We evaluated the muscle fiber characteristics, the mean proportion of muscle fiber types and its range of individual difference in human vertebral muscle. Muscle samples used were from subjects who had a relatively brief history of spinal dysfunction such as compression fracture, disc hernia etc., and obtained from precisely defined superficial and deep sites on both sides of the vertebral column. In particular, samples were collected from three different levels of the column and flash-frozen sections of biopsied adult vertebral muscles were stained for H–E, trichrome, PAS, regular and reversed myosin ATPase, and SDH. Discrimination of muscle fiber types in H–E and trichrome stained sections was not evident. Three types of muscle fibers were, however, evident in PAS-stained sections according to the degree of positivity in observed vertebral muscles. The mean proportion of musele fiber types was different in regular and reversed myosin ATPase, and SDH stains and the majority of fiber types in human vertebral muscles was type I in three different levels of vertebral clumn. There was a decreasing tendency in percentage of type I fibers at both superficial and deep levels as the vertebral column descended. The size of muscle fibers was relatively larger in deep levels than in superficial levels of vertebral muscles. The human vertebral muscle showed moderately individual and regional differences in the mean size of fiber types. The evaluation for the combination patterns of various enzyme histochemical activities showed that the common musele fiber types(type I, II A and II B) were moderately reduced in the mean proportions and unusual rare muscle fiber types increased in number. And the decreasing tendency in the mean proportion of type as the vertebral column descended was not evident in the combination patterns of histochemical activities
Adult ; Coloring Agents ; Discrimination (Psychology) ; Fractures, Compression ; Hernia ; Humans ; Individuality ; Muscles ; Myosins ; Spine

Purpose: Dislocation is the second most common cause of failure, after implant loosening, in revisional THA (Total hip arthroplasty), and its evaluation and treatment still remain controversial issue. This study was undertaken to evaluate the risk factors after THA using the posterolateral approach and posterior soft tissue repair. Materials and Methods: Between January 1998 and May 2003, 211 consecutive primary total hip replacement arthroplasties using the posterolateral approach and posterior soft tissue repair were performed by the same surgeon. To compare the dislocation groups (6 cases) with the non-dislocation groups (205 cases), we randomized 120 of the non-dislocation cases. The risk factors for hip dislocation were categorized into patient factors and surgical factors. Patient factors included gender, age, preoperative diagnosis, underlying systemic disease, and alcoholic history. Surgical factors included position of the component (acetabular version and inclination, femoral anteversion), leg length discrepancy, and sum of anteversions of the cup and stem. Their parameters were measured on postoperative radiographs. Statistics were performed with Fishe`s Exact test and T test. Results: Dislocations occurred at an overall incidence rate of 2.8% (6/211cases). There were 4 (1.9%) cases of anterior dislocations and 2 (0.9%) cases of posterior dislocations. Dislocations occurred on average at postoperative day 6.1 and all dislocated hips were reduced with the closed method, except for one case that was treated surgically. There was no statistical significance in patient factors between the two groups, except for neurologic disease and alcoholic history. However, the sum of the acetabular and femoral anteversions in the anterior dislocation group was larger than that of the non-dislocation group by approximately 19 degrees. Conclusion: Our results demonstrated that by using the posterior approach and repair of soft tissue, the posterior dislocation rate after total hip replacement arthroplasty can be reduced and the sum of the acetabular and femoral anteversions had more influence on dislocations after THAs than did either anteversion alone.
Acetabulum ; Alcoholics ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations ; Hip Dislocation* ; Hip* ; Humans ; Incidence ; Leg ; Risk Factors*

