Refractory deformity in ankylosing spondylitis is caused by loss of normal lordotic curvature in lumbar spine. For the correction of deformity, monosegmental osteotomy, intracorporal decancellation and multisegmental osteotomy are used. Among them, multisegmental osteotomy is reported to be safe because of its small correction amount at each level. Since 1989, authors treated 5 cases of ankylosing spondylitis with severe kyphotic deformity by multisegmental osteotomy and transpedicular instrumentation. All were young males between 22 and 35 years of age. Preoperative kyphotic deformity was 80°, 105°, 72°, 35°, 55° (Av. 70°) and amount of correction was 55°, 105°, 72°, 20°, 40° (Av. 58°) respectively. Levels for osteotony were 4 to 8 segments and correction at a level was 5° to 13° (Av. 8.3°). Normal standing upright posture and vision for straight forward were obtained in all. Instrumentation was Zielke in three Cotrel-Dubousset in two. One case of Zielke instrumentation showed rod failure. However, all showed solid bony union without any loss of correction or pseudoarthrosis. From the above experience, multisegmental osteotomy for the treatment of kyphotic deformity in ankylosing spondylitis was believed to be a safe and effective method of treatment.
Congenital Abnormalities ; Humans ; Male ; Methods ; Osteotomy ; Posture ; Pseudarthrosis ; Spine ; Spondylitis, Ankylosing

We developed an animal model to recreate the condition of an open fracture in communication with the maxillary sinus. We then studied wound healing of the sinus wall structures following fracture in the presence of autogenous bone and alloplastic implant. This model is designed to simulate the repair of an orbital floor fracture in humans. The New Zealand White rabbit was used as the animal model. Standardized 8mm defects were made bilaterally in the maxillary sinuses to include bone and mucosa in 36 rabbits. Two different implants and autogenous calvarial bone graft were placed in the soft-tissue pockets to obturate the defects, exposing one surface of the implant to the open sinus. Medpor porous polyethylene, silicone and calvarial bone implant were compared. Animals were killed at 1, 2 and 8 weeks after implantation. Gross examination of the specimens for the amount of mucosal closure and implant tissue fixation was performed. Histological sections were evaluated for bone and soft-tissue morphology juxtaposed to the implant. Complete closure of the mucosal defect was demonstrated with each type of implant. Medpor implants showed both vascular and soft-tissue ingrowth into pores by week 1. Bone ingrowth was seen by week 2. Closure of the Medpor obturated defects occurred more rapidly than in the silicone group. The Medpor implants and calvarial bone demonstrated bone and soft-tissue fixation, callus formation and maturation, while mature overlying mucosa was reconstituted over the defects. Silicone implants demonstrated a fibrous tissue reaction within 1 week of implantation and they never became fixed to bone or soft tissue. Maxillary sinus wall regeneration occurred in all defects. This study supports clinical observations of maxillary sinus wall regeneration in humans.
Animals ; Bony Callus ; Fractures, Open ; Humans ; Maxillary Sinus ; Models, Animal ; Mucous Membrane ; New Zealand ; Orbit ; Polyethylene ; Rabbits ; Regeneration ; Silicones ; Tissue Fixation ; Transplants ; Wound Healing

This study attempted to clarify the morphological changes of the uriniferous tubules in the postobstructed kidneys of rabbits by electron microscopy. A total of l3 rabbits weighing about 2.5 kg were used. Under penthothal sodium anesthesia, complete ureteral obstruction was accomplished by ligation on the left ureter 1 cm above the ureterovesical junction. The experimental animals were sacrificed at the second and fourth week after the unilateral ureteral ligation. Tissue specimens taken from the renal cortex and medulla were fixed in a mixture of 2% paraform-aldehyde-2.5% glutaraldehyde (phosphate buffer, pH 7.2 ) prior to fixation in 1% osmium tetroxide (phosphate buffer, pH 7.2), and embedded in Epon 8l2. The sections were cut with LKB-III ultratome. Ultra thin sections were contrasted with uranyl acetate and lead citrate, and examine with a JEM-100B electron microscope. The results were as follows: 1. In the 2 weeks group of postobstruction, the abnormal morphology of the uriniferous tubules was: diminution in microvilli and basal invaginations, widening of intercellular space, focal necrosis of the epithelium, desquamation of tubular cells and splitting of the basal lamina. The degenerative changes were severe in the distal tubule, loop of Henle and collecting duct. However, the changes were mild in the proximal tubules. 2. In the 4 weeks group of postobstruction, the degenerative changes were more severe and generalized in all portions of the uriniferous tubules, and focal necrosis and desquamation of the epithelial cells were prominent in the distal tubules and collecting ducts. 3. In both groups of postobstruction, the epithelial cells with mild deformity, such as a decrease of microvilli and basal invaginations, were still preserved in all portions of the uriniferous tubules. From these findings in the obstruct nephropathy, degenerative changes are progressively expedited and partially produced in the urinary tubules.
Anesthesia ; Animals ; Basement Membrane ; Citric Acid ; Congenital Abnormalities ; Epithelial Cells ; Epithelium ; Extracellular Space ; Glutaral ; Hydrogen-Ion Concentration ; Kidney ; Ligation* ; Loop of Henle ; Microscopy, Electron ; Microvilli ; Necrosis ; Osmium Tetroxide ; Rabbits* ; Sodium ; Ureter* ; Ureteral Obstruction

No abstract available.
Appendicitis* ; Child* ; Humans

No abstract available.

