No abstract available.

Reversible posterior leukonecephalopathy syndrome RPLS), a neurologie disorder associated with evidence of posterior cerebral edema on neuroimaging studies, has been described in both adults and children. Conditions predisposing to RPLS include malignant hypertension, renal dysfunction, toxemia of pregnancy, interferon therapy, and the use of immunosuppressive agents. When associated with acute hypertension, RPLS typically occurs concurrently with the fulminant clinical syndrome of hypertensive encephalopathy We describe occipital lobe seizures, in the setting of only moderate elevations of blood pressure, as the major clinical manifestation of RPLS.
Adult ; Blood Pressure ; Brain Edema ; Child ; Humans ; Hypertension ; Hypertension, Malignant ; Hypertensive Encephalopathy ; Immunosuppressive Agents ; Interferons ; Neuroimaging ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Pre-Eclampsia ; Seizures

Slipped femoral capital epiphysis is a rare entity in Korea and only three cases have been reported so far1,2,3). One of our cases was a unilateral mild chronic slip in a 14 year old boy with Frohlich body type. It was treated by gentle closed reduction followed by knowles' pin fixation. The other case, a 20 year old female, presented chondrolysis of the left hip. Scrutinization of roentgenograms revealed typical features of an unrecognized slipped femoral capital epiphysis. It was treated by Wagner resurfacing replacement arthroplasty.
Arthroplasty, Replacement ; Epiphyses ; Female ; Hip ; Humans ; Korea ; Male ; Somatotypes

In order to investigate the mechanism of antibacterial effect of electrical stimulation on bone and joint infection, 5, 50 and 500 µA constant currents were passed through the silver electrodes and stainless electrodes on the Brain Heart Infusion agar culture plates which contained Staphylococcus aureus, Pseudomonas aeruginosa, and Lscherichia coli. After 24 hours of incubation, the widths of inhibitory zone around the electrodes were measured. The broth dilution susceptibility test was also used to verify the antibacterial effects of electrically generated silver in the Brain Heart Infusion broth. The results were as follows. 1. Silver anodes using constant currents manifested antibacterial effects definitely on the three bacterias, but stainless anodes showed none. 2. Antibacterial effects of silver anodes on the three bacterias increased in proportion to current density. However, antibacterial effects were negligible when current density was under 2 nA/mm2. 3. When current density was between 6.6 and 660 nA/mm2, there were no statistically significant differences in the antibacterial effects among 5, 50 and 500µA constant currents. 4. The culture broth containing silver ions generated by constant current electrolysis also manifested antibacterial effects. The retentate showed stronger antibacterial effects than the filtrate. Form these results, following conclusions were drawh. 1. The antibacterial eff ct of silver electrode using constant current was due to silver ions rather than electricity itself. 2. The substance which showed most effective antibactericity effects was silver complex larger than 2,000 m.w. and heat-unstable.
Agar ; Bacteria ; Brain ; Electric Stimulation ; Electricity ; Electrodes ; Electrolysis ; Heart ; Ions ; Joints ; Pseudomonas aeruginosa ; Silver ; Staphylococcus aureus

