No abstract available.
Magnetic Resonance Imaging*

In the investigation of patients with internal disc disruption, a discography has been the best method to decide whether intervertebral disc is normal or abnormal. Magnetic resonance imaging (MRI) of the spine is a new technique which offers an alternative method of obtaining this information. Some authors have reported MRI was more accurate than discography, but other reports have indicated discography was more useful test in symptomatic lumbar disc disease. The authors performed retrospective study to evaluate the diagnostic value of the image findings of MRI and discography in the internal disc disruption. Image findings of MRI and discography were analyzed comparing to pattern of provocative pain during discography. The concordant pain at discography was considered as a gold standard for evaluation of the diagnostic value of these modalities. The image findings of MRI and discography for 60 discs of 21 patients were graded and compared with the pain response at discography. The validity and predictive value (PV) of these modalities were calculated and the correlation between these image findings was evaluated. The sensitivities of discography and MRI were 83.3% and 90.9% respectively. The specificities of these findings were 47.1% and 46.7%. The positive PV of discography and MRI were 52.6% and 55.6%, and the negative PV were 80% and 87.5% respectively. There was no statistical significance in these discrepancies. The determinations of symptomatic disc level based on image findings are unreliable. The MRI can be considered as a screening test for internal disc disruption since it is non-invasive and sensitive diagnostic tool. The fusion level should be decided by the pain pattern at discography.
Humans ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Mass Screening ; Retrospective Studies ; Spine

Anterior plate fixation of the cervical spine provides good primary stability to allow early mobilization without significant external support. Despite the obvious advantages of anterior cervical fixation, neurological injury resulting from the direct trauma of a drill bit or screw are possibile with this technique. In addition, screw loosening leading to dyphagia has been reported. The cervical spine locking plate (CSLP) system maintains the mechanical advantages of internal fixation and eliminate the neurological risks of perforating the posterior cortex. The purpose of this study is to review our experience with this device, to critically assess its ability to stabilize the cervical spine, and to assess for complications associated with this device. The authors reviewed 28 consecutive patients in whom the CSLP system was applied between April 1994 to April 1995. Average age was 44 years ranged from nineteen to seventy-two. Patients with trauma were eight and degenerative diseases were twenty. Eighteen screws were inserted in C3 bodies, twenty-four in C4, forty-one in C5, thirty-six in C6, twenty-four in C7, two in Tl and nine on grafted bone. With a mean follow-up of 15 months, 27 of 28 patients went on to fusion. Mean time to fusion was three months (range 2-5). Fusion status of one patient was considered as uncertain. Three patients had screws placed in the disc rather than in bone. One patient suffered deep wound infection, which developed to tracheoesophagial fistula. No patient showed neurological injury as a result of this device.
Early Ambulation ; Fistula ; Follow-Up Studies ; Humans ; Spine* ; Transplants ; Wound Infection

STUDY DESIGN: Thirty-eight patients with thoracolumbar and lumbar burst fractures were evaluated according to the treatment methods of the retropulsed fragments. OBJECTIVE: To confirm the pure effect of ligamentotaxis according to the approaching methods to tile involved area. SUMMARY OF BACK GROUND DATA: Retropulsed fragments were effectively treated by indirect posterior reduction. Regardless of size of the retropulsed fragments, remodelling process of the retropulsed fragments was progressed during follow-up period. METHODS: 38 patients with burst fractures of thoracolumbar and lumbar spine were divided into two groups according to tile reduction method of the retropulsed fragments ; the one group consisted of 18 cases which were treated by posterior instrumentation and indirect reduction(Group I: ligamentotaxis) and the other groups consisted of 20 cases which were treated by posterior instrumentation and posterior direct reduction(Group II). Change of neural canal compromise rate, neurologic status, remodelling process of the retropulsed fragments were measured using pre-, post-operative and follow-up radiographs and CT. RESULTS: Comparing the two groups, neural canal compromise rates were decreased at postoperative period but, there were no significant differences in both groups. There were no correlation of neurologic status and neural canal compromise rate. We could confirm the remodelling process of the retropulsed fragments, but there were no significant changes according to the size of the retropulsed fragments between two groups. CONCLUSIONS: Indirect reduction by posterior instrumentation( ligamentotaxis ) could effectively treat the retropulsed fragments in burst fractures of thoracolumbar and lumbar spine without directs posterior reduction.
Follow-Up Studies ; Humans ; Neural Tube ; Postoperative Period ; Spine

