No abstract available.
Dyspnea*

STUDY DESIGN: Thirty-four cases of surgically treated spinal stenosis which were followed up for more than 5 yeras were analysed. OBJECTIVES: To know the relationship between long-term clinical results and various clinical factors. SUMMARY OF LITERATURE REVIEW: Pedicle screw fixation is a common procedure after wide decompression for spinal stenosis. But, there is few report showing its long-term result. MATERIALS AND METHODS: We evaluated the long term results of surgically treated spinal stenosis patients according to the sex, method of fusion, level of fusion, radiologic change of adjacent level, hardware problem and complication. There were 11 males and 23 females. Average age was 53.2 years(range 34-68 years). Radiographically follow up was averaged 72 months(range 60-104 months). Clinically follow up period was averaged 76 months(range 60-113 months). Eight patients were operated with PLIF and 26 patients were with posterolateral fusion. One level surgery was done in 18 patient and more than two level in 16 patients. RESULTS: Twenty-seven patients(79%) showed satisfactory result at 2year and 5 year follow-up. Two patients showed change of clinical result during follow-up. Clinical result was much better in monosegmental surgery and in male sex. Six patients showed narrowing of disc space at non-surgery level and 2 patients had compression fracture. Complications were 1 deep infection, 2 dural tears, 9 donor site pain, 2 metal failures and 1 metal pull-out. CONCLUSIONS: We concluded that there is no significant change of clinical results between two year follow-up and five year follow-up. Clinical complications and metal problems are not related with the unsatisfactory results. Multiple level surgery and female sex are two variables related with the unsatisfactory clinical outcome.
Decompression* ; Female ; Follow-Up Studies* ; Fractures, Compression ; Humans ; Male ; Spinal Stenosis* ; Tissue Donors

It is well known that double contrast knee arthrography is useful in diagnosis of meniscal lesions and other knee pathology, But intra-articular structures become less well delineated shortly after injection into the kneejoint with water soluble contrast media because of rapid absorption and dilution of the injected media. This limits the time when sharply detailed arthrograms are obtainable and precludes repeat delayed arthrogram withougreinjection of contrast media. In order to overcome this major disadvantage, the authors used epinephrine which has vasoconstrictive effect and is expected to reduce fluid movement across the synovial membrane temporarily. The authors attempted to compare epinephrine inhanced double contrast arthrographic group, einephrine(+) group, to thedouble contrast arthrographic group withoug epinephrine, epinephrine(-) group, by statistical evaluation. Eachgroup consisted of 35 cases and 7 lateral films of knee joint were taken sequentially 2,6,10,15,10,20,30, and 60 minutes after injection of contrast media, and were assessed by 5 certified radiologists. The resuls were as follows; 1. The difference of mean score of quality between epinephrine(+) group and epinephrine(-) group was statistically significant at every time interval (p value<0.01 at 2 minutes, p<0.01 at all other time intervals).Epinephrine(+) group was superior to the epinephrine(-) group in quality of film. 2. Numbers of cases above scoreof 2 which was considered to be of diagnostic quality in evaluating meniscal lesions were larger in epinephrine(+)group than epinephrine(-) group in quality of film. 3. Only 43% of cases was above score of 2 at 10 minutes inepinephrine (-) group, but 97% at 10 minutes and 80% at 20 minutes respectively in epinephrine(+) group. Therefore duration for adequate study of arthrogram is prolonged more than two times in epinephrine(+) group. 4. At 30 minuts, 57% of cases was above score of 2 in epinephrine(+) group while at 15 minuts, 80% of cases was below scoreof 2 in epinephrine(-) group. This makes it possible to repeat study without additional injection of contrast media or postponing of the examination in half of cases, if necessary. 5. The use of epinephrine in kneearthrography results in significant enhancement of radiographic quality initially (p<0.01). Therefore we can fluoroscope in good condition and obtain films of fine quality.
Absorption ; Arthrography ; Contrast Media ; Diagnosis ; Epinephrine ; Knee Joint ; Knee ; Pathology ; Synovial Membrane ; Water

