BACKGROUND AND PURPOSE: Frequently the conventional nerve conduction studies (NCS) with testing usual peripheral nerves did not reveal any abnormalities in patients with early polyneuropathy. Recently Lee and Oh demonstrated that the interdigital sensory nerve conduction studies (NCS) of the foot were very sensitive in detecting early changes of neuropathy. The authors performed the study to see abnormal features of interdigital NCS in early phase of polyneuropathy and to understand the sensitivity of interdigital NCS in making diagnosis of polyneuropathy. METHODS AND MATERIALS: The interdigital NCS of the foot were performed in 19 clinically suspected polyneuropathy with no abnormalities by the conventional NCS (group I), in 7 polyneuropathy with electrophysiological abnormalities by the conventional NCS (group II), and 10 normal controls without clinical or electrophysiological findings of polyneuropathy (group III). The interdigital NCS were done according to the original description of Oh et al ,using the near-nerve needle recording at the level of ankle with averaging technique. The maximal nerve conduction velocity (NCV), the largest negative NCV, the amplitude and the duration of compound nerve action potential (CNAP) were analysed in each recording of I,V digital and I-II, II-III, III-IV, IV-V interdigital nerves of the foot. RESULTS: The abnormal interdigital NCS findings were found in 9 out of 19 patients in group I (47.4% ) , 7 out of 7 patients in group II(100.0%) ,and none in group III.(0.0%). In group I, the most common abnormal findings were no recordable CNAP (77,7%) and the second were the decreased amplitude of CNAP (66.6%). The decreased NCV were found only in one case ( group I-19). The digital or interdigital nerves involvement were symmetrical and the number of involved branches ranged from one to twelve, being averaged to be 7. In group II, the most common abnormalities were no recordable or decreased amplitude of CNAP (85.7 %) and the decreased NCV were found in 1 out of 7. Three out of 7 showed abnormalities in all digital or interdigital nerves and the remaining four showed abnormal findings in at least 4 among 12 digital or interdigital nerves. CONCLUSION: The interdigital NCS with the near nerve needle and averaging technique increased the diagnostic sensitivity in those subjects with clinically suspected polyneuropathy (group I) and the most common abnormal features in the interdigital NCS were the amplitude changes of CNAP. Therefore the authors suggest that the interdigital nerves of the foot are involved earlier in the process of polyneuropathy and the interdigital NCS of the foot might provide enhanced sensitivity for detecting early polyneuropathy.
Action Potentials ; Ankle ; Diagnosis ; Foot* ; Humans ; Needles ; Neural Conduction* ; Peripheral Nerves ; Polyneuropathies*

No abstract available.
Krukenberg Tumor*

No abstract available.
Choriocarcinoma* ; Female ; Ovary* ; Pregnancy

BACKGROUND: Blepharospasm and apraxia of lid opening (ALO) are nonparalytic causes of involuntary eyelid closure (IEC). Recently Aramideh (1994) divided the IEC into 5 groups by electromyography (EMG) study, and reported that each group had different responses to Botulinum A toxin treatment. Objective : We looked whether clinical observation can match the EMG, and possibly predict the response to Botulinum A toxiu treatment. Method : Based on EMG study of Aramideh (1994), clinically observable characteristics of each group were defined. One of the authors reviewed the videotapes of IEC and applied the above criteria to make the clinical diagnosis. Other author blinded to the clinical information performed 2 channel EMG of levator palpebrae superioris (LP) and orbicularis oculi (00) muscles, and made the EMG diagnosis. Clinical and EMG diagnoses were matched. Results : Twenty five patients (5 men and 20 women) were included in the study. Clinically, 16 were diagnosed as group I (blepharospasm), 1 as group 111(combined blepharospasm and LP motor impersistence), 7 as group tV(combined blepharospasm and involuntary LP inhibition), and 1 as group V(involuntary LP inhibition). There were no patient in group ll (combined dystonic activities of LP and 00). On EMG study, 14 were diagnosed as group 1, 2 as group ll, 1 as group 111, 7 as group IV, and 1 as group V The mismatch between the two diagnoseis occurred between group I and tV in 4 patients, group I and ll in 2, and group I and 111 in 2. Conclusions : Clinical observations are generally correct in predicting EMG diagnosis. Holvever groups with mixed features(ll, 111, and Iv) are difficult to diagnose by clinical observation only. Usefulness of clinical and EMG diagnosis on predicting Botulinum A toxin response will need to be evaluated. Key Words : Involuntary eyelid closure, Blepharospasm, Apraxia of lid opening, Electromyography.
Apraxias ; Blepharospasm ; Botulinum Toxins, Type A ; Diagnosis* ; Electromyography ; Eyelids* ; Humans ; Male ; Muscles ; Videotape Recording

