OBJECTS: There was a trend to perform fusion and instrumentation in spinal stenosis surgery, because of extensive decompression and instability. However, the introduction of microscope in spine operation can minimize the range of excision of anatomical structure and reduced the decompressin level in the multiple lesions and the incidence of spinal fusion. The purpose of this study were to assess the outcome of this procedure in 3 years follow up and to identify the clinical features of the patients and technical aspects of the operation that were associated with a poor outcome. MATERIALS AND METHODS: Twenty-one patients were identified as having had a microscopic decompression without arthrodesis, for degenerative lumbar spinal stenosis over 60 years or their who had osteoporosis with Saville's index 2 or higher. The follow up period was more than 3 years. The clinical results was evaluated by Kim's criteria. RESULTS: Eleven cases were above good results in two levels involved 14 cases, 2 cases above good results in three levels involved 5 cases and 1 case above good results in four levels involved 2 cases. In the cases of affected duration, 7 cases are less than 1 year or more than 5 years each 6 cases and 2 cases were above good results by the criteria. We concluded that the long-term outcome of decompressive surgery in the elderly is good; it does not differ from that reported for younger patients . CONCLUSIONS: Selective microscopic decompression is one of the effective method for the elderly patients or patients with osteoporosis in addition to multiple stenotic lesions.
Aged ; Arthrodesis ; Decompression* ; Follow-Up Studies* ; Humans ; Incidence ; Osteoporosis* ; Spinal Fusion ; Spinal Stenosis* ; Spine

Interleukin-6 (IL-6) is introduced as a marker of disease. At present, a variety of method may be used to quantify expression of this protein. Antigen capture-ELISA is a sensitive and accurate quantification method previously used with ovine, rat, and human IL-6 proteins. However, it has never been reported to quantify porcine IL-6 protein using capture ELISA. In this study, we generated and characterized a set of IgY and mono-specific polyclonal antibodies to recombinant porcine IL-6 (rpIL-6), and combining these with a sensitive and specific capture-ELISA for a diagnostic purpose. cDNA encoding the mature protein coding region of porcine IL-6 was cloned and expressed with pQE-30UA expression vector. rpIL-6 was then expressed and purified by using Ni-NTA resin. Protein mass of 24 kDa was found with SDS-PAGE and the identity of the protein was confirmed by Western-blot. Production of polyclonal antibodies against rpIL-6 was performed using the purified rpIL-6 in mice and hens. An antigen capture-ELISA was developed with the antibodies after their extraction. To compare the IL-6 level in the different sanitary state of farms, pig sera were randomly collected and concentration of IL-6 in the sera was measured with the antigen capture-ELISA. The capture-ELISA with the optimal concentration of antibodies, in this study, was able to detect about 10 ng/ml of rpIL-6. IL-6 levels determined with the capture-ELISA in pig sera showed positive correlation with the sanitary states of the farms. These results suggested that the developed antigen capture-ELISA could be a good tool for the screening of microbial infection in pig farms.
Animals ; Biological Markers/blood ; Blotting, Western/veterinary ; Chickens ; Cloning, Molecular ; DNA, Complementary/genetics/isolation&purification ; Electrophoresis, Polyacrylamide Gel/veterinary ; Enzyme-Linked Immunosorbent Assay/methods/*veterinary ; Female ; Immunoglobulins/*blood ; Interleukin-6/*immunology ; Mice ; Mice, Inbred ICR ; Recombinant Proteins/immunology ; Swine/*immunology

BACKGROUNDS: Korean Activities of Daily Living(K-ADL) scale was developed to measure the elderly function. The aim of the present study was to establish the validity and reliability of Korean Activities of Daily Living(K-ADL) scale. METHODS: Clinical validity and convergent validity was tested. Reliability was tested by internal consistency(Cronbach's alpha), two weeks test-retest method, and interrator correlation. RESULTS: Cronbach's alpha was 0.937. 2 weeks test-retest correlations in all 7 items were higher than 7.0. Interrator agreements were high in all 7 items(h=0.86~1.0). Nonnal control group had lower scores than patients group in all 7 items(p=0.000). Correlation coefficients between K-ADL score and braindisability grade was between -0.465(eating) and -0.696(bathing)(p=0.000). CONCLUSIONS: Korean Activities of Daily Living(K-ADL) scale is a valid and reliable instrument. In the future, the studies showing an association between K-ADL and mortality, prognosis are needed.
Activities of Daily Living ; Aged ; Humans ; Korea ; Mortality ; Prognosis ; Reproducibility of Results*

No abstract available.

