STUDY DESIGN: Retrospective study. OBJECTIVES: We analyzed the clinical results of thoracic myelopathy caused by ossification of yellow ligament (OYL) and to explore prognostic factors after surgical treatment. SUMMARY OF LITERATURE REVIEW: Thoracic myelopathy due to OYL is difficult to treat; surgery is considered as treatment of choice. However, studies of the clinical results and prognostic factors are few due to its rare presentation. MATERIALS AND METHODS: Twenty six patients who had surgery for thoracic myelopathy caused by OYL were evaluated from February 2002 to April 2012. We describe the analysis of the clinical results after surgery and prognostic factors. RESULTS: Modified Japanese orthopedic association (JOA) score was recorded in all patients by 5.7+/-1.3 points (range, 2-9 points) preoperatively, 7.8+/-1.7 points (range, 4-10 points) postoperatively, and 8.4+/-2.1 points (range, 5-11 points) at final follow-up. Hirabayashi recovery rate was recorded by 60.2+/-20.2% (range, 45.5-72.0%) postoperatively, 64.5+/-17.3% (range, 50.2-75.1%) at final follow-up. The Visual Analogue Scale (VAS) score was also improved by 7.6+/-1.8 points (range, 7-10 points) preoperatively, 4.5+/-1.3 points (range, 3-6 points) postoperatively, and 3.8+/-1.6 points (range, 2-5 points) at final follow-up. Both modified JOA score and VAS score improved significantly (p<0.05). In prognostic factor analysis, OYL type on CT axial image, duration of symptom, and preoperative severity of myelopathy was significant (p<0.05). CONCLUSION: We showed the effectiveness of surgery on patients who suffer from thoracic myelopathy caused by OYL and that OYL type identified by CT axial image, duration of symptom, and preoperative severity of myelopathy were significant prognostic factors.
Asian Continental Ancestry Group ; Follow-Up Studies ; Humans ; Ligaments* ; Orthopedics ; Retrospective Studies ; Spinal Cord Diseases*

STUDY DESIGN: A retrospective-based study. OBJECTIVES: To evaluate the usefulness of iliac screws in the surgical correction of sagittal imbalance by changes of spinopelvic parameters. SUMMARY OF LITERATURE REVIEW: Although reports exist regarding the fusion rates on lumbosacral fusion by iliac screws, no previous studies address the issue of changes of spinopelvic parameters on surgical correction of sagittal imbalance by iliac screws. MATERIALS AND METHODS: We analyzed a total of 23 patients who were operated on by pedicle subtraction osteotomy and posterior fusion on sagittal imbalance. Patients were divided into two groups: 1) non-iliac screw fixation and; 2) iliac screw fixation. The two groups were compared during the preoperative and postoperative stages, and the last follow-up spinopelvic parameters of two groups. RESULTS: Spinopelvic parameters, except for pelvic incidence, were corrected after surgery; some corrected values of spinopelvic parameters were lost during follow-up. There was a statistically significant difference in the last follow-up period between lumbar lordosis and pelvic tilt. Values of postoperative lumbar lordosis and pelvic tilt was similar to each other; however, during the follow-up period corrected values of spinopelvic parameters of non-iliac screw fixation group were more lost. There were no statistically significant changes in postoperative and last follow-up sacral slope and pelvic incidence. CONCLUSIONS: Sagittal imbalance could be corrected by pedicle subtraction osteotomy, and corrected values of lumbar lordosis and pelvic tilt of iliac screw fixation group could be maintained well compared to non-iliac screw fixation. Iliac screw fixation could be useful for maintenance of corrected values of spinopelvic parameters in surgical correction of sagittal imbalance.
Animals ; Follow-Up Studies ; Humans ; Incidence ; Lordosis ; Osteotomy

