Foreatiers disease is a peculiar type of ankylosing hyperostosis of the spine characterized by ossification of the anterior and right lateral aspects of the vertebral column, particularly in the thoracic region. The clinical, pathological and reontgenographic features of the disorder allowed its differentiation from other spinal diseases including ankylosing spordylitis and osteoarthritis. A case of Forestiers disease is presented with brief review of literatures.
Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal ; Osteoarthritis ; Spinal Diseases ; Spine

OBJECTIVES: REM sleep behavior disorder (RBD) has received little attention in epidemiologic studies. This study aimed to determine the prevalence of probable REM sleep behavior disorder (pRBD) in the elderly population and its clinical features. METHODS: A random sample of 1,588 was selected from a roster of 14,050 elderly population living in Osan city. The subjects were asked to fill out the REM sleep behavior disorder screening questionnaire (RBDSQ). Subjects whose score were 5 or higher on RBDSQ underwent a diagnostic phase of person-to-person assessment by experts in RBD. RESULTS: Among 1,588 subjects, 886 elderly subjects participated in the screening phase and 123 subjects were assessed in the diagnostic phase. Eleven subjects were diagnosed as having pRBD, so prevalence was 1.5% (95% CI=0.70-2.30%). The frequency of depression and cognitive decline was significantly increased in patients with pRBD compared to subjects without pRBD, and there was no difference in sleep disturbances between two groups. CONCLUSIONS: Probable REM sleep behavior disorder is not rare in the elderly but frequently under-recognized. More attention should be paid to evaluation and treatment of RBD.
Aged ; Depression ; Epidemiologic Studies ; Humans ; Mass Screening ; Prevalence ; Surveys and Questionnaires ; REM Sleep Behavior Disorder ; Sleep, REM

BACKGROUND: Pravastatin, HMG-CoA reductase inhibitor, has been known to be the most effective drug in patients with hypercholesterolemia. We studied the effectiveness and side effects of this drug. METHODS: We studied twenty four patients(8 males, 16 females), with pravastatin 5mg bid for 8 weeks, whose fasting serum total cholesterol levels were higher than 240mg/dl on the first visit. Lipid profiles were checked at 2 weeks interval for 8 weeks and compared with baseline level individually. RESULTS: Among lipid profiles, pravastatin significantly decreased the total cholesterol from 282.8mg/dL to 224.5mg/dL(reduction rate, 21%), the LDL cholesterol from 197.2mg/dL to 143.8mg/dL(27%), the total cholesterol/HDL cholesterol ratio from 6.2 to 4.6(25%), and the LDL cholesterol/HDL cholesterol ratio from 4.1 to 2.7 (34%). These changes were statistically significant(p<0.05). Triglyceride and HDL cholesterol showed no significant changes compared to baseline levels during treatment. The clinical and laboratory findings after treatment did not show serious abnormalities except two patients who dropped out due to side effect such as constipation and skin eruption. CONCLUSION: Results from the present study show that short-term pravastatin therapy seems to be effective and safe in patients with hypercholesterolemia.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Constipation ; Fasting ; Humans ; Hypercholesterolemia ; Hyperlipidemias* ; Male ; Oxidoreductases ; Pravastatin* ; Skin ; Triglycerides

Despite the progress in the treament of the subretinal neovascular membrane(SRNVM) by the development of laser photocoagulation, it has been reported difficult to manage with laser photocoagu1ation on which developed in high myopic eyes: first, their location in relation to the foveola is usually difficult to discriminate; second, subretinal neovascular m6mbrane developes very close to the foveola; third, the atrophic photocoagulation scar may extend to the foveola. The interferone alpha 2a has been known to suppress angiogenetic activity, and its application to subretinal neovascular membrane in high myopia has been suggested. The effect of interferon alpha 2a on neovascular membrane in high myopia was investigated by the authors. Subjects included 16 eyes with interferon treament and 12 eyes as control who had been followed for 3 months or longer. The median total dose in these patients was 75 X 10(6) units, given over a six- to eight-week period. In the interferon treament group, the activity of neovascular membrane decreased in 9 eyes(56%) and the visual acuity improved in 7 eyes(44%). In contrast, the control group showed a sustained activity of neovascular membrane and the visual acuity was improved in only one eye(6%). Therefore, interferon alpha 2a can be considered as an alternative method in the management of the some subretinal neovascualr membrane in high myopia which is resistant to the other treament.
Cicatrix ; Humans ; Interferon-alpha* ; Interferons* ; Light Coagulation ; Membranes* ; Myopia* ; Retinaldehyde* ; Visual Acuity

Despite the progress in the treament of the subretinal neovascular membrane(SRNVM) by the development of laser photocoagulation, it has been reported difficult to manage with laser photocoagu1ation on which developed in high myopic eyes: first, their location in relation to the foveola is usually difficult to discriminate; second, subretinal neovascular m6mbrane developes very close to the foveola; third, the atrophic photocoagulation scar may extend to the foveola. The interferone alpha 2a has been known to suppress angiogenetic activity, and its application to subretinal neovascular membrane in high myopia has been suggested. The effect of interferon alpha 2a on neovascular membrane in high myopia was investigated by the authors. Subjects included 16 eyes with interferon treament and 12 eyes as control who had been followed for 3 months or longer. The median total dose in these patients was 75 X 10(6) units, given over a six- to eight-week period. In the interferon treament group, the activity of neovascular membrane decreased in 9 eyes(56%) and the visual acuity improved in 7 eyes(44%). In contrast, the control group showed a sustained activity of neovascular membrane and the visual acuity was improved in only one eye(6%). Therefore, interferon alpha 2a can be considered as an alternative method in the management of the some subretinal neovascualr membrane in high myopia which is resistant to the other treament.
Cicatrix ; Humans ; Interferon-alpha* ; Interferons* ; Light Coagulation ; Membranes* ; Myopia* ; Retinaldehyde* ; Visual Acuity

BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

The main goals of surgical teatment of thoracolumbar vertebral fractures are to achieve reduction, stability and early, painless mobilization. A further aim is to avoid late malposition and to preserve mobility and lordosis. The main disadvantage of Harrington instrumentation and similar methods are that this device fixate five to seven vertebrae. The Cotrel-Dubousset(C-D) instrumentation provides a stable construct for fixation of spine fracture. The advantages of C-D pedicle screw for thoracolumbar spinal fractures are that compression or distraction force can be applied in the same rod and used to achieve anatomical reduction of spinal fractures and rigid fixation can be obtained with short instrumentation. The C-D instumentation was done for 15 unstable thoracolumbar spinal fractures at Seoul Red Cross Hospital from January, 1988 to January, 1990. The results were as follows. 1. The most common cause of the spine fracture was fall down, and majority are within 20-40 old age. 2. The most common involved site was T12 and Ll vertebrae (66.7%). 3. The most common type of injury was burst fracture by according to Denis classification(60%). 4. The complication was developed mostly in neurological deficient patient. 5. The advantage of the C-D instrumentation: (1) rigid and short osteosynthesis of spine fracture, (2) compression or distraction force can be applied in the same rod, (3) early mobilization with a brace is possible. 6. The rigid fixation can be obtained.
Animals ; Braces ; Early Ambulation ; Humans ; Lordosis ; Pedicle Screws ; Red Cross ; Seoul ; Spinal Fractures ; Spine

Neonatal Hemangioendothelioma (HE) is the most common type of hepatic vascular tumor that presents in infancy. HE generally undergo spontaneous regression within a year, but it may become symptomatic and be associated with life-threatening complications including congestive heart failure, consumptive coagulopathy and hepatic rupture. We report five cases of neonatal hepatic HE with brief review of the literatures. The report include a case of HE associated with AV malformation complicated by congestive heart failure who was successfully treated by hepatic artery embolization, a case of HE associated with transposition of great artery (TGA), and three cases of asymptomatic HE with spontaneous involution.
Arteries ; Heart Failure ; Hemangioendothelioma* ; Hepatic Artery ; Rupture

PURPOSE: To investigate changes in the ovary revealed by MR imaging before and after radiotherapy in premenopausal patients with cervical carcinoma. MATERIALS AND METHODS: Thirty-three premenopausal patients with cervical carcinoma underwent radiation therapy at an average dosage of 11,279 (external: 5,352; internal: 5,927) cGy. Before and after this therapy, all underwent pelvic MR imaging using a 1.5T MR scanner (GE Medical Systems, Milwaukee, U.S.A.). The average interval of follow-up MR imaging was 7.2 months, and axial T1-weighted and axial and sagittal T2-weighted MR images were obtained. The presence, size number of follicles, and differentiation of the zonal anatomy of the ovary were determined by two radiologists, who reached a consensus. RESULTS: After radiation therapy, all patients ceased menstruation. For ovaries, the detection rates before and after radiation therapy were 94% (62/66) and 39% (26/66) (p<0.05), respectively, and average ovary size was 2.6x1.9x2.2 cm before and 1.7x1.3x1.4 cm after therapy (p<0.05). The average number of ovarian follicles before and after therapy was 5.1 and 3.1, respectively (p<0.05). T2-weighted imaging, demonstrated differentiation of zonal anatomy in 74% of cases (46/62) before radiotheraphy, and 15% (4/26) after (p<0.05). CONCLUSION: Our study has shown that after radiation therapy in premenopausal patients with cervical cancer, detection rates, average size, and the number of ovaries decreased, findings which are similar to those for normal postmenopausal ovary. MR imaging can reveal structural change in ovaries.
Cervix Uteri* ; Consensus ; Female ; Fluconazole ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Menstruation ; Ovarian Follicle ; Ovary* ; Radiotherapy* ; Uterine Cervical Neoplasms

We reviewed retrospectively 23 patients treated with M-VAC (Methotrexate. Vinblastine, Doxorubicin, Cisplatin) from October 1987 to June 1990 at our hospital to evaluate predictive variables for response to chemotherapy and long term survival free of disease. Treatment consisted of monthly cycles of 30mg. per m2 methotrexate, followed 24 hours later by 3mg. per m2. vinblastine, 30mg. per m2. doxorubicin and 70mg. per m2. cisplatin and concluded with repeat vinblastine and methotrexate on days 15 and 22. The Median number of cycles was 3 (range 2 to 5). Complete plus partial remission were observed in 13 of 23 patients (57%) with a median survival or 13 months (range 7+ to 32+ months). Stabilization occurred in 3 patients (14%) and progression in 7 patients (29%) with median survivals of 10 months (range 7+ to 11 months) and 8 months(4 to 12+ months). 1 year survival rate was 77% in complete puls partial remission and 66% in stabilization and 28% in progression. 10 patients with a complete plus partial remission are alive with a median follow up of 15 months ( range 4 to 32+ months), of whom 1 is surviving for more than 2 years. Toxicity included moderately severe myelosuppression that resulted in nadir sepsis in 1 patient mild to moderate anorexia, vomiting, alopecia and renal dysfunction. Though the number of availuable patients are limited, these preliminary results suggest that treatment with M-VAC is effective against disseminated urothelial transitional cell tumors.
Alopecia ; Anorexia ; Cisplatin ; Doxorubicin* ; Drug Therapy* ; Follow-Up Studies ; Humans ; Methotrexate ; Retrospective Studies ; Sepsis ; Survival Rate ; Urothelium* ; Vinblastine* ; Vomiting