The results of surgical treatment for isthmic spondylolisthesis in children and adolescent have been well documented. Successful clinical results with fusion can be expected in children and adolescent. But in adults, instability was not the only problem. In addition to their instability, adults were more likely to have degenerative disc changes and nerve compression not solved by fusion only. The role of decompression in the surgical treatment of adult isthmic spondylolisthesis remains controversial. Anterior interbody fusion could obtain indirect decompression of nerve root through widening of intervertebral space. Posterolateral fusion with transpedicular fixation could get direct decompression. So, the purpose of this study is to compare the clinical results of the anterior interbody fusion and the posterolateral fusion with transpedicular fixation for the treatment of isthmic spondylolisthesis in adults. We reviewed the clinical data of 40 adult patients who had been taken operation due to isthmic spondylolisthesis from June, 1977 to June, 1994. The anterior interbody fusion was performed in 20 patients (Group I) and the posterolateral fusion with transpedicular fixation was performed in 20 patients (Group II). The mean age of group I was 44.1 years old (21-62), and that of group II was 41.3 years old (21-57). The gender of patients was 8 males and 12 females in group I, and 5 males and 15 females in group II. The symptoms and signs of group I and II were similar. The duration of follow-up was average 3.6 years (1.1-16 years) in group I and average 2.3 years (1.1-6 years) in group II. The anterior slippage of group I by Taillard method was 16.1% and was corrected into 10.4% after opera-up was average 3.6 years (1.1-16 years) in group I and average 2.3 years (1.1-6 years) in group II. The anterior slippage of group I by Taillard method was 16.1% and was corrected into 10.4% after operation. That of group II was 15.2% and corrected into 9.8% after operation. The fusion rate at 12 months after operation was 90% in group I and 95% in group II. The clinical results were analysed by Kim's criteria that was focused on the improvement of clinical symptoms. The satisfactory results were obtainted in 85 % of group I and 90 % of group II. So there was no significant difference of clinical results between the anterior interbody fusion and the posterolateral fusion with transpedicular fixation for the treatment of isthmic spondylolisthesis in adults (p<0.05).
Adolescent ; Adult* ; Child ; Decompression ; Female ; Follow-Up Studies ; Humans ; Male ; Spondylolisthesis

No abstract available.
Humans ; Ilium* ; Tissue Donors*

Growth factors influencing the function of chondrocytes are insulin-like growth factor I(IGF-I), basic fibroblast growth factor(bFGF), transforming growth factor-beta1(TGF-beta1), and epidermal growth factor(EGF). To find out the role of four kinds of growth factors in the biosynthesis of type I and II collagen represented as the phenotype of the disc cells, we cultured the disc cells isolated from rabbit intervertebral discs primarily and then checked cell proliferation, the expression of type I and II procollagen mRNA, and the immunohistochemical stains with type I and II collagen antibodies during in vitro culture in the maintenance medium containing low serum concentration with adding four kinds of growth factors. The results are as follows. FBS(10% Fetal bovine serum) group showed the highest cell proliferation potential. EGF and TGF groups showed remarkable cell proliferation, but there was no significant difference in IGF and FGF groups comparing to control group. A partial clone that encodes the rabbit type II procollagen C-propeptide region(RbCo12A1) was successfully isolated by reverse transcription-polymerase chain reaction using total RNA extracted from articular chondrocytes of rabbits. The identity of the cDNA clone was confirmed by DNA sequencing of the polymerase chain reaction products. A comparison of human al(II) cDNA sequence showed high sequence homology(83.6%). Type I procollagen mRNA expressed highly in EGF group. FGF, IGF, and TGF groups showed no significant expression comparing to control group. FBS group showed lower expression than control group. Type II procollagen expression was increased with passage of time, so at Day 10 it was the highest in all groups. Control group showed the highest expression among 6 experimental groups. The expression of type II procollagen in FGF and TGF groups was slightly lower than that of control. EGF and IGF groups showed markedly decreased expression comparing to control group. That in FBS group was the lowest, so it was three times lower than control group. In immunohistochemical stains with type I collagen, there was no difference among control, FBS, and EGF groups. FGF, IGF, and TGF groups showed increased positivity on stain comparing to control group, but the positivity didnt exceed 10%. For type II collagen, EGF and FGF groups showed decreased positivity, but there was no significant difference in FBS, IGF, and TGF groups comparing to control group. On the basis of this study, it may be concluded that TGF-pl showed the possibility of regeneration or delay the degeneration process of the intervertebral disc through the contribution to the stimulatory effects of cell proliferation and the synthesis of type II collagen. For the clinical use of this, more studies about the combination effects with FBS or other kinds of growth factors and finding out the ideal concentration about TGF-pl will be needed.
Antibodies ; Cell Proliferation ; Cells, Cultured* ; Chondrocytes ; Clone Cells ; Collagen Type I ; Collagen Type II ; Collagen* ; Coloring Agents ; DNA, Complementary ; Epidermal Growth Factor ; Fibroblasts ; Humans ; Intercellular Signaling Peptides and Proteins* ; Intervertebral Disc* ; Phenotype ; Polymerase Chain Reaction ; Procollagen ; Rabbits ; Regeneration ; RNA ; RNA, Messenger ; Sequence Analysis, DNA

