OBJECTIVE: The objectives of this study were to clarify the short-term effects of transforaminal epidural steroid injection (TFESI) for degenerative lumbar scoliosis combined with spinal stenosis (DLSS), and to extrapolate factors relating to the prognosis of treatment. METHOD: Thirty-six patients with lumbar radicular pain from DLSS were enrolled. Subjects were randomly assigned to one of two groups (steroid or lidocaine group). We compared the effect of pain suppression at 2, 4 and 12 weeks after the procedure between the two groups. Radiographic analysis included measurement of the Cobb's angle, the upper endplate obliquities of L3 and L4, and maximal lateral olisthy between two adjacent lumbar vertebrae. Sagittal plane measurement included lumbar lordosis, and thoracolumbar kyphosis. Statistical analysis of both radiographic and clinical parameters along with treatment outcome was performed to determine any significant correlations between the two. RESULTS: There were no significant differences in the demographic data, initial visual analogue scale (VAS) or Oswestry disability index (ODI) between the steroid group (n=17) and the lidocaine group (n=19). Two, 4, and 12 weeks after injection VAS, ODI showed a significantly greater improvement in the steroid group compared to the lidocaine group (p<0.05). The radiographic and clinical parameters were not significantly correlated with treatment outcome. CONCLUSION: Our findings suggest that fluoroscopic transforaminal epidural steroid injections appear to be an effective non-surgical treatment option for patients with degenerative lumbar scoliosis combined with spinal stenosis (DLSS) and radicular pain.
Animals ; Constriction, Pathologic ; Humans ; Kyphosis ; Lidocaine ; Lordosis ; Lumbar Vertebrae ; Prognosis ; Scoliosis ; Spinal Stenosis ; Treatment Outcome

The purpose of this study was to investigate the arthro-sonographic appearance of the chronic anterior talofibular ligament (ATFL) injury. Twenty-nine patient, who were identified to have partial or complete ATFL tears by conventional ultrasonography were included. Intraarticular injection of 5 mL of fluid (2.5 cc lidocaine+2.5 saline) was performed under ultrasound-guidance, which was followed by arthrosonography. Among 23 patients with partial tear which was detected by the conventional ultrasonography, 11 patients were identified to have complete tear by the arthrosonography. Among 6 patients with complete tear was detected by conventional ultrasonography, all of them identified to have complete tear by the arthrosonography. Arthrosonography is helpful in evaluation the configuration of ATFL complete tear and detecting complete tear by making them appear larger and apparent after instillation of fluid.
Humans ; Injections, Intra-Articular ; Ligaments

Bilateral trans-scaphoid perilunate fracture dislocations are uncommon and have been rarely reported in the literature. Furthermore, it is more difficult to manage in the case of Fenton's syndrome (scaphocapitate fracture syndrome, trans-scaphoid trans-capitate fracture dislocation). These injuries occur after a high-energy trauma caused by fall from height or vehicular accidents. These fracture dislocation patterns have very few reported cases in the literature and little information as to the diagnosis, management, and surgical approach for treatment. We present a case of scaphocapitate fracture syndrome on the right hand and trans-scaphoid trans-triquetral perilunate injury on the left hand at the same time.
Diagnosis ; Dislocations* ; Hand

BACKGROUND AND OBJECTIVES: The majority of laryngeal tumors are known to be SCC (squamous cell carcinoma). Non-SCC (non-squamous cell cancers) of the larynx represent a diverse spectrum of diseases with different prognosis and ratio-nales of management from SCC. Therapeutic options to these tumors depend on their histopathological characteristics and clinical behaviors. The purpose of this study was to assess the unique aspects of the non-SCC and to draw diagnosis and provide management options and prognostic variables. MATERIALS AND METHOD: Eleven non-SCC of the larynx from the 212 patients who were diagnosed with larynx cancer during their 3-year visits from 1997 to 2000 were reviewed retrospectively. RESULTS: The incidence of non-SCC was 5.2%. Pathology of non-SCC revealed 3 cases of malignant lymphoma, 2 cases of verrucous cell carcinoma and neuroendocrine carcinoma one case each of basaloid squamous cell carninoma, salivary duct carcinoma, adenocarcinoma, and spindle cell carcinoma. The most common site of origin was supraglottis (6 case, 56.5%), followed by glottis (4 cases, 36.4%) and subglottis (2 cases, 17.2%). Non-Hodgkin's lymphomas and basaloid squamous cell carninoma were treated by chemotherapy. The remaining cases were treated with surgery followed by postoperative radio-therapy or postoperative chemotherapy. The mean follow-up period was 26.8 months (12-43 months). CONCLUSION: Non-SCC accounts for approximately 5.2% of all malignancies of the larynx. Tissue biopsy is the most important diagnostic tool for the non-SCC of the larynx and the tissue sample must be obtained from the deep portion of the submucosal layer. Except for malignant lymphomas, the combined therapy that includes surgery would be the best method of treatment for non-SCC.
Adenocarcinoma ; Biopsy ; Carcinoma, Neuroendocrine ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Glottis ; Humans ; Incidence ; Laryngeal Neoplasms ; Larynx* ; Lymphoma ; Lymphoma, Non-Hodgkin ; Pathology ; Prognosis ; Retrospective Studies ; Salivary Ducts

