Based on a study of 140 caaes of spondyloses with chronic backache, the sites and types of spurs and underlying congenital anomalies were analized. The following results were obtained. The most common sites of spurs were expected to be between L5 & S1 but contrary to the expectation, these were found most commonly between L4 & L5 and between L3 & L4. The reason for the preponderance of the spurs between L4 & L5 and L3 & L4 were not immediately available. All spurs represent claw type except in 4 cases which resemble traction spurs of McNab but without segamental instability. There were 39 cases of congenital anomalies. 28 of them were of tropism. Thus we conclude that the most common congenital anomaly associated with spondylosis is tropism.
Animals ; Back Pain ; Hoof and Claw ; Spine ; Spondylosis ; Traction ; Tropism

BACKGROUND AND OBJECTIVES: As previously reported, unstable angina is usually related to characteristic coronary artery lesion's morphology analyzed by coronary angiogram. This takes the form of an eccentrically placed convex stenosis with a narrow neck due to one or more overhanging edges or irregular, scalloped borders, or both. Although most studies were done for lesions with high degree stenosis(>50%), recent studies emphasized the role of vulnerability of plaque in acute coronary syndrome and even mild degree stenotic lesions may progress rapidly to evoke acute coronary syndrome. Therefore in this study, we analyzed the morphological characteristics of coronary artery lesions with mild degree stenosis as well as severe stenosis. MATERIALS AND METHODS: We conducted a retrospective study of 96 patients with angina pectoris (42 of stable patients and 54 of unstable patients) who underwent coronary angiography. Each lesions with 25% or greater diameter stenosis were categorized into simple and complex lesion(convex intraluminal obstruction with a narrow neck or irregular borders, diffuse irregularities, ulceration, thrombus). Calcification of coronary artery, extents of lesions were analyzed and stenosis grade and location were categorized by AHA classification. RESULTS: There were no significant differences between the stable angina and unstable angina in risk factors and vessel involvement, numbers of lesions, calcification and total obstruction. In morphologic analysis, complex lesions were more frequent in unstable angina than stable angina (49% vs 33%, p<0.05). The mean of percent diameter stenosis was not signigicantly different between two groups, but severe stenotic lesions with 90% or more stenosis were more frequent in unstable angina (34% vs 22%, p<0.05). Locations of involved vessels were similar between the angina groups. Complex lesions were distributed more frequent in RCA and simple lesions were more in LAD and LCX (p<0.05). CONCLUSIONS: The lesions with both complex morphology and severe degree stenosis are closely implicated in unstable angina.
Acute Coronary Syndrome ; Angina Pectoris ; Angina, Stable ; Angina, Unstable* ; Classification ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels* ; Humans ; Neck ; Pectinidae ; Retrospective Studies ; Risk Factors ; Ulcer

Vasectomy is one of the accepted simple procedure as a contraceptive method. However, there have been no reliable reports on the rate of sperm disappearance from the ejaculate following vasectomy. Rieser found the 14 of the 21 patients with follow-up semen studies required an average of 8 weeks to be azoospermic, and Freund and Davis described that sperm free semen was noted after 6 to 10 ejaculations following bilateral vasectomy. In order to determine the exact end point in terms of the frequency of ejaculations after vasectomy to be sperm free in the ejaculate, a clinical observation was made on the 50 vasectomized patients for the last 3 years. Bilateral vasectomy was performed through a midline incision in the scrotal raphe under local anesthesia (2% procaine). Each semen specimen was collected by coitus using condom. The results obtained were as follows; l) The fourth decade was the most prevalent age group to have had vasectomy(44 cases). The mean number of children was 3. 3 (male 2.2, female 1.1). The 25 patients (38.5%) had two sons and a daughter, and there were no patients without a son. 2) The postoperative first specimen was obtained in all of the 50 cases, the second in 35, the third in 27. the fourth in 20, the fifth in 15, the sixth in 10, the seventh in 3, and the eighth in only one. 3) The meat volume of the semen was not varied with the frequency of ejaculations. The average number of the spermatozoa on the first ejaculate following vasectomy was 43 millions, 23 millions on the second, 16 millions on the third, and 2 millions on the fourth. 4) On the rate of sperm free in the ejaculates in terms of the number of the ejaculations, 7.4 per cent became azoospermic on the third, 20 per cent on the fourth, 33 per cent on the fifth, 60 per cent on the sixth, and 67 per cent on the seventh ejaculation.
Anesthesia, Local ; Child ; Coitus ; Condoms ; Contraception ; Ejaculation ; Female ; Follow-Up Studies ; Humans ; Male ; Meat ; Nuclear Family ; Semen ; Spermatozoa* ; Vasectomy*