The purpose of this experiment was to determine the effect of dividing the periosteum circumferentially on the growth of long bones and the effect of partial division of the periosteum on the formation of angular deformity of growing bones and to investigate the tethering effect of the periosteum on the epiphyseal plate as its possible mechanism. One hundred twenty rabbits, one-month old with average weight of 570g, were divided into four groups. In the first group, the periosteum of the right distal femur was completely divided circumfer- entially; in the control group, the medial aspect of the right distal femur was surgically approached but the periosteum was not divided, in the third group, the medial half of the peristeum of the right distal femur was divided transversely; in the fourth group, the medial half of the periosteum was divided and resutured. Following the operation, X-rays were taken every two weeks until twelfth week and then at twentieth week and the length of the femur and the physis-shaft angle were measured. l. After complete circumferential division of the periosteum, the ratios of right over left femoral length before operation, and two, four, six, eight, ten, twelve, and twenty weeks postoperatively, were 100.0±0.0%, 102.1±0.1%, 102.±0.0%, 102.9±0.0%, 103.5±0.0%, 103.6±0.0%, 103.5±0.0%, and 103.5±0.0%, respectively. The overgrowth was most conspicuous during the first two weeks. On the other hand, in the control group there was slight overgrowth, but this was not statistically significant. 2. After partial division of the periosteum, the physisvhaft angles before operation, and two, four, six, eight, ten, twelve, and twenty weeks postoperatively, were 91.0±1.2, 87.8±2.5,84.4±2.4, 83.1±3.2, 84.2±3.5, 86.4±2.3, 86.2±2.3, and 86.8±1.9, respectively. The valgus deformity was induced most conspicuously during the first four weeks, whereas partial correction of the de- formity took place between the eighth and tenth week postoperatively. After repair of the partially divided periosteum, only 0.9 of angular deformity was observed at sixth week, but this became statistically insignificant at tenth week as were in the complete division and control groups. 3. Histologically, no difference was observed in the cartiage cells of the epiphyseal plate and the bony trabeculae of the metaphysis between the control group and other groups. The divided periosteum regenerated at the ninth week, this being same also in the repaired group. There was no statistical difference in the thickness of the epiphyseal plate between the operated femur and the opposite normal femur in the completely divided group, this being same in the control group. Threr was also no statistical difference in the thickness of the epiphyseal plate between the medical and lateral halves in the partially divided group, this being same in the repaired group. Based on these results, the investigator was able to draw following conclusions. 1. In the growing long bone, complete circumferential division of the periosteum near the epiphyseal plate results in stimulation of growth and lengthening of bone. 2. Partial transverse division of the periosteum results in asymmetrical overgrowth, inducing an angular deformity. 3. It is suggested that the mechanism of overgrowth following division of the periosteum lies in the removal of the tethering effect of the periosteum. These findings may bear clinical implications on leg length inequality and angular deformities following certain fractures and epiphyseal injuries during growth period.
Bone Lengthening ; Congenital Abnormalities ; Femur ; Growth Plate ; Hand ; Humans ; Leg Length Inequality ; Periosteum ; Rabbits ; Research Personnel

During the period from 1979 to 1987, bone bridge connecting epiphysis to metaphysis was removed and replaced with a free fat transplant for partial epiphyseal plate closure in 7 patients. Bone bridge resection and free fat interposition was repeated in one patient. Average age of the patients was 9.2 years and sites of epiphyseal plate closure were distal femur in 6 patients and proximal tibia in one patient. The causes of closure were physeal fracture(4), infection(2) and a complication of intramedullary nailing(1). The mean follow-up period was 3 years 9months. Tomograms specifically determine the location and the extent of bone bridge. Successful results which mean spontaneous correction of angular deformity or decreased limb length discrepancy, were obtained in 3 patients. Although deformity recurred or limb length discrepancy was increased somehow, some benefits were obtained in another 2 patients. Benefits from the procedure was negligible or questionable in 2 patients. The poor results were seemingly related to physeal closure following infection and larga size of bone bridge. Bone bridge resection and free fat interposition was considered to be effective method for the treatment of the partial epiphyseal plate closure in the selected cases.
Congenital Abnormalities ; Epiphyses ; Extremities ; Femur ; Follow-Up Studies ; Growth Plate ; Humans ; Methods ; Tibia

PURPOSE: We investigated the efficacy of transurethral needle ablation (TUNA) of prostate for benign prostatic hyperplasia (BPH) in patients with low compliance to medical therapy and high risk operative morbidity and mortality. MATERIALS AND METHODS: Total 38 patients with BPH and low compliance to medical therapy and high risk operative morbidity and mortality were treated with TUNA under the local anesthesia and evaluated prospectively using the international prostate symtom score (IPSS), Qmax, satisfaction score and postvoid residuals (PVRs), and followed for 3 months after treatment. RESULTS: The mean pretreatment symptom score was 24.82+/-5.76. At 1 and 3 months after treatment, the mean symptom score was decreased to 13.63+/-7.07 and 9.21+/-6.28, respectively (p<0.01). The mean pretreatment satisfaction score was 4.63+/-0.85. It was decreased to 2.84+/-1.26, 1.92+/-1.34 at 1, 3 months (p<0.01). The mean pretreatment Qmax was 5.26+/-3.37mL/s. It was increased to 9.53+/-4.54mL/s, 11.97+/-4.52mL/s at 1, 3 months (p<0.01). The mean pretreatment PVRs were 131.85+/-123.05mL. It was decreased to 49.68+/-38.28mL, 26.77+/-17.92mL at 1, 3 months (p<0.01). CONCLUSIONS: TUNA treatment in the management of BPH improved symptom scores, peak flow rates with lower morbidity. TUNA appears to be a useful alternative treatment for BPH in patients with low compliance to medical therapy and high risk operative morbidity and mortality.
Anesthesia, Local ; Compliance* ; Humans ; Mortality* ; Needles* ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Tuna