Sjogren syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in dry mouth and eyes. Approximately one-third of patients present with systemic manifestations, but respiratory muscle involvements have been rarely reported. We report a case of acute respiratory failure complicated by primary Sjogren syndrome. Muscle biopsy revealed perivascular lymphocytic infiltrations. Corticosteroid therapy improved respiratory muscle weakness. Sjogren syndrome should be considered as one of the underlying diseases causing acute respiratory failure.
Autoimmune Diseases ; Biopsy ; Exocrine Glands ; Humans ; Mouth ; Muscular Diseases ; Respiratory Insufficiency ; Respiratory Muscles* ; Respiratory Paralysis ; Sjogren's Syndrome*

Surgical revascularization is very effective for the relief of chest pain, improvement of exercise tolerance and ventricular performance in certain ischemic heart diseases. Bypass graft angiography and native coronary angiography after coronary artery bypass graft(CABG) were required for the evaluation of graft patency, progression of the native coronary artery disease and to predict the prognosis of the patients after CABG. The cases included in this study involved 15 patients who underwent selective bypass graft angiography among 102 CABG cases. Thirty eight sites were bypassed by saphenous vein and two sites by internal mammary artery. The results were as follows: 1) The overall patency rate of the saphenous vein bypass graft was 76.3% and the two sites of the internal mammary artery bypass graft were both patent. 2) The patency rate of direct anastomosis was 86.2% and of sequential anastomosis, 44.4%. 3) In eight patients who underwent native coronary angiography, five patients showed progression of grafted coronary artery disease. Among them, two patients had accompanying progression of coronary artery disease in non-grafted vessels. 4) Follow up treadmill test performed in six patients showed improvement of exercise tolerance in all patients. 5) There was some increase in the ejection fraction of the left ventricle after CABG in six patients who received follow up left ventriculography.
Angiography* ; Chest Pain ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Exercise Test ; Exercise Tolerance ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mammary Arteries ; Myocardial Ischemia ; Prognosis ; Saphenous Vein ; Transplants*

Human sperm are not only pleomorphic but also tend to show large numbers of obvious abnormalities that may be associated with infertility. It is known that the greater the numbers of abnormalities present in each sperm (teratozoospermic index) relates closely to abnormalities in sperm function and the presence of infertility. The variation in morphology that may be seen among human sperm involve the head, midpiece and tail. An oval head is deemed to be normal but many shape and size variations can be seen in an ejaculate, and these include large, small or tapering heads. Amorphous heads are now known to be associated with chromosomal anomalies and a sperm may even show the presence of a double head. Another anomaly of sperm morphology that is occasionally seen is the abnormality known as globozoospermia. In this condition, the sperm head lacks an acrosome and, as a consequence, the head of each spermatozoon becomes rounded. We have experienced a case of globozoospermia which was conceived by intracytoplasmic sperm injection. So we report this case with a brief review of literatures.
Acrosome ; Head ; Humans ; Infertility ; Male ; Sperm Head ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

