In the assessment of thoracolumbar fractures, computed tomography (CT) is superior to other imaging modalities especially when a more definitive assessment of the posterior elements of the spine or the neural canal is desired. We evaluated 55 patients with acute thoracolumbar burst fractures, and correlated the amount of neural canal impingement (NCI), demonstrated on computed tomographic scans, with each patients neurologic status, level of injury and extent of recovery when neural deficit was present. The results were as follows ; l. Average NCI was significantly higher in cases with neurologic deficits (57.3%) than in cases with no deficit (29.8%). But the range of NCI was much overlapped between the two groups (32-100% with deficits vs. 8-69% with no deficit). 2. In cases with neurologic deficits, average NCI was significantly higher in lumbar spine (75.0%, range; 61-100%) than in thoracolumbar spine (49.2%, range; 32-87%). 3. There was no neurologic deficit in cases with NCI less than 30% in thoracolumbar spine and less than 60% in lumbar spine. 4. In thoracolumbar spine, there was more significant relationship between NCI and patient's neurologic status in T12 than in Ll. 5. The NCI did not directly correlate with the extent of recovery of neurologic deficits when present.
Humans ; Neural Tube ; Neurologic Manifestations ; Spine

The patella is an important component of the extensor mechanism of the knee. It serves to increase the mechanical advantage of the quadriceps muscle by increasing its lever arm. Therefore, if possible, when the patella is fractured, it should be repaired rather than excised. Present surgical techniques for the patellar fractures utilizes principles of anatomic reduction with repair of any associated retinacular tears, rigid internal fixation, and early institution of joint motion exercises. To compare the efficacies of the commonly used wiring techniques, we performed tension tests with transversely bisected patellar models fixed with circumferential wiring, Magnuson wiring, modified tension band wiring and modified tension band wiring combined with circumferential wiring. Also, we reviewed 66 surgically treated patellar fractures from Jan. 1984 to Dec. 1988, when we had given every effort to preserve the patella using modified tension band wiring or modified tension band wiring combined with circumferential wiring. l. According to the results of the tension tests, modified tension band wiring and Magnuson wiring were more rigid than circumferential wiring and the rigidity of modified tension band wiring was much increased when combined with circumferential wiring. 2. Of the 66 cases, 46 cases were treated with modified tension band wiring combined with circumferential wiring, and the remainder were treated with modified tension band wiring. 3. On the whole, good and excellent results were achieved in 87.9% (58 cases). Unsatisfactory results were obtained in 15.0% of cases treated with modified tension band wiring and in 10.9% of cases treated with modified tension band wiring combined with circumferential wiring. 4. Most of the unsatisfactory cases were so severely comminuted that could not be achieved anatomic reduction, rigid internal fixation and early joint motion exercises.
Arm ; Exercise ; Joints ; Knee ; Methods ; Patella ; Quadriceps Muscle ; Tears

BACKGROUND: The information on nasal transport and the metabolism of peptides have been obtained from pharmacokinetic investigations in experimental animals. However, there are no transport and metabolic studies of human nasal epithelial cells. In this study, the permeability characteristics and the metabolic properties of in vitro human nasal cell monolayers were investigated. Material and METHODS: Normal human inferior nasal conchal tissue samples were obtained from patients undergoing endoscopic nasal cavitary surgery. The specimens were cultured in a transwell using an air-liquid interface (ALI) culture, and the transepithelial electrical resistance (TEER) value of the blank filter and confluent cell monolayers were measured. To determine the % leakage of mannitol, 4µmol 14C-labelled mannitol was added and the % leakage was measured every 10 minute for 1 hour. RESULT: Human nasal epithelial cells in the primary culture grew to a confluent monolayer within 7 days and expressed microvilli. The tight junction between the cells was confirmed by transmission electron microscopy. The TEER value of the blank filter, fifth day and seventh day reached 108.5 ohm.cm2, 141 ohm.cm2 and 177.5 ohm.cm2, respectively. Transcellular % leakage of the 14C-mannitol at 10, 20, 30, 40, 50 and 60 minutes was 35.67±5.43, 34.42±5.60, 32.75±5.71, 31.76±4.22, 30.96±3.49 and 29.60±3.68 %, respectively. CONCLUSION: The human nasal epithelial monolayer using ALI using techniques is suitable for a transcellular permeability study. The data suggests that human nasal epithelial cells in as ALI culture technique shows some promise for a nasal transport and metabolism study.
Animals ; Culture Techniques* ; Electric Impedance ; Epithelial Cells* ; Humans* ; Mannitol ; Metabolism ; Microscopy, Electron, Transmission ; Microvilli ; Peptides ; Permeability ; Tight Junctions

