The most important spinal disorders in childhood are malformations and mass lesions. High-resolution, real-time ultrasonography of the spine enables the differentation of intraand paraspinal structures in a significant way. This examination does not require sedation, does not use radiation, can be performed in the nursery or an incubator and is less expensive than computed tomography or magnetic resonance imaging. The sonographic appearence of the various kinds of spinal dysraphism is demonstrated and illustrated. Based on our preliminary experience spinal sonography appears to be useful in neonates and infants as the first imaging device for differentiation of cmplex malformation and as a screeing method for occult spinal dysraphism.
Humans ; Incubators ; Infant* ; Infant, Newborn* ; Magnetic Resonance Imaging ; Neural Tube Defects ; Nurseries ; Spinal Dysraphism* ; Spine ; Ultrasonography*

Epithelioid hemangiomo, is belong to a group of unusual vascular proliferation accompanying prominent eosinophilic infiltration. It is usually classificed as a subset of angiolymphoid hyperplasia with eosinophilia despite of its peculiar endothelial morphology(i.e., vacuolization and hobnail appearance etc.). Histopathologically, the lesion was characterized by exuberant. proliferation of capillaries, epithelioid-appearing erdothelial cell, endothelial cytoplasmic vacuolization, solid sheets of endothelial cells, massive eosinophilic infiltration and lymphoreticular hyperplasia. The lesions are most common in he head-neck region and are characterized by single or multiple smooth-top papules or plnqu s of varying colors. We report two cases of epithelioid hemangioma occurring on the left auricle and scalp. The chiet complaints were pruritus and they have been early bleeding even in trivial trauma. Microscopically, the lesions were consisted of a prolifration of small to medium-sized blood vessels surraunded by inflammatory infiltrates predominantly composed of lymphocytes, histiocytes and eosinophils. The vessels were lined by epithelioid-appearing endothelial cells haveing enlarged round nuclei and abundant easinophilic or clear cytoplasm. Some vessels showed luminal obliteration by proliferating epithelioid endothelial cells. Occasionally, blood vessels were lined by hobnailor scallop-shaped endothelial cells. In immunohistochemical finolings, the epithelioid endothelial cells or proliferated capillaries were immunoreactive to factor VII-related antigen and negative to lysozyme.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Capillaries ; Cytoplasm ; Endothelial Cells ; Eosinophils ; Hemangioma* ; Hemorrhage ; Histiocytes ; Hyperplasia ; Lymphocytes ; Muramidase ; Phenobarbital ; Pruritus ; Scalp

No abstract available.
Adrenalectomy*

Late aseptic loosening of the acetabular component following total hip arthroplasty become increasing frequently after about 10 years and has become a more severe problem both in frequency and severity than femoral component loosening. The complexity of acetabular revision depends largely on the reconstruction required to restore normal anatomy due to acetabular bone loss. The clinical and radiologic results of acetabular revision using a porocoated acetabular component fixed to the pelvis with screws were studied in 36 patients (40 hips) who had moderate or severe acetabular loss. Acetabular revision in patients whose bone stock had already been destroyed provied more formidable problems at revision surgery. The mean Harris hip score was improved 46 to 84. Bone graft union was achieved by 7.4 months and incorporated by 16 months. The graft bone resorption was noted minor degree lateral to the cup. Of 40 cases, 2 cases required re-revision of acetabular cup for identifiable failure of fixation and one was showed probable loosening. The results of the present study suggest that revision of the acetabulum with use of a hemispherical cementless component stabilized with multiple screws and morselized bone grafts filling bone defects appears to be successful in restoring bone stock and providing a stable, pain-free reconstruction.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Bone Resorption ; Hip ; Humans ; Pelvis ; Transplants

Persistent trigeminal artery is an embryonic remnant of the anastomotic channel linking the internal carotid artery and the basilar artery. Cases of vertebrobasilar insufficiency caused by the persistent trigeminal artery with internal carotid artery stenosis has been described previously, but vertebrobasilar insufficiency entirely due to in situ stenosis of the persistent trigeminal artery has not been reported. A 71-year-old man presented with frequent dizzy episodes. The brain MRI showed no parenchymal lesions. MR angiography showed poor visualization of vertebrobasilar system. He was diagnosed as having vertebrobasilar insufficiency. Cerebral angiography revealed that there was complete occlusion at the vertebrobasilar junction, and the basilar artery was supplied by the persistent trigeminal artery which had severe stenosis at its origin. There was no stenosis of the internal carotid artery of both sides. We believe that this is the first report of vertebrobasilar insufficiency due to stenosed persistent trigeminal artery, without internal carotid artery stenosis.

