Various kinds of spinal instrumentation have been developed for treatment of spinal disorders which are associated with instability. Recently, newly designed devices using pedicle screw were developed with advantages of short segment fixation and firm internal fixation. This is a retrospective clinical and roentgenographic study to evaluate the effectiveness of Cotrel 1. Of the 27 cases, spinal stenosis were 11, spondylolisthesis were 8, spondylolysis were 4, burst fracture were 2, metastatic bone tumor was 1, and failed back syndrome was 1 case. 2. Result of clinical evaluation by Hanley's criteria at last follow up were excellent in 7(27%), Good in 15(58% ), fair in 4(15%). (1 case of metastatic bone tumor was excluded). 3. In the cases of spondylolisthesis, we tried to reduce the displacement in 2 cases of Meyerding Grade II, and 1 case was reduced and 1 case was not reduced. In the cases of of Meyerding Grade I, no further displacement was developed. 4. The complications were observed in 10(37%)cases. A) Generalized complications were 2 cases of hematoma, 3 cases of superficial infection of wound, and 1 case of nerve root irritation. B) Failure in instrmentation were 1 case of screw breakage, 1 case of complete loss of fixation between screw and rod, and 2 cases of partial loss of fixation. 5. To prevent above mentioned complications in fixation of the instrument, the following factors are recommended: 1) Selection of the adequate length of rod. 2) Fixation of the additional implant such as security bolt when instability between screw and rod is predictable. 3) Selection of the closed head screw in the fixation of proximally sided screw if possible. 6. Cotrel-Dubousset instrument has many advantages such as rigid internal fixation, anatomical reduction, and good maintenance and also effective in reduction and maintenance of spondylolisthesis and in wide posterior decompression of spinal stenosis, but for prevention of some complications, precise use of instrument and good application of surgical technique will be needed.
Decompression ; Follow-Up Studies ; Head ; Hematoma ; Internal Fixators ; Pedicle Screws ; Retrospective Studies ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylolysis ; Wounds and Injuries

No abstract available.
Adult ; Humans

Mobius syndrome is generally considered to be a static disorder of congenital origin, and is manifested as unilateral or bilateral facial weakness and lateral gaze limitation. In most instances the syndrome occurs sporadically, but rarely familial cases have been reported. We report a family of three members with Mobius syndrome; a 7-year-old girl, a 6-year-old boy, and their 29-year-old mother. Each patient revealed facial diplegia, and unilateral or bilateral lateral rectus palsy. Brain MRI scans showed normal and there were no definite brainstem dysfunctions on electrophysiologic studies.
Abducens Nerve Diseases ; Adult ; Brain ; Brain Stem ; Child ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Mobius Syndrome* ; Mothers

Mobius syndrome is generally considered to be a static disorder of congenital origin, and is manifested as unilateral or bilateral facial weakness and lateral gaze limitation. In most instances the syndrome occurs sporadically, but rarely familial cases have been reported. We report a family of three members with Mobius syndrome; a 7-year-old girl, a 6-year-old boy, and their 29-year-old mother. Each patient revealed facial diplegia, and unilateral or bilateral lateral rectus palsy. Brain MRI scans showed normal and there were no definite brainstem dysfunctions on electrophysiologic studies.
Abducens Nerve Diseases ; Adult ; Brain ; Brain Stem ; Child ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Mobius Syndrome* ; Mothers

BACKGROUND AND OBJECTIVES: Herpes zoster(HZ) is a well known viral infection of the nervous system. HZ is associated with the neurologic complication. It may have been expected a change in the cerebrospinal fluid(CSF) of patients with HZ. The purpose of this paper is to present the correlation between CSF findings and neurologic complications in HZ. METHOD: The patients(n=75) with HZ were 31 male and 26 females, who were ranged in age from 15 to 79years(mean 53.4 years) admitted to department of Neurology of Chung Ang Gil General Hospital from June 1992 to May 1995. The patients were evaluated for the etiology, lesion distribution, and complications. CSF study was performed in 32 patients(male/female=20/12), whose age ranged from 16 to 79 years(means 51years) during 5 days to 10days after initial symptom onset. CSF findings were analyzed for their etiology, lesion distribution and complication. RESULTS: The CSF of 25 patients(78.1%) showed pleocytosis(5 to 49/mm3 in 10 patients, means, 62.1/mm3). 7 patients(12.3%) had meningitis symptoms, whose cell counts of CSF were more than 50/mm3(means 128.4/mm3) postherapeutic neuralgia was more common in elder patient than younger patients(p=0.005). Complications tended to correlate with the cell counts of CSF. There was no difference in CSF finding between cranial segmental involvements. CONCLUSION: We confirmed the pleocytosis in CSF of patients with HZ and suggest the development of complications in patients in patients with HZ tend to correlate with the cell counts of CSF.
Cell Count ; Female ; Herpes Zoster* ; Hospitals, General ; Humans ; Leukocytosis ; Male ; Meningitis ; Nervous System ; Neuralgia ; Neurology

