The cornell medical index is self-administered instrument that collects a large body of significant medical and psychiatric data. The original C. M. I. consists of 195 questions, but authors selected 60 questions from the original C. M. I. to simplify it. The purpose of this investigation is to clarify if there are any correlations between low back pain and extraskeletal disorders. This investigation was conducted on 144 in-and out-patients who were treated at the Department of Orthopaedic Surgery,Our Lady of Mercy Hospital, Catholic Medical College from Jan. to July 1977. Among them 75 patients were male,69 patients were female, and 22 patients had decompression laminectomy and discectomy. The results of this investigation are as follows; 1. The majority of patients with low back pain are 2nd to 4th decade. (Male: 30±10.7) (Femal:36.1±10.5) 2. Average number of complaints is 19.9/60 in male, 21.8/60 in female. 3. Complaints in section F(Fatigability) and G(mental) are predominant in all cases. 4. There are no significant difference in number of complaints between the operative and non-operative case, and between each decade.
Cornell Medical Index ; Decompression ; Diskectomy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Male ; Outpatients

Although the incidence of leprosy is decreased considerably, the deformity and disability of it is serioues. In the hand, combined median and ulnar nerve affection is most common, and it leads to many problems including opposition dysfunction and claw hand deformity. And opposition dysfunction is most significant disability in the hand function, so its correction or reconstruction is mandatory We performed 20 cases of opponensplasty from Oct. 91 to Apr. 94 at National Medical Center, and analyzed its results according to new assessment criteria invented by authors, and evaluated the efficacy of the operative treatments. The results were as follows: 1. The patients were 9 males and 11 females, average age was 48 years old, and average duration of paralysis was 28 years. The mean follow-up period was 2.8 years. And most common type of nerve affection was combined low median and high ulnar nerves. 2. We performed 18 cases of Burkhalter opponensplasty using extensor indicis proprius and 2 cases of Riordan opponensplasty using ring finger sublimis at the leprosy hands. 3. According to authors assessment criteria for leprosy hand, the result of operative treatment was excellent in two, good in ten, fair in seven, and poor in two patients. So we obtained more than good results in 50% patients. 4. We could obtain good result with Burkhalter opponensplasty in leprosy hand, especially when combined with proper preoperative physical therapy and adjuvant operation for release of contracture and joint stiffness.
Animals ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Hand Deformities ; Hoof and Claw ; Humans ; Incidence ; Joints ; Leprosy ; Male ; Paralysis ; Tendon Transfer ; Ulnar Nerve

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare and recently recognized disease of unknown etiology, characterized by remission and exacerbation of multiple bone lesions which radiologically and pathologically have the appearance of hematogenous osteomyelitis. The natural history appears to be slow and spontaneous resolution of the osseous lesions without specific treatment. And antimicrobial agents seem to have no beneficial effect. In proper clinical setting, CRMO should be considered, because recognition of this entity would help us to avoid costly and potentially harmful diagnostic and therapeutic interventions. We report a case of a 48-year-old adult who had chronic recurrent multifocal osteomyelitis.
Adult ; Anti-Infective Agents ; Humans ; Middle Aged ; Natural History ; Osteomyelitis

In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.
Extremities ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Melanoma ; Nitriles ; Pyrethrins ; Recurrence ; Sentinel Lymph Node Biopsy ; Skin ; Surgical Flaps ; Tendons ; Transplants

Priapism is a rare disease, but needs early intervention and appropriate management. We present 2 cases of ischemic low-flow priapism after intracavernosal injection of vasoactive drug. 43-year-old man and 61-year-old man visited our clinic complaining of continuous plan and erection persisting for several days after self cavernosal injection for increasing their erectile function. We performed blood gas analysis of cavernosal blood and color doppler ultrasound. And so we confirmed the diagnosis of low-flow priapism. Detumescence was finally achieved after the proximal shunt operation. Their erectile function was not recovered and they became permanent impotence.
Adult ; Blood Gas Analysis ; Diagnosis ; Early Intervention (Education) ; Erectile Dysfunction ; Humans ; Male ; Middle Aged ; Priapism* ; Rare Diseases ; Ultrasonography

