OBJECTIVE: The purposes of this study were to measure the effect of Stellate ganglion block(SGB) objectively and quantitatively by the use of sympathetic skin response(SSR), and to evaluate the cumulative effects and complications of repetitive SGB and to find out optimal numbers of injection per one cycle in the patients with reflex sympathetic dystrophy(RSD). METHOD: Six patients with RSD were evaluated with a SSR test before and after the injection of 1% lidocaine 4 ml by SGB method. RESULTS: There was a significant prolongation of latencies in SSR of the lesion side of sixty mixed cases by the SGB methods and SSR tests. There were no significant changes in the latency and amplitude of SSR from the lesion side between pre- and post injection states. There was a significant decrease of amplitude in the sound side after the injection. The differences of the amplitudes between pre- and post injections were significantly higher in the lesion side than the sound side. The degree of pain of the patients with RSD was evaluated by visual analogue scale(VAS), which scored on pre and post injection state decreased from 10 to 6.5 by 5 times injections, but did not decrease by more injections. CONCLUSION: We concluded that SGB is more effective in the RSD lesion side than the sound side and the SSR is a useful test for evaluating the effect of SGB.
Humans ; Lidocaine ; Reflex Sympathetic Dystrophy* ; Reflex* ; Skin* ; Stellate Ganglion*

Adjustable suture technique may be indicated for strabismus surgery when the surgical outcome will be uncertain. We used ketamine intramuscular injection for sedation the day, and performed adjustment after the surgery to enhance the postoperative success rate. The results were analyzed. The average age of the 29 pediatric patients was 53.5 +/-21 months and they were devided into 22 exotropia group and 7 esotropia group. The minimal postoperative observation period was 3 months(average 4.2+/-1.6 months). Among 22 exotropia patients, 13 patients were adjusted and the advancement amount was 1~2 mm. Esotropia was not adjusted. In the final follow-up evaluation, 19 exotropic patients(86.4%)and 7 esotropic patients showed the favorable outcome. However, 3 exotropic patients failed. Two were overcorrected and 1 was undercorrected. In 1 overcorrected case, the postoperative V pattern esotropia occurred. When the alignment can be measured and the picture of external eyes can be obtained, postoprative adjustment was possible after ketamine intramuscular injection. Since the degree of preoperative alignment and the precise evaluation of preadjustment alignment play an important role in determining the advancement amount, careful evaluation should be performed.
Anesthesia* ; Esotropia ; Exotropia ; Follow-Up Studies ; Humans ; Injections, Intramuscular ; Ketamine* ; Strabismus* ; Suture Techniques* ; Sutures*

The hallmark of exfoliation syndrome is the appearance of white granular deposits and dandruff-like flakes on the lens,iris and angle. The incidence of glaucoma is high,and due to zonular weakening, complications are likely to occur in cataract surgery. A histopathological study with electron microscopy was performed on the iris and conjunctival tissue in order to clarify the production process of exfoliation material in the eyes with exfoliation syndrome. The materials were obtained from 13 eyes with exfoliation syndrome during surgery for glaucoma or cataract. The clumps of microfibrils were observed in the extracellular matrix, and the exfoliation materials were closely related with microfibrils.It was found that the basic unit of the exfoliation materials was microfibril. The cellular degenerations were observed in the basement membrane of capillary endothelium, especially the cells near the iris vessels. The exfoliation materials were observed around the degenerated cells; the mature or immature exfoliation materials around the iris melanocyte which show the various degrees of degeneration. The more degeneration and melting of the cells, the larger amount of exfoliation materials. This study suggests that the exfoliation materials in the eyes with exfoliation syndrome are derived from the abnormal microfibril, abnormal basement membrane, and degenerated cell itself.
Basement Membrane ; Cataract ; Endothelium, Vascular ; Exfoliation Syndrome* ; Extracellular Matrix ; Freezing ; Glaucoma ; Incidence ; Iris ; Melanocytes ; Microfibrils ; Microscopy, Electron

We reviewed 14 children with unilateral fractures of femoral shaft who had an angular deformity after union of 10° to 25°. At an average follow-up of 32 months(15 to 65), we measured remodelling of the proximal physis, the distal physis and the femoral shaft. The average correction was 83% of the initial deformity and there was no relation between the remodelling rate and degrees of malunion. Of the correction of angulation, only 27% had occurred at the fracture site and 73% at physis. The ability of physis to remodel better than that of fracture site. In children under 13 years of age, malunion as much as 25° in flexion deformity will remodel enough to get normal alignment of the joint surfaces.
Child ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints

Early onset cerebellar ataxia with retained tendon reflexes is distinctive clinical syndrome characterized by progressive cerebellar ataxia of unknown etiology with an onset within the first two decades. This disorder was distinguished from Friedreich's ataxia by the preservation of the deep tendon reflexes. There is 22-year-old male with 13 year history of slowly progressive cerebellar ataxia and dysarthria. His elder brother, also, has milder clinical manifestations, electrophysiological and radiological abnormalities. We experienced two cases of early onset cerebellar ataxia with retained tendon reflexes developed in brothers which was diagnosed by clinical manifestations, electrophysiologic, radiologic studies and report with brief review of related literatures.
Cerebellar Ataxia ; Dysarthria ; Friedreich Ataxia ; Humans ; Male ; Reflex, Stretch* ; Siblings* ; Spinocerebellar Degenerations* ; Tendons* ; Young Adult

