1.Diagnostic Value of Image Findings of MRI and Discography for the Internal Disc Disruption.
The Journal of the Korean Orthopaedic Association 1997;32(3):497-505
In the investigation of patients with internal disc disruption, a discography has been the best method to decide whether intervertebral disc is normal or abnormal. Magnetic resonance imaging (MRI) of the spine is a new technique which offers an alternative method of obtaining this information. Some authors have reported MRI was more accurate than discography, but other reports have indicated discography was more useful test in symptomatic lumbar disc disease. The authors performed retrospective study to evaluate the diagnostic value of the image findings of MRI and discography in the internal disc disruption. Image findings of MRI and discography were analyzed comparing to pattern of provocative pain during discography. The concordant pain at discography was considered as a gold standard for evaluation of the diagnostic value of these modalities. The image findings of MRI and discography for 60 discs of 21 patients were graded and compared with the pain response at discography. The validity and predictive value (PV) of these modalities were calculated and the correlation between these image findings was evaluated. The sensitivities of discography and MRI were 83.3% and 90.9% respectively. The specificities of these findings were 47.1% and 46.7%. The positive PV of discography and MRI were 52.6% and 55.6%, and the negative PV were 80% and 87.5% respectively. There was no statistical significance in these discrepancies. The determinations of symptomatic disc level based on image findings are unreliable. The MRI can be considered as a screening test for internal disc disruption since it is non-invasive and sensitive diagnostic tool. The fusion level should be decided by the pain pattern at discography.
Humans
;
Intervertebral Disc
;
Magnetic Resonance Imaging*
;
Mass Screening
;
Retrospective Studies
;
Spine
2.Anterior Cervical Fusion with Cervical Spine Locking Plate.
The Journal of the Korean Orthopaedic Association 1997;32(1):8-15
Anterior plate fixation of the cervical spine provides good primary stability to allow early mobilization without significant external support. Despite the obvious advantages of anterior cervical fixation, neurological injury resulting from the direct trauma of a drill bit or screw are possibile with this technique. In addition, screw loosening leading to dyphagia has been reported. The cervical spine locking plate (CSLP) system maintains the mechanical advantages of internal fixation and eliminate the neurological risks of perforating the posterior cortex. The purpose of this study is to review our experience with this device, to critically assess its ability to stabilize the cervical spine, and to assess for complications associated with this device. The authors reviewed 28 consecutive patients in whom the CSLP system was applied between April 1994 to April 1995. Average age was 44 years ranged from nineteen to seventy-two. Patients with trauma were eight and degenerative diseases were twenty. Eighteen screws were inserted in C3 bodies, twenty-four in C4, forty-one in C5, thirty-six in C6, twenty-four in C7, two in Tl and nine on grafted bone. With a mean follow-up of 15 months, 27 of 28 patients went on to fusion. Mean time to fusion was three months (range 2-5). Fusion status of one patient was considered as uncertain. Three patients had screws placed in the disc rather than in bone. One patient suffered deep wound infection, which developed to tracheoesophagial fistula. No patient showed neurological injury as a result of this device.
Early Ambulation
;
Fistula
;
Follow-Up Studies
;
Humans
;
Spine*
;
Transplants
;
Wound Infection
3.Direct and Indirect Reduction of the Retropulsed Fragments in Thoracolumbar and Lumbar Burst Fractures.
Jin Man WANG ; Dong Jun KIM ; Seok Woo KIM
Journal of Korean Society of Spine Surgery 1998;5(1):70-78
STUDY DESIGN: Thirty-eight patients with thoracolumbar and lumbar burst fractures were evaluated according to the treatment methods of the retropulsed fragments. OBJECTIVE: To confirm the pure effect of ligamentotaxis according to the approaching methods to tile involved area. SUMMARY OF BACK GROUND DATA: Retropulsed fragments were effectively treated by indirect posterior reduction. Regardless of size of the retropulsed fragments, remodelling process of the retropulsed fragments was progressed during follow-up period. METHODS: 38 patients with burst fractures of thoracolumbar and lumbar spine were divided into two groups according to tile reduction method of the retropulsed fragments ; the one group consisted of 18 cases which were treated by posterior instrumentation and indirect reduction(Group I: ligamentotaxis) and the other groups consisted of 20 cases which were treated by posterior instrumentation and posterior direct reduction(Group II). Change of neural canal compromise rate, neurologic status, remodelling process of the retropulsed fragments were measured using pre-, post-operative and follow-up radiographs and CT. RESULTS: Comparing the two groups, neural canal compromise rates were decreased at postoperative period but, there were no significant differences in both groups. There were no correlation of neurologic status and neural canal compromise rate. We could confirm the remodelling process of the retropulsed fragments, but there were no significant changes according to the size of the retropulsed fragments between two groups. CONCLUSIONS: Indirect reduction by posterior instrumentation( ligamentotaxis ) could effectively treat the retropulsed fragments in burst fractures of thoracolumbar and lumbar spine without directs posterior reduction.
