BACKGROUND: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. METHODS: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. RESULTS: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were 156.7°, 152.2°, 61.1°, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. CONCLUSIONS: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.
California ; Elbow ; Follow-Up Studies ; Humans ; Humerus* ; Joint Capsule Release ; Methods ; Postoperative Complications ; Shoulder ; Surgeons ; Suture Anchors ; Sutures

A lesion in the cervico-thoracic junction can be of interest to neurosugeons, not only because its incidence is quite low, but also because there is not a published proper anterior approach. Currently the authors have experienced two cases of degenerative disease and one case of traumatic dislocation of the cervico-thoracic junction, in which the main lesions were located in the interspace or posterior portion of vertebral bodies at the junction between the cervical and thoracic spines and an anterior approach to the lesions should be considered. A supraclavicular approach has applied to these cases, by which a good surgical field was obtained. Furthermore the surgical results were good without any serious complication.
Dislocations ; Incidence ; Spinal Fusion ; Spine

Using computerized motion analysis techniques, kinematics of foot trajectories were quantitatively analyzed in twelve rats before and after dorsal spinal cord hemisection at the T6 level. Although overground locomotion in these animals returned to normal within four weeks, some kinematic variables during treadmill locomotion did not recover to pre-lesion level. Immediately following dorsal hemisection, amplitudes of both hindfeet horizontal and vertical movements were dramatically reduces. However, in three weeks, the amplitudes of horizontal movement(stride length) became significantly larger than of pre-lesion strides. On the other hand, amplitude of hindlimb vertical movement showed very little recovery. Forelimb-hindmill coordination was also disrupted initially but returned to normal within three weeks. The duration of hindlimb swing phase became significantly longer after sectioning and gradually recovered, but never to pre-lesion levels. Interestingly, amplitudes of forelimb vertical movement. which was depressed initially, became significantly largery three weeks after lesioning. A dramatic increase in the statistical variation of limb kinematics, which persisted even after motor recovery, is an important parameter for the evaluation of neural deficits in spinal cord injuries. Kinematic analysis is a sensitive technique for the detection of minor motor deficits following nerve injuries.
Animals ; Biomechanical Phenomena ; Extremities ; Foot ; Forelimb ; Hand ; Hindlimb ; Locomotion* ; Rats* ; Spinal Cord Injuries ; Spinal Cord*

To measure the birth registration rate and the validity of birth registration data in rural area, all of the 4,014 married women under 49 years of age who had not been sterilized in Gunwee county of Kyungpook province were followed by Myun health workers for 2 years from April 1, 1985 to March 31, 1987 and 766 births were detected. All of the birth registration records of Myun offices were reviewed on September 30, 1987 and 944 births which occurred within the above mentioned period were found. Actual birth date obtained by follow-up study were compared with the birth date on registration card. Among 766 births detected by follow-up study, 576 births(75.2%) which were reported within 6 months after birth were ascertained on the official registration records and 96 births(12.5%) were not found on the records although mother stated that the birth was registered. The registration rate within legal due date was 61.3% among 576 births detected by follow-up study and also ascertained on the official records. The registration rate within legal due date was lower in mothers under 20 years of age and above 35 years and in mothers who had only primary education. It was decreased as the birth order increased. The registration rate was higher in births occurred from October to March than births occurred from April to September. All of the births of 7 neonatal deaths were not reported. The registered birth date was consistent with the actual birth date in 78.0%. Birth date on record was earlier than the actual birth date in 6.8% and later in 15.3%. The consistency rate was lower in mothers above 35 years of age(54.5%), and in infants of 4th birth order and above(56.3%). The rate was increased as the maternal education level increased. The rate of boys was higher than that of girls. A higher percentage(17.4%) of infants born in March was registered with earlier date than the actual birth date and most of these registered birth dates were lunar calendar date. This might be related with the age for entering the primary school. The study findings revealed that the birth registration rate within legal due date and accuracy of report have been increased in recent years, but the infant mortality rate derived from the birth registration seems to be very inaccurate. It is suggested to let the medical personnel who delivered the baby report the birth by mail directly to the current address of parent while infants delivered at home without professional attendant may comply with the present registration system.
Birth Order ; Education ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Infant ; Infant Mortality ; Linear Energy Transfer ; Mothers ; Parents ; Parturition* ; Postal Service

