BACKGROUND: Facet joint have been implicated as a source of chronic low back pain. Radiofrequency denervation has demonstrated the most solid evidence. To increase safety and efficacy of treatment, computed tomography (CT) guidance injection has been used in several disease. The purpose of this study was to evaluate the efficacy of CT-guided radiofrequency rhizotomy in the treatment of facet joint pain. METHODS: A total of 40 patients were randomized to undergo radiofrequency facet joint denervation under CT guidance or C-arm guidance. All patients were examined visual analogue scale (VAS) score before treatment, 1 month, and 3 months after treatment. RESULTS: The VAS in both groups showed significant improvement over the 1-month interval. No significant difference in the VAS score among the group was observed. CONCLUSIONS: In this study there was no significant difference between CT guidance lumbar rhizotomy and C-arm guidance lumbar rhizotomy. Therefore CT-guided radiofrequency denervation of the lumbar facet joint was a minimally invasive technique that appears effective.
Denervation ; Humans ; Low Back Pain ; Rhizotomy ; Zygapophyseal Joint

It has been well known that human sera exert an inhibitory effect on the growth of dermatophytes and candida. Several different inhibitory serum factors have been isolated and investigated by some workers. In clinical aspects, the patients with diabetes are prone to derrnatophyte and candida infections. The authors attempted to investigate whether diabetic sera would have any difference in inhibitory effect on in vitro candidial growth compared with norma1 sera, Fifty and 30 serum samples were obtained from patients with diabetes and bealtby adults respectively, Aliquots of candida albicans were mcubated in the test tubes containing nutrient kiroth with addition of eacb serum. Iron was also added to saturate transferrin in the serum. The degree of candidial growth was determined by the change of percent transmission on spectrophotometry of the candida-inoculated nutrient broth in the test tubes during 24-hour incubation. The results were as followings: 1. The sera from both patients with diabetes and healthy adults were found to retain the inhibitory effect on in vitro candidial growth, though the transferrin, a known serum inhibitor, was removed by saturation with iron. 2. The inhibitory effect of diabetic sera was weaker than that of normal sera. 3. The degree of the inhibitory effect of each diabetic serum was not correlated with corresponding serum glucose level.
Adult ; Arthrodermataceae ; Blood Glucose ; Candida albicans* ; Candida* ; Humans ; Iron ; Spectrophotometry ; Transferrin

BACKGROUND: Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measurements in patients with chronic low back pain or radiculopathy. METHODS: ESR and hsCRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hsCRP and ESR were measured prior to lumbar epidural steroid injection. RESULTS: The mean ESR was 18.8 mm/h and mean hsCRP was 1.1 mg/L. ESR had a correlation with age. CONCLUSIONS: A significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain.
Arthritis ; Blood Sedimentation ; C-Reactive Protein ; Constriction, Pathologic ; Erythrocytes ; Female ; Humans ; Intervertebral Disc ; Low Back Pain ; Lower Extremity ; Male ; Radiculopathy ; Spinal Stenosis

We roport herein three cases of pruritic urticarial papules and plaques of pregnancy in two primigravidas and one multigravida in erythematous papules and urticarial plaques on both thighs, buttock and upper extremites. In the second case, lesions initially developed on both thighs and then preaded on abdomen, back and exter ities. Abdomen, thighs and extremites were involved in the third case. Histopathologic findings revealed acanthosis orfocal spongiosis in epidermis and lymphocytic perivascular infiltration with or without eosinophilsn dermis. They were treated with systemiror topical steroids and, mtihistamines. Itching was relieved within a few days after therapy and skin lesions resolved spontaneously after delivery.
Abdomen ; Buttocks ; Dermis ; Epidermis ; Pregnancy* ; Pruritus ; Skin ; Steroids ; Thigh

A case of cutaneous cartilaginous tumor was diagnosed from solitary nadular skin lesion on a toe of 59-year old female. Lack of information about cartilage tumors in the dermatologic literature suggest that they rarely develop as supeficial lesions. General clinico-pathologic feature of the tumor is reviewed.
Cartilage ; Chondroma ; Female ; Humans ; Middle Aged ; Skin ; Toes

