STUDY DESIGN: The authors retrospectively analysed the recovery of clinical symptoms after surgical treatment of lumbar HIVD. OBJECTIVES: To investigate the incidence of clinical symptoms, the recovery rate and time after surgical treatment and the difference between L4-5 and L5-S1 lesion. SUMMARY OF LITERATURE REVIEW: There are many reports concerning the clinical result of surgical treatment for the HIVD. They usually describe the result as excellent, good, fair and poor. We can't get any information about the recovery rate and recovery time of each clinical symptom from the reports . MATERIALS AND METHODS: Thirty-eight patients were treated by one level open discectomy from march 1991 to december 1995, The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocol. RESULTS: In preoperative examination, SLR was positive in 82%, motor deficit in 76%, sensory deficit in 74%, DTR change in 50%, and radiating pain in 100%. The recovery rate of SLR was 96.8%, motor deficit ; 93.6%, sensory deficit ,78.6%, DTR change ; 21% and radiating pain ,84.2%. The average recovery time of SLR was 3.4 months, motor deficit ; 1.9 months, sensory deficit ; 5.3 months, DTR change ; 4.1 months and radiating pain ; 3.2 months. Motor and sensory deficit was more frequent in L4-5 lesion but DTR change was usually noted in L5-S1 lesion. The recovery rate and time showed no great difference between the two level. CONCLUSIONS: The recovery rate was higher in SLR, motor deficit and radiating pain rather than sensory deficit and DTR change. The recovery time was fastest in radiating pain but variable nature was noted in sensory deficit. Above results may be helpful to explain the prognosis of the lumbar HIVD.
Diskectomy ; Humans ; Incidence ; Prognosis ; Retrospective Studies

BACKGROUND: There have been recent reports that the fat distribution within skeletal muscle and the amount of muscle mass are associated with insulin resistance and the development of type 2 diabetes mellitus (T2DM). This study evaluated the impacts of visceral fat and thigh muscle from patients with T2DM and healthy subjects on atherosclerosis and insulin resistance. METHODS: Forty-two patients with newly-developed T2DM and 11 healthy subjects were selected for the study. The diabetic patients were subdivided into two groups, those under 40 years of age, as the young T2DM (n=21) group, and 40 years-old or greater, as the old T2DM (n=21) group. CT scans were obtained for all patients at the L4-L5 level and at the mid-portion between the greater trochanter and upper margin patella. The carotid intima-media thickness (IMT) was also measured using high resolution B-mode ultrasonography. RESULTS: The mean visceral fat area (VFA) in the old T2DM group was 169.4+/-13.2cm2, which was significantly greater than that found in the healthy subjects (67.9+/-7.92cm2, P<0.001) and young T2DM group (127.1+/-10.4cm2, P<0.05). The mean visceral fat to normal density muscle area ratio (VMNR) in the old T2DM group was 1.50+/-0.19, which was greater than in the healthy subjects (0.46+/-0.52, P<0.001) and young T2DM group (1.01+/-0.10, P<0.05). The total thigh muscle areas in the young and old T2DM groups were smaller than that in the healthy subjects, but without statistical significance. VMNR showed a positive correlation with the IMT and HOMA-IR. However, the total thigh muscle area was negatively correlated with the IMT. The normal density muscle area also showed significant negative correlations with the IMT and HOMA-IR. In a multiple regression analysis, age and VMNR were the most important independent risk factors of an increased carotid IMT. CONCLUSION: This study showed that the role of thigh muscle, as well as that of visceral fat, played a very important role in the occurrence of atherosclerosis. VMNR was found to be an especially important independent factor for an increased carotid IMT.
Adult ; Atherosclerosis ; Carotid Arteries* ; Carotid Intima-Media Thickness ; Diabetes Mellitus, Type 2 ; Femur ; Humans ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat ; Muscle, Skeletal ; Patella ; Risk Factors ; Thigh* ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: A p53 gene is one of the member of tumor suppressor genes involved in the control of cell cycle. The alteration of the p53 gene induces uncontrolled cellular proliferation leading to the development of tumor. Mutations of the p53 gene were found in various human cancers including hematologic malignancies. The incidence of the p53 mutation in acute myelogenous leukemia was reported to be relatively low, however, there has been no report as to the incidence and the characteristics of the p53 mutation in acute myelogenous leukemia in Korea. METHODS: Polymerase chain reaction and single strand conformational polymorphism(PCR-SSCP) was done to screen abnormal band shifts in exons 5, 6, 7, 8 of p53 gene in myeloid blasts obtained from bone marrow aspirates at the time of diagnosis from patients with de novo acute myelogenous leukemia. Mutation of the p53 gene was confirmed by direct sequencing with Sanger method in the DNAs with abnormal band shifts. Cytogenetic analysis of the bone marrow was performed by G-banding method. RESULTS: Only 1(2%) out of 48 patients with acute myelogenous leukemia showed abnormal band shift in exon 5 with PCR-SSCP. Base sequence of exon 5 of this patient with normal karyotype was found to have silent mutation at codon 143 from GTG(valine) to GTA(valine). He had acute myelogenous leukemia of M6 subtype and the leukemia was refractory to two cycles of standard induction chemotherapy, succumbed to death at last. CONCLUSION: Mutation of the p53 gene was found to be very rare in acute myelogenous leukemia in Korea and it was thought to be involved in leukemogensis only in some patients.
Base Sequence ; Bone Marrow ; Cell Cycle ; Cell Proliferation ; Codon ; Cytogenetic Analysis ; Diagnosis ; DNA ; Exons ; Genes, p53* ; Genes, Tumor Suppressor ; Hematologic Neoplasms ; Humans ; Incidence ; Induction Chemotherapy ; Karyotype ; Korea ; Leukemia ; Leukemia, Myeloid, Acute* ; Polymerase Chain Reaction