0.05).CONCLUSION: The angle between the Lo line and IP line (angle of the Lo-IP line) showed no statistically significant difference in both the control and asymmetry groups. Therefore, the Lo line could be used as a horizontal reference plane in CBCT generated PA cephalograms.]]>
Cone-Beam Computed Tomography ; Facial Asymmetry ; Humans

STUDY DESIGN: This is a retrospective study analyzing the results of chip PLIF with pedicle screw instrumentation for various spinal lesions. OBJECTIVES: To analyze the clinical and radiologic results of chip PLIF and to compare the amount of blood loss and transfusion and operation time with the ordinary PLIF. SUMMARY OF LITERATURE REVIEW: The ordinary PLIF has 86-95% of radiologic union rate and 80% of clinical satisfactory rate. The problems of ordinary PLIF were donor site morbidity, limited bone resources, prolonged operation time and excessive blood loss. MATERIALS AND METHODS: Forty patients were treated by chip PLIF utilizing cubical chip bone obtained from spinous process, facets and lamina from October 1995 to October 1997. Twenty-four patients, followed up over 12 months, were included in this study. Radiologic union, disc space collapse and change of kyphotic angle were assessed by simple X-ray and clinical results by improvement of back pain, radicular pain and change of neurological deficits. Twenty-nine patients treated by ordinary PLIF were compared concerning the operation time, amount of blood loss and transfusion. RESULTS: The mean age was 51.5 years(27-68 years) and mean follow-up was 20.7 months(12-30 months). Complete radiologic union rate was 47.6%, which was lower than ordinary PLlf. Satisfactory clinical result rate was 79%, which was similar with other fusion methods. Operation time, amount of blood loss and transfusion were less than the ordinary PLIF. There were three complications that were one dural tear ailed two pedicle screw breakages. CONCLUSION: There was no relationship between radiologic union rate and clinical satisfactory result after chip PLIF. Although operation time is relatively short and blood loss is less, it's not a good method to obtain nice bony union in spinal lesions.
Back Pain ; Follow-Up Studies ; Humans ; Retrospective Studies ; Tissue Donors

Background. Ultimate goal for the treatment of the deformities in the lower extremities is to minimize the energy requirement and conserve the energy on walking and daily living. The normal energy saving mechanism is usually broken down in the patients with the deformities in the lower extremity, and they need more energy consumption. This is the reason why they feel fatigue frequently. It is well known that the deformity in the lower extremity cause excessive energy consumption. Objectives. There is no report that compared the energy consumption according to the deformities of the lower extremity. When we decide the priority of the treatment in cases of multiple deformities, it will be important to understand the energy demand according to each deformity. Therefore, it is the purpose of this study that assess the energy consumption according to the various types of lower extremity deformities. Method. We induced the multiple deformities in ten normal adults with the brace artificially. The induced deformities are as follows: Equinus deformity; mild (10degrees), moderate (20degrees), severe (30degrees), Knee flexion deformity; mild (10degrees), moderate (20degrees), severe (30degrees), Hip flexion deformity; mild (10degrees), moderate (20degrees), severe (30degrees). For the control group, same braces were applied without any deformity. Oxygen consumption was measured for the energy consumption with the Oxygen Consumption Meter (Morgan Oxylog II, Morgan Ltd. England). Heart rate was checked with the Telemonitor (Dynascope, Fukuda Ltd, Japan). We evaluated the inspired volume, oxygen rate, oxygen cost, and heart rate in each group and compared the data among the groups. Result. Energy consumption was higher in the hip deformity group, in the knee deformity group, and in the ankle deformity group in that order. Conclusion. When there are concomitant deformities in hip, knee and ankle, the priority of treatment may be hip, knee and ankle, in that order in terms of energy consumption.
Adult ; Ankle ; Braces ; Congenital Abnormalities* ; Equinus Deformity ; Fatigue ; Heart Rate ; Hip ; Humans ; Joints* ; Knee ; Lower Extremity* ; Oxygen ; Oxygen Consumption ; Walking

