Vertebral pedicle screws have been widely used for secure posterior spinal fixation. When postoperative CT scan films were made, the blurring of pedicle screws were observed and we could not figure nut the exact diameter of screw and canal encroachment. There is no information in the difference hetween actual diameter and measured diameter of pedcile screws in CT yet. In this study, we try to find out partial voiume averaging artifact of pedicle screws made of stainless steel and titanium. Partial volume averaging artifact occurs when the shape of an object changes within the thickness of the CT slice or when a relatively small object is only partially included within the slice. Four pig cadaveric spinal column including 6 vertebrae each were prepared and CT scans were performed after insertion of C-D screws(stainless steel) to the left and TSRH screws(titanium) to the right pedicle. Another CT scans were performed after insertion of C-D screws to the right and TSRH screws to the left pedicle. The third CT scans were made after removal of all the pedicle screws. Actual C-D screw diameter was 6mm and CT scanned diameter was 8. I 6+/-0.66mm. Actual TSRH diameter was 6.5 mm and CT scanned diameter was 6.59+/-0.34mm. In conclusion, stainless steel has more partial volume averaging artifact than titanium. Safety margin of pedicle screw made of stainless steel is about 2mm and that of titanium is about 1 mm.
Artifacts ; Cadaver ; Nuts ; Spine ; Stainless Steel* ; Titanium* ; Tomography, X-Ray Computed*

A muscular calf is esthetically unappealing in Asian women. Treatment by liposuction alone has poroven to be difficult due to a small amount of fat. We established a new method of transecting half of the gastrocnemius tendon in order to improve the contour of the calf. Thirty-five patients were operated on during the past 3 years. The medial or lateral half of the gastrocnemius tendon was cut using an endoscopic-guided 3M AGEE blade through a 1cm-sized incision. The portion of the muscle above the site of the transection was elevated from the underlying soleus muscles. We checked the calf circumference and evaluated the clinical results at 6 months postoperatively. An average 10% reduction in calf circumfernce was measured, showing a significant esthetic improvement. There were no significant changes in gait analysis or in the Cybex test. There were no specific complications related to the procedure. Through our clinical experience in 35 cases, we were able to prove that tenotomy is a effective, simple and easy method without severe morbidity.
Asian Continental Ancestry Group ; Female ; Gait ; Humans ; Lipectomy ; Muscles ; Tendons ; Tenotomy*

Immunosuppressive therapy based on the use of antilymphocyte globulin (ALG) has become standard therapy for patients with splastic anemia who are not eligible for bone marrow transplantation. In this study, T cell subsets before and after ALG therapy, hematologic responses, complications and prognostic factors were analysed. Eleven (42%) out of twenty-six patients treated with ALG showed response, but two patients showed relapse. Most of the response (9 cases) was noticed within 6 months after the initiation of ALG therapy (median: 3 months). The main complications of ALG therapy were fever (91%), thrombocytopenia (86%), neutropenia (63%), and serum sickness (56%). Four patients were died just ALG therapy because of serum sickness (2 cases), intracranial hemorrhage (1 case), and shock (1 case). Short interval from diagnosis to treatment suggested to show good response (P=0.0575), but it was not significant statistically. Lymphocyte subsets were measured in the blood of 23 patients. Helper T/suppressor T cell ratio (T4/T8 ratio) at the initiation of ALG therapy (day 0) was higher significantly in patients who were responded (P=0.0299). The patients who showed above 1.0 of T4/T8 ratio on day 0 might be speculated good response (P=0.032). More difference of T4/T8 ratio between day 14 after ALG therapy and day 0 might show good response (P=0.0673). Then the actuarial probability of survival at 3 years in patients treated with ALG was 77%. Our data suggest that ALG therapy may be used as an alternative treatment to bone marrow transplantation, and T4/T8 ration of peripheral blood at the initiation of therapy may be used as one of the prognostic factors.
Anemia ; Anemia, Aplastic* ; Antilymphocyte Serum* ; Bone Marrow Transplantation ; Child* ; Diagnosis ; Fever ; Humans ; Intracranial Hemorrhages ; Lymphocyte Subsets ; Neutropenia ; Recurrence ; Serum Sickness ; Shock ; T-Lymphocyte Subsets ; Thrombocytopenia

