The Ilizarov fixator allows significantly more axial motion at the fracture site than the conventional monofixators. But the transfixing wires have inevitable problems of soft tissue impalement. Therefore the Rancho mounting technique, replacing the transfixing wires with half pins, has become a common place. But the increment of the axial stiffness secondary to replacing transfixing wires with half pins has not been defined clearly yet. The authors measured the axial stiffness of the Ilizarov fixator and two different configurations of the Rancho frame. The group I frame was the Ilizarov fixator composed of four rings and two transfixing wires on each ring. The group II frame was the Rancho frame and it was constructed same as the Ilizarov frame but a transfixing wire was replaced with a half pin from two central rings respectively. The group III frame was another type of Rancho frame which was constructed same as the second group but the remaining transfixing wire was replaced with a half pin from the two central rings respectively. The axial stiffness of the Group I , II and Group III frames were 71.54+/-7.21N/mm, 89.65+/-6.42N/mm, 101.01+/-7.92N/mm respectively. The axial stiffness difference between the Group I frame and the Group II frame was statistically significant(p<0.01). Also the difference between the Group I frame and the Group III frame was statistically significant(p<0.01). This study shows that the replacement of two transfixing wires with two stainless half pins resulted in significant increment of the axial stiffness of the Ilizarov frame.

The thoracic and lumbar spine fractures were usually combined with neurological deficit. But the prognostic factors in degree of neurological damage and process of the recovery are controversial. The purpose of this study is to evaluate the factors affected neurological injury and the recovery. The 31 cases who had been performed surgical interventions due to traumatic thoracic or lumbar spine fractures with the neurological deficits were studied according to the radiographic findings of the spinal columns and neurological changes of the injured cord and/or the roots. The duration of mean follow-up was 32.6 months, and all cases were evaluated by motor index score and Frankel grade. Total cases were divided into complete paralytic (N=8) and partial paralytic(N=23) group. In incomplete paraplegia group, the neurological recovery rate was better than complete group(P < 0.001) and neurological recovery period was shorter than complete group (P=0.005). The neurologic deficits according to the Frankel grade were higher in Chance fracture, flexion-distraction and translation (complete paraplegia: 4/7 cases, 57.1%) than unstable bursting fracture (complete paraplegia: 4/24 cases, 16.7%)(P=0.031). The recovery rate of Chance fracture, flexion-distraction and translation were worse than unstable bursting fracture (0.001). The fracture which occurred in T5-11 showed higher incidence of complete paraplegia(75%) compared with that of the T12-L1(30.8%) & L2-4(7.1%)(p=0.021). The neurological recovery in motor index score in L2-4 was higher than T5-11 or T12-L1(P=0.0017). There was no correlation in kyphotic deformity and anterior body height loss between complete and incomplete paraplegia groups. But the A-P diameter of compromised neural canal showed significant difference between complete and incomplete paraplegia group(P=0.027)
Body Height ; Congenital Abnormalities ; Follow-Up Studies ; Incidence ; Neural Tube ; Neurologic Manifestations ; Paraplegia ; Spine

No abstract available.

BACKGROUND: Diagnosis of paucibacillary leprosy is difficult owing to lack of sensitive diagnostic tools. Recently, several investigators have studied the use of polymerase chain reaction(PCR) to detect Mycobacterium leprae. Using nested-PCR the sensitivity and specificity of DNA amplification is considerably improved. OBJECTIVE: The purpose of investigation is to assess the efficacy to nested-PCR which is applied to formalin-fixed, paraffin-embedded biopsies material of patients with leprosy. METHODS: Biopsy samples were taken from patients with lepromatous(11 patients) and tuberculoid (10 patients) leprosy, fixed in formalin, and embedded in paraffin. The DNA from samples was extracted and amplified through 25 cycles by using the outside pairs of primer(L1 and L2). The second amplification was allowed to proceed through 15 cycles using inside pairs of primer(L3 and L4). RESULTS: All twenty one samples showed 347-base-pair products. To confirm that the 347-bp product did correspond to the expected portion of the M. leprae groEL gene, the amplified product was digested with Pst I. Pst I digestion yielded 254-and 93-bp fragments, as predicted from the sequence of the M. leprae gene. The sensitivity was that a single organism was identified by nested-PCR. CONCLUSION: The nested-PCR is sensitive, specific, and simple diagnostic tool for leprosy.
Biopsy ; Diagnosis ; Digestion ; DNA* ; Formaldehyde ; Humans ; Leprosy ; Leprosy, Paucibacillary ; Mycobacterium leprae* ; Mycobacterium* ; Paraffin* ; Polymerase Chain Reaction* ; Research Personnel ; Sensitivity and Specificity