Although febrile convulsion (FC) is a common clinical entity with a high recurrence rate, no specific factors have been identified to be highly predictive of its recurrence. A total of 114 cases of FC identified during a 28 month period (January, 1989-May, 1991) was analysed. A slight predominance of boys over girls (1.3 to 1.0) was observed. the majority of cases (89.4%) were under 3 years of age and the most common age range for the onset of FC was 1~2 years. The most common form of FC was tonic type (54.0%), followed by tonic-clonic (32.5%), clonic (5.3%), and complex partial type (5.3%). Most FC episodes lasted less than 5 minutes (81.6%), and common clinical diagnosis underlying FC were as follows: pharyngotonsillitis (64.0%), bronchitis and/or pneumonia(16.7%), and gastroenteritis (9.7%). The family history for seizure disorder was present in 27.2% of the cases: FC in 21.1%, epiepsy in 4.4%, and both in 1.8%. Among 78 cases of the first FC, 43 cases were followed for 5 to 29 months without prophylactic anticonvulsant therapy. The overall recurrence rate of FC in this group was 67.4% and the highest incidence was observed in patients less than one year old (86.7%). A higher recurrence rate (80%) was observed in patients whose body temperature was lower than 39degrees C, as opposed to higher than 39degrees C (50%). It is concluded that the recurrence of FC is positively correlated with factors such as younger age (less than one year old), and lower body temperature at the time of onset of FC.
Body Temperature ; Bronchitis ; Diagnosis ; Epilepsy ; Female ; Gastroenteritis ; Humans ; Incidence ; Recurrence ; Seizures, Febrile*

A propecive analysis of 50 patients with acute interhemisphric subdural hemorrhage and tentorial hemorrhage, an unusual pattern of acute subdural hematoma, who were managed in a uniform way was analyzed to related outcome to hemorrhagic site, initial Glasgow Coma Scale(GCS) and combined injuries. The incidence of acute interhemisphric subdural hemorrhage(ISH) and tentoria hemorrhage(TH) after head trauma was 3.83%, 50 cases among 1303 head injured cases. And 80% of the above hemorrhage disapperaed within two weeks after trauma. There was no significant relationship between feature of hemorrhage and intial GCS(P>0.05), but there was highly significant relationship between initial GCS and Glasgow Outcome Scale(GOS) (p<0.001). There noted significant relationship between initial combined injury and GOS(p<0.01), and also brainstem injury and GOS(p<0.001).
Brain Stem ; Coma ; Craniocerebral Trauma ; Head ; Hematoma, Subdural* ; Hematoma, Subdural, Acute ; Hemorrhage* ; Humans ; Incidence

No abstract available.
Hyperlipidemias* ; Tarsal Tunnel Syndrome*

Appreciation of the normal variation of anterior and posterior diameter of the lumbar spinal canal under computerized axial tomogram may throw very important value on the diagnosis and treatment in lumbar spinal problems. The authers have measured the diameter of the lumbar spinal canal using EMI scanner CT 5005. The data was first based on the study of two cadaver lumbar spine and then the study of 268 normal Korean adults male 185, and female 83. The results were summerized as follows. 1. The diameter of the osseous segment was more narrow than articular segment in normal lumbar spinal canal, 2. The shape of lumbar spinal canal was oval in upper lumbar. but became triangular going down to the lower lumbar. There was no difference of diameter in sex. 4. The average diameter of anterior and posterior spinal canal was; L1 16.53± 0.18, L2 16.23± 0.215, L3 15.42± 0.26, L4 15.57± 0.43 and l% 17.7± 1.63mm respectively. 5. The average diameter of transverse spinal canal was; L1 23.31± 0.18, L2 23.76± 0.28, L3 24.78± 0.345, L4 26.07± 0.605 and L5 29.31± 1.19mm respectively. 6. It was more accurate to check out the pathology of the lumbar spinal canal using coinputerized axial tomogram than other method previously used.
Adult ; Cadaver ; Diagnosis ; Female ; Humans ; Male ; Methods ; Pathology ; Spinal Canal ; Spine

