Methods of treatment of Legg-Calve-Perthes' disease, (L.C.P.D.) are at present generally defined, and the individual approach is now more precise than before. But it is still controversial, particularly in older age groups. We analized the result of intertrochanteric varus osteotomy in 44 hips and innominate osteotomy in 23 hips of L.C.P.D., and compared the former with the later. To find out the influence of the both osteotomies on the femoral head (coxa magna), the relations between the stage and degree of involvement at operation and reult, and the postoperative progression of disease, the cases were analyzed and classified by Elizabethtown's stage and Catterall group. And also the duration of fragmentation stage after osteotomy was observed. Results were as follows: l. At the time of operation 45 hips were in avascular stage, 18 hips in fragmentation stage, and 4 hips in healing stage. 20 hips(29.8%) were classified as group II, 29(43. 3%) group III, and 18(23.1%) group IV. 2. After the osteotmy in case of avasculsr necrosis stage, average duration of fragmentation stage was 6.3 months after femoral osteotomy and 1 year 6 months after innominate osteotomy. 12 among 20 hips were skipped the fragmentation stage, and got into healing stage in case of femoral osteotomy. 3. After the osteotomy at the fragmentation stage, average duration of the fragmentation stage was 9.8 months after femoral osteotomy and 1 year 3 months in case of innominate osteotomy. 4. Regardless of the type of osteotomy, coxa magna was observed more frequently in the case who had surgery at the late stage and severely involoved head at the time of osteotomy. 5. In the case of femoral osteotomy, average preoperative neck shaft angle was 138.5°, and postoperative one was 113.5°. During the follow-up study, 12.0° of revalgarisation took place. 6. The result obtained by femoral osteotomy gave better results than those by innominate osteotomy. Regardless of the type of osteotomy, good results were obtained in case who had surgery at the early stage such as avascular stage, and had mild involvement as such group II.
Follow-Up Studies ; Head ; Hip ; Humans ; Neck ; Necrosis ; Osteotomy

Diverticulum is considered as common lesion involving any gastrointestinal tract from the pharynx to therectum. We reviewed 5806 cases of upper GI series and 801 cases of Barium enema during the period from Jan. 1978to Dec. 1981 in the Departement of Radiology, school of medicine, JeonBug National University Hospital to analizediverticula of the entire GI tract. The results are follows : 1. Roetgen examination of 5806 esophagus, stomachs,duodenums and small bowels, and 801 colons during the past four years: diverticular of esophagus, 60 cases(1.0%);diverticula of stomach, 42 cases (0.7%); diverticula of duodenum, 358 cases (6.2%); diverticula of small bowel,20( 0.3%); diverticula of the colon, 26 cases (3.2%). The location of diverticula inorder of frequency wasduodenum, colon, esophagus, stomach, and small bowel. 2. the most common site of diverticula of each GI tract wasfollows : diverticula of the esophagus, middle portion (84.7%); diverticula of stomach, the cardia(59.5%);diverticula of the duodenum, second portion(81.3%); diverticula of small bowel, the jejunum(96.4%) especially thelarger percentage were observed at the upper jejunum near the ligament of Treitz; diverticula of the colon, rightsided colon(80.8%), the cecum and ascending colon(57.1%) 3. Diverticula may occur at any age. The majority ofdiverticula of the entire GI tract were observed over 40 years of age. Especialy in diverticula of duodenum andcolon, thir frequency increase with age. 4. Duodenal diverticula were observed more frequently in womanthan in manbut in diverticula of the esophagus, stomach, small bowel, and colon, male was more frequently affected. 5. Thesize of diverticula of entire GI tract was variable. The majoprity of diverticula of the esophagus, stomach,duodenum and small bowel were intermediate size (10-49 mm). Diverticula of the colon were usually smaller than 10mm. 6. Multiplicity of diverticula of entire GI tract was 16.2% of 506 cases. In diverticula of esophagus,stomach, duodenum and small bowel, single lesion was more frequently found. on the other hand, the majority ofdiverticula of the colon were found as multiple lesion(69.2%).
Barium ; Cecum ; Colon ; Diverticulum ; Duodenum ; Enema ; Esophagus ; Gastrointestinal Tract ; Hand ; Humans ; Jejunum ; Jeollabuk-do ; Ligaments ; Male ; Pharynx ; Stomach

