PURPOSE: To determine the value of bilobate anterior epidrual extension(AEE) on MRI in differential diagnosis of tuberculous spondylitis, pyogenic spondylitis and malignant tumor. MATERIALS AND METHODS: SE TI-,T2- and Gd-DTPA enhanced Tl-weighted, sagittal and axial MR images of 39 patients(40 vertebral lesions), including 16 tuberculous spondylitis, 7 pyogenic spondylitis(8 lesions, consisting of 2 separate lesion of 1 patient), and 16 malignant vertebral tumors(15 metastases,1 lymphoma) with an AEE were reviewed. The frequency of bilobate AEE shown as double-convexity in the anterior epidural space on axial scans was evaluated in the above vertebral diseases. RESULTS: The bilobate AEE on the axial scans was seen in 12 out of the 16 tuberculous spondytitis(75%) and 1 out of 8 pyogenic spondylitis(13%), and 10 out of the 16 malignant tumor including 15 metastasis and 1 lymphoma(63%). CONCLUSION: The bilobate' ^EE of vertebral lesions is suggestive of tuberculous spondylitis or malignant tumor rather than pyogenic spondylitis. This pattern seems to be related with the preservation of the structures, including midline septurn, F~LL(Posterior longitudinal ligament), lateral membrane and fibrous membrane, limiting and surrounding the extension of the tuberculous spondylitis and malignant tumor, and with the early penetration or disruption of PLL, midline septurn, lateral & fibrous membranes in the pyogenic spondylitis.
Diagnosis, Differential ; Epidural Space ; Gadolinium DTPA ; Magnetic Resonance Imaging* ; Membranes ; Neoplasm Metastasis ; Spondylitis

Percutaneous coronary angioplasty is well established therapeutic modality in the management of coronary artery disease. However, the high restenosis rate of 30 to 50% limits its usefulness. The principal mechanism of restenosis, ntimalhyperplasia, is the proliferative response of vessel wall to injury, which consists largely of smooth muscle cells. A large body of animal investigations and a limited number of clinical studies have established the ability of ionizing radiation to reduce neointimal proliferation and restenosis rate significantly. Human studies have been reported that intravascular radiation after first restenosis inhibits a second restenosis. Encouraged by these reports, we are also conducting a double blind, placebo-controlled, randomized trial to evaluate this new therapeutic modality in patients with coronary artery stenosis. The objective of our trial is to determine the safety and efficacy of catheter-based solutional beta emitting radioisotope system in preventing restenosis after angioplasty. This review describes the vascular brachytherapy systems and isotopes that have been utilized in the initial clinical trials performed in this area of post PTCA coronary restenosis. The results of many worldwide ongoing clinical trials will determine whether this new technology will change the future practice of vascular intervention.
Angioplasty* ; Animals ; Brachytherapy ; Coronary Artery Disease ; Coronary Restenosis ; Coronary Stenosis ; Humans ; Isotopes ; Myocytes, Smooth Muscle ; Radiation, Ionizing

The present study was designed to evaluate the efficiency of total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio, CK-MB and newly developed troponin T in acute myocardial infarction. The level of troponin T was 0.010.02 pg/L in 34 healthy person, but the peak vaule of acute myocardial infarction ranged in 4.7-24.2 pg/L. Total lactate dehydrogenase was peaked in 1 to 3 days after chest pain and then progressively decreased, but LD1/LD2 ratio was persistently higher than 1.0 for 10 days in most patients. Total creatine kinase and CK-MB were peaked in 1-2 days, and normalized in 3-4 days, so they, were useful in early diagnosis of acute myocardial infarction, but not for the late stages of acute myocardiz l infarction. Troponin T is early elevated and persistently high level for more than 10 days. Comparing with total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio and CK-MB, troponin-T test improves the efficiency of serodiagnostic method for the detection of ischemic myocardial damage.
Chest Pain ; Creatine Kinase ; Early Diagnosis ; Humans ; Infarction ; L-Lactate Dehydrogenase* ; Lactic Acid* ; Myocardial Infarction* ; Phosphotransferases* ; Troponin T* ; Troponin*

Major pathogenic Gramnegative organisms such as P. aeruginosa, Serratia species, E. coli, Enterobacter species which are isolated from the specimens in large medical centers are greatly resistant to the commonly used antibiotics. Gramnegative bacilli, which had been isolated in Yeungnam Uni rersity Hospital during the period from December 1992 to April 1993 and turned out to be resistant to the primary antibiotics susceptibility test for chloramphenicoi, ampicillin, eephaiothin,- geniamicitt, tetracyclin, amikin and tobramycin, were subjected to the secondary antibiotics susceptibility test for aztreonam, ceftazidime, ciprofloxacine, cefotaxime, cefamandole, piperacillin, ticarcillin and sulfamethoxazole trimethopime. Out of 315 tested organisms, 167 organisms (53%) were resistant to all secondary antibiotics in vitro. Antimicrobial activity of ceftazidime (37.1%), aztreonam (11. %), ciprofloxacine (7.9%) against Gram negative bacilli were slightly more active than other antibiotics tested, while cefamandole was not active to all the Gramnegative bacilli tested. According to the specimens, E. coli was the most frequently resistant organisms to the primary antibiotics from urine, A. baumanii, from respiratory system and wounds, and P. aeruginosa from various specimens. In summary, Gram negative bacilli resistant to the primarily applied antibiotics also were resistant to the secondary antibiotics. Rearrangement of the antibiotics disks for the antibiotic susceptibility test should be considered.
Amikacin ; Ampicillin ; Anti-Bacterial Agents* ; Aztreonam ; Cefamandole ; Cefotaxime ; Ceftazidime ; Ciprofloxacin ; Enterobacter ; Piperacillin ; Respiratory System ; Serratia ; Sulfamethoxazole ; Ticarcillin ; Tobramycin ; Wounds and Injuries

