STUDY DESIGN: Lumbar disc degeneration and segmental instability of the lumbar spine are causes of low back pain. Disc degeneration causes specific changes of the intervertebral disc, and could affect anatomic variations of end plate and vetebral body. However, the exact relationship between degenerative changes of the intervertebral disc and segmental motion characteristics is not known. It is known that radial tears of the annulus fibrosus initiate or accompany degenerative process of nucleus pulposus and the motion segment. It is hypothesis of this study that the existence of radial tear in the annulus fibrosis affects 3 dimension motion characteristics of motion segment. For the purpose, the degree of intervertebral disc degeneration is newly classified by existence of radial tear. Then, the resulting biomechanical motions are investigated. OBJECTIVES: To investigate effects of disc degeneration by the classification on kinematic motions of the motion segment from human lumbar spine and to suggest a quantified method to determine spinal instability in vivo. MATERIALS AND METHODS: A total of 60 spinal motion segments from human lumbar spine was used for this study. To measure 3 dimensioal motion of the motion segments, Vicon system(Oxford, England) with 3 cameras reflective markers and VAX station was used. 6 kinds of pure moments(flexion, extension, right and left axial rotation, and right and left lateral bending) were applied to the motion segments using dead weight for each loading step. At the end of test(maximum loading), motion segments were frozen for anatomical study. For making clear the degree of the degeneration of the disc, a new classification based on MRI results was used: Grade 1 is a normal young disc without tear; Grade 2 is a normal aging disc without radial tear; Grade 3 is a degenerative disc with radial tear; and Grade 4 is a severely degenerative disc with radial tear and other degeneration such as showing decreased disc height. RESULTS: The upper lumbar specimens with radial tears has increased flexion motions as compared to the normal group. Also, the right and left axial rotation in radial tear group increased as compared to the normal group. However, there were no statistical differences in other motions. For the lower lumbar specimens, there were no significant differences in measured motions in all directions between the normal and radial tear groups CONCLUSIONS: These results suggests that the segmental motions are affected by radial tear in the intervertebral disc. Thus, the radial tear in the annulus fibrosus of lumbar intervertebral disc could cause the instability of lumbar spine. Further research is required to determine the relationship between other structural changes and biomechanical characteristics, and future studies should include in vivo investigations to correlate these findings to patients'symptoms.
Aging ; Classification ; Fibrosis ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Low Back Pain ; Magnetic Resonance Imaging ; Spine

With the advancement of modern medicine, diabatic foot gangrene rather than acute metabolic complications are eneountered as serious problem. The diabetic gangrene, one of the angiopathic and neuropathic complications, is difficult in treatment because of wound infection and delayed healing. The authors reviewed a series of 47 cases in 40 patient of diabetic gangrene that treated in orthopedic department of Eulji General Hospitsl, Seoul, from January 1982 to December 1987. We summarized the obtained results as following. 1. The overall incidence of diabetic gangrene was 0.42%, and 77.5% of patients with gangrene were in over 50 year age group. 2. 72.5% of patients with gangrene were 5–14 years in duration of diabetes. 3. The most common predisposing factor was local pressure(45%), and the most common site of lesions was big toe(34%). 4. Bacterial infections were shown in 90% of cases, and the most common organism wasstaphylococcus(56%).5. Diabetic retinopathy was the most common associated complication and neuropathy, nephropsthy in order. 6. According to the Wagner's classification, grade 4 lesion was most common(47%). 7. There was no correlation between primary healing and the lowest palpable pulse. 8. The overall rate of primary healing was 57%.
Bacterial Infections ; Causality ; Classification ; Clinical Study ; Diabetic Foot ; Diabetic Retinopathy ; Foot ; Gangrene ; History, Modern 1601- ; Humans ; Incidence ; Orthopedics ; Seoul ; Wound Infection

No abstract available.
Aneurysm

PURPOSE: To compare the suppressive effects in hepatocellular carcinoma patients of transhepatic arterial chemoembolization by the infusion of adriamycin-lipiodol emulsion and of this plus 10ml of cisplatin solution. MATERIALS AND METHODS: In a total of 151 cases, the frequency of intrahepatic recurrence was compared with follow-up angiographic findings after the first and second transhepatic arterial chemoembolization with adriamycin-lipiodol emulsion and adriamycin-lipiodol emulsion plus 10ml of cisplatin solution, respectively. RESULTS: Among 46 patients whose first single infusion was after mean 119 days, the recurrence rate was 22% ; for 42 who were given their first multiple infusion after mean 76 days this rate was 5% ; for 35 whose second single infusion was administered after mean 147 days, the rate was 34%, and among 28 whose second multiple infusion was after mean 110 days, the rate was 43%. CONCLUSION: During the first trial of transcatheter arterial chemoembolization with adriamycin-lipiodol plus cisplatin solution, hepatocellular carcinoma recurred much less frequently, but during the second trial with cisplatin, recurrence was not suppresed.
Carcinoma, Hepatocellular* ; Cisplatin* ; Follow-Up Studies ; Humans ; Recurrence*

