STUDY DESIGN: A retrospective analysis of 166 patients was undertaken to observe radiologically the changes of adjacent segments at follow-up more than three years after lumbar fusion. OBJECTIVES: The purpose of this study is to analyse the changes of adjacent segments and to correlate these changes to the length of using level and to the degree of deviation from physiologic lumbar lordosis. The authors also correlate these radiologic changes to the clinical symptoms. MATERIALS AND METHODS: In simple x-ray, authors observed traction spur, disc space narrowing, endplate sclerosis and vacuum phenomenon of adjacent segments. Authors used Gelb's criteria in segmental lordosis angle(SLA) and Katz's classification in clinical results. RESULTS: The average age was 49.6 years old and the average follow-up period was 57.2 months(4 years and 9.2 months). We observed radiologically the traction spurs in 35 cases(21.1%), end-plate sclerosis in 32 cases(19.3%), disc space narrowing in 33 cases(19.9%) and the vacuum phenomenon in 10 cases(6.0%). The numbers of fusion segments and the degree of unphysiologic segmental lordosis angle in fusion segments were related with the frequency and degree of changes of adjacent segments(P<0.05). The clinical results showed satisfaction in 142 cases(85.5%), unsatisfaction in 24 cases(14.5%) and low back pain in 24 cases(14.5%), leg pain in 11 cases(6.6%) and extension of fusion level in 4 cases(2.4%). In low back pain patients more than two kinds of radiological changes were frequently observed than the patients without low back pain(P<0.05). CONCLUSIONS: The radiological changes of adjacent segments were more frequently observed in long fusion and in fusion with unphysiologic lumbar lordosis angle. And these changes are frequently associated with low back pain. Thus long fusion and fusion with unphysiologic lumbar lordosis angle should be avoided if possible.
Animals ; Classification ; Follow-Up Studies* ; Humans ; Leg ; Lordosis ; Low Back Pain ; Retrospective Studies ; Sclerosis ; Spinal Fusion* ; Traction ; Vacuum

BACKGROUND:Acute vestibular neuronitis is the disease of which the etiology and pathophysiology are largely unknown . But the viral infection and ischemia of the labyrinth and the vestibular nerve are considered as general etiology. This study was performed to support the viral infection rather than the ischemic theory. MATERIALS & METHODS:We studied seventy years old female patient who showed painful vesicles on left auricle and vertigo with spontaneous nystagmus to the right side. We performed physical examination, serologic test, ENG test, pure tone audiogram, brain magnetic resonance imaging and polymerase chain reaction. RESULTS:We found small vesicles and vascular injection in left EAC, herpes zoster IgG positive, spontaneous right beating in electronystagmograpy, 54% left canal paresis in Caloric test , decreasing left side Tc in velocity step rotatory test, decresed gain, deviation to left in symmetry and phase lead in sinusoidal harmonic acceleration test, normal range hearing in pure tone audiogram, microangiopathy on cortex in brain MRI and negative PCR. CONCLUSION:This case supports viral infection etiology rather than ischemia in vestibular neuritis. But more studies to find the etiology of vestibular neuronitis are required.
Acceleration ; Brain ; Caloric Tests ; Ear, Inner ; Female ; Hearing ; Herpes Zoster ; Herpes Zoster Oticus ; Humans ; Immunoglobulin G ; Ischemia ; Magnetic Resonance Imaging ; Paresis ; Physical Examination ; Polymerase Chain Reaction ; Reference Values ; Serologic Tests ; Vertigo ; Vestibular Nerve ; Vestibular Neuronitis

PURPOSE: This study compared the accuracy of an abutment-framework (A-F) taken with open tray impression technique combining cementon crown abutments, a metal framework and resin cement to closed tray and resin-splinted open tray impression techniques for the 3-implant definitive casts. The effect of angulation on the accuracy of these 3 techniques was also evaluated. MATERIAL AND METHODS: Three definitive casts, each with 3 linearly positioned implant analogs at relative angulations 0, 30, and 40 degrees, were fabricated with passively fitted corresponding reference frameworks. Ten impressions were made and poured, using each of the 3 techniques on each of the 3 definitive casts. To record the vertical gap between reference frameworks and analogs in duplicate casts, a light microscope with image processing was used. Data were analyzed by two-way analysis of variance and the Tukey test. RESULTS: The open tray techniques showed significantly smaller vertical gaps compare to closed tray technique (P < .05). The closed tray and the resin-splinted open tray technique showed significantly different vertical gaps according to the angulation of implant (P < .05), but the A-F impression technique did not (P > .05). CONCLUSION: The accuracy of the A-F impression technique was superior to that of conventional techniques, and was not affected by the angulation of the implants.
Crowns ; Light ; Resin Cements

