Treatment modalities for herniated lumbar intervertebral disc are the conservative method, chemonucleolysis, percutaneous diskectomy and operation. Conservative treatment is effective in 70–80% of the acute stage and the other 20% requires chemonucleolysis, percutaneous diskectomy or operation. Indications for operation are cases not improved after conservative treatment, recurrent cases and cauda equina syndrome. Mixter and Barr(1934) demonstrated that laminectomy and surgical removal of disc material could relieve symptoms, but spinal segmental instability, incomplete removal of the disc and postoperative adhesion of the nerve root caused low back pain after long-term follow up. Thus, the authors evaluated the plain X-ray and computed tomographic findings in 21 cases of failed laminectomy to determine the cause of failure. The results were as follows ; 1. Among 21 cases, 18 cases complained of low back pain with sciatica and 3 cases complained of low back pain. 2. In all cases, disc space narrowing was detected on plain X-ray. Total laminectomy and diskectomy promote insufficiency and instability of the lumbar and lumbosacral spine. Whenever one attempts to do total laminectomy and diskectomy, it is recommended that spine fusion be performed in same operating field. 3. Several findings were detected on CT scan : 8 disc protrusions in the operation site, 6 disc protrusions in the operation site and spinal stenosis, 4 extradural scars, 1 extradural scar and other site disc protrusion and 2 cases of spinal stenosis and spondyloisthesis. 4. Computed tomography in cases of failed laminectomy offers more information than has been available by any other imaging method.
Cicatrix ; Diskectomy ; Diskectomy, Percutaneous ; Follow-Up Studies ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Laminectomy ; Low Back Pain ; Methods ; Polyradiculopathy ; Sciatica ; Spinal Stenosis ; Spine ; Tomography, X-Ray Computed

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*

BACKGROUND: The regular use of soaps and synthetic detergents has been associated with skin dryness and aggravation of dermatological conditions. OBJECTIVE: Our purpose was to investigate the irritancy of 10 hand dishwashing liquids on normal skin. METHODS: The skin changes, responding to repeat patch testing with 10 hand dishwashing liquids, were measured by visual scoring. RESULTS: The results are summarized as follows; 1. Of the 16 healthy volunteers 8 had reactions. 5 women and 3 men, but there was no significant difference in irritancy between men and women. 2. The mean irritancy scores of the 10 hand dishwashing liquids ranged from 0.06 to 0.88. 3. A prominent increase in the degree of erythema in the first 24 hour patch test did not persist beyond exposure day 5, but after day 5, augmented responses of the erythema and scales, even fissuring occurred. 4. The pH of the test solutions of the hand dishwashing liquids ranged from 5.0 to 6.0, but there appeared to be no correlation between pH and irritancy in the dishwashing liquids tested. CONCLUSION: Our data suggests that regular exposure to hand dishwashing liquids may cause disturbances of the skin in a substantial proportion of individuals, and workers should use hand dishwashing liquids in lower concentrations than recommended and only for short periods with protective measures.
Detergents ; Erythema ; Female ; Hand* ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Male ; Patch Tests ; Skin* ; Soaps ; Weights and Measures

BACKGROUND: The keratinocyte growth factor(KGF) is a recently identified mitogen for epithelial cells produced by nomal stromal fibroblasts. ln the skin, KGF has been shown to stimulate keratinocyte proliferation and differentiatian. Dendritic epidermal T cells(DETC) are skin-specific members of the epithelial y 8 T-cell family that reside normally in the murine epidermis. The DETCs recognize antigen expressed by damaged or diseased neighboring keratinoctyes and consequently secrete cytokines sueh as IFN- y, lL-2, IL-4, GM-CSF. OBJECTIVE: The purpose of this study was to observe the expression of KGF mRNA in keratinocyte and DETC as well as to investigate the cytokine-mediated intercellular communication between kerati- nocyte and DETC. METHODS: Using a RT-PCR(reverse transcription-polymerase chain reaction), we examined the expression of KGF mRNA in keratinocyte and DETC, and compared the level of KGF mRNA between resting and activated DETC with Con-A (concanavalin A).
Cytokines ; Epidermis ; Epithelial Cells ; Fibroblast Growth Factor 7* ; Fibroblasts ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Interleukin-4 ; Keratinocytes* ; RNA, Messenger* ; Skin ; T-Lymphocytes