Follow-Up Studies
;
Humans
;
Neural Tube
;
Postoperative Period
;
Spine
4.The Effect of Lactic Acid Concentration on Cell Morphology and Phenotype in Cultured Intervertebral Disc Cell of Rabbit.
Dong Jun KIM ; In Hwan JI ; Jin Man WANG ; In Hong CHOI
Journal of Korean Society of Spine Surgery 1997;4(2):195-202
STUDY DESIGN: Changes of morphology and phenotype of cultured cells in media added lactate were observed. OBJECTIVES: To evaluate the effect of lactate on morphology and phenotype of cultured intervertebral disc cell. SUMMARY OF LITERATURE REVIEW: It was reported that lactate and pH were important factor in the degeneration of intervertebral disc. However the effect of lactate on morphology and phenotype of cultured intervertebral disc cell have not been studied. MATERIALS AND METHODS: Cells were dissociated enzymatically from rabbit nucleus pulposus. After attaining monolayer growth, the cells were incubated in media added 2mM or 5mM lactate. Total cell counts and morphological changes of the cells were periodically observed. Changes in cell phenotype were investigated by use of anti-collagen antibody stain. RESULTS: The cell groups added no lactate and 2mM lactate showed no difference in cell counts, morphology and phenotype. The cell group added 5mM lactate showed a reduction in final cell Counts and highel'ratio of fibroblastic cell in total population. Anti-collagen I Ab stained the Intra-and extra-cellular area of fibroblastic cells and intracellular area of chondrocytic cells. CONCLUSIONS: The current study suggests that high concentration of lactate inhibit intervertebral disc cell proliferation and accelerate morphological and phenotypical change to fibroblastic cell.
Cell Count
;
Cell Proliferation
;
Cells, Cultured
;
Fibroblasts
;
Hydrogen-Ion Concentration
;
Intervertebral Disc*
;
Lactic Acid*
;
Phenotype*
5.Effect of the Pedicle Screw Fixation on the Anterior Lumbar Interbody Fusion Using the Freeze - Dried Structural Allograft.
Jin Man WANG ; Jong Keon OH ; Dong Jun KIM
The Journal of the Korean Orthopaedic Association 1998;33(6):1569-1576
The authors performed a study of 32 patients who had undergone anterior lumbar interbody fusion using allograft with posterior pedicular instrumentation. The clinical outcomes were evaluated and the radiographs were analyzed with respect to graft subsidence, interspace collapse, graft collapse, sagittal angle and fusion status. In 71% of the levels there was a loss of disc space height during the follow-up, with 18% of the levels being narrower than their preoperative height at late follow-up. Significant(more than 3mm) subsidence and collapse were noted in three and four levels respectively. Approximately 84% of the 32 patients had satisfactory results and a radiological fusion was obtained in 88.2% of the 34 levels. We consider the pedicle screw fixation improves the retention of interspace distraction and the fusion rate of allograft in anterior lumbar interbody fusion.
Allografts*
;
Follow-Up Studies
;
Humans
;
Spine
;
Transplants
6.Cervical Fusion with Conventional Plate and Screw Using the Technique of Purchasing Near Cortex
Jin Man WANG ; Kwon Jae ROH ; Dong Jun KIM
The Journal of the Korean Orthopaedic Association 1995;30(6):1656-1661
Anterior plate fixation of the cervical spine enhance anterior grafting technique and provide good primary stability to allow early mobilization without significant external support. This facilitastes nursing and shortens rehabilitation time. Although these advantages, the screw technique is risky and time-consuming since purchasing of posterior cortex is needed for obtatining maximum stability. The authors have tried to a technique of purchasing only near cortex. The objectives of this study were review of the result of this technique and the determining the factor influencing screw loosening. One hundred and five screws used in twenty-one patients for conventional cervical plate fixation from September 1990 to February 1994 were reviewed. Average age was forty-two years old ranged from nineteen to sixty-five. Patients with trauma were six and degenerative diseases were fifteen. Two screws were inserted in C3 bodies, ten in C4, thirty-two in C5, thirty-four in C6, ten in C7, two in Tl and fifteen in grafted bone. Twenty-four screws(16%) in six patients(28.6%) were loosened. Usually the first loosening was noted at about one month after operation. The incidence of loosening was significantly higher in lower cervical region(p < 0.001) and older age(p < 0.05). The disease entity or sex were not significant factor. This technique showed high rate of screw loosening especially in older age group or lower cervical lesion. We think the indication of this technique should be limited in young patient with upper cervical lesion.
