The radiologic findings of lumbosacral spine and measurement of lumbosacral angle were analysed in 238 with backache and 102 without backache which were visited at Chungnam National University from March 1980 to July 1981.The measurement of lumbosacral angle was based on a method of Fergson. The results obtained were as follows; 1. The age group of 18 to 29 years was most common in backache group and the male was affected more frequently than the female with the ratio of 1.9 to 1. 2. In patients with backache, the overall mean lumbosacral angles were 44.2±2.6 degrees in male and 35.8±2.0 degrees in female. In patients without backache, in control group, the overall mean lumbosacral angles were 32.6±0.7 degrees in male and 33.4±1.4degrees in female. 3. In control group, difference of means between male and female was about 1degrees in patients with backache, the overall mean lumbosacral angles were increased about 12degrees in male and 2degrees in female than control group. In patients with and without backache, no significant difference of lumbosacral angle between the 4 age groups was present. 4. In backache group, increased lordosis was more common and increased lumbosacral angle than the decreased lordosis. 5. In backache group, lumbosacral angle of abnormal radiologic findings in lumbosacral spine was significantly increased than control group. 6. In patients with backache, radiologic findings and its lumboscral angles were alumbosacral anomaly 56 cases (23.5%): 46.9 degrees, increased lumbar lordosis 46 cases (19.2%): 48.1 degrees, osteoarthritis 44 cases(18.5%) : 40.8 degrees, decreased lumbar lordosis 30 cases (12.6%): 29.9 degrees, in order, And these radiologic findings were similar with many other authors.
Animals ; Back Pain ; Chungcheongnam-do ; Female ; Humans ; Lordosis ; Male ; Methods ; Osteoarthritis ; Spine

No abstract available.
Bacteremia*

On the basis of the electrocardiographic ST-T changes, 46 patients with hypertensive heart disease were evaluated with echocardiography and classified into three groups; Those without any ST-T changes(group I, 6 patients) ; those with various nonspecific ST-T changes(group II, 20 patient); and those with full-blown LVh strain pattern (group III, 20 patients). In group III, left ventricular posterior wall thickness (p<0.01). interventricular septal thickness(p<0.05) and cardiac muscle mass(p<0.02) increased significantly and end-systolic dimension(p<0.05), relative wall thickness(p<0.02) also in creased significantly but ejection fraction decreased significantly (p<0.05). These results suggest that LVH strain pattern is associated with left ventricular hypertrophy or thickening, left ventricular dilatation and/or functional deterioration and that left ventricular wall thickness increase progressively even in the stage of LVH strain pattern on electrocardiogram.
Dilatation ; Echocardiography* ; Electrocardiography* ; Heart Diseases* ; Heart* ; Humans ; Hypertrophy, Left Ventricular ; Myocardium

The extensor plus finger is a rare condition, in which there is such tension of the extensor hood mechanism that simultaneous, complete flexion of the metacarpophalangeal joint and the interphalngeal joint is impossible. Full flexion of the metacarpophalngeal joint compels the interphalngeal joints to extend and vise versa. This condition is a severe handicap to grasp. The extensor plus state is produced by any condition which shortens the excursion of the extensor hood mechanism over the metacarpophalngeal joint and proximal phalanx. When the extensor hood (central extrinsic extensor and sagittal band) is the villain of the extenaor plus state, stretching out the hood by tenotomies of the central extrinsic extensor restored normsl function immediately. We experienced four cases of the extensor plus finger of a patient with severe crushing open forearm bone fracture, and treated the cases by staggered tenotomies or complete tenotomies of the central extrinsic extensor and division of the sagittal band, and obtained a satisfactory result.
Fingers ; Forearm ; Fractures, Bone ; Hand Strength ; Humans ; Joints ; Metacarpophalangeal Joint ; Tenotomy

