Recently spondylolysis and spondylolisthesis have become major causes of low back pain in the orthopaedic field and numerous methods have been designed for its treatment. The authors used the LSDS with posterolateral fusion for 12 cases of spondylolisthesis and spondylolysis having low back pain and tenderness, which were operated on during the 4 years from Jan. 1983 to Jan. 1986 at Wallace Memorial Baptist Hospital. The advantages of LSDS with posterolateral fusion are as follows. l. In the case of distraction spondylodesis of interspinous process between L4 and Sl; A. the diameter of intervertebral formaina as well as of the whole spinal canal is widened. B. decompression is accomplished. C. the mechanical stress on the posterior columns of vertebral arch is lessened because the plumb line is anteriorly transferred. 2. Technique of LSDS; the knee-elbow position has the advantages of maximal kyphosis together with expansion of the space between the vertebral arches, as well as a reduction in the tendency to bleed because the blood collects in the abdominal vessels. 3. Internal fixation of grafted bone is not necessary. 4. A large surface area for unit mass of graft is in contact with blood supply. 5. Hypertrophy or displacement of graft can not encroach upon the epidural space; as may occur in certain circumstances following posterior fusion. The results of treatment are follows; l. In the case of improvement of symptoms after facet infiltration and knee-elbow position, satisfa- ctory results after LSDS were obtained. 2. The progression of slipping was not occurred after LSDS. 3. In increased lumbar lordosis, we have noted the instability especially with the changes from the mean values in Fergusons angles. 4. In the slip angle, there is some tendency to the lumbosacral instability correlating with the in- crease in the body weight. 5. We have also noted that the functional result was not closely related with degree of displacement.
Animals ; Body Weight ; Decompression ; Epidural Space ; Hypertrophy ; Kyphosis ; Lordosis ; Low Back Pain ; Lysergic Acid Diethylamide ; Protestantism ; Spinal Canal ; Spinal Fusion ; Spondylolisthesis ; Spondylolysis ; Stress, Mechanical ; Transplants

No abstract available.
Animals ; Locomotion* ; Rats* ; Spinal Cord Injuries* ; Spinal Cord*

Ganglion cyst of the spinal facet joint is rare. It is believed that ganglion cysts on the dorsal aspect of the facet joints are asymptomatic and therefore are not clinically appreciated. But we have experienced a patient who had severe low-back and buttock pain and diagnosed as ganglion cyst located on the dorsal aspect of the right side facet joint between the fourth and fifth lumbar vertebrae. The treatment was surgical excision of the cyst and resulted in a satisfactory recovery. The differential diagnosis involving herniated lumbar intervertebral disc should not exclude ganglion cyst of the dorsal aspect of the lumbar facet joint.
Buttocks ; Diagnosis, Differential ; Ganglion Cysts* ; Humans ; Intervertebral Disc ; Lumbar Vertebrae ; Zygapophyseal Joint*

We have treated the open tibia shaft fractures, especially Gustilo type II, with unreamed interlocking intramedullary nail. In cases combined with soft tissue damage around fracture site, maintaining rigid internal fixation and preserving endoosteal blood supply is important in union of fracture and soft tissue healing. We have analyzed 18 cases of Gustilo type II open tibial shaft fractures managed with intramedullary nailing without reaming since 1991, the follow-up period was average 22 months. Most of the fractures were the result of moderate to high-energy trauma. In all 18 cases, nails were inserted via closed method. Static interlocking nailing was used in all cases. In 16 cases, union of the fracture was achieved from 16 to 25 weeks(average 23 weeks). In the other 2 cases, union was achieved in 7 months. There was no serious postoperative complication except one skin infection with skin defect managed by skin flap and one failure of the interlocking screw. These results are comparable with those obtained from other forms of fixation, including immobilization with a cast, reamed intramedullary nailing, and external fixation.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Immobilization ; Methods ; Postoperative Complications ; Skin ; Tibia

No abstract available.
Adult ; Humans ; T-Lymphocytes

No abstract available.
Female ; Ovary*

No abstract available.
Hematoma* ; Orbit*

No abstract available.
Carcinoma, Squamous Cell* ; Liver*

PURPOSE: This study was attempted to investigate the prevalence of the expression of c-fos protein, TGF-alpha and -beta, PCNA , DNA ploidy pattern and histopathological parameters of giant cell tumor (GCT) of bone and to correlate with prognosis and to extend our understanding on tumorigenesis of GCT. MATERIALS AND METHODS: Twenty eight cases of paraffin-embedded tissue were studied, classified as recurrent (5 cases) and non-recurrent group (12cases) within the limits of the cases which afforded surgical material on first operation. RESULTS: No significant difference was observed in cellularity of stromal cells, atypia of stromal and giant cells, presence of hemorrhage and necrosis between recurrent and non-recurrent group. However, presence of more than 10 mitotic figures in 10 high power fields in recurrent group was significantly higher than non-recurrent group (p<0.05). The immunoreactivity for PCNA was seen only in nuclei of stromal cells, whereas nuclei of giant cells showed negative staining. The positivity of PCNA revealed no significant difference between non-recurrent (mean; 40.9%) and recurrent group (34.4%). The expression of c-fos oncogene was seen in 5 cases (100%) in recurrent group, and 8 cases (66.7%) in non-recurrent group, and no significant difference was seen. No significant difference of expression of TGF-alpha was seen in 5 cases (100%) in recurrent group and in 11 cases (91.7%) in non-recurrent group. The expression of TGF-beta in stromal cells was significantly higher in non-recurrent group (80%) compared to recurrent group (100%) (p<0.05). In DNA analysis out of 18 cases, 4 cases (22.2%) were aneuploidy and 14 cases (77.8%) were diploidy. Among 4 aneuploidy cases, 3 cases (75%) had no recurrence, and 1 case (25%) had metastasis to lung and expired. No significant difference of DNA ploidy pattern was seen between the recurrent and non-recurrent group. CONCLUSION: Presence of more than 10 mitotic figures in 10 high power fields and less expression of TGF-beta are related to higher possibility of recurrence and it is suggested that the number of mitotic figure (more than 10/10HPF) and expression of TGF-beta could be helpful parameters in predicting recurrence of GCT.
Aneuploidy ; Carcinogenesis ; Diploidy ; DNA* ; Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells* ; Hemorrhage ; Lung ; Necrosis ; Negative Staining ; Neoplasm Metastasis ; Oncogenes ; Ploidies ; Prevalence ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Stromal Cells ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors*

Two cases of pseudoglaucoma were presented in this paper, which had been caused by lues and arteriosclerosis. We discussed the pathogenesis of pseudoglaucoma and reviewed the literature. Besides compression of the optic nerve and chiasm, ischemic optic neuropathy due to arteriosclerosis, lues, methanol intoxication, recurrent blood loss. and so forth, may produce optic nerve excavation and visual field defect without increase of IOP. We had much difficulty in explaining Rheese's view of our case, in which the optic canal was irregulary narrowed. We are of the opinion that narrowing of the optic canal may suggest secondary pathologic change due to chronic luetic optochiasmatic arachnoiditis.
Arachnoid ; Arachnoiditis ; Arteriosclerosis ; Methanol ; Optic Nerve ; Optic Neuropathy, Ischemic ; Visual Fields