Current Status of Biportal Endoscopic Decompression for Lumbar Central Stenosis

Degenerative lumbar spinal stenosis commonly occurs in elderly patients aged above 50-60 years. Surgical intervention is indicated for patient refractory to conservative management, and microscopic decompression has been used for direct spinal canal decompression. The development of surgical instruments and spinal endoscopic system can make possible endoscopic surgery as the useful treatment option for degenerative lumbar disease. Endoscopic spine surgery was mainly preformed in lumbar disc disease through transforaminal route. And then, endoscopic interlaminar approach was introduced using endoscopic drill, more developed endoscopic disc forceps, and Kerrison punches, and so on. Uniportal endoscopic spine surgery through interlaminar space can make possible direct spinal canal decompression in cases with lumbar spinal stenosis, however stiff learning curve still remains the limitation of this surgery. Biportal endoscopic spine surgery was also introduced as the minimal invasive spine surgery, which is basically similar to microscopic surgery and relatively familiar approach to spine surgeons. Biportal endoscopic spine surgery can offer clean operative view in monitor through continuous irrigation and endoscope with large diameter compared to uniportal endoscopic equipment, and this approach may be alternative surgical approach for decompression of lumbar spinal stenosis. Now many spine surgeons perform biportal endoscopic surgery for lumbar central spinal stenosis, and the reports have been published. He we write the technical procedure of biportal endoscopic surgery for lumbar spinal stenosis, discussing about surgical considerations, and also review the surgical outcomes from the previously published articles

Chylothorax in Gorham's disease.

A 25-yr-old woman presented with a right pleural effusion. Destruction of 9th through 12th ribs, adjacent vertebral bodies, and transverse processes was noted on plain radiograph and a large low-attenuated, irregular shaped mass lesion with peripheral rim enhancement, destroying vertebral body and transverse process, was revealed on the computed tomographic scan. Magnetic resonance imaging showed high signal on T1- weighted image and iso- and low signal on T2-weighted image for the mass lesion replacing the vertebral bony cortex and marrow space. An open rib biopsy revealed the histopathological changes of Gorham's disease (essential osteolysis), even though only bloody fluid filling the empty space and rib and vertebral transverse process destruction were grossly observed on operation. Even though there was no definite response to radiotherapy and pleurodesis, the patient showed stable condition up to 20 months after diagnosis

Expression of Pro-inflammatory Protein S100A12 (EN-RAGE) in Behçet's Disease and Its Association with Disease Activity: A Pilot Study

BACKGROUND: S100A12 is a member of the S100 family of calcium-binding proteins and is secreted either in inflamed tissues or in the bloodstream by activated neutrophils. Expression of S100A12 has been reported in various diseases, especially non-infectious inflammatory diseases, such as Kawasaki disease, giant cell arteritis and inflammatory bowel disease. OBJECTIVE: This study was conducted to determine both the tissue expression and the serum levels of S100A12 in Behçet's disease (BD) patients and the correlation of the S100A12 serum level with disease activity of BD. METHODS: We included in this study ten BD patients who fulfilled the criteria for diagnosis, according to the International Study Group for BD. The activity of BD was calculated using the BD Current Activity Form. The serum concentrations of both S100A12 and interleukin-8 were measured by the enzyme-linked immunosorbent assay, before and after treatment. Immunohistochemical studies were also performed to detect S100A12 expression in the skin. RESULTS: The serum S100A12 level was significantly increased in the active BD period (p<0.001), in the inactive BD period (p=0.041) and in patients with active Kawasaki disease (p=0.028), compared with the serum level in the healthy controls. The serum S100A12 level decreased significantly from baseline, compared to post-treatment (p=0.017). The activity score of BD was significantly correlated with the serum level of S100A12 (Spearman's coefficient=0.464, p=0.039). Immunohistochemical studies showed that S100A12 was strongly expressed in the erythema nodosum-like skin lesions of patients. CONCLUSION: S100A12 contributes to the pathogenesis of BD related to neutrophil hyperactivity and reflects the disease activity in BD patientsope

Accuracy of a high prostate-specific antigen level for prostate cancer diagnosis upon initial biopsy in Korean men

