The birth of myelography was presaged by Dandy's classic description of pneumoencephalography in 1919. After then, many contrast media, such as Pantopaque, Lipiodol, Abrodil, Dimer-X, and Conray-60, were developed and myelography was achieved in widespread popularity for diagnosis in low back pain, especially on the syndrome of herniated intervertebral disc. During the past few years, the picture has changed dramatically because of the availability of Metrizamide, a new, less toxic, non-ionic, aqueous medium. So, the authors have seen and studied 165 cases of. low back pain with respect to the diagnostic classification and clinical acceptance of Metrizamide myelographic examination from May, 1982 to April, 1985 at Department of Orthopaedic Surgery, College of Medicine, Soon Chun Hyang University. The results were summerized as followings; l. Among the 165 cases, myelographic finding was classified in 4 groups and 7 types, and showed as group 1(41), group 2 and type a(46), group 2 and type b(21), group 3 and type a(9), group 3 and type 1(15), group 3 and type c(16), and group 4(17). 2. The predominent type in the 57 operative cases was group 4(46, 27.9%). 3. In clinical analysis, tenderness was predominent in most types, but sensory changes in group 4. 4. Step by step in types, anatomical changes was seen more often than funtional changes in plain X-ray. 5. Myelographic accuracy was coincided with operative findings in 75.4% and 7 cases of false negative and 5 cases of false positive. 6. In disc findings, the extruded type was seen predominently in group 4 as 29.4%. 7. Above group 3 and type a, the prognosis of operative treatment was excellent than conservative.
Classification ; Clinical Study ; Contrast Media ; Diagnosis ; Ethiodized Oil ; Intervertebral Disc ; Iophendylate ; Low Back Pain ; Metrizamide ; Myelography ; Parturition ; Pneumoencephalography ; Prognosis

The incidence of intertrochanteric fracture of the femur in the elederly patient was lower than young in korea because of low average span and causes of injuries. But recently, the incidence is progressively in creased due to prolongation of korean average life span and improvement of residental enviroment. The mortality and morbidity are higher in spite of various treatment methods because of associated diseases and the poor general conditions of patients. Total 102 cases of intertrochanteric fracture of the femur were treated at the Department of Orthopaedic Surgery of Soonchunhyang University Hospital during the period from January, 1978 to December, 1985. Among them, 67 cases(65.7%) were over 60 years in the age, and of which 55 cases(one case was bilateral) were followed from 8 months to 3 years and 4 months(Average 14.7 months). The results were as followes: l. Out of 54 patients, 33 patients were female and the mean age was 74 years. 2. The most common cause is the injury from slip down and the ratio between in-door injury to out-door injury was 1.7: l. 3. The 41 cases(74%) out of the 55 cases were operated within 2 weeks after the accident, 35 cases were treated by Richard compression hip screw, 11 cases were by intramedullary nailing, and 9 cases were by multiple pinning. The multiple pinning were usually tried to patients of poor general condition, which was needed to shorten the operation times. 4. The mean duration of multiple pinning operation time was 1 hour 12 minutes, intramedullary nailing operation time was 1 hour 47 minutes and Richard compression hip screw operation time was 2 hour 42 minutes. 5. Among 55 cases, 20 cases(36%) were complicated.
Aged ; Female ; Femur ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Incidence ; Korea ; Mortality

Atypical femoral fractures are stress or insufficient fractures induced by low energy trauma or no trauma and have specific X-ray findings. Although the American Society for Bone and Mineral Research has excluded periprosthetic fractures from the definition of an atypical femoral fracture in 2013, this is still a matter of controversy because some authors report periprosthetic fractures showing specific features of atypical fractures around a well-fixed femoral stem. We report 3 cases of periprosthetic femur fractures that had specific radiographic features of atypical femoral fractures in patients with a history of prolonged bisphosphonate use; we also review relevant literature.
Arthroplasty* ; Femoral Fractures ; Femur ; Hip* ; Humans ; Periprosthetic Fractures

