No abstract available.
Animals ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary* ; Leptin* ; Rats* ; Receptors, Leptin*

STUDY DESIGN: We retrospectively reviewed the cervical myelopathy patients who underwent anterior or posterior surgery. OBJECTIVES: This study was undertaken to analyze the preoperative radiologic evaluation and the results of the treatment of cervical myelopathy. SUMMARY OF LITERATURE REVIEW: The surgical treatment of cervical myelopathy consisted of anterior/posterior or combined surgery according to lesion site, symptoms, number of involved sequents or prevalence of the surgeon. Material and METHODS: We reviewed the clinical and radiological aspects of 28 patients Preoperative plain radiographs and MRI were evaluated with clinical symptoms. Postoperative clinical evaluation was performed according to the Robinson's criteria. RESULTS: On plain lateral radiographs, spinal canal diameter were 13.4+/-2.6/12.5+/- 1.7mm, Pavlovratios were 0.78+/-0.09/0.66+/-0.08, spondylosis indices were 1.70/1.80mm, and the antero-posterior compression ration of spinal cord were 42.4+/-8/44.0+/-6% for anterior surgery and posterior surgery group each. The results of 15 patients who received anterior decompression and interbody fusion were excellent in 11, good in 2, and fair in 2 cases. The results of 13 patients who underwent laminoplasty were excellent in 9, good in 3, and fair in one case. CONCLUSIONS: The patients who have Pavlov ratio less than 0.8 and spondylosis index more than 1.5mm on plain radiograph are vulnerable to developing myelopathy. It is better to do anterior decom pression and interbody fusion in patients who have one or two segments involved and kyphotic deformity of the cervical spine. Otherwise, patients who involve more than 3 segments and narrow spinal canal can be managed using laminoplasty posteriorly.
Congenital Abnormalities ; Decompression ; Humans ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Spinal Cord Diseases* ; Spine ; Spondylosis

Appendiceal actinomycosis is very rare and its diagnosis is often difficult even in surgically resected specimens. Here we report two cases of appendiceal actinomycosis confirmed by pathologic examination of surgically resected specimens. Characteristic histologic features included transmural chronic inflammation with Crohn-like lymphoid aggregates and polypoid mucosal protrusion into cecal lumen through fibrous expansion of the submucosa. Chronic active inflammation involved the mucosa of the appendix and cecum around the appendiceal orifice. Crohn’s disease with predominant cecal involvement and inflammatory pseudotumor were considered as differential diagnoses. Careful examination revealed a few actinomycotic colonies in the mucosa, confirming the diagnosis. A high index of suspicion with awareness of the characteristic histologic features might prompt careful inspection for the actinomycotic colonies, leading to the appropriate diagnosis of this rare disease.

Appendiceal actinomycosis is very rare and its diagnosis is often difficult even in surgically resected specimens. Here we report two cases of appendiceal actinomycosis confirmed by pathologic examination of surgically resected specimens. Characteristic histologic features included transmural chronic inflammation with Crohn-like lymphoid aggregates and polypoid mucosal protrusion into cecal lumen through fibrous expansion of the submucosa. Chronic active inflammation involved the mucosa of the appendix and cecum around the appendiceal orifice. Crohn’s disease with predominant cecal involvement and inflammatory pseudotumor were considered as differential diagnoses. Careful examination revealed a few actinomycotic colonies in the mucosa, confirming the diagnosis. A high index of suspicion with awareness of the characteristic histologic features might prompt careful inspection for the actinomycotic colonies, leading to the appropriate diagnosis of this rare disease.

