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

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

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*

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*

PURPOSE: The purpose of this study was to explore adult diabetics' eating styles and factors which influence them. METHOD: The study adopted an ethnographic method based on a perspective which views the eating style as a cultural phenomenon. Data was collected through a personal interview, participant observation, and documented materials from Oct.2001 to Sept. 2002. In this study, fifteen adult diabetics, with an average age of 57, participated. Data analysis was done by the Spradley's taxonomic analysis technique. RESULT: The patients' eating styles were rooted in their viewpoint on illness as well as the meaning of food. Eating styles were classified into 4 types: Pathology-centered, symptom-centered, need-centered, and role-centered. CONCLUSION: A conventional approach to the treatment and management of diabetes did not consider the patient's inner world which may play an important role in the successful management of the disease. We found that it was critical for health care personnel to understand patients' values, beliefs and their way of life in order to facilitate the most successful self-care diet.
Middle Aged ; Male ; Korea ; Humans ; *Food Habits ; Female ; *Eating ; Diabetes Mellitus, Type 2/*diet therapy/nursing/psychology ; Culture ; *Attitude to Health ; Aged

BACKGROUND: Elevated plasma homocysteine concentrations are an independent risk factor for vascular disease. The metabolism of homocysteine is closely related to vitamin B12 and folic acid. The purpose of this study is to evaluate the correlation between homocysteine and vitamin B12 as well as folic acid in patients with coronary artery disease. METHODS: Sixteen patients, in whom coronary angiography revealed more than 50% of stenosis at least in one coronary vessel, were enrolled as the patient group, and sixteen hypertensive subjects were selected as the control group. Blood was collected in the peripheral vein to measure the concentrations of homocysteine, vitamin B12, and folate. We evaluated the correlation between homocysteine, vitamin B12 and/or folate in both groups. RESULTS: Total plasma homocysteine concentrations were higher in the coronary artery disease group than in the control group. There were no significant differences in the folate and vitamin B12 levels between the coronary artery disease group and the control group. In the control group, the concentrations of homocysteine showed negative correlation with both vitamin B12 and folate concentrations, but similar trends were not observed in the coronary artery disease group.
Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels ; Folic Acid* ; Homocysteine* ; Humans ; Metabolism ; Plasma* ; Risk Factors ; Vascular Diseases ; Veins ; Vitamin B 12*

No abstract available.
Methylprednisolone* ; Purpura, Thrombocytopenic, Idiopathic*

Evaluations of residual renal function and the therapeutic effectiveness in renal tuberculosis have largely been dependent on intravenous pyelogram or Contrast-CT scan, even though, exact renal function are not evaluated with there methads. 99mTc-DMSA is a radiopharmaceutical that is trapped in the functioning tubular cells of the kidney and therefore, quantitative renal function could be evaluoted by ineasuring the counts of renal radioactivity and concomittant evaluation of renal morphology could be passible with the analog imapes of the radioactivity. The authors retrospectively analyzed 99mTc-DMSA scans of 75 kidndys of 67 patients with confirmed renal tuberculosis. We classified the morphologies of tuberculous kidneys as 6 types. We classified the morphologies of tuberculous kidneys as 6 types such as the type with small cortical defect, with parenchymal ulcerocavernous lesions, ulcerocavernous fistula to pelvis, mass-like defects, contracted kidney with ureter visualization, and the type with nonvisualization of kidney, corresponding to the characters of renal tuberculous pathogenesis with abscess formation, ulcerocavernous fistula, and fibrosis, and correspondings to the renal anatomy with parenchyma, and pelvocalyceal collecting system. Their mean residual renal functions measured with 99mTc-DMSA uptake rates were 19.0%, 18.4%, 7.9%, 12%, 4.1%, 3.4% respectively.
Abscess ; Fibrosis ; Fistula ; Fluspirilene ; Humans ; Kidney ; Pelvis ; Radioactivity ; Retrospective Studies ; Succimer* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Tuberculosis, Renal* ; Ureter