Great strides have been made not only in the research of the endogenous electrical signals,but also in the clinical application on nonunions using exogenous electrical signals. We measured human skin steady state potentials on the anteromedial surface of the twenty-eight left proximal tibiae and investigated intraosseous induced potentials created by a capacitively coupled signal applied on the proximal tibia of ten rabbits' right hind limbs. Following results were observed: 1. Human skin epiphysio-metaphyseal and epiphysio-diaphyseal potential differences in resting state were 116.1±11.7µV, and 120.5±29.4µV, respectively(P> 0.05), while those in full weight bearing were 310.3±169.4µV, and 404.2±154.1µV, respectively (P<0.05). 2. Skin steady state potentials were affected by muscle contraction and load bearing. 3. Thraugh a sequence of applied voltage of 2, 5, 10, 20, and 30 volts peak to peak, linear increase in the intraosseous induced potentials were produced. 4. Intraosseous induced potentials increased, although their increasing rates being decelerated, with increasing frequencies of 2, 20, 60, 120, and 200 KHz. 5. Higher intraosseous induced potentials were produced,as conductive jelly was applied between the capacitor plates and skin.
Extremities ; Humans ; Muscle Contraction ; Skin ; Tibia ; Weight-Bearing

The purpose of this study is to investigate the effect of lengthening in long bones on the articular carilage by observing the changes in articular cartilage, Fifty-seven rabbits of growing period were divided into four lengthening groups; 5%, 10%, 20%, and 30%. Lengthening by callotasis that was done on the left tibiae and right tibiae were used as control. After lengthening histopathological, histochemical and autoradiographic studies were done on the proximal and distal tibial articular cartilages. That following observations were made. 1. As compared with controls, statistically significant degenerative changes were noted in proximal and distal articular cartilages when the tibiae were lengthened 10% or more. 2. In the proximal joints, the changes were significant between 10% and 20% lenghtening groups, but not between the 20% and 30% lengthening groups. 3. In the distal joints, the changes were significant. Not only were there between 10% and 20% lengtening groups but also there were between 20% and 30% lengtening groups. 4.Degenerative changes were frequently found in the intermediate zone between the periphery and the center, where most of the weight is borne.5. Decrease in matrix content of degenerated articular cartilage was noted by histochemical studies using safranin-0 and Alcian-blue.6. Autoradiography with S04 was done to quantitate matrix content of articular cartilage, and the mean uptake ratio of the articular cartilage was slightly higher than others in the 30% lengthening group. This esuggest decreased matrix synthesis, but no statistical significance was found. Following conclusion were drawn from above observations. 1. In rabbits, tibial lengthening tended to cause microscopic degenerative changes, and the changes begun to appear when the tibiae were lengthened 10% or more. 2. When lengthened over 20%, the changes became more pronounced in the distal joint than in the proximal joint.
Autoradiography ; Bone Lengthening ; Cartilage, Articular ; Joints ; Leg ; Osteogenesis, Distraction ; Rabbits ; Tibia

Epidural nerve block is the most widely practiced procedure in the pain clinic. Accidental dural puncture during epidural nerve block also has been associated with postdural puncture headache and total spinal anesthesia. Especially, total spinal anesthesia is the most serious complication of epidural nerve block and can lead to a life threatening conditions. We have experienced two cases in whom total spinal anesthesia occurred during epidural nerve block for neck and lower back pain control. Immediately after epidural nerve block, the patients became unresponsive and apneic with loss of muscle tone in all extremity. We performed resuscitations and about 3 hours later the patients recovered completely without any complication.
Anesthesia, Spinal* ; Extremities ; Humans ; Low Back Pain ; Neck ; Nerve Block* ; Pain Clinics ; Post-Dural Puncture Headache ; Punctures ; Resuscitation