No abstract available.
Equidae*

BACKGROUND: The relation between treadmill exercise testing and ambulatory ST segment monitoring in detection of ischemia in patients with coronary artery disease has not been well established, with pathophysiologic mechanisms underlying the development of ischemia in the ambulatory setting not being well elucidated. This study was performed to determine the relation between myocardial ischemic indexes on exercise testing and on Holter monitoring. METHODS: We analized 25 patients with stable angina and angiographically documented coronary artery disease, who exhibited ischemia both on a Bruce protocol exercise test and on 24-hr Holter monitoring while receiving routine antianginal medications. RESULTS: Mean heart rate at the onset of 1mm ST segment depression during exercise testing(74.4 VS 114.1 beats/min, p<0.01). Overall the correlations between ischemic indexes on both test were weak. But heart rate at the onset of ischemic episodes during Holter monitoring had a good correlation with heart rate at 1mm ST depression during exercise test. And the number of ischemic episodes on Holter monitoring revealed a weak negative correlation with duration of exercise during treadmill test. CONCLUSION: Ischemic indexes on exercise testing cannot accurately predict ischemic indexes on Holter monitoring in patients with coronary artery disease. In that regard, Holter monitoring may provide other clinical information in addition to that obtained by exercise testing in selected patients.
Angina, Stable ; Coronary Artery Disease ; Depression ; Electrocardiography, Ambulatory* ; Exercise Test* ; Heart Rate ; Humans ; Ischemia* ; Myocardial Ischemia

Apert's syndrome is an uncommon, congenital disturbance in the growth of bone and soft tissue affecting principally the head, the hands and the feet. So there is skull malformation, most often oxycephaly, associated with malformation of both hands and feet. This syndrome was first reported by Apert in 1906. Since that time, over 200 cases have been reported. Recently we have experienced two cases of typical Apert's syndrome. We made a brief literature review.
Craniosynostoses ; Foot ; Hand ; Head ; Skull

No abstract available.
Hip

No abstract available.
Dermatofibrosarcoma* ; Mohs Surgery*

No abstract available.
Femur* ; Gestational Age* ; Ultrasonography*

Cervical intraepithelial neoplasia in human consist of dysplasia of various developmental stages and squamous cell carcinoma in situ of various types. These lesions can be diagnosed cytologically on cervico-vaginal smears, although the diagnostic reproducibility is limited. To obtain the objects morphologic distinction between normal squamous epithelial cell in different maturation, different stages of dysplastic cells and varieties of in situ carcinoma cells, Kontron IBAS-1 imaging analyzer was applied for the measurement of nuclear and cytoplasmic areas of each categorised cells. The followings are results obtained: 1) Nuclear and cytoplasmic areas of superfical (36.9 micrometer2, 2319.9 micrometer2) intermedicate (45.7 micrometer2, 2989.7 micrometer2) and parabasal cells (50.8 micrometer2, 432.7 micrometer2) of normal squamous epithelium origin are mostly distinctive between cell types. However, cytoplasmic areas of both superficial and intermediate cells and nuclear areas of both intermediate and parabasal cells are not significantly different. 2) Normal squamous cells and various dysplastic cells show obvious difference in their nuclear and cytoplasmic areas, while difference between cytoplasmic areas of both parabasal (432.7 micrometer2) and severe dysplastic cells (409.7 micrometer2) are not statistically significant. 3) No statistical difference is observed in between nuclear areas of both moderate dysplastic (112.3 micrometer2) and severe dysplastic cell (117.6 micrometer2). 4) Varieties of carcinoma in situ cells and severe dysplastic cells are in difference in their nuclear and cytoplastic areas, whereas nuclear areas from both in situ carcinoma cells (95.3 micrometer2) of large cell type and severe dysplasia (117.6 micrometer2) are not distinctive. The results lead the author to consider that the morphometric analysis for various parameters of cell constituents are of value in making objective distinction between cells from cervical intraepithelial neoplasia in human.
Humans