PURPOSE: To determine the significance of anomalous position of the gallbladder. MATERIALS AND METHODS: Sixteen patients with anomalous position of the gallbladder were evaluated for analysis. The diagnosis was confirmed by ultrasonography(15 patients) and oral cholecystography(1patient). Among those, six patients underwent CT scan and a patient had 99mTc-DISIDA scan. The images were analysed with respect to the location of the GB and configuration and associated abnormality of the liver and hepatobiliary systems. Medical records of each patient were also reviewed. RESULTS: Among 16 patients having an anomalous position of the gallbladder, nine had retrodisplaced gallbladder, four had left-sided gallbaldder, two had suprahepatic gallbladder, and one had floating gallbladder. Except for one patient, fifteen had abnormality in the liver such as focal atrophic or hypoplastic change and liver cirrhosis. Intrahepatic stones were demonstrated in 6 patients. CONCLUSION: Our results showed that anomalous position of the gallbladder was commonly associated with atrophy or hypoplasia of the liver rather than congenital in origin. The possiblity of an anomalous location of gallbladder should be kept in mind when GB is not in its normal location.
Atrophy ; Diagnosis ; Gallbladder* ; Humans ; Liver ; Liver Cirrhosis ; Medical Records ; Technetium Tc 99m Disofenin ; Tomography, X-Ray Computed

No abstract available.
Humans ; Infant* ; Intussusception*

No abstract available.
Ichthyosis, Lamellar*

PURPOSE: We performed this study to describe the findings of MR Myelography(MRM) of herniated disc disease, spinal stenosis and spinal tumor and to evaluate the usefulness of the MRM in comparison to MRI. MATERIALS AND METHODS: MRI and MRM were performed in 31 patients with herniated disc disease(12 patients), spinal stenosis(11 patients) and spinal tumor(8 patients). MRI and MRM were done with 1.5-T Signa MR, using fat suppressed heavily T2-weighted fast spin echo technique. We retrospectively analyzed MRM images about the thecal sac indentation, compression or displacement of the nerve root, extent and degree of narrowing of spinal canal, relationship between spinal tumor and spinal cord. MRM findings were compared with MRI in all cases. RESULTS: In 18 herniated disc cases of 12 patients, focal filling defect with cutoff or displacement of the nerve root in eight cases of paracentral herniated disc was seen. Cutoff and displacement of the nerve root were more clearly delineated on MRM than rvlRI. In the patients of spinal stenosis(11 cases), hourglass deformity of the thecal sac or complete spinal block of the subarachnoid space was clearly demonstrated. The extent and severity of spinal stenosis were more accurately evaluated on MRM than MRI. MRM finding of intramedullary tumor(3 cases) was enlargement of spinal cord. Five cases of intradural extramedullary tumor showed intradural filling defect, which caused contralateral displacement of the spinal cord with meniscus sign on inferior margin of the mass. CONCLUSION: MRM shows characteristic findings of herniated disc disease, spinal stenosis and spinal tumor. MRM yields excellent definition of the thecal sac, nerve roots and nerve root sleeves in relation to herniated disc and may be more accurate in evaluation of the degree and extent of spinal stenosis than MRI.
Congenital Abnormalities ; Constriction, Pathologic ; Humans ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging ; Myelography* ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Spinal Diseases ; Spinal Stenosis ; Subarachnoid Space

Microsurgical compoeite tissue transplantation to date has contributed to reconstructive surgery by expediting transfer of large blocks of tissue. We have performed the first successful transplantation of microneurovascular tendocutaneous free flap from the dorsum foot to the defect of dorsum hand including extensor tendons. We considered the free flap with extensor tendons from the dorsum foot was the best donor site for functional recovery of the defect of dorsum hand. Two cases of tendocutaneous free flap transplantation were performed at the Department of Orthopedic Surgery of Hanyang University Hospital, and satisfactory results were obtained.
Foot ; Free Tissue Flaps ; Hand ; Humans ; Orthopedics ; Tendons ; Tissue Donors ; Tissue Transplantation ; Transplants

PURPOSE: To analyze the complications and improvement of neurologic injury after operative treatment in the fracture-dislocations of thoracic and lumbar spine in long-term follow-up. MATERIALS AND METHODS: A retrospective review of 39 patients, who were operated on for fracture-dislocations in thoracic and lumbar spine from May 1982 to May 1995 was conducted. We evaluated the result with Denis classification for type of fracture-dislocations and with Frankel classification for the neurologic injury. Average levels of fusion were 4.56 segments, ranging from 2 to 7 segments. RESULTS: According to the Frankel classification, the most common neurologic status at initial presentation was grade A in 28 cases (71.8%) and cases with complete paraplegia showed no improvement in long-term follow-up at all. Six other cases with incomplete paraplegia showed average neurologic improvement of 1.5 grade. Ischial sore was most common (13 cases) complication. CONCLUSIONS: Fracture-dislocations showed a higher incidence of neurologic injury than other spine fractures. Complete paraplegia was most common with no neurologic improvement in longterm follow-up. Incomplete paraplegia showed neurologic improvement. The cases of complete paraplegia had more complications than cases of incomplete paraplegia. The authors think that the postoperative care of complete paraplegia is important.
Classification ; Follow-Up Studies ; Humans ; Incidence ; Paraplegia ; Postoperative Care ; Retrospective Studies ; Spine*

No abstract available.
Fractures, Spontaneous* ; Osteoporosis*