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate clinical & radiologic significance about complications of spinopelvic fixation with iliac screw in patients with adult spinal deformity. SUMMARY OF LITERATURE REVIEW: Complications of iliac screw fixation in adult spinal deformity patients was obscure in spite of the good results of iliac screw fixation. MATERIALS AND METHODS: We analyzed 27 patients, followed over 1-year, with adult spinal deformity (lumbar degenerative kyphosis, degenerative lumbar scoliosis, flat back syndrome). The study was done for complications of iliac screw fixation by clinical and radiological evaluations. RESULTS: Post-operative iliac screw prominence were 15 cases (55.5%), iliac screw breakage was 1 case (3.7%), bursitis was 1 case (3.7%), sacroiliac joint pain were 5 cases (18.5%), halo sign around iliac screw were 23 cases (85.1%), and 3 cases (11.1%) were performed reoperation. There was no significance between halo sign and sacroiliac joint pain. CONCLUSIONS: Iliac screw fixation is a very useful operative method without severe complications on spinopelvic fixation. There are some complications of iliac screw fixation and iliac screw prominence is a most common problem, but few counterplan exits. So, further studies about reducing complication method, management protocols of iliac screw complication were needed.
Adult ; Bursitis ; Congenital Abnormalities ; Humans ; Kyphosis ; Reoperation ; Retrospective Studies ; Sacroiliac Joint ; Scoliosis

STUDY DESIGN: Retrospective study. OBJECTIVES: As we analyze the incidence and the risk factor for proximal junctional problem after surgical treatment of lumbar degenerative sagittal imbalance, we want to contribute to reducing the junctional problem of surgical treatment of lumbar degenerative sagittal imbalance. SUMMARY OF LITERATURE REVIEW: Surgical treatment of degenerative spinal deformity has increased. Rigid fixation was a risk factor for degenerative change of adjacent segment and failure, and it remains a big challenge for the junctional problem of surgical treatment. However, research on the correlation with risk factors is rare. MATERIALS AND METHODS: Forty four patients (mean age 66.5; range, 50-74) who had surgery due to lumbar degenerative sagittal imbalance were evaluated by the risk factor associated with junctional problems from January, 2005 to December, 2011. The risk factors were analyzed by surgical factor (proximal fusion level, using iliac screw, correction or undercorrection of lumbar lordosis compared with pelvic incidence) and patient factor (age, bone marrow density, body mass index). RESULTS: Junctional problems occurred in 18 patients (41%) out of 44 patients. Among these problems, there were 10 cases of fractures, 8 cases of junctional kyphosis, and 4 cases of proximal screw pull out. . Among the risk factors, only the correction or undercorrection of lumbar lordosis compared with pelvic incidence in surgical factor was statistically significant. Other surgical factors and patient factors were not statistically significant. CONCLUSIONS: Junctional problems after a surgical treatment of lumbar degenerative sagittal imbalance were common. However, we could not know the exact risk factor of junctional problems except the degree of correction of lumbar lordosis compared with pelvic incidence, because most of the risk factors were not statistically significant. So, further evaluations of the risk factor of lumbar degenerative sagittal imbalance are required.
Animals ; Bone Marrow ; Congenital Abnormalities ; Humans ; Incidence ; Kyphosis ; Lordosis ; Retrospective Studies ; Risk Factors*

Kikuchi's disease usually occurs in young women and is characterized by localized lymphadenitis (mostly cervical) usually associated with fever. It is considered a self-limited disease and most patients recover spontaneously within a few weeks to 6 months without any serious sequelae. However, patients with Kikuchi's disease require a systemic survey and regular follow-up for several years because it may be associated with other diseases such as systemic lupus erythematosus. To our knowledge, there are very few reports of Kikuchi's disease accompanied by hemophagocytic lymphohistiocytosis. Biopsy of a right cervical lymph node in a 35-year-old female who presented with fever and masses in the right cervical region showed necrotizing lymphadenitis and a diagnosis of Kikuchi's disease was reached. She was started on methylprednisolone pulse therapy (500 mg for 3 days) but developed generalized rash and fever. Laboratory data showed pancytopenia, elevation of serum transaminase and ferritin levels. Bone marrow and liver biopsy showed proliferation of histiocytes and Kupffer's cells engulfing lymphocytes, platelets and red blood cells, respectively. We report a case of Kikuchi's disease accompanied by hemophagocytic lymphohistiocytosis.
Adult ; Biopsy ; Bone Marrow ; Diagnosis ; Erythrocytes ; Exanthema ; Female ; Ferritins ; Fever ; Follow-Up Studies ; Histiocytes ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphadenitis ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic* ; Methylprednisolone ; Pancytopenia

