During the past decade, internal fixation techniques for stabilization of spinal fracture, correction of spinal deformity and immobilization in degenerative spinal diseases have increased in general, pedicle screw fixation of the spine provides the three dimensionally rigid grip on each vertebra and minimizes the levels of spinal segment that is needed for proper fixation. But with the increasing use of pedicle screw, there is an increase in incidences of complication. Major complications of pedicle instrumentation are screw malposition, pedicle fracture, iatrogenic foraminal encroachment, injury to the facet joints or vessels, and mechanical failure. These complications may be associated with irreversible damage of both vertebral and neural elements. Therefore, full understanding and knowledge of vertebral morphology is essential for proper instrument fixation and avoidance of complications. A total of 500 pedicle measurements were made from L1 to L5 vertebra. Five morphometric parameters were studied, transverse pedicle width, transverse pedicle angle, depth to anterior cortex, sagittal pedicle width, sagittal pedicle angle. Measurements were done using both spinal computed tomography and simple lumbar X-rays. As for the results, the means of transverse pedicle width is 7.9-16.6mm, transverse pedicle angle is 8.3-29.1 degrees And depth to anterior cortex is 43.8-47.9mm. The results were compared with previous data.
Congenital Abnormalities ; Hand Strength ; Immobilization ; Incidence ; Spinal Diseases ; Spinal Fractures ; Spine ; Zygapophyseal Joint

Acquired Chiari malformation is a term describing the low lying cerebellar tonsils subsequent to the documentation of a normal hind brain. It is radiograpnhically indistinguishable from Chiari-I type malformation. Ventricular and lumbar shunting are known predisposing factors in patients who develop such tonsilar descent. Managements of acquired Chiari malformations include ventriculoperitoneal(V-P) shunt. Ventriculoatrial(V-A) shunt or posterior fossa decompression after removal of lumboperitoneal(L-P) shunt. The authors recently have encountered a patient who developed an acquired chiari malformations after V-P shunt for hydrocephalus associatd with neurocysticercosis. This case of chiari malformation is presented as our report, together with pertinent literature review.
Causality ; Deception ; Decompression ; Humans ; Hydrocephalus ; Neurocysticercosis* ; Palatine Tonsil ; Rhombencephalon ; Ventriculoperitoneal Shunt*

BACKGROUND: Congenital adrenal hyperplasia (CAH) results from an inherited defect in enzymatic steps required to synthesize cortisol from cholesterol. 21-hydroxylase deficiency accounts for 95% cases of CAH. It appears that the frequency and the type of the responsible mutations differ according to the ethnic background and the type of mutation can predict the clinical outcomes such as salt losing type (SL), simple virilizing type (SV) and non-classic type (NC). METHODS: We have analyzed CYP21 genes in 55 Korean cases (110 chromosomes) of CAH by Southern blotting, PCR-dot hybridization and PCR amplification-created restriction site method. The patients include 43 cases of SL and 12 of SV. None of the NC was found. RESULTS: We found the mutations in 94% (103/110) of the examined chromosomes. A total of 10 types of mutations were discovered. The mutations include aberrant splicing of intron 2 (i2, 35%), CYP21 gene deletion (32%) and I172N (11%) in order. When the relationship between the clinical types and genotypes were correlated, most of the SL patients have either i2 (42%) or CYP21 gene deletion (41%), while SV patients have I172N (33%) or P30L (21%). The parents' mutation was investigated in 20 cases. In 4 families, one of the parents was not the obligatory heterozygote carrier i.e. did not have a mutation. The results suggest the high incidence of de novo mutation. CONCLUSION: We have identified the frequency of mutations of the CYP21 in Korean AGS patients. Our results shows that the clinical type of AGS can be predicted from the genotypes of CYP21. Also the high incidence of de novo mutation of CYP21 confirmed the genetic instability of major histocompatibility III region where the CYP21 is located.
Adrenal Hyperplasia, Congenital ; Adrenogenital Syndrome* ; Blotting, Southern ; Cholesterol ; Gene Deletion ; Genotype* ; Heterozygote ; Histocompatibility ; Humans ; Hydrocortisone ; Incidence ; Introns ; Parents ; Phenotype* ; Polymerase Chain Reaction ; Steroid 21-Hydroxylase*