The purposes of this clinical study are to observe the clinical findings of the high lumbar disc herniation, to analyze the of the posterior approach and to define the surgical indications of the high lumbar disc herniation. We analyzed the 13 cases which were treated at the Deparment of the Orthopaedic Surgery, National Medical Center from March 1988 to December 1992(Mean follow up rate : 17. 2 months). 1. We operated 10 cases by posterior approach and 1 case by anterior approach due to marked degenerative osteophyte. 2. We evaluated the post-operative results by modified Macnab criteria, the 2 cases showed no symptomatic improvement because of respectively associated high lumbar osteophyte and lower lumbar spinal stenosis. 3. On conclusion, suspicion is important in cases of incompatible clinical symptoms and signs of the intervertebral disc herniation. MRI is the most recommended diagnostic tool, because it can provide the high lumbar levels with saggital section image and differentiate herniation from degenerative osteophyte. As for the surgical indications of high lumbar disc herniations, we suggest marked dural compression by disc or sequestered disc materials in MRI, definite neurological complications such as ankle clonus, increased DTR, weakness of quadriceps and hip flexor muscle and severe radiating pain on the anterior thigh. We recommended the posterior approach for the surgical intervention of high lumbar disc herniation except cases marked degenerative osteophytes.
Ankle ; Clinical Study ; Follow-Up Studies ; Hip ; Intervertebral Disc ; Magnetic Resonance Imaging ; Osteophyte ; Spinal Stenosis ; Thigh

The transpedicular screw fixation is known to be capable of providing more secure correctional, force and rigid fixation to the spine. But it is often accompanied by various complications, including stress shield effects, loosening in osteoporotic spine, pseudoarthrosis, hardware problems and long-term change in motion behaviors at the adjacent motion segment and etc. The purpose of this study is to compare the flexible and rigid rods system in terms of complications and problems for various degenerative lumbar diseases. From September 1991 to November 1994, 41 patients were operated with the flexible rods system (group A) and 39 patients with the rigid rods system (group B). They were followed up for more than 4 years. The flexible rods system was composed of 41 cases of Wiltse system and the rigid rods system was composed of 29 cases of Diapason, 8 cases of TSRH and 2 cases of CD instrument. The resuits of the study were as follows: 1. By standard Cobb lateral measurement, 7 cases in group A and 10 cases in group B showed significant loss of sagittal angle (>4), post-operatively. 2. Hardware failure was noted in 7 cases in group A and 10 cases in group B. In group A, rod bending was seen in 4 cases, rod breakage in 2 and screw loosening in one. In group B, screw loosening was observed in 5 and screw-rod locking mechanism failure in 5 cases. 3. In spondylolisthesis patients, 10 cases in group A and 14 in group B, there was no statistically significant differences between the two groups in the reduction rate immediately after surgery and loss of reduction at the last follow up. 4. Clinical results were good to excellent in 85.4% of patients in group A and 82.1% of group B. No statistically significant differences between the two groups were found, 5. No statistically significant differences between the two groups were found with respect to degenerative changes at the adjacent motion segment to the fused level and pseudoarthrosis.
Follow-Up Studies ; Humans ; Pseudarthrosis ; Spine* ; Spondylolisthesis

We report a familial case of neuronal type of Charcot-Marie-Tooth disease diagnosed by sural nerve biopsy, nerve conduction study, and electromyography.
Biopsy ; Charcot-Marie-Tooth Disease* ; Electromyography ; Neural Conduction ; Neurons* ; Sural Nerve

No Abstract Available.
Cytomegalovirus* ; Enzyme-Linked Immunosorbent Assay* ; Humans*