Kikuchi's disease usually occurs in young women and is characterized by localized lymphadenitis (mostly cervical) usually associated with fever. It is considered a self-limited disease and most patients recover spontaneously within a few weeks to 6 months without any serious sequelae. However, patients with Kikuchi's disease require a systemic survey and regular follow-up for several years because it may be associated with other diseases such as systemic lupus erythematosus. To our knowledge, there are very few reports of Kikuchi's disease accompanied by hemophagocytic lymphohistiocytosis. Biopsy of a right cervical lymph node in a 35-year-old female who presented with fever and masses in the right cervical region showed necrotizing lymphadenitis and a diagnosis of Kikuchi's disease was reached. She was started on methylprednisolone pulse therapy (500 mg for 3 days) but developed generalized rash and fever. Laboratory data showed pancytopenia, elevation of serum transaminase and ferritin levels. Bone marrow and liver biopsy showed proliferation of histiocytes and Kupffer's cells engulfing lymphocytes, platelets and red blood cells, respectively. We report a case of Kikuchi's disease accompanied by hemophagocytic lymphohistiocytosis.
Adult ; Biopsy ; Bone Marrow ; Diagnosis ; Erythrocytes ; Exanthema ; Female ; Ferritins ; Fever ; Follow-Up Studies ; Histiocytes ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphadenitis ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic* ; Methylprednisolone ; Pancytopenia

In order to evaluate the morphologic types of appositional angle-closure glaucoma, biometric measurements were made in angle-closure glaucoma patients using Ultrasound biomicroscopy (UBM). Twenty-six patients with primary angle-closure glaucoma and 21 cataract patients with as a control group were examined. The angle-closure glaucomatous eyes were classified as type B in which the angle closure started at the bottom of the angle and type S in which the angle closure occurred in the vicinity of Schwalbe's line. The trabecular-ciliary process distance (TCPD, type B; 873.20+/-86.77 microm, type S; 832.52+/-82.96 microm, control; 1233.50+/-73.01 microm, p = 0.000) and the angle opening distance (AOD500, type B; 89.75+/-63.27 microm, type S; 88.85+/-72.95 microm, control; 304.40+/-104.30 microm, p = 0.000) were significantly shorter in patients with angle closure vice control group. No significant difference were noted in the three groups of patients in regards to iris thickness or ciliary process-iris angle. In this study, we have demonstrated that there are two types of appositional angle-closure and have shown the forward rotation of the ciliary process without changes of the ciliary process-iris angle in cases of angle-closure glaucoma.
Adult ; Aged ; Aged, 80 and over ; Anterior Chamber/*ultrasonography ; Comparative Study ; Female ; Glaucoma, Angle-Closure/*ultrasonography ; Gonioscopy/methods ; Human ; Male ; Middle Age ; Prospective Studies ; Weights and Measures

