We analysed 26 cases of pyogenic osteomyelitis of the spine who were treaed at Younsei University Hospital during 25 years from January 1952 to August 1977 by operative or conaervative treatment. The diagnosis of pyogenic osteomyelitis of the spine is not easy and very confused. The cause and entry of the offending organism is mainly by venous drainage from the genitourinary and lower extremity circulation and the next is direct spreading from the adjacent focus. The typical clinical symptom is severe pain and tenderness over the lesion accompanied by febril history and the clinical course is relatively rapid than tuberculosis of the spine. In blood examination leukocytosis is uncommon but it showed relative increase of neutrophils in 62%, and erythrocyte sedimentation rate in 89%. Radiological findings are narrowing of joint space, erosion and/or destuctive change of vertebral body, vertebral marginal sclerotic change, and new bone formation and less frequently abscess shadow. The results obtained from this study were as follows, 1) The incidence of pyogenic osteomyelitis of the spine among total cases of the pyogenic osteomyelitis was 2.5% and the ratio of the pyogenic osteomyelitis of the spine to the spine tuberculosis was 2.8%. 2) The sexual incidence was in 11 and 15 each male and female. and the avrage, prevalent age was 34 years of age. 3) The pathogenic organism was isolated in 20 cases from the diseased focus during surgical procedure; stapyhloccus in 16 cases, pseudomonas in two and in a case of E.coli and proteus each. 4) The lumber vertebrae was mostly involved, i.e.lumbar in 11 cases, cervical in four, thoracic in nine, lumbosacral and sacrum in one each. 5) The operative treatment was performed in 23 cases and conservative in 3 cases with the satisfatory result in all cases. 6) We conclude that the focal curettage with anterior interbody fusion through anterior approach was better than the conservative treatment.
Abscess ; Blood Sedimentation ; Curettage ; Diagnosis ; Drainage ; Female ; Humans ; Incidence ; Joints ; Leukocytosis ; Lower Extremity ; Male ; Neutrophils ; Osteogenesis ; Osteomyelitis ; Proteus ; Pseudomonas ; Sacrum ; Spine ; Tuberculosis

The present study is concerned with angiographic findings of bone tumors in patients who have been admitted to Severance Hospital from April 1968 to March 1971. Angiography of peripheral tumors is a valuabIe procedure in that it provides important information concerning the presence or absence of a tumor, defines its size and extent, and gives indication of malignancy. Angiography as an additional aid in the diagnosis of malignant bone lesions was first presented by dos Santos, Lamas and Caldos (1931). Begg (1955) stated that a normal angiogram of a limb shows that the branches of the main artery follow a slightly curved and undulating course, and that their calibre slowly and progressively decreases. None of these vessels are seen to reach the periosteum, nor is the nutrient artery ever visible. dos Santos (1931) proposed certain angiographic criteria of malignancy, notably the presence of numerous irregular vessels at the transit of the contrast medium from the arteries to the veins. Margulis(1964)stated a large number of malignant neoplasms are highly vascular and present chaotic patterns. Their vessels have irregular lumina and arteriovenous communications are present within them. Areas of intense contrast staining occupy parts of or the entire tumor. This appearance, frequently described, has been assumed to be characteristic of and uniformly encountered in malignant tumors. Angiographies in the present study include 6 cases of Osteogenic sarcoma, 4 cases of Chondrosarcoma, 2 cases of Giant cell tumor, 1 case of Liposarcoma, 1 case of Kaposis sarcoma, 1 case of Hemangioma, 1 case of Metastatic bone tumor, 1 case of Fibrous dysplasia and 1 case of Neurofibromatosis. Angiography was performed 13 times under local and 5 times under the general anesthesis. 20 to 30cc of 50 per cent Hypaque was utilized for examination. Angiographic findings are as follows: 1. HypervascuIarity is seen in osteogenic sarcoma, giant cell tumor, hemangioma and metastatic bone tumor. But neurofibromatosis and fibrous dysplasia are avascular. 2. Irregularity of the vascular net work seems characteristic in osteogenic sarcoma, hemangioma, and metastatic bone tumor. 3. Blood pools are seen prominently in osteogenic sarcoma, giant cell tumor, hemangioma and metastatic bone tumor. but no blood pools in neurofibromatosis and fibrous dysplasia. 4. Arteriovenous shunt is seen in osteogenic sarcoma, chondrosarcoma, hemangioma and metastatic bone tumor. But there is no A-V shunt in giant cell tumor, liposarcoma, Kaposis sarcoma, neurofibromatosis and fibrous dysplasia. 5. Retention of contrast medium is seen prominently in osteogenic sarcoma and hemangioma. But no retention of contrast medium is noted in liposarcoma, neurofibromatosis and fibrous dysplasia. While I do not regard arteriography as a necessary procedure for the differantial diagnosis of all presumptive bone neoplasms, it is indeed valuable in selected cases, in differential diagnosis of bone tumors and in the demonstration of the vascularity and extent of extraosseous soft tissue masses and it can be helpful in selecting an appropriate biopsy site. By indicating the size ar,d vascularity of a lesion and its major blood supply, it may influence the surgical approach.
Angiography ; Arteries ; Biopsy ; Bone Neoplasms ; Chondrosarcoma ; Diagnosis ; Diagnosis, Differential ; Diatrizoate ; Extremities ; Giant Cell Tumors ; Hemangioma ; Humans ; Liposarcoma ; Neurofibromatoses ; Osteosarcoma ; Periosteum ; Sarcoma, Kaposi ; Veins