To observed whether the specific IgG antibody test using ELISA was useful in diagnosis of presently ill patients of paragonimiasis, a total of 95 sera were tested. The sera were collected from 21 egg positive cases, 8 from positive reactors of intradermal test, 7 from Clonorchis infected, 9 from other parasitic diseases and 50 from apparently non-infected cases. By the result, the sensitivity of the test was 86% and the specificity was 100%. There were no cross reactions between Paragonimus antigen and other parastic infections. Specific IgG antibody test by micro-ELISA was concluded to be useful for mass screening of the presently ill paragonimiasis in the field.
parasitology-helminth-cestoda ; Spirometra sp. ; sparganum ; sparganosis ; immunology ; diagnosis ; ELISA

Nemaline myopathy is a rare congenital m opathy, characterized by nonprogressive or slowely progressive muscle weakness associated with rod-like structures in muscle fibers and characteristic dysmorphic features. We report the first farnilial nemaline myopathy in two generations of the same family, confirmed by muscle biospy in an 11-year-old boy and his mother. The patients had hypotonia and slowly progressive muscle weakness of the four limbs associated with characteristic facial dysmorphism and skeletal deformities. Light and electron microscopic study of a muscle biopsy showed numerous nemaline rods in both patients.
Biopsy ; Child ; Congenital Abnormalities ; Extremities ; Family Characteristics ; Humans ; Male ; Mothers ; Muscle Hypotonia ; Muscle Weakness ; Myopathies, Nemaline*

OBJECTIVES: The study was conducted to estimate the carcinogenic risks from the ingestion of some carcinogenic pesticides (CPs) in vegetables sampled at a local agricultural product market in Seoul. METHODS: After applying a hazard identification step, we selected four pesticides, such as DDT, dieldrin, folpet, and heptachlor epoxide, for this risk assessment. Concentrations of each pesticide were measured from randomly sampled vegetables. In order to estimate the human exposure levels, we combined the concentration of pesticides in the vegetables with consumption rate of those vegetables. Three scenarios were hypothesized for human exposure assessment. Scenario I was the most conservative which supposed the undetected CPs would be the detection limit values. Scenario II was assumed that the undetected CPs would be a half of the detection limit values, and finally scenario III merely considered only values greater than the detection limit values. We finally presented the estimated carcinogenic risks on the basis of the traditional risk assessment procedure suggested by U.S. EPA. RESULTS: Pesticides including DDT, dieldrin, folpet and heptachlor epoxide were detected in 9 samples (6%) in the range of 0.0006~0.09ppm. The daily intake levels of carcinogenic pesticides were estimated in the range of 0.0009~0.0079 microgram/day. As we expected, excess cancer risks based on scenario I was also the highest (1.1x10-8~ 5.5x10-5). CONCLUSIONS: We found that the estimated risks from the pesticides we investigated were not serious. We, however, propose that a continuos monitoring is needed to make sure for the protection of public health.
DDT ; Dieldrin ; Eating ; Heptachlor Epoxide ; Humans ; Korea* ; Limit of Detection ; Pesticides* ; Public Health ; Risk Assessment* ; Seoul ; Vegetables*

OBJECTIVE: To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. METHODS: From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. RESULT AND CONCLUSION: Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).
Alcohol Drinking ; Birth Order ; Chronic Disease ; Cohort Studies* ; Education ; Female ; Humans ; Korea ; Menopause* ; Middle Aged ; Mortality ; Odds Ratio ; Proportional Hazards Models ; Smoke ; Smoking

No abstract available.
Leukemia, Myelomonocytic, Juvenile* ; Xanthogranuloma, Juvenile*

To evaluate the progress of clinical and histopathological changes of dermat ophytosis caused by M. gypseum, its inoculation study was done in 16 male New Zealand white rabbits(control: 4, innoculation : l2). The results were as follows . Clinically Initial erythema, scales, and crusts developed in 1 week after inoculation. They reached maximum severity on the 14th to 18th day and disappeared on the 25th to 44th day after inoculation. I-Iist,opathologically : The earliest findings were mild focal acanthosis and for al vascular ilatations and cellular infiltrations of the papillary dermis on the 4th day after inoculation. Their severity increased to the moderate degree until the. 8th day when mild hyperkeratosis was notec1, and lasted to the 13th day, Maximum degree of the findings including parakiratosis, intraepidermal microabscesses and middermal changes was seen on the 16th to 22nd day, and disapveared gradually between the 25th day and the 46th day. Hyphae and spores were founil on the PAS stainings until the 22nd clay. M. gypseum was not cultured from the lesions after the 25th day. seven of 10 rabbits injected intradermally with trichophytons became positive in 2 to 4 weeks after inoculation. All these findings suggest that the maximum inflammatory response is the result of immunologic reaction and the increased epidermal turnover rate may play a. major role in the shedding of remained fungi of the horny layer.
Dermis ; Erythema ; Fungi ; Humans ; Hyphae ; Male ; Microsporum* ; New Zealand ; Rabbits* ; Spores ; Trichophyton ; Weights and Measures