A clinical study of spinal tuberculosis was made on 81 patients, who had been treated at the Department of Orthopedic Surgery, Seoul Red Crose Hoapital, during the 4 years period from January 1974 to December 1977. The results obtained were as follows; 1) The patients have been increased since 1977. 2) The ratio of male to female was not significant, but the age distribution showed a peak incidence in the third decade. 3) The lumbar spine was most commonly involved, being in 43.4% of the cases, while the dorsal spine occupied 27.7%. Considering the age, however, the dorsal spine was most commonly involved in the children as compared to the lumbar spine in the adults 4) In 84.2% of the patients, chemotheraphy was begun prior to operation and in 57.8% for a period less than 4 weeks. 5) The major associated tuberculous lesions elsewhere and complications were pulmonary tuberculosis in 28.4% paraplegia in 27.2% and draining sinus or buldging mass over body surface in 21.0%. 6) The number of involved vertebral bodies was higher in children than in adults. 7) Paraplegia presented a peak incidence in the second decade (42.9%). The number of vertebral bodies involved and the extent of destruction and kyphotic angulation were more severe in the paraplegic group than in the nonparaplegic group. 8) In the paraplegic group, thoracic, cervico-thoracic, and thoraco-lumbal spines comprised 71.8% of the cases. In our experience, the paraplegic group of early onset was better than that of late onset in regard to prognosis for recovery. 9) 22 patients who had complete or incomplete paraplegia had a variety of pathological lesions in or near the spinal canal. The most, common lesion was a sequestrum or a sequestrated disc.
Adult ; Age Distribution ; Child ; Clinical Study ; Female ; Humans ; Incidence ; Male ; Orthopedics ; Paraplegia ; Prognosis ; Seoul ; Spinal Canal ; Spine ; Tuberculosis, Pulmonary ; Tuberculosis, Spinal

The Acromioclavicular joint is classified as a diarthrodial joint. Its stability is maintained by articular capsule, acromioclavicular ligament, articular disc, coraco clavicularligament(trapezoid and conoid ligament) and attached muscles. 17 cases of acromioclavicular dislocation which had been seen at Seoul Red Cross Hospital during the period of January 1975 through December 1977 were studied. The following observations were made. 1. This injury is more prevalent in male (82%) with the peak incidence in the 3rd and 4 th decades (53%). 2. Conservative treatment was given in 11 cases by adhersive strapping around the elbow and lateral one third of the clavicle reinforced by Velpeau dressing for 3 weeks, then followed by active exercise. 3. Operative treatment consist of modified Phemister technique in 3 cases, Mumford technique in 2 cases, and Dewar and Barington's technique in 1 case. 4. Results were evaluated in 4 groups as excellent, good, fair, and poor according to Gerald weitzman's classification(1975). 5. Overall results of more than good (satisfactory) was obtained in 72.7% of the 11 cases with conservative treatment and in 50% of the 6 cases with operative treatment.
Acromioclavicular Joint ; Bandages ; Clavicle ; Clinical Study ; Dislocations ; Elbow ; Humans ; Incidence ; Joint Capsule ; Joints ; Ligaments, Articular ; Male ; Muscles ; Red Cross ; Seoul

In accidents, the spines are generally subjected to one of five types of violence; pure flexion, flexion and rotation, extention, vertical compression, or direct shearing force by Holdsworth's report. Flexion and rotational violence, so-called, unstable rotational fracture-dislocation results in paraplegia commonly. The treatment of the fracture-dislocations of the thoracic and lumbar spine had varied widely during the past 100 years, including conservative and operative treatment, but there is no definitive study that convincingly show the superiority of either operative or nonoperative treatment till now. Ten cases of the unstable thoracolumbar vertebral fracture or fracture-dislocations during the past two years were reported in this paper. In unstable types on the thoracolumbar vertebral fracture or fracture-dislocations, direct blow was the most common cause of injury and the thoracolumbar junction extending from T10 to L1 was the most common location of injury in this report. Three among four paraplegic patients were received flexion and rotational violence and the remaining one, direct shearing force. All four paraplegic parients were operated. Among them two cases, the one who was performed open reduction and simple wire fixation and the other open reduction and Harrington instrumentation, recovered almost completely except mild motor weakness of lower extremities. All cases complained of remaining back pain more or less without relation to the method of treatment.
Back Pain ; Clinical Study ; Humans ; Lower Extremity ; Methods ; Paraplegia ; Spine ; Violence

Moyamoya disease is characterized by progressive stenosis of the distal portion of the internal carotid arteries and fragile collateral vessels in the brain. The precise pathogenesis is still not known. Although extracranial vessel involvement is very rare, coronary arterial involvement has recently been reported. Here, we report a case of diffuse, multivessel coronary spasm leading to cardiac arrest and myocardial infarction in a 47-year-old man with moyamoya disease with no underlying emotional or physical stress.
Brain ; Carotid Artery, Internal ; Constriction, Pathologic ; Death, Sudden, Cardiac ; Heart Arrest* ; Humans ; Middle Aged ; Moyamoya Disease* ; Myocardial Infarction ; Spasm*

