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

PURPOSE: Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in renal failure. The aim of this study is to evaluate the successful access rate and risk factors of arteriovenous fistula (AVF) in the arm for dialysis at a single center. MATERIALS AND METHODS: Patients undergoing vascular access operation between January 2006 and December 2011 were retrospectively identified. RESULTS: A total of 362 vascular access operations were performed. There were 338 autologous AVFs (93.4%) and 24 prosthetic grafts (6.6%). Men comprised 58.3% of all subjects. Mean age was 59.5+/-14.7 years. There were 187 diabetes mellitus patients (51.7%). There was a mean duration of 70.3+/-21.1 days between access creation to first cannulation. Overall successful access rate for dialysis was 95.9%. Of 338 autologous AVFs, 326 patients had patent AVFs for dialysis (96.4% surgical success rate), while 21 of 24 prosthetic grafts were patent (87.5% surgical success rate). A total of 141 patients (38.9%) came to surgery with preoperative central venous catheters (CVC) of which 130 (35.9%) AVFs had a patent fistula in the arm. The only risk factor related to successful access rate of AVF was preoperative CVC placement (P=0.012). CONCLUSION: Successful vascular access rate was 95.9%. The only risk factor related to patent access of AVF was preoperative CVC placement. At least 6 months prior to expected dialysis, AVF surgery is recommended, which may overcome the challenge of co-morbid conditions from having a preoperative CVC.
Arm* ; Arteriovenous Fistula ; Catheterization ; Central Venous Catheters ; Diabetes Mellitus ; Dialysis* ; Fistula ; Humans ; Male ; Renal Insufficiency ; Retrospective Studies ; Risk Factors* ; Transplants

No abstract available.
Spinal Cord Injuries* ; Spinal Cord*

Traumatic spondylolisthesis of the axis is the fracture of both pedicles and is called commonly as hangman' s fracture. The fractures with the anterior displacement more than 3mm and the angulation, more than 11 degrees were classified as unstable and the surgical methods were recommended for the treatment of the fractures. As for the surgical methods, anterior C2-3 fusion with plate fixation or transpedicular screw fixation were used. However, the differences between the clinical results of both methods were not reported in the literatures. In order to clarisy the clinical results of both methods, the authors evaluated the clinical results of 11 patients treated by anterior plate fixation and 7 patients treated by transpedicular fixation who were operated on between Mar. 1987 and,Jan: 1992. Minimum follow-up period was 12 months. 1. As the surgical complications, two cases of transient dysphagia in anterior fixation group and three cases of malinserted screw in transpedicular fixation group were observed. 2. Limitation of rotatory neck motion, less than 20 degrees in one direction was observed in four cases of transpedicular fixation group. 3. Anterior angulation, more than 10 degrees was noted in three cases of transpedicular group. 4. Mild intermittent neck pain was observed in two cases of anterior fixation group and two cases of transpedicular fixation group. Constant neck pain was present in three cases of transpedicular fixation group. 5. Over-all clinical results were excellent or good in all of anterior fixation group, and in four of seven transpedicular group. Although the clinical materials were limited in number, method of anterior plate fixation was recommended by the authors in the management of traumatic spondylolisthesis of axis, because of the easier technique and the better clinical results than the transpedicular screw fixation.
Deglutition Disorders ; Follow-Up Studies ; Humans ; Methods ; Neck ; Neck Pain ; Spine ; Spondylolisthesis

The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

No abstract available.
Blood Platelets* ; Diagnosis* ; Flow Cytometry* ; Integrin beta3* ; Thrombasthenia*

Cockayne syndrome is a rare autosomal recessive disorder that results in postnatal growth failure and progressive neurological dysfunction. Associated clinical features are gait disturbance, progressive pigmentary retinopathy and other ocular anomalies such as cataracts and optic disk atrophy, sensorineural hearing loss, dental caries and cutaneous photosensitivity. The disease is clinically heterogeneous with a wide range in the type and severity of symptoms. We experienced a case of Cockayne syndrome in 13 year-old male, who had delayed development, hypophasia, characteristic physical appearance, cutaneous photosensitivity, dental caries. We reported the case with review of literatures.
Adolescent ; Atrophy ; Cataract ; Cockayne Syndrome* ; Dental Caries ; Gait ; Hearing Loss, Sensorineural ; Humans ; Male ; Optic Disk ; Retinitis Pigmentosa

