STUDY DESIGN: This study analyzed the efficacy of the reduction and its maintenance using the posterior pedicular screw system in adult patients undergoing surgical treatment for symptomatic, isthmic spondylolisthesis. OBJECTIVE: To evaluate the effect of the reduction for lumbar isthmic spondylolisthesis in adult. SUMMARY OF LITERATURE REVIEW: If the increase of the shear force is approved as a main biomechanical feature of spondylolisthesis, reduction of the shear forces to the physiologic level must be regarded as the goal of surgical treatment. MATERIALS AND METHODS: 11 cases were treated with posterior monosegmental two point f;cation and posterolateral fusion (Group 1), 8 cases with a combined surgery of posterior monosegmental two point fixation, posterolateral fusion and anterior interbody fusion (Group 2), and 20 cases with posterior two segmental three point fixation and posterolateral fusion (Group 3). We assessed the clinical results and the radiologic objective parameters. RESULTS: The patients were followed up for more than 2 years (mean : 64 months). The satisfactory clinical results were 9 cases (81.8%) in Group 1 ,7 cases (87.5%) in Group 2 and 17 cases (85%) in Group 3. Radiologically, the efficacy of reduction and its maintenance were satisfactory results in Group 2, and the changes of the slip angle and the disc height showed that the loss of correction was greater than postoperative correction, although there were no statistical significant differences in the three groups. CONCLUSION: According to the our results, there was no significant relationship between the clinical result and the rdiological one. However, we think that the correcton of the deformity using the posterior pedicular screw system have some biomechanical advantages and seem to be recommendable for the treatment of isthmic spondylolisthesis in adults.
Adult* ; Congenital Abnormalities ; Humans ; Spondylolisthesis*

Synthetic hydroxyapatite is a safe, nontoxic, biocompatible, and osteoconductive material. Hydroxyapatite-coated implants have the property of achieving a very strong bond with living bone in a relatively short period. From March 1992 to June 1994, 140 hydroxyapatite-coated primary total hip prostheses were implanted. This study included 60 cases that could follow up minimum 3 years. At the time of mean follow up, 45 months after operation, the mean Harris hip score was 92 points. Only two patients complained of thigh pain at last follow up. On radiographic evaluation, radiolucent lines were seen around the uncoated distal part of the stem in 46 percents of the implants. No radiolucent line was observed around the coated area of the prosthesis. Cancellous condensation was seen in 95 per cents of the implants at the Gruen zone 2 and 6 area. Cortical hypertrophy was present in 32 percents. Fourteen cases had the gaps at the bone to acetabular cup interface in the immediate postoperative period. The gaps disappeared in 12 months after operation. Five implants were revised because of polyethylene wear, cup migration and periprosthetic fracture. The clinical outcome was excellent. But this result was obtained in the relatively short-term follow up. Longer-term data will be the only true test of the value of hydroxyapatite coated implant.
Acetabulum ; Arthroplasty, Replacement, Hip ; Durapatite* ; Follow-Up Studies ; Hip Prosthesis* ; Hip* ; Humans ; Hypertrophy ; Periprosthetic Fractures ; Polyethylene ; Postoperative Period ; Prostheses and Implants ; Thigh

PURPOSE: Elevated-rim acetabular liner enhances stability in total hip arthroplasty and has been widely accepted. But it has potential adverse effects. So, we assessed the effects of the elevated-rim acetabular liner clinically and radiologically. MATERIALS AND METHODS: We reviewed the results of 74 total hip arthroplasties of 64 patients that had been performed from January 1993 to March 1995. Thirty-six cases of the 74 cases used elevated rim acetabular liner and 38 cases did standard liner. Dislocation rate, Harris hips score, osteolysis and revision rate were compared between two groups. RESULTS: There were no significant differences in mean anteversion, abduction angles of the cup and femoral offsets between two groups. Four of the 38 cases with the standard liner had a dislocation, compared with one of 36 cases with the elevated-rim liner (P=0.358) . Femoral osteolysis was observed 7 cases (18.4%) in the standard liner group and 14 cases (38.8%) in the elevated-rim liner group. Acetabular osteolysis was observed 17 cases (44.7%) in the standard group and 21 cases (58.3%) in the elevated-rim group. Nine cases (23.6%) had been revised in the standard group and 6 cases (16.6%) in the elevated group. CONCLUSION: Excessive wear and breakage of the polyethylene by impingement was developed in the elevated-rim polyethylene liner.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Dislocations ; Hip ; Humans ; Osteolysis ; Polyethylene