Anatomic Variation ; Arteries ; Humans ; Korea ; Maxilla ; Osteotomy ; Sphenoid Bone ; Spine

PURPOSE: The purpose of this study was to evaluate the clinical and radiological results of revision total hip arthroplasty using modular distal fixation stems for proximal femoral deficiency. MATERIALS AND METHODS: Forty-five patients (47 hips) were analyzed more than 24 months after revision total hip arthroplasty that used modular distal fixation stems and was performed between 2006 and 2012. There were proximal femoral defects in all cases. Preoperative femoral defect classification revealed Paprosky type II in 31 cases, type IIIA in 7, and type IIIB in 9. The mean duration of follow-up was 53.4 (25-100) months. We evaluated the Harris hip score (HHS), walking ability according to Koval as clinical parameters, stem stability, and stem position change as radiographic parameters. Kaplan-Meier survival analysis was performed. RESULTS: The average HHS improved form 39.5 points to 91.3 points and walking ability also improved in most cases; all patients had stable fixation of the femoral stem. Postoperative complications included 5 cases of infection and 2 cases of dislocation. The survival rate with the end point of re-revision surgery due to infection or dislocation was 86% after 8-year follow-up. CONCLUSION: Cementless revision total hip arthroplasty using modular femoral stems is useful because the stems can be stably fixed on the diaphyseal portion of the femur, which has relatively good bone quality at mid-term follow-up.
Arthroplasty, Replacement, Hip* ; Classification ; Dislocations ; Femur ; Follow-Up Studies ; Hip ; Humans ; Postoperative Complications ; Survival Rate ; Walking

OBJECTIVES: Previous studies have suggested that oxidative injuries to the neuron may have important role in the pathophysiologic mechanisms of dementia of Alzheimer's type. In the present study, we evaluate the plasma levels of albumin, total bilirubin, and uric acid in the patients with dementia of Alzheimer's type, and compare to those of the healthy controls. METHODS: The plasma albumin, bilirubin, and uric acid levels were measured by standard methods in 102 patients with dementia of Alzheimer's type (male 42, female 60) and 99 healthy controls (male 47, felmale 52). The Korean version of Mini Mental Status Examination (MMSE-K) was used to evaluate the cognitive functions of patients with dementia of Alzheimer's type. RESULTS: The plasma albumin (F=36.179, p<0.001), bilirubin (F=101.508, p<0.001), uric acid (F=12.688, p<0.001) levels in the patients with dementia of Alzheimer's type were significantly lower than those of the healthy controls. The scores of MMSE-K were positively correlated with the plasma albumin level in the patients with dementia of Alzheimer's type after adjusted for covariates such as age, gender, and body mass index (p=0.017). CONCLUSION: This study supported that oxidative injuries might be involved in the pathogenesis of dementia of Alzheimer's type, as well as suggested that some antioxidant might be associated with the cognitive functions in dementia of Alzheimer's type.
Antioxidants* ; Bilirubin ; Body Mass Index ; Dementia* ; Female ; Humans ; Neurons ; Plasma* ; Serum Albumin ; Uric Acid

Acute pancreatitis is occasionally caused by endoscopic treatments or radiologic interventions of the pancreatobiliary tract. However, no reports indicate that acute pancreatitis resulted from the insertion of a percutaneous transhepatic cholangiography (PTCS) catheter in the common bile duct (CBD). A 65-year-old woman visited our hospital with acute cholangitis due to about 3 cm-sized CBD stones. We planned to perform PTCS because of the large stones and altered anatomy (Billroth II). The patient was discharged after tract dilatation and insertion of a PTCS catheter in the distal CBD without manipulations of Ampulla of Vater (AOV). However, she visited the emergency room due to acute pancreatitis at three days after discharge. Computed tomography revealed upstream dilation of the main pancreatic duct following the compressed area of a large stone and catheter. Thus, we report a case that presented with acute pancreatitis induced by insertion of a PTCS catheter without manipulations of AOV.
Aged ; Ampulla of Vater ; Catheters* ; Cholangiography ; Cholangitis ; Common Bile Duct* ; Dilatation ; Emergency Service, Hospital ; Female ; Humans ; Pancreatic Ducts* ; Pancreatitis*

The title of page 189 should be corrected.

