Transitional vertebrae include lumbarization and sacralization of lumbosacral region. The prevalence of transitional vertebra was reported as 3 to 21%. It is known that transitional vertebra is related to herniated nucleus pulposus and spinal stenosis but there is no report in English literature about the relationship of transitional vertebra to spondylolysis or spondylolytic spondylolisthesis. The purpose of this study is to evaluate the relationship of transitional vertebra to spondylolysis or spondylolytic spondylolisthesis and to find out the clinical relevance for the treatment. The cases included 182 cases of spondylolysis or spondylolytic spondylolisthesis who were treated at Severance hospital from 1987 to 1993. There were 33 cases of transitional vetebra; 12 lumbarization and 21 sacralization. And there were remaining 149 cases of control group. The degree of anterior sippage was measured by Meyerding's grading and percentage of Taillard method. As the results, the degree of average anterior slippage of L4 was 14.5% in the cases of isthmic defect in L4 and sacralization. The average slippage of L4 was 11.4% in the control group. The degree of average anterior slippage of L5 was 12.5% in the cases of isthmic defect in L5 and lumbarization, and 9.5% in the cases of isthmic defect in L5 and sacralization. The average slippage of L5 was 16.2% in the control group. In summary and conclusion, the cases with isthmic defect in L4 and sacralization showed more anterior slippage than the cases with isthmic defect in L4 without transitional vertebrae, and the cases with isthmic defect in L5 and sacralization showed less anterior slippage than the cases with isthmic defect in L5 without transitional vertebrae. It is concluded that more aggressive treatment is recommended in the cases of isthmic defect in L4 and sacralization, whereas more conservative treatment is recommended in the cases of isthmic defect in L5 and sacralization.
Lumbosacral Region ; Methods ; Prevalence ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylolysis

Ninety two injuries of the main nerves in the upper extremity observed in 79 patients, were studied at the Department of the Orthopedic Surgery, 17th Army Hospital from May 1965 to Aug. 1968. The treatment given consisted of neurolysis in 15, neurorrhapy in 77(primary 43 and secondary 34) and tendon transplantation and transfer in 11 cases. The results for the median, ulnar and radial nerves after primary and secondary suture were analyzed with respect to the level of injury(high and lower). The results of the median nerve repair were more succesful than those of the ulnar nerve, In these two nerve injuries, the sensory recovery was better than the motor and secondary suture gave better results than primary suture. Thirteen cases failed to respond to primary or secondary nerve repair, among those tendon transfer or tendon transplantation was tried in eleven cases, from the latter approximately 25% of motor recovery could be seen.
Hospitals, Military ; Humans ; Median Nerve ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Radial Nerve ; Sutures ; Tendon Transfer ; Tendons ; Ulnar Nerve ; Upper Extremity

STUDY DESIGN: A retrospective study was made of patients undergoing posterolateral fusion of the lumbar spine. OBJECTIVES: To compare the clinical outcomes of the patients who underwent posterolateral fusion of the lumbar spine with commercially available allogeneic bone graft with those patients in a similar consecutive control group who underwent posterolateral fusion of the lumbar spine with autogenic bone graft and to determine whether the commercially available allogeneic bone is useful for postero-lateral fusion of the lumbar spine. SUMMARY OF LITERATURE REVIEW: Major differences exist in the ability of an allogeneic bone graft to regenerate a viable cellular network as compared to an autogenic bone graft. This is related to the immunologic response of the host to the foreign bone. The fusion rate of deep freezing allogeneic bone graft was reported as 80-100%. MATERIALS AND METHODS: Seventy-nine patients with spondylolisthesis treated with decompression, fixation with pedicle screws and posterolateral fusion were retrospectively reviewed. Nineteen patients (group 1) were treated with commercially available allogeneic bone (Tutoplast) graft mixed with autogenic bone and the remaining 60 patients (group 2) were treated with autogenic bone graft. Operating time, amount of transfusion, duration of hospital stay, symptom improvement, fusion rate, duration of fusion, and complications were studied. RESULTS: There were no significant differences between the two groups in terms of duration of hospital stay, amount of transfusion, symptom improvement, and complications . However, there were significant differences between the allogeneic and autogenic groups in terms of operating time (212.3 versus 230.9 minutes), fusion rate (36.8% versus 98.3%), and duration of fusion (10.2 versus 6.4 months), respectively. CONCLUSIONS: Commercially available allogeneic bone is less useful for posterolateral fusion of the lumbar spine.
Decompression ; Freezing ; Humans ; Length of Stay ; Retrospective Studies ; Spine* ; Spondylolisthesis ; Transplants

No abstract available.
Cerebral Palsy* ; Contracture* ; Hip* ; Muscle Spasticity*

