No abstract available.
Pregnancy*

Fifty percents of patient with achondroplasia present neurological disturbances of varying degree. Congenital narrowing of the spinal canal in achondroplastics seems to be the main cause of the cord disturbance, and there are several other causes such as prolapse of intervertebral discs, spondyloarthitic degenerative manifestations and wedging of vertebral body. Surgical treatment of the cord disturbance consist of anterior decompression with fusion and posterior decompression. We experienced L1-2 disc herniation in achondroplasia with rapid progression of neurologic symptoms and treated with posterior decompression. Two years after operation, the patient had good result.
Achondroplasia ; Decompression ; Humans ; Intervertebral Disc ; Neurologic Manifestations ; Prolapse ; Spinal Canal

BACKGROUND: Among constituents of the skin, hair follicle is an organ where nerve fibers with the most highest density are distributed. Recently, it has been reported that neuropeptides, which are secreted by nerve fibers, have important roles in the hair growth and hair cycle change, and that, the expression of various growth factors and apoptosis-related molecules are important in the hair growth and hair cycle change. Therefore, it was thought of import to analyse the relationship between the effect of neuropeptides and the expression of various factors to control hair growth in the hair follicle and hair follicle cells. OBJECTIVE: The purpose of this study was to investigate the relationship between the effect of neuropeptides and the expression of various hair growth-related factors at the level of hair follicle after pretreatment of cultured hair follicles and dermal papilla cells with SP. METHODS: Normal human scalp samples were obtained, and anagen hair follicles and dermal papilla cells were isolated and were cultured in Dulbeco's Modified Eagle's Medium (DMEM) with several combination of supplements in an atmosphere of 5% CO2/95% air incubator. We divided the culture plates into two groups; i.e. control group (DMEM only) and SP group (10-6M SP dissolved in DMEM). The results were evaluated by measuring linear hair growth and hair follicle morphology under a light microscope. Also, after pretreatment of cultured hair follicle and dermal papilla cells with SP, we examined changes of expression of hair growth factors (FGF-7, IGF-1, VEGF), hair growth-inhibitory factors (IL-1alpha, IL-1beta), and apoptosis-related molecules (p53, caspase-3). RESULTS: The following results were obtained. 1. SP did not have any statistically significant effect on the rate of linear hair growth in cultured hair follicles. However, it prolonged the anagen stage of hair cycle. 2. In hair follicles, the expression of FGF-7, a hair growth factor, was increased more than control, while the expression of caspase-3, an apoptosis-related molecule, was decreased more than control. Also, morphological changes as well as the changes of expression of hair growth factors and apoptosis-related molecules were not found in dermal papilla cells. However, the expression of IL-1beta, a hair growth-inhibitory factor, was decreased more than control. CONCLUSION: We can conclude from the results that SP has growth-stimulatory effect and especially prolongs the duration of anagen phase without affecting the rate of linear hair growth. Also, in hair follicles and dermal papilla cells, SP shows hair growth-stimulatory effect at the molecular levels.
Atmosphere ; Caspase 3 ; Hair Follicle* ; Hair* ; Humans* ; Incubators ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Nerve Fibers ; Neuropeptides ; Scalp ; Skin ; Substance P*

The use of subcutaneously tunneled, cuffed central venous catheters like Broviac's or Hickman's has increased and complications related to catheter removal has also increased. However, there are only few reports of complications that occur at the time of removal. The authors report an unusual case of catheter fracture during removal of Broviac catheter.
Catheters* ; Central Venous Catheters

No abstract available.
Broad Ligament* ; Female ; Leiomyoma* ; Leiomyosarcoma*

The prognostic factors for extrahepatic biliary atresia (EHBA) after Kasai portoenterostomy include the patient's age at portoenterostomy (age), size of bile duct in theporta hepatis (size), clearance of jaundice after operation (clearance) and the surgeon's experience. The aim of this study is to examine the most significant prognostic factor of EHBA after Kasai portoenterostomy. This retrospective study was done in 51 cases of EHBA that received Kasai portoenterostomy by one pediatric surgeon. For the statistical analysis, Kaplan-Meier method, Logrank test and Cox regression test were used. A p value of less than 0.05 was considered to be significant. Fifteen patients were regarded as dead in this study, including nine cases of liver transplantation. There was no significant difference of survival to age. The age is also not a significant risk factor for survival in this study (Cox Regression test; p = 0.63). There was no significant difference in survival in relation to the size of bile duct. However, bile duct size was a significant risk factor for survival (Cox Regression test; p = 0.002). There was a significant difference in relation to survival and clearance (Kaplan-Meier method; p = 0.02). The clearing was also a significant risk factor for survival (Cox Regression test; p = 0.001). The clearance of jaundice is the most significant prognostic factor of EHBA after Kasai portoenterostomy.
Bile Ducts ; Biliary Atresia* ; Humans ; Jaundice ; Kaplan-Meier Estimate ; Liver Transplantation ; Prognosis ; Retrospective Studies ; Risk Factors

The purpose of this study is to determine how accuratively and reliably the Perdriollo s method can measure vertebral rotaton according to the level of vertebra and true axial rotation. Standard AP radiographs were taken using 10 dry human vertebra (two set of T3, T6, T9, T12, L3) with 5degrees increments in axial rotation, ranging from 0degrees to 50degrees. In order to evaluate the reliability of Perdriolle s method, three observers measured each radiograph twice, and intet-and intraobserver variance were estimated. The accuracy of Perdriolle's method was analyzed by total error analysis, root mean square error (RMSE) and Deviation of differences. 372 errors were made in the 660 measurement and 88.9% of all measurements were within +/- 5degrees of true rotation angle. There were no signigicant difference in the intraobserver measurement at each level whereas interobserver measurements were significantly different only at T3 level. The measurement was also the least accurate at T3 (RMSE=6.2292). We concluded that Perdriolle's method using torsion meter is an accurate and reliable one to measure the vertebral rotation with less accuracy and reliability in high thoracic level.
Humans ; Spine

