Refractory deformity in ankylosing spondylitis is caused by loss of normal lordotic curvature in lumbar spine. For the correction of deformity, monosegmental osteotomy, intracorporal decancellation and multisegmental osteotomy are used. Among them, multisegmental osteotomy is reported to be safe because of its small correction amount at each level. Since 1989, authors treated 5 cases of ankylosing spondylitis with severe kyphotic deformity by multisegmental osteotomy and transpedicular instrumentation. All were young males between 22 and 35 years of age. Preoperative kyphotic deformity was 80°, 105°, 72°, 35°, 55° (Av. 70°) and amount of correction was 55°, 105°, 72°, 20°, 40° (Av. 58°) respectively. Levels for osteotony were 4 to 8 segments and correction at a level was 5° to 13° (Av. 8.3°). Normal standing upright posture and vision for straight forward were obtained in all. Instrumentation was Zielke in three Cotrel-Dubousset in two. One case of Zielke instrumentation showed rod failure. However, all showed solid bony union without any loss of correction or pseudoarthrosis. From the above experience, multisegmental osteotomy for the treatment of kyphotic deformity in ankylosing spondylitis was believed to be a safe and effective method of treatment.
Congenital Abnormalities ; Humans ; Male ; Methods ; Osteotomy ; Posture ; Pseudarthrosis ; Spine ; Spondylitis, Ankylosing

No abstract available.
Gangwon-do* ; Humans

Centrifuge high +Gz training has been reported to provoke cardiac arrhythmias in ostensibly healthy individuals, and ECG monitoring of aircrew undergoing such training is recommended for their safety. However, there are few reports about ECG responses during actual high +Gz flight. Therefore, we start this study to determine the ECG responses during actual high +Gzz flight of F-5. In our study, twenty-four pilots, ages 25-37 and one Flight Surgeon were monitored by Holter ECG monitor for four hours, which included periods before, during, and after either a high +Gz or low +Gz flight in a F-5, Actual flight times ranged from 28-78 minutes. Sixteen(16) pilots were monitored in both high +Gz (>5Gz) and low +Gz (<3Gz) flight, the flight surgeon and seven(7) pilots were monitored only in high +Gz flight, one pilot was monitored only in low +Gz flight. Heart rate(HR) and cardiac rhythm were evaluated during a total of 41 flights. During the high +Gz flight, there was one episode of visual black out and dyspnea, three episodes of gray out, and one episode of fatigue. During the low +Gz flight, there were two episodes of coughing. The frequency of occurrence of Ventricular Ectopic Beats (VEs) (Premature Ventricular Contractions (PVCs), especially in-flight VEs(PVCs), was significantly higher in pilots who hart symptoms during the flight as compared to pilots who had no symptoms in one pilot, we recorded 16 VEs (PVCs) over the four houris wlth 10 VEs occurring during the flight. Another pilot experienced 254 Supraventricular ectopic beats (SVEs)(Premature Atrial Contractions (PVCs) or Premature Junctional Contractions (PVCs)) with a total of 87 SVEs recorded during the flight. In high +Gz flight, there were, overall, twelve (12) cases of VEs and fifteen (15) cases of SVEs. In low +Gz flight, there were four (4) cases of VEs anti ten (10) cases of SVEs. In addition, We correlated the HR 30 minutes before flight (range of 52-117 bpm) with maximum in-flight HR (range of 92-178 bpm). We found that the maximum HR during the flight was lower with increased pilot's experience (i.e., age and total flight time). There was no significant difference noted in HR and cardiac arrhythmias when comparing high +Gz and low +Gz flight. During the high +Gz flight, stress may cause symptoms with minor cardiac arrhythmias. Further studies shou1d be done to better correlate the exact relationship and timing between onset of +Gz forces, arrhythmias, and occurrence of adverse clinical symptoms.
Arrhythmias, Cardiac ; Cough ; Dyspnea ; Electrocardiography* ; Fatigue ; Heart ; Ventricular Premature Complexes

