Ossification of the ligamentum flavum(OLF) is a well recognized cause of acquired spinal canal stenosis resulting in myelopathy, radiculopathy, or a combination of both. OLF is extremely rare in caucasian patients, but is one of the most common causes of compression of the posterior thoracic spinal cord in Japan. In most cases, it has been found in the thoracolumbar regions, and rarely in the cervical region. It is frequently but not alwalys found in association with ossification of the posterior longitudinal ligament(OPLL) and may cause cumulative damage, if comhined with OPLL. We experienced a case of ossification of the ligamentum flavum and posterior longitudinal ligament with sacral radiculopathy, which was treated hy posterior decompressive laminectomy and removal of the ossified ligamentum flavum and posterior longitudinal ligament. The day after operation, the radiating pain and paresthesia dramatically improved.
Constriction, Pathologic ; Humans ; Japan ; Laminectomy ; Ligamentum Flavum* ; Longitudinal Ligaments* ; Paresthesia ; Radiculopathy* ; Spinal Canal ; Spinal Cord ; Spinal Cord Diseases

The giant intra-articular osteochondroma of the knee is very rare and is probably result of synovial metaplasia of the fibrous capsule or of the adjacent connencive tissue of a joint, and of the fragment of articular cartilage. The gross findings and histology are consistent with the osteochondroma. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 19 years old man who had history of knee injury when he was 16 years old. The mass was excised and the symptome was relieved.
Cartilage, Articular ; Joints ; Knee Injuries ; Knee ; Metaplasia ; Osteochondroma

No abstract available.
Pneumothorax, Artificial* ; Treatment Failure* ; Tuberculosis, Pulmonary*

PURPOSE: The purpose of this study was to identify the attitude of persons with an mental disability to marriage. METHODS: The Q-methodology which provides a method of analyzing the individual's subjectivity was used. The 30 participants classified 36 selected Q-statements on a 9 point scale to make a normal distribution. The collected data was analyzed by a PC Quanl Program. RESULTS: Four types of attitude of persons with an mental disability to marriage were identified. Type I: Actively supportive-resistant against social bias, Type II: Passively supportive-reliant on others, Type III: Intensively desiring-less sense of reality, Type IV: Controlling desire-more sense of reality. CONCLUSION: The results of this study suggest a need develop a variety of programs specifically designed for each type of attitude to change attitudes to marriage for persons with an mental disability.
Bias (Epidemiology) ; Humans ; Marriage* ; Mentally Disabled Persons

Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease(CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15mm in long diameter and 3mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (P=0.002), Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (P=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.
Collagen* ; Female ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Male ; Pleural Effusion ; Pulmonary Fibrosis

The 447 cases of skin tumors were studied at the departments of dermatology and surgical pathology, National Medical Center in Seoul during the period of 18 years and 8 months from January, 1959 to August, 1977. The results were as follows: 1) the total number of specimens surveyed in the study was 447, among which benign tumors accoungted for 234 cases and malignant tumors for 213. 2) Male to female ratio for benign tumors was 1.2:1 and for malignant tumors 2.2:1. 3) Among the 234 cases of benign tumors, 67 cases were epidermal cyst. 53 cases of hemangioma and 34 cases of pigmented neni. 4) Among the 2 cases of malignant melanoma. 5) The peak age incidence for benign tumors were below the 2nd decade, The peak ago incidence for malignant tumors were 50th decade. 6) the sites of predilection of the epidermal cysts were trunk, face and neck. The sites of predilection of the hemangiomas and pigmented nevi were face. 7) The sites of peredilection of the squamaous cell carcinomas were penis(27.1%), lower extremities(25.7%) and face(21.5%) The sites of predilection of the basal cell carcinomas were face(83.3%) 8) The ratio of squamous cell carcinoma ws basal cell careinoma was 4:1. 9) The accuracy of clinical dianosis were 42.7% for benign tumors and 79.3% for malignant tumors.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidermal Cyst ; Female ; Hemangioma ; Humans ; Incidence ; Male ; Melanoma ; Neck ; Nevus, Pigmented ; Pathology, Surgical ; Seoul ; Skin*

PURPOSE: This study was to investigate difficulties in daily activities and tingling from patients having treatment of FOLFOX chemotherapy after colon resection. METHOD: This study included 103 patients hospitalized for FOLFOX chemotherapy in one of the university affiliated hospital from August 1, 2008 through September 30, 2009. Data were collected using the questionnaire comprised general symptoms, tingling, difficulties in daily activities and coping behavior. Using the SPSS 14.0 program, data analytic methods include Chi-Square test, ANOVA, Scheffe's test. RESULTS: The tingling sensation occurred in hands, feet, mouth, throat. Contacts with cold objects and the number of chemotherapy cycle worsen tingling sensation. Patients experienced difficulties in daily activities such as personal hygiene, kitchen work, eating cold food, sleeping cold, using fine motors like button up, writing, or using knife. The coping behavior included drinking warm water, sleeping warm, using gloves and socks, wearing comfortable shoes, massaging hands and getting help from supporters. CONCLUSION: An educational guideline for promoting coping behavior to relieve tingling sensation and difficulty in daily living in patients with FOLFOX chemotherapy is needed.
Activities of Daily Living ; Adaptation, Psychological ; Antineoplastic Combined Chemotherapy Protocols ; Cold Temperature ; Colon ; Drinking ; Eating ; Fluorouracil ; Foot ; Hand ; Humans ; Hygiene ; Leucovorin ; Mouth ; Organoplatinum Compounds ; Pharynx ; Surveys and Questionnaires ; Sensation ; Shoes ; Writing

