Long term follow-up study was done on 38 cases of anterior fusion for spinal tuberculosis especially about effect of buttress graft. The average follow-up period was 16 months. 14 cases of effective buttress group were appeared' to achieve more rapid bony union and prevent further kyphosis or lateral wedging of the involved vertebral body than inadequate buttress group of 7 cases.
Follow-Up Studies ; Kyphosis ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Total 40 cases of serial bone scans with Tc99-m-MDP performed on less than 24 hour, 2nd day, 3rd day, 5th day, 1 week, 4 week, 12 week and 1 year respectively after fractures in tibia were analysed. All 5 cases of bone scans performed within 24 hour after injury showed increase in generalized tracer uptake and 3 cases of them(60%) showed localized increase in tracer uptake at the fracture sites. The earliest bone sean performed 9 hour after injury showed generally and locally increased uptake at the fracture sites. All 5 cases of bone scan performed 1 year after injury sinowed localized increased uptake at the fracture sites and 2 cases of them (40%) showed generalized increase in tracer uptake. Bone scans performed 12 week after injury showed the most outstanding increase in generalized and localized tracer uptake. Bone scans performed 1 year after injury showed decreased amount of generalized increase in tracer uptake (but more increased uptake than normal) but the localized increase in traccer uptake at the fracture sites was observed persistently. More study should be needed to clarify the corelationship between the presence of cold spots during the fracture healing and the union of the fractures. It is difficult to differentiate the old fractures to fresh fractures with the bone scans performed within 1 year because of persistent increase in tracer uptake to 1 year after fracture.
Fracture Healing ; Tibia ; Tibial Fractures

Four patients were treated who had limited flexion of the hips and various degrees of contracture of the abduction and external rotator muscles because of fibrosis of the gluteus maximus muscle. Each patient had a typical restriction of motion such that an affected hip could not be flexed in the usual sagittal plane, but had to be flexed in abduction. Genetic, congenital and postnatal factors have been suggested as the cause of fibrosis of gluteus maximus muscle. Three of the 4 patients reported here are of congenital origin and another one is of postnatal factor repeated intramuscular injections. Excellent correction of the hip contracture was achieved in all patients by division of the fibrotic bands.
Contracture ; Fibrosis ; Hip Contracture ; Hip ; Humans ; Injections, Intramuscular ; Muscles

BACKGROUND: The results of reoperative valve replacement can be improved if appropriate analysis for the risk of reoperation was achieved. The purpose of our study was to analyze the results of reoperations for failure of bioprosthesis, and to define the risk factors in high-risk populations for reoperative procedures. MATERIAL AND METHOD: The series of 46 consecutive patients who had undergone first reoperative replacement for failed bioprosthesis between 1993 and 2001 were reviewed retrospectively. Mean age was 42+/-12 years, mean body surface area was 1.52+/-0.15 m2. The reoperative procedure comprised of 36 MVR, 8 DVR, and 2 AVR. The first operation comprised of 2 DVR, 1 AVR, and 43 MVR. Factors which were choose to assess a predictor of results in reoperative valve replacement were sex, old age(>60 years), early age at first operation(<30 years), long interval between first and redo operation(>15years), poor NYHA functional class(>3), LV dysfunction(LVEF<45%), long operation time(>8hours), endocarditis, combined procedures, and renal insufficiency. RESULT: Overall mortality was 4.3%(2 cases). The risk factors that influenced postoperative complications and unexpected postoperative results were lower ejection fraction(p=0.012), older age(p=0.045), endocarditis(p=0.023), long operation time above 8 hours(p=0.027). There was no statistically significant factor influencing hospital mortality. CONCLUSION: No factor influenced the mortality. Better results could be achieved if reoperation was performed carefully in poor left ventricular function, old aged patient, and with endocarditis. Effort to shorten the operation time would be helpful on postoperative results.
Bioprosthesis ; Body Surface Area ; Endocarditis ; Heart Valve Prosthesis ; Hospital Mortality ; Humans ; Mortality ; Postoperative Complications ; Renal Insufficiency ; Reoperation ; Retrospective Studies ; Risk Factors* ; Ventricular Function, Left

Laparoscopic cholecystectomy has resulted in various bile duct injuries. Treatment of these injuries is usually difficult and often leads to an intractable clinical course. We herein present a case of isolated right anterior sector (RAS) duct injury induced by laparoscopic cholecystectomy. The bile duct injury was successfully treated by hepatic atrophy induction. Imaging studies revealed that the RAS duct was severed, probably due to rare anatomical variations. Considering the difficulty in surgical reconstruction, atrophy induction of the involved hepatic parenchyma was attempted. This treatment consisted of embolization of the RAS portal branch to inhibit bile production, induction of heavy adhesion at the bile leak site to ensure percutaneous pigtail clamping, and sequential clamping and removal of pigtail catheters. This procedure took 3 months prior to pigtail catheter removal. She was free from other complications during the first 12 months and to date. She will be followed up for 5 years overall including surveillance for hepatobiliary complications. Although this therapeutic induction of atrophy approach is not universally applicable, it can be considered to be a feasible option in unique situations such as this one.
Atrophy ; Bile ; Bile Ducts ; Catheters ; Cholecystectomy, Laparoscopic ; Constriction ; Dietary Sucrose

No abstract available.
Heart* ; Thoracic Surgery*

The authors want to correct the title because this article.

