The first myelography with air was carried out by Walter Dandy in 1919, and the myelography with positive contrast medium was done by Sicard and Forestier in 1922. Since Pantopaque was adopted as a contrast material by University of Rochester group in 1944, it has been rapidly popularized. Although higher diagnostic accuracy has been made with a development of the diagnostic aids such as electromyography, discography, epidural venography and computerized tomography, myelography has been popularized in our country with electromyography. The authars have seen and studied 107 cases of herniated lumbar disc with respect to the diagnostic accuracy of myelographic examination from January, 1976 to December, 1981 at the department of Orthopedic Surgery, Yonsei University College of Medicine. The results were as follows: l. Of the 107 cases, 59 were found in the age of 20 to 40 years and the ratio of male and female was 2:l. 2. Fifty eight cases (54.2%) had no history of back injury, but 40 cases (37.4%) had sprain of the back and 9 cases had direct trauma history. 3. In all cases, plain X-ray and myelogram were taken. Among them 55 cases showed narrowing of intervertebral space in plain film, and 100 cases showed positive myelographic findings such as lateral indentation of dural sac (41 cases), hour-glass defect (30 cases), root sleeve defect (12 cases), block defect (10 cases) and combined defects (7 cases). 4. Sixty one cases which confirmed by operation, the most frequent level of disc herniation was in L4-5 space. Clinical diagnosis was correct in 57.4%, and myelographic accuracy was coincided with operative finding in 80.3%. 5. Twelve (19.7%) of the 61 cases showed discrepancy between myelographic and operative findings, and these 12 cases consisted of 5 cases of level discrepancy, 3 cases of false positive and 4 cases of false negative.
Back Injuries ; Clinical Study ; Diagnosis ; Electromyography ; Female ; Humans ; Iophendylate ; Male ; Myelography ; Orthopedics ; Phlebography ; Sprains and Strains

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW: Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
Adipose Tissue ; Back Pain ; Cauda Equina ; Diagnosis ; Epidural Space ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Physical Examination ; Radiculopathy ; Spinal Canal ; Spinal Cord ; Spinal Stenosis ; Spine

In 1960 Jacobson and Suarez introduced the operating microscope to vascular surgery and demonstrated the superiority of small vessel repair using magnification. The first clinical replantation of an arm in the western world was performed by Malt in 1962, and Komatsu and Tamai reported the successful replantation of a completely amputated thumb in 1965. To perform a digit or hand replantation, microsurgical anastomosis of blood vessels is absolutely essential to revascularize the severed part. Without accurate repair of bone, nerves and tendons in addition to vascular anastomosis, however, it is impossible to gain functional success when replanting a digit or hand. This is a difficult task because all structures must be reconstructed at the same level and time. Even if the repair of some structures has been postponed, the secondary reconstruction may also be troublesome due to circular scarring at the replantation level. Since replantation surgery has been popularized throughout the world in recent years, the replantation sucess rate has increased and the surgeons interest in functional reconstruction of replanted digits or hands has been stimulated. The authors have seen and studied 6 cases of upper Jimb and 20 cases of finger replantation from May, 1980 through January, 1982 at the department of orthopedic surgery, Yonsei University College of Medicine. The results were as follows: I. The average age was 20 years and the male to female sex ratio was 4.5:1. 2, The causes of injury are detailed as follows: electric saw(6); cutting machine(5); roller(4}; presser(2); stone(2); others(3). 3. The level of amputation in 26 replantations was as follows: thumb, 3 cases; index finger, 4 cases; middle finger, 9 cases; ring finger, 4 cases; palm, I case, wrist, 3 cases; forearm, 1 case; upper arm, 1 case. 4. The maximum ischemic times for successtul results were 16 hours in limb replantation and 22 hours in finger replantation. 5. Six limbs, with four complete and two incomplete amputations, have been replanted and all six limbs survived: Twenty digits, with nine complete and eleven incomplete amputations, have also been replanted and 6.5 cases of nine complete amputations and 10 cases ot eleven incomplete amputations survived. A total of 22.5 cases(86.5%) of replanted limbs and digits survived. 6. The results of joint motion, two point discrimination, sensory recovery and status of sweating due to recovery ot sympathetic nervous function following replantation were satisfactory. 7. In the early stage of our series, postoperative systemic heparinization was used in some cases, but recently we have achieved good recults without it. 8. Main causes of reattachment failure were tissue crushing and secondary thrombosis of the anstomosed vessels.
Amputation ; Arm ; Blood Vessels ; Cicatrix ; Clinical Study ; Discrimination (Psychology) ; Extremities ; Female ; Fingers ; Forearm ; Hand ; Heparin ; Humans ; Joints ; Male ; Orthopedics ; Replantation ; Sex Ratio ; Surgeons ; Sweat ; Sweating ; Tendons ; Thrombosis ; Thumb ; Western World ; Wrist

