The epidural injection of corticosteroid reduces the inflammatory process of the neural structure and its neighbor structures. Morphine, also injected epidurally, has been reported to alleviate severe pain with the short-acting property. In attempt to prolong the effectiveness of pain relief, we have studied the effect of the epidural injection of the morphine and steroid frorg May 1987 to Oct. 1987, and compared with the effect of the epidural injection of the steroid and local anesthetics from Jan. 1986 to Oct. 1987. In this study, we obtained following results; 1. The major causative diseases were herniated necleus pulposus in 34 cases(48.5%), spinal stenosis in 16 cases(22.9%) and spondylolisthesis in 9 cases(12.9%). 2. In morphine-injected group, 100% of acute group and 92.3% of chronic group was improved. In non-morphine injected group, there was no significant difference between the acute and chroinc groups. 3. The effect of epidural morphine and steroid was as follows; Complete relief 14 cases (63.6%), marked improvement 5 cases(22.7%), moderate improvement 2 cases(9.2%) and no relief 1 case(4.6%). The overall improvement was resulted in 21 cases(95.4%). 4. The effect of epidural steroid and local anesthetics was as follows; Complete relief 10 cases(20.8%), marked improvement 14 cases(29.2%), moderate improvement 12 cases(25%~ and no relief 12 cases(25%). The overall improvement was resulted in 36 cases(75%). 5. The average duration of pain relief was 2.5 months in morphine injected group and 1.3 months in non-morphine injected group. 6. The side effects associated with opiate, such as generalized pruritus, nausea, vomiting and urinary retention were reported in 16 cases(72.7%), but responded readily to Naloxone injection and subsided within 24 hours. It is considered that epidural injection of morphine and steroid prolong the effect and duration of pain relief for low back pain and sciatica when compared with the epidural injection of steroid and local anesthetics.
Anesthetics, Local ; Injections, Epidural ; Low Back Pain ; Morphine ; Naloxone ; Nausea ; Pruritus ; Sciatica ; Spinal Stenosis ; Spondylolisthesis ; Urinary Retention ; Vomiting

No abstract available in English.
Tibia

The soleal line in 115 (left; 61, right; 54) cases of tibiae was studied morphometrically by the method of Mysorekar and Nandedkar. 1. The soleal line showed a uniform character throughout in 26 cases and a mixed characters in 89 cases. The bones showing uniform character were seen generally as a lineal line or wide line. 2. The soleal line having mixed characters divided into three parts. In the upper and middle thirds, the major type of line was wide line. In the lower third, the line was commonly seen as a lineal line. In about 12% of the bones examined the line was seen as a groove, particularly in the middle and lower thirds. 3. The soleal line commenced 1-2cm below the fibular facet In about 61% of cases. 4. The length of the soleal line was 10.5cm, and the ratio to that of the tibia was about 30%. The results of this study provide the characters of the soleal tne of the tibia in Korean. The soleal line, unlike the textbook description, generally shows mixed characters of a line.
Methods ; Tibia*

Colloidal gold 198Au were injected into 40 knee joints of rabbits for the study of the change of synovial membrane. We verified even distribution of Colloidal gold 198Au about knee joints by use of scintigraphy. After then, histopathological examinations were performed by periodic intervals. The following results are obtained form this study. l. Intra-articular injection of Colloidal gold 198Au into rabbit's knee joints resulted in a mild resctive inflammation at synovium. In was charscterized by an infiltration of eosinophils and by sclerotic changes in the subsynovium and by fibrosis of synovial vessels. 2. From this study, intra-articular injection of Colloidal gold 198Au may by benefit to treat the chronic synovial effusion in human.
Colloids ; Eosinophils ; Fibrosis ; Gold Colloid ; Humans ; Inflammation ; Injections, Intra-Articular ; Knee Joint ; Rabbits ; Radionuclide Imaging ; Synovial Membrane

In fusion of lumbar spine, every fused motion segments shows varisble limitation of motion in flexion, extension and lateral bending according to their types and level of fusion. The motion segment of lumbar spine is three joint complex which consists of posterior two articular facet joints and an anterior intervertebral disc. Nowadays, orthopedic surgeon prefer anterior fusion due to direct identification and removal of diseased tissue, reduction of fractured fragments, restoration of intrevertebral space, early rehabilitation and no damage of nerve root and cord, and is prefered short Segmental Spinal Instrumentation(e.g. Cotrel Dubousset Instrumentation, etc.) due to short and rigid fusion, no necessity of external support and low limitation of motion. We studied 58 cases of fused lumbar spine which had been operated since Sep.1983, by X-ray overlay method and 20 cases of healthy lumbar spine as eontrol group. In this study, we obtained following results ; 1. Harrington Rod Instrumentation reveals the most remarkable limitation of motion, whereas, C.D.I. and A.I.F. reveal the least limitation of motion. 2. Distinct differencies of motion are repersented by its range of fusion and range of motion in 2 segmental fusion reveals remarkable decreasement from range of motion in single segmental fusion. 3. In single segmental fusion, the most limitation of motion was represented in Harrington Rod Instrumentation and posterior fusion with bone graft. There is remarkable decreasement of flexion at lumbosacral junction by its site of fusion. 4.In double segmental fusion, the most limitation of motion was represented in Harrington Rod Instrumentation and there is no significant difference of motion by its site of fusion.
Intervertebral Disc ; Joints ; Methods ; Orthopedics ; Range of Motion, Articular ; Rehabilitation ; Spine ; Transplants ; Zygapophyseal Joint

