Management of patients with unstable fracture or fracture-dislocation of thoraco-lumbar spine continues to be controversial. One area of disagreement involves spinal fusion with internal fixation for prevention of later spinal instability. Intemal fixation of the spine without fusion has been advocated in the treatment of the unstable thoraco-lumbar fracture or dislocation. During the period of January 1981 to March 1984, thirty-two patients underwent fixation by Harrington distraction rod without fusion for the treatment of thoraco-lumbar fractures. Eight cases among them had second operation for the removal of the Harrington rods in 13.4months after Harrington rod fixation and were followed up clinically and radiolagically for 1 year at the Department of Orthopaedic Surgery, St. Mary's Hospital, Catholic Medical College and Center. The rationales for this procedure were to minimize the number of permanently stabilized segments and to provide more spinal mobility. We have expected that spontaneous fusion of vertebral body occur by the prolonged immobilization with Hamngton distraction rods. After the Harrington rods, the average conection rate of kyphotic angle was 41.8% and average correction rate of height of collapsed vertebral body or displacement of vertebral body was 42.3% at one year follow up. Instrumentations in eight patient were removed at 13.4 months after the initial surgery and the patients were followed up for one year. At the time of removal of instrumentation, unilateral partial facetectomy was done for histologic examination of the facet joint which is above the lower Harrington hook in four patients. The average correction rate of kyphotic angle was 37.5% and the average correction rate of height of collapsed or displaced vertebral body was 40.6% at one year after the removal of H-rods. The range of spine motions were incresed gradually. But histologic findings of the immobilized facet joint revealed fibrillation, fissures, thinning of the normal cartilagenous surface, decreased cartilagenous cellularity, and vascular tidemark invasion which are characteristics of osteoarthritis. Through this study, we obtained following conclusions: 1. Immediate Harrington distraction rodding was effective for the anatomic reduction of the collapsed vertebral body. And it provided immediate spinal stability, and spontaneous fusion of vertebral body. 2. Prolonged immobilization of the spine by Harrington rods is believed to have deleterious effect on articular cartilage of the immobilized facet joint as the degenerative changes of the cartilage of the facet joint was consistently found in this study. And it was regarded as a predisposing factors in the development of symptomatic arthritis of the spine. 3. If a fractured and collapsed vertebral body can be reduced by Harrington distraction rods, a spontaneous fusion of vertebral body occur. Harrington rodding without fusion could be one of the useful surgeries for management of the fractures and fracture-dislocation of the spine.
Arthritis ; Cartilage ; Cartilage, Articular ; Causality ; Dislocations ; Follow-Up Studies ; Humans ; Immobilization ; Osteoarthritis ; Spinal Fusion ; Spine ; Zygapophyseal Joint

Effects of several cytokines(IL -1beta, TNFalpha, and IFNgamma) have been examined on fetal rat osteoblast-like cells. To investigate whether cytokines play direct causal roles in production of lysosomal enzyme, fetal rat osteoblast-like cells were treated with IL-1beta, TNFalpha, and IFNgamma, respectively or combined. And acid phosphatase was determined by biochemical method. Alkaline phosphatase was assayed to determine the effects of IL-1beta, TNFalpha, and IFNgamma on the expression of this enzyme. And also experiment of calcified nodule formation was performed to assess the effects of cytokines on the bone-forming activity of osteoblast-like cells in vitro. Acid phosphatase activity was significantly increased by the addition of IL-1beta and TNFalpha, whereas decreased by IFNgamma, However, no significant changes in alkaline phosphatase activity was observed when the osteoblast-like cells were treated with IL-1beta and TNFalpha. Interestingly, IFNalpha showed stimulatory effect on alkaline phosphatase activity. The number of calcified nodules was decreased by treatment of cultures with 1ng/ml IL -lbeta, 20ng/ml TNFalpha, and 500 u/ml IFNgamma continuously for 21 days, while considerable number of calcified nodules were formed in control group of osteoblast-like cell in culture for 21 days. These results seem to suggest that cytokines may play crucial roles in bone remodeling through the direct action on the osteoblast-like cell.
Acid Phosphatase ; Alkaline Phosphatase ; Animals ; Bone Remodeling ; Cytokines* ; Interleukin-1beta ; Rats* ; Tumor Necrosis Factor-alpha