The term “non-ossifying fibroma of bone” was introduced by Jaffe and Lichenstein in 1942 to describe a distinctive benign lesion occuring near the ends of the long bones in young people, and the lesion was subsequently described by Hatcher as a developmental defect rather than a true tumor. This lesion was presented as a clear-cut entity on the basis of pathological, clinical and roentgenographic manifestations. The diagnosis of non-ossifying fibroma was made by the histopathological findings of the curetted tissues. The authors have seen and studied 5 cases of non-ossifying fibroma from February 1976 to September 1981. The average duration of follow up was 2.2 years, with a range from 0.8 to 5 years, and the results of treatment were as follows: l. Of the five cases, two were associated with pathologic fractures. 2. The sites of the lesions in all cases were the long bones in the lower extremity. 3 In all cases, the complaints were of only a few days or weeks duration before admission to the hospital, and no cases were discovered incidentally by roentgenographic examination. 4. Good results were obtained by treatment with curettage and bone graft.
Curettage ; Diagnosis ; Fibroma ; Follow-Up Studies ; Fractures, Spontaneous ; Lower Extremity ; Transplants

Acute thyroid abscess is an uneommon type of neck infection. We experieneed a case of staphylococcal thyroid abscess in 29 year old man, diagnosed by needle aspira~tion and culture of the aspirate. The patient had complained fever and slowly growing anterior neck swelling. Needle aspiration of the cold nodule prior to broad spectrum antibiotics was performed. After Surgical excision combined with antibiotics, he was discharged with elinical improvement. The laboratory diagnosis and clinical course was summarized and is reported with relevent references.
Abscess ; Anti-Bacterial Agents ; Clinical Laboratory Techniques ; Fever ; Humans ; Neck ; Needles ; Staphylococcus aureus ; Staphylococcus ; Thyroid Gland

OBJECTIVES: It is widely accepted that estrogen has favorable effects on cardiovascular diseases, especially in the postmenopausal women. Endothelin-1(ET-I), released from the vascular endothelium, is a 21-amino acid peptide with strong vasoconstrictor activity. However, the effect of estrogen on the vasoconstriction to ET-1 has not been extensively studied. METHODS: To investigate the effect of estrogen (175beta-estradiol) on the vascular contraction to ET-1, porcine coronary artery(PCA) rings were suspended in organ chambers(37 degrees C, 95% O2/5% CO2) for measurement of isometric tension change. Endothelium was removed mechanically if necessary. In acute experiments, vascular rings were preincubated for 15minutes with 3different concentrations of 170beta-estradiol(10(-6), 10(-5), 10(-4)M) and concentration-contraction curves to cumulative doses of ET-1 were constructed. In the experiments after a longer exposure to 17beta-estradiol, the vessels with endothelium were exposed in the 5% CO2 incubator to 3different concentrations of 17beta-estradiol(10(-9), 10(-8), 10(-7)M) for 44-50 hours, and then concentrationcontraction curves to ET-1 were obtained. RESULTS: Incubation for 15minutes with 170beta-estradiol(10(-4)M) inhibited ET-1-induced contraction in the vessels with endothelium(area under the curve and maximal contraction, p<0.05 compared with control). This effect persisted regardless of the sex and the presence or absence of the endotheliurn. Incubation of the vessels far a longer time with 170beta-estradiol(44-50 hours) resulted in the inhibition of maximal contraction to ET-1(p<0.05) by a lower concentration of 175beta-estradiol(10(-7)M) than in acute experiments in male PCA rings, but an enhanced contraction to ET-1(area under the curve; p<0.05) by 10M of 175beta-estradiol was observed in female PCA rings. CONCLUSION: Short-time incubation with 17Pbeta-estradiol has an inhibitory effect on the contraction to ET-1 in PCA rings. This effect is independent of the presence of the endothelium and the sex of the pigs. A longer incubation with 17beta-estradiol results in a similar inhibitory effect on male(but not female) PCA rings, suggesting that a sex-related difference may exist concerning the effect of 17beta-estradiol on ET-1-induced contraction.
Cardiovascular Diseases ; Coronary Vessels* ; Endothelin-1* ; Endothelins ; Endothelium ; Endothelium, Vascular ; Estrogens ; Female ; Humans ; Incubators ; Male ; Passive Cutaneous Anaphylaxis ; Swine ; Vasoconstriction

PURPOSE: We conducted a study on patients who underwent hip joint arthroplasty because of unstable femur intertrochanteric fractures with greater trochanter bony fragments. After dividing patients into three groups depending on their fracture patterns, we evaluated the clinical and radiological outcomes of different operation methods applied to each of these groups. MATERIALS AND METHODS: Using Evan's classification, we defined an unstable intertrochanteric fracture as those characterized as stage 4 or 5. Of the 137 patients presenting with an intertrochanteric fracture with osteoporosis (bone mineral density, <−2.5) between March 2014 and October 2015, 63 met the eligibility criteria and were included in this study. Next, patients were divided into three groups based on their greater trochanter fracture patterns (discerned with three-dimensional computed tomography images); different fixation methods were applied to each group by a single orthopaedic surgeon. RESULTS: Taken as a whole, 50 out of 63 patients experienced no reduction in walking distance in their daily lives. Harris hip score increased from 74.8 to 85.7 point and we considered this a relatively good result. Radiologically, we observed complete bone union in 62 cases (98.4%); the lone exception was in a patient who experienced osteolysis. There were also 3 cases who removed greater trochanter reattachment device due to broken implant and 1 case of dislocation. CONCLUSION: The different fixation methods applied to three distinct groups with varying fractures patterns were successful in achieving proper reduction and fixation of greater trochanteric fractures. We also observed reduced bone union periods when arthroplasty was performed in patients with unstable intertrochanteric fractures. Lastly, we believe these approaches may also aid in achieving early ambulation and early rehabilitations.
Arthroplasty* ; Classification ; Dislocations ; Early Ambulation ; Femur* ; Hip ; Hip Fractures* ; Hip Joint ; Humans ; Methods* ; Miners ; Osteolysis ; Osteoporosis ; Walking