BACKGROUND/AIMS: Pancreatic cancer (PC) patients have poor prognoses because this cancer is typically diagnosed at an advanced stage and the therapeutic options are limited. We examined the potential of metabolic profiling for early diagnosis and identification of potential therapeutic targets. METHODS: Ten patients and 10 healthy volunteer controls older than 20 years of age were enrolled between May and December 2015. The patients were confirmed to have pancreatic ductal adenocarcinoma cytologically or histologically. Blood plasma samples were derivatized and analyzed by gas chromatography mass spectrometry (GC-MS). Untargeted GC-MS data were analyzed using statistical methods, including Wilcoxon rank-sum test and principal component analyses. RESULTS: L-lysine was 1.36-fold higher in patients than in healthy controls (p<0.05). L-leucine was 0.63-fold lower (p<0.01) and palmitic acid was 0.93-fold lower (p<0.5) in patients than in controls. Orthogonal partial least squared-discriminant analysis revealed significant differences between the patients and controls. CONCLUSIONS: This study suggests that the metabolic profiles of patients with PC are distinct from those of the healthy population. Further studies are required to develop methods for early diagnosis and identify therapeutic targets.
Adenocarcinoma ; Early Diagnosis ; Gas Chromatography-Mass Spectrometry ; Healthy Volunteers ; Humans ; Korea ; Leucine ; Lysine ; Metabolome ; Palmitic Acid ; Pancreatic Ducts ; Pancreatic Neoplasms ; Plasma ; Principal Component Analysis ; Prognosis

BACKGROUND: Two genetic loci, PKD1 and PKD2, have been identified as being responsible for ADPKD, and PKD1 is known to be associated with poor prognosis. However, the presence of intrafamilial clinical diversity suggests the presence of disease-modifying loci. Because the mechanism of renal failure in ADPKD includes cystic growth and tubulointerstitial atrophy and fibrosis, we studied the associations between two cytokine gene polymorphisms in the TGF-beta gene, which are known to be related with chronic tubulointerstitial inflammation, and ADPKD progression in Korean patients. METHODS: 47 normal controls and 114 individuals with ADPKD were genotyped by PCR-RFLP, and the TGF-beta gene leader sequence of T869C(Leu10Pro) variant was compared with MspA1I and G915C (Arg25Pro) with BglI. Statistic significances were determined using the Chi-square test. RESULTS: The distribution of alleles for the TGF-beta Leu10Pro polymorphism in ADPKD was : T 52%, C 48%, which was similar to the Korean(56 : 44, p= 0.670) and Western controls(65 : 35), and in addition, no differences were found between the CRF and the non-CRF groups(p=0.571) or the early hypertension and the normotension groups(p=0.252). The distribution of alleles for the TGF-beta Arg25Pro polymorphism was all GG type, which was different from Western controls(90 : 10, p=0.000). CONCLUSION: Our results suggest that the polymorphism at Arg25Pro of TGF-beta in Korean population has different allele distribution from Western, and the polymorphism at Leu10Pro of TGF-beta has no association with the renal progression of Korean ADPKD patients.
Alleles ; Atrophy ; Fibrosis ; Genetic Loci ; Humans ; Hypertension ; Inflammation ; Polycystic Kidney, Autosomal Dominant* ; Prognosis ; Renal Insufficiency ; Transforming Growth Factor beta*

BACKGROUND: Autosomal dominant polycystic kidney disease(ADPKD) is the most common hereditary renal disease in adults, and its major complaints include pain and abdominal fullness due to cyst expansion. So far, for the control of these symptoms, cyst ablation with ethanol or tetracycline, laparoscopic manipulations and surgical marsupialization have been used. METHODS: We used conventional ethanol(n=9) or n-butyl cyanoacrylate(NBCA) plus lipiodol solution (n=18) or both(n=3) for separate cysts as the sclerosing agent in 24 adult Korean ADPKD patients. And their clinical courses after treatment were evaluated. RESULTS: The male to female ratio was 8 : 16 and the mean age at the treatment was 50 yrs(S.D. 13.1). Causes for aspiration were pain in 14 and abdominal fullness in 7 patients and the range for the cyst diameters aspirated were 5-16 cm. Flank pain or discomfort were decreased subjectively in most cases except two. Mean arterial pressures(S.D.) (mmHg) before and after procedure were as follows 112(11.1)(basal), 96(9.6)(1 month) and 98(9.7)(6 month)(p < 0.05, paired-t test). Blood urea nitrogen levels(mg/dL) were not changed 6 month later[24 (12.1) vs. 22(14.6)]. There was no major complication such as bleeding or infection and no death and associated with procedure. There was no difference of therapeutic effect according to sclerosing agent. CONCLUSION: NBCA was as effective as conventional ethanol for sclerotherapy in ADPKD and cyst ablation therapy showed a BP-lowering effect in short-term period.
Adult ; Blood Urea Nitrogen ; Ethanol ; Ethiodized Oil ; Female ; Flank Pain ; Hemorrhage ; Humans ; Male ; Polycystic Kidney, Autosomal Dominant* ; Sclerotherapy* ; Tetracycline