STUDY DESIGN: Prospective study. OBJECTIVES: To assess the correlation between symptom improvement and spinal canal dimensions in patients who underwent selective nerve root block for lumbar spinal stenosis. SUMMARY OF LITERATURE REVIEW: When the canal size is relatively small, the pressure on the nerve root increases. Decompressive surgery relieves more pain in such patients. MATERIALS AND METHODS: From July 2009 to March 2011, 141 patients received selective nerve root block for 1-level central lumbar spinal stenosis in our hospital. We evaluated the patients using a visual analog scale (VAS) before the procedure and 1 hour, 1 month, and 3 months following the procedure. We measured the spinal canal using magnetic resonance imaging. RESULTS: There was no significant correlation between spinal canal dimensions and the pre-procedure VAS. We divided the patients into 3 groups using the average and the standard deviation of the patients' spinal canal dimensions (<73.1 mm², 73.1-172.5 mm², >172.5 mm²) (p<0.01). One hour after the procedure, the VAS scores changed by 1.43±1.8, 1.62±1.7, and 1.53±1.5, respectively, with no significant differences among the 3 groups. However there were significant differences in the VAS changes 1 month and 3 months following the procedure, with results of 2.39±1.7 and 1.39±1.5, 4.65±2.1 and 4.28±2.3, and 4.97±2.2 and 6.83±1.9 (p<0.01), respectively. CONCLUSIONS: The smaller the area of the spinal canal, the less likely symptoms were to improve after selective nerve root block. The results of this study will help predict the effects of selective nerve root block in spinal stenosis patients.
Humans ; Lumbosacral Region ; Magnetic Resonance Imaging ; Nerve Block ; Prospective Studies ; Spinal Canal* ; Spinal Stenosis* ; Visual Analog Scale

PURPOSE: As a new strategy to modulate drug resistance in the treatment of relapsed or refractory non-Hodgkin's lymphoma(NHL), continuos infusion of drugs has been incorporated into the chemotherapy. We conducted a phase II study to determine the activity and safety of EPOCH (etoposide, vincristine, doxorubicin, cyclophosphamide, prednisolone) chemotherapy, in which the natursl products are administered as a continuous infusion, for previously treated NHL's of intermediate grade. MATERIALS AND METHODS: EPOCH chemotherapy (etoposide 50 mg/m2/day 24 hour- continuous infusion, days 1~4, vincristine 0.4 mg/m2/day 24 hour-continuous infusion, days 1~4, doxorubicin 10 mg/m2/day 24 hour-continuous infusion, days 1~4, cyclophosphamide 750 mg/m2 i.v., day 5, prednisolone 60 mg/m2/day p.o. days 1-5) was given to eligible patients every 3 weeks and we assessed response and toxicity of the regimen. RESULTS: Between June 1993 and December 1995, total 56 patients entered this trial and 49 were evaluable. The complete response rate was 41%(95% C.I.: 27-55%). After follow up of 9~50(median 38) months, progression free survival was 0~39+(median 7) months and the overall survival was 1~44+(median 14) months. The prognostic factor analyses showed that B symtoms and serum LDH level before treatment and response to previous treatment affected complete response rate, and patients' performance status and response to previous treatment affected progression free survival and overall survival. Toxicities of EPOCH regimen were leukopenia, stomatitis, nausea/vomiting and neurotoxicity, but they were tolerable. There was 1 case of treatment-related death due to sepsis. CONDUSION: EPOCH chemotherapy was safe and effective for the patients with relapsed NHL. However, the results of patients with NHL refractory to previous treatment were so poor that more intensive, novel treatment would be needed for this category of patients.
Cyclophosphamide ; Disease-Free Survival ; Doxorubicin* ; Drug Resistance ; Drug Therapy* ; Follow-Up Studies ; Hodgkin Disease* ; Humans ; Leukopenia ; Lymphoma, Non-Hodgkin ; Prednisolone ; Sepsis ; Stomatitis ; Vincristine*

