No abstract available.
RNA*

No abstract available.

One of various decompression methods in treatment of spinal stenosis is the indirect instrumental decompression. Theoretically, the distraction of the disc space can widen the intervertebral foramen of the stenotic segment and even increase the canal diameter by distracting the posterior annulus as well as reduce the extent of decompressive laminectomy site. The indirect instrumental decompression, however, was not guaranteed to maintain the restored discal height because of the loss of fixation strength between rod and screw, viscoelasticity of vertebra itself, bone density, type of screw and rod, and operative technique. As well the magnitude of the stresses on the instrumentation particularly at the rod-screw interface may depend on rod-contouring in order to make mormal sagittal curvature of the lumbar spines. Therefore, the aim of this experimental study was to evaluate the effect of different rod-contour on the axial sliding strength in Compact Cotrel-Dubousset (CCD) instrumentation. Axial sliding strength was tested by Universal Test Machine (Instron). Test was performed for 3 groups of different rodcontouring on the biomechanical axial strength: straight rod (no contour), 10 and 20 contouring rod. The length of contact surface between rod and screw was measured with Fuji pressure sensitive film. The study was performed using 6.5 mm open body screws and 7 mm rods of CCD instrumentation. Axial sliding strength of straight rod was 2518.6N, 1871.8N in 10 and 1528.8N in 20 contouring rod. The length of contact surface between rod and screw significantly decreased according to degree of rod contouring; 9.88mm in straight rod, 9.08mm in 10 and 8.57mm in 20 contouring rod. There was a statistically significant linear correlation (R=0.96) between failure load and length of contact surface. Therefore, this study has shown that excessive contour of the rod in order to make normal sagittal curvature of the lumbar spine using CCD instrumentation cannot provide sufficient axial sliding strength. That may be a cause of loss of restored disc space height after surgery.
Bone Density ; Decompression ; Laminectomy ; Spinal Stenosis ; Spine

Relapsing polychondritis is an uncommon disease manifested by episodes of progressive inflammation and destruction of cartilage. While the cause remains unknown, an autoimmune pathogenesis appears likely. Characteristic features include auricular chondritis, arthritis, nasal chondritis, ocular inflammation, respiratory tract involvement and audiovestibular damage. The clinical course of patients may vary from a relatively benign illness free of clinically evident visceral involvement, to one of episodic or smoldering activity with variable intensity, to a f ulminant illness and death within months of diagnosis. Dapsone, corticosteroid and immunosuppressive agent remain the effective therapies. We have experienced a case of relapsing polychondritis and active pulmonary tuberculosis in a 69-year-old man. He suffered from arthralgia and swelling of joints for several months on the first admission and initially was diagnosed as pseudogout based on polyarthritis and chondrocalcinosis of right knee joint. During follow-up, chondritis of both auricles and nose, which was proved by the biosy of right auricle, and relapse of polyarthritis were developed. His spu tum smear for acid-fast bacillus was postive on the second admission. Then he was diagnosed as relapsing polychondritis and active pulmonary tuberculosis and has achieved improvement with medication of dapsone and antituberculosis drugs according to susceptability test during followed-up. Thus we report this case with literature review.
Aged ; Arthralgia ; Arthritis ; Bacillus ; Cartilage ; Chondrocalcinosis ; Dapsone ; Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Joints ; Knee Joint ; Nose ; Polychondritis, Relapsing* ; Recurrence ; Respiratory System ; Tuberculosis, Pulmonary

STUDY DESIGN: A retrospective analysis was performed on 40 patients who had had previous lux bar spine surgeries. OBJECTIVE: To determine what factors most influenced surgical outcome and to analyze results in a series of revision lumbar surgeries. SUMMARY OF BACKGROUND DATA: Satisfactory surgical outcome of the revision lumbar surgery range from 28% to 82% and are rarely comparable to primary surgery. Many factors predicting outcome from repeat lumbar surgery haute been listed. METHODS: Forty patients were analyzed who had had previous lumbar surgeries. The patients were classified into 5 groups according to diagnosis: 3 Infection,5 instability,8 nonunion, 14 HNP and 10 spinal stenosis. of 40 patients,33 patients(82.5%) underwent fusion with instrumentation for repeat surgery. Their clinical course was followed for a minimum of 1 year. The number of surgery on each mpatient was 1.3 times on an average. RESULTS: Overall, 80% of patients had a satisfactory result. Obviously extruded or sequestrated HNP in MRI findings, complete block of contrast with severe radiculopathy and/or myelopathy in spinal stenosis, complete decompression, neurolysi s and fusion with instrumentation, and longer than 6 month pain relief after precious surgery were correlated with satisfactory outcome. However, the number of precious operation, age, repair of pseudarthrosis , no abnormality at surgery and combined multiple degenerative joint disease were significantly correlated with poor surgical outcome. The most common complication during repeat surgery was dural tear in 5 cases(12.5%). CONCLUSIONS: Success rate of revision surgery was low as compared to primary operation. Therefore, erroneous diagnosis and faulty surgical technique understandably lead to failure, and precise attention to preoperative and intraoperative detail can minimize these sources of error.
Decompression ; Diagnosis ; Humans ; Joint Diseases ; Magnetic Resonance Imaging ; Pseudarthrosis ; Radiculopathy ; Reoperation ; Retrospective Studies ; Spinal Cord Diseases ; Spinal Stenosis ; Spine* ; Tears

No abstract available.
Aneurysm* ; Bone Cysts* ; Spine*

No abstract available.
Incidence* ; Leukemia*

One case of cerebral embolism developed during cessation of supraventricular tachycardia in Wolff-Parkinson-White syndrome is reported with brief review. Twenty five years old, male was admitted to Seoul National University hospital with palpitation. He had numerous episodes of paroxysmal tachycardia for 3 years. He was diagnosed as Wolff-Parkinson-White syndrome at this hospital, ca 6 months prior to admission. Wolff-Parkinson-White syndrome was improved with atropine test at that time. The electrocardiogram on admission revealed Wolff-Parkinson-White synd rome associated with supraventricular tachycardia. He developed cerebral embolism after paroxysmal tachycardia of 22 days.
Atropine ; Electrocardiography ; Humans ; Intracranial Embolism* ; Male ; Seoul ; Tachycardia, Paroxysmal* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome*

No abstract available.
Dislocations* ; Elbow*

The gout is a hereditary condition of disturbed uric acid metabolism. There are medical and surgical management in tophaceous gout for prevention of recurrence of acute attack and creation of a negative uric acid balance. The surgical management is removal of tophaceous material in the soft tissue and osseous structure. Aditionally, the resection of bone and joint, arthrodesis and bone graft improve the functional capacity of the gouty patients. A 53 years old man was managed by removal of tophaceous materials in both prepatellar area, left olecranon area and both feet and arthrodesis of left first metatarsophalangeal joint with autogenous iliac bone graft and supportive medication with probenecid and indomethacine, and was followed up from March, 1986 to April, 1987. There was no significant difference in duration between the union of nonpathologic fracture and the union of arthrodesis area in this gouty patient. We found the progressive recovery of normal trabeculation in previous destructive bone lesions with drug therapy, but there was no specific change in the soft tissue lesions.
Arthrodesis ; Drug Therapy ; Foot ; Gout ; Humans ; Indomethacin ; Joints ; Metabolism ; Metatarsophalangeal Joint ; Olecranon Process ; Probenecid ; Recurrence ; Transplants ; Uric Acid