STUDY DESIGN: The authors is to report the clinical and radiological results of proximal half corpectomy with one motion segment fusion in Denis type B burst fracture. OBJECTIVES: To evaluate the efficacy of proximal half corpectomy in Denis type B burst fracture of thethoracolumbar and lumbar spine. SUMMARY OF LITERATURE REVIEW: For the operative management of burst fracture, various mothods including posterior ligamentotaxis, posterolateral decompression, anterior decompression or combined were reported. Among the methods, anterior decompression by the corpectomy of fractured vertebral body and fusion with or without instrumentation is the one of the widely accepted method of treatment. However, anterior decompression by excision of whole vertebral body has the disadvantage of high complication rate due to the instability from the large defect and long length of bone graft. Moreover, two motion segments have to be sacrified, which is very important especially in thoracolumbar and lumbar area. Material and METHODS: 43 cases operated from 1989 to 1996 and the minimum follow up period was two years and compared with that of 48 cases who were treated by total corpectomy and two motion segment fashion from 1986 to 1989. RESULTS: Solid bony union was obtained in 43 cases within 6 months and no back pain was complained in 39 cases (93%) at last follow up. There was no significant difference between two groups in correction of anterior vertebral height and kyphotic angle. Length of bone graft was 3.0cm in half corpectomy group and was 6.3cm in total corpectomy group. Hardward breakage or graft collapse was not observed in proximal half corpectomy, while there were 5 cases in total corpectomy. CONCLUSION: Proximal half corpectomy and fusion of one motion segment in Denis type B burst fracture is believed to be a successful method which can minimize the fused level, increase the stability, preserve motion segment and reduce the complication.
Back Pain ; Decompression ; Follow-Up Studies ; Spine* ; Transplants

STUDY DESIGN: Sixteen patients with congenital kyphoscoliosis were evaluated the clinical and radiological results according to the treatment method. OBJECTIVES: To provide a guideline for surgical treatment of congenital kyphoscoliosis SUMMARY OF LITERATURE REVIEW: Congenital kyphoscoliosis is an abnormal coronal and sagittal curvature of spine that is caused by the presence of vertebral anomalies, which causes a significant deformity and disability. Correction of the deformity is challenging and accompanied by high risk of complications. Many methods of operative treatment were recommended with various results. MATERIALS & METHODS: We reviewed 16 patients of congenital kyphoscoliosis who were operated from 1984 to 1997, and follow-up periods were over 12 months in all. The average age of surgery was 12 years (ranged from 4 to 20 years). Nine cases were operated by excision of quadrant hemivertebra through combined anterior & posterior approach and 6 cases were treated only by posterior instrumentation and one underwent posterior on bloc spondylectomy. RESULTS: The type of curves were thoracic in 5, thoracolumbar in 9, lumbar area in 2 patients. Average angle of kyphosis was 55 degree preoperatively, 25 degree postoperatively, and 39 degree at the follow up study. Average angle of scoliosis was 48 degree, 22 degree, and 27 degree, respectively. In 9 cases corrected by excision of quadrant hemivertebra; kyphotic angle was changed from 62degrees preoperatively, to 22degrees postoperatively and to 36 degree at the end of follow up study, while scoliotic angle was changed from 47degrees, to 12degrees and to 21degrees, respectively. In 6 cases corrected by posterior instrumentation kyphotic angle was changed from 52degrees preoperatively, to 33degrees postoperatively and to 48degrees degree at the follow up study, while scoliotic angle was changed from 53degrees, to 33degrees and to 37degrees, respectively. CONCLUSION: Excision of quadrant hemivertebra through combined anterior and posterior approach or posterior instrumentation were resulted in significant loss of correction during the remaining growth period due to the secondary change of adjacent vertebrae. So, to obtain better correction and to reduce the recurrence of deformity, more aggressive approach including the concept of three dimentional osteotomy involving the upper and lower adjacent curve may be considered.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteotomy ; Recurrence ; Scoliosis ; Spine

