The treatment of fractures of the dens is controversial and the major controversy has centered on type II fracture of Anderson and D'Alonzo classification because of its high incidence of nonunion when they were treated by external immobilization like halo apparatus. The posterior arthrodesis of atlas and axis which has been recommended by many authors results in the limitation of rotation of neck. In an attempt to promote bone union and to eliminate functional impairment, the authors have treated 7 consecutive cases of type II dens fracture by direct screw fixation with one or two screws. Minimum follow up period was 15 months(Av. 20mos.). Ages were varied between 23 to 68 years. Amounts of displacement on arrival were more than 4mm in all. Ambulation was started from the day after operation with the external support. Bone union was observed in 6 cases within 3 months without limitation of rotation. One nonunion with losening of screw and one transient dysphagia were observed. The authors believe that the procedure has the advantages in bone union and neck motion, but it requires surgeon's experience and the modification of implant for secure fixation.
Arthrodesis ; Classification ; Deglutition Disorders ; Follow-Up Studies ; Immobilization ; Incidence ; Neck ; Walking

No abstract available.
Decompression* ; Neurologic Manifestations*

Supracondylar fracture of the humerus is the most common fracture of the elbow in children and it can also be one of the most difficult fractures to be treated. A number of methods to manage supracondylar fracture of the humerus in children, have been being practiced and the ideal one is generally agreed with prompt, accurate and anatomical. reduction performed with the least possible trauma, and, it will prevent most complications. It is essential to minimize additional trauma to the already traumatized joint and pericapsular tissues including blood vessles and nerves. 105 patients with supracondylar fracture of the humerus managed at the Department of Orthopedic Surgery, Busan National University from January, 1971 to June, 1976 were reviewed and the following results were obtained. 1. The age of the patients ranged from 2 years to 14 years; the average age was 7. 0 year. 70 patients were boys. 2. The left side was involved in 62 patients; The distal fragment was displaced posterioly in 102 patients and anteriorly in 3 patients The medial displacement in the posteriorly displaced distal fragment was 60 patients. 3. 20 fractures were treated by open reduction and internal fixation. The indications for open reduction were failure to obtain accurate reduction after a few attempts of closed reduction in 15, an open fracture in 2, acute vascular embarrassment in 2, and redisplacement after open reduction in 1. 4. 15 of the 20 fractures treated by open reduction were re-examine 1 to 5 years; The results were normal elbow motion in 10, loss of extension (average 24 degree) in 5, loss of flexion in 2 and neuro-vascular complication in 2.
Busan ; Child ; Elbow ; Fractures, Open ; Humans ; Humerus ; Joints ; Orthopedics

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

No abstract available.
Spine* ; Spondylitis, Ankylosing*

The development of aorticpulmonary bodies was studied by electron microscope in human fatuses ranging from 40mm to 260mm crowm-rump length. The aorticpulmonary bodies were observed in the wall of the aorta, and of the pulmonart trunk and arteries. At 40mm fetus, the aorticopulmonary bodies were composed of clusters of primitive glomus cells, primative supporting cells, unmyelinated nerve fibers, and capillaries. The primitive glomus cells possessed large nuclei, dense-cored vesicles, many Golgi complexes, rough endoplasmic reticulum, and, multivesicular bodies, the primitive supporting cells were agranular with attenuated cytoplasmic processed which partially ensheathed the primitive glomus cells. Synaptic contacts between the axon terminals and the aoma of primitive glomus cells were first observed. The primitive glomus cells increased somewhat in size and number by 90mm fetus, but retained essentially the same characteristics as at the earlier stage. Desmosome-like contacts between glomus cells and adjacent cells were commonly seen. At 160mm fetus, the glomus cells had increased accumulations of all organells and numerous dense cored vesicles. The supporting cells completely invested the glomus cells. Two types of nerve terminals were observed. One type contained small agranular vesicles which was identified as cholinergic axon terminal. The other contained a majority of small granular vesicles which was classfied as adrenergic axon terminal. Synaptic contacts between the cholinergic axon terminals and the soma of the glomus cell were observed. During next prenatal stage up to 260mm fetus the glomus cells and the supporting cells resembling those in adult were present. It is concluded that the ultrastructural features of these aorticopulmonary bodies are similar to those of the carotid body. It is therefore suggested that the aorticopulmonary bodies of the human fetures have a chemorecepter function similar to that of the carotid body.
Adult ; Aorta ; Arteries ; Capillaries ; Carisoprodol ; Carotid Body ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Fetus* ; Golgi Apparatus ; Humans* ; Multivesicular Bodies ; Nerve Fibers, Unmyelinated ; Presynaptic Terminals

