STUDY DESIGN: The treatment of a stable fracture around thoracolumbarjunction is a controversial subject. OBJECTIVES: To evaluate the result from long term follow-up of the stable spinal fracture around thoracolumbar junction according to the operation, osteoporosis and in situ extension bar, respectively. SUMMARY OF BACKGROUND DATA: The thoracolumbar junction is a transitional zone in which the kyphotic angle of thoracic spine is continued to the lordotic angle of lumbar splne. So it is prone to be injured biomechanically, and the stability of the spine around thoracolumbar junction is not determined yet. METHODS: We studied retrospectively 105 cases of the stable fracture around thoracolumbar junction from January 1985 to December 1995. The criteria of the stability were a compression fracture by Denis F., a bursting fracture without involvement of posterior column, a neural enchroachment of bony fragment below 30%, fracture without subluxation or dislocation in spinal junction. RESULTS: The most common cause was traffic accident and, the first lumbar vertebrate was common site. Below 30% of initial compression, the progression was not exceded 5% in operative group. But in nonoperative group, anterior compression was more progressed than initial compression over 5%. The degree of anterior compression was affected by osteoporosis and in situ extension bar just after injury. CONCLUSIONS: We suggest an anterior compression abode 30% in spinal body of thoracolumbar junction for an additional operative indication. The prognosis may be affected by osteoporosis and in situ extension bar.
Accidents, Traffic ; Dislocations ; Follow-Up Studies* ; Fractures, Compression ; Osteoporosis ; Prognosis ; Retrospective Studies ; Spinal Fractures ; Spine ; Vertebrates

STUDY DESIGN: The purpose of this study was to determine whether facet joint orientation and/or tropism influences the prevalence of disc degeneration in MRI in young patients. OBJECTIVE: 41 patients with disc degeneration disease including HNP in MRI were assesed on facet joint angles and tropism between 18 and 30 years old. SUMMARY OF BACKGROUD DATA: The patients who had back pain had association between disc degeneration and facet tropism in adults. But some authors have suggested that facet tropism has no clinical relevance. Physiologic aging and premature disc degeneration induce a gradual loss of water and proteoglycan from nucleus pulposus. METHODS: We reviewed the 41 MRI of lumbar spine with disc degeneration and measured facet joint angles on the mid-disc cut, which was parallel to inferior vertebral end-plate of superior vertebra. In simple X-ray, we reviewed relation between the transitional vertebrae and disc degeneration. It was analyzed statistically the facet joint angles and facet tropism in each levels. RESULTS: The mean facet angles was more increased in upper vertebral facet joints but statistically nonspecific. The facet tropism was not significant in all lumbar levels and the effects of transitional vertebrae on disc degeneration were ignorable and unclear. CONCLUSIONS: No statistical relationship was found among the magnitude of the angle and facet tropism and the presence of disc degeneration at any levels in young patients.
Adult ; Aging ; Back Pain ; Equidae ; Humans ; Intervertebral Disc Degeneration ; Magnetic Resonance Imaging ; Prevalence ; Proteoglycans ; Spine ; Tropism* ; Young Adult* ; Zygapophyseal Joint

The diagnosis and treatment of avascular necrosis of femoral head advanced, after Freud issued examples of bilateral avascular necrosis of femoral head (AVN) in 1926. But still not fixed in treatment and diagnosis. Recently early diagnosis and treatment produced good result. Whole body bone scan, intraosseous pressure mornitoring, intramedullary venography, C-T, or MRI, Selective femoral angiography also used in early diagnosis. Selective femoral angiography was performed for 56 patients, who has suspected as AVN by sumple X-ray and WBBS in order to estimate. How the femoral angiographic finding exist in AVN. In the control group femoral angiography performed to 5 person with normal stage of clinical and radiologic finding. So the result are as following l. All cases in the control group were not observed terminal branch of superior and inferior capslar branch. 2. In AVN the alteration of vasculature appeared 22 patients among 56 patient. 3. The altered vasculature presented 87.5% in traumatic group and 31.5% in nontraumatic group. 4. Collateral circulation was 22.2% in the cases of patients under 6 moths of the time interual between etiological events and clinical symptoms, 89.5% over 6 months. 5. Collateral circulation received 86.8% from inferior gluteal artery two cases from superior gluteal artery, and three cases form obturator artery. 6. Clinical tolerance was supposed to in well developed collateral circulation. According to the above results, Vascular alteraion were noted very much in traumatic group and development of collateral circulation were related promote clinical tolerance. Selective femoral angiography was not effective to assist early diagnosis and treatment of AVN for it could not detect terminal branch of superior and inferior capsular artery that reflected intraossous vasculsture. We need the new nethod of angoigraphy in order to early diagnosis.
Angiography ; Arteries ; Collateral Circulation ; Diagnosis ; Early Diagnosis ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Moths ; Necrosis ; Phlebography