A case of Osteogenic sarcoma arised from orbit 4 years after the radiation therapy for retinoblastoma in a 9 years old girl is presented. 4 Years ago, under the diagnosis of retinoblastoma, the left orbital exenteration was performed and was treated with x-ray radiation giving 4.500 gamma tumor dose in 4, weeks. On admission, the left orbital cavity was filled with hard mass and orbital bone revealed extensive destruction with osteoplastic changes on x-ray, and diffuse sarcomatous growth of anaplastic cells with abundant osteogenesis and osteoclastic activity microscopically. It is of authors' opinion that osteogenic sarcoma of orbital bone in this presented case might developed by irradition on retinoblastoma.
Child ; Diagnosis ; Female ; Humans ; Orbit ; Osteoclasts ; Osteogenesis ; Osteosarcoma* ; Retinoblastoma*

PURPOSE: The purpose of this study is to evaluate the relationship between developmental lumbar spinalstenosis and its BMD value by using the single energy quantitative CT(SEQCT). MATERIALS & METHODS: Eighty normal volunteers(20-60years) were selected as a control group and 28 patients with developmental lumbar spinal stenosis were selected as a disease group. The two groups were divided into a younger (20-39years) and an older subgroup(40-60 years), and were further divided into male and female subgroups. All the cases showed no evidence of metabolic disease, fracture, herniated nucleus pulposus, degererative spondylosis, infectious disease, tumors orhad no history of absolute immobilization of more than two weeks. All underwent lumbar spine CT and SEQCT. We measured bone mineral density(BMD) at the cancellous bone of L1, 2, 3 and obtained the mean and its one standard deviation, and compared the data between each subgroup of the control and the disease group using ANOVA. RESULTS: There was a significant low BMD value in the younger male patient subgroup compared with the control subgroup(P<0.05). CONCLUSION: Developmental lumbar spinal stenosis in a young male may be a factor of decreasing BMD of the body of the spine.
Communicable Diseases ; Female ; Humans ; Immobilization ; Male ; Spinal Stenosis* ; Spine ; Spondylosis

A case of postirradiation extraskeletal osteosarcoma with aggressive fibromatosis of the overlying soft tissue of radiation field is reported in a 57 year old house wife who was treated with operation and radiation therapy for cervix carcinoma of the uterus 23 years ago. The overlying aggressive fibromatosis showed characteristic radiation angiitis and atrophic vascular changes such as hyaline degeneration and obliteration of the capillaries which were highly campatible with radiation changes. She also had multiple osteogenic sarcoma in pelvic cavity, occurring in the mesentery bed. As for the histogenesis in this case, we thought the possiblity that fibroblasts went through a process of differentiation into osteoblasts that were responsible for bone formation in the process of malignant change of the aggressive fibromatosis.

Effects of Ultratiolet (UV) light was studied in isolated thoracic aortae of rabbits and porcine coronary arteries. The following results were obtained. 1) Radiation of UV light did not affect both arterial rings in resting tension. 2) Both arterial preparations contracted with various vasoconstrictors (KCI,NE,PE,BayK 8644 and (+S202 etc.) were relaxed by UV light radiation in a radiation time-dependent fashion. 3) The magnitudes of the relaxation were not significantly different in both the rings with or without intact endothelium. 4) MB and LY markedldy reduced the UV light-induced relaxation in both the rings. 5) PP significantly attenuated the UV light-induced relaxation of rabbit thoracic aorta, but did not affect that of porcine coronary artery. 6) The UV Light-induced relaxation of porcine coronary artery was significantly attenuated by DT or NF, while that of rabbit thoracic aorta was not. 7) (+)S202 significantly potentiated the UV light-induced relaxation of porcine coronary artery contracted with KCI or Hist. Above results suggest that the UV light-induced relaxation of vascular smooth muscles is independent on the endothelium, and the relaxation results from primarily activation of guanylyl cyclase and is in part related to adenylyl cyclase and calcium metabolism. In adddition, a dihydropyridine calcium agonist, (+)S202, may sensitize vascular smooth muscle to the relaxing effect of UV light through some unknown mechanism.
Adenylyl Cyclases ; Aorta, Thoracic ; Calcium* ; Coronary Vessels ; Endothelium ; Guanylate Cyclase ; Metabolism ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Rabbits ; Relaxation* ; Ultraviolet Rays ; Vasoconstrictor Agents

