. Median best corrected visual acuity improved from 0.4 to 1.0 after one year of treatment (p < 0.001). We noted more improvement in vision with the use of decompressive surgery than with non-surgical methods (p < 0.05). Recurrences occurred in 7 patients who had not received orbital radiotherapy. CONCLUSIONS: Visual field defects and apical crowding seen on orbital imaging were the most sensitive indicators for the detection of DON. Treatment with intravenous steroids pulse therapy, radiotherapy and orbital decompression effectively improved visual outcomes in cases of DON.
Adult ; Aged ; Combined Modality Therapy ; *Decompression, Surgical ; Diabetes Complications ; Evoked Potentials, Visual ; Female ; *Graves Ophthalmopathy/pathology/surgery/therapy ; Humans ; Male ; Middle Aged ; Pulse Therapy, Drug ; Pupil Disorders ; *Radiotherapy ; Recovery of Function ; Recurrence/prevention & control ; Retrospective Studies ; Steroids/*administration & dosage ; Visual Acuity ; Visual Fields ; Young Adult

No abstract available.
Colorectal Neoplasms* ; Electrophoresis* ; Genes, ras* ; Humans* ; Point Mutation* ; Polymerase Chain Reaction*

This study explored the differences of clinical response, plasma homovanllic acid concentration, haloperidol and reduced haloperidol concentration after 4 weeks haloperidol treatment between higher and lower baseline homovanllic acid concentration groups of schizophrenic patients. After a 2-weeks washout period, they entered the 4 week haloperidol treatment period. The psychopathology was assessed at baseline just before haloperidol trial and then at 1, 2, 4 week using Positive and Negative Syndrome Scale(PANSS). Also the measurement of plasma homovanillic acid(HVA), haloperidol(HP) and reduced haloperidol(RHP) levels were assessed with high performance liquid chromatography at the same time of PANSS assessments. There were no significant differences on the positive, negative, general symptom score of PANSS, haloperidol and reduced haloperidol levels at the end of 4-week between higher plasma HVA group(bsaeline pHVA> or =12.69ng/ml, 10 subjects) and lower plasma HVA group(bsaeline pHVA<12.69ng/ml, 9 subjects). In higher group, the treatment response mainly occured in 2 weeks after treatment, but in lower group, that occured therough 4 weeks. And in higher group, pHVA decresed constantly, but in lower group, pHVA did not changed in 4 weeks. There was significant correlation between plasma haloperidol levels and the clinical improvement(persentile improvement of PANSS positive, general symptom, total score) at the end of 4 week. But no significant correlation were found between plasma reduced haloperidol and RHP/HP ratio and clinical improvement. These results suggest that baseline HVA level is not a valuable therapeutic predictor but it is able to suggest that higher baseline pHVA group and lower group may have different pathophysiology.
Chromatography, Liquid ; Haloperidol ; Homovanillic Acid* ; Humans ; Plasma* ; Psychopathology

No abstract available.
Humans

No abstract available.
Child* ; Humans ; Lung Diseases, Interstitial*

OBJECTIVE: To compare an isotonic lumbar extension exercise program utilizing lumbar extension exercise machines with modified combination program of isotonic lumbar extension exercises, including dynamic stabilization exercise, to improve and maintain trunk stability in the patient with microscopic lumbar discectomy. METHOD: We studied 41 male workers who underwent microscopic lumbar discectomy. Group 1 (n=24) was treated with the isotonic lumbar extension exercise program. Group 2 (n=17) was treated with the modified combination program of dynamic lumbar stabilization exercise and isotonic lumbar extension exercise. The categories that were evaluated and measured were trunk stability, isometric peak torque of lumbar extensor, weight distribution rate of both leg and trunk muscle balance, and Oswestry low back pain (LBP) disability index. RESULTS: After 3 months, group 1 revealed higher isometric peak torque, weight distribution rate of both leg and trunk muscle balance compared with that of group 2. At the end of 6 months, group 2 revealed higher isometric peak torque compared with that of group 1. CONCLUSION: We suggested that combined exercise program, that included the dynamic lumbar stabilization exercise and the isotonic lumbar extension exercise, was a valuable treatment for postoperative lumbar rehabilitation.
Diskectomy* ; Exercise ; Humans ; Leg ; Low Back Pain ; Male ; Rehabilitation ; Torque

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications in Korea. Gastrointestinal toxicity, including peptic ulcer, is a common adverse effect of NSAIDs. Risk factors for NSAID-related peptic ulcer include a previous history of peptic ulcer, advanced age, high dose, concomitant use of corticosteroids, anticoagulants, other NSAIDs including low-dose aspirin. Preventive measure(s), such as COX-2 inhibitor, proton pump inhibitor or misoprostrol, should be done for patients requiring NSAID therapy who have high-risk factor(s) for peptic ulcer. Low dose aspirin also increases the risk of peptic ulcer, so preventive measure(s) should be done for high-risk patients. The eradication of Helicobacter pylori is recommended for high-risk NSAID-users. Treatment strategies for peptic ulcers in NSAID users are mostly the same for peptic ulcers in NSAID non-users.
Anti-Inflammatory Agents, Non-Steroidal/*adverse effects ; Anti-Ulcer Agents/therapeutic use ; Anticoagulants/adverse effects ; Aspirin/*adverse effects ; Cyclooxygenase 2 Inhibitors/therapeutic use ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Humans ; Misoprostol/therapeutic use ; Peptic Ulcer/drug therapy/prevention & control/*therapy ; Proton Pump Inhibitors/therapeutic use