ABSTRACT
Surgical decompression for cervical radiculopathy includes anterior cervical discectomy and fusion, anterior or posterior cervical foraminotomy, and cervical arthroplasty after decompression. The aim of this study was to evaluate the usefulness of a CO2 laser in posterior-approach surgery for unilateral cervical radiculopathy. From January 2006 to December 2008, 12 consecutive patients with unilateral cervical radiculopathy from either foraminal stenosis or disc herniation, which was confirmed with imaging studies, underwent posterior foraminotomy and discectomy with the use of a microscope and CO2 laser. For annulotomy and discectomy, we used about 300 joules of CO2 laser energy. Magnetic resonance imaging (MRI) was used to evaluate the extent of disc removal or foraminal decompression. Clinical outcome was evaluated by using visual analogue scale scores for radicular pain and Odom's criteria. For evaluation of spinal stability, cervical flexion and extension radiographs were obtained. Single-level foraminotomy was performed in 10 patients and two-level foraminotomies were performed in 2 patients. Preoperative radicular symptoms were improved immediately after surgery in all patients. No surgery-related complications developed in our cases. Postoperative MRI demonstrated effective decompression of ventral lesions and widened foraminal spaces in all cases. There was no development of cervical instability during the follow-up period. Posterior foraminotomy and discectomy using a microscope and CO2 laser is an effective surgical tool for unilateral cervical radiculopathy caused by lateral or foraminal disc herniations or spondylotic stenosis. Long-term follow-up with radiographs showed no significant kyphotic changes or spinal instability.
Subject(s)
Humans , Arthroplasty , Constriction, Pathologic , Decompression , Decompression, Surgical , Diskectomy , Follow-Up Studies , Foraminotomy , Lasers, Gas , Magnetic Resonance Imaging , RadiculopathyABSTRACT
Surgical decompression for cervical radiculopathy includes anterior cervical discectomy and fusion, anterior or posterior cervical foraminotomy, and cervical arthroplasty after decompression. The aim of this study was to evaluate the usefulness of a CO2 laser in posterior-approach surgery for unilateral cervical radiculopathy. From January 2006 to December 2008, 12 consecutive patients with unilateral cervical radiculopathy from either foraminal stenosis or disc herniation, which was confirmed with imaging studies, underwent posterior foraminotomy and discectomy with the use of a microscope and CO2 laser. For annulotomy and discectomy, we used about 300 joules of CO2 laser energy. Magnetic resonance imaging (MRI) was used to evaluate the extent of disc removal or foraminal decompression. Clinical outcome was evaluated by using visual analogue scale scores for radicular pain and Odom's criteria. For evaluation of spinal stability, cervical flexion and extension radiographs were obtained. Single-level foraminotomy was performed in 10 patients and two-level foraminotomies were performed in 2 patients. Preoperative radicular symptoms were improved immediately after surgery in all patients. No surgery-related complications developed in our cases. Postoperative MRI demonstrated effective decompression of ventral lesions and widened foraminal spaces in all cases. There was no development of cervical instability during the follow-up period. Posterior foraminotomy and discectomy using a microscope and CO2 laser is an effective surgical tool for unilateral cervical radiculopathy caused by lateral or foraminal disc herniations or spondylotic stenosis. Long-term follow-up with radiographs showed no significant kyphotic changes or spinal instability.
Subject(s)
Humans , Arthroplasty , Constriction, Pathologic , Decompression , Decompression, Surgical , Diskectomy , Follow-Up Studies , Foraminotomy , Lasers, Gas , Magnetic Resonance Imaging , RadiculopathyABSTRACT
OBJECTIVE: We have introduced a method of characterization of invading glioma cells by using molecular analysis of marginal invading tumor cells and molecular profiles of glioma tumor margin. METHODS: Each of tumor core and marginal tissues was obtained in 22 glioma patients. Tumor core cells and marginal cells from each glial tumor were collected by laser capture microdissection or intraoperative microdissection under the operating microscope. Expression of MMP-2, MMP-9, CD44 and RHAMM mRNA by invading glioma cells compared with tumor core was confirmed by realtime-PCR of twenty-four glioma specimens. Clinical data also were reviewed for invasion and recurrence pattern of the gliomas radiologically and invasive rim pattern microscopically. RESULTS: Overall results of the molecular analysis showed that relative overexpression of MMP-2, MMP-9 and RHAMM were noted at the invasive edge of human glioma specimens comparing to the tumor core but CD44 was highly expressed in the tumor core comparing to the margin. High marginal expression of MMP-2 and MMP-9 were noted in poorly ill-defined margin on the pathological finding. High marginal expression of CD44 and MMP-2 were demonstrated in the midline cross group on the radiological review, and that of RHAMM and MMP-2 were showed in the aggressive recurrence group. High expression of MMP-2 seems to be involved in the various invasion-related phenomenons. CONCLUSION: Up-regulation of MMP-2, MMP-9, CD44 and RHAMM was noted in invasive edge of gliomas according to the various clinical situations.