The author analysed foreign body in the airway, divided into two groups vegetable foreign body group(VFBG) and non-vegetable foreign body group(N-VFBG), according to the nature, in 88 patients aged from 5 months to 15 years who were diagnosed and treated under ventilating bronchos-copy at Department of Pediatrics and Otolaryngology, Pusan National University Hospital from 1980 to 1990. Of the 88 patients analysed, 13 were followed for review, which comprised clinical assessment, chest radiography, and perfusion lung scan. The follwing results were obtained. 1) The highest incidence was seen in the age group of 1 to 3 years old especially in VFBG, bur no difference in incidence among each age group was observed in N-VFBG, The ratio of incidence between male to female was 2:1 ein total and, in N-VFBG, the incidence of male 8 times higher than female. 2) A wide variety of foreign bodies was recovered, with peanut being by far the most common (50%) and the ratio of incidence between VFBG and N-VFBG was 6 to 4. 3) The time interval of less than 24 hours between aspiration and admission was most frequently seen in 38% and of more than 3 weeks in 11%. The time interval in VFBG and the group with left bronchial lodging was longer than of N-VFBG and the group with right bronchial lodging, each respectively but no statistical difference was observed. The time interval in the group with bronchial lodging was significantly longer than of the group with laryngeal and tracheal lodging. 4) Frequent symptoms and signs were coughing, dyspnea, fever, decreased air entry, coarse breathing sound and rales. In total, clinical manifestations were more common in VFBG, especially in the incidence of fever, decreased air entry, coarse breathing sound and rhonchi. 5) The roentgenographic findings on admission were emphysema, pneumonia and atelectasis in the order of frequency. The incidence of emphysema and complex roentgenographic findings were more common in VFBG whereas in N-VFBG radioopaque foreign body normal roentgenographic findings were more common. 6) The prevalence of bronchial lodging was over 70% regardless of age group. No difference of predilection was observed between right and left bronchial lodging before 7 years old, but after 7 years old right bronchial lodging was significantly seen. 7) The longer the time lag before admission after aspiration, the longer the duration of hospitalization was in VFBG but with no statistical significance. However, no correlation between time lag and the duration o hospitalization was observed in N-VFBG. The group with bronchial lodging had significantly longer duration of hospitalization compare to that of the group with laryngeal and tracheal lodging, The group with left bronchial lodging had longer duration of hospitalization compare to that of the group with right bronchial lodging but with no statical significance. 8) Of the 13 cases reviewed, one had abnormal lung perfusion scan in spite of normal clinical assessment and chest X-ray, who was treated on 20 days days after aspiration of peanut in the right bronchus.
Bronchi ; Busan ; Child ; Child, Preschool ; Cough ; Dyspnea ; Emphysema ; Female ; Fever ; Follow-Up Studies* ; Foreign Bodies* ; Hospitalization ; Humans ; Incidence ; Lung ; Male ; Otolaryngology ; Pediatrics ; Perfusion ; Pneumonia ; Prevalence ; Pulmonary Atelectasis ; Radiography ; Respiratory Sounds ; Thorax ; Vegetables