PURPOSE: The most important factor in longevity studies of dental prostheses is objective and consistent evaluation of the prosthesis. The Korean Academy of Prosthodontics suggested developing a standardized method for longevity studies of dental prostheses. The purpose of this study is to evaluate previously-used criteria and to develop new criteria, in the form of a procedure flowchart and an evaluation sheet. These new criteria may be able to provide a unified standard for future longevity studies of dental prostheses. MATERIALS AND METHODS: A literature review was performed about the evaluation of dental prostheses. Taking into account the strengths and weaknesses of previously used criteria, a novel, intuitive and objective method was developed for assessment of dental prostheses. Then, a pilot survey was performed with the newly developed flowchart and evaluation sheet to determine problems and implement possible improvements. RESULTS: Thirty cases of fixed dental prosthesis (FDP), 25 cases of removable dental prosthesis (RDP), and 13 cases of implant supported prosthesis (ISP) were evaluated. The average life expectancy estimate was 12.82 years for FDP, 5.96 years for RDP, and 4.82 years for ISP with Kaplan-Meier survival analysis. Additionally, possible improvements discovered by the pilot survey were reflected in the flowchart and evaluation sheet. CONCLUSION: The newly developed KAP criteria, flowchart and evaluation sheet enabled objective and consistent results in trial longevity studies of dental prostheses. It is expected that future studies will not only use the KAP criteria but also further improvement will be made on them.
Data Collection ; Dental Prosthesis* ; Kaplan-Meier Estimate ; Korea* ; Life Expectancy ; Longevity* ; Methods ; Prostheses and Implants ; Prosthodontics* ; Software Design ; Survival Rate

BACKGROUND: Charcot-Marie-Tooth (CMT) disease is pathologically divided into the following two types: demyelinating type and axonal type. This study aimed to analyze the results of the electrophysiological studies of CMT1A and to reevaluate the clinical significance of nerve conduction studies (NCS). METHODS: The subjects of the study were 18 patients with genetically confirmed CMT1A during the period of 1995. 1.-2004. 8. The NCS data from 22 family members of the patients were also included. The nerve conduction velocities, conduction blocks and compound muscle action potentials were analyzed. RESULTS: The subjects were composed of 19 males and 21 females. The mean NCV was 21.70 m/s in the median nerve, and the conduction block was observed in 13 patients (32.5%). The NCV was uniformly slow. The intrafamilial variation of NCVs between parents and their children were analyzed in 30 patients from 11 families. The mean velocity was 24.44+/-3.67 m/s in parents and 19.53+/-5.37m/s in their children. CONCLUSIONS: The CMT1A showed the slowness in NCV, one of the characteristics of demyelinating neuropathy, and this slowing had a uniform pattern. Nerve conduction block was also frequently observed, the pattern of which was diffuse without dispersion, and non segmental. Because the NCV of the children tended to be slower than that of the parents, CMT1A may not be a simple progressive disease. The onset and progression of CMT1A may be determined by other genetic and environmental factors.
Action Potentials ; Axons ; Child ; Female ; Humans ; Male ; Median Nerve ; Neural Conduction ; Parents

PURPOSE: We evaluated the clinical and radiographic midterm results of primary total hip arthroplasty (THA) using a 36 mm diameter femoral head on 1st generation highly cross-linked polyethylene (HXLPE) in patients 50 years and less with minimum five year follow-up. MATERIALS AND METHODS: We retrospectively reviewed 31 patients (41 hips) aged 50 years and less underwent primary THA with a 36 mm diameter femoral head on HXLPE between 2004 and 2010. Clinical follow-ups included specific measurements like modified Harris hip scores (HHS) and Merle d'Aubigne and Postel score. For radiologic evaluations, together with position of acetabular cup at six weeks later of postoperation, we separately calculated the penentrations of femoral head into polyethylene liners during postoperation and one year later check-ups, and during one year later check-ups and final check-ups. RESULTS: There were no major complications except for one case of dislocation. Average modified HHS at final follow-up was 88 (81-98), and Merle d'Aubigne and Postel scores were more than 15. Mean acetabular cup inclination and anteversion were 45.81°(36.33°-54.91°) and 13.26°(6.72°-27.71°), respectively. Average femoral head penetration of steady-state wear rate determined using radiographs taken at one-year postoperatively and at latest follow-up was 0.042±0.001 mm/year. CONCLUSION: Based on minimum 5 years clinical results, we think 36 mm metal head coupling with HXLPE as the good alternate articulation surface when planning THA for patients aged 50 years and less.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Dislocations ; Follow-Up Studies* ; Head* ; Hip ; Humans ; Polyethylene* ; Retrospective Studies