No abstract available.
Ataxia* ; Brain Stem Neoplasms* ; Mesencephalon*

OBJECTIVE: The IDET(Intradiscal electrothermal therapy) appears as a new therapeutic modality for intractable discogenic back pain. We carried out a prospective study to analyze and evaluate the therapeutic effects of IDET. METHODS AND RESULTS: During a six month period, we performed IDET in 39 patients with chronic low back pain using RITA Model 30 Electrosurgical device. The patients included 21 men and 18 women. The mean patient age was 50.2 years(range 21-73 years). All patients underwent preoperative plain radiography and MRI for excluding non-discogenic back pain. We conducted discography-CT to reveal painful discs in all patients. During the study, we measured intradiscal pressure subjectively. The area of annular tear, which identified with post-discography CT scan, was coagulated in 90degreesC of temperature for 15 minutes. Of the 17 patients who were followed up more than three months after surgery, the 10 patients(58.8%) experienced clinical improvement. Three patients had high intradiscal pressure on discography, other three patients had loss of disc height more than 30% of normal on plain radiography, and one patient suffered from postoperative epidural abscess. All of these patients were included in the remaining no improvement group(41.2%). CONCLUSION: The IDET procedure could be an alternative modality for discogenic back pain. It appears that a patient who has low intradiscal pressure on discography and intact disc height on plain radiography is considered a good candidate for IDET.
Back Pain ; Epidural Abscess ; Female ; Humans ; Low Back Pain* ; Magnetic Resonance Imaging ; Male ; Prospective Studies ; Radiography ; Tomography, X-Ray Computed

PURPOSE: To evaluate the diagnostic value of MRI of the shoulder. MATERIALS AND METHODS: Between January andJune 1997, shoulder MRI and arthroscopy were performed in a total of 48 patients with shoulder pain (n=30) orshoulder instability (n=18). Forty-five were males and three were females; their ages ranged from 16 to 67 (mean32.5) years. The period between shoulder MRI and arthroscopy was between one and 390 (mean, 42.2) days. Twenty-sixpatents underwent MR arthrography (AMR), and 22 conventional MRI(CMR). Each image was analyzed for rotator cuffinjury, glenoid labral injury, SLAP lesion, and biceps tendon injury. RESULTS: On arthroscopy, one disease wasfound in 34 patients, two were found in six, three diseases were found in seven, and one patient had fourdiseases. Arthroscopic diagnosis was as follows: rotator cuff injury, 29 ; SLAP lesion, 12 ; glenoid labralinjury, 10 ; biceps tendon injury, 4 ; subacromial bursitis, 2 ; chronic synovitis, 1 ; adhesive capsulitis, 1 ;superior glenohumeral ligament injury, 1 ; normal, 1. For rotator cuff injury, the sensitivity of MRI was 65.5%and specificity was 93.0% (AMR : 66.7%, 95.8%, CMR : 65.2%, 86.4%). For SLAP lesion, sensitivity was 58.3% andspecificity was 97.2% (AMR : 66.7%, 100%, CMR : 50%, 93.8%) ; for glenoid labral injury, sensitivity was 80.0% andspecificity was 89.5% (AMR : 85.7%, 84.2%, CMR : 66.7%, 94.7%), and for biceps tendon injury, the false negativerate was 100%. CONCLUSION: In cases involving glenoid labral injury, the diagnostic accuracy of shoulder MRI wasrelatively high ; in rotator cuff injury and SLAP lesion, however, diagnosis was limited, and in biceps tendoninjury was difficult. We suggest, however, that MR arthrography has certain diagnostic advantages overconventional MRI.
Arthrography ; Arthroscopy ; Bursitis ; Diagnosis ; Female ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Male ; Rotator Cuff ; Sensitivity and Specificity ; Shoulder Joint* ; Shoulder Pain ; Shoulder* ; Synovitis ; Tendon Injuries

No abstract available.
Adult* ; Humans ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

