AIM: To define the indications of C2 pedicle lag screw or C2 pedicle screw associated with C3 lateral mass screw to treat Hangman fracture, and evaluate the clinical applications. METHODS: Thirty-four patients with Hangman fracture were selected from Changzheng Hospital between February 2000 and December 2004, including 10 patients of type Ⅰ, 12 patients of type Ⅱ, and 8 patients of type Ⅱa, 4 patients of type Ⅲ. Levine-Edwards classification and graded: 2 patients of grade C spinal injury, 12 patients of grade Ds and 20 patients of grade E according to Frankel scale. Patients with typeⅠHangman's fracture were fixed by C2 pedicle lag screw, and patients with typeⅡ, Ⅱa and Ⅲ Hangman fracture were fixed by C2 pedicle screw associate C3 lateral mass screw. Postoperative neurofunctional recovery and fracture healing were studied. RESULTS: A total of 34 subjects were involved in the analysis of results. ① Frankle classification of postoperative neurofunctional recovery: There were 2 cases of grade C, 1 case recovered to grade E, and one case recovered to grade D. There were 12 cases of grade D, including 11 cases of recovered to grade E and one without change. ② In 3-6 months follow-up, X-ray of anterior-posterior and lateral position showed that all fractures healed without loose screw, vertebra artery injury or other complications. CONCLUSION: C2 pedicle lag-screw, C2 pedicle screw associated with C3 lateral mass screw are safe, effective in the treatment of Hangman fracture, which can to retain the function of upper cervical spine as great as possible.

No abstract available.
Fingers*

No abstract available.
Child* ; Hand* ; Humans

OBJECTIVETo observe the effect of activation of aldehyde dehydrogenase 2 (ALDH2) by ethanol on the expression of c-Jun N-terminal kinase (JNK) in the kidney of diabetic rats.

METHODSEightheen healthy male SD rats were randomly divided into 3 groups (n = 6): normal control group, diabetes group and ethanol + diabetes group. After 8 weeks, 24 h urine samples from rats were collected to detect urinary protein content. The kidney was isolated and the ratio of kidney weight/body weight (index of kidney weight) was detected. The levels of fasting blood glucose, glycosylated hemoglobin serum urea nitrogen and serum creatinine were measured. Morphological changes of renal tissue were observed by optical microscope. The protein expressions of ALDH2 and JNK in renal tissue were detected by Western blot.

RESULTSCompared with the normal control rats, the levels of fasting blood glucose, glycosylated hemoglobin, serum urea nitrogen, serum creatinine and the index of kidney weight were increased markedly in diabetic rats. The expression of ALDH2 protein was decreased, while p-JNK, JNK protein expressions and the ratio of p-JNK/JNK were increased. The morphological observation was shown that the amount of glomerular mesangial matrix were increased, basement membrane were thickened and capillary lumen were narrowed. However,in ethanol + diabetes group, renal function was improved and the damage of renal structure was attenuated. The expression of ALDH2 protein was increased, while p-JNK, JNK and the ratio of p-JNK/JNK were decreased.

CONCLUSIONEnhanced ALDH2 expression can protect kidney in diabetic rats, which may be relevant with inhibitting the activity of JNK pathway.

Aldehyde Dehydrogenase ; metabolism ; physiology ; Aldehyde Dehydrogenase, Mitochondrial ; Animals ; Diabetes Mellitus, Experimental ; enzymology ; Ethanol ; pharmacology ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Kidney ; enzymology ; Male ; Mitochondrial Proteins ; metabolism ; physiology ; Rats ; Rats, Sprague-Dawley