Recurrent peritonitis is the major complication of continuous ambulatory peritoneal dialysis (CAPD) and a common reason for discontinuation of this form of therapy. Polymicrobial peritonitis by gram- negative organisms suggests intraabdominal pathology not directly associated with CAPD, necessitating early removal of catheter and/or abdominal exploration. The source of infection may still be gastrointestinal, especially in light of the polymicrobial gram-negative peritonitis and rarely be gastrointestinal malignancy. We recently experienced a case of 64-year-old woman with recurrent CAPD peritonitis by polymicrobial gram-negative organisms, originated from colon cancer. Colon cancer was confirmed by barium enema, abdominal CT and colonoscopic biopsy. She underwent right hemicolectomy and removal of catheter simultaneously. The biopsy revealed a moderately to poorly differentiated adenocarcinoma with abundant mucin production.
Adenocarcinoma ; Barium ; Biopsy ; Catheters ; Colon* ; Colonic Neoplasms* ; Enema ; Female ; Humans ; Middle Aged ; Mucins ; Pathology ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tomography, X-Ray Computed

Recently, the world's first transgenic dogs were produced by somatic cell nuclear transfer. However, cellular senescence is a major limiting factor for producing more advanced transgenic dogs. To overcome this obstacle, we rejuvenated transgenic cells using a re-cloning technique. Fibroblasts from post-mortem red fluorescent protein (RFP) dog were reconstructed with in vivo matured oocytes and transferred into 10 surrogate dogs. One puppy was produced and confirmed as a re-cloned dog. Although the puppy was lost during birth, we successfully established a rejuvenated fibroblast cell line from this animal. The cell line was found to stably express RFP and is ready for additional genetic modification.
Animals ; Animals, Genetically Modified ; Cloning, Organism/methods/*veterinary ; Dogs/*genetics ; Female ; Gastrointestinal Tract/metabolism ; Gene Expression Regulation ; Kidney/metabolism ; Liver/metabolism ; Luminescent Proteins/*genetics/metabolism ; Lung/metabolism ; Male ; Myocardium/metabolism ; Nuclear Transfer Techniques/veterinary ; Spleen/metabolism ; Trachea/metabolism

BACKGROUND: Cardiovascular disease is the leading cause of death in patients with type 2 diabetes. Clinically, evaluating cardiovascular autonomic neuropathy (CAN) is important to predict cardiovascular mortality because it is correlated with cardiovascular death. The pulse wave velocity (PWV) correlates well with arterial distensibility and stiffness. It is also a useful approach for evaluating the severity of systemic atherosclerosis in adults. So, we evaluated that the relationship between cardiac autonomic neuropathy and the brachial-ankle pulse wave velocity (baPWV) in patients with type 2 diabetes. METHODS: We retrospectively analyzed 465 patients (209 men and 256 women) with type 2 diabetes. We checked the clinical characteristics and the laboratory tests and we assessed the diabetic complications. Standard tests for CAN were performed by DiCAN (Medicore, Seoul, Korea): 1) heart rate variability during deep breathing (the E/I ratio), 2) a Valsalva maneuver, 3) 30:15 ratio of R-R interval the blood pressure response to standing, and 5) the blood pressure response to handgrip. The CAN score was determined according to the results of the test as following: 0 = normal, 0.5 = borderline, 1 = abnormal. We also measured the baPWV by using a VP 1000 (Colin, Japan) and all the analyses were performed with the SPSS version 14.0. P values < 0.05 were considered significant. RESULTS: The CAN score is associated with the maximal baPWV, age, systolic blood pressure, microalbuminuria, the duration of diabetes, angiotensin II receptor blocker treatment, calcium channel blocker treatment, beta-blocker treatment and nephropathy. After adjusting for age, the baPWV is a independent predictor of the risk for CAN (beta = 0.108, P = 0.021). CONCLUSION: The CAN is associated with the baPWV in patient with type 2 diabetes.
Adult ; Atherosclerosis ; Blood Pressure ; Calcium Channels ; Cardiovascular Diseases ; Cause of Death ; Diabetes Complications ; Heart Rate ; Humans ; Male ; Pulse Wave Analysis ; Receptors, Angiotensin ; Respiration ; Retrospective Studies ; Valsalva Maneuver