BACKGROUND: Diabetes mellitus is a heterogeneous group of disorders characterized by high serum glucose levels and by disturbances of carbohydrate and lipid metabolism. There are many cutaneous signs of this common endocrinopathy, such as nercobiosis lipoidica diabeticorum, diabetic bullosis, shin spot, diabetic pruritus, etc. OBJECTIVE: In this study, we investigated whether extracellular matrix gene expression in cultured skin fibroblast is influenced by insulin and Insulin-like growth factor-I(IGF-I). METHOD: Total RNA was isolated from insulin or IGF-I treated human skin fibroblasts. The Northern blot and slot-blot hybridization were then conducted. RESULTS: The mRNA levels of pro α1(I) collagen, pro α1(I11) collagen, fibronectin in insulin and IGF-I treated normal skin fibroblasts increased compared with untreated normal skin fibroblasts. CONCLUSION: Our results show that insulin and IGF-I stimulate collagen formation in normal skin fibroblast at physiological concentrations. Therefore, these demonstrate that insulin can modulate the expression of extracellular matrix gene.
Blood Glucose ; Blotting, Northern ; Collagen ; Diabetes Mellitus ; Extracellular Matrix* ; Fibroblasts* ; Fibronectins ; Gene Expression ; Humans ; Insulin* ; Insulin-Like Growth Factor I ; Lipid Metabolism ; Methods ; Pruritus ; RNA ; RNA, Messenger ; Skin*

Cutaneous metastases from internal carcinornas are relatively rare. The frequency of metastases to the skin varies from 0.5-4.4%. We report a case of cutaneous metastasis suspected to originat from stomach cancer. A 44-year-old female, who had an episode of total gastrectony under diagnosis of stornach cancer three years ago, had multipe painless erythernatous nodules on the case and neck for one year. Histologic findings shows atypical anaplastic cell infiltration at the derr is and subcutaneous tissues. Cells with hyperchrornatic and erally displaced nuclei were recogniz d PAS staining shows positive reactions within the cells of glarid like structure. She died twelve month after the appearance of the cutaneous lesions.
Adult ; Diagnosis ; Female ; Humans ; Neck ; Neoplasm Metastasis* ; Skin ; Stomach Neoplasms ; Stomach* ; Subcutaneous Tissue

The Melkersson-Rosenthal syndrome consists of the associated of indings of facial nerve paralysis, facial swelling and scrotal tongue. We report a case of MRS where a 20 year old female had diffuse swelling on her face and lips for 10 years. This was also accompaiined with difficulty of facial expression and fissured tongue. The improved with intralesional injection: of triamcinolon acetonide 40mg for 3 consecutive weeks and 2 every other week.
Facial Expression ; Facial Nerve ; Facial Paralysis ; Female ; Humans ; Injections, Intralesional ; Lip ; Melkersson-Rosenthal Syndrome ; Tongue, Fissured ; Young Adult

BACKGROUND: Neurofibroma, the hallmark of neurofibromatosis, is a cutaneous or subcutaneous lesion, with a variable clinical presentation. Histologically, neurofibroma consists of proliferation of nerve derived cellular elements, together with an abundant, collagenous extracellular matrix. Specifically, neurofibroma has been shown to contain 30-50% collagen in its matrix. Objective 5. METHODS: We examined the expression of extracellular matrix genes (collagen, fibronectin, laminin), TGF-b mRNA and Ha-ras oncogene mRNA by using Northern and slot-blot hybridization and immunoperoxidase stains. Result: In Northern blot analysis, Ha-ras and TGF-b genes revealed respectively, 8.8kb and 2. 5kb sized mRNA transcripts in neurofibroma. These parameters were normal in the control. The expression of these genes were 1.9, 2.0 fold increased in neurofibroma. In slot-blot analysis, expression of type I collagen showed fibronectin genes to be 2,401+210, 540+43, respectively, in neurofibroma. So there were 3.7 fold, 2.1 fold, differences respectively, compared to the normal control. However, there were no significant changes of type IV collagen and laminin Bl mRNA levels between neurofibroma and normal skin tissues. Irnmunoperoxidase staining by rnonoclonal anti type IV collagen antibody in neurofibroma showed type IV collagen to be diffusely and weakly stained in tissue. On staining by monoclonal anti-laminin antibody, laminin was stained in a matrix and around vessels. CONCLUSION: The increased expression of extracellular matrix genes may suggest that there is a subpopulation of fibroic cells in neurofibroma which are stimulated by TGF-b. Ha-ras genes which might have accumulated with the differentiation of neural tissue may be related to the pathogenesis of neurofibroma tissue formation. Further studies are needed to determine whether the other factors are related to the pathogenesis of neurofibroma.
Blotting, Northern ; Collagen ; Collagen Type I ; Collagen Type IV ; Coloring Agents ; Extracellular Matrix* ; Fibronectins ; Genes, ras* ; Laminin ; Neurofibroma ; Neurofibromatoses* ; RNA, Messenger ; Skin