Objective To study the effect of fluoride on bone metabolism in rats, and to understand the mechanism of pathogenesis of skeletal fluorosis. Methods A total of 80 Wistar rats were randomly divided into 4 groups that included control group (distilled water), low-dose group(NaF, 50 mg/L), medium-dose group (NaF,100 mg/L) and high-dose group(NaF, 150 mg/L), respectively. After being bred for 12 weeks, the rats were put to death (etherization). Incidence of dental fluorosis was estimated, and serum was collected. Radioimmunoassay was employed to detect the levels of osteocalcin (BGP), parathyroid hormone (PTH) and calcitonin (CT), respectively.Colorimetry method was employed to determine the levels of alkaline phosphatase (ALP) and acid phosphatase (ACP). Results Incidence of dental fluorosis between the four groups was significantly different statistically(x2 =82.81 ,P ＜ 0.01 ). The incidence was significantly different(x2 = 22.67, 40.00, 40.00, all P＜ 0.01 ) between low-dose ( 80%, 16/20), medium-dose ( 100%, 20/20), high-dose groups ( 100%, 20/20) and control group (0,0/20),respectively. Serum levels of BGP, PTH, CT were significantly different between the groups(F = 38.614, 20.778,3.023, P ＜ 0.01 or ＜ 0.05). There was no significant difference between the four.groups of ALP and ACP in serum (F = 0.609,2.895, all P ＞ 0.05 ). Serum BGP in low-dose, medium-dose and high-dose groups[ ( 19.60 ± 12.79),(33.41 ± 10.81 ), (39.46 ± 9.51 )mg/L, respectively] was significantly higher than that of the control group[ (7.35 ± 3.22)mg/L, all P ＜ 0.01 ]. Serum PTH in low-dose, medium-dose and high-dose groups[ (72.27 ± 25.38), (67.80 ± 12.01), (106.52 ± 36.37)pmol/L] was significantly higher than that of the control group[(47.08 ± 9.22)pmol/L,all P ＜ 0.01 ]. Serum PTH of the high-dose group was significantly higher than that of the low-dose and the mediumdose groups(all P ＜ 0.01 ). Serum CT in medium-dose and high-dose groups[ ( 13.39 ± 2.07), ( 15.05 ± 4.77)pmol/L ] was significantly lower than that of the control group[ (26.06 ± 28.31 ) pmol/L, all P ＜ 0.05 ] and also significantly lower than that of the low-dose group [ (24.49 ± 14. 10) pmol/L, all P ＜ 0.05 ]. Conclusions Fluoride affects bone metabolism in rats, BGP, PTH and CT play a key role in the pathogenesis of skeletal fluorosis.

Objective To evaluate the effect of home-made immobilization device with KV-CBCT in lung-SBRT and investigate its clinical use value.Methods Choosing 10 lung tumor patients (half centre type tumor;half peripheral type) random analysis the interfractional and intrafractional setup errors in the SBRT process by this fixed device with KV-CBCT.The concrete method is using Varian's KV-CBCT scans the patients before and after the SBRT each time,then make the registration between the reconstructed 3 d image and the planned CT image (both based on bone landmark),we then obtain the average setup errors in LR,AP and SI directions.Simultaneously,this research make contrastive analysis of setup errors among this fixed device and other fixed devices such as vacuum pad,phantom in body IMRT.All data make one-factor analysis of variance by SSPS 17.0.Results All the setup errors data was gaussian distribution,the centre type interfraction was at (0.01 ±0.32) cm (LR),(-0.08 ±0.38) cm (AP),(0.14 ±0.36) cm (SI) of the cross section,peripheral type interfraction was at (0.01 ± 0.32) cm (LR),(-0.08 ± 0.38) cm (AP),(0.14 ± 0.36) cm (SI) of the cross section (P =0.001).We found out that the average of lung tumor's setup error at all three directions have no significant difference-the largest was the AP directions (P =0.003),the second was the SI direction (P =0.003) and the smallest was the LR direction (P =0.001).The central type has no significant difference at three directions.Compare to the other fixed device,the average setup errors of our device are (0.09 ± 0.33) cm (LR),(-0.10 ± 0.44) cm (SI),(0.17 ±0.35) cm (AP) better than the report at present paper.As the interfraction setup error was small enough by using this fixed device while it has beyond the system algorithm,the registration software of system shows (0.0 ± 0.0 cm).Conclusions The range of lung tumor motion can be cut down obviously and enhance each placement accuracy,repeatability,on SBRT with home-made immobilization device.

Tetanus is a neurologic disease which features the muscle spasm as the hallmark. It is an infectious disease with high mortality rate triggered by tetanospasmin produced by Clostridium tetani. This report concerns incidence of tetanus consequent to oriental medical care such as acupuncture and moxibustion. Although the tetanus occurrence has shown a remarkable decline since nationwide vaccinations in some of the developed countries, including Korea, it still remains to be an important issue, to be dealt within Korea, as the majority of the patients are old aged and Korean population is rapidly becoming an aging society. Furthermore, since more elders are coming to rely on Oriental medicine in Korea, the Korean elders are at a higher risk than elsewhere. The lack of medical experiences, including those in oriental medical field, has been hindering early diagnosis of Tetanus. This study aims to encourage rapid and accurate decisions in diagnosis and treatment through reviewing symptoms particularly specific to tetanus, and also to arouse attention to the riskiness of invasive procedures involving skin puncture.
Acupuncture ; Aged ; Aging ; Clostridium tetani ; Communicable Diseases ; Developed Countries ; Early Diagnosis ; Humans ; Incidence ; Korea ; Medicine, East Asian Traditional ; Metalloendopeptidases ; Moxibustion ; Punctures ; Skin ; Spasm ; Tetanus ; Tetanus Toxin ; Vaccination

