Inspissated bile syndrome (IBS) is a relatively rare condition. Many treatment options are available, including medication, surgery, and surgical interventions, such as insertion of cholecystostomy drain, endoscopic retrograde cholangiopancreatography, internal biliary drainage, and percutaneous transhepatic biliary drainage (PTBD). We herein report the first case of IBS that was successfully treated with PTBD in a two-month-old infant in Korea. PTBD was initiated on postnatal day 72. On postnatal day 105, we confirmed complete improvement and successfully removed the catheters. This report suggests that PTBD is a viable and safe treatment option for obstructive jaundice in very young infants.
Bile* ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystostomy ; Drainage* ; Humans ; Infant* ; Jaundice, Obstructive ; Korea

OBJECTIVE: There are few studies of osteoporotic burst fractures with spinal canal compromise that were treated with kyphoplasty. The purpose of this study was to assess the efficacy and the safety of kyphoplasty for the treatment of thoracolumbar spine osteoporotic burst fractures without neurological deficits and to investigate predictors that can improve the effectiveness of this treatment. METHODS: From October 2004 until December 2010, 79 osteoporotic burst fracture patients with asymptomatic spinal canal compromise were treated by kyphoplasty. Kyphoplasty involved injecting polymethylmethacrylate (PMMA) from the anterior one-third of the vertebral body into the posterior one-third of the vertebral body. PMMA powder and liquid were mixed in a ratio of 1:3 at 21-23degrees C. Preoperative and postoperative visual analog scores (VAS), kyphotic angles, the heights of the vertebral body, and the degrees of spinal canal compromise were analyzed. The relationships between the factors and the VAS difference between the preoperative and postoperative states were analyzed. RESULTS: The mean postoperative VAS, the postoperative kyphotic angle, the vertebral body height measurement from the anterior and the middle of the body were significantly improved after kyphoplasty (p<0.05). Postoperatively, the mean VAS was restored from 7.35 to 2.11, the postoperative kyphotic angle was restored from 18.21degrees to 12.08degrees, the vertebral body height measurement from the anterior of the body was from 18.56mm to 23.54mm and the middle of the body was from 24.81mm to 27.90mm. Among the variables, only the duration of symptoms before surgical treatment was implicated as a factor in the outcome (p<0.01). CONCLUSION: Kyphoplasty is a very effective and safe therapeutic modality for the treatment of osteoporotic burst fractures without neurological deficits. The standardization of this procedure helps to avoid complications. In the acute stages, early treatment is more effective for the reduction of pain. Further investigation is warranted in order to assess the effectiveness of early surgery in improving outcome.
Body Height ; Humans ; Kyphoplasty ; Osteoporotic Fractures ; Polymethyl Methacrylate ; Spinal Canal ; Spine

Inonotus obliquus is a fungus that causes white heart rot on several broad-leaved species. This fungus forms typical charcoal-black, sterile conks (chaga) or cinder conks on infected stems of the birche (Betula spp). The dark brown pulp of the sterile conk is formed by a pure mycelial mass of fungus. Chaga are a folk remedy in Russia, reflecting the circumboreal distribution of I. obliquus in boreal forest ecosystems on Betula spp. and in meridional mountain forests on beech (Fagus spp.) in Russia, Scandinavia, Central Europe, and Eastern Europe. Distribution at lower latitudes in Western and Southern Europe, Northern America, Asia, Japan, and Korea is rare. Infected trees grow for many years without several symptoms of decline. The infection can penetrate through stem injuries with exterior sterile conks developing later. In the Czech Republic, cinder conk is found on birches inhabiting peat bogs and in mountain areas with a colder and more humid climate, although it is widespread in other broad leaved species over the Czech Republic. The most common hosts are B. pendula, B. pubescens, B. carpatica, and F. sylvatica. Less frequent hosts include Acer campestre, Acer pseudoplatanus, Alnus glutinosa, Alnus incana, Fraxinus excelsior, Quercus cerris, Q. petraea, Q. robur, Q. delachampii, and Ulmus sp.
Acer ; Alnus ; Asia ; Betula ; Climate ; Czech Republic ; Ecology ; Ecosystem ; Europe ; Europe, Eastern ; European Continental Ancestry Group ; Fagus ; Fraxinus ; Fungi ; Heart ; Humans ; Japan ; Korea ; Medicine, Traditional ; North America ; Quercus ; Russia ; Scandinavia ; Soil ; Trees ; Ulmus ; Wetlands