No abstract available.
Spondylolisthesis* ; Zygapophyseal Joint*

For confirmative diagnosis of bone and joint tuberculosis, it is made by culture method, inoculation to guinea pig, or histological examination of the specimen obtained from a lesion site. But plain reontgenogram is not valuable for early detection of the disease because specific, abnormal finding is not found in early stage and only found in late stage as progressive destruction of bone and joint. Many reports were made thst whole body bone scan, as diagnostic tool, was valuable in other orthopedic disease, but report for its diagnostic value in bone and joint tuberculosis is very rare. The study was carried out on 35 patients of bone and joint tuberculosis who whole body bone scan was performed before operation from Janusry, 1978 to December, 1987 in Depaartment of Orthopedic Surgery, Yonsei University college of Medicine. The following results were obtained. 1. Value of early detection of tuberculosis is not much as pyogenic infection. Intensity of uptake was decreased in tuberculosis than acute pyogenic osteomyelitis and arthritis, but increased than chronic osteomyelitis. 2. Intensity of uptake was decreased in female than male, and also increased in age. group under 10 and over 60 than other age group. 3. The longer duration of the disease, the more decreased intensity of uptake. 4. Intensity of uptake is increased in joint tuberculosis than bone, snd also increased in tuberculosis of spine than long bone. 5. Multifocal disease was detected in 14.3% by whole body bone scan.
Animals ; Arthritis ; Diagnosis ; Female ; Guinea Pigs ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Osteomyelitis ; Spine ; Tuberculosis ; Tuberculosis, Osteoarticular

Pathological laughing and crying(PLC) is a condition that is characterized by episodic, brief, contextually inappropriate, uncontrollable outbursts of laughing and/or crying. It can be observed in patients with various neurological disorders. PLC often causes distress in interpersonal functioning and activities for patients and their families. PLC can be recognized easily with proper understanding of the condition and its nature. Also it generally shows good response to various pharmacological treatments. This review aims to encourage the diagnosis and treatment of PLC by providing definition and clinical presentation of PLC, analysis of its pathophysiology and various current treatment options.
Crying* ; Diagnosis ; Humans ; Nervous System Diseases

No abstract available.

No abstract available.
Diagnosis* ; Magnetic Resonance Imaging* ; Spondylitis*

The clinical study on recurrent dislocation of the shoulder was performed on fourteen cases who were treated by Putti-Platt operation from July 1967 to November 1968. The cases studied were treated at the 17th Army Hospital in Kwang-ju and U.S. 121st Evacuation Hospital in Bu-pyung. Ages in initial dislocation were varied from 11 to 25 with an average of 18 years. Five cases of them were recurred over ten times prior to operation. On radiological findings, Hill-Sachs lesion has been revelaed in 57.1%. On pathological finding, Bankart lesion was seen in 78.5% and detachment of the glenoid labrum with capsular separation in 28.6%. No recurrence has been encountered in this s ries, and average rarige of abduction was gained upto 165 and external rotation 30°.
Clinical Study ; Dislocations ; Gwangju ; Hospitals, Military ; Recurrence ; Shoulder

Pachydermoperiostosis (idiopathic hypertrophic osteoarthropathy) ia an unusual syndrome of familial nature and characterized by clubbing of the digits, periosteal new bone formation especially over the distal ends of the long bones, and coarsening of the facial features with thickening and furrowing of the skin of the face and forehead. The case of a 46 year old male exhibiting the above characteristics is reported, The same tendencies were exhibited by his father before him. A review of literature is included.
Fathers ; Forehead ; Humans ; Male ; Osteoarthropathy, Primary Hypertrophic ; Osteogenesis ; Skin