It has been suggested that hormonal manipulation may be proved to be an alternative mode of therapy, especially in cases of unresectable or recurrent meningiomas, and the effect of the endocrinological therapy may be influenced by the presence or absence of hormone receptors in meningiomas. The assessment of biological behavior of the tumors is important to plan postoperative adjuvant therapy and follow-up schedules, and the evaluation of cell proliferative activities has been known to be valuable in prediction of recurrence and aggressiveness of meningiomas. The purpose of this study was to investigate the status of hormone receptors and cell proliferative activities, and to determine the relationship between nucleolar organizer regions(AgNORs) and flow-cytometric methods in evaluating cell kinetics of meningiomas. Cytosolic estrogen receptors(ER) and progesterone receptors(PR) were studied in meningiomas removed from 43 patients. Cell proliferative index(PI) based on tumor cell-cycle stage(%S+%G2M) was calculated by flow-cytometic studies of paraffin- embedded meningioma tissue blocks, and the mean number of AgNORs per cell was measured by silver-colloid staining technique. Evaluable results of hormone receptors, PI, and AgNORs could be obtained in 40, 37, and 41 of original meningiomas, respectively. Significant levels of ER(ER+) were found in 27.5% of the patients, while significant PR levels(PR+) were detected in 40%, PR+ were found in 14(40%) of 35 benign meningiomas but in all of the one atypical and one malignant meningiomas. It appeared with the anaplastic histological features of necrosis or brain infiltration had higher incidence of PR+ than the tumors without them, and the higher the cell proliferative activities, the higher the incidence of PR+PI of two atypical and one malignant menigiomas were rather higher but the number of AgNORs of them were significantly higher than thoes of thirty benign meningiomas(p<0.05). The tumors with the histological feature of mitotic figures had proliferative activities than those without mitotic figures(p<0.05). Thirty-three percent of the benign meningiomas had the PI value higher than 30%, and about twelve percent of the benign meningiomas had the AgNORs greater than 2.5 per cell. a linear correlation was demonstrated between PI and the number AgNORs(r=0.71, p<0.001). These results suggest that antiprogesterone therapy may be of use in treatment of highly proliferative or aggressive meningiomas, and the number of AgNORs showing correction with PI may reflect the cell kinetics well and be of value in predicting recurrence of meningmas and in planning postoperative adjuvant therapy.
Appointments and Schedules ; Brain ; Cytosol ; Estrogens* ; Humans ; Incidence ; Kinetics ; Meningioma* ; Necrosis ; Nucleolus Organizer Region ; Progesterone* ; Receptors, Progesterone* ; Recurrence

OBJECTIVES: Glioblastomas, the most common type of primary brain tumors, are highly invasive and cause massive tissue destruction at both the tumor invading edges and in areas that are not in direct contact with glioma cells. As a result, patients with high-grade gliomas are faced with a poor prognosis. Such grim statistics emphasize the need to better understand the mechanisms that underlie glioma invasion, as these may lead to the identification of novel targets in the therapy of high grade gliomas. Protein kinase C(PKC) is a family of serine/threonine kinases and an important signal transduction enzyme that conveys signals generated by ligand-receptor interaction at the cell surface to the nucleus. PKC appears to be critical in regulating many aspects of glioma biology. The purpose of this study was to assess accurately the role of PKC in the invasion regulation of human gliomas based on hypothesis that protein kinase C(PKC) is functional in the process of glial tumor cell invasion. METHOD: To test this hypothesis, U-87 malignant glioma cell line intracellular PKC levels were up and down regulated and their invasiveness was tested. Intracellular PKC level was characterized using PKC activity assays. Invasion assays including barrier migration and spheroid confrontation were used to study the relationship between PKC concentration and invasiveness. RESULT: The cell line which were treated by PKC inhibitor tamoxifen and hypericin exhibited decreased PKC activity and decreased invasive abilities dose dependently both in matrigel invasion assay and tumor spheroid fetal rat brain aggregates(FRBA) confrontation assay. However, the cell line that was treated by PKC activator 12-O-tetradecanylphorbol-13acetate(TPA) did not exhibit increases in either PKC activity or invasive ability. CONCLUSION: These studies suggest that PKC may be a useful molecular target for the chemotherapy of glioblastoma and other malignancies and that a therapeutic approach based on the ability of PKC inhibitors may be helpful in preventing invasion.
Animals ; Biology ; Brain ; Brain Neoplasms ; Cell Line ; Drug Therapy ; Glioblastoma ; Glioma* ; Humans ; Phosphotransferases ; Prognosis ; Protein Kinase C* ; Protein Kinases* ; Rats ; Signal Transduction ; Tamoxifen

