Since the term “facet syndrome” was introduced by Ghormley in 1933, arthropathy of the lumbar facet joint has long been recognized as an important source of low back pain, even sciatic pain. And facet joint injection has been helpful in the diagnosis and therapy for this facet syndrome. However, considering the possible complications such as infection, neurologic deficit and difficulty in locating the symptpmatic joint, and placebo effect, we have frequently doubted about clinical application of these procedures. This study is a retrospective review of 18 patients who got lumber facet joint injection for low back and leg pain with various previous indication that are not response to convential therapy for 2 months or more for therapeutic purpose. The response to facet joint injection was analyzed according to the entire spectrum of symptoms, physical findings, and X-ray findings. 13 or 15 patients with back pain with thigh or groin pain aggrevated by extension/rotation of trunk had successful response but patients with leg pain below the knee joint or pathology in the other structures in the spine got poor response. Strict diagnostic criteria through scoring system, provocation test, relief test and analysis of patient's signs and symptoms is needed to get higher degree of predictability and effectiveness of facet joint injection.
Back Pain ; Diagnosis ; Groin ; Humans ; Joints ; Knee Joint ; Leg ; Low Back Pain ; Neurologic Manifestations ; Pathology ; Placebo Effect ; Retrospective Studies ; Spine ; Thigh ; Zygapophyseal Joint

The treatment of tibial shaft fracture has become one of the most controversial subjects in orthopedic surgery. Comminuted, segmental and rotationally unstable fractures or bone defect at fraction site have problems of the fixation. The interlocking nail solve these problems. We have experienced 8 cases of the tibial shaft fractures treated with interlocking nail from 1986 to 1988. Authors analyzed these cases and out own clinical study. The results were as follows. 1. The average bone union rate was about 15 weeks. 2. The interval between operation and crutch walking was 4.3 weeks. 3. The merits of this operation were the short hospitalization and early adaptation of social activity. 4. The advantage is be able to do early ambulation without following muscular atrophy or joint stiffness. 5. The results were assessed on clinical examination and radiographic appearance by Hamza et al. An excellent results were 7 cases and good result was 1 case.
Clinical Study ; Early Ambulation ; Hospitalization ; Joints ; Muscular Atrophy ; Orthopedics ; Walking

PURPOSE: For the production and evaluation of the tissue-equivalent phantom. MATERIALS AND METHODS: We used agarous gel and oil as a basic component of the mixture and added Tween 80 for the stabilization of phantoms. We did the test for homogeneity and measured T1 and T2 relexation times of each phantom tube. RESULTS: T1 relaxation time ranged from 642 to 2781 msec and T2 relaxation times from 42 to 157 msec. Each phantom was significantly different in T1 relaxation time and T2 relaxation time (p < .0001). CONCLUSION: Tissue equivalent phantom may provide good information on the optimal sequence before MR imaging of patients and may be valuable if it is used with the patients' MR imaging.
Agar ; Humans ; Magnetic Resonance Imaging* ; Polysorbates ; Relaxation

No abstract available.
Antibodies* ; Coxiella burnetii* ; Coxiella* ; Korea* ; Prevalence* ; Q Fever*

BACKGROUND AND PURPOSE: Frequently the conventional nerve conduction studies (NCS) with testing usual peripheral nerves did not reveal any abnormalities in patients with early polyneuropathy. Recently Lee and Oh demonstrated that the interdigital sensory nerve conduction studies (NCS) of the foot were very sensitive in detecting early changes of neuropathy. The authors performed the study to see abnormal features of interdigital NCS in early phase of polyneuropathy and to understand the sensitivity of interdigital NCS in making diagnosis of polyneuropathy. METHODS AND MATERIALS: The interdigital NCS of the foot were performed in 19 clinically suspected polyneuropathy with no abnormalities by the conventional NCS (group I), in 7 polyneuropathy with electrophysiological abnormalities by the conventional NCS (group II), and 10 normal controls without clinical or electrophysiological findings of polyneuropathy (group III). The interdigital NCS were done according to the original description of Oh et al ,using the near-nerve needle recording at the level of ankle with averaging technique. The maximal nerve conduction velocity (NCV), the largest negative NCV, the amplitude and the duration of compound nerve action potential (CNAP) were analysed in each recording of I,V digital and I-II, II-III, III-IV, IV-V interdigital nerves of the foot. RESULTS: The abnormal interdigital NCS findings were found in 9 out of 19 patients in group I (47.4% ) , 7 out of 7 patients in group II(100.0%) ,and none in group III.(0.0%). In group I, the most common abnormal findings were no recordable CNAP (77,7%) and the second were the decreased amplitude of CNAP (66.6%). The decreased NCV were found only in one case ( group I-19). The digital or interdigital nerves involvement were symmetrical and the number of involved branches ranged from one to twelve, being averaged to be 7. In group II, the most common abnormalities were no recordable or decreased amplitude of CNAP (85.7 %) and the decreased NCV were found in 1 out of 7. Three out of 7 showed abnormalities in all digital or interdigital nerves and the remaining four showed abnormal findings in at least 4 among 12 digital or interdigital nerves. CONCLUSION: The interdigital NCS with the near nerve needle and averaging technique increased the diagnostic sensitivity in those subjects with clinically suspected polyneuropathy (group I) and the most common abnormal features in the interdigital NCS were the amplitude changes of CNAP. Therefore the authors suggest that the interdigital nerves of the foot are involved earlier in the process of polyneuropathy and the interdigital NCS of the foot might provide enhanced sensitivity for detecting early polyneuropathy.
Action Potentials ; Ankle ; Diagnosis ; Foot* ; Humans ; Needles ; Neural Conduction* ; Peripheral Nerves ; Polyneuropathies*