Synovial chondromatosis is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue which disintegrates into the joint and continues to grow. Of the eight cases of synovial chondromatosis seen by the authors, three cases involved the knee, two of these were bilateral, three cases involved the elbow, one the hip joint and one the proximal phalanx of the right middle finger. The diagnosis of synovial chondroamtosis was made by histopathological findings of the excised mass. Most synovial chondromatosis cases obtained favorable results by removing masses from the joint and at the same time performing a partial synovectomy, except one case in which degenerative arth ritis had developed proeoperatively.
Cartilage ; Chondromatosis, Synovial ; Connective Tissue ; Diagnosis ; Elbow ; Fingers ; Hip Joint ; Joints ; Knee

The Subtrochanteric fracture requires long period healing time and is difficult for treatment because it occurs in bone that is predominantly cortical and high stress concentrates in this region. The Subtrochanteric fracture is difficult for the reduction and maintenance because many of these fractures are comminuted from high velocity trauma and the angulation rotation occurs by the influence of the surrounding large and powerful muscles. During the period of February, 1980 to April, 1985, 62 cases of Subtrochanteric fractures were admitted and treated at the Department of Orthopedic Surgery, School of Medicine, Keimyung University, and results were obtained as follows: 1. Of 62 cases, 42 in man and 20 in woman and diffuse in ages. 2. Causes of Subtrochanteric fractures were 32 cases of traffic accidents, 21 cases of fall or slip down, 5 cases of others, and 3 cases of pathologic fractures. 3. Of 62 cases, Type I by Zickel classification was predominant (33 cases), and Type III-A, “three-part spiral fracture“ by Seinsheimer was predominant (24 cases). 4. The better results can be achieved through the bone graft in severe comminuted fracture and through the provision of good cortical load-bearing medially between the fragment during the reduction and fixation. 5. Earlier bone union and low complication of metallic failure and nonunion were achieved with Compression Hip Screw rather than Jewett nail. 6. The causes for the 6 metallic failure cases were comminuted fracture of medial cortical bone, failure in contact and fixation of medial free fragment, and weight bearing before complete union was achieved. 7. There was a breakage in nail-plate junction when Vitalium jewett nail was used. Also there were breakage and loosening of screws when Stainless steel Jewett nail was used. 8. Further studies in the advantages and disadvantages of Zickel nail, Ender nail, Compression Hip Screw, and Kuntscher nail treatment of subtrochanteric fracture are needed.
Accidents, Traffic ; Classification ; Clinical Study ; Female ; Femur ; Fractures, Comminuted ; Fractures, Spontaneous ; Hip ; Hip Fractures ; Humans ; Muscles ; Orthopedics ; Stainless Steel ; Transplants ; Weight-Bearing

OBJECT: The aim of this study is to determine whether exposure to chlorpromazine causes mutagenicity and genetic disorders. METHOD: Ames (Salmonella typhimurium) test and Rec assay (Bacillus subtilis) were used as indicators for DNA damage. Furthermore, the levels of umu operon expression by measuring the beta-galactosidase activity were monitered with the SOS umu test using S. typhimurium 1535 containing plasmid pSK1002. And the host-mediated assay was used to investigate the muta-genicity of chlorpromazine after the activation with in vivo metabolic systems. RESULTS: From the results, chlorpromazine did not affect DNA of S. typhimurium and B. subtilis strains and showed no mutagenicity at the all concentrations tested. These phenomena was also similar to that after metabolic activation of chlorpromazine in in vivo system. CONCLUSION: These results suggested that chlorpromazine did not show the mutagenicity and genotoxicity by four different methods used in this study.
beta-Galactosidase ; Biotransformation ; Chlorpromazine* ; DNA ; DNA Damage ; Operon ; Plasmids

