No abstract available.

There have been many debates concerning operative decompression of treatment of thoracolumbar burst fractures with retropulsed bone fragment. From March 1988 to February 1992, authors treated thirty-three thoracolumbar burst fractures by using transpedicular screw fixation and posterior fusion via the posterior approach. We attempted to reduce retropulsed fragment by ligamentotaxis alone and not to do posterolateral nor anterior decompression. After the reduction of fractured spine by posterior instrumentation, we tried to determine the efficiency of reduction of the retropulsed fragment by ligamentaxis along. As a method, we compared the change of anteroposterior, transverse to diameter and area of spinal canal of fractured spine between preoperative and the postoperative situation. The results were as follows; 1. The mean anteroposterior and transverse diameter of the spinal canal on computed tomogram film was 10.1mm & 21.8mm preoperatively & 12.4mm & 23.2mm postoperatively, showing an increase. 2. The area of spinal canal of involved spine on CT film was evaluated preoperatively & post-operatively, the mean spinal canal invasion rate decreased from 36.3% preoperatively to 14.3% postoperatively. 3. The degree of reduction of middle height on plain x-ray and reduction of spinal canal invasion on computed tomogram were statistically correlated(p < 0.01). 4. There was no correlation between the degree of canal narrowing and degree of neurologic impairment. also, there was no correlation between the reduction of retropulsed fragments and subsequent neurologic impairment. 5. There was the relatively satisfactory enlargement of the spinal canal on computed tomogram at the follow-up So we suggest that it is possible to get enough decompression through reduction of retropulsed fragment by ligamen to taxis alone without posterolateral decompression.
Decompression ; Follow-Up Studies ; Methods ; Spinal Canal ; Spine

BACKGROUND: Granuloma annulare is a chronic skin disease of unknown origin, that can present itself with diverse clinical and histopathologic findings. But no clinicopathological studies has been reported yet in Korea. OBJECTIVE: Our purpose was to investigate the clinicopathological findings of each type of granuloma annulare. METHODS: We observed twenty two cases of granuloma annulare and examined their clinical manifestations and histopathological findings. RESULTS: The incidence showed a bimodal peak between 3 to 4 years and 49 to 51 years in age and females were affected twice as much as males. The lesions are commonly located on the distal portion of the extremities. In histopathologic findings, perforating type was observed in 13.6% and subcutaneous type in 18.2%. In collagen alteration, fragmentation and hyalinization were observed in 72.7% and 81.8% respectively. Most infiltrated cells were epithelioid cells. In vascular changes, endothelial swelling and occlusion of vessels were common findings and vasculitis was shown in 36.4%. CONCLUSION: There were not epidemiologic differences from the reported studies in western patients. But the clinical manifestation and the histopathologic findings were so varied that differential diagnosis is important in diagnosis of granuloma annulare. Immunological and immunohistochemical studies may be necessary for differential diagnosis and elucidating pathogenesis of granuloma annulare.
Collagen ; Diagnosis ; Diagnosis, Differential ; Epithelioid Cells ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Hyalin ; Incidence ; Korea ; Male ; Skin Diseases ; Vasculitis

BACKGROUND: Chest pain is a problem that primary care physicians commonly face and often unnecessary work-up is done because of its clinical importance of cardiac origin. There are various studies on the causative disorders of chest pain, but studies on young adult males are relatively few. Therefore, we conducted this study on the cause of chest pain among young policemen. METHODS: Diagnosis and classification of chest pain were made among 106 policemen who visited the outpatient department of family medicine at the National Police Hospital from March 1, 2002 to June 30, 2002. RESULTS: The causes of chest pain were musculoskeletal (55%), psychogenic (17%), others (15%), gastrointestinal (7%) and respiratory (6%), but none of them were cardiovascular origin. The nature of chest pain were stabbing (41%), sharp (22%), pressing (18%), squeezing (16%) and substernal discomfort (3%). The duration of chest pain were below 10 minutes (37%), 10 minutes to 1 hour (15%), several hours (20%) and several days (28%). The location of chest pain were left chest (61%), right chest (18%), precordial (7%), epigastric (6%), substernal (4%) and others (4%). The frequencies of chest pain were more than once a day (23%), once a week (26%), once a month (11%), once more than 1 month interval (17%) and first attack (23%). The aggravating factors of chest pain were physical strain (25%), coughing (22%), psychologic stress (16%), smoking (10%), weather change (8%), drinking (7%), resting (5%), and overeating (6%). CONCLUSION: Our study showed that unnecessary tests should be avoided and adequate treatment matched to their causes through exact and detailed history taking should be done, because the causes of chest pain among young policemen are mostly non-cardiovascular origin.
Chest Pain* ; Classification ; Cough ; Diagnosis ; Drinking ; Humans ; Hyperphagia ; Male ; Musculoskeletal Diseases ; Outpatients ; Physicians, Primary Care ; Police ; Smoke ; Smoking ; Stress, Psychological ; Thorax* ; Weather ; Young Adult