Many authers insisted that the fracture-dislocation of the vertebral column with locked facet, bilateral dislocation of articular facets which resistant to closed reduction, were necessary to posterior stabilization with anterior decompression. But using Harrington-Distraction rod, we experienced that the acceptable reduction of locked facet and posterior impinged bony fragments without anterior decompression, were obtained.
Decompression ; Dislocations ; Spine

A review of 15 cases of the modified Bristow operation for recurrent anterior shoulder dislocation from Jan. 1983 to Dec. 1988 was presented. Using arthroscopy, we could examined the pathologic feature of the recurrent anterior dislocation of the shoulder. The results are as following. 1. The ages at the initial dislocation were ranged from 15 to 26 years and operated from 19 to 61 years. 2. The most common injury mechanism of the dislocation was sports injury (5 cases) and followings were traffic accident, military training, hanging with one hand. 3. The 10 cases were dislocated above 10 times before operation and 3 were dislocated above 10 times per year. 4. Bony lesions were detected on routine X-ray at 8, that is A-P and lateral view, Hill-sach's view, Stryker-notch view and West point view, Hermoddson view, and apical obique view. 5. Arthroscopic examination was done at 7 cases and could detect the pathologic lesion more exactly. 6. All were treated with modified Bristow method 7. Mean follow up periods were 2 year and 4 monthes. 8. The range of motion was not limited but external rotation was done about 18. 9. Excellent results were obtained by Rowe's grading system, mean 88.8.
Accidents, Traffic ; Arthroscopy ; Athletic Injuries ; Dislocations ; Follow-Up Studies ; Hand ; Humans ; Methods ; Military Personnel ; Range of Motion, Articular ; Shoulder Dislocation ; Shoulder

Ligament and tendon prostheses have all suffered because of failure of the particular material that has used in the past. Various materials, including, silk, nylon, Dacron, and combinstions of other synthetic substances, have all enjoyed temporary vogues and have vogues and have all passed out of habitual use because of collapse of the material employed. In an attempt to find an alternative material for use as a tendon or ligament prosthesis, a fundamentally new approach to the problem has been used, namely, that of tendon ligament induction. Carbon fiber has an attraction as a biologic implant because of its inherently inert nature when used in the pure form. Within recent years, it has been possible to manufacture filamentous carbon fiber of high purity and constant filament size, and this material has been examined as a tendon and ligament prosthesis. Both achilles tendons of 14 adult Korean rabbits were replsced with carbon fiber reinforced epoxies(CFRE, it was developed in department of chemical engineering, Chungnam national university, Daejeon, Korea) after artificially rupture, and serial histologic examination of neotendon formations and biologic responces in vivo were done during 8 weeks. The results obtained were as followings ;1. Hemorrhage and inflammatory reactions were observed at 2–3 weeks after operations. 2. Foreign body reactions were developed at 4 weeks after operation, also observed proliferations of foreign body giant cells and histiocytes. 3. Fibroblasts were increased at 4 weeks after operation, and most severe poliferations at 5–6 weeks. 4. Foreign body reactions and fibroblasts were markedly decreased at 7–8 weeks after operation, and examination of the collagen itself showed it to be closely similar to that found on the normsl side.5. Thus, it appeared that the carbon fiber initially acted as a tendon prosthesis.
Achilles Tendon ; Adult ; Carbon ; Chemical Engineering ; Chungcheongnam-do ; Collagen ; Fibroblasts ; Foreign Bodies ; Giant Cells, Foreign-Body ; Hemorrhage ; Histiocytes ; Humans ; Ligaments ; Nylons ; Polyethylene Terephthalates ; Prostheses and Implants ; Rabbits ; Rupture ; Silk ; Tendons