STUDY DESIGN: Retrospective study. OBJECTIVES: The purpose of this study was to compare factors that influence degenerative changes in patients undergoing total laminectomy and patients undergoing partial laminectomy. SUMMARY OF LITERATURE REVIEW: Lumbar or lumbosacral fusion with total or partial laminectomy may result in adjacent segment problems of the upper segment. However, the differences between the two procedures that may influence adjacent segment instability are still controversial. MATERIALS AND METHODS: We evaluated 95 patients, followed up for at least 2 years, who had been treated with short level (at most 2 levels) posterior lumbar interbody fusion with pedicle fixation, secondary to spinal stenosis. Treatment procedures included total laminectomy (42 cases) and partial laminectomy (53 cases). We analyzed the preoperative status of the intervertebral discs (Thompson grade), difference of disc height, and difference between preoperative segmental sagittal angle and last follow-up sagittal angle. We excluded cases that required revision secondary to infection, nonunion, or hematoma formation. However, we included cases that required revision due to adjacent segmental problems during the follow-up period. RESULTS: The mean age of the patients treated with total laminectomy was 59.0+/-10.9 years, and of the patients treated with partial laminectomy was 58.8+/-10.2 years. The preoperative Thompson grade showed no statistical difference. The difference in disc height and segmental sagittal angle between the preoperative and last follow-up examinations showed no statistical difference between the two groups. CONCLUSIONS: There was no significant difference in the radiographic or clinical outcomes based on removal or preservation of posterior structures. Nevertheless, we need further follow-up to evaluate adjacent segment degeneration.
Follow-Up Studies ; Hematoma ; Humans ; Intervertebral Disc ; Laminectomy ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis

PURPOSE: This study was performed to investigate the availability of the serum HSP72 and HSP27 as serologic markers of cardiac allograft rejection through rat heterotopic heart transplatation model. METHODS: Inbred Lewis rats were randomly divided into three groups: the allograft heart transplant group, the isograft heart transplant group, and the sham-operated group. Six animals were studied in each group. In allograft heart tranplant group, the Brown Norway rats were used as donors and in isograft heart tranplant group, the Lewis rats were used as donors. The sera of the allograft heart transplanted rats, isograft heart transplanted rats, and sham- operated rats were collected at preoperative time, 3 days after operation and 6 days after operation, and analyzed for HSP72 and HSP27 by Western blots. Quantifications of band densities were carried out by laser densitometer and the results were expressed as % preoperative densities. RESULTS: The levels of serum HSP72 of 3 days and 6 days after heart transplantation significantly increased in the allograft heart transplant group than in the isograft heart transplant group, respectively (160.2+/-44.8% vs. 109.0+/-34.7%, 276.0+/-72.1% vs. 175.0+/-44.2%, P<0.05). The levels of seum HSP27 of 3 days and 6 days after heart transplantation significantly increased in the allograft heart transplant group than in the isograft heart transplant group, respectively (162.3+/-62.7% vs. 118.4+/-37.0%, 235.7+/-67.1% vs. 127.9+/-40.8%, P<0.05). CONCLUSION: It is concluded that serum HSP72 and HSP27 are useful markers to detect the cardiac allograft rejection.
Allografts ; Animals ; Blotting, Western ; Heart Transplantation ; Heart* ; Heat-Shock Proteins ; Humans ; Isografts ; Norway ; Rats* ; Rats, Inbred Lew ; Tissue Donors ; Transplantation

Meningioma is a common brain tumor and the associated calcification is frequently found in imaging study. However, calcification of entire tumor bulk in meningioma is very rare finding. We present the clinical and radiological summery of our case which showed totally calcified meningioma and discuss the pathogenesis and clinical significance of such a tumoral calcification.
Brain Neoplasms ; Meningioma*

