STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p<0.05) and highest flexibility was observed in group 1 (age: 15-19yrs) and 15-19 segment 2. Flexibility was not different between male and female(p>0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Female ; Humans ; Male ; Microcomputers ; Pliability* ; Reference Values ; Spine ; Volunteers

No abstract available.
Immunoglobulins* ; Tetanus Toxoid* ; Tetanus* ; Vaccination*

Patients with advanced carcinoma of the bladder that relapses or persists after conventional therapy have a poor prognosis. The management of the patient with recurrent local or disseminated bladder cancer presents a difficult clinical problem. In l985, Sternberg et al reported 7l% significant tumor regression and 50% complete clinical remission with M-VAC(Methotrexate, Vinblastin, Adriamycin and Cisplatin) combination chemotherapy for treatment of advanced bladder carcinoma Herein, we report 4 cases of M-VAC combination chemotherapy in far advanced bladder carcinoma with had measurable metastatic lesions enough to evaluate the objective response of chemotherapy.
Doxorubicin ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Prognosis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Tetanus is a rare disease in the developed countries, including Korea, as a result of nearly universal active immunization. Because many physicians have little experience with its diagnosis and management, misdiagnosis and therapeutic delay may result in catastrophic consequences. We report one case of generalized tetanus. A previously healthy 35-year-old man was admitted to the emergency department because of stiffness on jaw and neck. board-like abdomen, extended and rigid both legs, chest tightness, and dyspnea. Seven days before admission, he was injured on the right thing at work. In the emergency department, he was given 5,000 units of human tetanus immunoglobulin intramuscularly, as well as diazepam 2 mg/hr intravenously. On the second hospital day, tracheostomy was performed. Ten days later, his condition was improved. Twenty eight days after admission, he was discharged without any complication.
Abdomen ; Adult ; Developed Countries ; Diagnosis ; Diagnostic Errors ; Diazepam ; Dyspnea ; Emergency Service, Hospital ; Humans ; Immunoglobulins ; Jaw ; Korea ; Leg ; Neck ; Rare Diseases ; Tetanus* ; Thorax ; Tracheostomy ; Vaccination

Meralgia paresthetica is a syndrome of pain or dysesthesia, or both, of the anterolateral thigh caused by entrapment or metabolic neuropathy of the lateral femoral cutaneous nerve. Many cases of meralgia paresthetica have been presented for a century. We have experienced a case of meralgia paresthetica which was misdiagnosed as lumbar radicu- lopathy at other hospital, of a 53-year-old man who had developed painful paresthesia and dysesthe- sia of the anterolateral thigh caused by soft tissue tuberculosis of oblique abdominal muscles just proximal to the lateral inguinal ligament where the lateral femoral cutaneous nerve passes. We report a case of unilateral meralgia paresthetica secondary to soft tissue tuberculosis with review of literatures because it has not previously been reported.
Abdominal Muscles ; Humans ; Ligaments ; Middle Aged ; Paresthesia ; Thigh ; Tuberculosis*

There are several causes developing diplopia after cataract surgery. Among these causes, central fusion disruption may be developed in longstanding unilateral traumatic cataract and uncorrected aphakia. The pathophysiology is unknown, but time interval between sensory deprivation and optical correction is an important factor. The characteristic signs and symptoms are exotropic, hypotropic or excyclotropic deviation, and intractable diplopia with vertical bobbing movement of non-fixing eye, particularly near the angle of superimposition with prism or haploscopic device. The authors report two cases of central fusion disruption in longstanding unilateral traumatic cataract and uncorrected aphakia.
Aphakia ; Cataract ; Diplopia ; Sensory Deprivation

Senile entropion is caused by following pathophysiologic changes ; disinsertion or weakness of lower lid retractor, upward migration and overriding of the preseptal orbicularis oculi muscle over pretarsal orbicularis muscle, horizontal lid laxity, and relative enophthalmos from absorption of orbital fat. There have been numerous procedures to correct senile entropion, but the difficulty of adequate and concurrent correction of all of the underlying defect result in high recurrence rate. Therefore, authors performed a combined procedure including reattachment of disinserted lower lid retractor or tucking of weakened lower tarsus, and the extirpation of overriding preseptal orbicularis oculi muscle. At the same time we performed the correction of the lower lid laxity using lateral tarsal strip procedure of full-thickness wedge resection. Authors performed this method in 21 cases of 17 patients and the cosmetic and functional result were satisfactory.
Absorption ; Ankle ; Enophthalmos ; Entropion* ; Humans ; Orbit ; Recurrence

No abstract available.
Antibodies* ; Coxiella burnetii* ; Coxiella* ; Prevalence*

Urinary diversion with a continent ileal reservoir has been performed in 2 patients following the method modified by Skinner. An important modification included isolation of a narrow strip mesentery for 6-8cm along the efferent and afferent limbs of the pouch to allow adequate ileal intussusception and fixation to prevent reflux and to ensure continence. The reservoir generally is emptied by intermittent catheterization every 4 to 6 hours during the day and once at night. The volume capacity of the reservoir is more than 590ml. Retrograde reservoirgrams have demonstrated no reflux in one patient and mild reflux in the other patient and post-operative excretory urograms show normal urinary tract in one patient and mild hydronephrosis in the other patient. All patients are satisfied with this type of urinary diversion.
Catheterization ; Catheters ; Colonic Pouches* ; Cystectomy ; Extremities ; Humans ; Hydronephrosis ; Intussusception ; Mesentery ; Urinary Diversion ; Urinary Tract

PURPOSE: Laparoscopic common bile duct exploration (LCBDE) has more advantages than conventional common bile duct surgery, but the use of this route for stone removal and biliary drainage remains controversial. The goal of this study was to investigate the usefulness of LCBDE in patients who had been failed in the endoscopic stone extraction. METHODS: From November 2005 to August 2008, 52 patients underwent LCBDE due to failure of endoscopic stone extraction in Chungnam National University Hospital. Clinical data were collected and analyzed retrospectively. RESULTS: Duodenal diverticulum (23 cases, 44.2%) was the most common cause in failure of endoscopic stone extraction and large common bile duct stone 12 cases (23.1%), previous upper gastrointestinal operation 10 cases (19.2%) were followed. Twenty four patients did not have preoperative biliary drainage, such as PTBD, ENBD, PTGBD. Forty-five patients (86.5%) of the 52 participating patients underwent LCBDE successfully, but 7 cases resulted in open surgery for the following reasons: 3 cases of severe intraabdominal adhesions, 3 cases of stone impaction in ampulla portion, and 1 case of a remnant stone. External biliary drainage was performed in 41 cases with T-tube (31 cases, 68.9%), PTBD (7 cases, 15.6%), ENBD (3 cases, 6.7%). The stone clearance of LCBDE was 95.6%. Remnant stone weredetected in 2 cases (4.4%) and removed with choledochoscope via external biliary drain. Postoperative complications happened in 5 cases (9.5%). Procedure related complications happened in 2 cases (3.8%). CONCLUSION: LCBDE is useful technique in patients with failed endoscopic stone extraction, and biliary drainage may be necessary for detection and removal of latent remnant CBD stones.
Common Bile Duct ; Dioxolanes ; Diverticulum ; Drainage ; Fluorocarbons ; Humans ; Postoperative Complications