The ectomycorrhizal roots were collected from the soils around the bases of basidiocarps of the four edible mushrooms in the stands of Pinus densiflora or Querus acutissima communities (Mt. Wol-Ak in Eastern Chung-Puk): The basidiocarps of Tricholoma matsutake (TM), Sarcodon asparatus (SA), S. imbricatum (SI), and Polyozellus multiplex (PM) are usually collected. The ectomycorrhizal roots of TM, PM and SI were related to the roots of P. densiflora, but the other to the roots of Q. acutissima in Korea. Particularly, the basidiocarps of PM were collected in the mixed stand of both P. densiflora and Q. acutissima. The morphologies of the ectomycorrhizal roots were observed to be the yellowish brown coral (dichromatous) or pyramid types in the roots of the pine, but dark brown un-branched sticks (roots) in the ends of ectomycorrhizal roots of Querus plants. The un-branched roots were covered with the dark mycelia (rhizomorph) around them. Therefore, the ectomyorrhizal roots of PM were observed to have two kinds of types; The single blackish un-branched roots were observed to be attached to the yellowish coral type roots. The bundles of TM mycelia were filled with cortical cells (in the roots of P. densiflora), but the mycelia of the other fungi (Aphylloporales) were massed between the cortical cells of P. densiflora or Q. acutissima. Their anatomical and gross features were considered to be simailar but very important in the ectomycorrhizal roots for these edible mushrooms.
Agaricales ; Anthozoa ; Fruiting Bodies, Fungal* ; Fungi ; Korea ; Mycorrhizae ; Pinus ; Soil ; Tricholoma

Isolated dorsal dislocation of the trapezoid is an unusual injury. In 1990 Ostroski found only 15 cases of dorsal dislocation of the trapezoid in the world literature. The trapezoid is a wedge-shaped bone with the larger dorsal and smaller volar surface area, and stabilized by strong palmar ligaments. Therefore the dislocation of the trapezoid is produced hy a violent force against the dorsum of the hand on a rigid object and often associated with other injuries of the hand. The diagnosis is often missed or delayed perhaps secondary to the difficulty in interpreting the X-ray if you have not kept in mind. Several therapeutic modalities are performed from the collected experience of the authors reporting this injury. A rare example of an isolated dorsal dislocation of the trapezoid bone is described.
Diagnosis ; Dislocations* ; Hand ; Ligaments ; Trapezoid Bone

Reconstruction of soft tissue defect with exposure of the tendons and bone in the lower third of the leg and the heel represents a challenge to plastic surgeons. The sural artery flap is a fasciocutaneous flap supplied by the sural artery that accompanies the sural nerve and connects with a septocutaneous perforator of the peroneal artery via a suprafascial network of vessels. For the coverage of soft tissue defects, we operated on 10 patients using a distally-based sural artery flap. The sites of the soft tissue defect were the lower third of the leg in 7 cases and the heel in 3 cases. The size of flap varied from 3.5x4cm to 12x18cm. Nine of 10 flaps survived completely. One flap in which the sural nerve was preserved showed partial necrosis but healed spontaneously. Two flaps showed slightly venous congestion which disappeared after a few days. The advantages of the sural flap are a reliable blood supply, easy and quick elevation of the flap, preservation of the major artery and minimal donor site morbidity. The disadvantage of the flap is hypoesthesia at the lateral part of the foot. In conclusion, the distally-based sural artery flap can be used safely for soft tissues coverage in the lower third of the leg and the heel.
Arteries* ; Foot ; Heel ; Humans ; Hyperemia ; Hypesthesia ; Leg ; Necrosis ; Sural Nerve ; Tendons ; Tissue Donors

