STUDY DESIGN: A retrospective analysis of 166 patients was undertaken to observe radiologically the changes of adjacent segments at follow-up more than three years after lumbar fusion. OBJECTIVES: The purpose of this study is to analyse the changes of adjacent segments and to correlate these changes to the length of using level and to the degree of deviation from physiologic lumbar lordosis. The authors also correlate these radiologic changes to the clinical symptoms. MATERIALS AND METHODS: In simple x-ray, authors observed traction spur, disc space narrowing, endplate sclerosis and vacuum phenomenon of adjacent segments. Authors used Gelb's criteria in segmental lordosis angle(SLA) and Katz's classification in clinical results. RESULTS: The average age was 49.6 years old and the average follow-up period was 57.2 months(4 years and 9.2 months). We observed radiologically the traction spurs in 35 cases(21.1%), end-plate sclerosis in 32 cases(19.3%), disc space narrowing in 33 cases(19.9%) and the vacuum phenomenon in 10 cases(6.0%). The numbers of fusion segments and the degree of unphysiologic segmental lordosis angle in fusion segments were related with the frequency and degree of changes of adjacent segments(P<0.05). The clinical results showed satisfaction in 142 cases(85.5%), unsatisfaction in 24 cases(14.5%) and low back pain in 24 cases(14.5%), leg pain in 11 cases(6.6%) and extension of fusion level in 4 cases(2.4%). In low back pain patients more than two kinds of radiological changes were frequently observed than the patients without low back pain(P<0.05). CONCLUSIONS: The radiological changes of adjacent segments were more frequently observed in long fusion and in fusion with unphysiologic lumbar lordosis angle. And these changes are frequently associated with low back pain. Thus long fusion and fusion with unphysiologic lumbar lordosis angle should be avoided if possible.
Animals ; Classification ; Follow-Up Studies* ; Humans ; Leg ; Lordosis ; Low Back Pain ; Retrospective Studies ; Sclerosis ; Spinal Fusion* ; Traction ; Vacuum

A total of 420 cases of tumors of bone and cartilage were seen and treated at our department during the 19 years period from January, 1957 to November, 1975, This studies reviewed and analysed clinically, radiologically and pathologically. One hundred fifty-three cases (36.4%) were benign tumors. These included osteochondroma-54 cases (35.3%), benign giant cell tumor-18 cases (11.8%), enchondroma and osteoma-15 cases (9.8%) each, fibrous dysplasia-14 cases (9.2%), solitary bone cyst-13 cases (8.5%), osteoid osteoma-11 cases (7.2%),aneurysmal bone cyst and non-ossifying fibroma-5 cases (3.2%) each, chondroblastoma-2 cases (1.3%), and chondromyxoid fibroma 1 case (0.6%). Two hundred sixty-seven cases (63.6%) were malignant tumors. Among these cases, one hundred forty-nine cases (55. 9%) were metastatic bone tumors and one hundred eighteen were primary malignant bone tumors. The latter included osteogenic sarcoma 54 cases (46.0%), chondrosarcoma-19 cases (16.1%), reticulum cell sarcoma-9 cases (7.6%), multiple myeloma and malignant giant cell tumor-8 cases (6.7%) each, Ewings sarcoma-7 cases (6.0%), fibrosarcoma-5 cases (4.2%), juxtacortical osteogenic sarcoma and liposarcoma-3 cases (2.5%) each, and lymphosarcoma 2 cases (1.7%). a greated incidence of malignant tumors. The result led us to conclude that; 1. In this study of bone tumors, the ratio between benign and malignant tumors was around 1: 1. 7, a greater incidence of malignant tumors. 2. Osteochondroma was the most frequently encountered benign bone tumor (35.3%), and followed by benign giant cell tumor (11.8%). 3. Excluding metastatic bone tumor, osteogenic sarcoma was the most frequently encountered malignant bone tumor (46.0%), and followed by chondrosarcoma (16.1%). 4. The most common site of solitary osteochondroma was around knee joint including the distal femur and the proximal tibia in 15 cases (45.5%). The peak age incidence was in the second decade of life and 43 cases were solitary and 11 cases were multiple lesion. 5. In 15 cases of enchondroma, 10 cases were solitary and 5 cases were multiple lesions. The common site was phalanges of the hand. 6. Giant cell tumor was 26 eases and to be divided into pathologically Grade I & II 18 cases (69%) and Grade III 8 cases (31%). 7. The average age of giant cell tumor was 33.8 years with the peak incidence in the third and forth decade of life. 8. The common sites of giant cell tunior were the distal femur in 8 cases and proximal tibial in 4 cases and distal radius in 6 cases. More than half of these series, the tumor occurred around the knee. 9. The sex distribution of chondrosarcoma showed 4 times of the male predominence. The 2 cases of secondary chondrosarcoma arose from osteochondroma and multiple osteochondromatosis. 10. The average age of osteogenic sarcoma was 25. 5 years with the peak incidence in the second decade of life. 11. The sex distribution of osteogenic sarcoma 42 males (77.8%) and 12 females (22.2%), a male predominance. 12. The common sites of osteogenic sarcoma were distal femur and the proximal tibia and proximal humerus in 42 cases (77.8%). 13. In metastatic bone tumor, male was predominent; 90 males (60.4%) and 59 females (39.6%), and common primary site of cancer included stomach (13.4%), lung (12.8%), breast (6.0%), liver (4.7%) and female genital organ (4.7%). 14. The most common sites of metastatic tumor to bone was spine in 46.3%, and followed by pelvis, ribs, femur and skull.
Bone Cysts ; Breast ; Cartilage ; Chondroma ; Chondrosarcoma ; Exostoses, Multiple Hereditary ; Female ; Femur ; Fibroma ; Genitalia ; Giant Cell Tumors ; Giant Cells ; Hand ; Humans ; Humerus ; Incidence ; Knee ; Knee Joint ; Liver ; Lung ; Lymphoma, Non-Hodgkin ; Male ; Multiple Myeloma ; Osteochondroma ; Osteosarcoma ; Pelvis ; Radius ; Reticulum ; Ribs ; Sex Distribution ; Skull ; Spine ; Stomach ; Tibia

