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

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

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.

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

The 2nd to 4th digit ratio (2D : 4D) as a predictor of the degree of expression of sexually dimorphic and other sex-hormone-mediated traits differs between the sexes, ethnics and race. The aim of this study is to identify characteristics and role of 2nd to 4th digit ratio as a sex determinant in Korean. This study was done on 664 individuals (332 males, 332 females). Data were collected by measuring index and ring finger length on both hands with digital callipers. The data were analyzed through the frequency, descriptive statistics, X2 test, independent t-test, paired t-test, Pearson correlation analysis using SPSS win 19.0. This study showed that the 2nd to 4th digit ratio (2D : 4D) in Korean men (0.96) was significantly lower than that of women (0.97). There was a significant difference in the types of 2nd and 4th finger length according to sex. There was a significant difference between right 2D : 4D and left 2D : 4D both of Korean men and women. Correlation between right and left hand digit ratio was .530 in men and .556 in women. The 2nd to 4th digit ratio accurately determinated sex in 89.1% males and 89.2% females for the left hand, and in 91.8% males and 91.9% females for the right hand. The results of this study suggest that 2nd to 4th digit ratio in Korean differs between males and females, moreover, it will be able to perform a role as a sex determinant.
Continental Population Groups ; Female ; Fingers ; Hand ; Humans ; Male

PURPOSE: To analyze the clinical and chest radiolographic findings of HIV-positive patients in Pusan survitude. MATERIALS AND METHODS: We reviewed the medical records of 74 admission cases of 41 HIV-positive patients (38 men and 3 women), confirmed in NIH and admitted to our hospital between May 1990 and September 1997. We evaluated the clinical findings including the pulmonary disease diagnosed at each admission, and using the pattern approach assessed the radiographic findings in 63 cases available among 74 admission cases. For statistical analysis the Pearson Chi-Square test was used, and the chest CT findings available in 19 cases among 17 patients were also evaluated. RESULTS: In all cases the mode of transmission was sexual contact, and they were more frequently contacted with foreigners (73%) than koreans (27%). During the follow-up period, pulmonary diseases were diagnosed in 52 (70%) of 74 admission cases. The diagnoses were pneumocystis carinii pneumonia (PCP, n=15), pneumo-nia(n=15), pulmonary tuberculosis(n=15), combined infection with PCP and pulmonary tuberculosis(n=5), and combined infection with PCP and bacterial pneumonia(n=1). The count of CD4+ lymphocyte in 33 of 55 available admissions cases was less than 50 cells/mm. In 28 patients (68%) who died, the time between confirmation of HIV-positive status to death ranged from 2 to 81 (mean, 39) months. Chest radiographs of 46 available admission cases (73%) showed the following abnormal findings: interstitial opacities(n=26), consolidation(n=17), single or multiple nodules (n=9), hilar or mediastinal lymph node enlargement(n=10), pleural effusion(n=8), cyst(n=2), mass(n=1), and pericardial effusion(n=1). Diffuse ground glass opacity was observed in eight (89%) of nine PCP cases (p<0.05), and in cases of pulmonary tubercolosis, hilar or mediastinal lymph node enlargement was frequent (p<0.05). CONCLUSION: Pulmonary diseases in HIV-positive patients in Pusan servitude were diagnosed during follow-up in 70% of cases. The majority of these diseases were infectious, and the incidence of PCP, pulmonary tuberculosis and pneumonia were similar. Diffuse ground glass opacity was more frequent in PCP, and mediastinal or hilar lymph node enlargement in pulmonary tuberculosis.
Busan* ; Diagnosis ; Emigrants and Immigrants ; Follow-Up Studies ; Glass ; Humans ; Incidence ; Lung Diseases ; Lymph Nodes ; Lymphocytes ; Male ; Medical Records ; Pneumonia ; Pneumonia, Pneumocystis ; Radiography, Thoracic* ; Thorax* ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

Since the 1960's, Korea has achieved rapid economic growth, longer life expectancy, accelerated urbanization and a westernization of diet. Cardiovascular disease has become the leading cause of death; however the prevalence of ischemic heart disease(IHD) remains low. A cross-sectional multiphasic screening service for 18,426 persons aged 30 64 years in a Medical Aid Program in Kyonggi-do Province was conducted from 1991 to 1993. Total cholesterol(TC), Fasting blood glucose(FBG), blood pressure(BP), and electrocardiographic(EKG) data were collected. The result as follows; 1. On the EKG findings, the age-adjusted prevalence of myocardial ischemia and myocardial infarction was 1.45% in men and 2.06% in women. 2. The mean blood pressure was 122.9/78.8mmHg. The age-adjusted prevalence of hypertension was 11.05% in men and 9.02% in women. The prevalence of hypertension showed increasing tendency according to age increase. In all age group, the prevalence of hypertension was higher in men than women. 3. The mean total cholesterol level was 184.4mg/dl in men and 189.2mg/dl in women. The age-adjusted prevalence of hypercholesterolemia was 4.88% in men and 5.67% in women. The total cholesterol level showed increasing tendency according to age increase, except 55 64 age group in men. 4. The prevalence of hyperglycemia is 5.8%. The age-adjusted prevalence of hyperglycemia is 6.72% in men and 4.50% in women. The prevalence of hyperglycemia showed increasing tendency according to age increase. 5. On the EKG findings, the prevalence of myocardial ischemia and myocardial infarction was higher in hypertension than normal, in all age group of men and women less than 40 years-old. Only in women more than 40 years-old, the prevalence of myocardial ischemia and myocardial infarction was higher in hypercholesterolemia and hyperglycemia. Nevertheless there is not statistical association between ischemic heart disease and previous risk factors in other age group, the prevalence of myocardial ischemia and myocardial infarction was higher in hypertension, hypercholesterolemia and hyperglycemia than normal. The result of this study suggest that relationships between major risk factor of ischemic heart disease and ischemic heart disease is similar to existing theory.
Adult ; Blood Glucose* ; Blood Pressure ; Cardiovascular Diseases ; Cause of Death ; Cholesterol* ; Diet ; Economic Development ; Electrocardiography* ; Fasting* ; Female ; Gyeonggi-do ; Heart ; Humans ; Hypercholesterolemia ; Hyperglycemia ; Hypertension* ; Korea ; Life Expectancy ; Male ; Multiphasic Screening ; Myocardial Infarction ; Myocardial Ischemia* ; Prevalence ; Risk Factors ; Urbanization