Background: We aimed to determine whether propofol-based total intravenous anesthesia (TIVA) is associated with mortality and morbidity following cranial neurosurgery compared with inhalation anesthesia. Methods: This nationwide, retrospective, population-based cohort study included patients who underwent cranial neurosurgery under general anesthesia between January 1, 2016, and December 31, 2021. The two study endpoints were 90-day mortality and postoperative complications. Results: In total, 144,506 adult patients were included: 65,442 patients (45.3%) who received TIVA (TIVA group) and 79,064 (54.7%) who received inhalation anesthesia (inhalation anesthesia group). After propensity score (PS) matching, 97,156 patients (48,578 in each group) were included. The 90-day mortality rates after cranial neurosurgery were 14.0% (6,660/48,578) in the TIVA group and 14.2% (6,779/48,578) in the inhalation anesthesia group. Moreover, the postoperative complication rates following cranial neurosurgery were 47.1% (22,411/48,578) and 50.3% (23,912/48,578) in the TIVA and inhalation anesthesia groups, respectively. Based on the logistic regression analysis, TIVA was not associated with 90-day mortality compared with inhalation anesthesia (odds ratio [OR]: 0.97, 95% CI [0.94, 1.01], P = 0.188) in the PS-matched cohort. Logistic regression analysis revealed that the TIVA group had a 12% (OR: 0.88, 95% CI [0.86, 0.90], P < 0.001) lower postoperative complication rate than the inhalation anesthesia group. Conclusions There was no significant association between the type of anesthesia and postoperative 90-day mortality in patients who underwent cranial neurosurgery in South Korea. However, propofol-based TIVA was associated with a lower incidence of postoperative complications than inhalation anesthesia.

Background: We aimed to determine whether propofol-based total intravenous anesthesia (TIVA) is associated with mortality and morbidity following cranial neurosurgery compared with inhalation anesthesia. Methods: This nationwide, retrospective, population-based cohort study included patients who underwent cranial neurosurgery under general anesthesia between January 1, 2016, and December 31, 2021. The two study endpoints were 90-day mortality and postoperative complications. Results: In total, 144,506 adult patients were included: 65,442 patients (45.3%) who received TIVA (TIVA group) and 79,064 (54.7%) who received inhalation anesthesia (inhalation anesthesia group). After propensity score (PS) matching, 97,156 patients (48,578 in each group) were included. The 90-day mortality rates after cranial neurosurgery were 14.0% (6,660/48,578) in the TIVA group and 14.2% (6,779/48,578) in the inhalation anesthesia group. Moreover, the postoperative complication rates following cranial neurosurgery were 47.1% (22,411/48,578) and 50.3% (23,912/48,578) in the TIVA and inhalation anesthesia groups, respectively. Based on the logistic regression analysis, TIVA was not associated with 90-day mortality compared with inhalation anesthesia (odds ratio [OR]: 0.97, 95% CI [0.94, 1.01], P = 0.188) in the PS-matched cohort. Logistic regression analysis revealed that the TIVA group had a 12% (OR: 0.88, 95% CI [0.86, 0.90], P < 0.001) lower postoperative complication rate than the inhalation anesthesia group. Conclusions There was no significant association between the type of anesthesia and postoperative 90-day mortality in patients who underwent cranial neurosurgery in South Korea. However, propofol-based TIVA was associated with a lower incidence of postoperative complications than inhalation anesthesia.

Background: We aimed to determine whether propofol-based total intravenous anesthesia (TIVA) is associated with mortality and morbidity following cranial neurosurgery compared with inhalation anesthesia. Methods: This nationwide, retrospective, population-based cohort study included patients who underwent cranial neurosurgery under general anesthesia between January 1, 2016, and December 31, 2021. The two study endpoints were 90-day mortality and postoperative complications. Results: In total, 144,506 adult patients were included: 65,442 patients (45.3%) who received TIVA (TIVA group) and 79,064 (54.7%) who received inhalation anesthesia (inhalation anesthesia group). After propensity score (PS) matching, 97,156 patients (48,578 in each group) were included. The 90-day mortality rates after cranial neurosurgery were 14.0% (6,660/48,578) in the TIVA group and 14.2% (6,779/48,578) in the inhalation anesthesia group. Moreover, the postoperative complication rates following cranial neurosurgery were 47.1% (22,411/48,578) and 50.3% (23,912/48,578) in the TIVA and inhalation anesthesia groups, respectively. Based on the logistic regression analysis, TIVA was not associated with 90-day mortality compared with inhalation anesthesia (odds ratio [OR]: 0.97, 95% CI [0.94, 1.01], P = 0.188) in the PS-matched cohort. Logistic regression analysis revealed that the TIVA group had a 12% (OR: 0.88, 95% CI [0.86, 0.90], P < 0.001) lower postoperative complication rate than the inhalation anesthesia group. Conclusions There was no significant association between the type of anesthesia and postoperative 90-day mortality in patients who underwent cranial neurosurgery in South Korea. However, propofol-based TIVA was associated with a lower incidence of postoperative complications than inhalation anesthesia.