Since 1952, Ilizarov external fixator has been developed and used for more than 30 years in Russia and world-wide interest on it has been prevalent during last 2-3 years. The fixation of the tension applied thin wires to the metal frame resist flexional and translational deformity just like other extenal fixators. But, it allows cyclic axial micro-motion at the fracture site without loss of reduction so that it can provide good environment for the fracture healing biologically and biomechanically. Another advantage of Ilizarov external fixator is that it permits mobilization of the adjacent joints and weight bearing of the fractured limb during the application of it and shortens the duration of administration. Since 1988, We applied the Ilizarov external fixator for the treatment of diffcult tibial fractures (open comminuted, segmented and comminuted fractures, nonunion, maunion) and obtained good results in 7 cases. So we report our results even if we had limited cases and experiences.
Congenital Abnormalities ; External Fixators ; Extremities ; Fracture Healing ; Fractures, Comminuted ; Joints ; Russia ; Tibia ; Tibial Fractures ; Weight-Bearing

Osteoporosis is a skeletal condition that is characterized by reduction in bone volume and an increased vulnerability to fracture, practically of the proximal femur and vertebrae. Unfortunately, osteoporosis does not usually become obvious until a patient presents with a fracture. For this reason, it has been referred to as the silent epidemic. While radiological examination remains the mainstay of diagnosis, there are certain disadvantages associated with this technique. Almost one third of the skeletal mass must be lost before osteoporosis becomes apparent on a plain radiograph and radiological artifacts are not uncommon. Many methods have been developed for quantitative assessment. of the skeleton. So osteoporosis can be detected early and its progression and response to therapy can be carefully monitored. Recently, quantitative computed tomography(QCT) has been investigated as a means for non-invasive quantitative determination of bone mineral density of the spine. Highly signifcant correlation have been found between vertebral trabecular mineral amount and quantity determined by QCT. Furthermore vertebral strength and failure load have been found to correlate well with trabecular density determined by QCT. Authors has analysed bone mineral density(BMD) of 213 patients who visited Severance Hospital, Yonsei University College of Medicine from Jan. 1988 to Sept. 1989. The aims of this study is to compare BMD of osteoporosis group with that of mormal group, to investigate correlation between BMD and age distribution, and to estimate fracture threshold in osteoporosis group. Following results were obtained:l. After 20 years of age, men lose an average of 0.83 per cent of bone per year, and women lose an average of 0.96 per cent per year. Such lost in women seems to be accelerated during and after menopause. 2. The bone mineral densities for the osteoporosis group are lower than those for the normal group by 28.4% for male and 29.7% for female. There was little difference between sex. 3. It is suggested that 90mg/cm3 of BMD is the fracture threshold for the osteoporosis group. 4. The compression fracture rate among post-menopausal women is 38.8%.
Age Distribution ; Artifacts ; Bone Density ; Diagnosis ; Female ; Femur ; Fractures, Compression ; Humans ; Male ; Menopause ; Miners ; Osteoporosis ; Skeleton ; Spine

Bone injuries of the extremities can be found in 0.2-2% of all living newborns. The most common location of the fracture was clavicle, and followed by humerus, femur in orders. Fractures of the femur are relatively rare. Authors have analyzed 9 cases of the femoral shaft fractures in the newborns, treated at Severence Hospital from January 1985 to March 1992. Seven cases were born by Cesarean section, two cases were by normal spontaneous vaginal delivery. Vertex presentation were three cases, breech presentation were five cases, and transverse presentation was one case. The mean birth weight was 2.93kg and four cases were born in prematurity. The location of fracture were seven cases in proximal shaft, one case in mid shaft, and one case in distal shaft. The type of fracture were all spiral fracture except two fractures. Five cases were treated by splint and 4 cases were treated by traction method. No further immobilization was needed for 8 cases but two weeks long leg cast after splint was applied for one case. Two cases of complication were noted. Skin necrosis developed due to the traction to the popliteal fossa and minimal anterior angulation of femora, and no functional deficit were found, but bony protrusion of proximal femora were palpated.
Birth Weight ; Breech Presentation ; Cesarean Section ; Clavicle ; Extremities ; Female ; Femur ; Humans ; Humerus ; Immobilization ; Infant, Newborn ; Leg ; Methods ; Necrosis ; Parturition ; Pregnancy ; Skin ; Splints ; Traction