Subject(s)
Humans , Glioma , Laser Capture Microdissection , Microdissection , Recurrence , RNA, Messenger , Up-RegulationABSTRACT
A case history is presented of a seminal vesicular cyst which caused recurrent epididymitis in a young boy. Seminal vesicular cyst is an uncommon disorder and is usually asymptomatic. Endoscopic cannulation of the cyst has been found to be the most useful diagnostic test. At first, the patient was managed by dilation of the orifice of ejaculatory duct in order to facilitate drainage. However, he suffered from incontinence and sustained retrovesical cystic mass. We therefore excised the seminal vesicular cyst by transvesical approach.
Subject(s)
Humans , Male , Catheterization , Diagnostic Tests, Routine , Drainage , Ejaculatory Ducts , EpididymitisABSTRACT
OBJECTIVE: Prognostic factors in 92 patients with brain metastases, treated in our hospital, are identified in order to determine subgroups of patients suitable for selection in future trials. METHODS: From January 1985 through March 1998, 117 patients with computed tomography(CT) or magnetic resonance(MR) image diagnosed brain metastases were referred to our department. The follow-up data of 92 cases were available in this study. One half of the patients were treated with conservative treatment(53.2%), the remainder were treated with surgery alone or surgery with radiation therapy. Information on potential prognostic factors was collected, and then univariate analysis was performed to determine significant prognostic factors. RESULTS: Overall median survival was 7.6 months, with 1-month, 1-year, and 2-year survival rates of 92.4%, 32.9% and 17.9% respectively. Age, performamce status and primary tumor treatment were significant prognostic factors on survival. Number and treatment modality of brain metastases were also identified as prognostic factors. Median survival in patients conservatively treated with steroid alone or with radiotherapy was significantly different from that in patients treated with surgery(p=0031). CONCLUSION: Age(80), number of brain metastases(single), treatmet modalities of primary tumor and brain metastases(surgical treatment) appeared to be statistically significant prognostic factors. These prognostic factors could be helpful to determine subgroups of patients suitable for selection in future trials.
Subject(s)
Humans , Brain , Follow-Up Studies , Neoplasm Metastasis , Radiotherapy , Survival RateABSTRACT
A rare case of multiple supratentorial and infratentorial hemangioblastomas in a 50-year old man is presented. There were neither manifestations of visceral tumors nor familial history. The two tumors were totally removed in two sessions and the diagnosis in both tumors were hemangioblastomas.
Subject(s)
Humans , Middle Aged , Diagnosis , Hemangioblastoma , von Hippel-Lindau DiseaseABSTRACT
The objective of this study was to understand the major changes of craniofacial dimensions and spatial growth pattern during the late embryonic and fetal period of human features. This study was performed with the selective materials of normal fetuses received from the Registry of Congenital Malformation of Seoul National University Hospital. The specimens consisted of nineteen embryos and sixty-six fetuses. The photomicrographs from mid-segittal sections of embryos were used for angular measurement, and the lateral cephalograms taken with soft X-ray were also measured in liners and angular aspects. All of the anatomical landmarks for the tracing of the photomicrographs and cephalograms were referred to the previous reports on literature. The sequential changes of prenatal craniofacial dimensions and agles were analyzed statistically and discussed on the focus about the developmental growth directions of human oro-facial structure arised from heterogeneous origins. The results are as follows, 1) Cranial base angle was almost formed at about 6 weeks old embryos with the average angle of 127.4 +/- 6.33degrees (n=3) and it was almost constant onwards. 2) The linear increase rates of anterior cranial base length and anterior facial height exceeded those of the posterior cranial base length and posterior facial height, and the maxilla grows more rapidly on the horizontal dimension than the vertical dimension during the fetal period. 3) The angular relationship between the anterior cranial base and palatal plane decreasedslightly during the fetal period, disclosing 11degrees at 12th week gestation and 5degrees at 41th weeks gestation. 4) Gonial angle was maintained almost constantly at about 130degrees during the fetal period from 12 weeks to 41 weeks of gestation.