The authors analysed the results of 300 microvascular decompression(MVD) procedures for hemifacial spasm. The follow up period ranged from 6months to 3years. Of these, 70% were women(mean age 54). The vessel most frequently found to compress the facial nerve was the posterior inferior cerebellar artery(43.3%) followed by anterior inferior cerebellar artery(26.7%). For the surgical results, 210 patients(70%) had complete relief of spasm within 3 days after MVD, 65 patients(21.7%) subsequently experienced complete relief, noted in 4 days to 6 months after MVD, ten patients had delayed partial relief and remaining 15 patients showed no improvement. Twelve patients of these 15 unresponsive patients underwent reoperation without beneficial results. Recently the authors have monitored facial elctromyography(EMG) intraoperatively to observe the abnormal late response. There were few cases of permanant major complications, including two cases of ipsilateral hearing loss, ataxia and no operation-related death. These results suggest that MVD is a safe and definite treatment for hemifacial spasm, if performed by experienced surgeon with gentle operative technique, and with intraoperative monitoring such as auditory evoked potential and facial EMG, better surgical results with less complications can be expected.
Ataxia ; Evoked Potentials, Auditory ; Facial Nerve ; Follow-Up Studies ; Hearing Loss ; Hemifacial Spasm* ; Humans ; Microvascular Decompression Surgery* ; Monitoring, Intraoperative ; Reoperation ; Spasm

Two cases of cavernous hemangioma of the cauda equina are presented. Cavernous hemangioma of the cauda equina is rare vascular malformation. This is the fifth and sixth case of cavernous hemangioma of the cauda equina in the literature. These cases are female patients. MRI is more sensitive method than spinal myelography and CT in diagnosis of cavernous hemangioma of the cauda equina. Total removal was possible without immediate post-operative complication.
Cauda Equina* ; Diagnosis ; Female ; Hemangioma, Cavernous* ; Humans ; Magnetic Resonance Imaging ; Myelography ; Vascular Malformations

Although fibromas are the most common renal medullary tumor identified at autopsy. their small sized and benign course make clinical detection extremely difficult. Only 9 clinical cases of renal medullary fibromas have been reported. Many fibromas of the renal medulla, previously considered as bamahomas. seemed to be composed of tumerous transformation of renomedullary interstitial calls Herein we report on a patient with huge renal medullary fibroma treated by right radical nephrectomy.
Autopsy ; Brain Stem Neoplasms ; Fibroma ; Humans ; Nephrectomy

We reported a case of huge cystic trigeminal neurinoma. The patient was 35 year old female with trigeminal nerve dysfunction and hemiparesis. The computed tomography disclosed a huge cystic low density mass at the temporal base and suprasellar cistern that extended to cerebellopontine cistern through the tentorium, and enlargement of Meckel's cave on coronal scan. Through the infratemporal and retromastoid suboccipital approach, the cystic content was aspirated and cyst wall was removed. The cystic change of neurinoma may be due to mucoid degeneration and liquifaction.
Adult ; Female ; Humans ; Neurilemmoma* ; Paresis ; Trigeminal Nerve