We intended to evaluate the Young's modulus of trabecular bone and apparent density from Computed Tomography(CT) and Spherical Indentation test and to quantify relation ship between them. The distal femurs(31 age, male, left and right) were prepared for exprimentatin and were embedded with repect to anatomical orientation. Then the specimens were scnned at 1 mm intervals on GE9800 CT scanner and the Hounsfield Units(HU, or CT number) were extracted from each CT image. After scanning, the bones were sectioned with diamond saw, producing 8 mm cubes of trabecular bone(72 eachs) from the metaphyseal region of both distal femur. The cubes were mechanically tested in inferior-superior(IS), anteriorposterior(AP), and medial-lateral(ML) direction with custom-made device, Spherical Indentatin Tester. After testing, the real apparent density of specimens were measured. The results of this study showed that the IS modulus was singificantly greater than both the AP and ML modulus and the AP modulus was also greater than ML modulus significantly(p<0.01). A linear relation ship between HU and real apparent density was found to be significant(R2=0.68) and significant power relationship between the apparent density and the tangent moduli(either by CT or physical measures) was also found.
Diamond ; Elastic Modulus* ; Femur ; Humans* ; Male ; Ships

We present two very interesting cases of acute graft-versus-host disease (GVHD), whose skin rashes initially appeared on the localized area of total nodal irradiation (TNI) performed previously to prevent graft rejection and/or GVHD. The histopathologic findings showed some dyskeratotic cells in the epidermis and perivascular mononuclear cell infiltration in the upper dermis. The immunohistochemical studies revealed that HLA-DR was diffusely strongly positive in a number of keratinocytes, whereas both CD4 and CD8 were focally weakly positive in the perivascular lymphocytes in the upper dermis. Later on, liver dysfunction and diarrhea developed and skin rashes began to spread over the other parts of the body in those two patients.
Dermis ; Diarrhea ; Epidermis ; Exanthema ; Graft Rejection ; Graft vs Host Disease* ; HLA-DR Antigens ; Humans ; Keratinocytes ; Liver Diseases ; Lymphocytes ; Skin*

Endoscopic incision therapy was applied to two patients with postoperative anast-omotic stenosis. Radial diathermy incision was performed by needle knife papillot-ome using cutting current. Tne anastomotic stenosis was characteristic of short fibrotic segment and frequent restenosis after dilatation. An sufficient caliber and smooth, supple wall at the site of the stenosis was produced by incisional therapy by needle knife papillotome using cutting current. Clinical symptoms and endoscopic findings were improved after endoscopic incision. It is concluded that endoscopic incisional therapy seems to be safe and effective method for the treatment of anastomotic stenosis after gastrointestinal operation.
Constriction, Pathologic* ; Diathermy ; Dilatation ; Humans ; Needles*

Endoscopic incision therapy was applied to two patients with postoperative anast-omotic stenosis. Radial diathermy incision was performed by needle knife papillot-ome using cutting current. Tne anastomotic stenosis was characteristic of short fibrotic segment and frequent restenosis after dilatation. An sufficient caliber and smooth, supple wall at the site of the stenosis was produced by incisional therapy by needle knife papillotome using cutting current. Clinical symptoms and endoscopic findings were improved after endoscopic incision. It is concluded that endoscopic incisional therapy seems to be safe and effective method for the treatment of anastomotic stenosis after gastrointestinal operation.
Constriction, Pathologic* ; Diathermy ; Dilatation ; Humans ; Needles*

Purpose: With the increasing incidence of recompression fractures after vertebroplasty or kyphoplasty, this study analyzed the risk factors that affect the occurrence of recompression vertebral fractures, such as cement distribution, existence of avascular necrosis (Kummell’s disease), type of procedures, bone mineral density, sex, and age. Materials and Methods: Two hundred and thirty-eight patients who underwent vertebroplasty or kyphoplasty at the author’s clinic from 2005 to 2015 were enrolled in this study. The patients were divided into four groups according to the distribution of injected cement. The patients were classified as type 1 and type 2 when injected cement was contacted only to the upper or lower endplate of the body respectively. They were classified as type 3 when both the upper and lower endplates were contacted by injected cement. When neither the upper nor the lower endplate was contacted, the patients were called type 4. This study statistically evaluated the effects of the risk factors, including the cement distribution on the incidence of recompression vertebral fracture after vertebroplasty or kyphoplasty. Results: There were 59 cases (24.8%) of recompression fracture after vertebroplasty or kyphoplasty, among the 238 cases. According to the analysis, the recompression of the vertebral body after vertebroplasty or kyphoplasty occurred more often when the compression fracture was accompanied by osteonecrosis at the body (p<0.05). The patients who had injected cement distributed at both upper and lower plate simultaneously (type 3) had a lower incidence of recompression fracture of the vertebral body after vertebroplasty or kyphoplasty (p=0.008). In addition, the kyphoplasty group had a lower incidence of recompression after the procedure than vertebroplasty group (p=0.02). Conclusion Careful attention should be given to these patients with osteonecrosis at the compression fracture level through a preoperative evaluation. In addition, if the injected cement does not contact both the upper and lower endplates, careful observation is required during the follow-up period based on the high incidence of vertebral recompression fractures proven through this study. Further technical and biomechanical research and efforts will be needed to make the cement contact both endplates.

