To determine the effects of central nervous system (CNS) involvement in systemic Lupus erythematosus (SLE) on cerebrospinal fluid (CSF), CSF studies of 35 cases of SLE (22 cases with CNS involvement and 13 cases without CNS involvement) were analyzed and compared with 20 normal CSF studies. The mean values of several CSF parameters were significantly changed in the group of SLE with CNS involvement (increased protein, white blood cell (WBC) counts and pressure, and decreased glucose contents), but not in the group of SLE without CNS involvement. In 22 case of SLE with CNS involvement, 10 cases (45.5%) were more than 4 WBC's in CSF, 12 cases (54.6%) more than 40 mg/dl of CSF protein and 8 cases (36.4%) less than 40 mg/dl of CSF glucose. CSF pressure was increased more than 200 mm CSF in 41.2%. On the other hand, in 13 cases of SLE without CNS involvement, the CSF studies were almost normal except 4 cases (30.8%) of more than 40 mg/dl in CSF protein.
Central Nervous System ; Cerebrospinal Fluid* ; Glucose ; Hand ; Leukocytes ; Lupus Erythematosus, Systemic*

No abstract available.
Cholesteatoma*

Fracture dislocation or dislocation of the knee can produce a popliteal artery injury that may be difficult to evaluate clinically. Diagnosis of disruption or thrombosis of the popliteal artery is frequently delayed until the opportunity to salvage the extremity is lost. 22 cases of popliteal artery injury were reviewed from July 1978 to December 1983, associated with severe knee trauma at the Orthopaedic department of Kyung Hee University Hospital, of whom average follow-up for about 52 months. The results obtained were as follows; 1. In all 22 cases, 14 cases (63. 6%) were amputated. The amputation rate was correlated with ischemic time after injury. 2. Resection of all injuried vessels with reconstitution of continuity by the use of an interposed saphenous vein graft is often warrented to avoid tension. 3. All 8 patients, which was managed conservatively, were amputated in all cases(100%). In cases of suspicious popliteal artery injury, early aggressive exploration and obvious microvascular reconstruction should be mandatory. 4. Subperiosteal fibulectomy-fasciotomy should be done routinely immediately after vascular injury. 5. Diagnosis of popliteal artery injury was based on the clinical findings but the capillary filling was not contributary. 6. The use of Doppler flowmeter and emergency arteriography was recognizedtobeanexcellent methods in determination of arterial injury.
Amputation ; Angiography ; Capillaries ; Diagnosis ; Dislocations ; Emergencies ; Extremities ; Flowmeters ; Follow-Up Studies ; Humans ; Knee ; Popliteal Artery ; Saphenous Vein ; Thrombosis ; Transplants ; Vascular System Injuries

Although segmental or subsegmental atelectasis may occur during anesthesia, mucous plugging of a mainstem bronchus has been uncommonly reported in anesthetized patients with chronic respiratory disease. However, pulmonary atelectasis following mucous plugging may rarely result normal patients. We report this case of an allegedly healthy patient was developed a left main stem bronchus obstruction, resulting in subsegmental collapse of left lower lung after the induction of general anesthesia.
Anesthesia* ; Anesthesia, General ; Bronchi ; Humans ; Lung ; Pulmonary Atelectasis

BACKGROUND: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. MATERIALS AND METHODS: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. RESULTS: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. CONCLUSION: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Finite Element Analysis ; Intervertebral Disc* ; Inventions ; Spine*

BACKGROUND: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. MATERIALS AND METHODS: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. RESULTS: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. CONCLUSION: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Finite Element Analysis ; Intervertebral Disc* ; Inventions ; Spine*

Sensory neuropathy is characterized by pure sensory dysfunction, ultimately evolving into areflexia and severe sensory ataxia in spite of the preservation of the other functions in the nervous system such as motor function. This disorder is known to be commonly found in cancer patients as a paraneoplastic syndrome, but nowadays many reports are made that sensory neuropathy is not merely related to malignancy but also with autoimmune disorders such as Sjogren's syndrome or polyclonal gammopathy, etc. Hence we report two patients who have been diagnosed as chronic idiopathic ataxic sensory neuropathy through electrophysiological and histopathological studies without any evidence of cancer or any other known cause.
Ataxia ; Humans ; Nervous System ; Paraneoplastic Syndromes ; Sjogren's Syndrome