PURPOSE: The aim of this prospective study was to evaluate whether additional intraoperative injection of Tarasyn (ketorolac tromethamine) provided a preemptive analgesic effect that improved postoperative pain. METHODS: Sixty patients scheduled for hemorrhoidectomy were randomly assigned to the study and control groups. For the control group (n=32), patients were treated with standard intravenous injections of Nubain (Nalbuphine hydrochloride; Jeil Pharmaceuticals Co, Seoul) per 8 hours for three times postoperatively for pain relief. In the study group (Tarasyn group, n=28), 60 mg of Tarasyn (ketorolac tromethamine; Roche Korea, Seoul) was injected into the internal sphincter muscle and around the operative wound at the time of hemorrhoidectomy as well as standard intravenous injections of Nubain . Parameters were measured of pain score from 0 (no pain) to 10 (agonizing pain), painless sound sleep, additional analgesic requirements, time to first bowel movement, and postoperative urinary retention. RESULTS: Rate of painless sound sleep was 75.0% and 53.1% in the Tarasyn and the control groups, respectively, which was significant statically between two groups (P<0.05). Time to first bowel movement was 2 and 3.2 days in Tarasyn and the control groups, respectively, which was also significant statistically (P<0.05). Voiding difficulty developed in one case (3.5%) in the Tarasyn group and he needed catheterization. In the control group, however, the number (15 cases, 46.9%; P<0.001) was much higher requiring more catherization (13 cases, 40.9%; P<0.001). Mean pain scores was significant statically between two groups (P<0.001). CONCLUSION: The data suggest that the use of intraoperative injection of Tarasyn is associated with a significant decrease in pain and urinary complications after hemorrhoidectomy.
Catheterization ; Catheters ; Hemorrhoidectomy* ; Humans ; Injections, Intravenous ; Korea ; Nalbuphine ; Pain, Postoperative ; Prospective Studies* ; Tromethamine ; Urinary Retention ; Wounds and Injuries

Baboon syndrome is used to denote a systemic allergic contact dermititis with a characteristic color and distribution pattern. It is also referred to as mercury exanthem, because inhalation of mercury vapor usually causes the skiri lesion in a sensitized person. Diffuse pi,ikish erythema of the buttock, upper inner thigh, and axilla are characteristic features. We report a case of baboon syndrome developed after exposure to the smoke of a burning amulete a charm written on a piece of paper in a 12 year-old female. Mercury sensitivity was confirrned by a patch test. Atomic absorption by a spectrographic method and Scanning electron microscopy/energy dispersive for analysis X-ray detected mercury in the urine and the ed scraped pigments from the amulet, respectively.
Absorption ; Axilla ; Burns ; Buttocks ; Child ; Erythema ; Exanthema ; Female ; Humans ; Inhalation ; Papio* ; Patch Tests ; Smoke* ; Thigh

Gastric lipomas are rare benign submucosal tumors which can present the diagnostic and therapeutic problems. The preferred treattment is observation or local excision. Since preoperative diagnosis and differentation from malignant tumors can be difficult by use of the conventional diagnostic modalities such as X-ray or endoscopic examination, patients are sometimes subjected to more extensive surgical procedures than warranted. As to the diagnosis of submucosal tumors of the upper digestive tract, a newly developed diagnostic modality of endoscopic ultrasonography(EUS) allows us to visuialize the structures underlying the gastrointestinal wall in a noninvasive maneuver, and can contribute to make differential diagnosis and decision of management. Strip biopsy is an endascopic tissue resection technique which permits resection of both mucosal and submucosal tissue regardless of the morphological type of the lesion, because the submucosal saline injections during the procedures make the flat or depressed lesions to be elevated. Now, we report a 56-yr-old female which had a Yamada type I polypoid gastric submucosal lipoma in the antrum, which could be performed the different diagnosis and successful endoscopic removal by endoscopic ultrasonography and strip biopsy.
Biopsy* ; Diagnosis ; Diagnosis, Differential ; Endosonography ; Female ; Gastrointestinal Tract ; Humans ; Lipoma*

A new method for combining ultrasonography snd endoscopy, endoscopic ultrasonography (EUS), was developed to improve the diagnostic accuracy of ultrasound by direct image of the target lesion via the gastrointestinal lumen. EUS has the unique ability to provide clear sonographic images of the wall structure of the stomach. This capability can be ultilized in assessing the depth of cancer invasion of the stomach by identifying which layer the ultrasonographic change extends to. However, the depressed types of early gastric cancer(EGC) are often accompanied by ulcerative change in the tumor foci. And the ultrasonographic picture is also influenced by the ulcerative change. (continue...)
Endoscopy ; Endosonography* ; Stomach ; Stomach Neoplasms* ; Ulcer ; Ultrasonography