STUDY DESIGN: Changes of morphology and phenotype of cultured cells in media added lactate were observed. OBJECTIVES: To evaluate the effect of lactate on morphology and phenotype of cultured intervertebral disc cell. SUMMARY OF LITERATURE REVIEW: It was reported that lactate and pH were important factor in the degeneration of intervertebral disc. However the effect of lactate on morphology and phenotype of cultured intervertebral disc cell have not been studied. MATERIALS AND METHODS: Cells were dissociated enzymatically from rabbit nucleus pulposus. After attaining monolayer growth, the cells were incubated in media added 2mM or 5mM lactate. Total cell counts and morphological changes of the cells were periodically observed. Changes in cell phenotype were investigated by use of anti-collagen antibody stain. RESULTS: The cell groups added no lactate and 2mM lactate showed no difference in cell counts, morphology and phenotype. The cell group added 5mM lactate showed a reduction in final cell Counts and highel'ratio of fibroblastic cell in total population. Anti-collagen I Ab stained the Intra-and extra-cellular area of fibroblastic cells and intracellular area of chondrocytic cells. CONCLUSIONS: The current study suggests that high concentration of lactate inhibit intervertebral disc cell proliferation and accelerate morphological and phenotypical change to fibroblastic cell.
Cell Count ; Cell Proliferation ; Cells, Cultured ; Fibroblasts ; Hydrogen-Ion Concentration ; Intervertebral Disc* ; Lactic Acid* ; Phenotype*

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

PURPOSE: To evaluate the efficacy of the arterial phase of dynamic spiral CT in the detection of pancreatic adenocarcinoma compared with the late phase. MATERIALS AND METHODS: Two phase spiral CT images of seventeen patients with pathologically proven pancreatic ductal adenocarcinomas were compared retrospectively. CT scans were performed with 5mm collimation at 1:1 pitch table speed. Images of arterial and late phases were obtained at 35 seconds and 180 seconds after initiation of administration of 100mL of contrast material(3mL/sec), respectively. Images of the arterial phase were compared with those of the late phase. RESULTS: Images of the arterial phase showed sufficient contrast between the tumor and adjacent pancreatic parenchyma in 12 cases, insufficient in four cases, and no significant contrast in one case. Images of the late phase showed sufficient contrast in five cases, insufficient in five cases, and no significant contrast in seven cases. Images of the arterial phase was superior to that of the late phase in 12 patients(70.6%). In six of the 12 patients, only the images of the arterial phase showed contrast between the tumor and the adjacent parenchyma. The images of late phase showed only one case of three metastasis detected on the images of the arterial phase. CONCLUSION: The arterial phase of spiral CT is superior to the late phase that is comparable with conventional CT in the detection of pancreatic adenocarcinoma.
Adenocarcinoma* ; Humans ; Neoplasm Metastasis ; Pancreatic Ducts ; Retrospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

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Ocular rosacea is the eye manifestations of rosacea, which involves the lids, conjunctiva, and cornea. A recent study revealed that all patients with cutaneous rosacea had some degree of ocular involvement which is often undiagnosed. It is difficult to make a diagnosis of ocular rosacea because it lacks clinical or pathological hallmarks. However, early diagnosis and treatment are emphasized to decrease morbidity and prevent potential blindness. We report a case of ocular rosacea in a 49 year-old man who showed blepharoconjunctivitis, keratitis, and cutaneous manifestations of persistent erythema, telangiectasia, and papules. The ocular symptoms and signs had improved significantly with tetracycline therapy.
Blindness ; Conjunctiva ; Cornea ; Diagnosis ; Early Diagnosis ; Erythema ; Eye Manifestations ; Humans ; Keratitis ; Middle Aged ; Rosacea* ; Telangiectasis ; Tetracycline