No abstract available.
Female ; Fibronectins* ; Hypertension, Pregnancy-Induced* ; Plasma* ; Pregnancy ; Pregnancy*

A 34-year-old Korean man presented with a 3 week history of a yellowish eczema like patch on the left thigh. Sixteen months prior, he was diagnosed with polymorphie r eticulosis of the left nasal cavity. The patient, refuse<3 conventional radiation therapy and took herbal medication and diet therapy instead. Biopsy of the nasal cavity, hard palate and left thigh lesians showed extensive necrosis and polymorphic infiltrates of atypical lymphocytes with angiodestructive invasion. Irnmunohistochemical study of left thiyh lesion showed strong CD2 positivity con sistent with the diagnosis of peripheral T cell lymphorra.
Adult ; Biopsy ; Diagnosis ; Diet Therapy ; Eczema ; Humans ; Lymphocytes ; Lymphoma, T-Cell, Peripheral ; Nasal Cavity ; Necrosis ; Palate, Hard ; Skin* ; Thigh

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 authors performed a study of 32 patients who had undergone anterior lumbar interbody fusion using allograft with posterior pedicular instrumentation. The clinical outcomes were evaluated and the radiographs were analyzed with respect to graft subsidence, interspace collapse, graft collapse, sagittal angle and fusion status. In 71% of the levels there was a loss of disc space height during the follow-up, with 18% of the levels being narrower than their preoperative height at late follow-up. Significant(more than 3mm) subsidence and collapse were noted in three and four levels respectively. Approximately 84% of the 32 patients had satisfactory results and a radiological fusion was obtained in 88.2% of the 34 levels. We consider the pedicle screw fixation improves the retention of interspace distraction and the fusion rate of allograft in anterior lumbar interbody fusion.
Allografts* ; Follow-Up Studies ; Humans ; Spine ; Transplants

The kinetic of the distal radioulnar joint(DRUJ) is complex. Motion of DRUJ consists of rotation of the around the relatively stationary ulna, poisoning of the ulna along its longitudinal axis, and translational motion, which occurs in the antero-posterior plane. In addition to the motions described, there also exists and abduction-adduction movements, diastatic motion. The CT scan is an ideal tool for evaluation the DRUJ. Since it provides a coronal cross-sectional image of the radius and ulna. The amount of translational motion occurring at the DRUJ has hot been determined. To evaluate the normal boundaries of the motion of the DRUJ, forty DRUJ in twenty normal volunteers(10 meles, 10 females) were evaluated by use of a computed tomography technique. The results were as follows. 1. Average translational motion according to forearm rotation was 3.1mm±1.3. 2. There was no statistic difference between both sex(p>0.05). 3. There was no statistic difference between dominant and nondominant hand(p>0.05). The contralateral criterion is useful in determing wrist problem.
Forearm ; Poisoning ; Radius ; Tomography, X-Ray Computed ; Ulna ; Wrist

We used skeletal scintigraphy which had a high sensivity in the diagnosis of acute fractures in clinically suspected scaphoid fracture to elevate diagnostic accuracy, and then evaluated the results. From February 1993 to April 1994, twenty patients with a clinical suspicion of a scaphoid fracture in spite of normal skeletal films had been examined with skeletal scinigraphy of the wrist Sensitivity was 100%, specificity 30.8%, positive predictable value 43.8%, and negative predictable value 100%. The patients with positive scintigraphy and normal x-ray were free from symptoms in 4-6 weeks in spite of no treatment. In conclusions, Skeletal scintigraphy is of major importance in carpal trauma to rule out scaphoid fracture. Information obtained through scintigraphy often proved a prerequisite both for the retrospective identification of the fracture and for repeat directed skeletal view. The lesions in the distal radius and other carpal bones may clinically mimic a scaphoid fracture. and the authors feel to need further specific diagnostic tools such as MRI in cases with carpal injuries and scinitigraphic uptake indicative of a fracture when even skeletal views turn out normal. However, scintigraphy doesn't seem to be a guide of trament in these patients.
Carpal Bones ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Radionuclide Imaging ; Radius ; Retrospective Studies ; Sensitivity and Specificity ; Wrist