PURPOSE: This study elicited Korean women's perceptions of the life situations that contribute to Hwabyung, a culture bound psychiatric illness in Korea, and delineated a typology of the perceived causative factors for this illness. METHOD: A purposive sample of 21 Korean women was recruited from a church, a senior center in Seoul and a clinic that provides traditional Korean and westernized medical services to patients in the Gyeonggi area. Inclusion criteria were: 1) the diagnosis of Hwabyung by a traditional doctor or "stress reaction and depression" by a westernized doctor; and 2) a score greater than 40 on the Hwabyung Self Report Instrument. Surveys using the HSRI and individual interviews using Q methodology were used. RESULT: The average age of the participants was 53.7 years (range 35-84). The mean score on the HSRI was 46.2 (range = 42-52). Data analysis showed that participants perceived three life situations to cause Hwabyung: vulnerable situation, lowered self esteem, and negative life events. CONCLUSIONS: Korean women, suffering from Hwabyung, perceived at least three different causal patterns for this illness. Nursing care plans should be tailored to meet these differences.
Diagnosis ; Female ; Gyeonggi-do ; Humans ; Korea ; Patient Care Planning ; Self Concept ; Self Report ; Senior Centers ; Seoul ; Statistics as Topic

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

Clinical observation was made on the 16 patients of penile carcinoma admitted to the Department of Urology, Seoul National University Hospital during the period from September, 1967 to August, 1976 and the following results were obtained. 1. The incidence of penile carcinoma was 0.5% of total inpatients of urologic department and 3.5% of male genitourinary tumors. 2. Age distribution was between 29 and 78, snowing highest incidence at 50-59 years. 3. Clinical findings were; mass 77%, discharge 28%, ulcer 25%, bleeding 13%, and inguinal lymphadenopathy 50%. 4. The average duration of the symptoms on admission to hospital was 10 months with the highest incidence in 1 to 6 months. 5. The locations of the tumors were; preputial cavity 87%, confined to glans 6%, penile shaft involved 6%. 6. Treatments were made with partial amputation in 50%, partial amputation with inguinal lymphadenectomy in 37%, and biopsy in 13%.
Age Distribution ; Amputation ; Biopsy ; Hemorrhage ; Humans ; Incidence ; Inpatients ; Lymph Node Excision ; Lymphatic Diseases ; Male ; Penis* ; Seoul ; Snow ; Ulcer ; Urology

No abstract available.
Paragonimiasis*

BACKGROUND: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. METHOD: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; RESULTS: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic 'fungus ball' pattern were observed in 53.8% of the 52 cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed foe needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9% (12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. CONCLUSION: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.
Anti-Bacterial Agents ; Aspergillus ; Chronic Disease ; Cough ; Diagnosis ; Female ; Fungi ; Glucocorticoids ; Hemoptysis ; Humans ; Korea ; Lung ; Male ; Medical Records ; Needles ; Pulmonary Aspergillosis* ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

In the standing lateral position, the pelvis is tilted in some degree anteroinferiorly. But there was no accurate and standard measurement about the pelvis tilting. The pelvis tilting affects on the lumbar lordosis, weight bearing area of the hip joint, and the anteversion of acetabulum. In the standing true lateral view of the pelvis, 5 points were marked: midpoint of both anterosuperior iliac spines (M), upper margin of symphysis pubis (S), lower margin of symphysis pubis(S), sacral promontorium (SP), coccyx tip (C). And using the additional horizontal plane (H), we measured the 4 angles : angle I ( < MSH), angle II ( < SPSH), angle III(
Acetabulum ; Adult ; Animals ; Coccyx ; Hip Joint ; Humans ; Lordosis ; Pelvis ; Pubic Bone ; Spine ; Weight-Bearing

The authors made an attempt to classify the supracondylar extension-valgus fracture according to the direction and location of the fracture line based on the radiographic manifestation. This new classification helps to dictate the model of treatment, possible sequence of reduction and the causes of deformity of the elbow after treatment. During the last 12 years of this study, 200 supracondylar fractures of the humerus were treated in the Kyung Hee University Hospital. Of the cases 82 were extension-valgus fractures. The results were as follows: 1. The supracondylar extension-valgus fracture were classified into 5 types: Type I: fish-tail fracture (14 cases) Type II : obtuse fish-tail fracture (27 cases) Type III: oblique fracture (16 cases) Type IV: oblique fracture with comminution of lateral column (14 cases) Type V: Transverse fracture (11 cases) 2. The displacement of the distal fragment in the fish-tail fracture is severe but it can be reduced easily by manipulation. Once reduction has been obtained, the fracture is stable and maintained by a long arm cast with acute flexion of the elbow alone. There is no need of percutaneous pinning. Among 14 cases of type I fracture there was no cubitus varus deformity. 3. The line of the obtuse fish-tail fracture lies distal to fish-tail fracture. This is unstable so it is necessary to percutaneous pinning. 4. The oblique fracture is produced by the hyperextension of the elbow and degrees of the obliquity of the fracture line were 12 to 20 degrees (Av. 14 degrees). The valgus angles in opposit elbows were 9 to 25 degrees (Av. 16 degrees). The forearm must be pulled into valgus position during the reduction of the fracture. 5. Type IV fracture occures under 4 years old, and more commonly in girls. This is unstable, so it is necessary to percutaneous pinning.
Arm ; Child ; Classification ; Congenital Abnormalities ; Elbow ; Female ; Forearm ; Humans ; Humerus