PURPOSE: To obtain the findings of normal variant types of lower cervical body configuration for the purpose of differention from compression fracture. MATERIALS AND METHODS: We retrospectively analysed simple true lateral radiographs of cervical spine from C3 to C7 in 157 pediatric patients who did not have definitive clinical symptoms of cervical spinal injury. We classified the variations of normal cervical spine into 5 types by their configuration. In case of rounded upper corner or anteriorly wedged type, we measured the height and the width of vertebral body to classify these types, and undertook ANOVA test and multiple range test to determine the correlation between the gross configuration and the measured values. RESULTS: Type 1 was similarly observed at each of C3 to C7 in age of 1-4 group but the frequency was markedly decreased in age of 5-8 group. Type 2a was frequently observed at both age groups, and its incidence increased considerally at C3 and C4 with advancing age. Type 2b was more frequently observed at C3 body and Type 3 was observed only at C3 body in age group 1-4. Type 4 was markedly increased at 5-8 age group. Type 2b and 3 were seen mostly at C3, but sometimes at C4 body. Height of body was statistically more significant than width of body in classification of type 2a, 2b and 3. CONCLUSION: The configuration of lower cervical spine in infants and children changes from immature oval type(type 1) to mature rectagular type(type 4) with increasing age. Among the 4 types, the rounded upper corner type or anterior wedging type of lower cervical spine should be differentiated from compresson fracture. We concluded that the height of cervical body is more significant than the width of body in simple radiographic classification of types 2a, 2b and 3.
Child* ; Classification ; Fractures, Compression ; Humans ; Incidence ; Infant* ; Retrospective Studies ; Spinal Injuries ; Spine

PURPOSE: Extensor toe signs are neurologic abnormal finding in upper motor neuron impairment, such as spastic diplegia in cerebral palsy. Though classic Babinski sign is widely used, many other methods elicit extensor toe signs are used as substitutes. However, these methods are not tried whether they are clinically valuable or not. So, we carried out these methods to spastic cerebral palsy patients, compared the sensitivities of these extensor toe sign tests and estimated their clinical value. METHODS: From April, 2000 to August, 2001, thirty patients who had been diagnosed spastic cerebral palsy at Chungnam National University Hospital were tested for extensor toe signs at restful supine position. The sensitivity of every extensor toe sign was compared with each other. RESULTS: The sensitivity of Babinski sign is 76%, Gonda-Allen sign 86%, Allen- Cleckley sign 63%, Chaddock sign 63%, Oppenheim sign 50%, Gordon sign 22% and the others less than twenty percent. Although the sensitivity of Gonda-Allen sign is higher than Babinski sign, it is not statistically significant. But these two methods are superior than the others. CONCLUSION: In patients having upper motor neuron impairments, Gonda-Allen sign and classical Babinski sign are more useful and more sensitive than the other tests, which elicit of extensor toe signs.
Cerebral Palsy* ; Child* ; Chungcheongnam-do ; Humans ; Motor Neurons ; Reflex, Babinski ; Supine Position ; Toes*

Albright's hereditary osteodystrophy is an inherited syndrome that encompasses endocrinologic anomaly of pseudohypoparathyroidim or less commonly, pseudo-pseudohypoparathyroidism and various physical stigmata such as mental retardation, short stature, skeletal anomaly of the hands, abnormal dentition, round facies, and osteoma cutis. Primary osteoma cutis in this syndrome presents at birth or in early infancy, preceding most of the other manifestations. This case is a typical presentation with osteoma cutis as the sole initial manifestation. Rather unfamiliar to dermatologists, Albright's hereditary osteodystrophy still deserves to be included in the differentials when an isolated case of osteoma cutis presents in a young child.
Child ; Christianity ; Dentition ; Facies ; Hand ; Humans ; Intellectual Disability ; Osteoma* ; Parturition ; Pseudopseudohypoparathyroidism

Golf is low demanded activity and becoming more popular. But it often occur problems in back, shoulder, elbow and wrist. Golf injuries in professional golfer are related overuse and frequency, while in amateur are related wrong swing technique. Also muscle activities in swing are different between professional and amateur. We report partial tear of pronator teres in middle aged amateur golfer with literatures.
Elbow ; Golf ; Humans ; Middle Aged ; Muscles ; Shoulder ; Wrist