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is thought to have antiatherosclerotic properties. On the other hand, NO activity is reduced in patients with metabolic syndrome, and endothelial dysfunction is an important early sign of atherosclerosis in patients with metabolic syndrome. The aim of this study was to investigate the effect of pioglitazone on the endothelial function in terms of the plasma NOx (combined nitrate/nitrite), the circulating inflammatory markers and the autonomic nervous system. SUBJECTS AND METHODS: We randomized 40 subjects with metabolic syndrome, and they were assigned to receive 15 mg of pioglitazone per day (the PIO group, n=21) during 12 weeks or they were placed in the placebo group (the PLA group, n=19). We estimate the endothelial function by performing vascular ultrasound. The plasma NOx levels, the levels of the inflammatory markers and the GRK2 levels were measured. RESULTS: After 12 weeks of therapy, flow mediated dilation (FMD) was improved in the PIO group (from 6.7+/-6% to 11.7+/-5%, respectively: p<0.05), but not in the PLA group. The level of plasma NOx was increased in the PIO group (from 67.7+/-30 nmol/dL to 92.9+/-41 nmol/dL, respectively: p<0.001), but not in the PLA group. The plasma levels of hsCRP and IL-6 dropped significantly (from 2.6+/-2.3 mg/L to 1.2+/-1.3 mg/L and 1.7+/-2.1 pg/mL to 0.7+/-0.5 pg/mL, respectively: p<0.05) in the PIO group, but not in the PLA group. The levels of GRK2 (the PLA group from 0.0061+/-0.0023 ng to 0.0075+/-0.0031 ng, and the PIO group from 0.0024+/-0.002 ng to 0.0015+/-0.001 ng, p=ns) didn't dropped significantly. CONCLUSION: Administration of PPAR-gamma agonist in patients suffering with metabolic syndrome improves their endothelial function, enhances the production of NOx and reduces the proinflammatory markers, but this is not related to sympathetic regulation. PPAR-gamma agonist may be able to modulate the progression of atherosclerosis.
Atherosclerosis ; Autonomic Nervous System ; Hand ; Humans ; Inflammation* ; Interleukin-6 ; Nitric Oxide ; Peroxisome Proliferator-Activated Receptors ; Peroxisomes* ; Plasma ; Ultrasonography

With regard to various pathologic conditions, it is important to understand not only MR findings, which dependon the anatomic location of intraventricular lesions, but also the anatomic location most appropriate for surgicalintervention. In this paper we will analyze and demonstrate the incidence and characteristic MR findings ofvarious intraventricular tumors according to the location of ventricles.
Incidence

Purpose: Paclitaxel is an anticancer drug that blocks cell division by stabilizing microtubules. Even though paclitaxel has been shown to be effective in killing bladder cancer cell lines in vitro, the in vivo absorption was extremely low. A paclitaxel formulation was prepared in solution only, which was bioadhesive, and its effects evaluated in the MBT-2 cell line and in C3H2 bladder cancer mice. In addition, the toxicity of the paclitaxel formulation was also evaluated. Materials and Methods: A muco-adhesive oily paclitaxel formulation was made by the combining of monoolein, tricaprylin, Tween 80 and paclitaxel. MBT-2 cells were cultivated in different concentration of taxol, and the tumoricidal activity measured by the indirect methylthiazol-2-yl-2, 5-diphenyl tetrazolium bromide (MTT) assay. In an in vivo study, the treatment regimen for the s.c. C3H2 mice was five consecutive once daily administrations, beginning on day 4 post tumor implant. The length and width of the tumors were measured twice a week, and the tumor volume calculated. On day 21, the tumor volume change and toxicity were evaluated. Results: The average particle size of paclitaxel-loaded lipid nanoparticle was about 600nm, with a polydispersity of 1,000. Only 2.6% of the MBT-2 cells were viable after 24 hour of treatment with the formulation at a paclitaxel concentration of 10mug/ml, while showing minimal toxicity of the formulation without paclitaxel. Paclitaxel-loaded lipid nanoparticles, administered orally, allowed significant antitumor activity in C3H2 mice (p<0.05). Conclusions: Paclitaxel-loaded lipid nanoparticles have a remarkable cytotoxic effect against MBT-2 cells, in a dose dependent manner, and the oral paclitaxel-loaded lipid nanoparticle therapy had an inhibitory effect on bladder tumors in a MBT-2 model, but without systemic toxicity. Therefore, oral paclitaxel-loaded lipid nanoparticles may be used for advanced bladder cancer patients.
Absorption ; Animals ; Cell Division ; Cell Line ; Homicide ; Humans ; Mice* ; Microtubules ; Nanoparticles* ; Paclitaxel ; Particle Size ; Polysorbates ; Tumor Burden ; Urinary Bladder Neoplasms* ; Urinary Bladder*