It is notoriously difficult to obtain a sound bony union of large segmental bone defects secondary to trauma or following tumor resection, infected nonunion, congenital pseudarthrosis of the tibia, and avascular necrosis of the femoral head with conventional methods. Recent advances in microsurgery have made it possible to provide a continuing circulation of blood in bone grafts so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. Thus, the grafted bone is achieved more rapid stabilization of bone fragments separated by a large defect without sacrificing viability. Thirty nine cases of the free vascularized fibular graft had been performed in the Department of Orthopedic Surgery, Kyung Hee University Hospital during the period of 3 years from October 1978 to December 1981. Of these, ll cases were congenital pseudarthrosis of the tibia, 4 cases were tuberculous spondylitis, 4 cases were infected nonunion, 7 cases were large segmental bone defects secondary to trauma, 9 cases were avascular necrosis of the femoral head and the other was one case. The results were obtained as follows: 1. The advantages of free vascularized living fibular graft are one stage procedure, resistance of torsion and angular stress, union with rapid hypertrophy of the graft, a shorter immobilization period and more rapid incorporation of the graft into the recipient area. 2. Free vascularized fibular graft can be widely used in the field of Orthopedic surgery. 3. The fibula is the bone best suited for reconstruction of a defect in a long bone. 4. In children, distal tibiofibular synostosis must be performed. 5. For prevention of clawing toe, the muscles around the bone is meticulously dissected, 6. Evaluation by selective arteriography and isotopic scanning both before and after operation may be used to assess the viability of the fibula graft.
Angiography ; Animals ; Child ; Fibula ; Head ; Hoof and Claw ; Humans ; Hypertrophy ; Immobilization ; Microsurgery ; Muscles ; Necrosis ; Orthopedics ; Pseudarthrosis ; Spondylitis ; Synostosis ; Tibia ; Toes ; Transplants

BACKGROUND: The major risk factors such as hypercholesterolemia, hypertension, diabetes melitus and cigarrete smoking have not been studied in an attempt to provide a composition of major risk factors in Korea. Also we have met with some patients without major risk factors. METHODS: A Retrospective Study was done on 160 patients of acute myocardial infarction who had been admitted to National Medical Center within 48 hours from onset, from January 1948 to December 1992 and studied on major risk factors of acute myocardial infarction. RESULTS: 1) Among major risk factors, smoking was found in 50%, hypertension in 49%, diabetes in 25% and hypercholesterolemia in 21%. 2) The percentage of patients without major risk factors was 19%. 3) Among major risk factors, hypertension, hypercholesterolemia and diabetes were increasing tendencies, recentely. CONCLUSION: Some patients with acute myocardial infarction don't have any major risk factors. Also hypertension, hypercholesterolemia and diabetes were increasing tendencies. So further study for other risk factors is needed and preventive management should require a commitment to behavior modification and alteration in life-style.
Behavior Therapy ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Myocardial Infarction* ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking

Insulin autoimmune syndrome (IAS) includes fasting or reactive hypoglycemia, hyperinsulinemia and the presence of insulin-binding antibodies in patients who have never been exposed to exogenous insulin. This report concems a 29-year-old male patient with Graves disease who had history of having taken methimazole for two months, without any consequence, 6 months previously. However, when methimazole was administered again for three weeks, the patient suffered hypoglycemia during the next fourth week. He denied history of diabetes mellitus (DM), of taking any oral hypoglycemic agent or of having received insulin injection. Laboratory data showed total serum insulin level > 300 pu/mL, C-peptide reactivity (CPR) 8.0ng/mL and insulin antibody 89%. After stopping methimazole, he was treated with radioiodine (131I). There was no episode of hypoglycemic attack during 8 months of follow-up.
Adult ; Antibodies ; C-Peptide ; Diabetes Mellitus ; Fasting ; Follow-Up Studies ; Graves Disease* ; Humans ; Hyperinsulinism ; Hypoglycemia ; Insulin ; Male ; Methimazole

No abstract available.
Diagnosis* ; DNA*