BACKGROUND: During the last few years, the in vivo study of the physiological parameters of the skin by non-invasive methods has been considerably developed. So far, there have been some reports on the skin characteristics only in parts, but there has not been any criteria to classify those of normal subjects. OBJECTIVE: The aim of the present study was to investigate the skin characteristics of healthy Korean subjects according to sex and sites using non-invasive methods. METHODS: To determine normal levels of sebum, skin hydration, transepidermal water loss (TEWL), skin elasticity and skin color according to sex, 163 subjects (male; 124, female; 39) were used to investigate 5 different anatomical sites. 6 different instruments were used: The Sebummeter SM 410, Corneometer CM 820, Evaporimeter EP1, Cutometer SEM 474, Chromameter CR-121, and Mexameter MX 16, for evaluating sebum excretion rate, capacitance, TEWL, mechanical property and skin color respectively. RESULTS: Differences were noticed depending on the anatomical sites and sex. Most of the measuring parameters were significantly different according to sites and sex. The values of sebum levels, capacitance and TEWL were higher in the males on the cheek, forehead and crows foot, whereas in the females, higher values were observed on the dorsum of the hand. The skin elasticity varied considerably among the nine-parameters but, for the elastic ratio (R2, R5), the females showed significantly higher values than the males in all sites except the forehead. Skin lightness (L* value) was higher in the females, whereas the males showed lugher values in the category of redness (a* value) and yellowness (b* value). The values of the eqrthema index (EI) and melanin index (MI) were also higher in the males on all sites. Correlations between the skin parameters mentioned above were calculated. A negative, correlation between capacitance and TEWL was observed only on the cheek (male/female, r =-0.2/ r =-0.4, p<0.05). The L* value correlated negatively with MI. Mioreover the values between a* and El also showed sipificant correlations in the male (cheek and dorsum of hand, y =0.2, forehead and crows foot, r =0.3, p<0.05). There were considerably significant correlations between the visual pigmentation score and instrumental skin parameters in the males (visual pigmentation score vs. L* value measured by Chromameter ; cheek/crows foot, r = -0.3/y =-0.4, visual pigmentation score vs. MI by Mexameter ; cheek/crows foot, r =0.2/ r =0.4, viisual winkle score vs. sebum excretion rate measured by Sebumeter ; cheek, r=0.2, visual winkle score vs. elasticity parameters measured by Cutometer ; cheek, R2/R5/R7, r =-0.3/ r =-0.2/ r =-0.3, p<0.05). CONCLUSION: Skin physiological parameters can be evaluated by non-invasive skin bioengineering methods which show quantitative modifications in physiological conditions in relation to sites and sex.
Bioengineering* ; Cheek ; Crows ; Elasticity ; Female ; Foot ; Forehead ; Hand ; Humans ; Male ; Melanins ; Pigmentation ; Sebum ; Skin*

It is the most important to select optimal culture conditions to promote safe embryo growth in the technique of human in vitro fertilization and embryo transfer. It has been shown that the addition of biologic fluids, such as blood serum, of various origins, improved fertilization and early cleavage rates in numerous species. The purpose- of this study is to attempt to measure developmental potential of mouse eggs fertilized and cleaved in Ham's F10 culture medium containing a chelating agent, EDTA and fetal cord serum. hi this study, we selected 40 female mice and 20 male mice, and investigated optimal serum concentration' for mouse embryo growth. Two cell stage mouse embryos were cultured in Ham's F-10 medium, Ham's F-10 medium with various concentrations of EDTA, or Ham's F-10 medium with EDTA and 10% human cord serum. Developmental ratios to morula in Ham's F-10 medium containing various concentrations of EDTA and/or 10% fetal cord serum were significantly higher than in unsupplemented Ham's F-10 medium (p<0.05). Developmental ratios to blastocyst in Ham's F-10 containing 10% fetal cord serum and 5011M or 100pM EDTA were significanldy higher than in unsupplemented Ham's F-10 medium (p<0.05). Developmental ratios to morula in Ham's F-10 containing 10% fetal cord serum and 100,uM EDTA were significanitly higher than in Ham's F-10 with 10% fetal cord serum used commonly in many human IVF centers(p<0.05). Developmental ratio to blastocyst in Ham's F-10 containing 10% fetal cord serum and 100pM EDTA was significanity higher than in Ham's F-10 with 200pM EDTA(p<0.05).
Animals ; Blastocyst ; Edetic Acid* ; Eggs ; Embryo Transfer ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Male ; Mice* ; Morula ; Ovum ; Serum

