Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and bone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient are remained back pain. According to above results we concluded that anterolateral internal fixation combined.with bone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.
Back Pain ; Congenital Abnormalities ; Conus Snail ; Decompression ; Decompression, Surgical* ; Humans ; Internal Fixators ; Ribs ; Spine

BACKGROUND AND OBJECTIVES: We performed this study to compare the endothelial function of the patients with newly diagnosed essential hypertension(EH) to age and sex-matched normal subjects or patients with known coronary artery disease(CAD) and to evaluate the effect of calcium channel blockers(amlodipine) on the endothelial dysfunction in patients with EH. MATERIALS AND METHOD: The endothelial function, expressed as percent brachial artery diameter changes at hyperemic phase compared to resting state, using high-resolution ultrasound was measured before taking amlodipine and 3 to 4 months after taking amlodipine(5 to 10 mg daily), when the high blood pressure(BP) was well controlled(129/83 mmHg), in patients with EH(mean age; 53 yrs, n=2). We also measured the endothelial function in normal subjects(mean age; 54 yrs, n=5) and patients with proven CAD(mean age; 56 yrs, n=0). RESULTS: The mean BP of the patients with EH, CAD, and normal subjects were 172/108 mmHg, 110/69 mmHg, and 113/72 mmHg, respectively. There were no significant differences among the study groups in regard to the serum glucose and various lipid levels. The endothelial function of the patients with EH(6.6+/-2.3%) was significantly(p=.000) lowered when compared to the normal subjects(14.3+/-3.3%), but did not show any significant differences when compared to the patients with CAD(8.6+/-3.4%). The endothelial function in patients with EH was significantly(p=.007) improved from 6.6+/-2.3 % to 11.0+/-2.7 % 3 to 4 months after taking the amlodipine. CONCLUSION: Calcium channel blockers, especially amlodipine, can improve endothelial dysfunction in patients with EH as well as controlling high BP.
Amlodipine ; Blood Glucose ; Brachial Artery ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Coronary Vessels ; Humans ; Hypertension* ; Ultrasonography

BACKGROUND AND OBJECTIVES: We performed this study to compare the endothelial function of the patients with newly diagnosed essential hypertension(EH) to age and sex-matched normal subjects or patients with known coronary artery disease(CAD) and to evaluate the effect of calcium channel blockers(amlodipine) on the endothelial dysfunction in patients with EH. MATERIALS AND METHOD: The endothelial function, expressed as percent brachial artery diameter changes at hyperemic phase compared to resting state, using high-resolution ultrasound was measured before taking amlodipine and 3 to 4 months after taking amlodipine(5 to 10 mg daily), when the high blood pressure(BP) was well controlled(129/83 mmHg), in patients with EH(mean age; 53 yrs, n=2). We also measured the endothelial function in normal subjects(mean age; 54 yrs, n=5) and patients with proven CAD(mean age; 56 yrs, n=0). RESULTS: The mean BP of the patients with EH, CAD, and normal subjects were 172/108 mmHg, 110/69 mmHg, and 113/72 mmHg, respectively. There were no significant differences among the study groups in regard to the serum glucose and various lipid levels. The endothelial function of the patients with EH(6.6+/-2.3%) was significantly(p=.000) lowered when compared to the normal subjects(14.3+/-3.3%), but did not show any significant differences when compared to the patients with CAD(8.6+/-3.4%). The endothelial function in patients with EH was significantly(p=.007) improved from 6.6+/-2.3 % to 11.0+/-2.7 % 3 to 4 months after taking the amlodipine. CONCLUSION: Calcium channel blockers, especially amlodipine, can improve endothelial dysfunction in patients with EH as well as controlling high BP.
Amlodipine ; Blood Glucose ; Brachial Artery ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Coronary Vessels ; Humans ; Hypertension* ; Ultrasonography