Agenesis of the right lobe of the liver is a rare anomaly which may be associated with stone diseases, portal hypertension, and other congenital anomalies. The radiological differential diagnosis includes lobar atrophy due to cirrhosis or hilar cholangiocarcinoma. We present a case of agenesis of the right lobe of the liver with characteristic clinical and radiological findings.
Atrophy ; Diagnosis, Differential ; Fibrosis ; Hypertension, Portal ; Klatskin Tumor ; Liver*

Agenesis of the right lobe of the liver is a rare anomaly which may be associated with stone diseases, portal hypertension, and other congenital anomalies. The radiological differential diagnosis includes lobar atrophy due to cirrhosis or hilar cholangiocarcinoma. We present a case of agenesis of the right lobe of the liver with characteristic clinical and radiological findings.
Atrophy ; Diagnosis, Differential ; Fibrosis ; Hypertension, Portal ; Klatskin Tumor ; Liver*

Cerebral rete mirabile is a unusual form of chronic cerebrovascular occlusive disease characterized usually by bilateral stenosis of distal internal carotid arteries and their vicinity, by a hazy network of collateral circulation at the base of brain called moyamoya vessels and clinically by recurring hemispheric ischemic attack in children. We have reported here 2 cases of cerebral rete mirabile in children and performed newly developed operative procedure which we think is an ideal surgical method for treatment of this disease in children and is compared with other surgical treatment.
Brain ; Carotid Artery, Internal ; Child* ; Collateral Circulation ; Constriction, Pathologic ; Humans ; Ischemia ; Surgical Procedures, Operative

The tethered cord syndrome is a clinical entity manifested by progressive motor and sensory changes in the legs, incontinence, back or leg pain, and scoliosis in young children. Based on remarkable neurological improvement after release of cord tension by sectioning the filum, it might be concluded that the neurological deficit was effected by cord tethering. The main objective of this experiments was to elucidate the pathophysiology involved in the tethered cord by observing the effect of tethered cord on regional spinal cord blood flow(rSCBF) and somatosensory evoked potentials(SEPs) and define a threshold relationship between SEP and rSCBF. Thirty adult cats, weighing 2.7 to 4.2kg were used in this study. The cats were divided into three groups as follows: Control group=non-tethered(10 cats), 5g-traction group=cord traction with 5g weight(10 cats). 10g-traction group=cord traction with 10g weight(10 cats). The rSCBF and SEP measurements were performed immediately after cord traction in each animal, at 30, 60, 90, 120 minutes and the final rSCBF at 3 hours by the hydrogen clearance technique. The results obtained were as follows: 1. Traction and resulted in a reduction of flow to 30%(6.0+/-1.4ml/100g/min) of normal control spinal cord flow(18.2+/-1.6ml/100g/min) at adjacent area of traction(L1) in 5g-traction group and 18%(3.5+/-0.7ml/100g/min) of normal control flow in 10g-traction group during the cord traction for 3 hours. 2. From 30 minutes to 3 hours following the cord traction, there was a tendency toward marked reduction of the blood flow at the adjacent area(L1, T10) in 10-traction group. 3. The rostral area of spinal cord away from traction was less influenced in a reduction of blood flow following the cord traction. 4. A close correlation was found between spinal evoked potentials and flow suggesting a threshold relationship. 1) The SEP was present shortly after traction though marked by altered in shape and suppressed. 2) The SEP responses progressively decreased in latency at the adjacent distal area of the cord during traction, however less changed in shape at the rostral area of the cord. 3) The SEP suppressed in shape if the blood flow in spinal cord was below 14ml/100g/min. 4) The neuronal dysfunction caused by tethered cord could be due to impairment of blood flow. It is assumed that prolonged neuronal dysfunction may lead to structural damage of the neuron.
Adult ; Animals ; Cats* ; Child ; Evoked Potentials ; Humans ; Hydrogen ; Leg ; Neural Tube Defects ; Neurons ; Scoliosis ; Spinal Cord* ; Traction

PURPOSE: This study was designed to compare the wound healing effect of silk fibroin, alginate and fibroin/ alginate blend sponge with clinically used Nu gauze in a rat skin defect model. METHODS: Two full thickness excisions were made on the back of Sprague-Dawley rat. The excised wound was covered with either of the silk fibroin(SF), alginate (SA), or fibroin/alginate blend sponge(SF/SA). On the postoperative days of 3, 7, 10 and 14, the wound area was calculated by image analysis software. At the same time, a skin wound tissue was biopsied. RESULTS: Healing time 50% (HT(50)) of SF/SA sponge treated group was dramatically reduced as compared with that of control treatment. We also found that the HT50 of SF/SA sponge was significantly decreased as compared with either those of SF or SA treatment. Furthermore, SF/SA treatment significantly increased the size of epithelialization and collagen deposition as well as the number of PCNA positive cells on epidermal basement membrane as comapred with those of control treatment. CONCLUSION: Our results suggest that the wound healing effect of SF/SA blend sponge is the best among other treatments including SF and SA during the whole wound healing period.
Animals ; Basement Membrane ; Collagen ; Fibroins ; Porifera* ; Proliferating Cell Nuclear Antigen ; Rats ; Rats, Sprague-Dawley ; Silk* ; Skin ; Skin, Artificial* ; Wound Healing ; Wounds and Injuries*