No abstract available.

This study was performed to evaluate the diagnostic value of colposcopy by comparing colposcopic findings with cytology, histology of colposcopically directed biopsy and final biopsy result on hysterectomy. From January 1, 1988 to August 31, 1996, the colposcopic examinations was undertaken in 1200 patients, excluding grossly visible carcinoma of the cervix. The result were as follows : 1. Colposcopic examinations were satisfactory in 95.4% and unsatisfactory in 4.58%. 2. The accuracy rate of cytologic diagnosis was 73.1% and colposcopic impression was 93.1%. 3. The false negative rate of colposcopic impression was 2.6%, much less than 24,7% of cytologic examination. 4. The cytologic accuracy rate in cervicitis was higher than that of colposcopic impression but the accuracy rate of colposcopic impression in diagnosis of cervical intraepithelial neoplasia was higher than that of cytology. 5. Among 97 cases in which colposcopically directed biopsy were performed, more advanced lesion were disclosed in 12 cases(12.4%).
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Colposcopy* ; Diagnosis ; Early Diagnosis* ; Female ; Humans ; Hysterectomy ; Uterine Cervical Neoplasms* ; Uterine Cervicitis

The current two most popular spine surgeries, discectomy and fusion, at best address the pathology of low back pain, but significantly change the normal structure and function of the disc and lead to further degeneration of the adjacent segments. Artificial disc replacement (ADR) is considered an alternative to fusion in treatment of the degenerative disc disease. It can restore the normal kinematic and load-shearing properties of diseased lumbar segments, maintaining stability and mobility with relief of pain. Over the past 40 years, a tremendous effort has been made to develop an artificial disc to replace the degenerated disc. Design criteria of artificial disc include endurance, biocompatibility, galvanic corrosion, geometry, constraints, dynamics, implant stability, and fail-safe. The indications of ADR are still not clear. But the principal indications include mono- and bi-segmental instability, the postnucleotomy syndrome, and spondylolisthesis up to Meyerding I after unsuccessful conservative treatment. The contra-indications are osteoporosis, previous or latent local infection, spondylolisthesis greater than Meyerding I, spinal stenosis, as well as degenerative spondylosis, mainly involving facet joints. There have been several reports about clinical results of ADR. The initial results seem to be good, but follow-up is too short for definite conclusions. Accurate patient selection is imperative to obtain good clinical results. Prospective and longer term studies are needed to evaluate the efficacy of ADR. The further development in designs and materials of artificial disc is the most important to duplicate not only the natural form of disc but also its function.
Corrosion ; Diskectomy ; Follow-Up Studies ; Low Back Pain ; Osteoporosis ; Pathology ; Patient Selection ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylosis ; Total Disc Replacement* ; Zygapophyseal Joint

No abstract available.
Shoulder*

No abstract available.
Ganglion Cysts* ; Knee Joint* ; Knee*

Background & Objectives: To determine the prevalence and characteristics of radiculopathy in Parkinson’s disease (PD) patients through electrodiagnostic tests, to assess associated radicular pain characteristics,and to investigate the relationship between pain and other clinical manifestations of PD. Methods: Electrodiagnostic testing including nerve conduction studies and needle electromyographywas performed to investigate comorbid peripheral neuropathy or radiculopathy. All patients were asked to complete aquality of life (QOL) measurement related to pain. Results: Thirty-two (39%) of 82 PD patients had radiculopathy based on electrodiagnostic testing. 46.9% with radiculopathy patients had involvement of multiple roots level. The most commonly involved root was L5 (83.3%). Patients with radiculopathy had longer PD durations (p=0.011) and higher posture-related axial scores on the UPDRS scale (p=0.017).There was a trend for pain in the leg and low back to occur more frequently in PD patients with radiculopathy. QOL is not significantly different according to the presence of radiculopathy in PD. Conclusions: This study demonstrates a high prevalence of radiculopathy, particularly multiple root involvement, and is correlated with pain complaints and with axial motor scores on UPDRS. These findings might be related to increased shear force at the intervertebral disc by axial rigidity and flexed posture in PD along with the duration and severity of PD disease course.
Parkinson Disease ; Radiculopathy