Polydipsia occurs frequently in chronic schizophrenic patients, some of whom develop hyponatremia. Although the underlying pathophysiology of polydipsia among psychiatric patients, recent reports indicate that clozapine treatment improves polydipsia-hyponatremia in schizophrenia. Two schizophrenic patients with polydipsia, followed for more than two years, showed improvement on clozapine. Case 1 was a patient without history of hyponatremia who improved from polydipsia and psychosis. Case 2 was an inpatient with polydipsia and hyponatremia who showed improvement of polydipsia and did nor recur hyponatremia. The limited information provided by these case reports suggest the need for controlled studies of the clozapine effect on schizophrenic patients with polydipsia.
Clozapine* ; Humans ; Hyponatremia ; Inpatients ; Polydipsia* ; Psychotic Disorders ; Schizophrenia*

PURPOSE: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of smoking cessation behavior based on Transtheoretical Model in industrial workers. METHOD: A convenience sample of 146 industrial workers except for the never smokers, were recruited at a H industry in Ulsan. Data were collected from February 1 to 28, 2002. The research instruments were Stages of Change of Smoking Cessation Measure(DiClemente et al, 1991), Process of change(Prochaska, 1988), Smoking Abstinence Self Efficacy (SASE: DiClemente et al, 1985) and Decisional balance(SDB; Kim, 1999). RESULT: The results of this study were as follows; 1. The subjects were distributed in each stage of smoking cessation change: There were 64 subjects (43.0%) in the precontemplation stage, 35 subjects(23.5%) in the contemplation stage, 28 subjects(18.8%) in the preparation stage, 14 subjects(10.1%) in the action stage and 7 subjects(4.7%) in the maintenance stage. 2. Analysis of variance showed that experiental process(F=2.808, p=.042), behavioral process (F=4.567, p=.004) self-efficacy(F=9.809, p=.000), pros(F=11.107, p=.000), cons(F=6.686, p=.000), pros- cons(F=3.446, p=.018) were significantly associated with the stages of smoking cessation change. 3. Through discriminant analysis, it was found that 'PROS' was the most influential variable in discriminating the four stages of change. CONCLUSION: This study can provide the basis of staged matching smoking cessation program using TTM for more effective and useful intervention.
Self Efficacy* ; Smoke* ; Smoking Cessation* ; Smoking* ; Ulsan

The pulmonary cytology has reached a high level of accuracy. By the examination of the sputum and/or bronchial brushings, it is now possible to make a diagnosis in 70% to 90% of patients with cancer. Primary melanoma of the lung is very rare and there have been reported about 20 cases in the world literature. We present a case of primary malignant melanoma of the lung in a 61-year-old male diagnosed by cytologic examination of sputum, bronchial brushing and aspirated pleural fluid. Histologic examination of bronchoscopic biopsy and examination of the skin and other primary sites confirmed the diagnosis.
Male ; Humans ; Biopsy

A malignant granular cell tumor (MGCT) occurred in the left shoulder of a 62-year-old man. The patient underwent wide marginal excision followed by chemotherapy and radiotherapy. A metastatic tumor was identified in the axillary lymph node 22 months after the excision of the shoulder mass. The primary tumor was a poorly circumscribed mass measuring 5 5 4 cm. On cut section, it was a solid mass with yellowish tan color. Histologically, both primary and metastatic tumor consisted of polygonal cells with abundant granular cytoplasm and a vesicular nucleus with a prominent nucleolus. Two to three mitotic figures per ten high power fields at 200 were counted. Tumor cells were weakly stained with periodic acid-Schiff (PAS) preparation both before and after diastase digestion, and were positive for S-100 protein, neuron-specific enolase (NSE), and vimentin. By electron microscopy, the cytoplasm was filled with numerous autophagolysosomes containing myelin figures, mitochondria, and fragmented rough endoplasmic reticula. Basal laminae and angulated bodies were also noted. These findings suggest schwannian differentiation of this tumor.
Amylases ; Basement Membrane ; Cytoplasm ; Digestion ; Drug Therapy ; Granular Cell Tumor* ; Humans ; Immunohistochemistry ; Lymph Nodes ; Microscopy, Electron ; Middle Aged ; Mitochondria ; Myelin Sheath ; Phosphopyruvate Hydratase ; Radiotherapy ; S100 Proteins ; Shoulder* ; Triacetoneamine-N-Oxyl ; Vimentin