No abstract available.
Anaphylaxis* ; Histamine Release* ; Histamine* ; Mast Cells*

BACKGROUND: In anesthesia for cesarean section, there is an increased incidence of maternal awareness because a light plane of general anesthesia is chosen for fetal safety and rapid recovery. Propofol may be the choice if smooth induction and rapid maternal recovery are desired. Authors tried to know that propofol has properties which suggest that it might be useful alternative to thiopental and enflurane. METHODS: Forty patients in ASA class I or II scheduled for cesarean section were allocated randomly to either propofol (n=20) (P) or thiopental-enflurane (n=20) (T-E) group. Anesthesia was induced with propofol 2 mg/kg IV and maintained by continuous infusion of propofol 8 mg/kg/hr in P group and was induced with thiopental 4 mg/kg IV and maintained by inhalation of 1 vol% enflurane in T-E group. All patients received vecuronium 0.1 mg/kg and 50% N2O-O2. Blood pressure, heart rate, Apgar score, umbilical arterial blood gas analysis and the incidence of maternal awareness using the isolated forearm technique (IFT) were evaluated. RESULTS: Diastolic pressure was decreased in P group than T-E group at 10 min after delivery. Heart rate was increased in P group than T-E group at immediate after extubation (p<0.05). For apgar score, umbilical artery gas analysis and maternal awareness there were not significant differences between two groups. CONCLUSIONS: In comparison with thiopental-enflurane, propofol infusion (8 mg/kg/hr) coupled with N2O was proved to be clinically satisfactory anesthesia for cesarean section with no adverse effects on both mother and neonate.
Anesthesia* ; Anesthesia, General ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Enflurane ; Female ; Forearm ; Heart Rate ; Humans ; Incidence ; Infant, Newborn* ; Inhalation ; Mothers ; Pregnancy ; Propofol ; Thiopental ; Umbilical Arteries ; Vecuronium Bromide

We report a case of a 36 year old female with coronary artery obstructive disease(Left coronary osteal stenosis), who had been admitted due to severe headache and vomitting. In admission, she was diagnosed as moyamoya disease on cerebral angiogram. She had no history of hypertension, diabetes mellitus, hyperlipidemia, smoking. She had experienced angina for 2 years, and 1 year ago she ws diagnosed as bypass surgery with left main coronary artery angioplasty. In moyamoya disease, several portions of extracranial arteries have been found to be involved, but so far, only one case has been reported the coronary involvement on coronary angiogram in the world. And, there has not been a report about moyamoya disease combined with left main osteal lesion yet. This present case indicates that we need to exam for extracranial vascular system including the heart in moyamoya disease.
Adult ; Angioplasty ; Arteries ; Constriction, Pathologic* ; Coronary Vessels ; Diabetes Mellitus ; Female ; Headache ; Heart ; Humans ; Hyperlipidemias ; Hypertension ; Moyamoya Disease* ; Smoke ; Smoking

