No abstract available.
Aldosterone* ; Child* ; Heart Defects, Congenital* ; Heart* ; Humans ; Plasma* ; Renin*

STUDY DESIGN: This biomechanical study was designed to perform flexibility tests in multiple loading directions to compare the stabilizing effects of supplemental hook or pedicle screw fixation on short segment pedicle instrumentation system. OBJECTIVE: To compare biomechanical flexibilities of short segment pedicle instrumentation constructs added by hook or pedicle screw fixation in an unstable calf spine model. SUMMARY OF BACKGROUND DATA: Short segment pedicle instrumentation is using recently for the surgical treatment of the unstable burst fractures of the thoracolumbar spine, but a high incidence of early screw tai lure in short segment pedicle instrumentation has reported. MATERIALS AND METHODS: Ten fresh frozen calf spines (T10-L3) were loaded with pure uncosstrained moments in flexion, extension, axial rotation, and lateral bending directions. A maximum moment of 6.4 Nm was achieved in 5 steps using dead weights. After removal of L1 vertebral body, testing was performed on intact specimens first and then each specimen after laminar hook or pedicle screw insertion on the short segment pedicle instrumentation of ISOLA implant. Any kinds of graft material or transfixation device were not used to make the worst possible case of instability of an injured spine. Three different fixation methods were instrumented. These included: (1) one level aboye and one level below with pedicle screw, (2) 2 levels above with pedicle screw and hook and one level below with pedicle screw, and (3) 2 levels abode and one level below with pedicle screws. RESULTS: At the level of corpectomy, all fixation methods significantly reduced motions in flexion, extension, and lateral bending as compared to the intact motion (P<0.001). The differences between all constructs were not statistically significant. The addition of a hook or screw on the short segment pedicle screw construct was not significantly reduced the flexibi lite as compared to the short segment pedicle screw construct. Axial rotational motions in groups I, II, and III were similar with each other and with intact motion as well and there were no significant statistical difference. The addition of the hook or screw on the short segment pedicle construct showed more stability as compared to the pedicle screw construct, but statistical difference was not. The addition of hook or screw on the short segment pedicle screw construct showed similar stability in all motions with each other. At the level above corpectomyl all tested fixation methods did not improve the axial rotational stability beyond the intact case, but reduced flexion, extension, and lateral bending motions significantly (p<0.001). The addition of hook or screw on the short segment pedicle screw construct showed significant stability in all motions (p<0.001) as compared to the short segment pedicle screw construct and their stabilities were similar with each other. CONCLUSIONS: All fixation methods showed more stabilities in all motions than normal specimen. The addition of pedicle screw on the short segment pedicle screw constructs are more stable than the addition of hook, but there was no statistical difference. Adding one level of fixation cranial to the fracture using pedicle screws or hooks may be necessary to decrease the rate of clinical failure and to enhance the stability of the construct with short segment pedicle instrumentation
Incidence ; Pliability ; Spine ; Transplants ; Weights and Measures

The characterization of genetic variation at the level of DNA has generated significant advances in gene mapping and disease diagnosis, and forensic identification of individuals. It is now possible to identify individual DNA from various tissue specimens, like hair, using the PCR and oligonucleotide probes. To date, however, the number of hairs needed, the preservation conditions, and the kinds of hair suitable for DNA extraction have not been well known. We performed DNA extraction using hairs from different body sites, using different numbers of hairs, under various different preservation conditions to investigate the acquisition conditions of DNA data from hair using PCR and specific HLA-DQA probe. HLA-DQA genotyping of DNA extracted from peripheral blood was performed to compare the results of hair and blood HLA-DQA genotyping from individuals. The results are as follows: 1) The concentration of DNA extracted from a single strand of hair is 5.23+/-0.54 g/ml. It is possible to extract sufficient DNA for HLA-DQA genotyping from a single strand of hair. 2) DNA concentration is different according to body site. Concentrations are 7.01+/-0.33 g/ml in scalp hair, 6.28+/-0.29 g/ml in axillary hair, and 6.10+0.24 microgram/ml in pubic hair. 3) There is no difference between the electrophortic bands resulting from DNA extracted from the hair of an individual preserved under different conditions, such as room temperature, exposure to sunlight, exposure to low temperature (+4degrees C), or exposure to moisture. 4) There is no difference between the electrophoretic bands resulting from DNA extracted from hair of a single individual preserved for different lengths of time. 5) In an individual, the HLA-DQA genotype obtained from peripheral blood is identical to that obtained from hair. Even though the amout of DNA obtained from hair is limited, it is possible to identify the HLA-DQA genotype of an individual using a single strand of hair. This requires adequate extraction of DNA for PCR analysis using an allele specific probe. We believe that HLA-DQA genotyping using the PCR method on DNA extracted from hair is useful for disease diagnosis and forensic science.
Alleles ; Chromosome Mapping ; Diagnosis ; DNA* ; Forensic Sciences ; Genetic Variation ; Genotype ; Hair* ; Oligonucleotide Probes ; Polymerase Chain Reaction* ; Scalp ; Sunlight

