Many believe the reduction in the number of mobile segments causes an increased strain in the unfused segments, predisposing them to early degeneration. This degeneration of the adjacent segment could be a cause of low back pain after spinal fusion. The clinical manifestations supporting the increased stress of the unfused segments are the significant incidence rates of spondylolisthesis, spondylolysis acquisita and spinal stenosis. However, there was a paucity of reports in the literature on the histological observation at the adjacent, unfused sgements. Therefore, the purpose of this study was to observe the histological changes of the unfused, mobile segments following fixation in the cat spine. The cat lumbar spines from L6 to L7 were fixed posteriorly with acrylic cement and wires. Histological and histochemical observation of the upper adjacent segment were performed after H-E, trichrome, reticulin and Safranin-O staining at postoperative 6 and 12 months, respectively. The results were as follows: 1. There were mild degenerative changes in the intervertebral disc, but no evidence of definitive degeneration in the articular cartilage of the facet joints at postoperative 6 months in the spinal fixation group. 2. The marked degenerative changes of the intervertebral disc were shown at postoperative 12 months in the spinal fixation group. Of 5 cats sacrificed at 12 months, 3 cats had irregular configuration of the fiber's arrangement of the annulus fibrosus. 3. At postoperative 12 months in the spinal fixation group, marked degeneration was noted on the articular cartilage of the adjacent facet joints. Through this study, it is clarified that degenerativce changes of the intervetebral disc and facet joint at the adjacent segments will develop after certain period of time following spinal fusion. Especially the facet joints of the adjacent, unfused segment were found to be most vulnerable to the adverse effects. This may be responsible for the back pain in the future after spine fusion.
Animals ; Back Pain ; Cartilage, Articular ; Cats* ; Incidence ; Intervertebral Disc ; Low Back Pain ; Reticulin ; Spinal Fusion ; Spinal Stenosis ; Spine* ; Spondylolisthesis ; Spondylolysis ; Zygapophyseal Joint

Three cases of congenital coxa vara were treated by subtroch-anterie abduction osteotomy with percutaneous pin fixation of both fragments. The indications of the corrective subtrochanteric osteotomy for coxa vara deformity were the neck-shaft angle of 100 degress or less, the presence of marked gluteus medius limp and the vertical neck defect with progression of the varus deformity. Through a lateral approach, the lateral aspect of the proximal end to the femoral shaft was exposed and 2 Steinmann pins were inserted through the upper and lower levels to the proposed osteotomy. The distal pin was inserted perpendicular to the long axis of the femur and the proximal pin at an algle of desired correction to the distal pin and a subtrochanteric transverse osteotomy was completed. Two Steinmann pins were paralell to each other by adducting the proximal fragment and abducting the distal fragment. and the lateral cortex of the proximal fragment was impacted into the marrow cavity of the distal fragment. The Steinmann pins were then incorporated in the hip spica cast. The object of the operation was to correct the coxa vara, to change the stress on the vertical fissure in the neck from shear to compression and to overcome shortening of leg. With this technically simple method, the authors achieved adequate correction of the deformity. The ostetomies healed rapidly and the medullary canal was re-established in all cases, The gait of each patient was markedly improved and the Trendelenburg test become negative in all of them. One of these patients showed a mild recurrence of varus deformity and limp 2 years following surgery.
Bone Marrow ; Congenital Abnormalities ; Coxa Vara ; Femur ; Gait ; Hip ; Humans ; Leg ; Methods ; Neck ; Osteotomy ; Recurrence

BACKGROUND: One of the most, probable pathogenesis of vitiliga is autoimmune. Systemic cor tico st,eroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. OBJECTIVE: We have assessed the clinical effect of a oral small oral dose of corticosteroid to minimize side effects in vitiligo patients. METHODS: Thirty four patients(9;male, 25;female) with vitiligo were evaluated in this study. The patients took 7.5mg-20mg prednisolone initially for 2 months and then the dosage was tapered to half of the initial dosiat the 3rd month and half of dose of 3rd month for the last 4th month. We compared the effcct of treatment of vitiligo before and aft.er the study by photographs. and side efferts were issessed at. 1, 2, 3 and 4 month. RESULTS: The arrest of the progression of vitiligo was noticed in 79% of patients and repigmentation was noticed in 59% of patients which is statistically significant. The effect, of treatment according to extent, duiation, type, and site of vitiligo were not statistically significant. The side effects of treatment were minimal and did not affect the course of treatment. CONCLUSION: Small doses of iral corticosteroids are effective without any significant side effects in preventing progression and loiiduce repigmentation of active spreading vitiligo and generalized type of vitiligo that is difficult to treat with topical corticosteroids.
Adrenal Cortex Hormones* ; Humans ; Prednisolone ; Vitiligo*

