No abstract available.
Stroke*

OBJECTIVES: There have been several studies documenting the changing level of the conus throughout infancy and childhood, but there is only a little detailed study that documents the range of conus positions in a living adult population, especially in Korean, without spinal deformity. METHODS: we made a sequential study of magnetic resonance images of the lumbar spine to determine the variation in position of the conus medullaris in 650 living korean adults population without spinal deformity who checked MRI to identify the cause of low back pain. The study population consisted of patients over the age of 16 years. A T1-weighted, midline, sagittal image was reviewed for identifying the postion of conus. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disc. RESULTS: The study group consisted of 305 men(47%) and 345 women(53%) with a mean age 45.9 years(range, 16-79 years). The conus existed commonly at the middle third of L1(131cases, 20.2%), at the L1-2 intervertebral space(129cases, 19.8%), and the lower third of L1(123cases, 18.9%). The mean position of conus was the lower third of L1(range, middle third of T12 to middle third of L3). Conclusions:The mean position of conus was at the lower third of L1(range, middle third of T12 to middle third of L3). This results was same as that of foreign study. Our results of living korean adult population could allow for safe clinical procedures such as lumbar puncture, spinal anesthesia, and help to explain the differences among observed neurologic injuries from fracture-dislocation at the thoracolumbar junction.
Adult* ; Anesthesia, Spinal ; Congenital Abnormalities ; Conus Snail* ; Humans ; Intervertebral Disc ; Low Back Pain ; Magnetic Resonance Imaging* ; Spinal Puncture ; Spine

PURPOSE: The aims of this study were to review the clinical characteristics of midgut volvulus and recognize the importance of the early diagnosis and treatment of midgut volvulus. METHODS: The medical records of 10 patients with midgut volvulus, diagnosed at the Dankook University Hospital, between May 1995 and May 2001, were retrospectively reviewed. RESULTS: There were 6 male and 4 female subjects. 80% of the patients were younger than 1 month old. The most common symptom was bilious vomiting. A simple abdominal X-ray was performed in 8 cases, with five of these 8 showing positive findings, such as a gasless abdomen or stomach dilatation. Ultrasonography was performed in all 10 cases. The sensitivity of the ultrasonography was 70%. UGI series was performed in 9 cases, and showed 100% sensitivity. Eight patients underwent surgical treatment. Seven infants in the early-diagnosis group had a Ladd operation performed, but only one patient whose diagnosis was delayed underwent a small bowel resection. The 7 patients that had undergone a Ladd operation showed good results after surgery. However, the one whose diagnosis had been delayed developed severe complications and mortality. CONCLUSION: The early diagnosis and adequate intervention for midgut volvulus can prevent life threatening complications. If the ultrasonographic findings are uncertain, especially when the midgut volvulus is untwisted after attack, UGI series or a barium enema should be performed to confirm the diagnosis.
Abdomen ; Barium ; Diagnosis ; Early Diagnosis ; Enema ; Female ; Gastric Dilatation ; Humans ; Infant ; Infant, Newborn ; Intestinal Volvulus* ; Male ; Medical Records ; Mortality ; Retrospective Studies ; Ultrasonography ; Vomiting

To evaluate the reproducibility in measuring the velocities of perifoveal hyperfluorescent dots, we analyzed fluorescein angiographs of 24 eyes[24 patients]which had central serous retinopathy. Fluorescein angiography was performed with a scanning laser ophthalmoscope[SLO, Rodenstock, Mnchen, Germany]Distances between 5 moving hyperfluorescent dots in a perifoveal capillary were measured at each consecutive frame[interval 1/30 sec]. And then velocities of 5 fluorescent dots were measured with image analysis program by converting the distances to real retinal size using the Littmann's curve in 20 eyes. In the other 4 eyes, the velocities between 5 fluorescent dots of each 2 to 4 capillaries were measured. Perifoveal capillary mean blood flow velocity and standard deviation were 2.08 +/-0.36 mm/sec, and mean coefficient of variation of the velocities measured in a vessel of one patient was 12.58%. However, reliability of the velocities of 2 to 4 capillaries on the 4 eyes was relatively low. In conclusion, the measurement of velocities between perifoveal fluorescent dots with scanning laser ophthalmoscope may be a reproducible method for a perifoveal capillary. However, reliability of measuring velocities was not sufficient enough to use the velocity of one perifoveal capillary as macular blood flow.
Blood Flow Velocity ; Capillaries ; Central Serous Chorioretinopathy ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Ophthalmoscopes* ; Retinaldehyde

No abstract available.
Brain Abscess* ; Brain* ; Catheters*

We studied the ultrastructural alteration of glomerular anionic sites in 6 patients with minimal change nephrotic syndrome, 5 patients with membranous glomerulonephritis, 4 patients with focal segmental glomerulosclerosis, and 4 patients with IgA nephropathy by staining with polyethyleneimine (PEI) as a cationic probe. The control study was examined by using a nephrectomy specimen of non-glomerular disease which had no proteinuria. This method seems to selectively stain heparan sulphate in the basement membranes and has been widely used to evaluate changes in basement membrane charge in various human diseases as well as in experimental studies. The anionic sites in the lamina rara interna and lamina densa of normal glomerular basement membrane were always less numerous and less regularly distributed than those in the lamina rara externa. Characteristic common findings in these glomeruli showed a marked decrease of glomerular anionic sites in the regions with immune-complex deposits and normal distribution in the regions with focally those being absorbed and newly forming glomerular basement membrane. They were not detected in the gap of the basement membrane and on the area of the detached overlying epithelium using the PEI method. But the foot process fusion of epithelial cells seems not to influence the loss of anionic sites on the glomerular basement membrane.
Basement Membrane ; Epithelial Cells ; Epithelium ; Foot ; Glomerular Basement Membrane* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Nephrectomy ; Nephrosis, Lipoid ; Polyethyleneimine ; Proteinuria