The presence of erythroblasts within Kupffer cell was studied for transmission electron microscopically with 5 human fetal livers from 11 to 23 weeks of gestation during the high activity of hepatic hemopoiesis. By using continuous series of thin sections electron microscopically, the objective of the present study was to evaluate the relevance between a migrated erythroblast and a Kupffer cell, and the migration of erythroblasts within Kupffer cells in the sinusoidal lumen. During the examined period the sinusoidal wall consisted of endothelial cells and Kupffer cells, being deficient in basement membrane. Erythropoietic cell-Kupffer cell interaction was often found as the emperipolesis and adhesion between the cells in human fetal liver under electron microscopy. The cytoplasm of the emperipoletic Kupffer cell contained several mitochondria, rough endoplasmic reticuli, clear vesicles, electron dense bodies, cellular debris with shrunken chromatin of enucleated nuclei, intact enucleated nuclei, and erythroblast bearing vacuoles as intact erythroblasts. Intracellular erythroblasts in the Kupffer cell remain unaltered with their normal structure and showed mitosis, enucleation and migration of erythroblast into the sinusoidal lumen. And a clear zone of a vacuole was readily seen around the intracellular erythroblast within Kupffer cell. On occasion, the hypertropic Kupffer cell with interacellular erythroblasts virtually occluded the sinusoidal lining cell. Processing of a migrating emperipoletic erythroblast within a Kupffer cell, the erythroblast migrated via migration pore through the luminal cell membrane of the Kupffer cell into the sinusoidal lumen. An invasion of a proerythroblast into Kupffer cell or a migration of the cell into the sinusoidal lumen had been found in human fetal liver from 11 to 13 weeks of gestation. The results demonstrate that migration of emperipoletic erythroblasts within Kupffer cells occurs in human hepatic hemopoiesis. We suggest that emperipolsis may be one of the mechanisms that support the maturation of erythroblasts in human fetal liver.
Basement Membrane ; Cell Communication ; Cell Membrane ; Chromatin ; Cytoplasm ; Emperipolesis ; Endothelial Cells ; Erythroblasts* ; Humans* ; Kupffer Cells* ; Liver ; Microscopy, Electron ; Mitochondria ; Mitosis ; Phenobarbital ; Pregnancy ; Vacuoles

0.05). Amnesia during local injection was observed in eight patients (34.8%). Compared with the preoperative anxiety score, the intraoperative anxiety score was decreased.CONCLUSION: In this study, we found cardiovascular and respiratory stability in intravenous sedation using dexmedetomidine with pethidine, in plate and screw removal, after orthognathic surgery. Furthemore, intravenous sedation using dexmedetomidine with pethidine shows adequate analgesic and sedative effects.]]>
Amnesia ; Anxiety ; Arterial Pressure ; Blood Pressure ; Dexmedetomidine ; Heart Rate ; Humans ; Hypnotics and Sedatives ; Meperidine ; Orthognathic Surgery ; Oxygen

Multiple coronary arteries to communicating with the left ventricular fistulae is a very rare congenital anomaly in adults. This anomaly involves three major coronary arteries that have a direct communication between these arteries and the left ventricle. Hemodynamically, it induces myocardial ischemia due to coronary steal syndrome and diastolic volume overload from a left-to-left shunt. A 70-year-old woman with essential hypertension was admitted to our clinic to evaluate complaints of exertional dyspnea. Clinical examination revealed a diastolic murmur at the apex. A coronary angiogram showed a common fistular channel connecting the right coronary artery, the left circumflex coronary artery, and the first large diagonal branch of the left anterior descending coronary artery with the left ventricular chamber. The patient's symptoms were relieved by the administration of calcium channel blocker and angiotensin II receptor blocker. We report a very rare case of three major coronary arteries communicating to the left ventricular fistulae via a common channel.
Adult ; Aged ; Arteries ; Calcium Channels ; Coronary Vessel Anomalies ; Coronary Vessels* ; Dyspnea ; Female ; Fistula* ; Heart Murmurs ; Heart Ventricles ; Humans ; Hypertension ; Myocardial Ischemia ; Receptors, Angiotensin