Degenerative arthritis of the lumbar spine is one of the main causes of the low back pain over the fifth decade of life. Nowadays, it seems that the number of obese person increases gradually and the role of Obesity in the development of articular degeneration remains controversial. The authors studied 100 cases of the primary degenerative arthritis of the lumbar spine clinically and statistically and compared 50 cases among these with 2 control groups, with and without low back pain, from Mar. 1982 to Sep. 1982. The results were as follows: 1. Among the patients with the degenerative arthritis of the lumbar spine, the ratio of male to female was 1:4, and the age group with the highest frequency was the 6th decade (47%) 2. 44% was obese in the arthritis group and 26% in the control group with low back pain and 12% in the control group without low back pain. 3. The relative risk of the hypothesis that the arthritic patient is obeser than the patient with low back pain but without degenerative changes on X-ray was 2.3, but the hyposthesis was proved to be statistically insignificant. The relative risk of the hypothesis that the arthriticpatient was obeser than the patient without low back pain and degenerative changes on X-ray was 6.3 and proved to be statistically significant.
Arthritis ; Female ; Humans ; Low Back Pain ; Male ; Obesity ; Osteoarthritis ; Spine

No abstract available.
Cartilage, Articular* ; Knee* ; Osmium Tetroxide* ; Synovial Membrane*

BACKGROUND: The laryngeal mask airway (LMA) should be correctly placed into the hypopharynx for adequate ventilation. The purpose of this study was to evaluate a LMA position relation to the laryngeal skeleton and narrowing degree of a LMA lumen by the epiglottis. METHODS: The LMA (# 3 or # 4) was placed into the hypopharynx after induction of anesthesia and muscle paralysis. The fiberoptic laryngoscopic findings through the lumen of LMA were recorded at ten minutes after LMA placements. The position of the LMA was estimated in relation to its distal aperture to the laryngeal skeleton as central, posterior, right and left lateral position. The narrowing degree of the LMA by the epiglottis was estimated as 0%, 1~25%, 26~50%, 51~75%, or 76~100%. RESULTS: The fiberoptic laryngoscope showed central positions in 70.1%, lateral deviations to the left or right in 21.2% and posterior positions in 9%. The most frequent incidence (84/231, 36.4%) of narrowing by the epiglottis is 76~100% but ventilating problems were not developed. However, ventilation was impossible immediately after LMA placement in one patient, so the LMA was removed and the trachea was intubated. Esophageal enterance was visible in one patient without regurgitation of the stomach content. CONCLUSIONS: These findings show that LMA provides a reliable and safe airway management technique, although inadequate positioning and narrowing of LMA lumen by the epiglottis may frequently occur.
Airway Management ; Anesthesia ; Epiglottis ; Gastrointestinal Contents ; Humans ; Hypopharynx* ; Incidence ; Laryngeal Masks* ; Laryngoscopes ; Paralysis ; Skeleton ; Trachea ; Ventilation

No abstract available in English.
Arthroscopy ; Knee Joint ; Knee

A retrospective study was designed to determine the diagnostic contribution of oblique view in 740 consecutive lumbar spine examinations done in adults. In 12 cases (1.62%) there was a change in the radiographic interpretation when the oblique views were used for diagnosis. Considering the significant gonadal radiation, additional cost, and limited diagnostic value, the authors feel that the oblique view should not be a routine part of the initial lumbar spine examination in adults.
Adult ; Diagnosis ; Gonads ; Humans ; Retrospective Studies ; Spine

