The incidence of low back pain as shown in the literature indicates that approximately 65~80% of the population at one time or another have had significant trouble. Low back pain causes one to lose time from work or other activity if an attack is significant, and it is also an universal problem in all economic and social brackets. The vast majority of etiological causes of low back trouble comes from discogenic origin, such as degenerative change of the intervertebral lumbar disc. Disc degeneration should be interpreted as a more or less physiological process which begins at about the age of 20 and continues throughout life. As disc degeneration proceeds, the normal physiologic biomechanics of low back can be transformed to pathomechanics of the spine as a causes of disability. Clinically plain radiography has been routinely used to substantiate the diagnosis of disc degeneration. The typical radiological abnormalities of degeneration are those of marginal spur, narrowing of disc space, Schmorls nodule and sclerosis of the opposing surfaces of the vertebral bodies, etc. However, these changes generally appear somewhat later when degeneration has eventually progressed and in the early stage are generally considered to be negative. Attention is directed to detection of pathomechanical abnormalities of disc degeneation with radiograms being taken in the standing dynamic position rather than in the supine non-dynamic position. The purpose of the study was to investigate some sigificant evidence of dynamograms to evaluate the changes in motion of the lumbar intervertebral joints, and to obtain comparison of the mobility of the joint involved with that of adjacent joints in the same spine. The case material consisted of one hundred and nine patients with discogenic low back pain. In clinical classification, the cases were separated into groups of lumbar insufficiency, intervertebral disc herniation and degenerative spondylosis for the purpose of analysis. Although this was an investigation of the significance in pathologic spines, ten normal subjects with no symptoms, between the ages of twenty and twenty five years, were included in the study as a control to interpret the findings. Non-dynamograms in the non-weight bearing supine position and dynamograms in the weight bearing standing position were made in each case. Non-dynamograms were taken with antero-posterior and lateral projections of the cases. Dynamograms were taken with antero-postericr and lateral projections, and additional lateral views in flexion and extension of spine. The focal film distance was eighty centimeters with the central ray at the third lumbar vertebra. Roentgenograms were analysed by comparison of non-dynamograms and dynamograms, and of groups of patients classified. The results of the study are as follows. 1. Early degenerative change such as abnormal mobility or primary instability was observed by dynamograms. 2. Dynamograms were helpful to detect the level of disc degeneration involved. 3. By dynamograms it has been found possible to deduce severity of disc degeneration. 4. Flexion-extension radiograms have appeared worthwhile to predict the level at which disc protrusion has occurred. In conclusion it is to be expected that there will be a valuable for dynamoradiological assessment in clinical application not only for diagnostic purposes in which it is possible to detect confirmatory evidence of early degeneration, and to predict the level and severity of disc degeneration, but also in the therapeutic aspect where one has to decide how to manage the lesion when it has occurred.
Classification ; Diagnosis ; Humans ; Incidence ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Joints ; Low Back Pain ; Physiological Processes ; Posture ; Radiography ; Sclerosis ; Spine ; Spondylosis ; Supine Position ; Weight-Bearing

OBJECTIVE: The objective of this study is to nfluence of sequential embryo transfers in an invitro fertilization was examined. METHOD: After in vitro fertilization, a maximum of 6 fertilized oocytes was enrolled in this study. At day 3 after an oocytes retrieval, embryos with good quality were transferred (mean 4.9), remaining embryos (mean 2.0/cycle) were cryopreserved at blastocyst stage (Group 1). At day 5 after oocytes collection, second a embryos had reached the blastocyst stage (Group 2) using P1 supplemented with 10 SSS and 30% Follicular fluid. No statistical difference in the pregnancy rate could be seen between the group without a second embryo transfer (n=21; 28.6%) and the group with a second transfer (n=52; 28.8%). RESULTS: The incidence of multiple pregnancy rate per embryo transfer was not statistically different between both group and no high-rank multiple pregnancy (greater than triplete) were observed (o.9%, 15.4%, respectively, p=0.74, chi2). Out of 114 cycles (506 embryos) cultured embryos in group 2, 52 cycles (159 embryos, 29.8%) reached the blastocyst stage. CONCLUSION: The second transfer did not have a significant effect on the pregnancy rate. The most important factor for the pregnancy seems to be the quality of the embryos transferred on day 3 following oocyte retrieval. We recommend embryo transfer is performed only one, day 2~3 or D5.
Blastocyst ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Follicular Fluid ; Incidence ; Oocyte Retrieval ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple

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

No abstract available.
Spine*

Acute arterial occlusion of the extremity may result from obstruction of an artery by embolism or by thrombosis in situ. This results in the sudden cessation of blood flow to an extremity. So immediate managements are required to prevent propagation of the clot and to restore blood flow to the ischemic extremity promptly. We report a case of a acute arterial occlusion which was developed during prolonged fasting. A 59-year-old male was transferred due to severe ischemic pain, coldness and loss of pulse in left lower extremity during fast. The arteriogram shows a complete obstruction of external iliac artery and non-visualization of femoral artery and popliteotibial artery in the left lower extremity. Selective intra-arterial urokinase thrombolytic therapy and percutaneous transluminal angioplasty resulted in recannulation of obstructed artery and relief of symptoms.
Angioplasty ; Arteries ; Embolism ; Extremities ; Fasting* ; Femoral Artery ; Humans ; Iliac Artery ; Lower Extremity* ; Male ; Middle Aged ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator

No abstract available in English.
Clinical Study

BACKGROUND: Epinephrine used in surgery to provide hemostasis may elicit ventricular arrhythmias. A desirable anesthetic would not sensitize the myocardium to exogenously administered epinephrine. So the effect of sevoflurane, which was introduced to clinical anesthesia recently, on cardiac arrhythmias induced by the infusion of epinephrine was compared with those of halothane which was already known to epinephrine-induced arrhythmia in the 14 mongrel dogs. METHODS: The authors compared the arrhythmogenicity (three or more premature ventricular contractions, PVCs)of intravenously administered epinephrine in 14 mongrel dogs who were randomly assigned to receive sevoflurane (1.7 vol%) or halothane (0.75 vol%) anesthesia equipotently. The arrhythmogenic doses of epinephrine determined in this comparative study were expressed by both infusion rates of epinephrine during sevoflurane and halothane anesthesia. RESULTS: The mean values of the arrythmogenic infusion rates of epinephrine were 27.1 7.6 g/kg for sevoflurane and 2.7 0.8 g/kg for halothane. CONCLUSIONS: We concluded that the arrythmogenic doses of epinephrine during sevoflurane were significantly higher than those during halothane anesthesia.
Anesthesia* ; Animals ; Arrhythmias, Cardiac ; Dogs* ; Epinephrine* ; Halothane* ; Hemostasis ; Myocardium ; Ventricular Premature Complexes

Submerged implants require secondary surgical uncovering of implants after healing period of 3 - 6 months. In surgical methods, there are surgical scalpel, tissue punch, electro-surgical, and laser-used uncovering, and laser-used uncovering, and so forth. The objectives of this study are investigation and assessment of 1) thermal change in clinical application for uncovering of HA-coated implant and pure titanium implant irradiated by pulsed Nd-YAG. CO2, and Er-YAG laser. 2) surface change of cover screws after irradiation using laser energy. The temperature of apex & side wall of implants were recorded at 10sec, 20sec, 30sec after 30sec irradiation to implant healing screw; 1) pulsed Nd-YAG laser; 2W, 20pps, contact mode 2) CO2 laser; water-infused & non-water infused state, 2.5-3.5W, contibuous mode, noncontact mode 3) CO2 laser; non-water-infused state, 3W, superpulse, noncontact mode 4) Er-YAG laser; (1) non-water infused state, 10pps, 60mj, contact mode (2) water-infused state, 10pps, 60mj, 80mj, 101mj, contact mode According to the results of this study, pulsed Nd-YAG laser is not indicated because of increase thermal change and pitting of metal surface of implant cover screw. By contrast, CO2 laser & Er-YAG laser are presumed to indicate because of narrow range of thermal change & near abscence of thermal damage of metal surface. Dental laser is thought to be much helpful to surgical procedure when it is used as optimal power and time condition considering characteristics and indications of each laser. Further research is needed to verify that these techniques are safe and beneficial to implant success.
Lasers, Gas ; Lasers, Solid-State ; Titanium

By animal experiments in rat, it has been known that Interleukin-6 (IL-6) is secreted from renal mesangial celle and is an autocrine growth factor for the proliferation of mesangial cells. According to these facts, several studies have been tried for its clinical usefulness by measuring their serum or urinary IL-6 in glomerulonephritis patients with mesangial proliferation. The authors measured urinary IL-6 levels by Interleukin-6 [123I] RIA kit (Amersham Co. UK) in 11 patients with minimal change nephrotic syndrome, in 3 patients with mesangial proliferative glomerulonephritis (MesPGN), in 3 patients with IgA nephropathy, in 9 patients with Henoch-Schonlein purpura nephritis (HSPN) in 2 patients with membranoproliferative glomerulonephritis (MPGN), and in 12 normal healthy children as a control group. The results obtained were summarized as follows: 1) There was no significant differences of urinary IL-6 levels between minimal change nephrotic syndrome patient group and normal control group (p=0.73). The level of urinary IL-6 was increased significantly in HSPN group compared to in normal control group, statistically (p=0.045). Also there were same results in the glomerulonephritis patients with mesangial proliferation in its histopathologic findings such as IgA nephropathy, MesPGN, MPGN. 2) There was a positive correlation between the degree of mesangial proliferation and the urinary IL-6 level. In conclusion, the urinary IL-6 level reflects the glomerular mesangial proliferation and could be useful as a predictive indicator for evaluation of its clinical course in patient with mesangial proliferative glomerulonephritis.
Animal Experimentation ; Animals ; Child* ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Humans ; Interleukin-6* ; Interleukins* ; Mesangial Cells ; Nephritis ; Nephrosis, Lipoid ; Purpura, Schoenlein-Henoch ; Rats

The purpose of this article is to present the clinical and laboratory procedures for single tooth restoration using "Combination Implant Crown". It is cemented on implant abutment and that abutment is screw-retained over implant body. This type of implant restorations has the advantages of cement-retained restoration while being antirotational and retrievable. And, more esthetic and functional result can be achieved by minimizing the size of access hole. The results were as follow : 1. Preparation of abutment below the cuffline should be avoided 2. Axial reduction of implant abutment should not be excessive because it may weaken the abutment 3. More esthetical and functional occlusal surface was achieved with a minimal access hole which is slightly larger than the diameter of hex driver to enable future total retrievability. 4. Combination Implant Crown has the advantages of both the cement-retained and screw-retained type implant restoration. 5. Cementation between implant crown and abutment reduces screw loosening through even force distribution.
Cementation ; Crowns* ; Tooth*