BACKGROUNDS AND OBJECTIVES: C-Reactive protein (CRP) levels are powerful predictors of cardiac complications and death in patients with unstable angina unrelated with myocardial cell damage or myocardial ischemia. This study was performed to determine the optimal timing to measure CRP to predict cardiac events in patients with unstable angina. MATERIALS AND METHOD: The study was comprised 50 patients with unstable angina (Braunwald Class IIIb). We randomized the study subjects by the time of CRP elevation (> 8mg/L): Group A (on admission, 15 patients), Group B (during hospitalization, 19 patients), and Group C (at discharge, 19 patients). RESULTS: 1) CRP levels (median and range) of Group A, B, and C were 10.6 (8.2-24.2), 12.8 (8.1-33.7), and 10.3 (8.1-18.7) mg/L, respectively (p=S). 2) During clinical follow-up at a mean duration of 12 months, there were 1 death, 1 myocardial infarction, 6 revascularization therapy (PTCA or CABG) and 11 recurrent angina. 3) In Group A, 10 cardiac events (1 myocardial infarction, 4 revascularization therapy, and 5 recurrent angina) occurred. The elevated levels of CRP predicted cardiac events during clinical follow-up with sensitivity of 53%(10/19), positive predictive value of 67%(10/15), and negative predictive value of 74%(26/35). In Group C, 13 cardiac events were occurred. Sensitivity, positive and negative predictive value to predict cardiac events of elevated levels of CRP were 68%(13/19), 68%(13/19) and 81%(25/31), respectively. 4) Elevated levels of CRP (>8mg/L) were predictors for cardiac events in patients with unstable angina (Group A; p<0.05, Group B; p<0.05, Group C; p<0.001). However, by logistic regression analysis, CRP values > 8mg/L at discharge were only predictive of cardiac events with odd ratio of 6.01 (95% CI 1.50-44.3, p<0.05). CONCLUSIONS: CRP (> 8mg/L) was elevated in 38% of patients at discharge and elevated levels of CRP at discharge were only predictive of cardiac events in patients with unstable angina.
Angina, Unstable* ; C-Reactive Protein* ; Follow-Up Studies ; Hospitalization ; Humans ; Logistic Models ; Myocardial Infarction ; Myocardial Ischemia

BACKGROUND/AIMS: Lamivudine is highly effective in suppressing hepatitis B virus replication and hepatitis B induced necroinflammatory activity. The objective of this study was to evaluate the virological and biochemical responses to lamivudine by patients with HBV associated chronic liver disease. In particular we stressed the importance of lamivudine therapy by patients with decompensated liver cirrhosis. METHODS: We conducted a one-year trial of lamivudine in 80 patients with HBV associated chronic liver disease (chronic hepatitis 44, cirrhosis 36). We classified these patients according to the severity of hepatic dysfunction as chronic B hepatitis (Group A) or liver cirrhosis (Group B). These patients were treated for 12 months with 100 mg daily doses of lamivudine. RESULTS: The seroconversion rate of HBeAg was 23.5% in group A patients and 26.7% in group B patients. The negative conversion of HBV-DNA was sustained for one year in 79.5% of patients in group A and 86.1% in group B. The normalization rates of serum ALT were 90.9% in group A and 88.9% in group B patients. No serious side effect after discontinuance of the treatment was found. There were 12 ALT breakthrough cases and all of them showed mutation of YMDD motif. However, they did not deteriorate clinically in spite of ALT elevation and HBV-DNA reappearance. The Child-Pugh scores improved even in patients with decompensated liver cirrhosis. CONCLUSION: One-year lamivudine treatment resulted in excellent virological and biochemical improvements and was well tolerated in the patients with HBV associated chronic liver disease, even in decompensated cirrhosis. We conclude that lamivudine is relatively safe in chronic hepatitis B and liver cirrhosis treatment.
Fibrosis ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Lamivudine* ; Liver Cirrhosis* ; Liver Diseases ; Liver*

While pleural effusion in multiple myeloma is relatively infrequent, myelomatous pleural effusion is extremely rare. We experienced a 61-year-old woman with IgD-lambda multiple myeloma and pleural effusion. The diagnosis was made originally by pleural biopsy, pleural fluid cytology and immunoelectropheresis of pleural fluid. Transient improvement of the pleural effusion was observed after administration of combination chemotherapy of vincristine, melphalan, cyclophosphamide, prednisone (VMCP)/vincristine, cyclophosphamide, adriamycin, prednisone (VCAP). Two months later, myelomatous pleural effusion recurred and no response to salvage therapy was observed. We reviewed the clinical feature of this case and literature concerning myelomatous pleural effusion.
Antineoplastic Agents, Combined/administration & dosage* ; Case Report ; Cyclophosphamide/administration & dosage ; Female ; Human ; Melphalan/administration & dosage ; Middle Age ; Multiple Myeloma/pathology ; Multiple Myeloma/drug therapy* ; Multiple Myeloma/complications* ; Plasma Cells/pathology ; Pleural Effusion/radiography ; Pleural Effusion/pathology ; Pleural Effusion/etiology* ; Prednisone/administration & dosage ; Tomography, X-Ray Computed ; Vincristine/administration & dosage

