Cervical spine injuries are increasing recently due to increasing traffic accidents. Many patients have been treated with cervical laminectomy but stabilization of the cervical spine has been neglected as a part of the treatment. 30 patients with cervical spine injuries who were admitted to our hospital from January 1, 1973 to December 31, 1978 were evaluated. The following observations were made: 1. The ratio between male and female was 2:1 and the majority(43%) were found in the 4th decades. 2. The common causes of cervical spine injuries were traffic accident(40%) and falls(33.3%). The most common site of the lesion was the 5th and 6th cervical spine level (33.3%). 3. Among 30 cases, 10 cases(33.3%) had complete paralysis, 12 cases(40%) incomplete paralysis, 6 cases (20%) had nerve root injury and no neurological change is 2 cases. 4. The mechanisms of cervical injuries were classified morphologically and flexion-rotation injuries (55.5%) were the most common. 5. We evaluated the results of treatment neurological & radiographically. In complete paralysis, there was no neurological improvement and cervical kyphosis increased after laminectomy. In incomplete paralysis and nerve root injury, anterior fusion showed slight neurological recovery but mild cevical kyphosis and displacement of the graft were observed. In posterior fusion or cast immobilization, we had a satisfactory result with a high fusion rate and normal cervical curvature. 6. lt is impossible to compare anterior interbody fusion with posterior fusion for neurological recovery. For early mobilization and rehabilitation, we emphasize early stabilization by anterior or posterior fusion according to the mechanism of injury.
Accidents, Traffic ; Clinical Study ; Early Ambulation ; Female ; Humans ; Immobilization ; Kyphosis ; Laminectomy ; Male ; Paralysis ; Rehabilitation ; Spine ; Transplants

PURPOSE: In determining image quality of mammography,many factors are related. Selection of film and screen is one of them. Authors took phantom images of nine film-screen combinations under properly controlled conditions and compared them to evaluate their image qualities. In addition, KVp, mAs and surface dose were evaluated at each combination to deterrhine proper exposure conditions. MATERIALS AND METHODS: Using phantom,images of nine film-screen combinations composed of Fuji MI-NC, UM-MA, UM-MH films and Fuji Fine,Medium, Kodak Min-R screeens were taken. Phantom(Ackermann Mammochip Phantom) was composed of simulations for microcalcifications, fibers, nodules, lymph nodes, breast tissue and breast cancer masses. For phantom of 4.5 cm compressed breast equivalent, 28 KVp was used. For 1.5 and 3.0 cm equivalant phantoms, 24 KVp and 26 KVp was used. At each KVp, mammographic images were taken at various mAs. Among images taken by this process, best images were selected and then, according to scoring method, comparison of image quality for each combination was done. With dosimation strip, surface doses for various conditions were evaluated. RESULTS: Combination of Fuji UM-MA film and Fuji Fine screen showed best image quality regardless of KVp or phantom thickness. For the best image, 10 mAs with 26 KVp was most ideal while mAs with 24 KVp was optimal for equivalent phantom of 3.0 cm thickness breast. At this condition, surface dose was less than other combinations when combinations involving UM-MH films were used. On the other hand,when combinations involving MI-NC films were used, surface dose was higher than others. CONCLUSION: Using phantom, image quality of film-screen combinations could be evaluated and compared. Such process can contribute to best quality image with decreased exposure and can play a role in quality asurance program.
Breast ; Breast Neoplasms ; Lymph Nodes ; Research Design

E-cadherin is one of intercellular adhesion molecules, and it has been demonstrated that E- cadhedrin acts as an invasion suppressor in vitro and loss of its expression is an important prognostic factor in human malignancies. However the prognostic value of loss of expression of E-cadhedrin in renal cell carcinoma (RCC) remains to be defined. We herein immunohistochemically examined the expression of E-cadhedrin in paraffin- embedded tissues of 43 patients with RCC to investigate the prognostic value of loss of expression of E-cadherin. Twenty three of 43 patients (54.5%) showed loss of expression of E- cadherin. There were significant correlations between loss of expression of E-cadherin and histopathologic grade, Robson stage, T stage, N stage and M stage (all p<0.05). Patients with loss of expression of E-cadherin showed significantly decreased 2 year disease free survival as compared with those with normal expression of E-cadherin (p<0.001). These results suggest that loss of expression of E-cadherin has a ominous prognostic value in patients with RCC.
Cadherins* ; Carcinoma, Renal Cell* ; Cell Adhesion Molecules ; Disease-Free Survival ; Humans ; Prognosis

No abstract available.
Compressed Air* ; Mouth* ; Rupture*

Nocturia is usually considered to be just one of the symptoms included with lower urinary tract symptoms (LUTS) and is treated with therapy based on LUTS. Recent research suggests, however, that nocturia is not merely a simple symptom of LUTS but is a multifactorial condition with many contributing etiological factors. The causes of nocturia can be classified into bladder storage problems, increased urine output, sleep disturbance problems, and other potential diseases. The frequency-volume chart (FVC) is very important in evaluating and diagnosing nocturia. Patients usually record the volume and timing of voids for a period of 1 to 3 days on the FVC. The FVC data can provide information on voiding patterns and clues about the etiology and treatment of nocturia. It is doubtful that alpha-blockers will have clinical significance for treatment because the difference in nocturia episodes between treatment with alpha-blockers and placebo is too small. Antimuscarinics also exert no effect on nocturnal polyuria, and the evidence supporting the efficacy of antimuscarinics for the treatment of nocturia is limited. However, several randomized placebo-controlled trials have shown the efficacy of oral desmopressin in the treatment of adults with nocturia. Short-acting hypnotics may be helpful for patients with sleep disturbances. Although surgical or interventional therapy is not indicated for nocturia, transurethral resection of the prostate appears to confer a greater improvement in benign prostatic hyperplasia symptoms including nocturia. The management of nocturia may require a team approach by making optimal use of multidisciplinary expertise.
Adult ; Deamino Arginine Vasopressin ; Humans ; Hypnotics and Sedatives ; Lower Urinary Tract Symptoms ; Muscarinic Antagonists ; Nocturia ; Polyuria ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder

No abstract available.
Tinea*

BACKGROUND: The fast EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used far transporting emergent patients. Authors, here upon, report the transporting experiences. METHODS: From Dec. 1, 1996 to Dec. 31,1997, Samsung Medical Centers EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. RESULT: A total of 65 patients were transported. Male to female ratio was 1.95 : 1. The mean transport time was 64.1min(10-160 min). Majority of the evacuated patients was surgical patients (General Surgery'16, Orthopedic surgery : 10, Neurosurgery : 6, Infernal medicine 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation amended The patients. No medical problems or deaths developed during the air evacuation period. CONCLUSION: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.
Aircraft* ; Critical Illness ; Emergencies* ; Female ; Humans ; Korea ; Male ; Neurosurgery ; Orthopedics ; Pediatrics ; Prospective Studies

Chondroma is a benign bone tumor and rarely involves the spine ; even if this occurs however, neurological symptoms and signs rarely arise. We encountered one case of chondroma which developed in the posterior arch of the atlas. The patient complained of quadriparesis, hypesthesia, and urinary frequency. MR imaging showed that the tumor had compressed the cord dorsolaterally at the C1 level. It was completely removed, and the posterior arch of the atlas and surrounding ligamentum flavum disclosed hypertrophy. Postoperatively, the neurological status of the patient improved. On pathologic examination, hypocellularity and mature hyaline cartilage was seen, as well as chondrocytes residing in the lacunae ; all these findings were compatible with benign chondroma.
Chondrocytes ; Chondroma* ; Humans ; Hyaline Cartilage ; Hypertrophy ; Hypesthesia ; Ligamentum Flavum ; Magnetic Resonance Imaging ; Quadriplegia ; Spinal Cord Compression* ; Spinal Cord* ; Spine

Heat-treated autogenous bone graft has been utilized in the cases with large hone defects associated with tumors, chronic osteomyelitis, and trauma. Conventional autoclaved autogenous bone grafting, however, has inherent disadvantages that included decreased biomechanical strength, and loss of osteogenesity. In contrast, despite devitalizing the tumor cells, low heat-treatment can render autogenous hone grafts to retain better biomechanical strength as well as to preserve osteogenesity by avoiding destruction of hone morphogenetic protein. To investigate biomechanical strength and osteogenesity of heat-treated autogenous bone grafts, rahbits were classified into three groups: groupl, in-situ implantation of autogenous graft in the diaphyseal defect of the tibia without any heat treatment; group 2, reimplantation of graft after low heattreatment; group 3, reimplantation of graft after autoclaving. Radiological, histological, and scintigraphic examination were performed postoperativeIy at 2nd, 4th, 6th, 9th, 12th weeks. And biomechanical test was performed postoperatively at 6th, 9th, 12th weeks. Biomechanical test revealed that there were no statistical differences among three groups at 6th week and 9th week. However, at 12th week postoperatively, there were significant differences between group 2 and group 3, and between group 1 and group 3. Radiological and histological examinations showed that new bone formation started earlier in groups l and 2, compared to group 3. Also bone remodeling was advanced in group I and 2, com- pored to group 3. Scintigraphically, the increase of 99mTc-MDP uptake was delayed in group3, compared to group l and 2. Based upon above findings, it was concluded that low heat-treated autogenous bone grafting was hetter than autoclaved autogenous bone grafting in promoting bone healing with retained biomechanical strength.
Bone Remodeling ; Bone Transplantation* ; Hot Temperature* ; Osteogenesis ; Osteomyelitis ; Replantation ; Technetium Tc 99m Medronate ; Tibia ; Transplants

Type II fracture of the odontoid process is the most common form of axis fracture, and because of the difficulty in healing, its results may be fatal. The authors subclassified these fractures as anteriorly displaced(type II-A), posteriorly displaced(type II-P), and non displaced(type II-N). Twelve patients with type II fractures underwent anterior screw fixation : three were type II-A : one, type II-P : and eight, type II-N. The mean duration of follow-up was 29.3 months, and all patients except two showed good alignment and stable fixation : these exceptions were type II-A, with 9mm displacement, and showed delayed failure of screw fixation. All type II-N, II-P, and II-A, with 3mm displacement, were successfully treated. We conclude that selection of the treatment modality should be based on the direction of displacement of odontoid process. For type II-N, II-P and II-A fractures, where displacement is mild, anterior screw fixation is a reliable method, but for type II-A fracture, with severe displacement, posterior fixation should be considered.
Axis, Cervical Vertebra ; Follow-Up Studies* ; Humans ; Odontoid Process*