We analyzed 41 cases of burst fractures on the thoracolumbar junction which were operated with Kaneda and Cotrel-Dubousset implant at Chosun University Hospital between 1989 and 1993. The purpose of this study was to evaluate the radiologic sign, the amount of reduction, complications, and functional results. The results were as follows: 1. According to McGrorys Criteria to evaluate the posterior superior vertebral body angle of burst fractures, 33 out of 41 cases(80.5%) were positive and the average angle degree was 107.6°. 2. The average postoperative kyphotic correction was 15.4° in the Kaneda group and 13.8° in the C-D group. The average loss of correction at follow-up examination was 5° in the Kaneda group and 4.8° in the C-D group. 3. Indirect reduction was achieved in 10 cases(50%) and we obtained a good indirect reduction even though canal compromise was over 50%. 4. The pain at operative site was much more severe in the Kaneda group(6 cases) than in the C-D group(2 cases) and both groups experienced 2 cases each of implant failure. 5. According to Denis' pain and work scale, 28 cases(63.8%) had good and excellent, 8 cases had fair and 5 cases had poor results. In summary we recommend doing 1) a posterior instrumentation first for stability and indirect reduction, if it is not a severe neurologic symptom and 2) anterior decompression if it is a severe or progressive neurologic symptom.
Decompression ; Follow-Up Studies ; Neurologic Manifestations

BCG osteomyelitis occurs in the infants and children as complication of BCG vaccination and its occurrence is very rare. It involves the metaphysis of the long bone and its development is chiefly hematogenous spread and direct inoculation. Radiologic feature shows well demarcated, eccentrically located destruction in the metaphysis of the long bone and soft tissue swelling about the lesion but periosteal reaction was absent initially. We experienced a case of BCG osteomyelitis which occurs in the left proximal humerus in 3 month after BCG vaccination.
Child ; Humans ; Humerus ; Infant ; Mycobacterium bovis ; Osteomyelitis ; Vaccination

Supracondylar fracture of the humerus is the most common fracture of the elbow in children For period of 4 years from Jan. 1980 to Dec. 1983, 54 children with dispaced supracondylar fracture of the humerus were classified by direction of displacement of distal fragment and treated by immediate closed reduction after lateral skeletal traction. 32 cases of these were followed up for more than 6 months. The results were obtained as follows.: 1) The most common incidence (79.6%) was 5 to 12 years of age and male and female ratio was 2.4 : l. The left humerus was involved in 35 cases (64.8%). 2) Of all fracture, extension type was 96.3% and flexion type 3.7%. 3) Under the exact anteroposteier and lateral views, fractures were classified by displaced direction of distal fragment. Immediate closed reduction was done by using thick and strong periosteal hinge after lateral skeletal traction. The more accurate anatomical reduction was obtained by maintenance of reduction state and further correction during lateral skeletal traction, and complications such as VIC, loss of reduction were lessened probably. 4) For follow up study of 32 cases, final result were analized according to Mitchells classification. Excellent results were obtained 23 cases (71.9%) Good results were 8 cases (25.0%) Unsatisfactory result was 1 case (3.1 %) 5) In 2 cases of treatment failure, the brachialis muscle was buttonholed by metaphyseal spike of the proximal fragment. 6) During lateral skeletal traction, superficial infection was developed through pin tract in 4 cases. These were treated by the administration of antibiotics and there were no complication such as osteomyelitis.
Anti-Bacterial Agents ; Child ; Classification ; Elbow ; Female ; Follow-Up Studies ; Humans ; Humerus ; Incidence ; Male ; Osteomyelitis ; Traction ; Treatment Failure