No abstract available.
Eosinophilic Granuloma* ; Eosinophils* ; Lymph Nodes*

PURPOSE: To analysis the efficacy of MRI in assessing fracture configuration and frequency of associated soft tissue injuries in tibial plateau fractures. MATERIALS AND METHODS: In the plain films and MRI of 47 cases with tibial plateau fractures,every fracture was classified by findings on plain film and MRI respectively according to the Schatzker system and they were compared with each other. The degree of displacement and depression of the fracture fragments were measured on plain film and MRI. RESULTS: MRI was more accurate in determining the classification of the fracture and measuring the displacement and depression of fragments. Fracture classifications were changed in 12 cases. Especially in Schatzker VI cases, articular step off over 2 mm and articular fragments over 2X2 cm were revealed in detail by MRI. Evidence of internal derangement of the knee was found in 38 (80.8%) cases. CONCLUSION: Most of the cases with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatment plan.
Classification ; Depression ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Soft Tissue Injuries

OBJECTIVES: Controversial arguments exists on both the case for and against on the accumulation of mitochondrial DNA (mtDNA) deletion in association to tissue and age. The debate continues as to whether this mutation is a major contributor to the phenotypic expression of aging and common degenerative diseases or simply a clinical insignificant epiphenomenon. The objective of this study was to determine whether the accumulation of mtDNA deletion is correlated with age-related and tissue-specific variation. MATERIALS AND METHODS: One hundred and fifty-seven tissues from blood, ovary, uterine muscle, and abdominal muscle were obtained from patients ranging in age from 31~60 years. After reviewing the clinical reports, patients with mitochondrial disorder were excluded from this study. The tissues were obtained at gynecological surgeries with the consent of the patient. Total DNA isolated from blood, ovary, uterine muscle, and abdominal muscle was amplified by two rounds of PCR using two pairs of primers corresponding to positions 8225-8247 (sense), 13551-13574 (antisense) for the area around deleted mtDNA and 8421-8440 (sense), 13520-13501 (antisense) for nested PCR product. A statistical analysis was performed by c2-test. RESULTS: About 0% of blood, 94.8% of ovary, 71.4% of uterine muscle, and 86.1% abdominal muscle harbored mtDNA deletion. When we examined the proportion of deleted mtDNA according to age deletion rate was 90% of ovary, 63.6% of uterine muscle, 77.7% of abdominal muscle in thirties and 100% of all tissue in fifties. CONCLUSION: The findings of this study suggest that the mtDNA deletion is varied in tissue-specific pattern and increases with aging.
Abdominal Muscles ; Aging ; Animals ; DNA ; DNA, Mitochondrial* ; Female ; Gynecologic Surgical Procedures ; Humans ; Mice ; Mitochondrial Diseases ; Myometrium ; Ovary ; Polymerase Chain Reaction

We report aprimary malignant pericardial mesothelioma. Thirty-eight-year-old male patient complained of dyspnea and chest pain with left shoulder pain. At first, we thought it was because of tuberculous constrictive pericarditis and performed medical management for one and a half years. But, the above symptom recurred repeatedly; therefore we did pericardiectomy and diagnosed his case as malignant pericardial mesothelioma. Tumor was sticked to the myocardium and complete resection was impossible. He received postoperative chemoradiotherapy.
Chemoradiotherapy ; Chest Pain ; Dyspnea ; Humans ; Male ; Mesothelioma* ; Myocardium ; Pericardiectomy ; Pericarditis, Constrictive* ; Pericarditis, Tuberculous ; Pericardium ; Shoulder Pain

