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

No abstract available.
Female ; Pregnancy ; Pregnancy, Multiple*

No abstract available.
Adenocarcinoma* ; Fallopian Tubes* ; Female

Paraplegia following intrathecal methotrexate(MTX) instillation is a rare complication and 18 cases have been reported in the literature. It has not been reported m Korea. We recenty experienced a 56 year-old female with quadriplegia following intrathecal MTX instillation. So we report a case of paraplegia following intrathecal MTX instillation with review of the literature.
Female ; Humans ; Korea ; Methotrexate* ; Middle Aged ; Paraplegia* ; Quadriplegia

No abstract available.
Pregnancy*

Takayasu's arteritis is a chronic inflammatory arteriopathy of unknown etiology involving mainly the aorta and the large arteries arising from its arch. It is characteristically a disease of young females of Oriental descent. It causes occlusion, coarctation or aneurysmal dilatation of the affected vessels. We report, with the review of the literature, a patient with Takayasu's arteritis who developed the cerebrovascular disease.
Aneurysm ; Aorta ; Arteries ; Dilatation ; Female ; Humans ; Stroke* ; Takayasu Arteritis*

OBJECTIVES: To determine if hysterectomy with or without ovarian preservation is asso-ciated with obesity in premenopausal women. METHODS: 581 women for routine check up from Jan. 1985 to Dec. 1995 in the depart-m ent of Gynecology at Korea Veterans Hospital were included. The obesity was evaluated by BMI(body mass index) scores. 80% of hysterectomy were confirmed from the hospital records. The age, weight, height, blood pressure, menstr- ual history, history of DM and hypertension, social history of alcohol and smoking and other cardiovascular risk factors such as cholesterol, HDL-cholesterol, triglycerides were checked. The 248 women with natural postmenopausal status before hysterectomy, taking hormonal replacement therapy after hysterectomy and having performed hysterectomy due to malign- ancy were excluded. RESULTS: All women performed hysterectomy were in premenopausal status in this study. Therefore, the final numbers of subjects included in the analysis was 333. Hysterectomy wit- hout ovarian preservation were performed in 58 cases and hysterectomy with ovarian pres- ervation were in 57 cases. The 218 premenopausal cases which did not performed hystere- ctomy were considered control group. BMI scores were higher in cases without ovarian pres- ervation than with ovarian preservation. And BMI score was associated with the postoper- ative duration in hysterectomy with ovarian preservation. CONCLUSIONS: We suggest that hysterectomy without ovarian preservation in premeno- paussal women were associated with increased obesity, especially BMI scores.
Blood Pressure ; Cholesterol ; Female ; Gynecology ; Hospital Records ; Hospitals, Veterans ; Humans ; Hypertension ; Hysterectomy* ; Korea ; Obesity* ; Risk Factors ; Smoke ; Smoking ; Triglycerides

