Interventional procedures around the cervical spine have been classically performed under the guidance of fluoroscopy with radiation hazards to patients and doctors. Even though under fluoroscopic guidance, vascular and nerve structures cannot be shown and there are actual risks for the patient. Nowadays, we can use high resolution image ultrasound around cervical spine procedures. Real time imaging is possible. Cervical root block, medial branch block and many other interventions can be performed under ultrasound guidance. In out-patient clinics, ultrasound is very helpful in management of cervical problems in differentiating the origin of pain and treatment for the pain. Ultrasound is radiation free, easy to use and the imaging can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound enables visualization of major nerves and vessels and thus leads to improved safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore performed a review to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.
Fluoroscopy ; Humans ; Incidence ; Outpatients ; Spine* ; Ultrasonography

No abstract available.

We evaluated the results of twelve total elbow arthroplasties that had been performed from Feb. 1986 to Mar. 1993 in ten patients. The duration of follow-up averaged three years two months(range, one year to seven years one month). There were six females and four males. Two females had bilateral procedures. The average age at the time of the operation was 35.3 years(range, 22 to 53). Five patients had severe rheumatoid arthritis, four patients had fracture sequelae around elbows and one patient had sequele of tuberculous arthritis. Total elbow arthroplasty had been performed for improving the range of motion and relief of pain. Total elbow arthroplasties had been performed in six cases of total ankylotic elbows and in six cases who complained severe painful limitation of motion of the elbow joints. Preoperatively, ankylotic group were fixed by 30 degrees of flexion on an average. In painful elbow group, the average total range of motion was 68 degrees. The prosthesis which were used in total elbow arthroplasties were semiconstrained type in nine cases and noncostrained in three cases. Most of the patients had relief of pain. Postoperative complications were permanent ulnar nerve palsy in one case, superficial infection in one case and dislocation in one case. Total gain of range of motion(ROM) was 17 degrees in painful elbow group and 102 degrees in ankylotic elbows. Total elbow arthroplasty was effective method for improvement of range of motion in ankylotic elbows and relief of pain in elbows which had painful limitation of motion.
Ankylosis ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Postoperative Complications ; Prostheses and Implants ; Range of Motion, Articular ; Ulnar Neuropathies

PURPOSE: Complete resection of the tumor nodule(mural nodule or solid portion of the tumor) is the essential goal of surgical treatment for heman-gioblastoma. The purpose of this study was to classify the morphologic types of intracranial hemangioblastoma on MRI and to compare the location and contour of tumor nodule on MRI with those on angiography. MATERIALS AND METHODS: The MRI findings of 34 lesions(38 lesions if 4 spinal cord lesions were included) in 26 patients(17 males and 9 females, range of age, 18-67 years, mean, 39 years) with surgically and histopathologically proved intracranial hemangioblastomas were reviewed. Seventeen patients underwent CT scanning in a short interval. Contrast-enahnced T1 -weighted imaging pa- tterns of hemangioblastoma were classified according to Ho's morphologic types. The location and contour of tumor nodule were compared between MRI and angiography in 15 patients(24 lesions). RESULTS: By location, cerebellar hemisphere was predominated(55%), followed by cerebellar vermis(26%), supratentorial region(5%), and medulla oblongata (3%). Spinal cord lesions(11%) were seen in 3 patients of 5 von HippeI-Lindau diseases. The frequency of morphologic types was as follows; Type 1 (purely cystic), 3%, Type 2(mural nodule), 50%, Type 3(cyst with wall enhancement), 3%, Type 4 (cystic nodule), 15%, Type 5(solid with internal cyst), 9%, and Type 6(solid), 20%. All tumor nodules(33 lesions) enhanced intensely with intravenous contrast material on MRI, of which 24 lesions(in 15 patients) revealed hypervascular masses fed by pial arteries on angiography. They were superficial and abutted pia mater partially or in large portion on both MR I and angiography. CONCLUSION: Over 70% of intracranial hemangioblastomas had a surrounding cyst, and superficial, pial-based location and number of the tumor nodules on MRI was correlated well with those on angiography. MRI is the examination of choice for preoperative evaluation of intracranial hemangioblastoma.
Angiography ; Arteries ; Female ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Male ; Medulla Oblongata ; Pia Mater ; Spinal Cord ; Tomography, X-Ray Computed

[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.
[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.
[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.
[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.
[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

BACKGROUND: Human cancel can be induced by various environmental factors such as virus, chemicals, and radiations. However, susceptibility of host to these environmental factors is not well studied. The purpose of this study was to investigate the chromosomal vulnerability to gamma-1rradiation of peripheral blood lymphocytes in patients with luring, gastric, and liver cancer. METHODS: Micronuclei (MN) test was done in 15 patients with gastric cancer, 18 patients with lung cancer, and 20 normal controls. Sister chromatid exchange (SCE) test was done in 13 patients with hepatocellular cancer and 14 normal controls. RESULTS: The baseline frequency of MN before irradiation in patients with lung cancer and gastric cancel was significantly higher than in controls (47+/-8, 73+/-9, and 8+/-l, respectively; p<0.01). After gamma-irradiation, the frequency of MN was also significantly higher than in controls (223+/-19, 269+/-43, and 285+/-56, respectively; p<0.05). The frequency of SCE in Patients with hepatocellular cancer was significantly higher her than in controls (9.0+/-0.6, 4.3+/-0.7, respectively; p<0.001). CONCLUSIONS: From this preliminay data, we concluded that chromosomes of peripheyal blood lymphocytes in patients with various cancers were more vulnerable to gamma-irradiation as compared to normal controls.
Humans ; Liver Neoplasms ; Lung Neoplasms ; Lymphocytes* ; Sister Chromatid Exchange ; Stomach Neoplasms