Between Jan. 1976 and May 1987, Sixteen supracondylar fractures of the femur were treated by interlocking nailing. Of the 16 cases, 7 cases were intercondylar, 12 cases were segmental fractures of the femur, 4 cases were open fractures in the type of wound. 1. The simple supracondylar fracture involving the distal 9cm of the femur can be treated by interlocking nailing which makes firm fixation and allows early ambulation. 2. If the supracondylar fracture is accompanied with intercondylar fracture, careful reduction and transcondylar fixation by means of tibial bolt or cancellous screws are essential before the insertion of the nail. 3. The shape of the bent nail must be depended on the type of the fracture. If the nail is to be inserted into the anterolateral aspect of the distal fragment, the degree of bending of the nail is 400cm, and posteromedial is 110cm in radius. 4. The authors made several sagittal holes the at dorsum of the nail. So the screw can be easily inserted to the nail perpendicularly or obliquely, when the insertion of the screw through the transverse holes is difficult. 5. Of the 15 cases treated by interlocking nailing, 5 cases were excellent, 4 cases were good, 2 cases were fair, 4 cases were failure by schatzker assessment.
Early Ambulation ; Femur ; Fractures, Open ; Radius ; Wounds and Injuries

Pigmented villonodular synovitis (PVNS) is a relatively rare condition. The disorder almost always involves a single joint and the knee is most commonly affected. We report on three cases of localized PVNS that involved the patella fat pad and synovium. Diagnostic and therapeutic arthroscopies were performed, and typical findings of localized PVNS were found. Complete resection of the lesions were performed arthroscopically. Arthroscopy can be used as an effective diagnostic and therapeutic tool for identification and resection of intraarticular localized PVNS of the knee.
Adipose Tissue ; Arthroscopy ; Joints ; Knee* ; Patella ; Synovial Membrane ; Synovitis, Pigmented Villonodular*

This study aims at analyzing the articulator of human body and its composition using the Magnetic Resonance Image (MRI, 0.5 Telsa). The MRI images were photographed for 1cm per every cm of human body using TR 600ms and TE 20ms spin-echo sequence. For this test, 6 healthy male subjects were sampled. The subject's heights and weights were measured before photographing and then their entire bodies were photographed in the MRI whole body scanner which has a 56cm diameter. It took 90~120 minutes to scan every subject's body during scanning the subjects were allowed to put their both hand beside their femurs. According to his height, each subject were photographed for 180~200 MR slices and every image was analyzed on the tracing paper via X-ray reading View Box. Then, the traced images were all volumized through computer scanner and CAD program, and thereupon, each volume was multiplied by its density coefficient. The results of study can be summarized as follows ; The mass of the bones occupied 8.41±0.62kg, which accounted for 11% of the body mass. The femurs accounted for 19.73±2.73% of the bone mass in terms of bodily articulation. The muscle occupied 39.70±5.28kg which accounted for 51.28±8.98% of the body mass. The part which has the richest muscle mass was femur which accounted for 33.93±5.58% of entire muscle mass. The fat accounted for 24.61±11.6% of the body mass, among which the back waist including inside intestinal fat occupied 30.66±3.64%. It was suggested through this study that MRI analysis is the most suitable method to evaluate the composition of human body and that the data acquired through MRI analysis may apply as references to other indirect or estimated evaluation of human body.
Body Composition* ; Dental Articulators ; Femur ; Hand ; Human Body ; Humans ; Magnetic Resonance Imaging ; Male ; Methods ; Weights and Measures

No abstract available.
Echocardiography* ; Heart Defects, Congenital* ; Hypertension*

PURPOSE: Carnitine plays a key role in the oxidation of fatty acids by facilitating their transport. As very low birth weight(VLBW) infants receiving total parenteral nutrition(TPN) with limited oral intake are likely to be carnitine-deficient state, they require exogenous supplementation of carnitine, however, effects of it remains controversial. To demonstrate effects of parenteral camitine supplementation on fat metabolism, weight gain and clinical outcome. We analyzed plasma levels of biochemical markers, changes of weight, and incidence of complications in 23 VLBW infants receiving TPN. METHOD: We randomly assigned 23 VLBW infants(<32 wks of gestational age) receiving TPN to carnitine-supplemented(100mg/kg per day) group(n=10) and control(n=13). Plasma total (TC), free(FC), and acyl carnitine(AC) levels and serum cholesterol, triglyceride and free fatty acid levels were measured before and 2 weeks after carnitine supplementation. RESULT: Decrements in TC for 2 weeks were significantly lower in carnitine group(41.6umol/l->32.3umol/l) than control group(46.3umol/l->25.2umol/l)(p<0.05). Changes of FC and AC were similar in both groups. Levels of cholesterol and triglyreride were similar in both groups. Days of regaining birth weight were faster in carnitine group than control group(15.3+/-3.4 vs 20. 8+/-11.1 days)(p<0.05). Rate of weight gain for two weeks were significantly faster than carnitine group than control group(p<0.05). No significant differences in clinical outcome were found. CONCLUSIONS: Carnitine supplementation in VLBW infants receiving TPN has an supportive nutritional regimen in that it reduces decrement in carnitine level and facilitate weight gain.
Biomarkers ; Birth Weight ; Carnitine* ; Cholesterol ; Fatty Acids ; Humans ; Incidence ; Infant* ; Infant, Very Low Birth Weight* ; Metabolism ; Parenteral Nutrition, Total ; Parturition ; Plasma ; Triglycerides ; Weight Gain