The search for tumor-avid agents for use in nuclear medicine imaging is an ongoing field of importance. The purpose of this study was to determine the affinity for radiolabeled vitamin B12 by a wide histologic variety of tumor types in mice. Seventeen different types of tumor were grown subcutaneously in female Balb/C or Balb nu/nu(nude) mice. When the tumors reached about 1 cm in diameter, mice were injected intraperitoneally with 57Co-vitamin B12. Twenty-foul hours later, the mice were sacrificed. Organs and tissues were removed, weighed, and activity per mg determined by gamma counter. Values represented cpm/mg tissue that was normalized to 20 grams body weight for each mouse. A wide variety of tumor types showed significant uptake and concentration of 57Co-vitamin B12, as evidenced by tumor:tissue activity ratios. For many tissues of great importance in terms of background(bone, muscle, blood), the tumor:tissue activity ratios of uptake were high. These data strongly suggest that further efforts to evaluate the utility of radiolabeled adducts of vitamin B12 for clinical use in oncologic imaging are warranted.
Animals ; Body Weight ; Female ; Humans ; Mice* ; Nuclear Medicine ; Vitamin B 12

BACKGROUND: A newly-found mitochondrial toxin, 3-nitropropionic acid (3-NP), has been proved to induce apoptosis in the striatum. Although striatal lesions produced by 3-NP could develop through an excitotoxic mechanism, the exact relationship between apoptosis induction and excitotoxicity after 3-NP treatment is still not clear. We investigated the role of excitotoxicity and oxidative stress on apoptosis induction within the striatum following intra-peritoneal injection of 3-NP. METHODS: 3-NP was injected for 5 days intra-peritoneally in three month-old mice. One day after the last injection, animals were decapitated. To confirm the presence of apoptosis, we performed in-situ detection of DNA fragmentation by using TUNEL technique and agarose gel elctrophoresis after DNA extraction from striatum. To examine the effect of frontal cortex removal on 3-NP-indeced apoptosis, we removed left frontal cortex by aspiration. For excitotoxicity, NMDA-receptor antagonist-MK 801, non-NMDA antagonist-NBQX, and saline were injected intraperitoneally before 3-NP treatment To detect superoxide, we administered hydroethidium (HEt: 200 ul; 1mg/ml) into the jugular vein 2 days after 3-NP, and the density of oxidized HEt in samples were examined under flouscent microscope. We performed caspase staining to test immunoreactivity of caspase 3 in samples. RESULTS: The TUNEL positive cells were not observed in the striatum ipsilateral to the frontal cortex-removed side, but found in the contralateral striatum. Superoxide radicals measured by using HEt and caspase immunoreactivity were also significantly weaker in the striatum ipsilateral to the frontal cortex-removed side than the contralateral striatum. TUNEL staining revealed less apoptotic changes in the striatum of MK801-treated group than NBQX-or saline-treated groups. DNA laddering on agarose gel electrophoresis was observed in the striatum of NBQX- or saline-treated mice, but not found in MK 801-treated group. CONCLUSION: We demonstrated that removal of the corticostriatal glutamate pathway reduced superoxide production as well as apoptosis induced by 3-NP and NMDA receptor antogonist, but not non-NMDA antagonist, prevented 3-NP-induced apoptosis in the striatum. These results suggest that NMDA-mediated glutamatergic excitotokicity plays an important role in 3-NP related striatal damage.
Animals ; Apoptosis ; Caspase 3 ; DNA ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Glutamic Acid ; In Situ Nick-End Labeling ; Injections, Intraperitoneal* ; Jugular Veins ; Mice* ; Mitochondria ; N-Methylaspartate ; Oxidative Stress ; Sepharose ; Superoxides