OBJECTIVE: The purpose of this study was to evaluate the reproducibility of measurements representing asymmetry of the mandible and to identify which landmarks would be more useful in 3-dimensional (3D) CT imaging. METHODS: Facial CT images were obtained from forty normal occlusion individuals. Eighteen landmarks were established from the condyle, gonion, and menton areas, and 25 measurements were constructed to represent asymmetry of the mandible; 8 for ramus length, 12 for mandibular body length, 1 for condylar neck length, 2 for frontal ramal inclination, and 2 for lateral ramal inclination. Inter- and intra-examiner reproducibility of the measurements was evaluated. RESULTS: Inter-examiner reproducibility of the measurements proved to be high except for 3 measurements. Intra-examiner reproducibility also proved to be high except for 2 measurements. Inter- and intra-examiner reproducibility of the measurements including Gonion proved to be low. CONCLUSIONS: The results of the present study indicate that the landmarks and measurements constructed in 3D CT images can be used for the diagnosis of facial asymmetry.
Facial Asymmetry ; Mandible ; Neck

No abstract available.
Gangwon-do* ; Humans ; Norovirus* ; Sequence Analysis*

Meconium peritonitis is a non-bacterial foreign body and chemical peritonitis caused by meconium contamination resulting from bowel perforation during late intrauterine or early neonatal periods. Prenatal ultrasonographic diagnosis of the meconium peritonitis provides the preparation for proper management and decreasing motality and morbidity of the neonate. We have experienced a case of meconium peritonitis diagnosed by ultrasonography at 34+4 gestational weeks and presented this case with a brief review of the literatures.
Diagnosis ; Foreign Bodies ; Humans ; Infant, Newborn ; Meconium* ; Peritonitis* ; Ultrasonography ; Ultrasonography, Prenatal*

Because primary antifungal prophylaxis is widely used for immunocompromised hosts, the incidences of unusual fungal infections have increased. Trichosporon asahii has emerged as an important life-threatening opportunistic systemic pathogen because of the increased use of cytotoxic or immunosuppressant agents, along with high mortality rates. Here, we describe a case of catheter-related T. asahii bloodstream infection with multiple septic skin nodules in both the arms and legs of the patient who was in the neutropenic period after allogeneic stem cell transplantation for myelodysplastic syndrome treated with prophylactic ciprofloxacin and itraconazole. We successfully treated her with intravenous voriconazole for more than a month without any complications. Clinicians should consider breakthrough Trichosporon infections when clinical progress in an immunocompromised patient with unexplained infection signs and symptoms does not improve despite proper treatment with antibiotics or various antifungal agents. In addition, voriconazole can be a good treatment choice for achieving better treatment results and prognosis.
Anti-Bacterial Agents ; Antifungal Agents ; Arm ; Catheter-Related Infections ; Ciprofloxacin ; Fungemia ; Humans ; Immunocompromised Host ; Incidence ; Itraconazole ; Leg ; Mortality ; Myelodysplastic Syndromes* ; Prognosis ; Skin ; Stem Cell Transplantation ; Trichosporon* ; Voriconazole

Because primary antifungal prophylaxis is widely used for immunocompromised hosts, the incidences of unusual fungal infections have increased. Trichosporon asahii has emerged as an important life-threatening opportunistic systemic pathogen because of the increased use of cytotoxic or immunosuppressant agents, along with high mortality rates. Here, we describe a case of catheter-related T. asahii bloodstream infection with multiple septic skin nodules in both the arms and legs of the patient who was in the neutropenic period after allogeneic stem cell transplantation for myelodysplastic syndrome treated with prophylactic ciprofloxacin and itraconazole. We successfully treated her with intravenous voriconazole for more than a month without any complications. Clinicians should consider breakthrough Trichosporon infections when clinical progress in an immunocompromised patient with unexplained infection signs and symptoms does not improve despite proper treatment with antibiotics or various antifungal agents. In addition, voriconazole can be a good treatment choice for achieving better treatment results and prognosis.
Anti-Bacterial Agents ; Antifungal Agents ; Arm ; Catheter-Related Infections ; Ciprofloxacin ; Fungemia ; Humans ; Immunocompromised Host ; Incidence ; Itraconazole ; Leg ; Mortality ; Myelodysplastic Syndromes* ; Prognosis ; Skin ; Stem Cell Transplantation ; Trichosporon* ; Voriconazole