Since Ender introduced the concepts of multiple flexible intramedullary nailing in 1970, Ender nailing has been mostly used in intertrochanteric fractures of the elderly patients, but it has been rarely used in younger patients because of serious complications such as shortening and external rotation deformity. Authors already contended that the incidence of such complications had intimate connection with the quality of bone, and accordingly with the age. To substantiate the contention, we analyzed thirty-four cases with more than one year follow-up among forty cases of intertrochanteric fractures treated with Ender nails during the period from 1982 to 1989. And the results are summarized as follows;1. The average age was 39 yrs., and the most common cause of fractures was fall from a height. 2. According to the Kyle et al. clsssification, stable fractures(type I & II ) were 13 cases(38%), and unstable fractures (type III & IV) were 21 cases(62%). 3. According to the Singh's index, the good in bone quality(Grade 4, 5, & 6) were 31 cases(91 %), and the poor(Grade 1, 2, & 3) were only 3 cases(9%). 4. Postoperative complications occurred in 6 cases(17%), which included ROM limitation of knee joint in three cases(9%), proximal migrations of nails in two(5%), and distal migrations of nails in one(3%). Among them, 4 cases required revisional operations. There was no case with apparent external rotation deformity over 20 and shortening over 2cm. 5. It is thought that, contradictory to common beliefs, Ender nailingis a safe method for intertrochanteric fractures of femur in younger patients with good bone quality, but requires some experiences and cautions to prevent such complications as external rotation deformity and shorterning.
Aged ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Incidence ; Knee Joint ; Methods ; Postoperative Complications

"Pseudomyxoma peritonei is a clinical entity in which the peritoneal surface and omentum are involved with gelatinous, mucinous implants, and often massive gelatinous ascites. Most cases originate from ruptured ovarian mucinous cysts or appendiceal mucoceles, and involve only the intraperitoneal cavity. But there is much confusion about its etiology, clinical manifestation, treatment, and prognosis. We experienced a case of pseudomyxoma peritonei originating from the mucinous cystic tumor of borderline malignancy in unilateral ovary with rupture. A case of pseudomyxoma peritonei is reported with a brief review of the literature."
Female ; Gelatin ; Mucins ; Mucocele ; Omentum ; Ovary ; Prognosis ; Pseudomyxoma Peritonei* ; Rupture

BACKGROUND: Cervical cancer is the second most commonly diagnosed cancers in women and is responsible for about 14 percent of all female cancer found in Korean women. Early detection is very important because the likelihood of a complete cure is greater, and among the early screen only tools to detect cervical cancers, a Pap smear is most widely used. It has the clinical significance to follow - up patients whose results are classified as class II in their Pap smear. Thereto we tried to find the factors associated with follow-up in class II patients. METHODS: On Pap smear practiced from Jan. 1, 2000 to Dec. 31 in a University Hospital, 159 patients Pap smear results were categorized as class II, and among the 159 patients, we were able to collect data from 107 patients who voluntarily answered a phone survey. The categories in the survey were the followings : follow- up for the Pap smear, age, age of marriage, presence of menopause, age of menopause, occupation, family history of chronic diseases or cancers, educational level, presence of concomittant diseases, income, average hospital visit frequency in a year, belief of general health, and reason for doing follow- up and reason for not doing it. RESULTS: Among 107 patients, only 62 patients (57.9 Percent) did follow-up for their Pap smear results. The reasons were doctors follow-up recommendation for Pap smear results and regular health check-up, and the two main reasons not doing follow-up were nonexistence of further symptom and financial distress. In a single variable analysis, the higher educational level, individual income, and hospital visit frequency, the more People had follow-up. But in multiple logistic anarsis, only individual income was statistically significant. CONCLUSION: The follow-up rate was as low as 57.9 percent, and the reasons why they did not follow-up were mainly the lack of understanding about the clinical significance of class II result on the Pap smear. Therefore, an advertisement and public education Programs to general public about cervical cancer will make more patients follow up their result on the Pap smear, especially to the low income and low education class people.
Chronic Disease ; Education ; Female ; Follow-Up Studies* ; Humans ; Marriage ; Menopause ; Occupations ; Uterine Cervical Neoplasms

PURPOSE: To determine the advantage and disadvantage of using tourniquet in the malleolar fracture treated with open reduction and internal fixation. MATERIAL AND METHOD: Randomized 12 patients were operated on with use of a tourniquet (Group T), and 12 patients without use of a tourniquet (Group NT). The operation time, the technical difficulty during operation, the incidence of postoperative complication and the intensity of postoperative pain were compared between the two groups. RESULT: The demographic of the two groups, including age, sex, fractire type, and delay after injury were similar. The average duration of the operation and the technical difficulty during operation were similar between the both group (76min. in Group T, 81min in Group NT, p=0.28) There were no severe complications, however, Four patients had local redness and oozing (3 in group T, 1 in group NT). The patients in group T had higher VAS (Visual Analogue Scale, p=0.014) and more frequencies of analgesic injection (p=0.03) than within 24 hours after operation than those in Group NT, which difference was more significant in male patients and the patient of more than 40-year old. CONCLUSION: Open reduction and internal fixation of the malleolar fracture without use of a tourniquet can be performed with little difficulty and the severity of postoperative pain and the incidence of postoperative complication can be reduced.
Adult ; Humans ; Incidence ; Male ; Pain, Postoperative ; Postoperative Complications ; Tourniquets*