PURPOSE: Cortical dysplasia (CD) designates a diverse group of malformations resulting from one or more abnormalities in the development of the cerebral cortex. We investigated the findings of interictal SPECT and the diagnostic usefulness of interical and ictal SPECT according to pathological grading (PG) in comparison with MRI. MATERIALS AND METHODS: This study included 16 patients (M:F=9:7, age: 19.9+/-11.8 yrs) with pathologically proven CD. Tc-99m ECD SPECT was performed in all patients: interictal 11, interictal and ictal 3, ictal 2. MRI were obtained in all patients and image analysis was done blindly as to the result of SPECT. Pathologic findings of CD were classified into grade 1 (G1, dyslamination), grade 2 (G2, dysplastic neurons) and grade 3 (G3, balloon cells). We compared SPECT with MRI in lesions-to-lesions and analyzed the result according to PG. RESULTS: In SPECT and MRI, 38 and 27 lesions were visually recognized. In 14 interictal SPECT, variable findings in 35 lesions were demonstrated: 26 were hypoperfusion, 7 hyperperfusion, 2 heterotopic perfusion in the white matter. By comparison between two studies, missed lesions were founded: SPECT were 1 lesion, MRI 12. Review of missed 12 lesions of MRI were followed according to PG; G1 patients were 16.7% (4/19), G2 40.0% (6/15), and G3 50% (2/4). CONCLUSION: Interictal SPECT in CD showed variable findings such as hypoperfusion, hyperperfusion or heterotopic perfusion. However, for detection of missed CD on MRI, SPECT may help to detect a functional abnormality of the lesion with high PG.
Cerebral Cortex ; Humans ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

Sternocostoclavicular hyperostosis is a benign ossifying diathetic disorder characterized by hyperostosis and soft tissue ossification of the clavicles, anterior portion of the first ribs, and manubrium, with variable hyperostosis or ankylosis in the spine and sacroiliac joints. A review of the literature and our own case describes the clinical findings and its characteristic features in RI, CT, and plain film.
Ankylosis ; Clavicle ; Hyperostosis ; Hyperostosis, Sternocostoclavicular* ; Manubrium ; Ribs ; Sacroiliac Joint ; Spine

The size of spinal canal is valuable ot detect the body encroachment of spinal canal and expansion due totumors by computed tomography. This study was desinged for taking accurate measurement of the normal thoracicspinal canal in korean adults. The anteroposterior diameter, interpediculate distance and cross-sectional area ofthoracic spinal canal were measured in 80 normal adults. The results were as follows. 1. In A-P diameter, middleparts of the canal were smaller values than those of upper and lower parts from T1 to T6, and upper parts of thecanal were larger than those of middle and lower parts from T7 to T10. 2. In interpediculate distance, middleparts of the canal revealed larger value than those of upper parts. 3. All measurements of male were larger thanthose of female at all levels of the spinal canals and 65 measurement(93%) were statistically significant.
Adult ; Female ; Humans ; Male ; Spinal Canal