No abstract available.
Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

PURPOSE: Most hepatic metastases are hypovascular, and CT scanning during peak hepatic enhancement is thusimportant for the detection of hepatic lesions. The purpose of this study was to determine whether images obtainedby bolus tracking show greater hepatic enhancement. MATERIALS AND METHODS: We prospectively evaluated 101 patientswho underwent helical CT of the abdomen, using either a fixed 60-sec delay(n=50) or bolus tracking (n=51). For thelatter, we used a hepatic enhancement threshold of 50HU over baseline on monitor phase to determine a 6-sec delaybetween the monitor and diagnostic scanning phase. For all patients, three region-of-interest measurements wererecorded, one at each of the upper, middle, and lower levels of the liver; the measurements were averaged andsubtracted from the baseline density that measured CT values in three different hepatic segments at the mid-levelof the liver. We compared mean enhancement above the baseline of the liver between fixed 60-sec delay and bolustracking. RESULTS: A statistically significant difference in the enhancement level of the liver (upper, p=.001;middle, p=.001; lower, p=.003) was noted between fixed 60-sec delay (upper, 65.3+/-16HU; middle, 67.4+/-16.5HU;lower, 68.5(19.4HU) and bolus tracking (upper, 75.2+/-15.5HU; middle, 74.4+/-13.7HU;lower, 75.6+/-13.6HU). With fixeddelay, 86% of patients reached 50HU of enhancement, but with bolus tracking, 98% reached this level. For onenhancement value of 60HU, the corresponding figures were 64% and 86%. Mean delay for the transition betweenmonitoring scans and diagnostic scan initiation was 63.8+/-7.9(range, 48-79)secs. For two patients in whom theenhancement curve did not reach threshold (50HU), the default time was 70 sec; one subsequently failed to reachthis same threshold. CONCLUSION: Using the same amounts of contrast material, bolus tracking provides a greaterlevel of hepatic enhancement than a fixed 60-ses delay, and is thus helpful for the detection of hypovascularmasses such as metastatic lesions.
Abdomen ; Humans ; Liver ; Neoplasm Metastasis ; Prospective Studies ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

The lymphoepithelial cyst (LEC) rarely occurs in the thyroid gland. The LEC has been thought to be related to developmental rest, namely solid cell nest, which is derived from ultimobranchial body. We report a case of lymphoepithial cyst in a 34- year-old woman clinically diagnosed with Hashimoto's thyroiditis. The cyst was located in mid to lower portion of the left lobe. It was a single unilocular cyst, which for the most part was lined with squamous epithelium, and at certain foci with ciliated columnar epithelium. The cyst wall showed a dense lymphocytic infiltration, numerous lymphoid follicles with germinal centers and admixed thyroid follicles. This morphology is similar to the branchial cleft cyst, with the exception of the thyroid follicles in the cyst wall. Near the cyst were several solid epidermoid cell nests. Immunohistochemical stain of this cyst-lining epithelium and solid cell nests showed CEA positivity. In view of the similarity in histomorphology and CEA positivity to branchial cleft cyst of the lateral neck, the LEC of the thyroid could also have been of branchial origin. However, the admixed thyroid follicles in the cyst wall suggests that the LEC of the thyroid gland might have derived from another branchial cleft as a ultimobranchial body, because it has the potential for thyroid follicular differentiation.
Branchial Region* ; Branchioma ; Epithelium ; Female ; Germinal Center ; Humans ; Neck ; Thyroid Gland* ; Thyroiditis ; Ultimobranchial Body

No abstract available.
Dislocations* ; Elbow*

The cornell medical index is self-administered instrument that collects a large body of significant medical and psychiatric data. The original C. M. I. consists of 195 questions, but authors selected 60 questions from the original C. M. I. to simplify it. The purpose of this investigation is to clarify if there are any correlations between low back pain and extraskeletal disorders. This investigation was conducted on 144 in-and out-patients who were treated at the Department of Orthopaedic Surgery,Our Lady of Mercy Hospital, Catholic Medical College from Jan. to July 1977. Among them 75 patients were male,69 patients were female, and 22 patients had decompression laminectomy and discectomy. The results of this investigation are as follows; 1. The majority of patients with low back pain are 2nd to 4th decade. (Male: 30±10.7) (Femal:36.1±10.5) 2. Average number of complaints is 19.9/60 in male, 21.8/60 in female. 3. Complaints in section F(Fatigability) and G(mental) are predominant in all cases. 4. There are no significant difference in number of complaints between the operative and non-operative case, and between each decade.
Cornell Medical Index ; Decompression ; Diskectomy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Male ; Outpatients

Macrodactyly, a disproportionate enlargement of one or more fingers or toes, is generally regarded as a rare congenital malformation. The skin, finger nail, subcutaneous fat tissue, vessels, nerves, tendons and phalanges are all enlarged. and the basic lesion appears to be the accumulation of fibrofatty tissue. The authors have recently experienced a case of pedal macrodactyly occured in the 4th and 5th toes of right foot, which was treated with ablation of the involved toes at the level of 4th and 5th metatarsal shaft. Postoperative course was uneventful. This paper is to present a case of pedal macrodactyly in 18 years old boy, experienced recently at our department and review the references relevant to macrodactyly.
Fingers ; Foot ; Humans ; Male ; Metatarsal Bones ; Skin ; Subcutaneous Fat ; Tendons ; Toes

Neuropathic joint, which was originally described by Charcot in 1868, has been reported by many authors since that time. Charcot's joint is a feature of various conditions, such as syringmyelia, diabetes mellitus, congenital indifference to pain and leprosy, but it is mostly depended upon tertiary syphilis. In the past few decades. the occurance of this arthropathy however, seemed to decrease with the discovery of antibiotics and efficient control of syphilis in many countries. But syphilis has become popularized in recent years because of the rapid development of transportation and an offence against public deoency throughout the world. Authors experienced 3 cases of Charcots joint in Our Lady of Mercy Hospital, Catholic Medical College, two of them were tabetic, one diabetic in origin, which affected four knee joints, two ankle joints and one tarsometatarsal joint. The patients were treated conservatively without surgical intervention on the affected joints. One was lost for foIlow up after being discharged from the hospital against medical advice and the res two cases have been on follow up. This paper is auned to illustrate the importance of clinical aspects of neuropathic joints which seemed to be in the tendency of increase in recent years. in spite of development of efficient managements of the causative diseases.
Ankle Joint ; Anti-Bacterial Agents ; Arthropathy, Neurogenic ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Leprosy ; Pain Insensitivity, Congenital ; Syphilis ; Transportation