Lovastatin is a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, which catalyzes the conversion of hydroxymethylglutaryl-coenzyme A to mevalonate, anearly and rate-limiting step in the synthesis of cholesterol. We studied the therapeutic effect and safety of lovastatin in 18 patients with nonfamilial primary hypercholesterolemia. Patients received 20mg/day lovastatin therapy as a single evening dose. If the total cholesterol level exceeded 200mg/dl after 2weeks of lovastatin therapy, the dosage of lovastatin was doubled. Mean percent total cholesterol level reductions from baseline were 26.4% and 31.9% after 4, and 8 weeks of lovastatin therapy respectively. Mean percent HDL-cholesterol level increase from baseline were 12% and 13% after 4, and 8 weeks of lovastatin therapy respectively. Adverse effects attributable to lovastatin were mild and temporary and no patient was withdrawn from therapy. We concluded that lovastatin was a well tolerated and effective agent for the treatment of nonfamilial primary hypercholesterolemia. Further studies are needed to establish the long-term safety and effectiveness of this drug.
Cholesterol ; Coenzyme A ; Humans ; Hypercholesterolemia* ; Lovastatin ; Mevalonic Acid ; Oxidoreductases

To evaluate the nephrotoxicity of cisplatin, serum levels of sodium, potassium, chloride, calcium, phosphorous, magnesium, BUN, creatinine and creatinine clearance were measured before and after administration of cisplatin in 18 cases of patients with malignant neoplasm. The results were as follows: 1) Serum calcium, magnesium, potassium and BUN levels were changed after cisplatin administration, but those changes were not statistically significant. 2) The mean value of creatinine clearance was not decreased significantly after treatment with cisplatin. 3) Acute renal failure was developed in one case, and four cases of hypocalcemia, hypomagnesemia were also detected after administration of cisplatin.
Acute Kidney Injury ; Calcium ; Calcium Chloride ; Cisplatin* ; Creatinine ; Humans ; Hypocalcemia ; Magnesium ; Potassium ; Sodium

Intertrochanteric fractures are common in older age group. Recently better implant design and surgical technique have improved clinical results. But still many patients suffer from high morbidity and mortality, because of accompanying osteoporosis and various senile diseases. From January 1991 to June 1994, we treated 54 patients older than 70 years with intertrochanteric fractures of femur. Among them, 23 patients were followed up at our hospital and the other patients were informed from police station. Lost follow up was ten patients and final follow up were 44 patients. Mortality was analyzed for the detection of causative factors, such as age, sex, associated medical problems. type of fracture, degree of osteoporosis, type of operation, internal between injury and operation and duration of admission. The results were as follows; 1. 26 patients survived and 18 patients died(Mortality rate :40.9%) 2. 10 patients died within 1 year(Mortality rate :22.7%) 3. Mortality was related to associated medical problems, interval between in jury and operation and type of fracture, which were statistically significant(P < 0.05).
Aged ; Femur ; Follow-Up Studies ; Hip Fractures ; Humans ; Mortality ; Osteoporosis ; Police