PURPOSE: To clarify the behavior of the lumbar spine under vertical compressive load and follower compressive load and to confirm the effect of the follower load on the stability of the spinal column using finite element method. MATERIALS AND METHODS: Describing follower compression test to overcome underestimation of load carrying capacity, the problem in existing ex-vivo lumbar spine compression test, with finite element analysis, comparing with the result of simple vertical compressive load, we analyze the property of kinetic behavior. After performing finite element modelling about L1-L5 lumbar vertebral column, analyze it about vertical compressive load and follower compressive load. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. With compressive load, change of lumbar spinal curve is so much, that geometrical analysis should be done. RESULTS: Under the follower compressive load, the vertebral column was so stiff that vertical displacement of the upper end plate of L1 was markedly reduced, comparing with that under the simple vertical compressive load. Sagittal rotation of that upper end plate was also decreased in the opposite direction. Compressive load on the intervertebral disc was evenly distributed along the entire column. The bending moment at each disc was reduced in the opposite direction. A lesser A-P shear force occurred at the intervertebral disc. CONCLUSION: As a result of finite element interpretation of lumbar spine, the stability and load carrying capacity was increased largely, and the compressive load was transmitted through the column in a more pattern, when follower compressive load applied. This can provide the basis for explaining the difference of early buckling occurrence reported in ex-vivo testing, and load carrying capacity of the lumbar spine in-vivo, but, for more precise replication of behavior of lumbar spine in-vivo to variable loading. A invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Natural Resources ; Finite Element Analysis ; Intervertebral Disc ; Inventions ; Spine*

OBJECTIVE: The aim of this study was to compare geometrically cross-sectional areas of two different laminoplasty techniques in same opening size. Some investigators have studied the expanded areas of the two different techniques using imaging study. Although it is unclear that postoperative spinal canal is correlated with the surgical outcome we just focused on mathematical and geometrical correlation of the expandable area with surgical opening size in different laminoplasty techniques. METHODS: To predict the expandable area by a midline splitting technique and a unilateral open door technique, we placed an imaginary isosceles triangle in the spinal canal and drew graphs for the equation of the expandable areas in same opening size using the Pythagorean theorem and mathematical program. To substitute the constant figures of mathematical formula we estimated the normal cervical spine CT scans of 50 Korean adults. RESULTS: We subtracted the imaginary triangle from the spinal canal and were left with the remaining area of the spinal canal that was not changed before and after surgery. In same opening size the expandable area by the midline splitting technique was same but slightly wider than the unilateral open door technique, irrespective of the triangular shape. For a normal isosceles triangle the results were the same. CONCLUSION: Using mathematical proof, the expandable area after the midline splitting technique was same but slightly larger than that after the unilateral open door technique, irrespective of the size of the lamina opening.
Adult ; Cervical Vertebrae ; Female ; Humans ; Ossification of Posterior Longitudinal Ligament ; Research Personnel ; Spinal Canal ; Spinal Cord Compression ; Spinal Osteophytosis ; Spine ; Tomography, X-Ray Computed

Extramedullary plasmacytomas (EMPs) are rare, low-grade and malignant transforming solitary tumors consisting of neoplastic plasma cell proliferation that occurs in the bones of the head and neck. Ninety percent of solitary EMPs occur in the head and neck region: these constitute, however, less than 1% of all head and neck malignancies. EMPs represent up to 4% of nonepithelial lesions of the upper respiratory tract. On initial presentations, they must be differentiated from multiple myeloma. At first, EMPs are frequently seen as masses or swellings, accompanied by nasal or pharyngeal symptoms. EMPs are of special interest to otolaryngologists, because the majority of these unusual tumors are present in soft tissues of the head and neck. We present the patient with EMPs of tonsil and adenoid and discuss the related literature on the presentation, epidemiology, workup and management of patient with this rare neoplasm.
Adenoids* ; Epidemiology ; Head ; Humans ; Multiple Myeloma ; Neck ; Palatine Tonsil* ; Plasma Cells ; Plasmacytoma* ; Respiratory System