Percutaneous transhepatico-biliary duodenal drainage(PTBDD) (n=2) and percutaneous transhepatic duodenaldrainage(PTDD) (n=1) were performed as palliative treatment of obstructed afferent loop in patients in whomobstructive jaundice had occurred after surgery for malignant tumors. All three patients experienced septic shockafter PTBDD or PTDD. We describe these cases and review the literature.
Duodenum ; Humans ; Jaundice ; Jaundice, Obstructive* ; Palliative Care ; Sepsis ; Shock, Septic*

No abstract available.
Liver Transplantation ; Liver ; Lymphoma, Follicular

No abstract available.
Intestinal Volvulus* ; Pregnancy*

PURPOSE: To determine the metaphyseal changes occurring in Legg-Calve-Perthes(LCP) disease using MRI. MATERIALS AND METHODS: Between 1992 to 1999, 80 LCP patients (87 hips) underwent MR imaging and plain radiography. All MR images were reviewed, bone marrow signal intensity, the size and location of the metaphyseal cyst and its epiphyseal necrosis grade determined. RESULTS: Metaphyses were abnormal in 43hips (49%), while bone marrow edema was present in 28 (32%) and a metaphyseal cyst in 30 (34%). Metaphyseal cysts were classified as either 'true' (n=9) or 'false' (n=21) according to the enhancement pattern. The maximum diameters of true and false cysts were 1.1+/-0.3 cm and 1.1+/-0.4 cm, respectively. Their most commom location was the anterior column; a true cyst occurred there in 7cases (78%), and false cyst in 16 (76%). Using the Waldenstrom classification, seven of the nine hips wih a true cyst (78%), were found to be at the avascular stage and 15 of the 21 with a false cyst (71%) were at the fragmentation stage. Seven of these nine (78%) and 19 of these 21 (90%) were Catterall grade IV. CONCLUSION: According to the findings of MR imaging, the metaphyseal changes occurring in LCP disease were bone marrow edema and metaphyseal cyst. This latter was visualized mainly in the anterior column and severely affected hip, and was classified as 'true' or 'false'.
Bone Marrow ; Classification ; Edema ; Hip ; Humans ; Legg-Calve-Perthes Disease* ; Magnetic Resonance Imaging ; Necrosis ; Radiography

PURPOSE: To report X-shaped stent insertion and its result in the patients with advanced hilar malignancy. MATERIALS AND METHODS:X-shaped stents were inserted in six patients with advanced hilar malignancy involving segmental branches of both intrahepatic bile ducts (IHD). The causes were cholangiocarcinomas in five patients and recurrent GB cancer in one. The procedure includes three steps: 1) the insertion of two wires through three IHDs in an X configuration, using a stone basket; 2) balloon dilatation of lesions, and 3) the in-sertion of two stents in an as X configuration. Stents were inserted after balloon dilatation in five patients, and without balloon dilatation in one. Changes in serum bilirubin levels and procedure-related problems were reviewed. RESULTS: In all patients, serum bilirubin levels gradually decreased, but in two, they increased again. One of these two died of sepsis after 1 month. There was bile leakage through the puncture and bile was extracted from malignant ascites. In the other patient, occlusion of the left stent tip occurred, and additional left PTBD was performed 3 months later. Hemobilia developed in all five patients with balloon dilatation, these all experianced pain during dilatation , but afterwards this disappeared. One stent without pre-balloon dilation showed incomplete self-expansion at the crossing part and supplementary balloon dilatations were performed. CONCLUSION: In patients with advanced hilar malignancy, X-shaped stent insertion is a new palliation. Problems such as hemobilia, pain, and intraperitoneal bile leakage may, however, occur.
Ascites ; Bile ; Bile Ducts, Intrahepatic ; Bilirubin ; Cholangiocarcinoma ; Dilatation ; Hemobilia ; Humans ; Punctures ; Sepsis ; Stents*

Anterior interosseous nerve syndrome is characterized by weakness of the flexor pollicis longus, the flexor digitorum profundus and the pronator quadratus in the presence of normal sensation. Although MR imaging findings of anterior interosseous nerve syndrome has been reported in a few articles, we report herein a case of anterior interosseous nerve syndrome involving more than usual muscles innervated by anterior interosseous nerve, caused by varient nerve innervation.
Magnetic Resonance Imaging ; Muscles ; Sensation