BACKGROUND: Blepharospasm and apraxia of lid opening (ALO) are nonparalytic causes of involuntary eyelid closure (IEC). Recently Aramideh (1994) divided the IEC into 5 groups by electromyography (EMG) study, and reported that each group had different responses to Botulinum A toxin treatment. Objective : We looked whether clinical observation can match the EMG, and possibly predict the response to Botulinum A toxiu treatment. Method : Based on EMG study of Aramideh (1994), clinically observable characteristics of each group were defined. One of the authors reviewed the videotapes of IEC and applied the above criteria to make the clinical diagnosis. Other author blinded to the clinical information performed 2 channel EMG of levator palpebrae superioris (LP) and orbicularis oculi (00) muscles, and made the EMG diagnosis. Clinical and EMG diagnoses were matched. Results : Twenty five patients (5 men and 20 women) were included in the study. Clinically, 16 were diagnosed as group I (blepharospasm), 1 as group 111(combined blepharospasm and LP motor impersistence), 7 as group tV(combined blepharospasm and involuntary LP inhibition), and 1 as group V(involuntary LP inhibition). There were no patient in group ll (combined dystonic activities of LP and 00). On EMG study, 14 were diagnosed as group 1, 2 as group ll, 1 as group 111, 7 as group IV, and 1 as group V The mismatch between the two diagnoseis occurred between group I and tV in 4 patients, group I and ll in 2, and group I and 111 in 2. Conclusions : Clinical observations are generally correct in predicting EMG diagnosis. Holvever groups with mixed features(ll, 111, and Iv) are difficult to diagnose by clinical observation only. Usefulness of clinical and EMG diagnosis on predicting Botulinum A toxin response will need to be evaluated. Key Words : Involuntary eyelid closure, Blepharospasm, Apraxia of lid opening, Electromyography.
Apraxias ; Blepharospasm ; Botulinum Toxins, Type A ; Diagnosis* ; Electromyography ; Eyelids* ; Humans ; Male ; Muscles ; Videotape Recording

No abstract available.
Intussusception*

No abstract available.

To observe the change in the status of stresses according to three different postural angulation of an intervertebral disc with or without nucleus pulposus, 6 specimens of a 3-dimensional photoelastic model of the spine were made of epoxy. The nucleus pulposus portion was replaced with silicon in three models, and the three were made without silicon. Through axial application of a vertical compressive load of 8 kg, the peculiar patterns of the isochromatic fringes were observed. Stresses on the intervertebral disc were analyzed according to three different postural angulations of the intervertebral disc with the nucleus pulposus and without the nucleus pulposus. The results of these study are as follow: 1. In an erect neutral posture with the nucleus pulposus, the stress concentration was much increased at the posterior portion rather than at the anterior portion. Also, the high stress was concentrated at the medial and central portion. In an erect neutral posture without the nucleus pulposus, the stress concentration was much increased at the anterior portion rather than at the posterior portion and the stress distribution seemed to be locally concentrated. 2. In a maximal flexed posture, the stress concentration was much increased at the posterior portion rather than at the anterior portion. Comparing the presence of the nucleus pulposus with the absence of the nucleus pulposus, the stress concentration was lower at the anterior portion in the presence of the nucleus pulposus than in the absence of the nucleus pulposus. However, the stress distribution at the posterior portion was nearly same in the two groups. According to the analysis of the stress distribution diagram, as a whole, the stress pattern around the disc was evenly distributed. 3. In a maximal extended posture, the higher concentration of the stress distribution at the anterior and medial portion rather than in the posterior and lateral portion was observed. The stress concentration was higher in the presence of the nucleus pulposus than in the absence of the nucleus pulposus. 4. Comparing the maximal flexed posture with the erect neutral posture, the stress concentration in the flexed posture was much decreased in the posterior portion rather than in the erect neutral posture, and an even distribution of the stress pattern in the flexed posture was observed. 5. In the presence of the nucleus pulposus, at the anterior and posterior portion, the stress concentration in the flexed posture was much decreased compared with the extended posture. In the absence of the nucleus pulposus, at the anterior and posterior portion, the stress concentration in the extended posture was much decreased compared with the flexed posture.
Intervertebral Disc* ; Posture ; Silicon ; Spine

The biocompatibility of the titanium has been estabilished through various experimental studies such as cell culture toxicity test, pyrogen test, mutagen test and others. In order to confirm biocompatibility after fabrication of titanium and to clarify the difference between the bone reaction after insertion of the lathed titanium rods and the bone reaction after insertion of the finished and polished rods, both rods were implanted into the proximal femur of a rabbit. Histologic reactions in the bone were observed according to the ASTM standards at the intervals of 6 weeks, 12 weeks and 26 weeks after implantation. The result were as follows In 6 weeks after implantation of lathed titanium rods, inflammatory reactions, such as minimal degree infiltration of polymorphonuclear leukocytes and lymphocytes were observed in all cases. This was thought to be caused by surgical trauma. However, inflammatory cell infiltration was not seen after implantation of polished and finished rods in all cases. The cellular infiltration and the histologic reaction of the bone after implantation of lathed group were significantly more pronounced than those after implantation of the finished group. In 12 weekt after implantation of lathed rods, two of four cases revealed a minimal degree of cellular infiliration and histologic reaction seemed to be more pronounced in the lathed group, but they were not significant statistically.
Cell Culture Techniques ; Femur ; Lymphocytes ; Neutrophils ; Titanium* ; Toxicity Tests