STUDY DESIGN: A retrospective review of the patients who have a fixation failure of instrumentalion for the spinal fusion in lumbar region. OBJECTIVES: To assess the incidence and different types of the mechanical failure of fixation and to evaluate their managements and their influences on the progression of a spinal fusion and to the clinical outcomes. SUMMARY OF LITERATURE REVIEW: Most of the spine surgeons have been experiencing the mechanical failures after instrumentations for a spinal fusion, eden though the incidence is decreasing with a modification of the implants. Reports on this problem are sporadic in conjunction with the other topics, rarely focusing on their management and their influences on the final outcomes. MATERIALS AND METHODS: 338 consecutive patients who had a lateral fusion in the lumbar region with an instrumentation of pedicle screws and rods, mostly with decompression, were reviewed to analyse the fixation failures of instrumentation after surgery. RESULTS: There were 26 patients (7.7%) who had the fixation failures of instrumentation, in terms of loosening around the pedicle screws in 18 patients (5.3%), the breakage of the pedicle screws in fide patients (1.5%), and the migration of a rod in three patients (0.9%). They were managed by prolonged use of brace and ergonomic back cares. Even with the fixation failures, 19 patients (73.1%) disclosed solid union uneventfully, but one patient had re-operation to obtain solid fusion. The final outcomes were satisfactory in 22 patients (84.6%), including four of six patients who had pseudoarthrosis. CONCLUSIONS: The fixation failure of instrumentation after a spinal fusion in lumbar region was not rare, but the progression of a spinal fusion usually quite well achieved and the final outcomes were not so bad, even with the implant failures and pseudoarthrosi s. Except for the persistently symptomatic pseudoarthrosis, only a prolonged use of brace and the ergonomic back cares are recommended for symptomatic patients.
Braces ; Decompression ; Humans ; Incidence ; Lumbosacral Region* ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion* ; Spine

While benign tumors of tendons and aponeuroses are observed commonly and have been defined adequately, malignant tumors originating from these tissues are rare. Among those reported most had been classified as synovial sarcoma or fibrosarcoma until Ezinger in 1965 described a new type that he called “clear cell sarcoma” of tendon and aponeurosis. Recently, Ultrastructural and histochemical analysis has revealed that the tumor cells contain melanin in the form of melanosomes in varying stages of development and currently, the neoplasm is considered a primary malignant melanoma of the soft tissue. A csse of clear cell sarcoma of flexor tendon in the wrist is reported, with an emphasis on its electron microscopic description.
Fibrosarcoma ; Melanins ; Melanoma ; Melanosomes ; Sarcoma, Clear Cell ; Sarcoma, Synovial ; Tendons ; Wrist

Calcaneus is more frequently fractured than any other tarsal bones. Because of complex contour of calcaneus, it is difficult to evaluate the type of fracture exactyly. Futhermore fractures involving subtalar joint give rise to chronic pain and functional incapacity. Many different methods have been tried for treatment, but there was no aggrement of its methods and results. From January 1981 to December 1986, calcaneal fractures of 62 cases in 52 patients were analyzed and the results obtained from this study were as follows :l. Of 52 patients, 41 patients were male and 11 female. 2. The cause of fractures was a falling down in 38 patients (76%), traffic accident in 8 patients (15%) and direct blow in 6 patients (12%) 3. According to Rowe;s classfication, Type I fracture was in 5 cases, Type II in 6 cases, Type lll in 5 cases, Type IV in 12 cases and Type V in 34 cases (55%). Of these Type V fracture, tongue type was in 21 cases and joint depression type in 13 cases. 4. The treatment was as follows : cast immobilization in 33 cases, closed reduction and pin fixation in 24 cases and open reduction in 5 cases. 5. The functional result was satisfactory in 44 cases (71%). The result was better in fractures not involving subtalar joint and among type V fractures, the result was better in fractures of tongue type treated with open reduction. 6. So, we recommended compressive bandage and early mobilization for fractures without displacement, axial fixation for tongue type fractures and open reduction for joint depression type fracture.
Accidental Falls ; Accidents, Traffic ; Bandages ; Calcaneus ; Chronic Pain ; Depression ; Early Ambulation ; Female ; Humans ; Immobilization ; Joints ; Male ; Subtalar Joint ; Tarsal Bones ; Tongue