Behcet's disease is a chronie inflammatory symptom complex consisting of recurrent oral ulcer, genital ulcer, ocular lesion or skin lesion. Intestinal involvement in Behcet's disease most commonly affects the ileocecal region in the patient with gestrointestinal symptoms, But esophageal involvement in Behcet's disease is very uncommon, most commonly affects the midesophagus with localized ulcerative lesion. A 38-Year-old woman with refractory and recurrent oral and genital ulcer was admitted because of aggravation of pharyngodynia and dysphagia. Gastrofiberscopic examination showed multiple, small sized ulcers on oral cavity and mid-to-distal esophagus. She was treated with steroid.
Adult ; Deglutition Disorders ; Esophagus ; Female ; Humans ; Mouth ; Oral Ulcer ; Skin ; Ulcer

Mild cognitive impairment (MCI) has been defined as a transitional state between normal aging and Alzheimer disease. Diffusion tensor imaging (DTI) can estimate the microstructural integrity of white matter tracts in MCI. We evaluated the microstructural changes in the white matter of MCI patients with DTI. We recruited 11 patients with MCI who met the working criteria of MCI and 11 elderly normal controls. The mean diffusivity (MD) and fractional anisotropy (FA) were measured in 26 regions of the brain with the regions of interest (ROIs) method. In the MCI patients, FA values were significantly decreased in the hippocampus, the posterior limb of the internal capsule, the splenium of corpus callosum, and in the superior and inferior longitudinal fasciculus compared to the control group. MD values were significantly increased in the hippocampus, the anterior and posterior limbs of the internal capsules, the splenium of the corpus callosum, the right frontal lobe, and in the superior and the inferior longitudinal fasciculus. Microstructural changes of several corticocortical tracts associated with cognition were identified in patients with MCI. FA and MD values of DTI may be used as novel biomarkers for the evaluation of neurodegenerative disorders.
Aged ; Aged, 80 and over ; Aging/*pathology ; Anisotropy ; Biological Markers ; Cerebral Cortex/*pathology ; Cognition Disorders/*pathology ; Diffusion Magnetic Resonance Imaging/*methods ; Female ; Humans ; Male ; Middle Aged ; Neural Pathways/*pathology ; Severity of Illness Index

BACKGROUND AND OBJECTIVES: A cutting balloon (CB) is a balloon catheter with 3 or 4 metal blades on its surface used for making controlled endovascular surgical incisions and promising minimal intimal injury. Some reports suggest advantages of the use of CB in the treatment of in-stent restenosis (ISR). The purpose of this study was to report the clinical experience of the use of CB for ISR. SUBJECTS AND METHODS: 28 patients were enrolled in this study. Angiographic success (defined by 40% residual stenosis), in-hospital, 30 days and 6 months clinical outcomes were evaluated. RESULTS: Angiographic success was 92.9% (26/28). The number of inflations and maximal inflation pressure were 2.8+/-0.9 and 10.1+/-1.3 ATM, respectively. The balloon/artery (B/A) ratio was 1.1+/-0.2. There was a case of stent insertion for treating type D dissection and a case of rotational atherectomy for suboptimal result after CB angioplasty. 25 cases underwent analysis through 6 months of clinical follow-up. During the 6-month clinical follow-up, 4 cases of re-PTCA were documented, while MACE during in-hospital time and the subsequent 30 days was 0%. CONCLUSION: Our experience demonstrated that CB can be performed safely and effectively in coronary ISR. Further clinical and angiographic effectiveness are warranted in a large-scale clinical trial.
Angioplasty ; Angioplasty, Balloon* ; Atherectomy, Coronary ; Catheters ; Coronary Restenosis ; Follow-Up Studies ; Humans ; Inflation, Economic ; Stents*

The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling," was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured maxillary lateral incisor associated with alveolar bone loss, which was achieved by forced orthodontic extrusion before implant placement. Through these procedures we could reconstruct esthetics and function in a hopeless tooth diagnosed with subgingival root fracture by trauma.
Alveolar Bone Loss ; Dental Implants, Single-Tooth ; Esthetics ; Incisor ; Orthodontic Extrusion ; Tooth