Acute pyogenic osteomyelitis is frequent in infants and children, usually hematogenous, and predominant in male. The etiology of acute osteomyelitis is of 3 types: hematogenous, direct innoculation, or postoperative. Acute pyogenic hematogenous osteomyelitis is the most frequent type in children. This study consisted of 119 cases of acute pyogenic osteomyelitis which were studied at the department of orthopedic surgery, Yonsei university, Severance hospital and Youngdong hospital for 10 years from Jan. 1974 to Dec. 1983. The result were as follows. 1. There were tendency to decrease the frequency of this disease graduaUy since 1973 except 1978. 2. 20 patient (16.8%) had the history of trauma and 43 patients (36.1%) had the entry site of infecting organism. 3. The most frequent involved sites were femur and tibia. 4. E.S.R. was definitely increased in 90.4% of male, in 100% of female. 5. 59.6% of patients revealed the definite bone change at admission on X-ray findings. 6. Staphylococcus coagulase positive was the most frequent organism isolated (95%). 7. The most sensitive antibiotics was cephalosporin and the most resistant was penicillin (90.2%). 8. The antibiotics treatment with immobilization of involved site was initially tried, if there was no symptomatic improvement, the various surgical process was performed with satisfactory result.
Anti-Bacterial Agents ; Child ; Clinical Study ; Coagulase ; Female ; Femur ; Humans ; Immobilization ; Infant ; Male ; Orthopedics ; Osteomyelitis ; Penicillins ; Staphylococcus ; Tibia

Soft tissues, which are widespread in body, are derived from a common primitive mesenchyme and the tumors arising from them tend to closely resemble the prototype tissue in varying degree. Some soft tissue tumors have benign course, which can be cured by local excision and the other have malignant course being resistant to therapy and resulting in recurrence to other organ of tissues. The authors reviewed 279cases of soft tissue tumors which had been treated at Department of Orthopedic Surgery in Severance Hospital, Yonsei University College of Medicine from January 1983 to December 1987. 1. Among 279cases of soft tissue tumors, 257(92.1%) were benign and 22(7.9%) were malignant. 2. Benign soft tissue tumors were common two times in female, and malignant tumors were relatively common in male. 3. Common sites of soft tissue tumors were 92 csses about the knee, 69 csses in the hand and wrist, 44 cases in the foot, 26 cases in the leg, 15 cases in the thigh, 14 cases about the elbow, 10 cases in the arm and foresrm. 4. The most common benign tumors was ganglion which was followed by Baker's cyst, hemangioma, fibromatosis, lipoma, epidermal cyst in decreasing order of incidence. Among malignant tumors, fibrosarcoma, malignant fibrous histiocytoma, malignant schwannoma, synovial sarcoma, leiomyosarcoma were common. 5. Most of the benign tumors was taken by locsl excision, and malignant tumors were were trested by wide resection with combination of chemotherapy. 6. Local recurrences of benign tumors were developed in 26(10.1%) out of 257cases, especially in fibromatosis and hemangioma.
Arm ; Clinical Study ; Drug Therapy ; Elbow ; Epidermal Cyst ; Extremities ; Female ; Fibroma ; Fibrosarcoma ; Foot ; Ganglion Cysts ; Hand ; Hemangioma ; Histiocytoma, Malignant Fibrous ; Humans ; Incidence ; Knee ; Leg ; Leiomyosarcoma ; Lipoma ; Male ; Mesoderm ; Neurilemmoma ; Orthopedics ; Popliteal Cyst ; Recurrence ; Sarcoma, Synovial ; Thigh ; Wrist

OBJECTIVE: Hypertensive disorder in pregnancy is one of the most serious obstetrical complications. Apolipoprotein E (Apo E) genotype is polymorphic and recently it was reported to be associated with preeclampsia. We undertook this study to clarify whether polymorphic marker of apolipoprotein E is associated with the development of hypertensive disorder in pregnancy. METHODS: Retrospective chart review was done. DNA was extracted from maternal blood of 124 healthy pregnant women and 253 women with hypertensive diseases in pregnancy. Hypertensive disorders complicating pregnancy include gestational hypertension (n=44), preeclampsia (n=158; mild=56, severe=102), preeclampsia superimposed preeclampsia (n=30), and chronic hypertension (n=21). Apo E allele was amplified by polymerase chain reaction, size fractionated on 4% agarose gels, and stained with ethidium bromide. RESULTS: We found all six possible genotypes of Apo E. However, three genotypes, E2/2, E2/4 and E4/4, were uncommon in Korean. We analysed the data according to each allele. Allele frequencies of the Apo epsilon2, epsilon3 and epsilon4 were as follows: 6.8%, 83.0%, 10.2% in women with gestational hypertension, 4.5%, 84.8%, 10.7% in women with mild preeclampsia, 5.9%, 85.3%, 8.8% in women with severe preeclampsia, 1.7%, 91.7%, 6.7% in women with superimposed preeclampsia, 0.0%, 90.5%, 9.5% in women with chronic hypertension, and 5.2%, 86.5%, 8.5% in normal controls. No significant difference in Apo E alllele frequency was found among these groups (P>0.05). CONCLUSIONS: The study suggests that specific allele of apolipoprotein E does not appear to be a risk factor for hypertensive disorders complicating pregnancy in Korean population.
Alleles ; Apolipoproteins ; Apolipoproteins E ; DNA ; Ethidium ; Female ; Gels ; Gene Frequency ; Genotype ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Risk Factors ; Sepharose