OBJECTIVE: The Id family of helix-loop-helix proteins are thought to affect the balance between cell growth and differentiation by negatively regulating the function of basic-helix-loop-helix (bHLH) transcriptional factors. The aim of this study was to investigate the expression pattern of Ids (Id-1,-2,-3, and -4) in preimplantation mouse embryos at mRNA and protein levels. METHODS: Oocytes and preimplantation embryos were collected from reproductive organs of female ICR mice following superovulation. RT-PCR was performed to investigate the mRNA expression patterns of Id genes and their protein were localized by immunofluorescence analysis. RESULTS: Id-1 and Id-3 mRNAs were strongly expressed at the germinal vesicle (GV) oocyte and the blastocyst stages. Id-2 mRNA was expressed throughout preimplantation embryo development, but Id-4 was not expressed. Immunofluorescence showed that Id-1 and Id-2 were predominantly localized in cytoplasmic region, but the immunofluorescence signal of Id-3 was weak throughout preimplantation embryo development. CONCLUSION: These data show for the first time that Ids are expressed in preimplantation mouse embryos and suggest that Ids may play an important role in early preimplantation embryo development and uterine physiological changes.
Animals ; Blastocyst ; Cytoplasm ; Embryonic Development ; Embryonic Structures* ; Female ; Fluorescent Antibody Technique ; Humans ; Mice* ; Mice, Inbred ICR ; Oocytes ; Pregnancy ; RNA, Messenger ; Superovulation

OBJECTIVE: The purpose of this study was to evaluate the prognostic value of sleep apnea syndrome in stroke patients by polysomnography. METHOD: Fifteen patients with ischemic stroke were studied with polysomnography. Medical history, sleep history, location of stroke, and severity of neurological deficit were recorded. Patients were observed by physician for evidence of snoring and excessive daytime sleepiness. Functional abilities were measured with the use of the Modified Barthel Index (MBI). To evaluate the autonomic nervous system, heart rate variability (HRV) study was done. RESULTS: Mean SaO2 during polysomnography was 88.2%, and mean recording time was 321 minutes. Apnea types were obstructive, mixed, and central. Respiratory Distress Index (RDI) correlated with functional outcome and mean SaO2. HRV study showed no significant changes under the orthostatic stress in apnea patients. CONCLUSION: We concluded that the sleep apnea syndrome could be a prognostic factor in rehabilitation outcome of stroke.
Apnea ; Autonomic Nervous System ; Heart Rate ; Humans ; Polysomnography ; Prognosis* ; Sleep Apnea Syndromes* ; Snoring ; Stroke* ; Treatment Outcome

Bronchiolitis obliterans organizing pneumonia (BOOP) preceding polymyositis is rare. In this report, a 40-year-old patient with fever, chillness, generalized myalgia and progressive exertional dyspnea, had bilateral interstitial infiltrates on chest radiograph. High-Resolution CT showed subpleural and peribronchial distribution of air-space consolidation. Open lung biopsy was consistent with BOOP. Prednisolone therapy led to improvement, but during tapering of prednisolone for 3 months to 30 mg, he complained of weakness of both lower legs. One month later, prednisolone was tapered to 15 mg a day, fever, chillness and generalized myalgia were recurred. He complained of weakness of both arms. The creatine kinase (CK) with MM isoenzyme, lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) were elevated. Anti-Jo1 antibody was positive. Vastus lateralis muscle biopsy was compatible wit h polymyositis. After injection of methylprednisolone for 1 week, the patient became afebrile, the dyspnea resolved, the pulmonary infiltrates decreased, and the muscle strength improved. The serum CK, LDH, AST levels declined significantly. Patients with idiopathic BOOP should have follow-up for the possible development of connective tissue disorders including polymyositis.
Adult ; Arm ; Aspartate Aminotransferases ; Biopsy ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Connective Tissue ; Creatine Kinase ; Cryptogenic Organizing Pneumonia* ; Dyspnea ; Fever ; Follow-Up Studies ; Humans ; L-Lactate Dehydrogenase ; Leg ; Lung ; Methylprednisolone ; Muscle Strength ; Myalgia ; Polymyositis* ; Prednisolone ; Quadriceps Muscle ; Radiography, Thoracic