STUDY DESIGN: This is a retrospective study. PURPOSE: We wanted to investigate the clinical relevance of the lumbar high intensity zone (HIZ) on magnetic resonance imaging (MRI) and the relationship of trauma history to internal disc disruption (IDD). OVERVIEW OF LITERATURE: HIZs on lumbar spine (L-spine) MRI have been suggested as a reliable marker of IDD by some authors. The prevalence and type of spinal trauma in IDD have not yet been carefully analyzed. METHODS: L-spine MRIs of 737 patients with low back pain with or without associated leg pain were reviewed for the presence of HIZs. HIZs on T2-weighted MR images were determined according to the Aprill and Bogduk criteria. A review of medical records and a telephone interview were performed for further analyses of pain. RESULTS: HIZs were found in 117 patients and 153 discs among a total of 737 patients who met the inclusion criteria. Both a medical record review and a telephone interview were possible with 99 patients. Among these, 42 patients had had an episode of trauma. Seventeen of these had a relatively high-energy injury such as a traffic accident or a fall. Regarding back pain, 27 patients complained of typical discogenic back pain. Only 11 patients had both a trauma history and typical discogenic pain and 41 patients (42%) had neither a trauma history nor typical natural pain. CONCLUSIONS: Given the low incidence of discogenic pain, a HIZ on an L-spine MRI appears less meaningful than often assumed as a specific marker of IDD. Trauma, such as a traffic accident, seems unlikely to be the main cause of IDD.
Accidents, Traffic ; Back Pain ; Humans ; Incidence ; Interviews as Topic ; Leg ; Low Back Pain ; Magnetic Resonance Imaging* ; Medical Records ; Prevalence ; Retrospective Studies ; Spine

Hyperlipidemia is a rare cause of pancreatitis. It has been believed that free fatty acids released from hydrolyzed serum chylomicrons or triglycerides and chylomicrons induce hyperlipidemic pancreatitis by damaging acinar cells and capillaries. Type I, IV or V hyperlipidemic (Fredrickson's classification) pancreatitides have distinctive features of increased and heightened serum chylomicron and triglyceride levels. In contrast, type IIb hyperlipidemia usually doesn't have increased chylomicrons. It is a dominant inherited genetic disorder and doesn't manifest the subjective symptom before combining vascular complications such as coronary artery disease. Only a few cases of type IIb hyperlipidemic pancreatitis have been reported. We experienced a male patient with recurrent hyperlipidemic pancreatitis combined with type IIb hyperlipidemia. We present the case report and a review of the literature of hyperlipidemic pancreatitis, especially cases in Korea.
Tomography, X-Ray Computed ; Recurrence ; Pancreatitis/*etiology/radiography ; Male ; Korea/epidemiology ; Hyperlipoproteinemia Type II/*complications/diagnosis/epidemiology ; Humans ; Adult

Congenital absence of a thoracic pedicle is a rare clinical entity, and this can be misdiagnosed as an acquired absence of the pedicle that is the result of trauma, tumor, or infection. Initial evaluations with conventional radiography frequently lead to misinterpretation and to misguided intervention. Computed tomography can be the most helpful modality to confirm the diagnosis. The congenital absence of pedicles, in contrast to the acquired absence of pedicles, can be managed successfully by conservative treatment or even without treatment. We report a case of an absent thoracic pedicle and we describe the presentation, diagnosis, and treatment together with a review of the literature.
Diagnosis ; Radiography ; Spine*

To produce an artificial fruiting body of Armillaria mellea on the oak sawdust medium, seven strains of A. mellea were used. The top surface of oak sawdust medium covered with ground raw carrot was inoculated with each of 7 strains and cultured for 30 days at 25degrees C in the dark condition until the mycelia of A. mellea completely colonized the medium from top to bottom. Then, the mycelia which were fully covered on the top surface of the medium were scratched slightly with a spatula and filled with tap water for 3 hours. To induce the primordial formation, the 7 strains of A. mellea were transferred to the growth chamber under the illumination (350 lux) of 12 hours and relative humidity of 85 +/- 5% in a day and then cultured at 16 +/- 1degrees C. Only A. mellea IUM 949 could form primordia on the sawdust medium, but the other strains did not make primordia at the same condition. The primordia of A. mellea IUM 949 were formed 10 days after complete colonization of the medium and the fruiting bodies were produced 7 days after a primordial formation. The experimental results suggested that IUM 949 strain might be a good candidate for mass production of fruiting bodies of A. mellea.
Armillaria* ; Colon ; Daucus carota* ; Fruit* ; Humidity ; Lighting ; Water

To screen additives and their mixed ratio suitable for the mycelial growth and fruiting body formation of Oudemansiella radicata in the oak sawdust, additives such as rice bran, fermented soybean powder and wheat bran were used. Generally, the mycelial growth of O. radicata has been stable on oak sawdust mixed with rice bran of 5~20%. In case that O. radicata was cultured for about 30 days at 22 +/- 1degrees C under the illumination (350 lux) of 12 hours and moisture condition of 90 +/- 5%, the primordia have been formed gradually from red-brown crusts covering the surface of oak sawdust media. Based on the experimental results from 9 strains of O. radicata, fruiting bodies were produced widely on oak sawdust medium mixed with rice bran of 5 to 30%. Even though fruiting bodies of O. radicata have been produced well on oak sawdust media mixed with rice bran, fruiting bodies of O. radicata were produced intensively on oak sawdust media mixed with rice bran of 10%. Therefore, this result will provide a basic information for commercial production of fruiting body of wild O. radicata. This result is the first report associated with an artificial fruiting body formation of O. radicata in Korea.
Dietary Fiber ; Fruit* ; Korea ; Lighting ; Soybeans