Subject(s)
Humans , Pregnancy , Embryonic Structures , Fetus , Growth and Development , Maxilla , Seoul , Skull Base , Vertical DimensionABSTRACT
In an effort to find more comprehensive and general diagnosis of erectile failure, we already have analysed 90 cases and reported the results. After that we added 199 more cases and performed a computer based analysis of total 289 cases in the dynamic changes of penile blood flow during natural physiologic erection after exposure to the audiovisual stimulation. The following results were obtained. 1. In normal volunteers, we were able to achieve uniform penogram findings in all cases with T.T.(Transit Time) ranging 1 to 3 minutes(mean 2.17 minutes), the EPT(Erection Persistent Time) over 30 minutes and no fluctuation phenomena after AVS. 2. Erectile failure group.(2.83 cases) (1) Group I.(108 cases; 38.2%). They demonstrated similar penogram features with the normal volunteers but EPT more than 5 minuets(mean 18.26 minutes) at least. most common causes were psychogenic origin(57 cases). (2) Group II.(175 cases ; 61.8%). Patients were showing abnormal penogram findings, and were divided into following 3 types. a) A type-Impossible type(10 cases ; 3.5%). They failed to show more than 2 fold increase in the maximal radioactivity after AVS when compared to the pre-stimuli level(mean 1.83 times). The underlying causes were identified to be arteriogenic and neurogenic. b) B type-Unstable type(124 cases ; 43.8%). They were unable to sustain erection due to fluctuation(mean 1.83 times). The underlying causes were psychogenic, vasculogenic and neurogenic origins. c) C type-Delayed type(41 cases ; 14.5%). They were showing T.T. more than 15 minutes(mean ; 23.71 minutes), and the underlying causes were arteriogenic, psychogenic and neurogenic origins. Based on these results, we have concluded that AVS-Penogram seems to the most appropriate diagnostic method for screening test and follow-up evaluation after vascular surgery. Through more clinical experience and investigation, and more comparison and analysis with other diagnostic methods, it will be a standard diagnostic approach in the future.
Subject(s)
Humans , Diagnosis , Follow-Up Studies , Healthy Volunteers , Mass Screening , RadioactivityABSTRACT
This study was designed to compare extreme variations in facial growth in order to examine the relationships between the glenoid fossa position and skeletal malocclusions. It was hypothesized that patients with large mandibular plane-sella nasion angles would have a more supenor fossa position than patients with small mandibular plane-sella nasion angles. It was also hypothesized that patients with large ANB angles would have a more postenor fossa position than patients with small ANB angle. For this study, the data from lateral roentgenocephaloprams of 72 Females and 72 males aged from 10 to 18 years were used. The results were as follows 1. In the case of large ANB angle, glenoid fossa position was relatively posterior than that of small ANB angle in Female, but it was not significant in male. 2. In the case of large APDI, glenoid fossa position was relatively anterior in female, but it was not significant in male. 3. In the case of large SN-Go Gn angle, glenoid fossa positron was relatively superior in both male and female. 4. In the case of large ODI, glenoid fossa position was relatively inferior in both male and female.
Subject(s)
Female , Humans , Male , Electrons , MalocclusionABSTRACT
The cutaneous horn rarely occurs on the penis and was reported only 43 cases since l854. The lesion is characterized by an overgrowth and a cornification of the epithelium, forming a solid protuberance. On microscopic examination there is extreme hyperkeratosis, dyskerstosis, and acanthosis This process usually develops over a pre-existing skin condition (i.e. wart, nevus, area of trauma or malignant change) and may enlarge quite rapidly Wide excision with removal of a margin of normal tissue around the base is the treatment of choice Recently we have experienced a case of penile cutaneous horn treated with partial penectomy.
Subject(s)
Animals , Male , Epithelium , Horns , Nevus , Penis , Skin , WartsABSTRACT
We report 2 cases of intrauterine unilateral testicular torsion This experience reemphasizes the necessity of a careful and complete examination of the newborn immediate after delivery. The presence of a scrotal mass in a newborn that does not transilluminate represent trosion of the spermatic cord until proved otherwise, and demands immediate surgical intervention through an inguinal approach for accurate diagnosis and appropriate therapy.
Subject(s)
Humans , Infant, Newborn , Diagnosis , Spermatic Cord , Spermatic Cord TorsionABSTRACT
The patient, 20 year-old female, complained of anterior open bite. She had tongue thrusting habit and suffered from maxillary sinusitis since 12-years old. Cephalometric analysis revealed slightly forward relationship maxilla, but normal in man-dible. The anterior open bite was corrected through retraction and extrusion of anterior segment and mesial movement of posterior segment under multibanded system after extraction of 4-first premolars. After 2 years and 3 months, she gained ideal overbite, overjet and good interdigitation of buccal segment.