No abstract available.
Achilles Tendon*

Grice extra-articular subtalar arthrodesis has been performed as either a temporizing or a definite procedure in young children to correct the dynamic hindfoot valgus deformity without affecting subsequent growth of the foot. Fifty eight extra-articular subtalar arthrodesis in thirty patients, performed at Seoul National University Children's Hospital from setpember 1985 to June 1989, were retrospectively reviewed to evaluate the clinical and radiographic results. There were 52 valgus feet in 26 patients and 6 varus feet in 4 patients secondary to cerebral palsy, meningomyelocele, congenital snomalies, and other neuromuscular diseases. In many instances, additional tendon surgeries were also required to correct deformities or achieve the muscle balance. The review consisted of personal interview, physical examination, and radiological assessment. On physical examination, preoperative hindfoot valgus deformty(mean: 14.3°clinically) was well corrected, postoperative hindfoot valgus ranging from neutral to valgus 5°clinically in 35 of 52 cases(67.3%). Correction of the lateral talocalcaneal angle on standing lateral radiographic view averaged 8.5 degrees(from 57.3 degrees preoperatively to 37.6 degrees postoperatively). In valgus feet, there were 3 cases with mild pain around the ankle joint. There were 5 cases of graft resorption and 2 cases of nonunion. Graft failure was more frequent when the proximal end of the graft was directed anterior to the weight bearing axis. With original Grice subtalar arthrodesis, satisfactory results were obtained in 34 of 52(65.4%) hindfoot valgus feet. In 6 varus feet, there were 1 undercorrection and 2 recurrence of varus deformity. We re-emphasize the importance of strict operative technique to obtain satisfactory results. We also believe that Grice procedure may be used for the correction of subtalar instability in selected cases of varus foot before muscle baancing procedures.
Ankle Joint ; Arthrodesis ; Cerebral Palsy ; Child ; Congenital Abnormalities ; Foot ; Humans ; Meningomyelocele ; Neuromuscular Diseases ; Physical Examination ; Recurrence ; Retrospective Studies ; Seoul ; Tendons ; Transplants ; Weight-Bearing

STUDY DESIGN: A new classification system for throacolumbar spine injury, Thoracolumbar Injury Classification and Severity Score (TLICS) was evaluated retrospectively. PURPOSE: To evaluate intrarater and interrater reliability of newly proposed TLICS schemes and to estimate validity of TLICS's final treatment recommendation. OVERVIEW OF LITERATURE: Despite numerous literature about thoracolumbar spine injury classifications, there is no consensus regarding the optimal system. METHODS: Using plain radiographs, computed tomography scanning, magnetic resonance imaging, and medical records, 3 clssifiers, consisting of 2 spine surgeons and 1 senior orthopaedic surgery resident, reviewed 114 clinical thoracolumbar spine injury cases retrospectively to classify and calculate injury severity score according to TLICS. This process were repeated on 4 weeks intervals and the scores were then compared with type of treatment that patient ultimately received. RESULTS: The intrarater reliability of TLICS was substantial agreement on total score and injury morphology, almost perfect agreement on integrity of the posterior ligament complex (PLC) and neurologic status. The interrater reliability was substantial agreement on injury morphology and integrity of the PLC, moderate agreement on total score, almost perfect agreement on neurologic status. The TLICS schems exhibited satisfactory overall validity in terms of clinical decision making. CONCLUSIONS: The TLICS was demonstrated acceptable intrarater and interrater reliability and satisfactory validity in terms of treatment recommendation.
Consensus ; Decision Making ; Humans ; Injury Severity Score ; Ligaments ; Magnetic Resonance Imaging ; Medical Records ; Reproducibility of Results ; Retrospective Studies ; Spine

PURPOSE: This study was undertaken to compare blood eosinophilic inflammatory markers between the acute period and clinical remission in children with upper respiratory infection (URI) -induced wheezing, and to assess the effects of atopy and age on these changes. METHODS: In 77 children with URI-induced wheezing, blood eosinophil count and serum eosinophil cationic protein (ECP) were measured during the acute wheezing phase and clinical remission period. The data were analyzed in the subgroups divided by atopy and age, respectively. RESULTS: Blood eosinophil count was significantly lower during acute period (181.6/microliter, 67.3-490.0) than that during clinical remission period (261.8/microliter, 120.7-567.7, P=0.001), and this significant eosinopenic response was found in non-atopic children (n=36) [92.2 (41.3-206.0) /microliter vs 204.5 (106.6-392.2) /microliter, P< 0.001], but not in atopic children (n=41). A significantly higher level of serum ECP was observed during acute period (15.1 microgram/L, 7.2-31.6) than during clinical remission (13.0 microgram/L, 6.6-25.7, P=0.05), and this difference was significant only in atopic children[24.2 (15.3-38.1) microgram/L vs 16.2 (8.3-31.6) microgram/L, P< 0.001]. A significant fall in blood eosinophil count during acute period was found only in children < or=4 years (n=37), while a significant rise in serum ECP was detected only in children > 4 years (n=40). However, these differences a due to dissimilar distribution of atopy in the two age groups. CONCLUSION: Our results showed different eosinophil responses to infection in non-atopic and atopic children with URI-induced wheezing. It appears that the blunted eosinopenic response in atopic children may be associated with the predominant Th2-like response to infection.
Child* ; Eosinophil Cationic Protein ; Eosinophils* ; Humans ; Respiratory Sounds*