No abstract available.
Signal Transduction*

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

Baker's cyst is found as most frequent cystic mass around the knee occurring between medial head of gastrocnemius muscle and semimembranosus muscle. The proximal or posterolateral extension of the cyst had been rarely reported and the cyst into the surrounding muscular tissue extremely rare. Intramuscular Baker's cyst that we report was found between lateral head of gastrocnemius muscle and popliteus tendon, and then extended into the plantaris muscle. With review of the literature, we here report a very rare case of plantaris muscular extension of Baker's cyst.
Head ; Knee ; Muscle, Skeletal ; Muscles ; Popliteal Cyst ; Tendons

A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

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

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

BACKGROUND: Various tools for the acute response system (ARS) predict and prevent acute deterioration in pediatric patients. However, detailed criteria have not been clarified. Thus we evaluated the effectiveness of bradycardia as a single parameter in pediatric ARS. METHODS: This retrospective study included patients who had visited a tertiary care children's hospital from January 2012 to June 2013, in whom ARS was activated because of bradycardia. Patient's medical records were reviewed for clinical characteristics, cardiologic evaluations, and reversible causes that affect heart rate. RESULTS: Of 271 cases, 261 (96%) had ARS activation by bradycardia alone with favorable outcomes. Evaluations and interventions were performed in 165 (64.5%) and 13 cases (6.6%) respectively. All patients in whom ARS was activated owing to bradycardia and another criteria underwent evaluation, unlike those with bradycardia alone (100.0% vs. 63.2%, p = 0.016). Electrocardiograms were evaluated in 233 (86%) cases: arrhythmias were due to borderline QT prolongation and atrioventricular block (1st and 2nd-degree) in 25 cases (9.2%). Bradycardia-related causes were reversible in 202 patients (74.5%). Specific causes were different in departments at admission. Patients admitted to the hemato-oncology department required ARS activation during the night (69.3%, p = 0.03), those to the endocrinology department required ARS activation because of medication (72.4%, p < 0.001), and those to the gastroenterology department had low body mass indexes (32%, p = 0.01). CONCLUSIONS: Using bradycardia alone in pediatric ARS is not useful, because of its low specificity and poor predictive ability for deterioration. However, bradycardia can be applied to ARS concurrently with other parameters.
Arrhythmias, Cardiac ; Atrioventricular Block ; Body Mass Index ; Bradycardia* ; Electrocardiography ; Endocrinology ; Gastroenterology ; Heart Arrest ; Heart Rate ; Hospital Rapid Response Team ; Humans ; Medical Records ; Pediatrics ; Retrospective Studies ; Sensitivity and Specificity ; Tertiary Healthcare

No abstract available.

Supracondylar fracture of the humerus in children is the most common fracture of the elbow in contrast with infant or adult, and there are also many problem in treatment and accompanying complication. These injuries are difficult to manage in case of a delayed initial treatment or repeated close manipulation. We analysed 32 cases which failed and delayed initial management, at department of orthopedic surgery, Chung Nam University Hospital from Jan. 1977 to Dec. 1981. The results obtained were as follows: 1. The cases admitted after unsatisfactory treatment at other hospital among all cases are most common (59.4%). 2. The average duration after trauma are 5.3 days. The average duration until successful reduction after initial trauma are 7.3 days, 3. In types of fracture, there are all displaced supracondylar fracture (Type II, III, IV). 4. In treatments, initial sucessful close reduction are 5 cases (15.6%). The others require other managements, ie, final successful tractions are 5 cases, final sucessful percutaneous pinnings are 5 cases and final open reductions are 16 cases. 5. Cubitus varus deformity was more common in manual reduction and traction groups than in open reduction and percutaneous pinning groups, but limitation of elbow motion was more common in open reduction and percutaneous pinning groups. 6. In complications, there were 5 nerve palsies (4 radial nerves, 1 median nerve), 3 pin tract infections, 1 myositis ossificans, 9 severe cubitus varus and 5 severe limitation of motion.
Adult ; Child ; Clinical Study ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Infant ; Myositis Ossificans ; Orthopedics ; Paralysis ; Radial Nerve ; Traction

PURPOSE: Prenatal sonography resulted in increased recognition of renal duplication anomalies and, therefore, earlier urological referral and evaluation. However, surgical approach in very young children is debating. We attempt to investigate clinical features and to propose the management strategies in patients with prenatally detected ureteroceles. MATERIALS AND METHODS: From 1982 to 1997, there has been 35 patients (47 units) of duplex system ureter in which both preoperative and postoperative imaging studies including DMSA renal scan were available. Among these, detailed diagnosis and treatment of prenatally detected (PreD) ureteroceles associated with duplex system (9 patients or 12 ureteroceles) were assessed compared with post-natally detected (PND) ones (26 patients or 35 ureteroceles). RESULTS: There were 2 males and 7 female patients in PreD group, whose ureteroceles presented as 6 unilateral (right 1, left 5) and 3 bilateral units. There were 3 patients (33%) presented with urinary tract infection in PreD group and 24 patients (92%) in PND group. Functional evaluation by DMSA renal scan revealed that 8 units (67%) were functioning in PreD group while 37% in PND group, which was not significantly different between two groups. Initial treatment in PreD group were performed in 11 units; transurethral ureterocele incision (TUI, 8 units), ureteroureterostomy (UUO, 1) and upper pole nephrectomy (UPNx, 2). Additional surgery was performed in 8 units, all of which were initially performed TUI. When initial functional status of the upper pole (UP) determined by renal scan were analyzed by ultimate mode of treatment, initially nonfunctioning parenchyme resulted in UPNx in 4 units and 8 functioning moiety were led to parenchyme-sparing surgery, implying TUI actually had not modified ultimate clinical course. Taken both PreD and PND together, UUO and ureteral reimplantation showed lower secondary operation rate. CONCLUSIONS: Although statistics did not fully support our clinical impression, patients with PreD ureterocele have higher proportion in preserving UP function compared with that of a PND. Our results shows direct approach to the upper pole according to the functional status is preferred.
Child ; Diagnosis ; Female ; Humans ; Male ; Nephrectomy ; Referral and Consultation ; Replantation ; Succimer ; Ultrasonography ; Ureter ; Ureterocele* ; Urinary Tract Infections