Pulmonary Aspergillomas usually arise from proliferation of Aspergillus in preexisting parenchymal cavities.202 college students (99 men, 103 women) aged 18% 26 years. Fasting blood samples were. The most common symptom in this disorder is hemoptysis, which may be minimal in amount or it may be massive & life threatening. The optimum therapy for pulmonary aspergilloma is controversial. The major options available include surgical resection of the lesion, a number of medical therapies, or simple observation of the patient for a time. Surgery is the most effective treatment but it is limited to some patient because most patients haute underlying pulmonary disease. Thus the various form of medical therapy was available with successful result. The authors present a case of percutaneous intracavitary amphoterician B injection for the treatment of pulmonary aspergilloma & its successful effect for the repetitive hemoptysis.
Amphotericin B* ; Aspergillus ; Fasting ; Hemoptysis* ; Humans ; Lung Diseases ; Male

A case of malignant eccrine acrospiroma of the anterior chest wall is reported. This mass had been present for 20 years and during rescent 5 years it showed frequent ulceration and bleeding suggesting malignant transformation. Microscopically, several foci malignant transformation from preexisting benign eccrine acrospiroma are seen and in immunohistochemical staining, the tumor cells both benign and malignant portion, show positive reaction to cytokeratin.

No abstract available.
Colorectal Neoplasms* ; Mucins*

We report a case of pure spinal epidural cavernous hemangioma and discuss the relationships among its clinical manifestation, diagnosis and treatment. A 35-year-old woman was admitted to our department with a six-month history of severe headache, nausea and back pain. Magnetic resonance imaging (MRI) of the thoracic spine showed a spindle-shaped epidural lesion extending into the neural foramen, with compression of the spinal cord at the T8-12 levels and multifocal mass lesions on the paravertebral muscles. The patient underwent microsurgery, the lesion was completely removed, and the patient recovered fully. The lesion in the spinal canal was dark-reddish and was located in the posterolateral epidural space. Histopathologic examination revealed a cavernous hemangioma. Pure spinal epidural cavernous hemangiomas have characteristic MRI findings; however, their differential diagnoses requires careful initial examination and a corresponding clinical correlation.
Adult ; Back Pain ; Caves ; Diagnosis, Differential ; Epidural Space ; Female ; Headache ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Imaging ; Microsurgery ; Muscles ; Nausea ; Spinal Canal ; Spinal Cord ; Spinal Cord Compression ; Spine

OBJECTIVE: Discectomy and/or spinal fusion have been the standard treatment options with proven effectiveness to treat degenerative spinal disease. To treat patients with more physiologic effective methods, there have been many efforts to develop various kinds of devices such as posterior dynamic stabilization and disc replacement. We reviewed our early experiences with the combined use of a partial disc replacement device, PDN-Solo(R) (Raymedica, Minneapolis, MN, USA) and an interspinous device, Coflex(R) (Fixanos, Pefonnas, France) in two.level lumbar degenerative disease. METHODS: A total of 13 patients with two.level lumbar degenerative disease underwent an operation from June 2003 to September 2004. A retrospective review of the clinical and radiological data was conducted for all the cases. The intervertebral disc height, the segmental lordotic angle and the total lumbar lordosis were measured. The clinical outcomes were evaluated by using the visual analogue scale (VAS), the Oswestry disability index (ODI) and MacNab's criteria. RESULTS: There were nine men and four women (mean age 34.4 years, range 21-64 years). The mean follow up period was 36.6 months (range 36-43 months). The average segmental lordotic angle of the PDN level was changed from 8.96degrees to 8.41degrees and that of the Coflex level was changed from 5.49degrees to 2.95degrees. The total lumbar lordotic angle was decreased from 33.74degrees to 32.40degrees. The intervertebral disc height of the PDN level was changed from 7.56 mm to 8.41 mm and that of the Coflex level was changed from 9.33 mm to 9.89 mm. The average degree of recovery from back pain was 5.6 points (from 8.9 to 3.3) and the average degree of recovery from leg pain was 4.4 points (from 7.5 to 3.1). The average degree of ODI recovery was 41.7 points (from 67.1 to 25.4). According to MacNab's criteria, the results were excellent in 4 patients (30.8%) and good in 7 patients (53.8%). CONCLUSION: Using the PDN with the Coflex may avoid rigid fixation in specially selected cases with two.level disease, i.e., those patients with spinal stenosis and a herniated lumbar disc. But further biomechanical tests and more longterm follow.up are needed.
Animals ; Back Pain ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Leg ; Lordosis ; Male ; Retrospective Studies ; Spinal Diseases ; Spinal Fusion ; Spinal Stenosis