While pleural effusion in multiple myeloma is relatively infrequent, myelomatous pleural effusion is extremely rare. We experienced a 61-year-old woman with IgD-lambda multiple myeloma and pleural effusion. The diagnosis was made originally by pleural biopsy, pleural fluid cytology and immunoelectropheresis of pleural fluid. Transient improvement of the pleural effusion was observed after administration of combination chemotherapy of vincristine, melphalan, cyclophosphamide, prednisone (VMCP)/vincristine, cyclophosphamide, adriamycin, prednisone (VCAP). Two months later, myelomatous pleural effusion recurred and no response to salvage therapy was observed. We reviewed the clinical feature of this case and literature concerning myelomatous pleural effusion.
Antineoplastic Agents, Combined/administration & dosage* ; Case Report ; Cyclophosphamide/administration & dosage ; Female ; Human ; Melphalan/administration & dosage ; Middle Age ; Multiple Myeloma/pathology ; Multiple Myeloma/drug therapy* ; Multiple Myeloma/complications* ; Plasma Cells/pathology ; Pleural Effusion/radiography ; Pleural Effusion/pathology ; Pleural Effusion/etiology* ; Prednisone/administration & dosage ; Tomography, X-Ray Computed ; Vincristine/administration & dosage

BACKGROUND: Although urinary incontinence is a common problem, its prevalence and severity in community is not well established. The main objects of this study were to define the prevalence in adult men and women who came to a primary care office for health care. METHODS: Men and women aged 20 years and over who came to family physician's offices seeking health care for any reason during an 2-week period were the subjects of a survey by anonymous questionnaire. Ten family practice offices in Cheonan Practice-Based Research Network participated. We defined "current significant urinary incontinence" as aver any degree of annoying incontinence in the past 12 months. RESULTS: Of the 1,130 responders, 46.3% experienced urinary incontinence. Incontinence was experienced by 26.7% of the men and 50.2% of the women. 'Current significant urinary incontinence' was experienced by 3.7% of the men and 10.12% of the women. CONCLUSIONS: Urinary incontinence is a common problem among those seen in primary care settings, and patients hesitate to seek cansultation of their problems with physicians. Therefore, family physicians should deal with the symptoms of incontinence more attentively during history taking.
Adult* ; Anonyms and Pseudonyms ; Chungcheongnam-do* ; Delivery of Health Care ; Family Practice* ; Female ; Humans ; Male ; Physicians' Offices ; Physicians, Family ; Prevalence* ; Primary Health Care ; Urinary Incontinence* ; Surveys and Questionnaires

Transformation efficiency, virus multiplication and foreign gene expression were characterized in the insect cells transformed with Autographa calfornica nuclear polyhedrosis virus (AcNPV) immediate early 1 gene (IE1). Transformation efficiency of insect cells by AcNPV IE1 gene vector horboring foreign gene was approximately 8-fold higher in the Sf9 cells transformed previously with AcNPV IE1 gene than in the normal Sf9 cells. Virus multiplication and foreign gene expression of recombinant baculovirus in the Sf9 cells transformed with AcNPV IE1 gene were similar to those of the normal Sf9 cells. These results suggest that transformed cells displaying foreign gene product by using AcNPV IE1 gene promoter will be useful for the diverse applications of insect cells.
Baculoviridae ; Gene Expression ; Insects* ; Nucleopolyhedrovirus* ; Sf9 Cells

Transformation efficiency, virus multiplication and foreign gene expression were characterized in the insect cells transformed with Autographa calfornica nuclear polyhedrosis virus (AcNPV) immediate early 1 gene (IE1). Transformation efficiency of insect cells by AcNPV IE1 gene vector horboring foreign gene was approximately 8-fold higher in the Sf9 cells transformed previously with AcNPV IE1 gene than in the normal Sf9 cells. Virus multiplication and foreign gene expression of recombinant baculovirus in the Sf9 cells transformed with AcNPV IE1 gene were similar to those of the normal Sf9 cells. These results suggest that transformed cells displaying foreign gene product by using AcNPV IE1 gene promoter will be useful for the diverse applications of insect cells.
Baculoviridae ; Gene Expression ; Insects* ; Nucleopolyhedrovirus* ; Sf9 Cells