OBJECTIVES: Recently,tinea pedis has been reported to be a type of occupational dermatoses because of its high prevalence in specific working conditions.Although there is no doubt that the environment surrounding work places, the usual habits of workers etc are intimately related to this skin conditions, there is some controversy as to whether or not this condition is a real occupational illness and what is the exact cause of the high prevalence of this illness is. In this study, the prevalence of tinea pedis in workers from the shipbuilding industry was investigated andthe risk factors of this disease were evaluated. This study also aimed to verify whether or not tinea pedis is one of the occupational diseases. METHODS: The results of interviews, questionnaires and clinical findings from 1,419 workers who visited the occupational health center for an annual routine check for their health state were analyzed. RESULTS: Among the 1,419 workers, 778 workers (54.8%)had tinea pedis. By simple logistic regression analysis,the prevalence of tinea pedis was found to be affected by some variables, including the job category, the types of work,the kinds of footwear, whether or not they were using communal baths in the work places, and a family history of tinea pedis.In contrast, by multiple logistic regression analysis,only utilization of the communal baths in the work places and a family history of tinea pedis turned out to be statistically significant risk factors. CONCLUSIONS: In this study, the major factors contributing to the high prevalence of tinea pedis are the use of communal baths in the workplace and a positive family history. However, the wearing of safety shoes was not statistically significant. Therefore, tinea pedis could not be confirmed to be an occupational disease. On the basis of these results, a solution to the environmental hygiene of communal baths and the personal hygiene of individuals needs to be improved in order to prevent tinea pedis.
Baths ; Humans ; Hygiene ; Logistic Models ; Occupational Diseases ; Occupational Health ; Prevalence* ; Questionnaires ; Risk Factors* ; Shoes ; Skin ; Skin Diseases ; Tinea Pedis* ; Tinea* ; Workplace

OBJECTIVE: To evaluate our early experience using self-expanding stents to treat atherosclerotic vertebral artery ostial stenosis (VAOS), with respect to technical feasibility and clinical and imaging follow-up results. MATERIALS AND METHODS: A total of 20 lesions in 20 patients underwent stenting of the VAOS using a self-expanding stent (Precise RX; Cordis Neurovascular, Miami Lakes, FL). Two patients were asymptomatic. We analyzed the technical success rate, causes of technical failure, occurrence of any vascular or neurological event, and the occurrence of any neurological abnormality or in-stent restenosis (ISR) seen on follow-up. The imaging follow-up was performed with Doppler ultrasound (DUS) as a primary screening modality. RESULTS: One instance of technical failure was caused by failure of the guidewire passage. The stent diameter was 5 mm, and post-stenting balloon dilatations were necessary in all cases. Stent misplacement requiring placement of an additional stent occurred in four cases. Following a 14.8 month average clinical follow-up time, two patients showed anterior circulation ischemia, which was not attributed to the VAOS we treated. Following a 13.7 month average DUS follow-up, five patients showed a mild degree of diffuse or focal intimal thickening in the stent lumen; however, none of the stenosis showed luminal loss of more than 50% and no stent fracture was noted. CONCLUSION: The use of self-expanding stents for treating VAOS was technically feasible and helped to improve artery patency during our limited follow-up interval.
Aged ; Blood Vessel Prosthesis Implantation/methods ; Feasibility Studies ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; *Stents ; Treatment Outcome ; Ultrasonography, Doppler/methods ; Vascular Patency ; Vertebral Artery/surgery/*ultrasonography ; Vertebrobasilar Insufficiency/*therapy

BACKGROUND/AIMS: The exercise ECG test (XECG) and computed tomography coronary angiography (CTCA) have been used widely in initial evaluations of coronary artery disease (CAD) in real-world practice. In this study, we compared the diagnostic power of CTCA and XECG, based on conventional coronary angiography (CCA). METHODS: We enrolled 589 consecutive patients retrospectively who had been examined with both XECG and CTCA for the evaluation of CAD in outpatient clinics. Significant stenosis was defined as more than 50% diameter stenosis. Triage to CCA and/or revascularization treatment (RT) by the results of XECG and CTCA and the diagnostic accuracy of both exams, based on CCA, were investigated. RESULTS: In the 589 patients, 107 (19%) were triaged to CCA for further evaluation; in 77 (12.8%) significant stenosis was detected on CCA. Also, 65 (11%) patients underwent RT. In the CTCA results, 120 patients had significant stenosis. Of them, 58 (48%) and 75 (62%) patients were triaged to RT and CCA, respectively. Based on the XECG, 115 positive patients were triaged to RT and CCA (23 [20%]/41 [35%]). Among 107 patients with CCA, the sensitivity, specificity, positive predictive value, and negative predictive value for significant stenosis on CCA of CTCA were 89.9%, 74.0%, 90.6%, and 71.4%, respectively, and those of XECG were 50.0, 67.9, 78.0, and 37.3, respectively. The kappa value of CCA and CTCA was 0.62 (p < 0.001) and that of CCA and XECG was 0.145 (p = 0.113). CONCLUSIONS: In real-world practice, CCA was decided on more frequently, based on CTCA. CTCA showed better diagnostic accuracy than XECG.
Ambulatory Care Facilities ; Constriction, Pathologic ; Coronary Angiography* ; Coronary Artery Disease ; Electrocardiography* ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Triage