PURPOSE: This study aimed to evaluate the cancer detection rate in a Korean population with prostate-specific antigen (PSA) levels greater than or equal to 20.0 ng/mL. MATERIALS AND METHODS: A total of 174 men 50 to 79 years old (median 69) included in the study. The median prostate volume of the patients was 44.8 mL (range 14.1 to 210.0) and their serum PSA ranged from 20.0 to 9725.0 ng/mL (median 44.8). RESULTS: Of 174 men 141 (81.0%) were diagnosed with prostate cancer on initial biopsy. In the total number of patients, the positive predictive value (PPV) was 62.9% for PSA 20 to 29.9, 72.7% for PSA 30 to 39.9 and 100% for PSA 40 to 49.9 ng/mL. In patients with an abnormal digital rectal examination (DRE), the values for these PSA ranges increased to 89.5%, 91.7% and 100%, respectively. The PPV was 81.0% for PSA cutoff of 20, 89.2% for a cutoff of 30, 95.4% for a cutoff of 40, and 94.7% for a cutoff of 50 ng/mL. In conjunction with an abnormal DRE, the values for these PSA cutoffs increased to 95.9%, 98.1%, 100%, and 100%, respectively. CONCLUSION: Our data suggest the ability to predict the presence of prostate cancer reliably on initial biopsy when PSA threshold is greater than or equal to 50 ng/mL. This PSA threshold may be lowered to 40 ng/mL in the presence of an abnormal DRE. In Korean men with high PSA, the detection rate of prostate cancer on biopsy appears to be comparable to that for American men

Analysis of shots on target and goals scored in soccer matches: Implications for coaching and training goalkeepers

The aim of this study was to analyse the characteristics and patterns of shots on target and goals scored  during the 2012-European Championship. The broadcasted matches were recorded and converted into  electronic video files for a computerbased analysis. This quantitative study examined 31 matches of the  championship and identified 123 shots on target (which were not goals) and 73 goals scored. The results  revealed that 88 (72%) shots on target and 39 (53.4%) goals scored were aimed at the low zones of the  goalposts. Goalkeepers blocked 80 shootings (65%) from outside of the penalty area, whilst 65 goals (89%) were scored inside the penalty area. Based on the low zones of the goalposts and shooting angles, 72 shots on target and goals scored were from different angles and 55 were from the same angles. There was a significant difference (χ2=20.61; p&lt;0.001) between the 26 goals from different angles and the 13 goals from the same  angles in the low zones of the goalposts. Methodical training programmes for low-flying balls, body  movements, decision-making and cooperative defence strategies were recommended for goalkeeper training.Key words: Soccer; 2012-European Championship; Match analysis; Goalkeeper training

Polychlorinated dibenzo-p-dioxins and dibenzofurans in sediments from the southeastern coastal areas of Korea

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Detection of Prostate Cancer at Low and Intermediate Serum Prostate-Specific Antigen Levels in a Country with a Low Incidence of Prostate Cancer

Background: The objective of this study was to evaluate the cancer detection rate and the pathologic findings of biopsy in men at low and intermediate prostate-specific antigen (PSA) levels in an Asian population. Methods: Patients between 40 and 79 years were entered into a study and 755 patients with serum PSA level of 2.0–10.0 ng/ml underwent trus-guided systematic biopsy. Patients were divided to low (PSA 2.0–4.0 ng/ml, n = 144) and intermediate (PSA 4.1–10.0 ng/ml, n = 611) PSA groups. Results: Patients in the low PSA group had significantly smaller prostates (P = 0.003) and lower PSA density (P &lt; 0.001). The rate of cancer detection was 16.7 % (24 of 144) in the low PSAgroup and 23.7 % (145 of 611) in the intermediate PSAgroup (P = 0.067). Inmenwith normal digital rectal examination (DRE), prostate cancer was diagnosed in 14 (13.3%) of the 105 men in the lowPSAgroup and99 (19.5%) of the 508men in the intermediatePSAgroup (P = 0.139). In all patients and patients with normal DRE, no statistically significant differences were found in the pathologic findings of biopsy between the two groups. Conclusions: Our findings provide a rationale to recommend prostate biopsy at lower PSA threshold in this population. At present, however, it is not clear that men who are treated when their cancers are detected at lower PSA levels have better outcomes than those who are treated when the PSA is higher than 4.0 ng/ml. Key words: prostate-specific antigen – prostate neoplasms – prostate cancer – Asia