Metastatic brain parenchymal tumors are among the most important cause of death in patients with cancer, but many physicians didn't have any efforts to treat of metastatic tumors because of their poor responses of treatment. With the recent development of MR techniques, we could diagnose and treat them earlier. Recently many reports for prognostic factors of metastatic brain parenchymal tumors led to assume a more active attitude toward the diagnosis and treatment. We analysed 250 cases of metastatic brain parenchymal tumors diagnosed with the brain CT scan or MRI scan at Yonsei University, Severance Hospital from January, 1992 to December, 1995 and following results were obtained. 1. Metastatic brain parenchymal tumors are found in 254 cases(38.5%) of all intracranial neoplasms. 2. The most common primary tumor is lung cancer(154 cases, 61.6%) followed by breast cancer (30 cases, 12%), GI cancer (15 cases, 5.6%) in the order and melanoma (11.9%), rectal cancer (11.3%), lung cancer (8.6%) exhibit relatively high rate of intraparenchymal metastasis in the order. 3. The most common presenting symptom and sign is headache(52.8%) followed by motor deficit (32.4%), nausea and vomiting(21.6%). 4. Metastatic brain parenchymal tumors are detected simultaneously (73 cases, 28.8%), precociously (9 cases, 3.6%), after (153 cases, 61.2%) diagnosis of the primary tumor. Interval between the diagnosis of primary tumor and development of intracerebral metastasis is short in lung cancer (15.2 month) and long in breast cancer (43.1 month), nasopharyngeal cancer (51 month). In radiologic findings, the lesions were located in supratentorial areas in 186 cases, and in infratentorial in 36 cases. Ring type(63.6%) in enhancement is more than nodular type (33.2%). 5. Hemorrhages are found in 15 cases (7.6%) and calcifications in 2 cases. Density of lesions are hypodense(72.8%) than hyperdense on CT scan and high signal intensity in T1, or T2 weighted image of MRI are 66.7% and 88.9%. 6. Treatments for metastatic brain parenchymal tumors are conventional adiation therapy(165 cases, 66%), surgery(22 cases, 8.8%), gamma knife surgery (19 cases, 7.6%) in the order and there were 36 cases(14.4%) who didn't have any treatment. There are 132 cases(58.2%) who alive and 118 cases(47.2%) who dead. 7. Good predilicting findings in prognosis of metastatic brain parenchymal tumors are single lesion and supratentorial location. However, there are no significant value between prognosis and interval primary-to-metastasis, age, type of primary cancer, type of presenting symptom, size of edema.
Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Cause of Death ; Diagnosis ; Edema ; Hemorrhage ; Humans ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Nasopharyngeal Neoplasms ; Nausea ; Neoplasm Metastasis ; Prognosis* ; Rectal Neoplasms ; Tomography, X-Ray Computed

BACKGROUND: There has been considerable progression in laboratory investigations of novel therapeutic approaches aimed at protecting the brain parenchyma in the setting of the acute ischemia. The zone of ischemia surrounding an area of infarction provides a target for neuroprotective agents. MK-801 is a well known non-competitive NMDA receptor antagonist and has a neuroprotective effect to ischemic penumbra zone. U-74389G is a compound of Lazaroid(21-Aminosteroid) and a free radical scavenger which has been investigated to a neuroprotective effect to ischemic penumbra zone. METHODS: The protective effects of single or combined pretreatment of U-74389G and MK-801 on the focal cerebral ischemia in the Sprague-Dawley rats were evaluated. The size of infarction after 2 hours occlusion-4 hours reperfusion of the left middle cerebral artery with modified Longa method was measured. The rats were given 3mg/Kg I.v. of MK-801 and U-74389G or 0.5ml of normal saline 30 minutes before middle cerebral artery occlusion. The size of infarction was described as the volume. RESULTS: U-74389G, MK-801, and combined U-74389G and MK-801 pretreatment reduced significantly the volume of infarction 55%, 64%, 24%, respectively compared with saline pretreatment (p<0.05) and the combined U-74389G and MK-801 pretreatment reduced significantly the volume of infarcted area compared with MK-801 or U-74389G pretreatment, 44%, 37%, respectively(p<0.05). There was no significant change of infarction volume between U-74389G and MK-801 pretreatment(p>0.05). CONCLUSIONS: These results show that single or combined pretreatment of U-74389G and MK-801 before 30 minutes of occlusion significantly reduced the volume of infarction compared with the control group in the focal cerebral occlusion-reperfusion of rats. And the combined pretreatment of U-74389G and MK-801 before 30 minutes of occlusion significantly reduced the volume of infarction compared with the single pretreatment of MK-801 or U-74389G in the focal cerebral occlusion- reperfusion of rats.
Animals ; Brain Infarction* ; Brain Ischemia ; Brain* ; Dizocilpine Maleate* ; Infarction ; Infarction, Middle Cerebral Artery ; Ischemia ; Middle Cerebral Artery ; Models, Animal* ; N-Methylaspartate ; Neuroprotective Agents ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

No abstract available.
Catheterization* ; Catheters* ; Fallopian Tube Diseases* ; Fallopian Tubes* ; Female