OBJECTIVES: In order to reveal the effectiveness of the intervention in the workplace on patients suffering from cervicobrachial disorder (CBD), we reexamined 96 workers out of 137 workers suffering from CBD on the assembly lines of an electric manufacturing factory by using questionnaires, physical exams and neurological exams. METHODS: Analyses were made of the characteristics of the 96 workers of this company suffering from 1994 to 1996 with special concern for differences before and after the improvement of the working environment. After reexamination of the 96 patients the following results were obtained. RESULTS: We observed an improvement in the 10 most common subjective symptoms of CBD. These symptoms included general fatigue, pain on neck and shoulders, dullness of the upper extremities, back pain and discomfort and a tingling sensation in the hands and wrists (p < 0. 05). The percentage of workers who complained muscle tenderness of neck and shoulder were reduced (p < 0.05). the percentage of workers with abnormal Morley examination was reduced from 28. 5% to 2. 100 (p < 0.01), and of workers with abnormal EMG finding went from 12. 4% to 2. lao (p < 0. 01) and of grade 3 and grade 4 CBD was reduced from 42. 3% and 18. 3% respectively to 33. 3% and 2. ba (p < 0. 01). Grade 3 and over laborers of CBD had higher scores in somatization, anxiety, depression, hostility, interpersonal sensitivity, phobic anxiety, obsessive-compulsive, neurasthenic, hypochondriacal than other sufferers in the SCL-90-R exam (p < 0. 01). CONCLUSIONS: in conclusion intervention had effectiveness on subjective symptoms of neck and shoulder and decreasing abnormal finding of muscle tenderness, neurological examination and EMG.
Anxiety ; Back Pain ; Depression ; Fatigue ; Hand ; Hostility ; Humans ; Intervention Studies ; Myalgia ; Neck ; Neurologic Examination ; Questionnaires ; Sensation ; Shoulder ; Upper Extremity ; Wrist

This study was conducted to examine the effect of chronic low dose organic solvent exposures in the industries towards then neurobehavioral functions of workers subjective symptoms on neurobehavioral function as well as a visual reaction time test (Flicker test) were administered to 94 exposed and 162 unexposed workers in a oil refinery and some other auto-repair shops. The results obtained were as follows: 1. Symptom complaints were higher and Flicker test values were lower in exposed workers than in unexposed workers. 2. Flicker values were inversely correlated with urinary Hippuric acid concentration in exposed workers (r=-0.26, p<0.05). 3. Flicker values were inversely correlated with subjective symptom score (r=-0.15, p<0.05). Low Flicker value were also related with some subjective symptoms such as "Dimmed vision", "Nightmare", "weakness on extremity" in workers as a whole. While symptoms of "Dimmed vision", "Nightmare" only observed among exposed workers.
Reaction Time

Spasmodic torticollis (ST) is a focal dystonia caused by a tonic or intermittent spasms of the neck muscles. Botulinum toxin type A has been known to be one of the effective treatments for the cervical dystonia. We report the result of low dose botulinum toxin type A injection in 26 patients with spasmodic torticollis. In addition to the careful neurological examination, a needle polymyographic analysis was used to identify muscles responsible for ST. The most common combination of the involved muscles was splenius capitus and sternocleidomastoid muscle. The mean dose of botulinum toxin used in the patient was 100 units (range ; 80-140 units). Mean dose of 25 units (range ; 20-30 units) for levator scapula, 30 units (range ; 20-40 units) for semispinalis, 37 units (range ; 25-50 units) for sternocleidomastoid, 40 units for trapezius and 58 units (range ; 40-100 units) for splenius capitus muscle were injected. Using Tsui score (for objective response rating scale) and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS ; for objective and subjective response rating scale), we assessed the patient before and 2, 6 and 10 weeks after the botulinum toxin injection. Seventeen of the 26 (65%) showed improvement on TWSTRS objective response rating scale, and 18 (69%) on Tsui scale. Comparing to the baseline score measured by Tsui scale, the amount of improvement was 37.1% (range 20-88%). Twenty one of the 26 (80.7%) reported improvement on subjective rating scale (TWSTRS). Twenty of the 21 responder on the subjective rating scale felt improvement within a week after the botulinum toxin injection. The beneficial effect lasted for 0.5 to longer than 9 months (mean ; 3.5months). We compared the result with that of the other studies in which larger doses of botulinum toxin were injected into the neck muscles selected on clinical ground. There was no significant difference of response rate and duration of beneficial effects. In our study, only two patients developed transient complications ; one
Botulinum Toxins* ; Botulinum Toxins, Type A ; Dystonic Disorders ; Humans ; Muscles ; Neck Muscles ; Needles ; Neurologic Examination ; Paraspinal Muscles ; Scapula ; Spasm ; Superficial Back Muscles ; Torticollis*