No abstract available.
Endometriosis* ; Female

Bone tumor in the trochanteric area is not infrequent and it is important to differentiate the tumors in this area for diagnosis, early settings of therapeutic plans and prognostic previsions. Twenty-one cases of benign bone tumors in the trochanteric area treated at Dept. of Orthopedi Surgery, College of Medicine, Ewha Womans University Hospital, from January 1975 to December 1983 were analysed and following results were obtained. l. of 21 cases, 10 cases were fibrous dysplasia, 6 cases were simple bone cyst, 3 were giant ce tumor and 2 were aneurysmal bone cyst. 2. Pathologic fractures were accompanied in 6 cases; 3 of fibrous dysplasia, 2 of simple bone cy: and 1 of aneurysmal bone cyst. 3. After treatment with curettage, bone graft and instrumentation, 3 cases recurred; 2 cases of fibrous dysplasia and 1 of simple bone cyst. 4. As prognostic factors, completeness of curettage, amount and source of bone graft were considered to be important.
Aneurysm ; Bone Cysts ; Clinical Study ; Curettage ; Early Diagnosis ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Transplants

Authors analysed 25 cases of the narrow spinal canal in cervical and lumbar region, who admitted to the Catholic Medical Center, Seoul from Jan. 1970 to August 1976. Correlation between neurologic feature and radiologic finding was attempted and compared the measurements of narrow cervical and lumbar spinal canal with that of the healthy Korean. The mean anterioposterior diameter of the cervical canal in healthy Korean was 16.2mm at C4, 16.4mm. at C5, 16.6mm. at C6, and 16.4mm. at C7. The ratio of canal to vertebral body in the plain lumbar spine was 1 : 3.9 at L3, 1 : 3.8 at L4 and 1 : 3.8 at L5. The measurements of 25 cases of narrow spinal canal were significantly reduced comparing with the healthy one. The clinical symptoms were closely related to the severity of the narrow spinal canal while there was intermittent or insidious course of symptom in the group of mild narrow spinal canal. Symptom of root compression or neurogenic claudication is frequent manifestation in the severe narrow spinal canal. and the symptom is correlated to the severity of the narrowing. Urinary disturbance and pyramidal tract sign were evident in the cervical narrow canal. The characteristic myelographic feature was multiple constrictive defect at the level of the narrow canal. Common findings in laminectomy were the thickened laminae and hypertrophied ligamentum flavum in the narrow canal. Herniated disc was not found but in one case in the cervical narrow canal at surgery. The recovery of the symptom was better in the group of the narrow canal who had mild degree of narrowing or who had the symptom in short duration rather than prolonged course.
Intervertebral Disc Displacement ; Laminectomy ; Ligamentum Flavum ; Lumbosacral Region ; Pyramidal Tracts ; Seoul ; Spinal Canal* ; Spine

PURPOSE: This study investigated the influence of patent ductus arteriosus (PDA) and its treatment on incidence and progression of retinopathy of prematurity (ROP). METHODS: The authors retrospectively reviewed the medical records of 408 infants who underwent screening examinations for ROP at the Neonatal Intensive Care Unit of our hospital. RESULTS: The total incidence of ROP was 23.5% (96 out of 408) and the patients that needed treatment were 7.4% (30 out of 408). The mean birth weight and gestational age was 1406.1 grams and 30.67 weeks in patients without ROP, and 979.8 grams and 27.46 weeks in patients with ROP, respectively. In both total and very low birth weight (VLBW) patients, the incidence of ROP was higher in the PDA group than the non-PDA group, but the PDA group was an independent risk factor only in the VLBW group (p = 0.033). The incidence of threshold disease was not significantly different between the PDA and control groups (p = 0.757). There was no significant difference of incidence of ROP and threshold disease among the 3 treatment groups for PDA. CONCLUSIONS: In VLBW patients, the presence of PDA increased the risk of ROP and its progression, thus more attention is needed for PDA patients. However, there was no significant difference in ROP incidence and progression according to different PDA treatment methods.
Birth Weight ; Diterpenes ; Ductus Arteriosus, Patent ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Mass Screening ; Medical Records ; Retinopathy of Prematurity ; Retrospective Studies ; Risk Factors

We describe 6 case of ectopic ureteral orifice was on vaginal wall and the most frequent symptom of ectopic ureteral orifice was incontinence. Vagino-gram and indigo carmine test was very important in diagnosis of ectopic ureteral orifice and identification of ectopic ureteral orifice and then nephrectomy, partial nephrectomy with ureterectomy was rational in treating ectopic ureteral orifice combining loss renal function.
Diagnosis ; Indigo Carmine ; Nephrectomy ; Ureter*