To observe the antihypertensive effects of the angiotensin-converting enzyme inhibitor, enalapril, a daily average dosage of 20mg was administred to 38 patients with essential hypertension for 4 weeks. Changes in blood pressure and heart rate, and the frequencies of adverse reactions during the drug administration were constantly observed. At the end of the 4th week of administration the mean diastolic blood pressure decreased from 104+/-11.3 to 91+/-7.9mmHg(<0.001), and the mean systolic blood pressure from 165+/-16.8 to 142+/-10.6mmHg(P<0.001), An effective antihypertensive action of enalapril was observed in 31 out of 38 cases(82%), and normalization of diastolic blood pressure below 85mmHg was shown in 27 cases(71%). The most remarkable antihypertensive effects were shown at the end of first week, and the effect increased progressively until the end of 4th week of therapy. There were no significant changes in heart rate during the observation period. Adverse reactions occured in only 7 cases(18%). These reactions included headache, dizziness, fatigue, skin rash and facial flushing in the order of frequency. Almost all of these reaction were mild and transient, disappearing spontanously without discontinuation of the medication. In conclusion, enalapril seems to be a safe and effective primary antihypertensive drug for the treatment of essential hypertension.
Blood Pressure ; Dizziness ; Enalapril* ; Exanthema ; Fatigue ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension

PURPOSE: To determine follow-up results for elderly patients with osteoporosis that received standard cemented bipolar hemiarthroplasty with double loop and tension band wiring for treatment of unstable intertrochanteric hip fractures. MATERIALS AND METHODS: Between May 2000 and May 2006, 86 cemented bipolar hemiarthroplasties were done in elderly patients who had unstable intertrochanteric fractures. The mean age at the time of surgery was 82 years. The average follow-up period was 5.3 years. We evaluated post-operative results by clinical and radiographic methods. RESULTS: At the final follow-up, the mean Harris hip score was 79.2. The mean time needed for full weight bearing following surgery was 4.2 weeks and 82.5 % of patients regained their preoperative level of ambulation. All patients achieved union in the lesser trochanter fracture, but substantial trochanter displacement was observed in 4 cases. There was one case of acetabular erosion. Superficial infections were found Post-operatively in 2 cases. One case with stem subsidence (<5 mm) showed satisfactory results without subsidence in further follow-ups. CONCLUSION: If cemented bipolar hemiarthroplasty is properly applied in the treatment of unstable intertrochanteric hip fractures in the elderly, systematic postoperative rehabilitation, and pain control can be achieved.
Aged ; Displacement (Psychology) ; Femur ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Hip Fractures ; Humans ; Osteoporosis ; Walking ; Weight-Bearing

PURPOSE: The purpose of this retrospective study was to evaluate clinical outcomes of endoscopic nerve decompression in patients with deep gluteal syndromes (DGS). MATERIALS AND METHODS: Between October 2013 and March 2015, 24 patients who underwent surgical treatment of DGS were retrospectively included in this study. The mean age was 47 years (range, 35 to 76 years), and there were 11 males and 13 females. The mean duration of pain was 12 months (range, 5 to 35 months) and the mean follow-up period was 32 months (range, 26 to 45 months). Clinical evaluations included the visual analog scale (VAS) pain score, modified Harris hip score (mHHS), and the symptom-rating scale. RESULTS: Significant improvement in symptoms following endoscopic decompression were achieved as measured using the VAS score (decrease in the mean from 7.1±0.9 to 2.5±1.5; P < 0.001) and mHHS (increase from 59.4±6.5 to 85.0±8.3; P < 0.001). CONCLUSION: Endoscopic sciatic nerve decompression was satisfactory for treating recalcitrant DGS, making it an effective treatment option to improve symptoms of DGS.
Decompression ; Female ; Follow-Up Studies ; Hip ; Humans ; Male ; Retrospective Studies ; Sciatic Nerve ; Visual Analog Scale

Purpose: To evaluate the timing of the improvement in surgical skills of the direct anterior approach for hip arthroplasty through an analysis of the clinical features and learning curve in 58 cases. Materials and Methods: From November 2016 to November 2018, 58 patients, who were divided into an early half and late half, and underwent hip arthroplasty by the direct anterior approach, were enrolled in this retrospective study. The operation time and complications (fracture, lateral femoral cutaneous nerve injury, heterotopic ossification, infection, and dislocation) were assessed using a chi-square test, paired t-test, and cumulative sum (CUSUM) test. Results: The mean operation times in total hip arthroplasty (26 cases) and bipolar hemi-arthroplasty were 132.1 minutes and 79.7 minutes, respectively, demonstrating a significant difference between the two groups. CUSUM analysis based on the results revealed breakthrough points of the operation time, decreasing to less than the mean operation time because of the 16th case in total hip arthroplasty and 14th case in bipolar hemiarthroplasty. Complications were encountered in the early phase and late phase: five cases of fractures in the early phase, no case in the late phase; eight and two cases of lateral femoral cutaneous nerve injury, respectively; three and two cases of heterotopic ossification, respectively; and one case of dislocation, one case of infection and three cases of others in the early phase. The CUSUM chart for the fracture rate during operation in the early phase revealed the following: five cases fracture (17.2%) in the early phase and no case in the late phase (0%). This highlights the learning curve and the need for monitoring the inadequacy of operation based on the complications. Conclusion Hip arthroplasty performed by the direct anterior approach based on an anatomical understanding makes it difficult to observe the surgical field and requires a learning curve of at least 30 cases.