Fifty eight diabetic patients and 20 normal controls were studied by the method of nerve conduction studies(NCS) and sudomotor skin reponse(SSR), and the following results were obtained. 1. SSR was easily obtainable in all normal control. 2. The patients with abnormal NCV showed more numbers of abnormal SSR than the pat ients with normal NCV. 3. The patients with abnormal SSR were significantly older than the patient with normal SSR, but duration of disease was not different between the patients with normal SSR and with abnormal SSR. 4. The levels of sugar at fasting and postprandial 2 hours, and level of HbAlC in serum were not different between the patients of norrnal SSR and of abnormal SSR. 5. The incidence of autonomic symptoms, such as syncope, sweating abnormality, impotence in male, urinary disturbance, postural hypotension, was not different between the patient of norrnal SSR and of abnormal SSR. 6. Among the patients of diabets, the number of abnormal nerves in terminal latency motor and sensory nerve condcution velocity, and amplitude of compound motor and nerve action potentiaL were significantly correlated with the number of abnormal nerves in SSR. 7. The absolute values of motor terminal latency, motor and sensory conduction velocity and amplitude of compound motor and sensory action potential in the patient of abnormal SSR were significanly decreased thai. The patients with norrnal SSR. The values of terminal latency in abnormal SSR were significanly prolonged than the patients with normal SSR We concluded that the SSR test is a valuabe one for early detection of sympathetic nerve invasion in the diabetes' patients.
Action Potentials ; Asian Continental Ancestry Group ; Diabetic Neuropathies* ; Erectile Dysfunction ; Fasting ; Humans ; Hypotension, Orthostatic ; Incidence ; Male ; Neural Conduction* ; Skin* ; Sweat ; Sweating ; Syncope

No abstract available.
Spine*

BACKGROUND: Benign gastric tumors can be safely removed laparoscopically without any problem. METHODS: Fifteen patients were considered candidates for laparoscopic resection of benign gastric tumors. Criteria for patient selection included who has persistent complaints of clinical symptoms, tumor size less then 5 cm, and benign characteristics. All patients underwent preoperative gastricfibroscopy, and some pathologically questionable cases also received abdominal computerized tomography (CT) and endoscopic ultrasonography (EUS). The operative procedures were performed using a gas or gasless laparoscopic technique. Especially in posterior wall gastric tumors, we used a long aorta clamp with the gasless technique instead of opening the anterior gastric wall. After resection of the tumor, we used hand sewing or a stapling device for anastomosis. The results of the operations and the clinical course were analyzed retrospectivelly. RESULTS: Final pathologic diagnoses included a heterotropic pancreas, a leiomyoma, a neurofibroma, a neurilemmoma and a gastrointestinal stromal tumor (GIST). Only one case was converted to a laparotomy. There was one instance of postoperative suture line bleeding. The mean operative time was 174 min, and the mean hospital stay was 6.3 days. One pathologically confirmed GIST case had malignant characteristics. CONCLUSION: Laparoscopic management of benign gastric tumors can be perform safely with excellent clinical course.
Aorta ; Diagnosis ; Endosonography ; Gastrointestinal Stromal Tumors ; Hand ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Leiomyoma ; Length of Stay ; Neurilemmoma ; Neurofibroma ; Operative Time ; Pancreas ; Patient Selection ; Surgical Procedures, Operative ; Sutures

No abstract available.
Dapsone*

Intravesical Bacillus Calmette-Guerin (BCG) therapy is an effective immunotherapy used for the treatment and prophylaxis of superficial bladder cancer. The mechanism through which BCG exerts its antitumor activity is not fully understood. However, several studies suggest that antitumor mechanism of BCG is associated with T-cell mediated immunity and lymphokines. In this report, the detection of IL-2(a lymphokine produced in response to BCG) in urine and serum specimens of patients treated with intravesical BCG is reported. Urine specimens of 10 superficial bladder cancers were obtained prior to BCG instillation, 4, 8, and 24 hours afterwards. Serum specimens of same patients were obtained before and 8 hours after BCG instillation. No change of serum IL-2 before and after BCG instillation were observed. Urinary IL-2 production increased significantly 4 and 8 hours (p<0.05) and decreased 24 hours after BCG instillation. Urinary IL-2 levels 24 hours after BCG instillation were similar to baseline values. Between urinary IL-2 of healthy men and cystitis patients were similar. These results suggest that BCG induce IL-2 production with highest level at 4 hours after BCG instillation and IL_2 might play a important role in antitumor mechanism of BCG. However, further studies are necessary to elucidate the antitumor mechanism of BCG.
Bacillus ; Cystitis ; Humans ; Immunotherapy ; Interleukin-2* ; Interleukins* ; Lymphokines ; Male ; Mycobacterium bovis* ; T-Lymphocytes ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Endometriosis* ; Female