BACKGROUND: Although aortic valve repair can reduce prosthesis-related complications, rheumatic aortic regurgitation (AR) caused by leaflet restriction is a significant risk factor for recurrent AR. In this study, we evaluated the long-term results of the leaflet extension technique for rheumatic AR. METHODS: Between 1995 and 2016, 33 patients underwent aortic valve repair using the leaflet extension technique with autologous pericardium for rheumatic pure AR. Twenty patients had severe AR and 9 had combined moderate or greater mitral regurgitation. Their mean age was 32.2±13.9 years. The mean follow-up duration was 18.3±5.8 years. RESULTS: There were no cases of operative mortality, but postoperative complications occurred in 5 patients. Overall survival at 10 and 20 years was 93.5% and 87.1%, respectively. There were no thromboembolic cerebrovascular events, but 4 late deaths occurred, as well as a bleeding event in 1 patient who was taking warfarin. Twelve patients underwent aortic valve reoperation. The mean interval to reoperation was 13.1±6.1 years. Freedom from reoperation at 10 and 20 years was 96.7% and 66.6%, respectively. CONCLUSION: The long-term results of the leaflet extension technique showed acceptable durability and a low incidence of thromboembolic events and bleeding. The leaflet extension technique may be a good option for young patients with rheumatic AR.
Aortic Valve ; Aortic Valve Insufficiency ; Follow-Up Studies ; Freedom ; Hemorrhage ; Humans ; Incidence ; Mitral Valve Insufficiency ; Mortality ; Pericardium ; Postoperative Complications ; Reoperation ; Rheumatic Diseases ; Risk Factors ; Warfarin

Hip joint preserving osteotomy surgery is the treatment of choice for young patients with early symptomatic structural abnormalities of the acetabulum and proximal femur. This is true even in the absence of severe secondary degenerative changes. These disorders can include hip instability from classic developmental dysplasia, post-traumatic acetabular dysplasia, hip impingement from retrotorsional acetabular deformities, or, rarely, post-traumatic problems. During the past 20 years, various techniques of acetabular and proximal femoral reorientation have evolved, making the procedure reliable, reproducible, and durable. In this report, the current indications and results of acetabular and proximal femoral osteotomies in patients with symptomatic acetabular structural problems will be discussed.
Acetabulum ; Congenital Abnormalities ; Femur ; Hip ; Hip Joint ; Humans ; Osteotomy

PURPOSE: Ischiofemoral impingement (IFI)-primarily diagnosed by magnetic resonance imaging (MRI)-is an easily overlooked disease due to its low incidence. The purpose of this study was to evaluate the usefulness of false profile view as a screening test for IFI. MATERIALS AND METHODS: Fifty-eight patients diagnosed with IFI between June 2013 and July 2017 were enrolled in this retrospective study. A control group (n=58) with matching propensity scores (age, gender, and body mass index) were also included. Ischiofemoral space (IFS) was measured as the shortest distance between the lateral cortex of the ischium and the medial cortex of lesser trochanter in weight bearing hip anteroposterior (AP) view and false profile view. MRI was used to measure IFS and quadratus femoris space (QFS). The receiver operating characteristics (ROC), area under the ROC curve (AUC) and cutoff point of the IFS were measured by false profile images, and the correlation between the IFS and QFS was analyzed using the MRI scans. RESULTS: In the false profile view and hip AP view, patients with IFI had significantly decreased IFS (P < 0.01). In the false profile view, ROC AUC (0.967) was higher than in the hip AP view (0.841). Cutoff value for differential diagnosis of IFI in the false profile view was 10.3 mm (sensitivity, 88.2%; specificity, 88.4%). IFS correlated with IFS (r=0.744) QFS (0.740) in MRI and IFS (0.621) in hip AP view (P < 0.01). CONCLUSION: IFS on false profile view can be used as a screening tool for potential IFI.
Area Under Curve ; Diagnosis, Differential ; Femur ; Hip ; Humans ; Incidence ; Ischium ; Magnetic Resonance Imaging ; Mass Screening ; Propensity Score ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Weight-Bearing