No abstract available.
Sparganosis*

OBJECTIVES: This study was undertaken to evaluate associated underlying disease and follow-up changes of multiple cortical defects(MCD) in recurrent acute pyelonephritis(APN) patients with MCD on DMSA scan. METHODS: DMSA scan was performed in 128patients who visited Asan Medical Center with recurrent APN and 80patients showed MCD. Intravenous pyelography(IVP), ultrasound of the kidney(US), voiding cystourethrography(VCUG) were performed to search associated underlying diseases and changes of MCD were studied with follow-up DMSA scan at least 6 months after initial DMSA scan. RESULTS: 1) Underlying diseases were detected in 34patients, including vesicoureteral reflux in 21, renal stone in 4, renal tuberculosis in 3, ureteral stenosis in 3, renal infarction in 1, megaureter in 1, neurogenic bladder in 1, 2) Follow up DMSA scan revealed no changes in 14patients, improvement in 2. CONCLUSION: The patients with multiple defects on DMSa scan have underlying abnormalities in 42%, so they need more radiologic studies such as VCUG, IVP, US. Multiple defects indicate irreversible damage in most patients.
Chungcheongnam-do ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Infarction ; Pyelonephritis* ; Succimer* ; Tuberculosis, Renal ; Ultrasonography ; Ureter ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux

Phospholipase C (PLC) isozymes play significant roles in transmembrane signal transduction. PLC- 1 is one of the key regulatory enzymes in signal transduction for cellular proliferation and differentiation. The exact mechanisms of this signal transduction of tissue damage and subsequent regeneration, however, were not clearly documented. This study was planned to determine the biological significance of PLC isozymes following irradiation in rat small intestine. Sprague-Dawley rats were irradiated to the entire body by a single dose of 8 Gy. The rats were divided into 5 groups according to the sacrifice days after irradiation. The expression of PLCs in each group was examined by the immunohistochemistry and immunoblotting. The histologic findings were observed using hematoxylin and eosin staining. The regenerative activity, which was estimated by mitotic count and proliferatin cell nuclear antigen (PCNA) immunostaining, was highest in Group III (5th day after irradiation). By the immunohistochemistry, the expression of PLC- 1 was higher in Group III and Group II (3rd day after irradiation), and was found in the regenerative zone of the mucosa. The expression of PLC- 1 was highest in Group I (1st day after irradiation) and was dominantly in the damaged surface epithelium. The immunostaining of PLC- 1 was negative in all groups. The results of the immunoblotting study was compatible to that of the immunohistochemical study. Group II and III showed positive bands for PLC- 1, and group I and II for PLC- 1. These results suggest that PLC- 1 plays a significant role in mucosal regeneration following irradiation. PLC- 1 may play a role in radiation - induced mucosal damage.
Animals ; Cell Proliferation ; Eosine Yellowish-(YS) ; Epithelium ; Hematoxylin ; Immunoblotting ; Immunohistochemistry ; Intestine, Small* ; Isoenzymes* ; Mucous Membrane ; Phospholipases* ; Rats ; Rats, Sprague-Dawley ; Regeneration* ; Signal Transduction ; Type C Phospholipases*

OBJECTIVE: Percutaneous kyphoplasty using a balloon-catheter is an widely accepted method which achieves the restoration of vertebral height and the correction of kyphotic deformity with little complication in osteoporotic vertebral compression fractures. The authors assess the results of 59 patients who underwent kyphoplasty, and analyze the factors that could affect the prognosis. METHODS: From December 2001 to May 2003, fifty-nine patients underwent kyphoplasty. The patients included 49 women and 10 men aged 52-85 years. Average t-score on bone marrow density was -3.58. About 7cc of polymethylmethacrylate(PMMA) was injected into the fractured vertebral body using Kyphon(R) under local anesthesia. The vertical height of all fractured vertebrae was measured both before and after surgery. Outcome data were obtained by comparing pre- and post-operative VAS score and by assessing postoperative satisfaction, drug dependency and activity. Various clinical factors were analyzed to assess the relationship with the outcome. RESULTS: The VAS score improved significantly, and the mean percentage of restored vertebral height was 53%. The mean improvement in kyphosis was 3.6degrees. Eighty-nine percent of the patients gained excellent or good results. Any of the clinical factors including the interval between fracture and operation, the degree of height loss, the degree of the vertebral height restoration or the correction rate of kyphosis did not affect the clinical results. CONCLUSION: Kyphoplasty is associated with a statistically significant improvement in pain and function with little complication. The clinical results are not affected by any clinical parameters. Further follow-up study is needed to determine whether the restoration affects the long-term clinical results.
Anesthesia, Local ; Bone Marrow ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphoplasty* ; Kyphosis ; Male ; Osteoporosis ; Prognosis ; Spine