Although the ultrasonography & CT have been regarded as a primary procedure in the differential diagnosis of upper abdominal mass, the CT was more superior in the diagnosis, its extent and relationship to the bowel in the cases of the leiomyosarcoma & leiomyoma of the stomach than those of the ultrasonography. The authors studied CT findings of 9 cases of pathologically proven gastric smooth muscle tumor (leiomyosarcoma 7, leiomyoma 2) during the last two years. The results were as follows: 1. CT findings of gastric leiomyosarcoma were often quite large mass, average 15 cm in diameter; extensive central necrotic or cystic changes were fou nd in all 7 cases, seen more clearly on postcontract scan; calcification and peripheral rim enhancement of the tumor were seen in one case each other. 2. Metastasis to the liver and the spleen was seen only in one case, which revealed centrally necrotic and ascites was found in one case. 3. Two cases of gastric leiomyoma were smaller in size, average 6.3 cm in diameter than those of leiomyosarcomaj central necrotic or cystic changes were less common and less extensive. 4. If there were no evidence of central necrotic or cystic changes in large peri-or juxtagastric tumor, ohe should consider other diagnostic possibilities such as left lobe hepatoma, exophytic stomach cancer, Iymphoma or other mesenchymal tumors than leiomyosarcoma.
Ascites ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential ; Leiomyoma ; Leiomyosarcoma ; Liver ; Muscle, Smooth ; Neoplasm Metastasis ; Smooth Muscle Tumor ; Spleen ; Stomach ; Stomach Neoplasms ; Ultrasonography

Cholangiocarcinoma is synonymous with bile duct carcinoma, and can originate in a small intrahepatic bileduct(peripheral type), a major intrahepatic duct including the hepatic hilus, an extrahepatic duct, or near thepapilla of Vater(central type). In a sense bile duct carcinoma of the peripheral type is cholangiocarcinoma of theliver; it has the same gross configuration as hepatocellular carcinoma, resulting in difficulty to differentiateon the CT. The authors studied CT findings of 14 cases of pathologically proven peripheral type cholangiocarcinomaof the liver during the last 4 years. The results were as follows: 1. Of 14 cases, 8 were female and 6 were male,and the age ranged from 5th to 7th decades. 2. Preoperative clinical diagnosis were as follows: hepatoma 8 cases,abscess 5 cases and metastasis 1 case in order of frequency. 3. Diagnosis were confirmed by hepatic lobectomy in 7cases, wedge resection in 5 cases and needle biopsy in 2 case. 4. Labratory findings were not specific, but therewere only 2 cases with elevated alpha-fetoprotein level. 5. Associated diseases were gallstones in 1 case,intrahepatic duct stones, in 1 case, extrahepatic duct stones in 2 cases, acute or chronic cholecystitis in 5cases and CS in 3 cases. 6. Angiographic and scintigraphic findings were helpful in differential diagnosis fromhepatoma but ultrasonography was non-specific. 7. The number of tumor were solitary in 12 cases and multiple in 2cases. Among solitary cases, the site of involvement of the liver were right lobe in 8 cases and left lobe in 4cases. 8. Common CT features of the intrahepatic peripheral cholangiocarcinoma of the liver were irregular,inhomogeneous, occasionally peripherally enhancing, low density liver mass, frequently accompained by diffuse orsegmental dilatation of the intrahepatic bile duct. If there were normal alphafetoprotein level, positive skinand/or stool examination for CS and difuse or segmental dilatation of the intrahepatic duct in low density livertumor on the CT, one should consider peripheral cholangiocarcinoma of the liver than hepatoma.
alpha-Fetoproteins ; Bile Ducts ; Bile Ducts, Intrahepatic ; Biopsy, Needle ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cholecystitis ; Diagnosis ; Diagnosis, Differential ; Dilatation ; Female ; Gallstones ; Humans ; Liver ; Neoplasm Metastasis ; Ultrasonography