Cervical spine injuries are increasing recently due to increasing traffic accidents. Many patients have been treated with cervical laminectomy but stabilization of the cervical spine has been neglected as a part of the treatment. 30 patients with cervical spine injuries who were admitted to our hospital from January 1, 1973 to December 31, 1978 were evaluated. The following observations were made: 1. The ratio between male and female was 2:1 and the majority(43%) were found in the 4th decades. 2. The common causes of cervical spine injuries were traffic accident(40%) and falls(33.3%). The most common site of the lesion was the 5th and 6th cervical spine level (33.3%). 3. Among 30 cases, 10 cases(33.3%) had complete paralysis, 12 cases(40%) incomplete paralysis, 6 cases (20%) had nerve root injury and no neurological change is 2 cases. 4. The mechanisms of cervical injuries were classified morphologically and flexion-rotation injuries (55.5%) were the most common. 5. We evaluated the results of treatment neurological & radiographically. In complete paralysis, there was no neurological improvement and cervical kyphosis increased after laminectomy. In incomplete paralysis and nerve root injury, anterior fusion showed slight neurological recovery but mild cevical kyphosis and displacement of the graft were observed. In posterior fusion or cast immobilization, we had a satisfactory result with a high fusion rate and normal cervical curvature. 6. lt is impossible to compare anterior interbody fusion with posterior fusion for neurological recovery. For early mobilization and rehabilitation, we emphasize early stabilization by anterior or posterior fusion according to the mechanism of injury.
Accidents, Traffic ; Clinical Study ; Early Ambulation ; Female ; Humans ; Immobilization ; Kyphosis ; Laminectomy ; Male ; Paralysis ; Rehabilitation ; Spine ; Transplants

BACKGROUND: The Fas antigen is a cell surface molecule that mediates apoptosis in many cell types. Matsues group indicated that keratinocytes constitutively express the Fas antigen and apoptosis was induced only on pretreatment with interferon-r (IFN-y) in cultured normal human keratinocytes (NHK). OBJECTIVE: We undertook this study to determine the induction of apoptosis by Fas antibody alone and/or in combination with IFN y, IL-1a in normal human keratinocytes (NHK) and transitional epithelioma cell lines (KB cell) which had lower levels of intracellular IL-1 receptor antago- nists (IL-1ra ). METHODS: We used cultured NHK and KB cells. Each cell was treated with IFN-r, IL-la and Fas antibody for induction of apoptosis. For quantifying the apoptosis, index fluorescent DNA- binding dyes were used. Result: Fas antibody alone could induce apoptosis not only in KB cells but also in NHK cells. The combination of Fas antibody and IFN-r enhanced the induction of apoptosis in NHK and KB cells. The IL-la alone could induce apoptosis only in KB cells which had relatively small amounts of IL-1ra compared to NHK. CONCLUSION: Our result may indicate that Fas antigen in human keratinocytes can regulate normal epidermal cellular differentiation and proliferation.
Antigens, CD95 ; Apoptosis* ; Carcinoma ; Cell Line ; Coloring Agents ; Humans* ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1 ; Interleukin-1alpha ; KB Cells* ; Keratinocytes*

We have tried fibrin adhesive, which mimics the end stage of plasmatic coagulation, in 26 patients with various neurosurgical problems such as: repair of cerebrospinal fluid (CSF) leaks, sealing of the vascular anastomosis sites, reinforcements of aneurysmal clippings, and hemostasis after resection of brain tumors. Presented in this report are 11 intracranial aneurysms, 11 brain tumors, 2 lipomyelo-meningoceles, and one each of cerebral arteriovenous malformation and torn dura resulting from a mastoidectomy. Procedures which seemed to be impossible or very difficult by conventional neurosurgical techniques could be accomplished in all cases without any complication. Our experience with fibrin adhesive suggests that it is a valuable adjuvant to various microneurosurgical procedures, and it may be potentially useful for protection of major cerebral veins and venous sinuses during cerebral retraction.
Adolescent ; Adult ; Aneurysm/surgery ; Child, Preschool ; Female ; Fibrin Tissue Adhesive/*pharmacology ; Hemostatic Techniques ; Human ; Male ; Middle Aged ; Neurosurgery

No abstract available.
Neck*

No abstract available.
Arnold-Chiari Malformation* ; Meningomyelocele*