BACKGROUND: The changes in lipid composition during epidermal differentiation has been reported in human and animal models. Because of the difficulties in getting adeguate specimens from human subjects, the authors used easily obtainable circumcised prepuce for lipid analysis. OBJECTIVE: To investigate the changes in lipid composition duriig cornification of the epidermis, the lipid compositions of whole epidermis and stratum corneum were analyzed by thin layer chromatography(TLC). METHODS: From circumcied prepuce whole epidermis and stratum orneum were separated by 10mM EDTA(ethylene diamine tatraacetate) in PBS(phosphate-buffered saline) or heat(60C), and 0.5% trypsin in PBS respectively. Lipids were extracted with methanolctloroform-HO mixture(4:2:1.6, v/ v, Bligh-Dyer solvent), TLC was performed and lipid composition was quantitated by photodensitometer. RESULTS: In the composition of stratum corneum lipids, sphingoliids were the highest(33.3+2.9%) followed by cholesterol, free fatty acids and cholesterol esters in cleceasing order, there were small percentages of triglycerides, cholesterol sulfate and squalene. CONCLUSION: In this study the lipid composition of epidermis was similar to that of stratum corneum rather than those of previous reports on epidermal lipids, which may indicate the regional characteristics of epidermal/stratum orneum lipids in hyperkeratotic prepuie.
Cholesterol ; Cholesterol Esters ; Epidermis* ; Fatty Acids, Nonesterified ; Humans ; Models, Animal ; Squalene ; Triglycerides ; Trypsin

Most of the macular hole retinai detachinents are limited to the perimacular area. Therefore, we must look for the peripheral retinal hole when the macular hole retinal detachment extends beyond equator. And the principle of operation should be on the peripheral retinal hole rather than macular hole. Authors studied the clinical feature of macular hole retinal detachment associated with the peripheral retinal hole. Among the 39 macular hole retinal detachment patients, peripheral hole was found in 12 patients (30.7%). Sex distribution was the same and mean age was 55.9 years old. Retinal detachment was not diagnosed for more than I month in 7 cases (58.4%). Nine cases (75.0%) were extensive retinal detachments extending beyond 3 quardrants. Nine cases (75.0%) had one peripheral hole and most of peripheral holes were found on the ternporal side. Associated diseases were cataract (5 cases, 38. 5%) and high myopia (5 cases, 38.5%). In 4 cases (33.3%) hole was found on the opposite side. Among the 12 macular hole retinal detachment patients, 11 operations were performed with the technique of gas injection and scleral buckling which lead to successful attachment in 5 cases (41.7%). Among the 7 cases in which reoperations were needed, 3 cases (42.9%) were recurred in 3 months. In 8 cases (66.7%) there were improvements of post-operative visual acuity.
Cataract ; Humans ; Myopia ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Scleral Buckling ; Sex Distribution ; Visual Acuity

Reactive human mesothelial cells were examined by immunocytochemical stain with intermediate fiiaments (cytokeratin [CK1, CK7, CK8, CK18, CD19], vimentin, desmin, actin), epithelial membrane antigen, carcinoembryonic antigen (CEA), MHC class II antigen (HLA-DR), LeuM-1 (CD15), alpha1-antitrypsin(ACT), alpha1-antichymotrypsin(ACMT), CD68(KP-1) and FcyRIII(CD16). The mesothelial cells were isolated from patients with liver cirrhosis and pleural effusion, and short-term cultured in RPMI 1640 media containing 10% heat inactivated fetal calf serum and 1% identical supernatant fluid of the patients transudates. The results obtained are as follows. 1. The cultured-reactive mesothelial cells were positive for the protein of cytoskeleton such as cytokeratin and vimentin, but negative for desmin and actin. The resting mesothelial cells showed positive reactions for cytokeratin, but negative for vimentin, desmin and actin. 2. The primary antibodies to the cytokeratin were strongly reactive for CK1, CK8 and CK18 but negative r CK7 and CK19 in both reactive and resting mesothelial cells. 3. Resting mesothelial cells showed negative reactions for CEA, but strong positive reactions in cultured-reactive mesothelial cells. 4. The markers for the monocytes/histiocytes(CD11b, CD14, CD16, CD68, lysozyme and alpha1-antitrypsin and alpha1-antichymotrypsin) were nonreactive in resting mesothelial cells, but lysozyme and alpha1-antitrypsin were weakly reactive in reactive and proliferative mesothelial cells. 5. MHC Class II molecule(HLA-DR antigen) was negative in both resting and reactive mesothelial cells. These results suggest that the short-term cultured, reactive mesothellal cells show a newly aberrant expression of the vimentin and carcino-embryonic antigen. The reason of the aberrant expression of the intermediate filament and oncofetal antigen in reactive and proliferative mesothellal cells should be further evaluated.
Actins ; Antibodies ; Carcinoembryonic Antigen ; Cytoskeleton ; Desmin ; Exudates and Transudates ; Follow-Up Studies* ; Histocompatibility Antigens Class II ; Hot Temperature ; Humans ; Hydronephrosis* ; Intermediate Filaments ; Keratins ; Liver Cirrhosis ; Mucin-1 ; Muramidase ; Pleural Effusion ; Salivary Glands ; Vimentin