This paper outlines the case of a 56 year-old man undertaking treatment by means of luxation and forced eruption of an ankylosed canine. At the time of diagnosis, the ankylosis of the tooth was not suspected, because there were not signs of intrusive luxation nor horizontal diaplacement. Only after the application of a vertical elastic force failed to erupt the maxillary left canine, was the ankylosis of that tooth suspected. At the time of reevaluation, the maxillary left canine hads no physiologic tooth mobility and emitted a sharp, ringing sound upon percussion. Hence, the maxillary left canine was considered ankylosed. The treatment course then changed to the extrusion of the canine through the surgical luxation of the tooth and the prompt application of vertical extrusive forces. The above outcome was successful for the patient not only in the orthodontic aspect, but also in terms of the periodontal considerations.
Ankylosis ; Diagnosis ; Humans ; Middle Aged ; Mortuary Practice ; Orthodontic Extrusion* ; Percussion ; Tooth ; Tooth Mobility

The purpose of this study was to evaluate the amount and interrelationship of hard and soft tissue changes after mandibular setback osteotomy and reduction genioplasty in mandibular prognathism with long anterior facial height. The control group (Group A) consisted of 20 patients who had severe horizontal discrepancy. They experienced presurgical orthodontic treatment and orthognathic surgery via mandibular setback. The experimental group (Group B) consisted of 20 patients who had severe horizontal and vertical discrepancy. They experienced presurgical orthodontic treatment and orthognathic surgery via mandibular setback and reduction genioplasty. The presurgical and postsurgical lateral cephalograms were valuated. The computerized statistical analysis was carried on with EXCEL 97 program. The results were as follows : 1. The correlation of hard and soft tissue horizontal changes in lower 2/3 of lower anterior facial height were high for both groups. The correlation coefficients of hard tissue changes and Ls, Stm, Li changes in group B were moderately higher than Group A. 2. The correlation of hard and soft tissue vertical changes in Group B were lower than Group A. (except for pointB-Ils, Me-Me') 3. The ratio for soft tissue to Pog in Group B was lower than Group A. The ratios of hard and soft tissue vertical changes were 32% at Ils, 54% at Pog', and 60% at Me'. 4. The ratio of lower anterior facial height to total anterior facial height was reduced for both group. But ratio of upper 1/3 of lower anterior facial height to total anterior facial height did not changed significantly in Group B. 5. Reduction genioplasty combined with mandibular setback procedure showed no change in upper one third(Sn-Stm) and significant decrease(Stm-Me') in the lower two thirds of the soft-tissue anterior lower facial height.
Genioplasty* ; Humans ; Orthognathic Surgery ; Osteotomy* ; Prognathism*

STUDY DESIGN: Retrospective study of prospectively-collected data. OBJECTIVES: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. SUMMARY OF LITERATURE REVIEW: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. MATERIALS AND METHODS: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. RESULTS: The average area of the spinal canal was 81.40±53.61 mm2 in the surgical group, compared to 127.75±82.55 mm2 in the nonsurgical group (p=0.042). The muscle area in the spinal canal was 5.17±1.30 cm2 in the surgical group, whereas it was 6.40±1.56 cm2 in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). CONCLUSIONS: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.
Fitness Centers ; Humans ; Lumbosacral Region ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Canal ; Spinal Stenosis ; Sprains and Strains