Isolated angiitis of the central nervous system is a rare clinicopathologic entity characterized by vasculitis restricted to the vessels of central nervous system without other apparent systemic vasculitis. It manifests headache, higher cortical dysfunction. focal neurologic dysfunction and cranial nerve palsies. We experienced a case of isolated angiitis of the central nervous system in 6 year-old girl who was admitted to out unit because of headache, hemiparesis and altered consciousness. The laboratory test for blood, urine, and cerebrospinal fluid are all within normal ranges. There was no evidence of systemic vasculitis. The contrast enhanced brain CT scan showed low densities along the left cerebellar hemisphere and posterior aspect of temporal lobe without enhancement, and left lateral internal carotid angiogram showed poorly contrast filling along the territory of left posterior cerebral artery due to narrowing or ischemic changes of the vessels. Axial T2WI (TR/TE, 2190/80) of magnetic resonance imaging showed multiple scattered high signal intensities at left pons with cerebellar hemisphere and diffuse high signal intensity along the left occipital lobe with enlarged surrounding gyral patterns, and axial T1WI(TR/TE, 665/25) showed intense gyral pattern contrast enhancement along the left occipital lobe. Steroid was tried with apparent benefit. We report a case of isolated angiitis of central nervous system with review of literature.
Brain ; Central Nervous System ; Cerebrospinal Fluid ; Child ; Consciousness ; Cranial Nerve Diseases ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Nervous System* ; Neurologic Manifestations ; Occipital Lobe ; Paresis ; Pons ; Posterior Cerebral Artery ; Reference Values ; Systemic Vasculitis ; Temporal Lobe ; Tomography, X-Ray Computed ; Vasculitis*

With porcine vertebrae, the static and dynamic holding power of the pedicle screws under various conditions were measured to understand the biomechanical nature of the transpedicular screw fixation in spine. The objectives of the present study were; (1) to find the correlation between the insertion depth of the screw and the resulting holding power, (2) to determine the effect of bone cement augmentation on the screw fixation in a loosened hole, and (3) to assess the load-sharing mechanism between the cortical and the cancellous one surrounding the screw in this fixational system. The geomorphological characteristics of each porcine vertebra was measured directly with a micro-caliper. The bone mineral density of the specimens was also measured. Material with screw was holded in the fixed cross head of material testing system(Autograph E-10T). Testing force was applied and graph was obtained in the chart record. The results of the static pull-out tests in this study showed that there was a statistically-significant positive correlation between the screw diameter and the pull-out resistance(p < 0.05). The strength of the fixation did not actually increase as much as the insertion depth of the screw increased in these tests(r=0.457). In low-cycle fatigue tests, the increased number of cycles was required to clinical failure in the deeper-inserted crews. Considering the mechanical failure, a statistically-significant positive correlation between the failure cycle and the insertion depth was observed in both deep and shallow insertion groups(p < 0.05). Nonpressurized PMMA augmentation appeared to restore the ability of the screws to withstand pullout loading of the original value. On the effect of the cortical and cancellous bone, the most important factor was the cortical bone of the entrance near the screw.
Bone Density ; Fatigue ; Head ; In Vitro Techniques ; Pedicle Screws ; Polymethyl Methacrylate ; Spine

Total hip arthroplasty for ankylosed hip has a higher risk of failure due to the poor condition of the hip abductors and the altered configuration of the bone, which lead to poor positioning or fixation of the prosthesis. Fifty-one hips (42 patients) converted to total hip arthroplasty between March 1983 and March 1994 have been reviewed three to thirteen years six months after operation. The average period of follow-up was four years nine months. Twenty six of the patients were men and sixteen were women. The average age at the time of operation was 40 years old (range,19 to 70 years). Among the 51 hips, bony ankylosis were 27 hips and fibrous ankylosis were 24 hips, spontaneous ankylosis were 40 hips and surgical ankylosis were 11 hips. The duration of hip fusion was 13 years six months in the bony ankylosis and 16 years one month in the fibrous ankylosis. Preoperatively 33 cases had low back pain, ipsilateral or contralateral knee or hip pain. In asymptomatic 18 cases, conversion total hip arthroplasty was also performed for the management of functional disabilities due to severe malpositioned ankylosis. At the time of the last follow-up, 25 cases were free from pain and six patients had a mild degree pain on the hip, knee or thigh. In bony ankylosis, the postoperative average hip motion ranged from 1.1 degrees to 93.2 degrees (average arc of motion of 92.1 degrees). In fibrous ankylosis, the postoperative average hip motion ranged from 1.7 degrees to 96.6 degrees (average arc of motion of 94.9 degrees). The average Harris hip score was improved from 66 to 86.9 in bony ankylosis and from 49 to 89.5 in fibrous anklyosis. The postoperative leg length discrepancy was 1.1 cm in average. The postoperative complications included heterotropic ossification in 25 cases (49%), cup loosening in two cases (3.9%) and stem loosening in three cases (5.6%). As for the clinical results, 24 cases (89%) of bony ankylosis and 23 cases (96%) of fibrous ankylosis had satisfactory functional results at the last follow-up. In conclusion, the conversion total hip arthroplasty could provide functional improvement, pain relief and especially correction of leg length discrepancy in most cases of ankylosed hip.
Adult ; Ankylosis ; Arthroplasty, Replacement, Hip* ; Female ; Follow-Up Studies ; Hip* ; Humans ; Knee ; Leg ; Low Back Pain ; Male ; Postoperative Complications ; Prostheses and Implants ; Thigh