No abstract available.
Diabetes Mellitus, Type 1* ; Immunogenetics* ; Korea*

The cells of anulus fibrosus(AF) and nucleus pulposus(NP) of intervertebral disc are thought to be different in their cell components and in their roles during degeneration. The purpose of this study was to evaluate the differences between the cells of AF and NP when lactate was added to the culture medium. After the monolayer culture of cells from the AF and NP of a rabbit was set up, the cells were divided into three groups and lactate doses of a OmM, 2mM or 5mM were added respectively. The production of interleukin-1(IL-1) and stromelysin were measured by RT-PCR and Southern blot- ting. Both cells of NP and AF produced IL-1. The Southern blot showed that the AF cells produced more IL-1. Stromelysin was produced in both NP cells and AF cells. AF cells produced more stromelysin during the culture and the production of NP cells decreased during the culture. These results suggest that fibroblast-like cells composed of AF are more tolerable of lactate and are more active in production of IL-1 and stromelysin under exposure to lactate. As a result, AF cells are thought to have an important role in intervertebral disc degeneration through the production of IL-1 and stromelysin.
Blotting, Southern ; Cell Culture Techniques ; Cellular Structures ; Interleukin-1 ; Interleukins* ; Intervertebral Disc Degeneration ; Intervertebral Disc* ; Lactic Acid ; Matrix Metalloproteinase 3* ; Spine ; Tolnaftate

The fractures which develop from a already structually damaged or weakened bones are called pathologic fracture and it can be caused by many different diseases. The way of treatment and prognosis of these pathologic fractures differ in many ways according to causative factors. So, regarding frature that developes without definite history of trauma, one shoud approach them with concepts of pathologic fracture. In the cases of pathologic fracture caused by metastatic bone tumors, physicians are employing more aggressive methods of treatment these days. Authors have analysed 87 cases of pathologic fracture who were admitted to department of orthopedic surgery, Severance Hospital during the period of 10 years(from Jan. 1976 to Dec. 1985). Those cases of osteoporosis were all excluded from the study. The conclusion were as follows : 1. There were no discrepancies regarding sexes but 69% of patients were over forty years of age. 2. Fifty percent of pathologic fracture were fractures of femur. 3. Most common causes were metastatic bone tumors(55%), and 36% of these were with unknown primary lesions. 4. In the cases that were caused by metastatic bone tumor, sugical treatment was performed on 46% of these cases. And most cases of patients who were treated with surgical methods improved in pain and ambulation state, especially in patients with use of bone cement.
Femur ; Fractures, Spontaneous ; Humans ; Orthopedics ; Osteoporosis ; Prognosis ; Walking

No abstract available.
Epilepsy* ; Vigabatrin*

Anterior plate fixation of the cervical spine provides good primary stability to allow early mobilization without significant external support. Despite the obvious advantages of anterior cervical fixation, neurological injury resulting from the direct trauma of a drill bit or screw are possibile with this technique. In addition, screw loosening leading to dyphagia has been reported. The cervical spine locking plate (CSLP) system maintains the mechanical advantages of internal fixation and eliminate the neurological risks of perforating the posterior cortex. The purpose of this study is to review our experience with this device, to critically assess its ability to stabilize the cervical spine, and to assess for complications associated with this device. The authors reviewed 28 consecutive patients in whom the CSLP system was applied between April 1994 to April 1995. Average age was 44 years ranged from nineteen to seventy-two. Patients with trauma were eight and degenerative diseases were twenty. Eighteen screws were inserted in C3 bodies, twenty-four in C4, forty-one in C5, thirty-six in C6, twenty-four in C7, two in Tl and nine on grafted bone. With a mean follow-up of 15 months, 27 of 28 patients went on to fusion. Mean time to fusion was three months (range 2-5). Fusion status of one patient was considered as uncertain. Three patients had screws placed in the disc rather than in bone. One patient suffered deep wound infection, which developed to tracheoesophagial fistula. No patient showed neurological injury as a result of this device.
Early Ambulation ; Fistula ; Follow-Up Studies ; Humans ; Spine* ; Transplants ; Wound Infection

In the investigation of patients with internal disc disruption, a discography has been the best method to decide whether intervertebral disc is normal or abnormal. Magnetic resonance imaging (MRI) of the spine is a new technique which offers an alternative method of obtaining this information. Some authors have reported MRI was more accurate than discography, but other reports have indicated discography was more useful test in symptomatic lumbar disc disease. The authors performed retrospective study to evaluate the diagnostic value of the image findings of MRI and discography in the internal disc disruption. Image findings of MRI and discography were analyzed comparing to pattern of provocative pain during discography. The concordant pain at discography was considered as a gold standard for evaluation of the diagnostic value of these modalities. The image findings of MRI and discography for 60 discs of 21 patients were graded and compared with the pain response at discography. The validity and predictive value (PV) of these modalities were calculated and the correlation between these image findings was evaluated. The sensitivities of discography and MRI were 83.3% and 90.9% respectively. The specificities of these findings were 47.1% and 46.7%. The positive PV of discography and MRI were 52.6% and 55.6%, and the negative PV were 80% and 87.5% respectively. There was no statistical significance in these discrepancies. The determinations of symptomatic disc level based on image findings are unreliable. The MRI can be considered as a screening test for internal disc disruption since it is non-invasive and sensitive diagnostic tool. The fusion level should be decided by the pain pattern at discography.
Humans ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Mass Screening ; Retrospective Studies ; Spine

