For many years, healing membranous bone fractures have been known to show a persistent lucency at the fracture interface. Radiographic follow-up has proven to be of little value as a guideline for healing of mandibular fractures. Recently, a fracture has been treated by rigid internal fixation by metallic plate and screws rather than closed reduction and wire fixation, we expected that some difference in the radiographic features of fracture healing. To investigate these questions we undertook a retrospective radiographic and clinical analysis of 33 followed patients with fractures of the body and angle of the mandible from 1993 to 1997. There were 26 male and 7 female patients ranging in age between 5 and 74 years, with an average of 29.7 years. All patients were managed by open reduction with metallic plates and screws. The length of follow-up ranged from 9 to 187 weeks. Total 81 radiographic follow-up films were obtained and divided into 3 grades according to the degree of radiolucency of fracture lines; grade 0 radiolucent fracture line and no evidence of fracture interface calcification, grade 1 decreased radiolucent area and evidence of fracture interface calcification, and grade 2 disappearance of fracture line.Until follow-up of 8 weeks, all of the radiographs showed grade 0. From 8 weeks to 16 weeks, 62.5 percent showed grade 0 and 37.5 percent showed grade 1. From 16 weeks to 48 weeks, 38.5 percent showed grade 1 and 61.5 percent showed grade 2. After follow-up of 48 weeks, all showed grade 2.In this study we have shown that the radiographic disappearance of mandibular fracture lines was usually accomplished by 48 weeks. We feel that radiographic union of the mandible is lagging well behind clinical union, but disapperance of the fracture line in rigidly fixated mandibular fracture was occurred earlier than healed by fibrous union. We propose that radiographic union of the mandible by approximately 1 year can be a guideline for the normal mandibular bone healing.
Female ; Follow-Up Studies* ; Fracture Healing ; Fractures, Bone ; Humans ; Male ; Mandible ; Mandibular Fractures* ; Retrospective Studies

STUDY DESIGN: A retrospective analysis was performed on 40 patients who had had previous lux bar spine surgeries. OBJECTIVE: To determine what factors most influenced surgical outcome and to analyze results in a series of revision lumbar surgeries. SUMMARY OF BACKGROUND DATA: Satisfactory surgical outcome of the revision lumbar surgery range from 28% to 82% and are rarely comparable to primary surgery. Many factors predicting outcome from repeat lumbar surgery haute been listed. METHODS: Forty patients were analyzed who had had previous lumbar surgeries. The patients were classified into 5 groups according to diagnosis: 3 Infection,5 instability,8 nonunion, 14 HNP and 10 spinal stenosis. of 40 patients,33 patients(82.5%) underwent fusion with instrumentation for repeat surgery. Their clinical course was followed for a minimum of 1 year. The number of surgery on each mpatient was 1.3 times on an average. RESULTS: Overall, 80% of patients had a satisfactory result. Obviously extruded or sequestrated HNP in MRI findings, complete block of contrast with severe radiculopathy and/or myelopathy in spinal stenosis, complete decompression, neurolysi s and fusion with instrumentation, and longer than 6 month pain relief after precious surgery were correlated with satisfactory outcome. However, the number of precious operation, age, repair of pseudarthrosis , no abnormality at surgery and combined multiple degenerative joint disease were significantly correlated with poor surgical outcome. The most common complication during repeat surgery was dural tear in 5 cases(12.5%). CONCLUSIONS: Success rate of revision surgery was low as compared to primary operation. Therefore, erroneous diagnosis and faulty surgical technique understandably lead to failure, and precise attention to preoperative and intraoperative detail can minimize these sources of error.
Decompression ; Diagnosis ; Humans ; Joint Diseases ; Magnetic Resonance Imaging ; Pseudarthrosis ; Radiculopathy ; Reoperation ; Retrospective Studies ; Spinal Cord Diseases ; Spinal Stenosis ; Spine* ; Tears

No abstract available.
Alprostadil* ; Ductus Arteriosus ; Heart Defects, Congenital* ; Humans ; Infant, Newborn*

Obesity has been implicated as a significant risk factor for multiple medical condition including hypertention, glucose intolerance, hyperlipidemia, hyperinsulinemia and fatty liver. Furthermore, obesity in childhood is believed to be a reliable predictor of a similar condition in adulthood. During the recent years, there has been a rapid rise in the incidence of childhood obesity in Korea due to increased dietary intake rich in caloric content. This study was undertaken to investigate the epidemiology and potential health complications of obesity observed in elmentary school students. A total of 3,103 children (1630 boys and 1,473 girls), ages ranging from 6 to 12, were studied with personal interview, physical examination, and laboratory evaluation. The results were as follows: 1) The prevalence of obesity was 13.44% with approximately equal distribution among boys (14.42%) and girls (12.36%). 2) The prevalence of childhood obesity in Seoul was significantly higher (18.62%) than that in Suwon (7.85%) and in Hongchon (6.02%). 3) A higher incidence of hypertension was dectected in obese subjects and this was more obvious in girls. 4) Hyperlipidemia and elevated Atherogenic Index were more frequently observed in obese group. 5) although fasting blood glucose levels were similar in both groups. AST and ALT abnormalities were much more prevalent in obese group. It is concluded that hypertension and other metabolic abnormalities are much more frequently observed in obese children and that our effects should be focused on the earliest dection, prevention and management of childhood obesity.
Blood Glucose ; Child* ; Epidemiology ; Fasting ; Fatty Liver ; Female ; Glucose Intolerance ; Gyeonggi-do ; Humans ; Hyperinsulinism ; Hyperlipidemias ; Hypertension ; Incidence ; Korea ; Obesity* ; Pediatric Obesity ; Physical Examination ; Prevalence ; Risk Factors ; Seoul