Purpose: The clinical outcomes were investigated to determine if arthroscopic management is a useful method for 19 hips with iliopsoas tendon impingement (IPI) after total hip arthroplasty (THA). Materials and Methods: Eighteen patients (19 hips), who complained of groin pain and flexion pain that persisted after THA from September 2013 to December 2019, were the subjects of this investigation. The mean time to manifestation after THA was four months (range, 1–9 months) in patients of an average age of 60 years (range, 50–69 years). Thirteen out of 18 patients underwent THA using the direct anterior approach and five by the lateral approach. IPI was diagnosed by the medical history, physical examination, blood test, radiographic examination using X-ray and computed tomography, and topical injection therapy. All patients underwent arthroscopic treatment and a dynamic arthroscopic physical examination after exposure to the iliopsoas tendon revealed impingement. Tenotomy was then performed on the muscle portion through the total tendon portion. Symptoms and pain levels of preoperative, postoperative and follow-up period were investigated and compared. Results: The Western Ontario and McMaster Universities Osteoarthritis Index score decreased from an average of 58.4 (range, 40–88) before surgery to an average of 35.0 (range, 15–76) after surgery. Similarly, the visual analogue scale decreased from an average of 4.0 (range, 2–6) before surgery to an average of 1.4 (range, 0–4) after surgery. Sixteen patients (88.9%) showed pain relief and improvement in the straight leg raise test, and two patients showed postoperative muscle weakness and sustained pain. In the follow-up period, muscle weakness improved. One patient underwent arthroscopic iliopsoas tenotomy at the lesser trochanteric level but the symptoms persisted.The clinical symptoms were improved after one more tenotomy at the joint level. Conclusion Arthroscopic iliopsoas tenotomy performed in patients with IPI after THA showed good clinical results.

Purpose: This study examined the patient-reported outcome scores at mid-term follow-up after arthroscopic labral preservation in patients with borderline hip dysplasia. Materials and Methods: Data were collected retrospectively from patients who underwent arthroscopic labral preservation. Among the 61 patients classified with hip dysplasia, patients with arthritis beyond Tönnis grade II were excluded, Patients with subchondral bony exposure were excluded even if they had arthritis of Tönnis grade I. Forty-two patients with borderline hip dysplasia were enrolled among patients whose lateral center edge angle (LCEA) was between 18° and 25°. The PRO scores including the modified Harris hip score (mHHS), hip outcome score activities of daily living (HOS-ADL), hip outcome score sport-specific subscale (HOS-SSS) and visual analog scale (VAS), were collected and compared preoperatively, and then at one year and a minimum of five years after surgery. Results: The mean preoperative LCEA and Tönnis angle were 20.9° (range, 18° to 25°) and 6.3° (range, 0° to 18°), respectively. The mean follow-up was 64.8 (range, 60 to 84) months. The mean mHHS increased from 73.5 before surgery to 86.2 in the fifth year after surgery (p<0.01), the mean HOS-ADL from 70.5% before surgery to 84.9% in the fifth year after surgery (p<0.01), and the mean HOS-SSS from 51.4 before surgery to 69.4 in the fifth year after surgery (p<0.01). The mean VAS score improved from 6.3 before surgery to 1.5 in the fifth year after surgery (p<0.01). Conclusion Arthroscopic labral preservation performed in appropriately selected patients with borderline dysplasia showed good results at mid-term follow-up. In borderline hip dysplasia without the progress of osteoarthritis and subchondral bone exposure, arthroscopic labral preservation may be considered a good and less invasive option.