No abstract available.

Purpose: The diagnostic usefulness of fetal echocardiography in congenital heart disease is well known. One of the indications for fetal echocardiography is presence of extracardiac anomalies and such coexistent congenital heart disease may have important implications for obstetric and neonatal management. MATERIALS AND METHODS: 496 women with singleton pegnancies with amgenital anomalies that underwent penatal care and follow-up in Severance Hospital for 5 years from 1991 to 1995 were evaluated for the incidence of congenital heart disease. RESULTS: The incidence of congenital heart disease in fetuses with the associated extracardiac anomalies were as follows; central nervous system 6.9%(11/160), gastro-intestinal system 10.7%(8/75), genito-urinary sysem 4.7%(4/85), others 5.6%(4/72). Thirty-one of eighty-ane fetuses with congenital heart disease were found to have the associated extracardidac anomalies and ten of them chenoscenal abnormalities. CONCLUSION: We recommend that fetuses with congenital extracardiac anomalies sbould be checked for the presence of congenital heart disease and chmmosomal abnormalities, if needed.
Central Nervous System ; Echocardiography ; Female ; Fetus ; Follow-Up Studies ; Heart Defects, Congenital* ; Humans ; Incidence

BACKGROUND: A few researches on apoptosis in proliferative glomerulonephritis including lupus nephritis, have been reported on the basis of animal experimental models and human renal biopsy tissues. Systemic lupus erythematosus has been reported as a disease with an apoptosis defect of lymphocyte, so that it leads to the decreased immunologic tolerance and activated autoimmunity. The lupus nephritis is frequently accompanied with a interstitial fibrosis and tubuloepithelial change, as compared to other nephitis. In addition to that, the pathologic evolution from one class to other class is also feasible and these things make us to think that the lupus nephritis is tightly linked to the apoptosis. METHOD: We evaluated the relationship between the apoptosis and pathologic characteristics, which was focused on class IV, in 22 patients with clinically and biopsy proven lupus nephritis by comparing with control specimens. The study on the apoptosis was observed through in situ DNA nick end-labeling method and the review on the medical history. RESULTS: 1) An apoptosis in glomerulus was observed in only five patients (zero in Class II, 50% in Class IV) of proliferative glomerulonephritis. But 14 patients (50% in Class II, 75% in Class IV) were detected on the site of tubulo-interstitium. 2) The apoptosis detected in tubulo-interstitial area was significantly correlated with nephrotic syndrome (P<0.025), but correlations with the complement serum level, renal function and the used amount of steroid was not determined. CONCLUSION: The apoptosis of glomerulus in the lupus nephritis was observed in 50% of proliferative cases (especially, in class IV), but in the area of tubulointerstitium, the higher rate (more than 50%) of apoptotic expressions were observed in class II and class IV. The observation on apoptosis in renal tissue could be another prognostic factor.
Animal Experimentation ; Apoptosis* ; Autoimmunity ; Biopsy ; Complement System Proteins ; DNA Breaks, Single-Stranded ; Fibrosis ; Glomerulonephritis ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Lymphocytes ; Nephrotic Syndrome