The 5 year-survival rates were examined to evaluate the prognositic significance of the expression of the p53 protein and the positivity of the PCNA in 108 cases of advanced gastric carcinoma. The p53 protein and PCNA were stained by immunohistochemistry in the tissue of the gastrectomized specimen. The results were as follows. 1) The overall 5 year-survival rate of advanced gastric carcinoma was 42.3 % and the significant prognostic factors were a pathologic stage and p53 protein(p<0.005). 2) The expanding or infiltrating type by Ming's classification and the intestinal or difftise type by Lauren's classification had similar prognosis. 514_ @@l %R-t 3) The 5 year-survival rate of the p53-positive group was 25.1% and that of p53-negative group was 56.1%(p<0.005). 4) The 5 year-survival rate of the PCNA low-grade tumors by PCNA stain(<50%)was 48.7% and that of the high-grade tumor(>=50%)was 29.9%(p>0.1). 5) There was a tendency to have a good prognosis in the p53-negative group and low grade tumors in the stage 11, III, and IV. There was a significant difference between p53 protein positive and negative groups in the stage III(p<0.005), but no significant differences were found in the other groups. The above results indicate that the p53 protein is an another useful tool for prediction of the prognosis in advanced gastric carcinoma.
Stomach Neoplasms

BACKGROUND: We performed this study to evaluate the lower limit of the normal endothelial function, which can differentiate normal values from abnormal ones and to evaluate the changes of the endothelial function according to ages. MATERIALS AND METHODS: Study populations were consisted of four groups: patients (group A) with coronary artery disease (CAD) (n=2, mean age: 55 yrs), patients (group B) with one or more risk factors of atherosclerosis (n=3, mean age: 54 yrs), age- and sex-matched healthy subjects (group C, n=5, mean age: 54 yrs), and healthy young subjects (group D, n=3, mean age: 26 yrs). We measured the flow-mediated endothelium-dependent dilation (FMD) of brachial artery using a high-resolution ultrasound in all subjects. We analyzed the receiver operating characteristic (ROC) curve. RESULTS: The FMD of the A and B group were significantly lowered (8.6+/-3.7% vs 9.9+/-4/5% than C (14.3+/-3.3%, p<0.001) or D group (18.0+/-3.5%, p<0.001). The FMD level of 11.5% had 76.3% of sensitivity and 76% of specificity to differentiate normal endothelial function from abnormal one. The spearman correlation coefficient between ages and FMD in groups C and D was -0.543 (p<0.001). CONCLUSIONS: The endothelial function was decreased in patients with CAD or risk factors of atherosclerosis. We observed the age-related declining tendency of endothelial function in healthy subjects. 11.5% FMD) may be used to identify the person at risk of atherosclerosis.
Atherosclerosis* ; Brachial Artery ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Reference Values ; Risk Factors* ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography

Chronic ulcerative colitis is a systemic inflammatory disease with uncertain etiology primarily involving the colonic mucosa. The mucosal biopsy interpretation is important for an evaluation of the disease state and further medical or surgical treatment. However, few clinical and pathological studies of the endoscopic diagnosis of this disease are available in Korea. Therefore, we evaluated the clinical and pathological characteristics of it diagnosed by endoscopic biopsy and analysed the reasons for the discrepancy between clinical and pathologic diagnosis for a more accurate endoscopic mucosal biopsy diagnosis in the future. A total of 702 cases of colonic mucosal biopsy specimens during Feb. 1994 and Jan. 1995 at Severance hospital, Yonsei University College of Medicine were reevaluated for the study. A clinical diagnosis of ulcerative colitis, after endoscopic examination, was made in 61(8.7%) cases. A pathological diagnosis was made when there is an increased inflammatory cell infiltration in the mucosa with evidences of a chronic crypt injury in the biopsy specimens. Using this criteria, a diagnosis was made in 32(52.3%) cases. In 29 cases the diagnosis was made in the first biopsy specimen and in the remaining 3 cases the diagnosis was made in the second or third biopsy specimens. No pathologic diagnosis of ulcerative colitis was made in the cases that clinical diagnosis was not. In the 32 cases diagnosed as ulcerative colitis, 14 cases were involved the rectum and sigmoid colon, 9 cases were involved up to the descending colon, 1 case was involved up to the transverse colon and 8 cases showed pancolonic involvement. In 29 cases, which ulcerative colitis was suspected clinically but was not consistent with it pathologically, 8 cases were proved to be ischemic colitis, 5 cases were acute infectious colitis and one case was Crohn's disease by repeat examination and follow up. Ten cases were histologically within normal range and lesions subsided spontaneously with no recurrence. A conclusive diagnosis could not be made in 5 cases during this study period. From these results, we conclude that ulcerative colitis can be diagnosed accurately by endoscopic biopsy, and clinical follow up and repeat examination are valuable in the differential diagnosis of this disease.
Diagnosis, Differential ; Biopsy

