A relationship between preceding acute paralytic poliomyelitis and the later development of motor neuron disease has only occasionally been suggested since it was first postulated by Charcot in 1875. The authors recently experienced a 20-year-old male who was considered to have postpoliomyelitis muscular atrophy. We report this case in view of its rarity and necessity of differential diagnosis from other neuromuscular disorders. Clinical presentation included slowly progressive muscle wasting of left thigh for 4 years, mild weakness of left arm and both thigh, intermittent fasciculation, and previous history of acute paralytic poliomyelitis. Electromyographic findings showed fibrillation potentials, positive sharp waves, fasciculations, giant motor unit potentials and reduced interference patterns. Muscle biopsy revealed scattered small angulated fibers, individual myofiber degeneration and mild inflammatory cell infiltration.
Arm ; Biopsy ; Diagnosis, Differential ; Fasciculation ; Humans ; Male ; Motor Neuron Disease ; Poliomyelitis ; Postpoliomyelitis Syndrome* ; Thigh ; Young Adult

Bony defect is one of the most common problems in craniomaxillofacial surgery. Although aurogenous bone graft is the best choice for the treatment of bone defect, it provides many problems such as donor site morbidity, irregular absorption, and limited amount of harvest. To overcome the shortcomings of autogenous bone graft many bone substitutes have been introduced. The ideal bone substitution is to have characteristics such as cheap, easy to obtain, rapid fusion to recipient bone, hard structure, long maintenance of shape and volume, low infection rate, and low exposure rate. Among those bone substitutes which have been widely used we chose lyophilized cartilage allograft because of low antigenecity, low resorption rate, easiness of carving and ling term preservation. From August 1993 to August 1997, 66 patients had been performed craniomaxillofacial reconstruction with lyophilized cartilage allograft. Orbital wall reconstruction and correction of enophthalmos were 24, correction of cleft lip and nose deformity were 19, temporal augmentations were 7, and others 16. Complications such as infection, exposure were not common. And partially removed cartilage was proved some calcification. Radiologic follow-up presented well positioned lyophilized cartilage allograft. Two radiologic works revealed haziness of bone density at the site of cartilage allograft. This suggests the ossification of lyophilized cartilage allograft. Together with liw infection rate, low exposure rate, and good framework for osteoconduction, lyophilized cartilage allograft are regarded as one of the good bone substitutes.
Absorption ; Allografts* ; Bone Density ; Bone Regeneration ; Bone Substitutes ; Cartilage* ; Cleft Lip ; Congenital Abnormalities ; Enophthalmos ; Follow-Up Studies ; Humans ; Nose ; Orbit ; Tissue Donors ; Transplants

No abstract available.
Gallstones* ; Lithotripsy* ; Ultrasonography*

The authors studied the diagnostic usefulness of the Topographic analysis of EEG, using Topography ststem 700 (San-ei), in evaluation of supratentorial focal cerebral lesions of 27 patients with various etiology, comparing with visual anslysis of EEG. Focal cerebral lesions, which were proven with brain C-T, were 11 cases of cerebral infarction, 6 of intracranial hematoma, 6 of cerebral gliolysis and 4 of others. The topography system displays the spatial distribution of activity in the classic delta, theta, alpha and beta frequency and computed mapping of EEG displays equipotential maps of square of roots of power spectra over each frequency band. For visual analysis of slow waves and background activity changes, Mayo classification system of EEG abnormality was used and for visual evaluation of topographic display, above system was also applied with some modification in order to compare with the data of visual analysis of conventional EEG. The results of the study were as follows; 1. While visual analysis of conventional anlysis of EEGs showed abnormality only in 13 cases (48.1%) of 27, topographic analysis showed abnormality in 22 cases (81.5%). Topographic analysis was more sensitive than than visual analysis of the EEG and topographic analysis was thought to be more sensitive in assessment of local slow waves as well as minor changes, especially slight asymmetry, of background EEG activity. 2. Topographic analysis showed higher concor dance rate (55.6%) to the brain C-T finding in lateralization of supratentorial focal cerbral lesion than that (44.4%) of visual analysis of the conventional EEG.
Bisoprolol ; Brain ; Cerebral Infarction ; Classification ; Electroencephalography* ; Hematoma ; Humans