No abstract available.
Amputees* ; Humans ; Phantom Limb*

STUDY DESIGN: A retrospective analysis of the patients who had cauda equina syndrome caused by a herniated lumbar disc. OBJECTIVES: To assess the clinical debates concerning the diagnosis, treatment, and results of treatment. SUMMARY OF LITERATURE REVIEW: This syndrome has been considered as an absolute indication of surgical treatment in the herniated lumbar disc and poor prognosis after surgery were reported. Although there are debates on the timing of surgery, early recognition early surgical treatment are recommended for a better results of treatment. MATERIALS AND METHODS: 23 consecutive patients having a cauda equina syndrome caused by herniated lumbar disc were reviewed retrospectively. They were 14 males and 9 females having ages of 41.6 in average. The incidence of this syndrome was 3.8% of the patients who had surgical treatment of herniated lumbar disc. RESULTS: All patients had bladder dysfunction in addition to the low back pain and radicular pain in the leg, but five patient did not recognize their urinary retention which were shaded by severe leg pain. A surgical treatment were performed for all patients at 6.8 days in average after onset of the bladder dysfunction. At follow-up of 3 years and 3 months in average after surgery, 20 patients(86.9%) had satisfactory resolution of the low back pain and leg pain, and all patients had complete recovery of motor weakness except one patients who had residual foot drop. Bladder function recovered satisfactorily in 18 patients (78.3%), but 4 patients had some difficulty of urination and one patient needed a sphinterotomy for urination. CONCLUSIONS: The cauda equine syndrome in herniated lumbar disc was often not recognized early and a poor result of treatment was not rare, particularly in the patients who had acute onset and severe bladder dysfunction. So, early diagnosis and active surgical treatment are recommended for a better results of treatment.
Cauda Equina* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Foot ; Humans ; Incidence ; Leg ; Low Back Pain ; Male ; Polyradiculopathy* ; Prognosis ; Retrospective Studies ; Urinary Bladder ; Urinary Retention ; Urination

A total of 36 typical Krukenberg tumors of the ovary was obtained from the pathology file of the Department of Pathology, College of Medicine, Seoul National University during a period of 17 years from January 1968 to December 1984. By definition, all were characterized by the presence of mucin containg signet ring cells within the cellular, nonneoplastic ovarian stroma. The clinico-pathologic characteristics of 36 Krukenberg tumors were as follow: The Krukenberg tumors accounted for 16.3% of all ovarian malignancies. The age of the patient at the time of diagnosis of the Krukenberg tumor ranged from 28 to 69 years with an average of 43 years. A primary carcinoma of stomach (31 cases) of colon (1 case) was found in 32 (88.9%) of 36 patients. The primary carcinomas was not detected in four cases, and autopsy was not performed in any case. In 22 cases the primary carcinomas had been diagnosed before ovarian tumors were found. The ovarian and the primary carcinomas were identified synchronously in 6 cases, while in 8 cases the primary carcinomas were not discovered until after the ovarian tumors had been treated. The gross diameter of the ovarian tumor ranged from 1.5cm to 28cm with an average of 10.3cm. The largest weighed 4,550gm. The Krukenberg tumors typically formed rounded or reniform, solid mass that were coarsely lobulated or bosselated. The cut surface was yellow white and associated frequently with nodular, myxoid or gelatinous area and cystic changes of various size. Both ovaries were involved in 29(80.6%) of the cases and one ovary in 7(19.4%). Krukenberg tumors classified into the three major types on the basis of the characteristic morphologic patterns of signet ring cells. The first type was classic Krukenberg tumor(28 cases) represented by predominent components of typical signet ring cells. The second type was tubular Krukenberg tumor(5 cases) characterized by tubular structures resembling a Sertoli-Leydig cell tumor. The third type was re tiform Krukenberg tumor (3 cases) characterized by an irregular network of elongated, often slitlike tubules and cysts, which resembled the rete testis.

The 2nd to 4th digit ratio (2D : 4D) reflects exposure level of sex hormones in fetal period and there are various methods for finger length measurement. The aim of this study is to identify an accurate and effective method for finger length measurement. This study was done on 272 individuals (115 males, 157 females). Data were collected by measuring index and ring finger length on both hands by calipers, ruler, photocopy, and radiography. The data were analyzed through independent t-test, paired t-test, Pearson correlation analysis using SPSS win 19.0. This study showed that the 2nd and 4th finger measured by radiography were the longest finger both of males and females and revealed the largest length difference between 2nd and 4th finger. There were significant sex differences all of 4 measurement methods in 2D : 4D, especially remarkable sex difference by radiography and photography. The 2D : 4D by indirect measurement was lower than that of direct measurement. Correlation between digit ratio by radiography and by photocopy was 0.590 and correlation between digit ratio by radiography and by calipers was 0.586. The results of this study suggest that indirect measurement by radiography can be alternated by photocopy primarily and by calipers secondarily.
Female ; Fingers ; Gonadal Steroid Hormones ; Hand ; Humans ; Male ; Photography ; Sex Characteristics