PURPOSE: The prognosis of a ductal adenocarcinoma of the body and tail of the pancreas is poor because it is usually diagnosed at an advanced stage and is rarely resectable. The aim of this study was to evaluate the clinical outcomes after a surgical resection of an adenocarcinoma of the distal pancreas. METHODS: A total of 311 patients with an adenocarcinoma of the distal pancreas were admitted between 1985 and 2001, and of these, 54 patients were surgically treated; 29 patients underwent a distal pancreatectomy (extended resection in 12 cases), 9 underwent a palliative bypass, and 16 underwent a open biopsy. The clinical outcome of the 29 patients who underwent a surgical resection for the adenocarcinoma of the distal pancreas was retrospectively analyzed. RESULTS: The resectability rate was 9.3% (29/311). In the resected cases, the cumulative 3-year survival rate was 14.9%, whereas it was 0% (p=0.013) in the non-resected cases. Moreover, a significant survival difference was found between the curatively resected cases (n=16, 28.1%) and the palliatively resected cases (n=13, 0%)(p=0.003). After the curative resection, 11 patients (68.8%) developed a recurrence. Three patients survived more than 3 years (46, 74, 56 months), of whom only one had no recurrent disease. The size of the tumor and the residual tumor were identified as independent significant prognostic factors by multivariate analysis. CONCLUSION: Only a curative resection can offer long-term survival as well as a survival benefit in patients with a ductal adenocarcinoma of the body and tail of the pancreas. Therefore, a surgical resection should be preferably performed and efforts for a curative resection should be made. However, adjuvant therapy, local and systemic, needs to be further developed because most patients develop a recurrence after the resection.
Adenocarcinoma* ; Biopsy ; Carcinoma, Pancreatic Ductal ; Humans ; Multivariate Analysis ; Neoplasm, Residual ; Pancreas* ; Pancreatectomy ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate

The aim of this study was to evaluate the role of demineralized and particulate autogenous tooth, and interleukin-6 in bone regeneration. A demineralized and particulate autogenous tooth was prepared and human osteoblast-like cells (MG63) and human osteosarcoma cells were inoculated into the culture. The rate of cell adhesion, proliferation and mineralization were examined, and the appearance of cellular attachment was observed. An 8 mm critical size defect was created in the cranium of rabbits. Nine rabbits were divided into three groups including: An experimental group A (3 rabbits), in which a demineralised and particulate autogenous tooth was grafted; an experimental group B (3 rabbits), in which a demineralized, particulate autogenous tooth was grafted in addition to interleukin-6 (20 ng/mL); and a control group. The rabbits were sacrificed at 1, 2, 4 and 6 weeks for histopathological examination with H-E and Masson's Trichrome, and immunohistochemistry with osteocalcin. The cell-based assay showed a higher rate of cell adhesion, mineralization and cellular attachment in the experimental group A compared with the control group. The animal study revealed an increased number of osteoclasts, newly formed and mature bones in the experimental group A compared with the control group. Eventually, a higher number of osteoclasts were observed in the experimental group B. However, the emergence of newly formed and mature bone was lower than in the experimental group A. The current results suggest that treatment with demineralized and particulate autogenous tooth and interleukin-6 is not effective in stimulating bone regeneration during the bone grafting procedure.
Animals ; Bone Regeneration* ; Bone Transplantation ; Cell Adhesion ; Dentin* ; Humans ; Immunohistochemistry ; Interleukin-6* ; Miners ; Osteocalcin ; Osteoclasts ; Osteosarcoma ; Rabbits ; Skull ; Tooth ; Transplants