62 cases of the fracture of the pelvis admitted to the orthpedic department of Wonju Christian Hospital during past 5 years from 1975 to 1979 were reviewed and clinical results were obtained as follows: 1. Males were frequent than females and almost 3rd to 4th decades of life. 2. The causes of injury were traffic accident, coal minor accident, and falling. 3. Stable type is the most common in this series and among the unstable types, lateral compression type is the most common and then straddle type and vertical shear type. 4. The most common complication is uro-genital injury. 5. The residual complications at the end of treatment remained in some cases, Arthritis of sacroiliac joint, Impotence, Urethral stricture, Low back pain, etc. 6. All of the cases were treated conservatively and their results were somewhat good except 4 cases. 7. Surgical treatment would be considered, if necessory, to decrease the complications and reduce hospital days.
Accidental Falls ; Accidents, Traffic ; Arthritis ; Coal ; Erectile Dysfunction ; Female ; Gangwon-do ; Humans ; Low Back Pain ; Male ; Pelvic Bones ; Pelvis ; Sacroiliac Joint ; Urethral Stricture

We analyzed 34 cases of large bone defect caused by trauma, infection and tumor resection from July, 1979 to June, 1985. The bony defect were restored by vascularized fibular graft or vascularized fibular transposition. 22 cases were the traumatic segmental loss and 7 cases were infected ones and 5 cases were the loss following tumor resection. Vascularized fibular graft was performed in 19 cases and vascularized fibular transposition was performed in 15 cases. The 33 cases(97%) of 34 cases had obtained sound bony union and average union time had been 18.6 weeks. Even local infection in the bone, vascularized fibular graft or transposition can be performed. Grafted or transposed fibula had been hypertrophied about 1.2 times in anteroposterior and lateral film which had been measured in the center of the fibula. The most common complication was the clawing of first or second toe. If the ipsilateral fibula is intact, the vascularized fibular transposition is better and if not, vascularized fibular graft is preferred. Operation using the vascularized fibula is a excellent method for the restoration of large bone defect in long bone.
Animals ; Fibula ; Hoof and Claw ; Methods ; Toes ; Transplants

The ICU at Severance Hopital was opened with 7 beds on October 18, 1968 and expanded to 19 beds on February 2, 1981. From 1970-977, We statistically analyzed 3,072 ICU patients. During the period of years from March 1975 to February 1982, We have analyzed clinically 4,348 ICU patients. The Results were as Follows: 1) During the 7 years the total number of patients was 4,383. ln 1981, 1063 patients were admitted to the ICU: this number being almost twice that of in 1980. 2) During the 7 years, the overall mortality was 15.1%, highest in 1976(30.1%) and lowest in 1979(11.5%). It has decreased annually, 12.4% in 1980, 12.3% in 1981. 3) Total admission days in ICU were 18,148 days, the average patient stay in ICU being 4.17 days. The majority of the patients(81.2%) stayed in ICU less than 5 days. The number of patients staying in ICU more than 6 days increased every year from 14.2% in 1975 to 22% in 1981. 4) About 50% of the patients admitted were under the forties-age group. The number under the teens old group was 19%, this group representing the highest number of patients admitted to the ICU. The highest mortality(18.5%) occurred in the 1 to 10 yearold-age group. 5) The number of patients admitted to the department of internal medicine was 1,574 cases, which was the highest among all departments. The mortality rate was highest in the neurosurgery department(41.9%). In 1981, the number of ICU patients in cardiac surgery and pediatrics was increased three time compared with that of 1975. 6) All ICU patients have been divided into two categories, operative and non-operative cases. The operative cases were 2,150, non-operative cases 2,198 cases. Mortality rate was 10% in operative cases, 20% in non-operative cases. 7) Case expired from march 1981 to February 1982: The number of expired parients including those with a poor prognosis was 183 cases. The number of patients that expired under the 10-year-age group was the highest, 78 cases. The cases that expired in internal medicine and pediatrics were 63 and 58 cases respectively. The causes of death were due to damage of central nervous system, cardiovascular system, respiratory system in that order. From the above results, it can be concluded that in spite of an increase in patients, the mortality rate has decreased annually.
Adolescent ; Cardiovascular System ; Cause of Death ; Central Nervous System ; Humans ; Intensive Care Units* ; Critical Care* ; Internal Medicine ; Mortality ; Neurosurgery ; Pediatrics ; Prognosis ; Respiratory System ; Thoracic Surgery