BACKGROUND: Prospective studies suggest that C-reactive protein (CRP) is a novel and indepen-dent risk factor of coronary heart disease. High-sensitivity methods for CRP (hs-CRP) measurement are needed for this purpose. In this study, we evaluated the performance of Cobas Integra 700 (Roche Diagnostics, Basel, Switzerland) and aimed to establish the distribution of serum CRP concentrations in healthy Koreans with the hs-CRP method. METHODS: The subjects of this study were 853 males (age; 45.9 +/- 9.8 years) and 546 females (age; 45.7 +/- 10.8 years) who visited the Health Promotion Center of the Asan Medical Center for routine health checks. Hs-CRP was measured with the Cobas Integra 700. The within-day precision, the between-day precision, the degree of correlation, the linearity, and the detection limit of hs-CRP were also analyzed with the Cobas Integra 700. RESULTS: The within-day coefficients of variation (CVs) were 0% and 1.3%. The between-day CVs were 4.0% and 3.0%. The percentage of relative nonlinearity was 0.78%. The correlation coefficient of the Cobas Integra 700 with the Behring Nephelometer was 0.994. The lower detection limit was 0.064 mg/L and the functional detection limit was 0.472 mg/L. The geometric mean concentration of CRP in Koreans was 0.69 mg/L. The mean CRP of the male population was 0.79 mg/L, which was higher than that of Korean females (0.54 mg/L) (P<0.0001). There was a significant trend to higher CRP values with increasing age (P<0.05). CONCLUSIONS: The linearity, the precision, the correlation, the detection limit of the Cobas Integra 700 were satisfactory. The age and sex-specific guidelines for hs-CRP would make the early intervention for coronary heart disease possible.
C-Reactive Protein* ; Chungcheongnam-do ; Coronary Disease ; Early Intervention (Education) ; Female ; Health Promotion ; Humans ; Limit of Detection ; Male ; Risk Factors

Although conventional barium study has been used for diagnosis of gastrointestinal lymphoma, CT is superior tobarium study in the evaluation of its extent and relationship to the bowel, lymph node enlargement, and distantmetastasis. The authors analyzed CT features of 21 cases of pathologically proven gastrointestinal lymphoma forrecent 5 years. The results were as follows: 1. In a total 21 cases of gastrointestinal lymphomas, 13 cases wereprimary gastrontestinal lymphoma and others were secondary. But there was no difference in CT featurs betweenthem. 2. Male predominates over female(17:4), and type age ranged from 5 to 73 years old, most common
Abdominal Pain ; Barium ; Colon ; Diagnosis ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Male ; Mesentery ; Methods ; Omentum

BACKGROUND AND OBJECTIVES: he patients with atrial septal defect generally have no symptoms in the childhood, and have nonspecific symptoms such as dyspnea on exertion, fatigue, and palpitation even in the late period of adult. Thus delayed diagnosis for whom surgical correction was undoubtedly needed remains to be resolved. Accordingly, the simple and noninvasive method such as electrocardiography in patients with atrial septal defect having the nonspecific symptoms or having no symptoms warrants to be developed. This study was performed to see whether the crochetage pattern on R wave in inferior limb leads is effective for the electrocardiographic diagnosis of atrial septal defect and relates to the magnitude of left to right shunt. METHODS: Our subjects were 129 patients diagnosed as the atrial septal defect by the echocardiography and cardiac catheterization from January 1992 to June 1998. We selected 57 persons, as control group, who showed the normal findings under the echocardiography and also showed the incomplete right bundle branch block on the electrocardiography. We compared the frequency of the crochetage pattern in inferior limb leads between the two groups. Also we compared the frequency of the crochetage pattern before operation and after operation according to the quantity of the left to right shunt in the operated 40 patients with atrial septal defect. RESULTS: ) The crochetage pattern was observed in 61.2% in patients with atrial septal defect and its frequency was greater than that of the control group (38.6%, p=0.005). 2) The crochetage pattern was disappeared by the operation in 16/29 patients (55.2%, p=0.001). 3) The frequency of disappearance of the crochetage pattern after operation differed significantly according to shunt severity: 72.2% for a Qp/Qs> or =3.0 group, 18.2% for a Qp/Qs<3.0 group (p=0.015). CONCLUSION: The crochetage pattern on R wave in inferior limb leads was helpful to the electrocardiographic diagnosis of the atrial septal defect. The disappearance of the crochetage pattern after operation was correlated with shunt severity.
Adult ; Bundle-Branch Block ; Cardiac Catheterization ; Cardiac Catheters ; Delayed Diagnosis ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography* ; Extremities* ; Fatigue ; Heart Septal Defects, Atrial* ; Humans