Fibrolipoma is a rare histological variant of lipoma characterized by proliferation of mature fat and fibrous tissue. Most of the benign lipomatous tumors in the palm reported in the literature developed in the nervous tissue, especially the median nerve sheath. We report an unusual form of fibrolipoma on the palm which arose from the subcutaneous tissue or superficial palmar fascia in the palm, not the nerve or tendon sheath. There was no recurrence 3 years after surgical removal was performed.
Fascia ; Lipoma ; Median Nerve ; Recurrence ; Subcutaneous Tissue ; Tendons

The evaluation of growth potency can be done with many physiologic indicators. It has well known that skeletal maturity has a close relation with both sexual maturity and somatic maturity, but the correlation between skeletal maturity and dental maturity was believed to be less certain. But, recent studies show that specific teeth. including lower canines, present close correlations with skeletal maturity, So, in this study, we studide hand-wrist X-ray films and orthopantomagrams of 387 Korean boys and girls aged from 7 to 15; the purpose was to determine skeletal and dental maturity, and to find out a new method to estimate individual skeletal maturity using multiple-regression model, without the help of hand-wrist X-ray film. As a result of this study, followings were observed. 1. The following multiple-regression model can estimate skeletal maturity index (SMI) with 84% accuracy, and regression coefficient of chronologic age, sex and lower canine show statistical significance. SMI = 0.60 x chronolngic age - 1.67 x sex** + 0.88 x lower canine* - 0.55 x lower 2nd molar* - 10.3 * : mean age corresponding each developing atage, ** : male = 1, female = 0 2. The followering multiple-regression model can estimate skeletal age with 87% of accuracy, and regression coefficient of chronologic age, sex and lower canine show statistical significance. Skeletal age = 0.75 x chronolngic age - 0.55 x sex** + 0.71 x lower canine* - 0.09 x lower 2nd molar* - 5.77 * : mean age corresponding each developing atage, ** : male = 1, femal = 0
Female ; Humans ; Male ; Tooth ; X-Ray Film

PURPOSE: The purpose of this study was to evaluate the accuracy of contrast enhanced magnetic resonance angiography (CE-MRA) in the visualization of the renovascular anatomy for the preoperative evaluation of living renal donors. MATERIALS AND METHODS: Thirty-one consecutive potential living renal donors were investigated. Ten patients underwent both digital subtraction angiography (DSA) and CE-MRA, and twenty-one underwent CE-MRA alone before the donor nephrectomy. The intraoperative findings on the number of renal vessels were compared with those of the DSA and CE-MRA. RESULTS: DSA and CE-MRA showed 100% agreement in identifying the main renal arteries, accessory renal artery, and renal veins before surgery. In the DSA and CE-MRA group (n=10), the accuracy relative to the intraoperative findings was 92.3% (12/13) for the renal artery and 100% (10/10) for the renal vein. In the CE-MRA alone group (n=21), 93.3% (28/30) accuracy was shown for the renal artery and 91.3% (21/23) for the renal vein compared with the intraoperative findings. CONCLUSIONS: CE-MRA showed similar agreement and accuracy to DSA. As a minimally invasive technique, CE-MRA has the potential to replace DSA.
Angiography, Digital Subtraction ; Humans ; Magnetic Resonance Angiography* ; Nephrectomy ; Renal Artery ; Renal Veins ; Tissue Donors* ; Transplantation

