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

No abstract available.
Endometriosis* ; Female ; Humans

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

No abstract available.
Melanoma*

No abstract available.

Rheumatoid arthritis is a chronic inflammatory systemic disease of young or middle aged adults, characterized by destructive and proliferative changes in the synovial membrane, periarticular structures, skeletal muscle and perineural sheath. Eventually joints are destroyed, ankylosed and deformed. Therefore the aim of treatment is to keep the inflammatory process at a minimum, thereby preserving joint motion, maintaining health of muscles supplying motor power about the joint, and preventing secondary joint stiffness and deformity. Much of the increasing enthusiasm for surgical treatment of rheumatoid arthritis revolves around preventing the destruction of cartilage and tendon simply by excising as much as possible of the tissue that produces the destruction, namely the inflamed synovial membrane. Synovectomy probably is the earlient and most rewarding procedure that can be done in the treatment of rheumatoid arthritis. For the period of 11 yesrs from March 1966 to December 1977, 16 cases of rheumatoid knees were treated by synovectomy and the results of clinical observation was as follows. 1. Synovectomy was performed in 16 knees of 13 patients and 11 patients were followed up. 2. Of 13 patients, 10 patients were female and 3 patients were male. 3. Peak age incidence was in the third decade (38.4%) and the postoperative results were more satisfactory in younger patients than in older patients. 4. Post operative range of motion was not specifically correlated to the duration of symptom. 5. Postoperative results were not specifically correlated to the laboratory findings. 6. Postoperative range of motion was satisfactory in 6 cases and was unsatisfactory in 5 cases.
Adult ; Arthritis, Rheumatoid ; Cartilage ; Congenital Abnormalities ; Female ; Humans ; Incidence ; Joints ; Knee ; Male ; Middle Aged ; Muscle, Skeletal ; Muscles ; Range of Motion, Articular ; Reward ; Synovial Membrane ; Tendons

Supracondylar fractures of the humerus is the most common elbow fractures in children. Many papers has been published about the treatment of the supracondylar fractures of the humerus in children and prevention of both Volkmann's ischemic contractures and nerve injuries associated with these fractures, however, unfortunately it is still one of the most difficult fractures to manage. After successful reduction, the late complications of loss of elbow motion, the change in carrying angle, myositis ossificans, and progressive ulnar nerve palsy still lie ahead. For the period of 5 years from January 1975 to December 1979, 110 patients who had been treated for supracondylar fractures of the humerus at Severance Hospital, Yonsei University Coilege of Medicine were studied and analyzed retrospectively and the results are summerized as follows: 1. The age of the patients varied from 1 to 26 years, the majority (80.0%) being between 4 to 11 years and the fractures were on the left side in 71.8% and males comprized 75.5%. 2. The extension type comprized 94.5%. 3. Most common complications were cubitus varus deformities. 4. Percutaneous pinning and open reduction and internal fixation elicited rare cubitus varus diformities. 5. Limitation of motion was most frequent camplication after open reduction and internal fixation. 6. All cases which showed cubitus varus deformities were initially medially displaced fractures. 7. Four median nerve injuries were associated with posterolateral displacement and one radial nerve injury was associated with posteromedial displacement. 8. Finally, with prompt and adequate treatment, there were no Volkmanns ischemic contractures seen in this study.
Child ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Ischemic Contracture ; Male ; Median Nerve ; Myositis Ossificans ; Radial Nerve ; Retrospective Studies ; Ulnar Neuropathies

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

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.
Spine*