Avascular necrosis of the carpal lunate (Kienbock's Disease) was first described by Peste in 1843. It's etiology is still unknown. Since Lippman, in 1949, there have been many operative treatments for this disease but they had many complications and technical difficulties. The treatment of Kienbock's disease by resection of the lunate and replacement with fascia lata through the dorsal approach is very simple in operation method and its results were satisfactory in follow up study for postop 12, 18 months. We report two cases of Kienbock's disease with brief review of literature.
Fascia Lata ; Fascia ; Follow-Up Studies ; Methods ; Necrosis ; Osteonecrosis

A major problem in the repair of the torn Achilles tendon has been providing the restoration of the anatomic continuity such that virtually normal plantar flexion power and ankle mobility result. Continuity should be restored without subsequent pain, disconfiguration, occupational limitations. If possible, postoperative complications, or tendon-rerupture should be avoided. Surgeons have long advocated the use of strips of facia and other tissues, including the plantaris tendon, to reinforce the repair of the torn Achilles tendon, The repair effected by these methods not infrequently is bulky and not too secure. Non-absorbable suture materials utilizing in the end to end anastomosis of the torn Achilles tendon cause sinus formation and discharge of suture materials. A secure method of repair for the tom Achilles tendon, which decreases sinus formation and is not bulky, should be required. The plantaris tendon, which has been used as a reinforcing material, can be utilized in the end-to-end anastomosis of the torn Achilles tendon by detaching from the muculotendinous junction. The 11 patients with the torn Achilles tendon were treated by end-to-end anastomosis using the plantaris tendon as suture material. The postoperative results were staisfactory without significant functional deficit and complication.
Achilles Tendon ; Ankle ; Humans ; Methods ; Postoperative Complications ; Surgeons ; Sutures ; Tendons

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus or superior orbital fissure has been termed Tolosa-Hunt syndrome. We have experienced a case of Tolosa-Hunt syndrome in an 11 year old boy who has diagnosed with several clinical signs and symptoms such as severe ocular pain, headache, ptosis, proptosis, slight limitation of eyeball motion, nausea and vomiting, and the brain and orbital C-T scan which shows the right ethmoid and sphenoid sinusitis and inflammatory thickening of dura an the planum spenoidale.
Brain ; Cavernous Sinus ; Child ; Exophthalmos ; Headache ; Humans ; Inflammation ; Male ; Nausea ; Ophthalmoplegia ; Orbit ; Sphenoid Sinus ; Sphenoid Sinusitis ; Temazepam ; Tolosa-Hunt Syndrome* ; Vomiting

From October 1990 through July 1991, 187 women who complained of urinary incontinence underwent investigation in the department of urology, especially urodynamically, compared with 42 women with female urethral syndrome as control group. The following results were obtained ; mean functional urethral length was 3.1+/-0.9cm and mean maximal urethral closure pressure was 80.2+/-2.4cmH2O in genuine stress incontinence patients. But each results of female urethral syndrome were 3.6+/-0.7cm and 121.1+/-3.8cmH2O, respectively, and were higher than those of genuine stress incontinence (p <0.05 ). The incidence of positive pressure equalization of genuine stress incontinence was higher than that of control group, as 85.6% and 14.3% (p<0.05). The findings of uroflowmetry and cystometry showed within normal limits in genuine stress incontinence and poor voiding pattern in female urethral syndrome. Conclusively. urodynamic study was important for diagnosis and follow up of genuine stress incontinence.
Diagnosis ; Female ; Humans ; Incidence ; Urinary Incontinence ; Urodynamics* ; Urology