BACKGROUND AND OBJECTIVES: Fibroblasts interact with eosinophils and play a key role in the pathogenesis of airway diseases. The aims of this study were to investigate whether Th1 or Th2 type cytokines can induce mRNA and protein expression of eotaxin and RANTES in human nasal fibroblast (HNF) and to verify the correlation between the stimulation of different cytokines and chemokines in HNF. Materials and Methods: Cultured HNF were stimulated by IL-13, TNF-alpha, IFN-gamma, IL-13 with TNF-alpha, IL-13 with IFN-gamma, TNF-alpha with IFN-gamma for 6, 24 and 48 hours. In addition, HNF were stimulated by different concentration of IL-13 (0.2, 2, 20, 200 ng/ml). MRNA expression of eotaxin and RANTES were revealed by RT-PCR and protein of eotaxin and RANTES were revealed by ELISA. RESULTS: TNF-alpha and IFN-gammar induced mRNA and protein expression of RANTES in HNF and they synergistically induced protein expression of RANTES. RANTES expression increased in a time dependent manner. IL-13 induced mRNA and protein expression of eotaxin in HNF and it synergistically reacted with TNF-alpha or IFN-gamma. The effects of IL-13 on mRNA and protein expression of eotaxin increased in a concentration dependent manner. CONCLUSION: Th1 or Th2 type cytokines induce mRNA and protein expression of eotaxin and RANTES in human nasal fibroblasts. TNF-alpha or IFN-gamma induce more RANTES than eotaxin but IL-13 induces more eotaxin than RANTES. There may be some synergic effects of cytokines for mRNA and protein expression of chemokines.
Chemokine CCL5* ; Chemokines ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Fibroblasts* ; Humans* ; Interleukin-13 ; RNA, Messenger* ; Tumor Necrosis Factor-alpha

PURPOSE: In the fifth edition of International Union Against Cancer (UICC) TNM, nodal staging for gastric cancer is based on the number of metastatic lymph nodes. Variability in the extent of lymphadenectomy and lymph node retrieval can affect the number of metastatic lymph nodes. In this study, the authors attempted to evaluate the influence of nodal yields on the staging of gastric cancer and survival rates. METHODS: A retrospective study was performed in 4354 consecutive patients with gastric cancer, who had undergone curative resection (R0) with nodal yields of 15 or more from 1986 to 1995. Patients were classified into three groups according to the number of nodes examined: patients with nodal yields of 15 or more but less than 30 for group A, 30-39 for group B, and 40 or more for group C. The number of metastatic lymph nodes and the survival rates for each pTNM stage were analyzed for each group. RESULTS: The number of metastatic lymph nodes significantly increased with nodal yields. Greater nodal yields resulted in a higher survival rates with a statistically significant difference between patients with nodal yields of 30 or more, and those with less than 30 in stage IB (p<0.05) and IIIB (p<0.01). CONCLUSION: Our results suggest two possibilities of stage migration and survival benefit according to the difference of nodal yields. Therefore, for minimizing stage migration and maximizing the benefit of survival, at least 30 or more lymphnodes should be resected and examined in gastric cancer surgery.
Humans ; Lymph Node Excision ; Lymph Nodes ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

PURPOSE: The majority of patients with early gastric cancer show long-term survival after surgery. So a special attention must be directed to preserving gastric function in these patients. When node-negative early gastric cancer could be diagnosed preoperatively, then minimally invasive surgery can be performed to ensure a postoperative better quality of life. MATERIALS AND METHODS: The pathological records of 2,137 consecutive patients with early gastric cancer who underwent curative operations from January 1986 to December 1998 at Seoul National University Hospital were reviewed. RESULTS: Lymph node metastases were observed in 285 patients (13.3%). In mucosal carcinoma, lymph node metastases were observed in 50 of 1,108 cases (4.5%), and in submucosal carcinoma, in 234 of 1,026 cases (22.8%). The tumor size, depth of invasion and gross appearance were associated with lymph node metastasis. In mucosal carcinoma, the size and histologic differ entiation were associated with lymph node metastasis. In submucosal carcinoma, the size and gross appearance were associated with lymph node metastasis. CONCLUSION: In early gastric cancer, the limited surgery can be applied only to cases satisfying the following criteria; (1) mucosal tumor, (2) size < or =2 cm, (3) elevated type or (4) depressed type which are histologically differentiated and (5) size < or =1 cm among the depressed type his tologically undifferentiated.
Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Quality of Life ; Seoul ; Stomach Neoplasms* ; Surgical Procedures, Minimally Invasive