Freys syndrome is characterized by attacks of facial erythema and gustatory sweating occurring in the cutaneous distribution of the auriculotemporal nerve. After sugery, trauma, abscess, or other diseases of the parotid gland, the postganglionic sympathetic and parasympathetic nerve fibers are disrupted. Some misdirected auriculotemporal nerve fibrils join with the distal sympathetic nerves innervating the sweat glands and subcutaneous vessels. We report a case of Freys sindrome in a 6-year old boy without any definite injury to the parotid gland. After considering our case and review of literature of Freys syndrome in children, we conclude that there may be a congenital defect in the auriculotemporal nerve innervation responsible for cases occuring in children.
Abscess ; Child* ; Congenital Abnormalities ; Erythema ; Humans ; Male ; Nerve Fibers ; Parotid Gland ; Sweat Glands ; Sweating, Gustatory

During the course of infectious mononucleosis, intake of ampicillin and its analogues such as amoxicillin may cause hypersensitivity skin rashes. We report herein a case of ampicillin induced skin rash in a 41-year-old female patient with infectious mononucleosis. Infectious mononucleosis was confirrned by datetion of IgM antibody against Epstein-Barr(EB) viral capsid antigen(VCA) in her serum. During the icuteillness, she taked ampicillin for 3 days, and 1 week after the intake of ampicillin, a genertliz:d erythernatous and purpuric maculopapualr eruption developed. Physicians should be careful not to use ampicillin and its analogue if batients are suspected to be infected with EB virus as ampicillin induces severe skin rashes in patients with infectious mononucleosis.
Adult ; Amoxicillin ; Ampicillin* ; Capsid ; Exanthema* ; Female ; Humans ; Hypersensitivity ; Immunoglobulin M ; Infectious Mononucleosis* ; Skin*

The clinical study was performed to 28 patients with the pericardiac effusion who were admitted in Busan university Hospital and Paik Hospital, In-Je Medical College, Busan, korea during March 1976 and July 1981. The results were as following; 1) 12 cases(42.9%) of total 28 pericardiac effusion occured in 3rd decade, 8(28.5%) in 2nd decade and 5 cases(17.9%) in 4th decade. Sex distribution showed male to female 2.5:1. 2) With etiological distribution there were 15 cases(53.6%) tuberculous, 5(17.9%) nonspecific, 3(10.7%) malignant, 2(7.1%) pyogenic, 2 traumatic and 1(3.6%) rheumatic. 3) On admission 28 cases(100%) complained of dyspnea, 24(85.7%) distant heart sound, 20(71.4%) each engorged jugular vein and edema, 18(64.3%) each cough and abdominal fullness, 17(60.7%) each sputum and chest discomfort and pain, 12(42.9%) fever, 11(39.1%) orthopnea, 10(35.7%) chilling, 7(25%) oliguria, 4(14.6%) palpitation and 3(17.2%) headache. Increased cardiac dullness was observed in 26 cases(71.4%), hepatomegaly 18(64.3%), pulmonary rales 17(60.7%), ascites 13(46.1%), fever 12(42.9%), pericardiac friction rub 10(35.7%), splenomegaly 7(25%), paradoxical pulse 6(21.4%) and jaundice 2(7.1%). 4) On amission SGOT and SGPT level was increased each in 15(53.6%) and 13(46.7%), TTT and CCF abnormal in 10(35.7%), and 8(28.5%), serum NPN, BUN, creatinine increased in each 10(35.7%), 11(39.1%), 8(28.5%), WBC increased in 6(21.4%), RBC decreased in 8(28.5%) and ESR increased in 16(57.1%). 5) Characteristics of pericardiac effusion showed hemorrhagic 17(60.7%), serosangeous 6(21.4%), sangeous 3(17.2%) and pyogenic 2 cases(7.1%). 6) The ECG on admission revealed low voltage in 25(89.1%), depressed ST segment in 13(46.1%) and inverted T wave in 12(42.9%). 7) Chest X-ray showing cardiomegaly 28(100%), pleural effusion in 20(71.4%), and pulmonary congestion in 16(57.1%). 8) The m mode and 2-D Echocardiogram showed echo free space in 28 cases and after pericardiocentesis the space was reduced or disappeared. 9) 19 cases of 28(67.5%) were improved clinically, while 5 cases(17.9%) were not improved and 4 cases(14.6%) died.
Alanine Transaminase ; Ascites ; Aspartate Aminotransferases ; Busan ; Cardiomegaly ; Cough ; Creatinine ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Fever ; Friction ; Headache ; Heart Sounds ; Hepatomegaly ; Humans ; Jaundice ; Jugular Veins ; Korea ; Male ; Oliguria ; Pericardiocentesis ; Pleural Effusion ; Respiratory Sounds ; Sex Distribution ; Splenomegaly ; Sputum ; Thorax