This study was conducted to find out the characteristics, type of the duty and job satisfaction of health care managers at the worksite. The subjects of this study were 306 health care managers serving at worksite situated in Kyungin presently in 1994, concerning their job. Major depedent variables were health management, environmental management, and health planning related with health care managers' job; these variables were measured by nominal scale consisted of 9 items respectively. The collected data were analysed and some major results are as follows; 1. It appeared that according to the qualification of health care managers, nurses showed high performing rate in duty of health managerment and health planning, Industrial hygienist showed high performing rate relating to working environmemt managemant, and regarding their holding an additional post, the number of environmental managers held more an additionnal post than other qualified managers, thereby showing significant relatively, and however, no relation with qualification was there in decision making. 2. The performing rate relatiag to health management was significantly correlate with female, youth, unmarried, higher education, general affairs in post of duty, general employee in position, only duty of health, low monthly income and nurse. But, the performing rate relating to environmental management was significantly correlate with manufacturing industries, industrial health and safety committee, male, old age, married, long work duration, additional post, high monthly income, and hygienist and environmental managers. The performing rate relating to health planning was significantly correlate with the performing rate relating to health and environmental management, but the performing rate relating to health management was not significantly correlate with the performing rate relating to environmental management. 3. In multiple regression analysis, common major determinants of the performing duty relating to health management, environmental management and health planning were industrial health and safety committee, type of industry, education, and qualification of industry's health care managers. Additionally, age was selected as highly correlated with the performing duty relating to environmental management, and work duration and post of duty of health care managers in industry were selected as highly correlated with the performing duty relating to health planning, Based on the results indicated above, it could be understood that characteristics of the worksite-industrial health and safety committee, scale and types of industry, and characteristics of health care managers-age, education, post of duty, work duration and qualification had relations with their type of the duty. Therefore, it is required that the reference to the above-showing results such as guiding for them to precisely grasp their performing duty according to their qualification, heightening their participation in decision-making, extending the industrial health service, etc., operation and management of health care managers at the worksite should be made into being more efficient.
Adolescent ; Decision Making ; Delivery of Health Care* ; Education ; Female ; Hand Strength ; Health Planning ; Humans ; Job Satisfaction ; Male ; Occupational Health ; Single Person ; Workplace*