No abstract available.
Cell Line* ; Chromosome Aberrations* ; Cytogenetics* ; Humans* ; Neuroblastoma*

BACKGROUND: Intravenous urography(IVU) has long been accepted as the primary radiologic study for the diagnosis of renal colic. But the IVU does pose disks of contrast material reactions and exposure to radiation. Recently, IVU has been challenged as a first line modality and ultrasonography proposed as a replacement. We, therefore, felt obliged to re-evaluate the IVU, KUB and ultrasonography as diagnostic tools. METHODS: We evaluate the sensitivity and specificity of ultrasound, IVU and KUB in detecting urinary calculi in suspected acute renal colic, a prospective study of 69 patients, both sides of kidney and ureter, who visited urban university hospital emergency center from September 1997 to January 1998. Our sonographic criteria far a positive examination consisted of visualization of urinary tract calculus and/or hydronephrosis and/or urinoma. RESULTS: In Ultrasonography, the accuracy, sensitivity and specificity were 94, 94 and 94%. In IVU and KUB, they were 90, 81, 98% and 71, 43, 96%. CONCLUSION: Ultrasonography is very useful diagnostic tool in initial evaluation of acute renal colic.
Calculi ; Diagnosis ; Emergencies ; Humans ; Hydronephrosis ; Kidney ; Prospective Studies ; Renal Colic* ; Sensitivity and Specificity ; Ultrasonography* ; Ureter ; Urinary Calculi ; Urinary Tract ; Urinoma

Accidental or suicidal fatalities of paraquat (Gramoxon) poisong are occasionally seen in the emergency room or intensive care unit in this country. In most cases, respiratory symptoms and eventual death by respiratory distress occur within several days. The most striking pathologic change is fibrosis of the lung due to widespread proliferation of fibroblastic cell. We experience a 21-year-old woman with huge bulla on left lung and diffuse fibrosis in other site, who ingested paraquat 10 months ago. After thoracoscopic removal of bulla, the patient survive without progression of pulmonary complication till now.
Emergency Service, Hospital ; Female ; Fibroblasts ; Fibrosis ; Humans ; Intensive Care Units ; Lung ; Paraquat ; Pulmonary Fibrosis* ; Strikes, Employee ; Young Adult

Although several kinds of instrumentation systems are available for the transpedicular screw fixation in the treatment of spondylolisthesis, the clinical results and the difference between them remdins unclear. In order to study the feasibility of Zielke instrumentation system for that purpose, the author analysed the clinical results of 73 patients with mild or moderate degree of spondylolisthesis who were instrumented with the systems and followed up 25 months in average(Min. 12Ms). The results between the groups with different rod thickness in the system, 3.2mm(20 patients), 4mm(33 patients) and 5mm(20 patients), were compared to study the most appropriate thickness. Reduction of the deformity were done by aid of temporarilly applied Harrington system in 3.2mm group. Inlayed reduction potential coming from the jointing mechanism was utilized in the cases with less than 30% of slippage in 4 and 5mm group. Percentage of slippage was changed from 20% preoperatively, to 4% postoperatively and 6% at the end of follow up. The methods of fusion after reduction and fixation were anterior in 25 and posterolateral in 48. Bony fusion was achieved in all but one with pathological spondylolisthesis. Rod failures were observed in two of 3.2mm and one of 4mm group, and loosening of the joint were developed in three of 5mm group. Clinically, 93% of the patient showed excellent and good results at the end of follow up. From the results, we concluded that the instrumentation is a efficient method of treatment with several advantages in the reduction capacity and the stability of fixation. However, this system has several points in its mechanics that needs to be improved.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Mechanics ; Methods ; Spondylolisthesis