BACKGROUND AND OBJECTIVES: Herpes zoster(HZ) is a well known viral infection of the nervous system. HZ is associated with the neurologic complication. It may have been expected a change in the cerebrospinal fluid(CSF) of patients with HZ. The purpose of this paper is to present the correlation between CSF findings and neurologic complications in HZ. METHOD: The patients(n=75) with HZ were 31 male and 26 females, who were ranged in age from 15 to 79years(mean 53.4 years) admitted to department of Neurology of Chung Ang Gil General Hospital from June 1992 to May 1995. The patients were evaluated for the etiology, lesion distribution, and complications. CSF study was performed in 32 patients(male/female=20/12), whose age ranged from 16 to 79 years(means 51years) during 5 days to 10days after initial symptom onset. CSF findings were analyzed for their etiology, lesion distribution and complication. RESULTS: The CSF of 25 patients(78.1%) showed pleocytosis(5 to 49/mm3 in 10 patients, means, 62.1/mm3). 7 patients(12.3%) had meningitis symptoms, whose cell counts of CSF were more than 50/mm3(means 128.4/mm3) postherapeutic neuralgia was more common in elder patient than younger patients(p=0.005). Complications tended to correlate with the cell counts of CSF. There was no difference in CSF finding between cranial segmental involvements. CONCLUSION: We confirmed the pleocytosis in CSF of patients with HZ and suggest the development of complications in patients in patients with HZ tend to correlate with the cell counts of CSF.
Cell Count ; Female ; Herpes Zoster* ; Hospitals, General ; Humans ; Leukocytosis ; Male ; Meningitis ; Nervous System ; Neuralgia ; Neurology

No abstract available.
Nocardia Infections*

Total 7,446 pedicle measurements were made from T1 to L6. Direct dimensional measurements were obtained from dried adult human spinal columns. Parsmeters considered were the pedicle isthmus diameter in the coronal and sagittal planes, pedicle angles in the transverse and sagittal planes, and the depth to the anterior cortex in a line parallel to the midline of the vertetral body and along the pedicle axis. The results were as follows. 1. The widest pedicle transverse diameters were seen at L6, the narrowest at T4. 2. The widest pedicle superoinferior diameters were seen at T12, the narrowes at T1. 3. In the transverse plane, the posterolateral to anteromedial pedicle axis orientations were seen at all levels except at T12 and T12. 4. In the sagittal plane, the pedicles angled caudally at L5 and cephaladly from L3 to T1. 5. In the thoracolumbar junction, the percentage less than 6mm in the transverse diameters of pedicles is most high at L1(27%) and followed by at the level L2, T11 and T12. 6. The use of 6mm transpedicular screws can be expected to violate the cortex of the pedicles in a significant number in the upper lumbar spine. 7. The 5mm transpedicular screws can be used safely below the T11 level. 8. It is advisable to use roentgen image intensifier during insertion of the transpedicular screws.
Adult ; Humans ; Lumbar Vertebrae ; Spine

Tricho-rhino-phalangeal syndrome (TRPS) is a hereditary disorder characterized by craniofacial and skeletal abnormalities. A mutation of the TRPS1 gene leads to TRPS type I or type III. A 20-year-old male patient visited our neurologic department with chronic fatigue. He presented with short stature, sparse hair, pear-shaped nose, and brachydactyly. Radiologic study showed short metacarpals, metatarsals with cone-shaped epiphyses, hypoplastic femur and hip joint. Panel sequencing for OMIM (Online Mendelian Inheritance in Man) listed genes revealed a de novo heterozygous frameshift mutation of c.1801_1802delGA (p.Arg601Lysfs*3) of exon 4 of the TRPS1 gene. The diagnosis of TRPS can be challenging due to the rarity and variable phenotype of the disease, clinicians should be aware of its characteristic clinical features that will lead a higher rate of diagnosis.
Brachydactyly ; Databases, Genetic ; Diagnosis ; Epiphyses ; Exons ; Fatigue ; Femur ; Frameshift Mutation* ; Hair ; Hip Joint ; Humans ; Male ; Metacarpal Bones ; Metatarsal Bones ; Nose ; Phenotype* ; Wills ; Young Adult

OBJECTIVE: The aim of this study was to investigate the 3-dimensional position of the center of resistance of the 4 maxillary anterior teeth, 6 maxillary anterior teeth, and the full maxillary dentition using 3-dimensional finite element analysis. METHODS: Finite element models included the whole upper dentition, periodontal ligament, and alveolar bone. The crowns of the teeth in each group were fixed with buccal and lingual arch wires and lingual splint wires to minimize individual tooth movement and to evenly disperse the forces to the teeth. A force of 100 g or 200 g was applied to the wire beam extended from the incisal edge of the upper central incisor, and displacement of teeth was evaluated. The center of resistance was defined as the point where the applied force induced parallel movement. RESULTS: The results of study showed that the center of resistance of the 4 maxillary anterior teeth group, the 6 maxillary anterior teeth group, and the full maxillary dentition group were at 13.5 mm apical and 12.0 mm posterior, 13.5 mm apical and 14.0 mm posterior, and 11.0 mm apical and 26.5 mm posterior to the incisal edge of the upper central incisor, respectively. CONCLUSIONS: It is thought that the results from this finite element models will improve the efficiency of orthodontic treatment.
Crowns ; Dentition ; Displacement (Psychology) ; Finite Element Analysis ; Incisor ; Periodontal Ligament ; Splints ; Tooth ; Tooth Movement