PURPOSE: Late-onset hypogonadism (LOH) in aging males is a clinical and biochemical syndrome characterized by a decline in serum testosterone levels. LOH results in various physical and mental disabilities. We evaluated the relationship between serum testosterone levels and symptoms of LOH. MATERIALS AND METHODS: During an andropause screening program, we examined responses to the Saint Louis university androgen deficiency in aging males (ADAM) questionnaire and results on the International Index of Erectile Function (IIEF-5) in terms of clinical symptoms and evaluated serum total testosterone levels for a biochemical diagnosis of LOH in healthy community-living volunteers aged over 40 years. RESULTS: The mean age of the 534 men was 59.1 years (range, 40 to 79 years), and their mean serum testosterone level was 464.1+/-171.9 ng/dL. The serum testosterone level decreased significantly with age. There was a 92.5% positive response rate to the ADAM questionnaire. The percentage of patients whose serum testosterone level was <350 ng/dL among those with a positive response to the ADAM questionnaire was 25.6% (137 patients). The mean serum testosterone level among patients with a positive or negative ADAM questionnaire was 472.4+/-198.5 ng/dL and 487.3+/-165.7 ng/dL, respectively (p>0.05). There was no significant correlation between IIEF-5 scores and serum testosterone levels. CONCLUSIONS: Among men over 40 years of age, 25.6% met the clinical and biochemical diagnostic criteria for LOH. There was no relationship between serum testosterone levels and symptoms of LOH.
Aged ; Aging ; Andropause ; Humans ; Hypogonadism ; Male ; Mass Screening ; Testosterone

Idiopathic hypercalciuria is one of the major causes of asymptomatic hematuria in children and adults. However, the etiology of idiopathic hypercalciuria(IH) is not conclusive. In spite of many hypothesis about its genetic predisposition, the evidence for a genetic basis in the pathogenic mechanism of IH is fragmentary. In this study, we evaluated familial tendency and environmental factors influencing the pathogenesis of this disorder in patients with IH and their families. We investigated 24 children with IH and their 72 first-and second-degree relatives in this study. Twenty four patients had visited department of Pediatrics, Korea University Guro Hospital between July 1991 and July 1994 and had been diagnosed as IH. We measured fasting urine Ca/Cr ratio of 72 relatives of patients and if it is over 0.21, measured excreted calcium level of 24-h urine and serum Ca, P, Mg, BUN, Cr concentrations and PTH level. To analyse some environmental factors, we interviewed them(24 patients and their 72 relatives) about socioeconomic statuses, medications, history of conditions leading to secondary hypercalciuria, and preference for calcium-rich foods. 1) Out of 24 patients, 15 were absorptive hypercalciuria(AH) and 9 were renal hypercalciuri(RH). 2) The family investigations revealed IH in 9 out of 72 relatives of the 24 index patients and also showed a familial tendency in 12.5%. The familial tendency was 26.7% in families of children with AH(4 of 15 families) and 55.6% in families of children with RH(5 of 9 families)(p<0.05). 3) In personal interviews, there were no significant differences of nutritional habit between patients with AH and patients with RH. And then, the mean urine Ca/Cr ratio was significantly higher in the group preferring calcium-rich diet(18 persons) than in the group preferring calcium-low diet(14 persons) (p<0.05). We conclude that idiopathic hypercalciuria, especially, renal hypercalcuria, seems to have a familial tendency.
Adult ; Calcium ; Child ; Fasting ; Genetic Predisposition to Disease ; Hematuria ; Humans ; Hypercalciuria* ; Korea ; Pediatrics ; Social Class

No abstract available.
Down Syndrome*