OBJECTIVE: Vitrification requires a high concentration of cyroprotectant (CPA) and an elevated cooling speed to avoid ice crystal formation. We have evaluated the effect of different combinations of cooling rate and CPA on embryonic integrity (developmental competence) in order to increase the efficiency of vitrification without impairing embryo viability. We hypothesized that the combination of CPA or the increase of cooling rates can reduce the concentration of toxic CPA for vitrification. As consequently, we performed experiments to evaluate the effect of various composition of CPA or slush nitrogen (SN2) on the mouse embryonic development following vitrification using low CPA concentration. METHODS: Vitrification of mouse embryos was performed with EM grid using liquid nitrogen (LN2) or SN2 and different composition of CPAs, ethylene glycol (EG) and dimethylsulfoxide (DMSO). After vitrification-warming process, their survival and blastocyst formation rates were examined. For analyzing long-term effect, these blastocysts were transferred into the uterus of foster mothers. RESULTS: Survival and blastocyst formation rates of vitrified embryos were higher in EG+DMSO group than those in EG only. Furthermore, the group using SN2 with a lower CPA concentration showed a higher survival of embryos and developmental rates than group using LN2. CONCLUSION: The combination of EG and DMSO as CPAs may enhance the survival of mouse embryos and further embryonic development after vitrification. SN2 can generate high survival and developmental rate of vitrified/warmed mouse embryos when a lower concentration of CPA was applied. Therefore, these systems may contribute in the improvement of cryopreservation for fertility preservation.
Animals ; Blastocyst ; Cryopreservation ; Dimethyl Sulfoxide ; Embryonic Development ; Embryonic Structures ; Ethylene Glycol ; Ethylenes ; Female ; Fertility Preservation ; Ice ; Mental Competency ; Mice ; Nitrogen ; Pregnancy ; Uterus ; Vitrification

PURPOSE: To evaluate the 3 to 8 year follow-up clinical and radiological results after NexGen(R) total knee arthroplasty (TKA). MATERIALS AND METHODS: Ninety-six knees in 75 patients, who could be followed up more than 3 years after NexGen(R) TKA [cruciate retaining (CR) type:34, posterior cruciate substituting (PS) type:62] from March 1997 to May 2002, were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), Knee Society Score (KSS), knee functional score, tibiofemoral angle and postoperative complications. RESULTS: The ROM increased from preoperative mean flexion contracture of 9.3 degrees and further flexion of 116.4 degrees to a postoperative mean flexion contracture of 2.1 degrees and further flexion of 126.3 degrees (ROM: 124.2 degrees). The ROM of CR type improved from 112.7 degrees to 123.1 degrees, and the PS type improved from 105.3 degrees to 124.9 degrees (p>0.05). The KSS and knee function score improved from 54 and 41 before surgery to 94 and 87 after surgery, respectively (p>0.05). The tibiofemoral angle changed from preoperative varus 5.7 degrees to postoperative valgus 5.2 degrees. The complications were two cases of infection and two cases of early loosening. CONCLUSION: The 3 to 8 year follow-up results after NexGen(R) TKA were satisfactory in both the CR and PS types. However, a longer term follow-up evaluation will be necessary.
Arthroplasty* ; Contracture ; Follow-Up Studies* ; Humans ; Knee* ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies