OBJECTIVE: Moyamoya disease (MMD) is an uncommon cerebrovascular disorder, characterized by progressive occlusion at the terminal portion of the internal carotid artery. Incidence of the disease is high in East Asia and familial MMD accounts for about 15% of the disease. Although the pathogenesis is unknown, association of HLA class I or II alleles with MMD has been reported with conflicting results. We investigated whether there is a difference in HLA class II association between familial and non-familial forms of the disease. METHODS: A total of 70 Korean children with MMD, including 16 familial cases (10 probands), and 207 healthy controls were studied. Among familial cases, only 10 probands were used for the HLA frequency analysis. High resolution HLA-DRB1 and DQB1 genotyping was performed using polymerase chain reaction (PCR)-sequence specific oligonucleotide hybridization and PCR-single strand conformation polymorphism methods. RESULTS: The phenotype frequencies of HLA-DRB1*1302 (70.0%) and DQB1*0609 (40.0%) were significantly increased in familial MMD compared to both controls [vs. 15.5%, corrected p (pc) = 0.008, odds ratio (OR) = 12.76; vs. 4.3%, pc = 0.02, OR = 14.67] and non-familial MMD patients (vs. 14.8%, pc = 0.02, OR = 13.42; vs. 1.9%, pc = 0.02, OR = 35.33). The frequencies of DRB1 and DQB1 alleles in non-familial MMD patients were not significantly different from those in controls. CONCLUSION: Our findings suggest that the genetic polymorphism of HLA class II genes or other closely linked disease relevant gene(s) could be a genetic predisposing factor for familial MMD.
Alleles ; Carotid Artery, Internal ; Cerebrovascular Disorders ; Child ; Chimera ; Far East ; Genes, MHC Class II ; HLA-DQ Antigens ; HLA-DR Antigens ; HLA-DRB1 Chains ; Humans ; Incidence ; Moyamoya Disease ; Odds Ratio ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Genetic

No abstract available.
Neuroendoscopy*

No abstract available.

No abstract available.
Craniosynostoses*

PURPOSE: This study was conducted to analyze industrial workers' stresses from physical symptoms, PWI, JCQ and tasks in classification of Sasang constitutions. METHOD: Data were collected from industrial workers in J Province from May 2003 to June 2003. Questionnaires were distributed and collected on the day of their physical examination. Collected data were analysed through chi2-test. RESULT: Health-related characteristics showed that most of smokers and drinkers were Taeumins and this result was statistically significant. Physical symptoms related to constitutions indicated that GI and neurologic symptoms are significantly more frequent in Soeumin. The percentage of subjects with moderate risk was high in order of Soyangin, Taeumin and Soeumin while the percentage of subjects with high risk was high in order of Soeumin, Taeumin and Soyangin. CONCLUSION: Through this study, Lee Jae Ma's theory was be confirmed compatible with disease characteristics. However, research with more various subjects and variables needs to be made.
Classification ; Constitution and Bylaws* ; Neurologic Manifestations ; Physical Examination ; Surveys and Questionnaires

No abstract available.
Epidural Abscess*

No abstract available.
Skull Base* ; Skull*

Spondylolisthesis, frequently encountered problems with increasing incidence, has been recognizid as an important clinical entity in orthopaedic field. Several methods were applicated as operative treatment of spondylolisthesis; posterior fusion or H-graft, posterolateral fusion, anterior fusion, fixation with internal devices and etc. During the past 12 years from March 1972 to February 1984, 34 patients among the 42 patients were treated surgically at Department of Orthopaedic Surgery of Ewha Womans University Hospital and following results were obtained. 1. The average age was 45.2 years(19 ~ 64 years) and female was predominent(64.7%). Isthmic type was 17 patients(50.0%), degenerative type was 13 patients(38.2%) and dysplastic type was 4 patients(11.8%). Below 40 year old, dysplastic and isthmic type were predominent and degenerative type was more common in the age group above forties. 2. The most prevalent site was L5-Sl; 21 cases(61.8%) and L4-5; 13 cases(38.2%) in orders. In isthmic type L5-Sl was 13 cases and in degenerative type, L4-L5 was 9 cases. By Meyerding classification, grade I was most common(26 patients, 76.5%). 3. The clinical pictures were low back pain only and little improvement with conservative treatment(type I: 9 patients), low back pain with sciatica(type II: 13), type II plus neurologic signs such as motor weakness, sensory change or change of D.T.R(type III, 10) and little low back pain with mainly sciatica(type IV, 2). 4. Of 34 patients, anterior interbody fusion were done in 10 patients ; posterior and posterolateral fusion with decompression were done in 22 patients. Only laminectomy were done in 2 patients(type IV). 5. Fusion rate was observed in 21 patients(95.5%) among 22 patients with posterior or posterolateral fusion and 8(80%) among the 10 patients with anterior fusion. Postopertive functional results by Gill's criteria were excellent or good in 31 patients(91%). 6. There were no difference in fusion rate and functional results in operative methods.
Classification ; Clinical Study ; Decompression ; Female ; Humans ; Incidence ; Laminectomy ; Low Back Pain ; Neurologic Manifestations ; Spondylolisthesis

Calcaneus is more frequently fractured than any other tarsal bones. Because of complex contour of calcaneus, it is difficult to evaluate the type of fracture exactyly. Futhermore fractures involving subtalar joint give rise to chronic pain and functional incapacity. Many different methods have been tried for treatment, but there was no aggrement of its methods and results. From January 1981 to December 1986, calcaneal fractures of 62 cases in 52 patients were analyzed and the results obtained from this study were as follows :l. Of 52 patients, 41 patients were male and 11 female. 2. The cause of fractures was a falling down in 38 patients (76%), traffic accident in 8 patients (15%) and direct blow in 6 patients (12%) 3. According to Rowe;s classfication, Type I fracture was in 5 cases, Type II in 6 cases, Type lll in 5 cases, Type IV in 12 cases and Type V in 34 cases (55%). Of these Type V fracture, tongue type was in 21 cases and joint depression type in 13 cases. 4. The treatment was as follows : cast immobilization in 33 cases, closed reduction and pin fixation in 24 cases and open reduction in 5 cases. 5. The functional result was satisfactory in 44 cases (71%). The result was better in fractures not involving subtalar joint and among type V fractures, the result was better in fractures of tongue type treated with open reduction. 6. So, we recommended compressive bandage and early mobilization for fractures without displacement, axial fixation for tongue type fractures and open reduction for joint depression type fracture.
Accidental Falls ; Accidents, Traffic ; Bandages ; Calcaneus ; Chronic Pain ; Depression ; Early Ambulation ; Female ; Humans ; Immobilization ; Joints ; Male ; Subtalar Joint ; Tarsal Bones ; Tongue

The spinal injuries were classified into bursting fracture, fracture-dislocation, seat-belt injury, compression fracture according to the three column theory by Denis. The bursting fracture and fracture-dislocation required the most careful planning. So, myelography, computerized tomography enabled us to diagnose the spinal fracture including retropulsed bony fragment into the spinal canal. There was much controversy as to appropriate treatment af unstable thoraco-lumbar fractures. The frequent surgical treatment of thoraco-lumbar spinal fractures was still posterior spinal instrumentation including Harrington rod system. Since 1964, the use of anterior spinal instrumentation had been started by Dwyer, Dunn, Kostrik, Slot, and Zielke used anterior spinal instrumentation in unstable thoraco-lumbar spinal fractures, but not popular. This study suggested the experience to accomplish the decompression of the neural elements and stabilization of the spine by using Kandea device in unstable thoraco-lumbar spinal fractures. 12 patients treated with this Kaneda device in unstable thoraco-lumbar spinal fractures were analyzed from Dec. 1988 to May, 1989 at the Department of Orthopaedic Surgery, Ewha Womans University Hospital. We obtained the following conclusions. The results were as follows. 1. The common injury mechanism was falling down in 5 cases, the frequent injury site was 1st lumbar vertebra. 2. According to Denis classification, the bursting fractures were in 8 cases(68% ), the fracture-dislocations were in 4 cases(33%). 3. The average preoperative kyphotic angulation was 24.5 degrees(range 8 to 45) and postoperative angulation was 5 degrees(range 2 to 15), the correction rate was 79.6% and correction degree was average 19.5 degrees. 4. The advantages were the fixation of one level above and below the injury site, sufficient neural decompression, firm spinal stabilization, early mobilization with a brace and elimination of the 2nd posterior procedure. 5. The fixation of vertebral plate was difficult due to the invariable size of vertebral plates, especially, in upper thoracic spinal fracture and children's fracture.
Accidental Falls ; Braces ; Classification ; Decompression ; Early Ambulation ; Female ; Fractures, Compression ; Humans ; Myelography ; Spinal Canal ; Spinal Fractures ; Spinal Injuries ; Spine