Studies for diagnostic analysis using three-dimensional (3D) CT images are recently in progress and needs for 3D craniofacial analysis are increasing in the fields of orthodontics. It is especially essential to analyze the facial soft tissue after orthodontic treatment and orthognathic surgery. In this study 3D CT images of adults with normal occlusion were taken to analyze the facial soft tissue. Norms were obtained from CT images of adults with normal occlusion (12 males, 11 females) using a computer program named V works 4.0 program. 3D coordinate planes were established using soft tissue Nasion as the reference point and a total of 20 reproducible landmarks of facial soft tissue were obtained using the multiple reconstructive sectional images (axial, sagittal and coronal images) of the V works 4.0 program; soft tissue Nasion, Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B, soft tissue Pogonion, soft tissue Menton, Endocanthion (Rt/Lt), Alare lateralis (Rt/Lt), Cheilion (Rt/Lt), soft tissue Gonion (Rt/Lt), Tragus (Rt/Lt), and Zygomatic point (Rt/Lt). According to the established landmarks and measuring method, the 3D CT images of adults with normal occlusion were measured and the normal positional measurements and their Net (sigma=root(x2 + y2 + z2)) values were obtained using V surgery program. In the linear measurement between landmarks, there was a significant difference between males and females except Na'-Sn and En(Rt)-En(Lt). The normal ranges of Na'-Zy, Na'-Ch and Na'-Go' (facial depth) were obtained, which was difficult to measure by two-dimensional (2D) cephalometric analysis and facial photographs. These data may be used as references for 3D diagnosis and treatment planning for patients with malocclusion and dentofacial deformity.
Adult ; Dentofacial Deformities ; Diagnosis ; Female ; Humans ; Lip ; Male ; Malocclusion ; Orthodontics ; Orthognathic Surgery ; Reference Values

Hallux valgus has been defined as a static subluxation of the first metatarsophalangeal joint with lateral deviation of the proximal phalanx on the first metatarsal head from the longitudinal axis of the first metatarsal with medial deviation of the first metatarsal. And first-second metatarsal angle is increased as well as bursal hypertrophy over the medial eminence of the first metatarsal head. Many procedures have been reported for the treatment of the hallux valgus ranging from resection arthroplasty to distal first metatarsal or basal first metatarsal osteotomy. Of these, Johnson and Corless have required sufficiently good results in the modifying Mitchell osteotomy into Chevron osteotomy. The Chevron procedure is an osteotomy involving the distal portion of the first metatarsal, lateral displacement of the metatarsal head with exostosectomy, and tightening of the medial capsular structures. Authors studied 17 cases in 10 patients with the hallux valgus deformity treated by Chevron osteotomy at the Department of Orthopedic Surgery, Capital Armed Forced General Hospital from September 1987 to September 1989. The results were as follows; 1. Seven patients (12 cases) were male and three patients (5 cases) were female. All patients had bilateral hallux valgus deformity. 2. The average first-second intermetatarsal angle was 11 degrees and average valgus angle was 32 degrees, preoperatively. They were corrected to 9 degrees and 14 degrees respectively. 3. The metatarsalgia of the great toe was subsided in all cases and they were satisfied with the result of their operations in respect to cosmetically and functionally. Avascular necrosis of capital fragment, nonunion, and dorsal angulation were not developed in any case. But, one case had marginal skin necrosis, presumably due to excessive compressive dressing. 4. Chevron osteotomy is a technically easy procedure and it can be obtained early bone healing with less complication.
Arm ; Arthroplasty ; Bandages ; Congenital Abnormalities ; Female ; Hallux Valgus ; Hallux ; Head ; Hospitals, General ; Humans ; Hypertrophy ; Male ; Median Eminence ; Metatarsal Bones ; Metatarsalgia ; Metatarsophalangeal Joint ; Necrosis ; Orthopedics ; Osteotomy ; Skin ; Toes

Breast surgery is a common procedure performed in women. Many women who undergo breast surgery suffer from ill-defined pain syndromes. A nerve block is used in the treatment of the acute and chronic pain, but the effectiveness of the treatment has been limited because of its short duration. Recently, the advent of pulsed radiofrequency lesioning (PRF) has proved a successful treatment for chronic refractory pain involving the peripheral nerves. We experienced a case of a 52-year-old female patient complaining of chronic breast neuropathic pain after breast reduction, which was relieved after PRF lesioning of the 4th thoracic spinal nerve and its root.
Breast ; Chronic Pain ; Female ; Humans ; Middle Aged ; Nerve Block ; Neuralgia ; Pain, Intractable ; Peripheral Nerves ; Spinal Nerves