PURPOSE: Phospholipase C (PLC) isozymes ply significant roles in transmembrane signal transduction. PLC-i 1 acts as the intracellular effector in signal transduction for cellular proliferation and differentiation. Ras oncoprotein is also involved in cell growth. We determined the biological significance of PLC and ras oncoprotein in regeneration following radiation and the effect of different modes of administration of 5-FU. MATERIALS AND METHODS: To determine the effect of the administration mode of 5-FU on the regeneration of intestinal mucosa of rats following radiation, we compared the expression of PLC and ras oncoprotein in six groups. Group I had no treatment. GroupII received radiation( 8 Gy) only. Group III received radiation(8 Gy) and 5-FU(150mg/kg) continuous intravenous (iv) infusion for 12 hours. Group iv bolus injection. Group V received only 5-FU(150mg/kg) iv bolus injection. Through immunoblotting and immunohistochemistry, we examined the expression of PLC and ras oncoprotein in rat jejunum at 96 hours after radiation or 5-FU administration and at 120 hours after radiation and 5-FU administration. We also investigated the histological findings using hematoxylin and eosin stain. RESULTS: In the immunohistochemistry study, PLC-i 1 expression was the highest in group III followed by groups II and VI in that order and was weakly positive in groups V and VI. PLC-i 1 was hardly detected in the control group. The expression of ras oncoprotein wss the same as the PLC-i 1 expression for all groups. These results were confirmed by the histological findings regarding the mucosal regeneration. In the immunoblotting analysis, PLC-i 1 expression was the highest in group III followed by group IV and II in that order. This difference between the immunoblotting and immunohistochemistry study was due to the high expression of PLC-i 1 on the damaged surface epithelium rather than to its expression in the regeneration region as observed in the immunohistochemistry study for group IV. The expression of PLC- 1 was positive only in group V and VI, which received both radiation and 5-FU, and the expression of PLC-b 1was negligible for all groups. CONCLUSION: These results suggest that PLC-i 1 mediated signal transduction and ras oncoprotein may have a significant role in mucosal regeneration after radiation, and that continuous iv infusion of 5-FU may induce active regeneration in intestinal mucosa following radiation. In addition, the expression of PLC- 1 in combined group of radiation and 5-FU implies that PLC- 1 may be involved in signal transduction mediated by concerted action between radiation and 5-FU.
Animals ; Cell Proliferation ; Eosine Yellowish-(YS) ; Epithelium ; Fluorouracil* ; Hematoxylin ; Immunoblotting ; Immunohistochemistry ; Intestinal Mucosa* ; Isoenzymes ; Jejunum ; Phospholipases* ; Rats* ; Regeneration* ; Signal Transduction ; Type C Phospholipases*

This study was to determine which of two routes of administration of 5-fluorouracil (5-FU) is more effective, by measuring the radioactvity in the body tissues of gastric cancer patients after the administration of 5-FU-l4C via the systemic intravenous and the regional intra-arterial routes. After the drug was administered intravenously in one group of patients, and intra-arterially in another; samples of portal venous blood, the liver, the lymph nodes, and the normal and the cancerous tissues of the stomach were obtained. The radioactivities of the samples were measured, and it was found that those of the regional lymph nodes, the liver, and the normal and the cancerous tissues of the stomach were much higher in the latter group. The regional intra-arterial routes is the more effective way to administer 5-FU in patients with stomach cancer.
Carbon Radioisotopes/diagnostic use ; Comparative Study ; Fluorouracil/administration & dosage ; Fluorouracil/metabolism* ; Human ; Injections, Intra-Arterial ; Injections, Intravenous ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/metabolism