PURPOSE: The Roux en Y method has rarely been performed due to longer operation time and high risk of complication, despite several merits including prevention of bile reflux. We conducted a retrospective review of the result of Roux en Y reconstruction using two circular staplers after subtotal gastrectomy. MATERIALS AND METHODS: From December 2008 to May 2009, a total of 26 patients underwent Roux en Y reconstruction using two circular staplers after subtotal gastrectomy, and seventy-two patients underwent Billroth-I reconstruction. Roux en Y anastomosis was performed using two circular staplers without hand sewing anastomosis. We compared clinicopathologic features and surgical outcomes between the two groups. All patients underwent gastrofiberscopy between six and twelve months after surgery to compare the bile reflux. RESULTS: No significant differences in clinicopathologic findings were observed between the two groups, except for the rate of minimal invasive surgery (P=0.004) and cancer stage (P=0.002). No differences in the rate of morbidity (P=0.353) and admission duration (P=0.391) were observed between the two groups. Gastrofiberscopic findings showed a significant reduction of bile reflux in the remnant stomach in the Roux en Y group (P=0.019). CONCLUSIONS: When compared with Billroth-I reconstruction, Roux en Y reconstruction using the double stapler technique was found to reduce bile reflux in the remnant stomach without increasing postoperative morbidity. Based on these results, we planned to begin a randomized controlled clinical trial for comparison of Roux en Y reconstruction using this method with Billroth-I anastomosis.
Anastomosis, Roux-en-Y ; Bile ; Bile Reflux ; Gastrectomy ; Gastric Stump ; Hand ; Humans ; Pilot Projects ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stomach Neoplasms

Fabry disease is a rare, X-linked inborn error of glycosphingolipid catabolism caused by a mutation in the gene encoding the alpha-galactosidase A (GLA) enzyme. We report two cases of Fabry disease in a 12-year-old boy who had acroparesthesia and in his elder brother with milder symptoms who were diagnosed by GLA activity assays and the presence of the GLA gene mutation.
alpha-Galactosidase ; Child ; Enzyme Replacement Therapy ; Fabry Disease ; Humans ; Siblings

This study was carried out to investigate the development rates of human embryos co-cultured with cumulus cells to each blastocyst stage. Human zygotes were co-cultured on cumulus cell monolayer in YS medium supplemented with 20% hFF. On day 2, if patient had four or more 'good' embryos(regular blastomeres without fragmentation), embryos were further cultured for 72hrs. Blastocysts on day 5 were classified into early blastocyst (ErB), early expanding blastocyst (EEB), middle expanding Blastocyst (MEB), and expanded blastocyst (EdB) on the basis of their morphological aspects of trophectoderm cells and blastocoele. Subsequently, maximum 3 of best blastocysts were transferred in 486 cycles. The results in this study were as follows: Patients who had four or more 'good' embryos on day 2 were 498 persons, but patients whose embryos could not be transferred due to failure in development to the blastocyst stage on day 5 were 12 persons (2.4%). The development rate of embryos to the blastocyst stage was 58.2% (2,885/4,957) on day 5, and the rates that developed to the ErB, EEB, MEB, and EdB stage were 15.0% (743/4,957), 14.9% (739/4,957), 14.4% (714/4,957), and 13.9% (689/4,957), respectively. Total 1366 blastocysts were transferred in 486 cycles (mean number=2.81). The implantation rate and the ongoing implantation rate obtained by observing the number of G-sac and FHB were 29.9% (409/1,366) and 22.5% (308/1,366), respectively. The clinical pregnancy rate was 51.2% (249/486), and the ongoing pregnancy rate was 39.1% (190/486). Among women showing ongoing pregnancy, women with singleton were 50% (95/190), women with twin were 37.9% (72/190), and women with triplet were 12.1% (23/190). Although triplet pregnancy rate in this study was high such as 12.1%, because many blastocysts with high viability were produced in our co-culture system using cumulus cells on day 5, we really believe that a multiple pregnancy except twin should not occur by selecting good embryos for maximum two blastocyst transfer. These results demonstrate that autologous cumulus cells may be used for the production of blastocysts with high developmental competence, and the use of autologous cumulus cells to be collected easily, and to be treated conveniently at OPU must be an effective means for obtaining high implantation and pregnancy rate.
Blastocyst* ; Blastomeres ; Coculture Techniques* ; Cumulus Cells* ; Embryo Transfer ; Embryonic Structures* ; Female ; Humans* ; Mental Competency ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Pregnancy, Triplet ; Triplets ; Zygote