STUDY DESIGN: A comparative in vivo study between ceramics with different compositions. OBJECTIVES: To compare the biodegradation and osteoconduction properties of CaO-SiO2- P2O5- B2O3 glass-ceramics and Cerabone(R)-AW. Summary of Literature Review: Bioglass ceramics can be used as bone graft substitutes. However, no study has been undertaken to investigate the possibility of CaO-S i O2-P2O5-B2O3 glass-ceramics as a bone graft substitute. MATERIALS AND METHODS: Porous CSPB2 implants (44.07% CaO, 40.28% SiO2, 8.1% P2O5 and 5.0% B2O3), porous CSPB3 implants (43.76% CaO, 43.41% SiO2, 4.05% P2O5 and 7.5% B2O3) and porous Cerabone(R)-AW were prepared by the polymer sponge method. Single-level posterolateral spinal fusions were performed on sixty New Zealand white male rabbits. The animals were divided into four groups (9 of autograft, 17 per 3 kind of porous implant group) according to the implant material used: autograft, CSPB2, CSPB3 and Cerabone(R)-AW. Radiographs were performed every two weeks. All animals were sacrificed 12 weeks after surgery. Manual palpation and uniaxial tensile strength were determined. The proportion of the area occupied by the ceramics in the final compared to the initial radiographs was calculated. Decalcified and undecalcified histological sections were evaluated by light microscopy. RESULTS: Fifty one rabbits were evaluated. The union rates were 100 (9 out of 9), 80 (8 out of 8), 81.1 (9 out of 11) and 90.9% (10 out of 11) in the autograft, Cerabone(R)-AW, CSPB2 and CSPB3 groups, respectively. The proportion of the area occupied by Cerabone(R)-AW (90.8 % +/- 14.0) was significantly higher than for CSPB2 (73.1% +/- 11.5) and CSPB3 (73.5% +/- 10.0)(p=0.0011). The mean values of the tensile strengths of Cerabone(R)-AW (214. +/- 57.3N), CSPB2 (214. +/- 57.3 N) and CSPB3 (217 +/- 70.1 N) were not significantly different (p>0.05). CONCLUSION: CSPB2 and CSPB3 had similar tensile strengths and fusion rates of the fusion masses as those of Cerabone(R)-AW; however, they degraded more rapidly than Cerabone(R)-AW. These findings suggest that CSPB2 and CSPB3 grafts can be used as a more ideal new bone graft substitutes than Cerabone(R)-AW.
Animals ; Autografts ; Bone Regeneration ; Ceramics ; Humans ; Lumbar Vertebrae* ; Male ; Microscopy ; New Zealand ; Palpation ; Polymers ; Porifera ; Rabbits ; Spinal Fusion ; Tensile Strength ; Transplants

STUDY DESIGN: A prospective study. OBJECTIVES: To investigate the usefulness of selective nerve root block (SNRB) as a prognosis predictor of a lumbar disc herniation. SUMMARY OF LITERATURE REVIEW: The biochemical factors of radiculopathy, as opposed to the biomechanical factors, are more reversible and responsive to a corticosteroid injection. MATERIALS AND METHODS: Fifty patients underwent SNRB for the radiculopathy caused by a herniated lumbar disc and were followed for at least 1 year. The straight leg raising (SLR) angle, visual analog scale (VAS) and the patients' subjective satisfaction, using the Weber criteria, were initially investigated, and again at 1 week and 1 month after the procedure, and finally at the final follow-up. The patients were divided into two groups according to the final satisfaction. Group 1 (satisfactory prognosis, N=32) had Excellent/Good results at the final follow-up, whereas Group 2(unsatisfactory prognosis, N=18) had Fair/Poor final results, or underwent surgical treatment. The improvements in the SLR and VAS at 1 week and 1 month were compared between two groups. The subjective satisfaction each time was compared to the final outcome; the relative risks were also calculated. RESULTS: The improvements in the SLR and VAS for Group 1 were significantly better than those for Group 2 at both 1 week and 1 month (p<0.05). Those patients with Excellent/Good results at 1 week and 1 month manifested satisfactory final outcomes (p<0.05). The risks of the patients with Fair/Poor results at 1 week and 1 month manifesting unsatisfactory final outcomes were 6.8 and 15.2 times higher than those with Excellent/Good results. CONCLUSION: Selective nerve root block could be a useful method, not only to relieve acute leg pain, but also to predict the longterm prognosis of a herniated lumbar disc. Early surgical treatment could be considered for the patients not manifesting significant improvement until 1 month after SNRB.
Follow-Up Studies ; Humans ; Leg ; Prognosis* ; Prospective Studies ; Radiculopathy ; Visual Analog Scale