No abstract available.
Gallbladder* ; Lithotripsy*

BACKGROUND AND SIGNIFICANCE: PPA is the clinical syndrome that reveals a marked, progressive loss of language functions over time with relative preservation of non-linguistic cognitive functions. Patients with this syndrome eventually develop a general dementia, but the natural history, neuropathology, and etiology are poorly understood. We report a patient who suffered from progressive aphasia unaccompanied with prominent cognitive deficits for 5 years. CASE: A 64-year-old man presented with an at least a 5-year history of a progressive language disorder. The initial symptoms were a disability to speak in complete sentences, word-finding difficulty, verbal hesitancy, and resultant social withdrawal. Over the next 5-years, his symptoms slowly worsened, but non-verbal cognitive functions such as memory, visuospatial skill, and daily living activities were preserved. Eventually, the patient was mutistic, incommunicable, and impaired in general intelligence parallel with personality and mood changes like emotional lability, impersistence, or agitation. The imaging of brain revealed generalized atrophy with more prominent changes in the left temporal lobe and the degree of atrophy progressed on the follow-up study 4 years later. The brain SPECT showed hypoperfusion in the left frontotemporal area. Initially, the patient scored 25 points with Mini-Mental State Examination but worsened to 3 points 4 years later. Language examination at the onset showed mildly decreased fluency, naming, and reading. Recently, our patient has become mutistic and alexic, but has preserved some comprehension. COMMENT: Non-dementic patients with progressive language disturbances as a result of the left focal temporal atrophy from 2-year of onset, have the possibility of being diagnosed with PPA, frontotemporal degeneration, Pick disease, or Alzheimer disease. But we suggest that characteristic isolated linguistic dysfunction with preserved cognitive function in PPA may be a distinct from other degenerative diseases of dementia.
Activities of Daily Living ; Alzheimer Disease ; Aphasia ; Aphasia, Primary Progressive* ; Atrophy ; Brain ; Comprehension ; Dementia ; Dihydroergotamine ; Follow-Up Studies ; Humans ; Intelligence ; Language Disorders ; Linguistics ; Memory ; Middle Aged ; Natural History ; Pick Disease of the Brain ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon

A molecularly cloned human cellular H-ras (c-H-ras) oncogene(pbc N1 plasmid) was treated with N-acetoxyacetylaminofluorene (AAAF) in vitro and subcloned into E.coli. This was done to identify the mutational changes at specific codons of the gene. Guanine nucleotides were identified as the major AAAF binding site of the DNA adduct formed. Base changes in codons 12 and 61 were determined by the analysis of restriction fragment length polymorphism (RFLP) and site specific oligonucleotide hybridization. RFLP was observed due to the loss of the Hpall recognition site at codon 11 and 12 of AAAF-treated c-H-ras gene. Hybridization of AAAF treated c-H-ras with 32P-labeled oligonucleotide probes for the mutant alleles of codon 61 showed no substitutions at codon 61. From these results, it is assumed that AAAF treatment in vitro caused mutation at codon 12 but not at codon 61 of the c-H-ras oncogene and that codon 12 is the primary target of mutation by AAAF
Acetoxyacetylaminofluorene/*pharmacology ; Chromatography, Thin Layer ; Codon ; *DNA Damage ; Electrophoresis, Agar Gel ; Genes, ras/*drug effects/genetics ; Human ; Mutagenesis, Site-Directed ; Oligonucleotide Probes ; Plasmids/drug effects/genetics ; Polymorphism, Restriction Fragment Length