PURPOSE: Hypertrophic scarring and depression are the principal problems of burn rehabilitation. This study was done to verify the effects of skin rehabilitation massage therapy (SRMT) on pruritus, skin status, and depression for Korean burn survivors. METHODS: A pretest-posttest design using a nonequivalent control group was applied to examine the effects of SRMT for 3 months in a group of 18 burn survivors. The major dependent variables-including pruritus, objective and subjective scar status, and depression-were measured at the beginning and at the end of the therapy to examine the effects of SRMT. RESULTS: Burn survivors receiving SRMT showed reduced pruritus, improved skin status, and depression. The remaining scar also showed improvement in skin pigmentation, pliability, vascularity, and height (compared to the surrounding skin) as measured on the Vancouver Scar Scale (VSS). CONCLUSIONS: The findings demonstrate that SRMT for burn survivors may improve their scars both objectively and subjectively, and also reduce pruritus and depression.
Adult ; Burns/complications/*rehabilitation ; Cicatrix, Hypertrophic/etiology/*prevention & control ; Depressive Disorder/etiology/*prevention & control ; Female ; Humans ; Male ; *Massage ; Pruritus/etiology/*prevention & control

BACKGROUND: The aim of this study is to compare the diagnostic power of transorbital Doppler (TOD) and magnetic resonance angiography (MRA) in detecting carotid siphon disease (CSD) confirmed by conventional angiography (CA) and elucidate the diagnostic role of TOD in CSD. METHODS: We recruited the patients who underwent TOD, MRA and CA within 2 months. TOD velocities above 75cm/sec or no flow was defined as abnormal. Carotid siphon on MRA and CA was divided into C2 & C4 segments; stenosis more than 50% or occlusion on the segment corresponding to the flow direction of TOD was defined abnormal. RESULTS: Sixty patients (44 males and 16 females, mean age: 55.4+/-12.2 years) were recruited. In 117 available carotid siphons 16 vessels (13.7%) were detected as abnormal by CA, 23 vessels (19.7%) by TOD, and 29 vessels (24.8%) by MRA. When CA was used as a gold-standard, the sensitivity and specificity of TOD were 75.0% and 89.1% while those of MRA were 87.5% and 85.1%, respectively. Positive predictive value was about half (52.2% in TOD and 48.3% in MRA) and negative predictive value was over 95% (95.7% in TOD and 97.7% in MRA). The diagnostic accuracy was 87.2% in TOD and 85.5% in MRA. When TOD and MRA were normal, CA was also normal in 98.7% and when both tests were abnormal, CA was abnormal in 78.6%. But when one of two tests was abnormal, CA was abnormal only in 16.7%. Diagnostic consistency of TOD & MRA was acceptable (kappa value = 0.409). Among 23 carotid siphons, which were abnormal on TOD, 11 vessels were normal on CA; false positive rate was 47.8%. But we could find the presumed causes of false positive results in most of cases, such as contralateral proximal ICA occlusion, ipsilateral ICA stenosis just proximal to carotid siphon, etc. CONCLUSIONS: Transorbital Doppler is as good as MRA in noninvasive detection of carotid siphon disease. Despite of the relatively low positive predictive value of TOD and MRA, the combination of their results increases the diagnostic accuracy in carotid siphon disease and may reduce the need of conventional angiography.
Angiography* ; Constriction, Pathologic ; Female ; Humans ; Magnetic Resonance Angiography ; Male ; Sensitivity and Specificity

No abstract available.
Child* ; Humans ; Infant* ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: This study examined the effects of spirituality promoting intervention for the stomach and colon cancer patients. METHOD: A quasi-experimental design was used. Data collection was carried out from April 2004 to June, 2004 at a cancer center in Korea. The intervention included pray, meditation, group education and discussion for coping with cancer. The experimental group were received a 1-hour intervention per week for 6 weeks, while the control group received usual care. Data collection was done at pre and post intervention. The degree of spirituality was measured by the Korean version of WHOQOL-SRPB pilot test(WHO Quality of Life-Spirituality, Religiousness and Personal Beliefs pilot test) Module, and social support was measured using scores on a PRQ 85(Personal Resources Questionnaire). Fighting spirit was measured by the scores of MAC(Mental Adjustment to Cancer) scale. RESULTS: The experimental group showed significant increase in the scores of social support and fighting spirit compared to those in the control group after the intervention. There were no significant changes in terms of the spirituality score compared to the baseline score in the experimental group and the control group. CONCLUSION: This intervention appeared to be effective in increasing social support and fighting spirit, which considered to be very helpful in cancer adjustment.
Colonic Neoplasms ; Data Collection ; Education ; Humans ; Korea ; Meditation ; Spirituality* ; Stomach