No abstract available.
Spine*

No abstract available.
Thanatophoric Dysplasia*

PURPOSE: To determine the usefulness of the fat-suppressed (FS) conventional spin-echo (CSE) sequence for the diagnosis of meniscal tears. MATERIALS AND METHODS: We retrospectively reviewed 323 MR images of the knee, the standard of reference being the findings of arthroscopy. In all knees, fast SE proton density-weighted and T2-weighted sagittal and coronal images and double-echo in steady state (DESS) sagittal images were obtained, and during 202 MR Procedures, FS-CSE T1-weighted sagittal images were also obtained. The results of MR imaging were then correlated with those of arthroscopy, the accuracy with which meniscal tears were diagnosed being compared between two groups: group I (202 knees for which FS-CSE T1-weighted sagittal images were obtained), and group II (121 knees for which these images were not obtained). For statistical analysis the chi-square test was used. RESULTS: In group 1, sensitivity, specificity and accuracy were 94.7%, 92.4% and 93.5%, respectively, for the medial meniscus, and 83.3%, 95.7% and 90.5% for the lateral meniscus. In group II, the corresponding findings were 92.5%, 94% and 93.3%; and 87.3%, 98.2% and 92.5%. The differences between the groups were not statistically significant (p>0.05) CONCLUSION: For meniscal tears of the knee, the addition of FS-CSE T1-weighted MR imaging to the fast SE proton density-weighted, T2-weighted and DESS sequences does not enhance diagnostic accuracy.
Arthroscopy ; Diagnosis ; Knee* ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Protons ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: To report four cases in which temporary complication developed after using Gentian Violet as a marker in LASIK procedure. METHODS: Four cases who had undergone LASIK using Gentian Violet (Viscot Surgical Marker, U.S.A.) as a marker were followed. During follow up, corneal edema and opacity developed in landmark area which appeared as a hot spot in topography. Topical Corticosteroids and antibiotics applied for 3 weeks. RESULTS: At 3 month after LASIK, the corneal opacity and edema were disappeared. CONCLUSIONS: Temporary complication may develop by gentian violet following LASIK procedure. When using highly concentrated gentian violet marking pen, great attention should be paid not to make any corneal erosion.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Corneal Edema ; Corneal Opacity ; Edema ; Follow-Up Studies ; Gentian Violet* ; Gentiana* ; Keratomileusis, Laser In Situ*

PURPOSE: In order to know the effects of inaccurate laser shot of vertical or horizontal direction, we evaluated the clinical results of LASIK according to the use of fixation ring and the accuracy of the focusing beam on the corneal stromal bed. METHODS: LASIK was performed in 73 eyes with one surgeon between April, 2001 and January, 2002 were divided into two groups: those who exceeded -6.00D were high myopia group (37 eyes), and those who did not were low myopia group (36 eyes). We retrospectively analyzed the results of the LASIK in two methods, the one is the evaluation of the vertical directional error with the accuracy of the focusing beam and the other is the horizontal error with the use of fixation ring. We measured the preoperative and postoperative uncorrected visual acuity, spherical equivalent, and the postoperative predictability. RESULTS: There was no significant statistical difference in the spherical equivalent, uncorrected visual acuity, postoperative predictability between the use and nonuse of fixation ring and good and bad accuracy of focusing beam in high myopia and low myopia (P>0.05). CONCLUSIONS: These results suggest that a little difference in the accuracy of focusing beam on the corneal stromal bed and the use of fixation ring would not affect the clinical result after LASIK.
Keratomileusis, Laser In Situ* ; Morinda ; Myopia ; Retrospective Studies ; Visual Acuity

OBJECTIVE:The purpose of this study is to evaluate the CT findings of the carcinoma of the ampulla of Vater and to differentiate from other periampullary carcinoma including the carcinoma of the distal common bile duct and pancreas head. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 13 cases of the carcinoma of the ampulla of Vater, 20 cases of the carcinoma of the distal common bile duct and 20 cases of the carcinoma of the pancreas head confirmed by pathology. Five millimeter consecutive settings of CT scan were performed in all cases on ampulla level with supine position. The CT findings were retrospectively evaluated in view of common bile duct dilatation, pattern of termination of bile duct, pancreatic duct dilatation, protruding mass in duodenal lumen, and regional lymph node metastasis. RESULTS: All case of the carcinoma of the ampulla of Vater(13/13) and distal common bile duct(20/20) showed common bile duct dilatation with abrupt termination. Among the 10 cases of the carcinoma of the pancreas head with common bile duct dilatation, five cases each had is abrupt termination(5/20) and gradual stenosis of bile duct(5/20). Five cases of the carcinoma of the ampulla of Vater(5/13) and four cases of the carcinoma of distal common bile duct(4/20) showed pancreatic duct dilatation and all cases of the carcinoma of pancreas head show pancreatic duct dialtation(20/20). Twenty cases of the carcinoma of the ampulla of Vater showed protruding mass in the medial wall of the second portion of the duodenum(12/13) but only one case of the carcinoma of the distal common bile duct(I/20) and five cases of the carcinoma of the pancreas head (5/20) had protruding mass in the duodenal lumen. Only one case of the carcinoma of the ampulla of Vater showed(1/13) regional lymph node metastasis but three cases of the carcinoma of the distal common bile duct(3/20) and 18 cases of the carcinoma of the pancreas head(18/20) showed regional lymph node metastasis. CONCLUSION: Common bile duct dilatation with abrupt termination, protruding mass in the duodenal lumen and rare lymph node metastasis in CT may suggest the carcinoma of the ampulla of Vater.
Ampulla of Vater* ; Bile ; Bile Ducts ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Head ; Lymph Nodes ; Neoplasm Metastasis ; Pancreas ; Pancreatic Ducts ; Pathology ; Retrospective Studies ; Supine Position ; Tomography, X-Ray Computed