Early Ambulation
;
Humans
;
Incidence
;
Nursing
;
Rehabilitation
;
Spine
;
Transplants
7.A Case of Mucoepidermoid Carcinoma in Pulmonary Tuberculosis Patient.
Jae Man JEONG ; Ju Young SONG ; Jae Rack HONG ; Young Jun KIM ; Moon Shik KIM
Tuberculosis and Respiratory Diseases 1994;41(4):429-434
Mucoepidermoid carcinoma of lung are rare carcinoma arising from the submucosal glands tissue of the proximal tracheobronchial tree. The carcinoma can be divided into low grade and high grade varienties. The most important factors in the prognosis include histological grading and the ability to achieve a complete surgical resection. We experienced a case of high grade mucoepidermoid carcinoma in pulmonary tuberculosis patient of 67 years old male who has been suffered from left chest pain for several weeks. He was not treated and died seventeen months later.
Carcinoma, Mucoepidermoid*
;
Chest Pain
;
Humans
;
Lung
;
Male
;
Prognosis
;
Trees
;
Tuberculosis, Pulmonary*
8.The clinical aspects of pulmonary tuberculosis patient failed in retreatment.
Young Jae IM ; Ju Young SONG ; Jae Man JEONG ; Young Jun KIM ; Moon Shik KIM
Tuberculosis and Respiratory Diseases 1993;40(4):404-410
No abstract available.
Humans
;
Retreatment*
;
Tuberculosis, Pulmonary*
9.A Case of Addison's Disease: Partial Recovery of Adrenocortical Function Following Antituberculous Medication.
Kang Seo PARK ; Jong Il JUN ; Kyung Keun CHO ; Mi Sook KIM ; Jin Man HUH ; Man Soon BAEK ; Moon Jun NA
Journal of Korean Society of Endocrinology 1997;12(4):642-646
Addisons disease is relatively rare than secondary adrenal insufficiency and result from progressive adrenocortical destruction. The common causes are idiopathic autoimmune atrophy and tuberculosis of adrenal glands. It is generally regarded as incurable in the sense that substitution therapy is required for the rest of the patients life. We report a case of tuberculous primary adrenal insufficiency which was confirmed by biopsy. This case was treated with antituberculous medication and showen to have improved adrenocortical function after six months.
Addison Disease*
;
Adrenal Glands
;
Adrenal Insufficiency
;
Atrophy
;
Biopsy
;
Humans
;
Tuberculosis
10.A Clinical Study of Malignant Germ Cell Tumors of the Ovary.
Jun Hee NA ; Jun Sung KO ; Yong Man KIM ; Young Tak KIM ; Joo Hyeon NAM ; Jung Eun MOK
Korean Journal of Gynecologic Oncology and Colposcopy 1994;5(2):66-76
Malignant germ cell tumore occur in children and young women in reproductive age, of all the germ cell maligaanci orily pure dysgerminiomas had a high cure rate prior to 1970. This was due to the exquisite wdioseneitivity of these tumors. Multiple agent chemotherapy has dramatieally improved the pr nosis af patients with malignant ovarian germ cell tumors. The purpose of this study is to report the experience at Aaan Medical Center, department of Obstetrics and Gynecology, in 16 patients withmalignant ovarian germ cell tumors treated between July, l989 and June, l994. We analyzed the effect of age, histolagic subtype, FIGO stage, surgical pmcedurse and regimens of chemotherapy, on the prognosis of thwe tumors. The results obtained were as follows: 1. In histologic subtypes, dysgenninoma(38.0%), endodermal sinus tumor(25.0%), squamous cell carcinoma arising in mature cystic teratoma(19.0%), mixed cell tumor(6.0%), immature teratoma(6.0%), malignant ectodermal tumor in mature cystic teratoma(6.0%), were counted in order. 2. No site predilection was identifed. 3. Main initial symptoms were abdominal distension(31.0%), abdominal pain(31.0%), abdominal mass palpation(25.0%), amenorrhea(6.0%) in order. 4. Multiple tumor markers were considered to be useful in diagnosis and follow up of malignant germ cell tumors of ovary. 5. The mean age of malignant ovarian germ cell tumors was 29.5 years, and 11 cases(69.3%) of tumors under the age of 30.0 years. 6. The survival rate seemed to be decreased with advancing FIGO stage.
Carcinoma, Squamous Cell
;
Child
;
Diagnosis
;
Drug Therapy
;
Ectoderm
;
Endoderm
;
Female
;
Follow-Up Studies
;
Germ Cells*
;
Gynecology
;
Humans
;
Neoplasms, Germ Cell and Embryonal*
;
Obstetrics
;
Ovary*
;
Prognosis
;
Survival Rate
;
Biomarkers, Tumor