STUDY DESIGN: Retrospective study of date collected prospectively.OBJECTIVES: To report analytic results about association factors related to effect of conservative treatment in surgically indicated single level lumbar spinal stenosis patient.SUMMARY OF LITERATURE REVIEW: There have been various reports about clinical outcomes and relative factors after surgical treatment of spinal stenosis. However, there are few reports about factors related to effect of conservative treatment in surgically indicated lumbar spinal stenosis patient.MATERIALS AND METHODS: We based on 40 patients who had visited our hospital from May 2010 to April 2016 who were traceable for at least three years. We analysed 20 patients who improved symptom and who didn't improved symptom then investigated association factors related to effect of conservative treatment. Clinical assessment was conducted using questionnaire and spinal canal's area and muscle amount were measured in the MRI.RESULTS: Average of the spinal canal of not-improved group is 91.29(±34.26) mm², improved group is 130.70 (±32.18) mm² and impoved group is wider (p=0.001). Muscle mass of improved group is 91.47(±9.43) cm², not-improved group is 79.26 (±14.35) cm², and improved group is wider (p=0.003). Repetitive strain and traffic accident were related in not-improved group (p=0.028). However, practiced stretching continuously were related to symptom improvement (p=0.022).CONCLUSIONS: Association factors related to effect of conservative treatment are cases of wide spinal canal, wide muscle amount, repetitive sprain, traffic accident and stretching. A small muscle amount can be considered as a key factor related to surgical conversion.
Accidents, Traffic ; Humans ; Lumbosacral Region ; Magnetic Resonance Imaging ; Paraspinal Muscles ; Prospective Studies ; Retrospective Studies ; Spinal Canal ; Spinal Stenosis ; Sprains and Strains

OBJECTIVES: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients.SUMMARY OF LITERATURE REVIEW: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. MATERIALS AND METHODS: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. RESULTS: The average area of the spinal canal was 81.40±53.61 mm2 in the surgical group, compared to 127.75±82.55 mm2 in the nonsurgical group (p=0.042). The muscle area in the spinal canal was 5.17±1.30 cm2 in the surgical group, whereas it was 6.40±1.56 cm2 in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). CONCLUSIONS The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.

OBJECTIVES: To report analytic results about association factors related to effect of conservative treatment in surgically indicated single level lumbar spinal stenosis patient.SUMMARY OF LITERATURE REVIEW: There have been various reports about clinical outcomes and relative factors after surgical treatment of spinal stenosis. However, there are few reports about factors related to effect of conservative treatment in surgically indicated lumbar spinal stenosis patient. MATERIALS AND METHODS: We based on 40 patients who had visited our hospital from May 2010 to April 2016 who were traceable for at least three years. We analysed 20 patients who improved symptom and who didn't improved symptom then investigated association factors related to effect of conservative treatment. Clinical assessment was conducted using questionnaire and spinal canal's area and muscle amount were measured in the MRI. RESULTS: Average of the spinal canal of not-improved group is 91.29(±34.26) mm², improved group is 130.70 (±32.18) mm² and impoved group is wider (p=0.001). Muscle mass of improved group is 91.47(±9.43) cm², not-improved group is 79.26 (±14.35) cm², and improved group is wider (p=0.003). Repetitive strain and traffic accident were related in not-improved group (p=0.028). However, practiced stretching continuously were related to symptom improvement (p=0.022). CONCLUSIONS Association factors related to effect of conservative treatment are cases of wide spinal canal, wide muscle amount, repetitive sprain, traffic accident and stretching. A small muscle amount can be considered as a key factor related to surgical conversion.

No abstract available.
Bleomycin* ; Drug Therapy, Combination* ; Etoposide* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

Retrograde cerebral perfusion under hypothermic circulatory arrest is a simple and useful adjunct to avoid cerebral ischemic injury in the treatment of aortic arch pathology. In the surgery of distal aortic arch and proximal descending aortic lesions through the left thoracotomy incision, right atrium-retrograde cerebral perfusion (RA-RCP) through a venous cannula positioned into the right atrium is simpler than retrograde cerebral perfusion through superior vena cava. The time limits for RA-RCP during aortic arch reconstruction have yet to be clarified. We, herein, present a case with uneventful recovery after RA-RCP of 94 minutes during reconstruction of aortic arch and descending aorta. These data suggest that RA-RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RA-RCP exceeds 90 minutes.
Aneurysm, Dissecting ; Aorta, Thoracic* ; Brain ; Brain Ischemia ; Catheters ; Heart Atria ; Pathology ; Perfusion* ; Thoracotomy ; Vena Cava, Superior