Systemic lupus erythematosus (SLE) is a multisystemic disease that can involve the gastrointestinal tract, liver, and biliary system. Symptomatic pancreatic involvement, however, has rarely been reported. It may be part of the primary disease process, such as vasculitic or autoimmune etiology, or associated with drug therapy, in particular corticosteroid. We report here a lupus patient who developed severe pancreatitis within 30 hours of initiation of corticosteroid therapy; we also discuss the relation between pancreatitis and systemic lupus erythematosus.
Biliary Tract ; Drug Therapy ; Gastrointestinal Tract ; Humans ; Liver ; Lupus Erythematosus, Systemic* ; Pancreatitis*

A defective HIV-1 helper virus DNA, pHyPC, was assembled by deleting the RNA packaging signal, env, nef and the 3'LTR sequences. HIV-1 like virus particles that carry the HIV-1 receptor, CD4 were generated by coexpression of pHyPC and plasmid DNAs encoding different chimeric CD4 proteins. The CD4 particles, sharing the CD4 ectodomain, precisely fused to different membrane anchors. CD4(+) particles specifically bound to HIV-1 Env expressing cells, but any signs of infection into these cells were not detected. Binding was only partially blocked by either polyclonal anti-CD4 antibodies or by high concentrations of soluble CD4. Suprisingly, CD4(+) particles also adsorbed to HeLa, CHO, NIH3T3 and COS-7 cells in the absence of HIV-1 Env expression. Adsorption was comparable in strength and speed to the highly specific CD4-Env interaction. CD4(-) particles exhibited only background levels of binding. Cell binding was CD4- dependent, but it was independent of the cell type from which the CD4(+) particles originated. Interestingly, CD4-dependent/Env-independent binding was only found when CD4 was present on virus particles. This suggests that the micro-environment of CD4 on virus particles uniquely expose this new cell binding activity. Its high affinity could explain in part why infection of Env(+) cells by CD4(+) particles was not detected. Further experiments will be required to evlauate whether this strong membrane interaction could represent one step in the multiple-step viral entry process.
Adsorption ; Animals ; Antibodies ; COS Cells ; DNA ; Helper Viruses ; HIV-1* ; Membranes ; Plasmids ; Product Packaging ; RNA ; Virion

The adverse effects of prolonged exposure of pancreatic islets to supraphysiologic glucose concentrations (i.e. glucose toxicity) is mediated at least in part by glucose oxidation and the subsequent generation of reactive oxygen species (ROS) that can impair insulin gene expression and beta cell function. Multiple biochemical pathways and mechanisms of action for glucose toxicity have been suggested. These include glucose autoxidation, protein kinase C activation, methylglyoxal formation and glycation, hexosamine metabolism, sorbitol formation, and oxidative phosphorylation. There are many potential mechanisms whereby excess glucose metabolites traveling along these pathways might cause beta cell damage. However, all these pathways have in common the formation of reactive oxygen species that, in excess and over time, cause chronic oxidative stress, which in turn causes defective insulin gene expression and insulin secretion as well as increased apoptosis. The intracellular peroxide levels of the pancreatic islets (INS-1 cells, rat islets) by flow cytometry were increased in the high glucose media compared to 5.6 mM glucose media. The insulin, MafA, PDX-1 mRNA levels and glucose stimulated insulin secretion (GSIS) were decreased in high glucose media compared to 5.6 mM glucose media. The HO-1 seems to mediate the protective response of pancreatic islets against the oxidative stress that is due to high glucose conditions. Also, we observed decreased glutathione level, gamma-GCS expression and increased oxidized LDL, malondialdehyde level at leukocytes and mesothelial cells from patients with Korean Type 2 Diabetes (esp, poorly controlled patients). In conclusion, this pathophysiologic sequence sets the scene for considering antioxidant therapy as an adjunct in the management of diabetes, especially type 2 Diabetes.
Animals ; Apoptosis ; Flow Cytometry ; Gene Expression ; Glucose ; Glutathione ; Humans ; Insulin ; Insulin-Secreting Cells ; Islets of Langerhans ; Leukocytes ; Lipoproteins, LDL ; Malondialdehyde ; Oxidative Phosphorylation ; Oxidative Stress ; Protein Kinase C ; Pyruvaldehyde ; Rats ; Reactive Oxygen Species ; RNA, Messenger ; Sorbitol