The rupture of anterior cruciate ligament has been diagnosed by stress test, radiogram and diagnostic arthroscopy, but these methods have several disadvantages of lack of objectivity, exposure to radiation and risk of anesthesia. To eliminate these difficulties, the K-T 1,000 knee ligament arthrometer was used for the objective diagnosis in the injury of anterior cruciate ligament. We performed instrumented measurement of anterior-posterior laxity of the knee in 100 normal subjects by using the K-T 1,000 knee ligament arthrometer under the 15 lb., 20 lb. and maximum anterior pulls, and 20 lb. posterior push. The following results were obtained: 1. The mean anterior displacement at 20 lb.: 4.43mm The mean posterior displacement at 20 lb.: 2.30mm 2. The mean right knee-left knee difference in anterior displacement: 0.89mm 3. The mean anterior compliance index: 1.16mm So, we believed that a right knee-left knee difference and a anterior compliance index are sensitive measures of the integrity of the anterior cruclate ligament. And this test method was helpful for the diagnosis and objective recording in the injury of anterior cruciate ligament. This test method has following advantages: 1. There is no anesthesia risk. 2. The patient and examiner undergo no radiation exposure. 3. Diagnostic arthroscopy may be avoided. 4. Due to patient comfort, there is minimal muscle guarding.
Anesthesia ; Anterior Cruciate Ligament ; Arthroscopy ; Compliance ; Diagnosis ; Exercise Test ; Humans ; Knee ; Ligaments ; Methods ; Radiation Exposure ; Rupture

13 cases of salmonella spondylitis were experienced for 4 years since 1973 and are reviewed with follow-up of 12 months period in average. All cases had febrile disease for 1 to 4 weaks and the symptoms of spondylitis started at febrile stage in 4 cases and at convalescent stage in 9 cases. The pathologic lesions found on x-rays involved 2 to 3 vertebral bodies mostly in middle lumbar spines ranging from thoracolumbar junction to lumbosacral junction. Needle aspirations for the spinal lesions were tried in 9 cases and salmonella typhi group “D” was identified in 5 cases. Needle aspiration was safe, simple, and valuable diagnostic method. Diagnosis of the other cases ware made clinically. It was difficult to differentiate from tuberculous spondylitis or pyogenic spondylitis, but there was some differential points in history, physical findings, laboratory and x-ray findings. All cases responded well to conservative treatments with antibiotics and immobilization and no case indicated surgery.
Anti-Bacterial Agents ; Aspirations (Psychology) ; Clinical Study ; Diagnosis ; Follow-Up Studies ; Immobilization ; Methods ; Needles ; Salmonella typhi ; Salmonella ; Spine ; Spondylitis

During the past three years, 110 consecutive cases of intravenous lidocaine anesthesia under tourniquet for surgery in the upper extremities were observed. The cases were simple injuries or diseases which needed simple surgery or closed reduction requiring only a short period of time. A tourniquet with double cuff was utilized. After tourniquet inflation, 0.5% or 0.75% lidocaine was injected intravenously in the amount of 1.5 mg per Kg body weight. Satisfactory anesthesia was performed in all except 18 cases who had some discomfort of tourniquet origin and analgesics were necessary. No significant complication was noticed. The technic was very simple, safe and effective for simple procedures on hands or forearms.
Analgesics ; Anesthesia ; Anesthesia, Conduction ; Body Weight ; Forearm ; Hand ; Inflation, Economic ; Lidocaine ; Tourniquets ; Upper Extremity

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