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that is characterized by progressive death of motor neurons in the cortex, brainstem, and spinal cord. Until now, many treatment strategies have been tested in ALS, but so far only Riluzole has shown efficacy of slightly slowing disease progression. The pathophysiological mechanisms underlying ALS are multifactorial, with a complex interaction between genetic factors and molecular pathways. Other motor neuron disease such as spinal muscular atrophy (SMA) and spinobulbar muscular atrophy (SBMA) are also progressive neurodegenerative disease with loss of motor neuron as ALS. This common thread of motor neuron loss has provided a target for the development of therapies for these motor neuron diseases. A better understanding of these pathogenic mechanisms and the potential pathological relationship between the various cellular processes have suggested novel therapeutic approaches, including stem cell and genetics-based strategies, providing hope for feasible treatment of ALS.
Amyotrophic Lateral Sclerosis* ; Brain Stem ; Disease Progression ; Hope ; Motor Neuron Disease ; Motor Neurons ; Muscular Atrophy, Spinal ; Muscular Disorders, Atrophic ; Neurodegenerative Diseases ; Riluzole ; Spinal Cord ; Stem Cells

No abstract available.

The distributions and morphological characteristics of neurons displaying immunoreactivity to the catecholamine synthetic enzymes, tyrosine hydroxylase[TH], dopamine-beta-hydroxylase[DBH], and phenyletha-nolamine-N-methyltransferase[PNMT] were examined in the adjacent sections of the diencephalon of the striped field mouse [Apodemus agrarius coreae].Only TH-, and no DBH- or PNMT-immunoreactive neurons were found in the diencephalon. In the preoptic area, TH-immunoreactive neurons were found in the anterior preoptic nucleus of Loo[APN], periventricular preoptic nucleus, medial preoptic nucleus, lateral preoptic nucleus and suprachiasmatic nucleus. In the hypothalamus, TH-immunoreactive neurons were found in theparaventricular hypothalamic nucleus, periventricular gray, retrochiasmatic area,anterior hypothalamic nucleus of anterior hypothalamic area and retrochiasmatic region of the hypothalamus. In the rostral tuberal region of the hypothalamus, TH-immunoreactive neurons were found in the paraventricular nucleus, periventricular gray and arcuate nucleus. In the midtuberal region of the hypothalamus, TH-immunoreactive neurons were found in the paraventricular nucleus, dorsomedial hypothalamic nucleus, zona incerta and arcuate nucleus. In the caudal tuberal region of the hypothalamus, dorsal hypothalamic nucleus, posterior hypothalamic complex and arcuate nucleus.
Animals ; Anterior Hypothalamic Nucleus ; Arcuate Nucleus ; Diencephalon* ; Dopaminergic Neurons* ; Dorsomedial Hypothalamic Nucleus ; Hypothalamus ; Immunohistochemistry ; Mice ; Neurons ; Paraventricular Hypothalamic Nucleus ; Preoptic Area ; Subthalamus ; Suprachiasmatic Nucleus ; Tyrosine

The diagnostic accuracy of myelography, electromyography, and clinical-neurological findings in 64 patients on whom the presence of herniated intervertebral disc was proved surgically from March, 1974 to February, 1980 in Severance Hospital was discussed and the results of this study was compared with those in comparable studies in the literature. 1. Of the cases in which operation revealed disc herniation or protrusion, the clinical neurological diagnosis was correct in 71.9%, the myelographic diagnosis was coincided in 79.7%, the electromyographic diagnosis was agreed in 73.4%. 2. In the patients which the patellar tendon reflex was weak or absent, operation revealed a herniation between L3 and L4 in 66.7%. The disc herniation bewteen L4 and L5 was noted in 93.0% of patients with weakness of the extensors of the great toe. Of the patients in whom the Achilles tendon reflex was weak or absent, operation revealed a tumbosacral disc herniation in 87.0%. 3. If the myelogram showed lumbar disc changes, these changes were confirmed at operation in the same level in all patients. 4. A disc herniation between L3 and L4 was demonstrated in aH cases of the patients had L4 denervation of the electromyographic findings. The disc herniation between L4 and L5 was seen in 93.0% of them had L5 denervation. A lumbosacral disc herniation was noted in 83.3% of them had 51 denervation. 5. Polyphasic motor units were significant in the absence of diagnosis of the herniated lumbar disc. 6. Signs of denervation in the spinal muscalature but not in the leg muscles were considered significant in patients with diagnostic problems of the lumbar radiculopathy. In summary, it is suggested that electromyography is not superior to the myeolgraphy or the clinicalneurogical examination. But the electromyography aids the surgeon in the dlagnosis of a compression lesion of a specific nerve root.
Achilles Tendon ; Denervation ; Diagnosis ; Electromyography ; Humans ; Intervertebral Disc ; Leg ; Muscles ; Myelography ; Patellar Ligament ; Radiculopathy ; Reflex ; Toes