A 4-year-old boy visited the hospital with exotropia after brain hemorrhage caused by trauma. He had undergone decompressive craniectomy and cranioplasty 18 months prior to presentation at our hospital. An alternate prism cover test showed more than 50 prism diopters (PD) of left exotropia when he was fixing with the right eye and 30 PD of right exotropia when he was fixing with the left eye at near and far distance. On the Hirschberg test, 60 PD of left exotropia was noted in the primary position. Brain computerized tomography imaging performed 18 months prior showed hypodense changes in the right middle cerebral artery and anterior cerebral artery territories. Subfalcian herniation was also noted secondary to swelling of the right hemisphere. The patient underwent a left lateral rectus muscle recession of 7.0 mm and a left medial rectus muscle resection of 3.5 mm. Three weeks after the surgery, the Hirschberg test showed orthotropia. On alternate prism cover testing, 8 PD of left exotropia and 8 PD of right esotropia were noted at distance. We report a patient who developed dissociated horizontal deviation after right subfalcian subdural hemorrhage caused by trauma.
Brain Injuries/*complications ; Child, Preschool ; Decompressive Craniectomy/*adverse effects ; Esotropia/*etiology/surgery ; Exotropia/*etiology/surgery ; Hematoma, Subdural/etiology/radiography/*surgery ; Humans ; Male ; Oculomotor Muscles/*surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Soil bacteria were screened for the ability to control cucumber anthracnose caused by Colletotrichum orbiculare through induced systemic resistance (ISR). Sixty-four bacterial strains having in vitro antifungal activity were used for selecting ISR-inducing strains in cucumber. Cucumber seeds (cv. Baeknokdadagi) were sown in potting mixtures incorporated with the soil bacteria, at a rate of ca. 10(8) cells per gram of the mixture. Two week-old plants were then transplanted into the steam-sterilized soil. Three leaf-stage plants were inoculated with a conidial suspension (5x10(5) conidia/ml) of C. orbiculare. Diseased leaf area (%) and number of lesions per cm2 leaf were evaluated on third leaves of the plants, 5~6 days after inoculation. Among 64 strains tested, nine strains, GC-B19, GC-B35, GK-B18, MM-B22, PK-B14, RC-B41, RC-B64, RC-B65, and RC-B77 significantly (P = 0.05) reduced anthracnose disease compared to the untreated control. In contrast, some bacterial strains promoted susceptibility of cucumber to the disease. From the repeated experiments using the nine bacterial strains, GC-B19, MM-B22, PK-B14, and RC-B65 significantly (P = 0.05) reduced both diseased leaf area (%) and number of lesions per cm2 leaf in at lease one experiment. These strains with control efficacy of 37~80% were determined to be effective ISR-inducing strains.
Bacteria* ; Colletotrichum* ; Soil*

BACKGROUND: The association of osteoporotic vertebral fracture or osteoporosis with coronary artery disease (CAD) was investigated in Korean men and women. METHODS: Four hundred consecutive postmenopausal women and men aged 50 years and older, undergoing coronary angiography, were enrolled for the evaluation of established or suspected coronary artery disease. CAD was diagnosed if there was narrowing of > 50% diameter in one or more major coronary artery. Morphometric vertebral fracture was assessed using lateral thoracic and lumbar spine radiographs. Bone mineral density was performed using dual-energy x-ray absorptiometry. RESULTS: Of the 400 subjects in the study (mean age of 61.9 +/- 11.6 years), 256 patients had CAD. Vertebral fracture was observed in 94 (23.5%) patients. There was no difference in vertebral fracture according to the presence or absence of CAD. In logistic regression analysis, vertebral fracture was not significantly associated with CAD after adjustment for multiple risk factors. Although women had lower BMD at any given site than men, BMD was not associated with the presence or absence of CAD among 191 patients. CONCLUSION: Our study demonstrated that osteoporotic vertebral fracture or osteoporosis was not associated with coronary artery disease in Korean men and women.
Aged ; Atherosclerosis ; Bone Density ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Female ; Humans ; Logistic Models ; Male ; Osteoporosis ; Risk Factors ; Spine

The Rh blood group D antigen is the most immunogenic of all antigens, next to ABO antigens. Anti-D immunization is clinically important since it may cause clinical problems, such as severe hemolytic transfusion reactions and hemolytic disease of the newborn. DEL is an extremely weak D variant that cannot be detected by basic serologic typing and is typed as D-negative without the absorption-elution techniques and RHD genotyping. Of the DEL phenotype, RHD (c.1227G>A) allelic variant is the most common in Korea. The DEL phenotype has been considered to carry only a few D antigens to induce anti-D immunization, but a few cases have reported that this allelic variant is capable of inducing anti-D immunization in a D-negative recipient, for which it is clinical significant. Herein, we present a case of primary anti-D alloimmunization in a RhD negative patient after receiving RHD (c.1227G>A) DEL red cell transfusion identified by serological and molecular tests, including RHD genotyping.
Erythrocyte Transfusion* ; Erythrocytes* ; Humans ; Immunization ; Infant, Newborn ; Korea ; Phenotype ; Transfusion Reaction