PURPOSE: The purpose of this study was to investigate the relationships among variables of somatic attribution, chronic pain, depression and chronic fatigue in the elderly. METHODS: Empirical data for testing hypothetical models was collected from 311 people over 65 years old in a community settings in Seoul, Korea in June and July, 2000. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling(LISREL) 8.0 program was used to find the best fit model which explained causal relationship of variables. RESULT: According to Accepted model, the relation of variables is that the somatic attribution is the influencing variable to chronic pain and depression and chronic pain and depression is the influencing variable to chronic fatigue. CONCLUSION: The findings of this study give useful information to construct intervention program relating chronic pain, depression and chronic fatigue for the elderly.

BACKGROUND: As determined from the recent investigations of discordant cardiac xenotransplantation, hyperacute rejection occurs mainly at the endothelial cells in donor microvascular systems, but this does not occur at cardiac valve leaflets or at medium-to-large caliber vessels. On the basis of this background, this study was performed to look into the biocompatibility for transplantation of a middle or large diameter xenogenic blood vessel by conducting xenogenic arterial transplantation with the carotid artery in a pig-to-goat model. MATERIAL AND METHOD: The experimental group was composed of 10 pairs of pig-to-goat combinations. They were divided into each period of 1 week, and 1, 3, 6 and 12 months. Four carotid artery grafts obtained through collection of the bilateral carotid arteries from two pigs were preserved at -70degrees C without other treatment, and then they were transplanted into the bilateral carotid arteries of two goats. Doppler ultrasonography was done on a periodic basis after transplantation to evaluate the patency of the grafted blood vessel. At the ends of a predetermined period, the grafts were explanted from the goats and they underwent gross examination. Hematoxylin-eosin and Masson's trichrome staining were conducted. In addition, in order to examine the immunological rejection of the grafted xenogenic blood vessel, immunohistochemical staining was conducted with T-lymphocyte indicator and von Willebrand factor. RESULT: Two goats at the each one-week period and the one-year period died during the experimental period because of a reason unrelated to the experimental procedure, and the remaining 8 goats survived until the end of each experiment period. On Doppler ultrasonography, unilateral carotid artery occlusion was found in a goat, whose period was specified as 3 months, among the 8 survived goats. However, the vascular patency was maintained well and there was no graft that formed aneurysms in the other goats. On gross examination, the region of vascular anastomosis was preserved well, and calcification of the grafted blood vessel was not shown. Histologically, the endothelial cells of the graft disappeared one week after transplantation, and then there was progressive spread of the recipients' endothelial cells from the anastomotic site. The reendothelialization occurred over the whole graft at one month after transplantation. The neointimal thickening and adventitial inflammation became severe by 3 months after transplantation, but this lessened at 6 months and 12 months, respectively. The rate of CD3 positive cells was very low among the infiltrated inflammatory cells. CONCLUSION: The fresh-frozen xenogenic artery kept its patency without being greatly influenced by xenogenic immune reaction.
Aneurysm ; Arteries ; Blood Vessels ; Carotid Arteries ; Endothelial Cells ; Goats ; Heart Valves ; Heterografts* ; Humans ; Inflammation ; Swine ; T-Lymphocytes ; Tissue Donors ; Transplantation, Heterologous ; Transplants ; Ultrasonography, Doppler ; Vascular Patency ; von Willebrand Factor

Twenty five patients (twenty seven hips) who had Chiari osteotomy at Kang Nam St. Marys Hospital between 1980 and 1995 were reviewed to evaluate the factors in the operative technique that contribute to successful outcome and assess the clinical results in various conditions. The length of follow-up ranged from one to fourteen years and the age of at operation ranged from four to twentythree years. Eighteen patients had developmental dysplasia of the hip: four, septic hip: three had another disorders, Prior to the Chiari osteotomy, fourteen hips had an femoral osteotomy and four, trochanteric arthroplasty. We used to the standard osteotomy as described by Chiari with certain modification. A pneumatic saw and osteotome are used instead of Gigli saw. This technique is simple procedure to make the correct level and angle. Bone graft was not performed in all cases even the osteotomy was displaced more than 50 percent of the iliac width. The overall results were 12 excellent, eight good, five fair, and two poor. In eleven patients, the osteotomy had to be displaced more than 50 percent to provide good coverage of the femoral head. Their results were good or excellent. A good result will be obtained if enough attention is paid to displacing the osteotomy. The osteotomy using the pneumatic saw provides accurate level and direction of osteotomy and it is an simple procedure also.
Adolescent* ; Arthroplasty ; Child* ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Osteotomy* ; Transplants