Superficial siderosis is a rare condition characterized by hemosiderin deposition in leptomeninges, subpial tissue, brainstem, cerebellum, spinal cord, and cranial nerves. Slowly progressive hearing loss and gait ataxia are invariable clinical manifestations. We report three patients with their clinical and radiological features. All patients presented with hearing loss and cognitive dysfunction. Two showed gait ataxia and myelopathic symptoms and signs. Decreased visual acuity, hand tremor, limb ataxia, dysarthria, and nystagmus were also present. All patients showed typical MRI findings: marked linear hypointensities around the cerebellum, brainstem, and the surface of the cerebral cortex, especially in sylvian fissures. Two patients had brain tumors : pituitary adenoma and oligodendroglioma. Another patient had no definite bleeding source. Hemosiderin deposition is caused by chronic and recurrent subarachnoid hemorrhage derived from tumor, vascular malformation, aneurysm, posthemispherectomy, and unknown bleeding sources. Diagnosis is easily made by characteristic clinical manifestations and MRI findings. The selective vulnerability of the cerebellum and the 8th cranial nerve depends upon their own histological and biochemical characteristics. Benefits of the iron chelating agents are questionable. Removal of the possible bleeding sources is the most reliable strategy to prevent the disease progression.
Adenoma ; Aneurysm ; Ataxia ; Brain Neoplasms ; Brain Stem ; Cerebellum ; Cerebral Cortex ; Cranial Nerves ; Diagnosis ; Disease Progression ; Dysarthria ; Gait Ataxia ; Hand ; Hearing Loss ; Hemorrhage ; Hemosiderin ; Humans ; Iron Chelating Agents ; Magnetic Resonance Imaging ; Oligodendroglioma ; Pituitary Neoplasms ; Siderosis* ; Spinal Cord ; Subarachnoid Hemorrhage ; Tremor ; Vascular Malformations ; Visual Acuity

No abstract available.
Hematoma*

BACKGROUND: Hyperthermia is known to be one of the important poor prognostic factors of ischemic stroke. However, the prognostic role of fever in hemorrhagic stroke is not clear. We investigated whether the prognostic role of fever is influenced by the type of stroke. METHODS: We analyzed the linical data of patients who were admitted to our hospital within three days after the onset of stroke during 28 months. We divided the patients into three groups according to the degree of maximum temperature recorded during the first seven days; no fever (< OR=37.2 degrees C), low grade (37.3~38.0 degrees C) or high grade (> OR=38.1degrees C) fever. Using the modified Rankin disability scale (MRDS) at discharge, clinical outcome was dichotomized into favorable (MRDS 0~2) and unfavorable (MRDS 3~5) categories. The size of lesion, age, sex, alcohol, diabetes, hypertension, initial glucose level, hypercholesterolemia, heart disease, smoking, previous stroke, and initial National Institutes of Health Stroke Scale (NIHSS) were investigated. RESULTS: Of 217 patients, 46.1% had no fever, 36.9% had low grade fever, and 17.1% had high grade fever. Fever was strongly correlated with outcome in patients with stroke of any type (p<0.05). The size of lesion was also significantly correlated with the degree of fever in patients with ischemic stroke (p=0.01). Multivariate analysis in the logistic model revealed that fever and NIHSS were independent predictors for a poor prognosis. CONCLUSIONS: Fever in patients with acute stroke is an independent poor prognostic factor regardless of stroke type.
Body Temperature* ; Fever ; Glucose ; Heart Diseases ; Humans ; Hypercholesterolemia ; Hypertension ; Logistic Models ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Prognosis ; Smoke ; Smoking ; Stroke*