There has been much dispute about the pathomechanics and the significance of the test even among the most competent surgeons in this field. Some have claimed that the posterolateral capsule must be torn to initiate the pivot shift. Some have even gone as far as to deny the importance of the anterior cruciate ligament as a main stabilizing structure of the knee. We evaluated the concept of MacIntosh in anatomical studies which were carried out at the both Pathology and Orthopedic department of Kyungpook National University, School of Medicine, Taegu Korea. Experiments have been carried out to study the etiology of anterolateral instability and the production of a pivot shift sign. In the cadaver knees and A/K amputation knees, which did not have any sign of instability or osteoarthritis, the anterior cruciate was severed by a short medial incision. We could immediately detect a pivot shift. No pivot shift resulted however when the posterolateral capsule was completely divided first and the anterior cruciate left intact, or when the medial collateral ligament and medial capsule were cut. If both the anterior cruciate and posterolateral capsule were divided the pivot shift became more prominent than after cutting the anterior cruciate alone. When the medial collateral ligament including the capsular structures was completely severed, however, the pivot shift disappeared. In summary the experiments show the following: 1. An isolated rupture of the anterior cruciate ligament or its combination with a partial tear of the medial collateral ligament may be detected with the pivot shift sign. 2. If the rupture of the medial collateral ligament is complete the pivot shift test can be negative in spite of a tear of the anterior cruciate ligament.
Amputation ; Anterior Cruciate Ligament ; Cadaver ; Collateral Ligaments ; Daegu ; Dissent and Disputes ; Gyeongsangbuk-do ; Humans ; Knee ; Korea ; Orthopedics ; Osteoarthritis ; Pathology ; Rupture ; Surgeons ; Tears

No abstract available.

Mechanical complications of acute myocardial infarction which may lead to heart failure or shock include ruptute of left ventricular free wall, ventricular septum and papillary muscle. The clinical characteristics of these lesions vary conservative management alone has high mortality rate, for which reason surgical repair of these defects are essential. Structural defects including rupture of the left ventricular free wall, ventricular septum, and papillary muscle, accout for 5% to 20% of all deaths from acute myocardial infarction. Among these, ventricular septal defects occur in approximately 1% of all myocardial infarction, and account for up to 2% of deaths subsequent to myocardial infarction. Rupture of the ventricular septum following acute myocardial infarction(AMI) is associated with high mortality rate, as 54% of the patients succumb within two weeks, 87% within two months and 92.5% during the first year. We experienced two cases of postinfarct ventricular septal defects(VSD) which had been repaired within 1 week after AMI due to progressive deterioration of patients` conditions, and were to be reoperated because of repeated septal ruptures in postoperation period and development of cardiogenic shock.
Heart Failure ; Heart Septal Defects, Ventricular ; Humans ; Infarction* ; Mortality ; Myocardial Infarction ; Papillary Muscles ; Rupture ; Shock ; Shock, Cardiogenic ; Ventricular Septum

BACKGROUND: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. MATERIALS AND METHODS: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. RESULTS: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. CONCLUSION: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Finite Element Analysis ; Intervertebral Disc* ; Inventions ; Spine*

BACKGROUND: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. MATERIALS AND METHODS: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. RESULTS: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. CONCLUSION: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Finite Element Analysis ; Intervertebral Disc* ; Inventions ; Spine*

PURPOSE: To clarify the behavior of the lumbar spine under vertical compressive load and follower compressive load and to confirm the effect of the follower load on the stability of the spinal column using finite element method. MATERIALS AND METHODS: Describing follower compression test to overcome underestimation of load carrying capacity, the problem in existing ex-vivo lumbar spine compression test, with finite element analysis, comparing with the result of simple vertical compressive load, we analyze the property of kinetic behavior. After performing finite element modelling about L1-L5 lumbar vertebral column, analyze it about vertical compressive load and follower compressive load. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. With compressive load, change of lumbar spinal curve is so much, that geometrical analysis should be done. RESULTS: Under the follower compressive load, the vertebral column was so stiff that vertical displacement of the upper end plate of L1 was markedly reduced, comparing with that under the simple vertical compressive load. Sagittal rotation of that upper end plate was also decreased in the opposite direction. Compressive load on the intervertebral disc was evenly distributed along the entire column. The bending moment at each disc was reduced in the opposite direction. A lesser A-P shear force occurred at the intervertebral disc. CONCLUSION: As a result of finite element interpretation of lumbar spine, the stability and load carrying capacity was increased largely, and the compressive load was transmitted through the column in a more pattern, when follower compressive load applied. This can provide the basis for explaining the difference of early buckling occurrence reported in ex-vivo testing, and load carrying capacity of the lumbar spine in-vivo, but, for more precise replication of behavior of lumbar spine in-vivo to variable loading. A invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Natural Resources ; Finite Element Analysis ; Intervertebral Disc ; Inventions ; Spine*