The Marjolin's ulcer is the malignant lesion developed in a burn scar or chronic fistula. Due to the low prevlalence of this lesion, there has been disagreement in its clinical features, methods of treatment, and prognosis. We evaluated 19 cases of patients who had been admitted to Severence Hospital from Jan. 1970 to Dec. 1958. The results were as follows : 1. The previous lesion was burn scar in 52% of the cases and fistula of chronic osteomyel-itis in 32%. 2. The mean latent period was 31.5 years. 3. The initial symptoms were increased pain(74%), discharge with foul odor(68%) and bleeding(58%). 4. Upon histological examination, all of the cases were squamous cell carcinoma. 5. The rate of recurrence of metastasis at time of diagnosis was 32%. 6. Of the 16 patients treated by surgery, local recurrence was noted in 4 cases. Three of these cases were patients who had been treated by excision and split thickness skin graft. 7. The time interval for local recurrence ranged from 6 months to 11 months(average 8. 8 months). In conclusion, the squauious cell carcinoma of the Marjolin's ulcer seems to have a worse prognosis than other squamous cell carcinoma and it requres aggressive treatment. The burn scar or chronic fistula that occured in elderly patients especially required more adequste treatment and close observation.
Aged ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Clinical Study ; Diagnosis ; Fistula ; Humans ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Skin ; Transplants ; Ulcer

Beyond the usual age of walking, the dysplasia of dislocated hip has become severe and its reversivility limited so that the reduced hip cannot maintained in stable position. The innominate osteotomy redirect cartilage of the hip and provide stability in the functional position of walking. The author have experienced 45 cases out of 42 patients with congenital dislocation of the hip who were treated by innominate osteotomy at Department of Orthopedic Surgery College of Medicine Yonsei University from Jan. 1979 to Dec. 1986. The analysis of result of operation has been Jan. 1979 at least 18 months follw-up study. 1. The mean age was 4.2 years ranging fron 18 months to 14 years.2. The mean value of parameters in preoperative evaluation, acetabular index was 37°, neck shaft angle 146°, CE angle −64° and leg length discrepency 1.5cm. After operation, actabular index was 20°, neck shaft angle 137° and CE angle 39° in average. And operated limb was longer as 0.5cm in average. 3. By anatomical assessment of NcKay, 17 cases were graded excellent, 19 cases good, 7 cases fair and 2 cases poor. Especially among the patients above 6 years old, only 6 cases were graded excellent or good. 4. As to the post-operative complication, limitation of motion was noted in 4 cases, redislocation in 2 cases, subluxation in 1 cases, avascular necrosis of femoral head in 1 case and infection in 1 case.
Acetabulum ; Cartilage ; Dislocations ; Extremities ; Head ; Hip ; Humans ; Leg ; Neck ; Necrosis ; Orthopedics ; Osteotomy ; Walking

No abstract available.
Humans ; Hypocalcemia* ; Infant, Newborn ; Prognosis*

STUDY DESIGN: Thirty-eight patients with thoracolumbar and lumbar burst fractures were evaluated according to the treatment methods of the retropulsed fragments. OBJECTIVE: To confirm the pure effect of ligamentotaxis according to the approaching methods to tile involved area. SUMMARY OF BACK GROUND DATA: Retropulsed fragments were effectively treated by indirect posterior reduction. Regardless of size of the retropulsed fragments, remodelling process of the retropulsed fragments was progressed during follow-up period. METHODS: 38 patients with burst fractures of thoracolumbar and lumbar spine were divided into two groups according to tile reduction method of the retropulsed fragments ; the one group consisted of 18 cases which were treated by posterior instrumentation and indirect reduction(Group I: ligamentotaxis) and the other groups consisted of 20 cases which were treated by posterior instrumentation and posterior direct reduction(Group II). Change of neural canal compromise rate, neurologic status, remodelling process of the retropulsed fragments were measured using pre-, post-operative and follow-up radiographs and CT. RESULTS: Comparing the two groups, neural canal compromise rates were decreased at postoperative period but, there were no significant differences in both groups. There were no correlation of neurologic status and neural canal compromise rate. We could confirm the remodelling process of the retropulsed fragments, but there were no significant changes according to the size of the retropulsed fragments between two groups. CONCLUSIONS: Indirect reduction by posterior instrumentation( ligamentotaxis ) could effectively treat the retropulsed fragments in burst fractures of thoracolumbar and lumbar spine without directs posterior reduction.
Follow-Up Studies ; Humans ; Neural Tube ; Postoperative Period ; Spine