Bone graft is an important procedure in craniomaxillofacial reconstruction and the success of reconstruction depends on the survival of the grafted bone. In this study, the survival of the membranous inlay bone graft on the mandibles of dogs was investigated with bone scan and histologic examination. The inlay bone graft, 1x2cm critical-sized bone, was completely separated from the lower border of the mandible of dogs and then refixed to the original site. Bone scan and histologic examination were done at 1,2,3 and 4 weeks postoperatively. The bone scan after 1 week showed radioisotope uptake on the margin of the grafted bone and the isotope count was 21% compared to the uptake of the normal bone. After 2 weeks, the radioisotope uptake in the grafted bone increased to 52% of normal bone uptake. After 3 and 4 weeks, the degree of isotope uptake was 111% and 124% respectively. Histological findings after 1 week showed the absence of osteoblastic activity and 6 viable blood vessels in one 200X magnified field, which was 25% compared to the vessels of the normal bone. After 2 weeks, osteoblastic activities were noted and the number of viable blood vessels totalled 15, which was 63% of the vessels of the normal bone. After 3 weeks, osteoblastic activities increased and the number of viable blood vessels totalled 21, which was 88% of the vessels of the normal bone. After 4 weeks, there were markedly increased osteoblastic activities with a total number of 23 vessels, which was 96% of the normal bone. In summary, the revascularization of the membranous inlay bone graft began from the first week after bone graft, and then it gradually increased. After 3 weeks, the revascularization had returned to a nearly normal value compared with the value of the near-by normal mandibular bone.
Animals ; Blood Vessels ; Dogs ; Inlays* ; Mandible* ; Osteoblasts ; Reference Values ; Transplants*

In the method for lithium (Li) analysis, flame emission photometry and atomic absorption spectrophotometry (AAS) have been used most frequently. In addition, lithium can be analyzed by ion-selective electrode (ISE) or fluorscence polarization immunoassay. We evaluated the comparison between AAS method based on the principle of absorption of light at 670.8 nm by Li and ISE method based on the principle of voliage difference generated by Li in contact with lithium ionophore. We compared with those obtained by AAS (AA/AE Spectrophotometer 551, Instrumentation Laboratory Co.) and ISE (SYNCHRON EL-ISE, Beckman Co.) in the serum and urine of 6 pati,,:nts- and evaluated time-related changes of serum lithium concentration after dosing in both methods. The results are summarized-as follows: 1. In within-run precision study for lithium concentration, coefficient variations (CVs, %) ranged from 1.34 to 2.17 for AAS and from 0.34 to 0.85 for ISE method. In between-run precision study for lithium concentration, CVs ranged from 1.23 to 1.72 for AAS and from 0.61 to 1.38 for ISE method. 2. The correlation study between AAS and ISE method resulted in Y= 0.946X+ 0.137 (N = 32, r= 0. 933, X= AAS, Y= ISE) for serum lithium and Y= 1. 092X+ 0. 977 (N= 28, r= 0.943, X= AAS, Y= ISE) for urine lithium. 3. Time-related changes of serum lithium concentration in both AAS and ISE method resulted in peak serum levels about 2 hours after dosing and then rapidly decreased after the peak serum level and finally arrived at nearly initial levels about 9 hours after dosing. 4. The reference range of serum lithium was found as undetectable level for both AAS and ISE method and the reference range of urine lithium to the urine creatinine was 0 0.00014 mmol/mg(mean 0.00002 mmol/mg) for AAS method.
Absorption ; Creatinine ; Immunoassay ; Ion-Selective Electrodes ; Lithium* ; Photometry ; Reference Values ; Spectrophotometry, Atomic ; Statistics as Topic

The purpose of this study was to investigate the possibility of distraction osteogenesis in membranous onlay bone graft on the mandible and to clarify the histology of bone repair during distraction osteogenesis in the membranous onlay bone in a dog model. Four dogs, 5 months of age at the beginning of the experiment, were used for this study. The zygomatic arch was exposed in the subperiosteal plane and the full-thickness zygomatic arch was harvested to 3 centimeters in length. The lateral surface of the mandibular body was exposed in the subperiosteal plane and the membranous onlay bone graft was performed with firm contact using screws. The osteotomy on the membranous onlay bone graft and underlying mandibular body was carried down week 1 in dog 1, week 2 in dog 2, week 3 in dog 3, and week 4 in dog 4 after membranous onlay bone graft. The external distraction device was applied to the mandibular body. Mandibular distraction was started 7 days after the operation at a rate of 1mm per day for a total of 10 mm distraction over 10 days. After completion of distraction, the distraction device was left in place for 6 weeks bony consolidation of the distracted area. Radiographs were carried out at 2 weeks, 4 weeks and 6 weeks after distraction. New bone between the native underlying mandibular segments was generated in the distracted zone in all dogs. The new bone between the native underlying mandibular segments was generated in the distracted zone in all dogs. The new bone between segments of membranous onlay bone graft was not generated in dog 1, but it was generated in dogs 2, 3 and 4. However, in dog 2 and 3, the new bone between segments of the distracted membranous onlay bone graft presented less firmness with fibrous tissue than that of the native underlying mandibular segment. Histologically, the distracted gap between segments of the membranous onlay bone graft was composed of much fibrous tissue in the central zone while activated osteoblastic cells formed new bone in the margins of the distracted gap in dogs 2 and 3. In dog 4, there were abundant osteoblastic activities in the distracted gap and the new bone appeared as nearly-normal cortical bone. In conclusion, these findings suggested that membranous onlay bone graft had an osteogenic capacity and that distraction osteogenesis was possible in membranous onlay bone graft.
Animals ; Dogs* ; Inlays* ; Mandible ; Osteoblasts ; Osteogenesis, Distraction* ; Osteotomy ; Transplants* ; Zygoma