BACKGROUND: It is well known that the cutaneous tuberculosis especially skin tuberculids is difficult to detect early and make a confirm diagnosis because the organism is seldom detected in a lesion by conventional methods such as AFB stain and culture. The polymerase chain reaction is a very powerful molecular biological tool in diagnosing infectious, neoplastic and genetic diseases. It has the merit of employing various samples, and to improving sensitivity by the modification of PCR techniques. Usage of the routinely formalin-fixed paraffin-embedded tissue as a sample for PCR is very useful in clinical examination, however the sensitivity and specificity have been known to be decreased. OBJECTIVE: To evaluate the efficacy of the nested-PCR in the diagnosis of different types of cutaneous tuberculosis, we tried to detect the DNA of Mycobacterium tuberculosis from routinely formalin-fixed paraffin-embedded tissue. METHODS: The various cutaneous tuberculosis and infectious granulomatous disease were retrospecitively selected by the findings of clinical, histopathological and bacterial culture. There were 9 cases of lupus vulgaris, 4 tuberculosis verrucosa cutis, 2 papulonecrotic tuberculid, 2 erythema induratum and 4 lupus miliaris disseminatus faciei. To amplify the 123bp DNA fragment of a repeated insertion sequence IS6110, two pairs of primers composing outside and inside primers were applied. RESULTS: The positive band was found in 10(91% ) of lupus vulgaris, 3 of tuberculosis verrucosa cutis, 1 papulonecrotic tuberculid and 1 erythema induratum. Four of the LMDF and 5 of the infectious granulomatous diseases were negative. CONCLUSION: The nested-PCR using routinely formalin-fixed paraffin-embedded tissue is a useful diagnostic tool if combined with the result of other clinical data. Also it may provide further insight into pathogenesis of skin tuberculids and the differential diagnosis of granulomatous skin diseases.
Diagnosis ; Diagnosis, Differential ; DNA ; Erythema Induratum ; Lupus Vulgaris ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin Diseases ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous*

BACKGROUND: It is well known that the cutaneous tuberculosis especially skin tuberculids is difficult to detect early and make a confirm diagnosis because the organism is seldom detected in a lesion by conventional methods such as AFB stain and culture. The polymerase chain reaction is a very powerful molecular biological tool in diagnosing infectious, neoplastic and genetic diseases. It has the merit of employing various samples, and to improving sensitivity by the modification of PCR techniques. Usage of the routinely formalin-fixed paraffin-embedded tissue as a sample for PCR is very useful in clinical examination, however the sensitivity and specificity have been known to be decreased. OBJECTIVE: To evaluate the efficacy of the nested-PCR in the diagnosis of different types of cutaneous tuberculosis, we tried to detect the DNA of Mycobacterium tuberculosis from routinely formalin-fixed paraffin-embedded tissue. METHODS: The various cutaneous tuberculosis and infectious granulomatous disease were retrospecitively selected by the findings of clinical, histopathological and bacterial culture. There were 9 cases of lupus vulgaris, 4 tuberculosis verrucosa cutis, 2 papulonecrotic tuberculid, 2 erythema induratum and 4 lupus miliaris disseminatus faciei. To amplify the 123bp DNA fragment of a repeated insertion sequence IS6110, two pairs of primers composing outside and inside primers were applied. RESULTS: The positive band was found in 10(91% ) of lupus vulgaris, 3 of tuberculosis verrucosa cutis, 1 papulonecrotic tuberculid and 1 erythema induratum. Four of the LMDF and 5 of the infectious granulomatous diseases were negative. CONCLUSION: The nested-PCR using routinely formalin-fixed paraffin-embedded tissue is a useful diagnostic tool if combined with the result of other clinical data. Also it may provide further insight into pathogenesis of skin tuberculids and the differential diagnosis of granulomatous skin diseases.
Diagnosis ; Diagnosis, Differential ; DNA ; Erythema Induratum ; Lupus Vulgaris ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin Diseases ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous*

Chronic postirradiation changes of skin reflect the injury of dermal structures particularly the vasculature and connective tissue. The clinical signs include atrophy, partial or complete destruc tion of cutaneous appendatges, telangiectasis, sclerosis of underlying tissue, pigrnentary changes, and in rare instances, ulceration with or without var ious premalignant and malignant neoplasms. The patient, was a 65-year-old man, who had been exposed to a large amount. of X-ray irradi- ation on his hands incidentally or accidentally for a long time. The skin changes of his hand were thickening and hardening of all digits loss or focal consttict,ion of digits, and keratotic papules. Epidermal hyperplasia and fibrous thickening of collagen bundles were found on skin biopsy. Gradual narrowingal of the bony caliber with eventual resorption was noticed on radiologic examination. It has been rarely reported in the literature that chronic radiation dermatitis develops severe and unusal manifestions such as acrosclerosis and loss of digit due to osteoradionecrosis.
Aged ; Atrophy ; Biopsy ; Collagen ; Connective Tissue ; Dermatitis* ; Hand ; Humans ; Hyperplasia ; Osteoradionecrosis* ; Sclerosis ; Skin ; Telangiectasis ; Ulcer