No abstract available.
Kidney Transplantation* ; Pregnancy*

No abstract available.
Fetal Development* ; Pregnancy* ; Ultrasonics*

Reconstruction of partial ear defect to approximate the opposite normal ear is actually very difficult. Because the patterns of partial ear defect (site, shape and size of defect) are extremely variable, the operative method on each case should be changed. In an effort to overcome these problems, many reconstructive methods have been reported so far. We experienced 11 cases of partial ear defect from September, 1995 to August, 1996 and different reconstructive methods were applied In this study, the most common cause of partial ear defect was trauma (9 cases) and the most common site was middle part of ear helix. The defects were varying from 1x2 cm to 1.5x5 cm in size. The methods that has been used for reconstruction of ear defect include direct closure, helical chondrocutaneous advancement flap, Dieffenbach's method, retroauricular flap, tubed bipedicled flap and so on. We could get to know the merits and demerits of each method through this follow up study. So authors obtained the several basic conclusions about the merits and demerits of each method and standard of method selection in various patterns of ear defects. From analysis of the cases with review of literature, the our conclusions are as follows. 1. If the size of de(tract is small and the patient does not want to have two times of operation, direct closure can be done with good results. 2. If the defect exists on ear auricle confuted to helix and if there are no or small amount of associated cartilage defect, tubued bipedicled flap seems to be proper. 3. With the ear auricle defect confined to helix, especially helix of upper ear auricle, helical chondrocutaneous advancement flap can brought tile best result, though it has disadvantage of being decreased in its size 4. If there are extensive defect on ear auricle extending over scapha and antihelix, retroauricular flap can be done with good results. 5. In the ear auricle defect acompanying considerably large cartilage loss, Dieffenbach's method is thought to be proper.
Cartilage ; Ear Auricle ; Ear* ; Follow-Up Studies ; Humans

According to the autopsy study for the temporomandibular joint disc position, rotation and sideway displacements as well as anterior displacement of TMJ discs are important aspect of internal derangement. There were some trials to suspect anterior and sideway disc displacements through MR images. But the sagittal and the coronal views of MRI could only show the image of cutted slices, these images were not sufficient for showing the entire correlations amomg glenoid fossa, condylar head and articular disc. In this study we combined the images of the each slice of sagittal views like drawing a map, then we could see the interrelations among these three major components of TMJ smore precisely. Applying this method to both asymtomatic volunteers and TMD patients, we classified the interrelationships between condylar head and articular disc of TMJ as twelve types. The distributions are as follows: 1. In asymptomatic volunteers cases, normal relations were 65.0%, sideways or rotational displacements without anterior displacement were 20.0%, only anterior displacements were 15.0%, and anterior displacements combined with rotational displacements were 5.0%. 2. In unaffected sides of TMD patients, normal relations were 42.1%, rotational displacements were 11.8% and anterior displacements were 47.0%. 3. In affected sides of TMD patients, normal relations were 10.6%, sideways or rotational displacements were 13.6%, anterior displacements were 75.8%. 4. In asymptomatic volunteers or unaffected sides of TMD patients, pure anterior displacement was more prominent than combined with sideways or rotational displacement, but in affected sides of TMD patients pure anterior displacement was less prominent.
Autopsy ; Head ; Humans ; Magnetic Resonance Imaging ; Temporomandibular Joint Disc ; Temporomandibular Joint* ; Volunteers