Tethered spinal cord syndrome can be defined as a low conus medullaris extending below L2 vertebral level and/or a thickened filum terminale above 2 mm in diameter. Among the neurologic symptoms, neurogenic bladder and bowel is the most common and leaves significant sequale that the patients being disabled not physically but socially. Early recognition and detethering operation are recommended but proper bladder management with regular follow-up should be accompanied for better prognosis. Here, three cases of the neurogenic bladder with tethered spinal cord syndrome who primarily had myelodysplasia are presented with review of the articles.
Cauda Equina ; Conus Snail ; Follow-Up Studies ; Humans ; Neural Tube Defects* ; Neurologic Manifestations ; Prognosis ; Urinary Bladder ; Urinary Bladder, Neurogenic*

OBJECTIVE: The purpose of this study is to investigate the incidence and types of skin lesions occurring in the patients with a spinal cord injury(SCI), traumatic brain injury(TBI), cerebrovascular accident(CVA), and an amputation. METHOD: Five hundred and eighty-nine charts from 1991 to 1997 were retrospectively reviewed. During the hospitalization, the skin lesions were examined by the dermatologists upon consultations. The patients were divided by their diagnosis of the SCI, TBI, CVA, and amputation. The incidence of the skin lesions were analysed. RESULTS: The number of patients was as follows; SCI 228, TBI 181, CVA 143, and amputation 37. The skin lesions occurred in 72 cases(12.9%) of which 30 cases(13.2%) occured in SCI, 21 cases(11.6%) in TBI, 15 cases(9.8%) in CVA and 7 cases(18.9%) in amputation. These include dermatophytosis 23 cases(23.9%), seborrheic dermatitis 21 cases(21.8%), pilosebaceous disorder 17 cases(17.7%) such as folliculitis, acne, and acneiform eruption, eczema 11 cases(11.4%), drug eruption 9 cases(9.4%), candidiasis 6 cases(6.3%), and others 9 cases(9.4%) such as steatocytoma multiplex, epidermal cyst, intertrigo, alopecia areata, and etc. The incidence of ANS related skin lesion such as seborrheic dermatitis and pilosebaceous disorder in SCI was significantly higher than in TBI and stoke, which the defect is in the brain(p<0.05). However, the incidence in other lesions such as dermatophytosis, eczema, and candidiasis was not significantly different between these two groups(p>0.05). The number of cases of ANS related skin lesions was 21(52.5%) and 3(42.9%) in SCI patients whose level of injury was from C1 to T6(in 40) and at or below T7(in 7) respectively. In contrast, the number of cases of other skin lesions such as dermatophytosis, eczema, and candidiasis was 15(37.5%) of C1 to T6 level and 4(57.1%) of at or below T7 level in the same SCI patients groups. CONCLUSION: This study illustrates that the incidence of skin lesion in rehabilitation unit is 72 cases of 589 patients(12.9%). The incidence of ANS related skin lesion is higher in the patients with spinal cord injury than brain lesion. And the level of injury is higher in SCI, the more skin lesions occur.
Acne Vulgaris ; Acneiform Eruptions ; Alopecia Areata ; Amputation ; Autonomic Nervous System ; Brain ; Candidiasis ; Dermatitis, Seborrheic ; Diagnosis ; Drug Eruptions ; Eczema ; Epidermal Cyst ; Folliculitis ; Hospitalization ; Humans ; Incidence ; Intertrigo ; Pressure Ulcer* ; Referral and Consultation ; Rehabilitation* ; Retrospective Studies ; Skin* ; Spinal Cord ; Spinal Cord Injuries ; Tinea

The purpose of this animal experiment was to evaluate the changes of bone mineral density in paralyzed limbs, and to assess the effects of electrically stimulating muscle contraction upon bone mineral density (BMD) in paralyzed limbs during the four week period immediately following spinal cord injury (SCI). Ten rabbits were used for the study, spinal cords were totally transected at the T11 spine level. The paralyzed quadriceps femoris of one limb was contracted by electrical stimulation for 60-minutes daily, while the other side was not stimulated as a control. The BMD of each lower limb was measured by Dual Photon Absorptiometry before and four weeks after acute SCI. BMD of both limbs decreased in all rabbits four weeks after SCI. The decrease in BMD for stimulated and non-stimulated limbs was 6.130 +/- 3.212% and 9.098 +/- 3.831%, respectively during the four-week period after SCI. The BMD of stimulated limbs decreased significantly less than that of the non-stimulated limbs. Electrically induced muscular contraction reduced bone mineral loss in the paralyzed limb during the early stage of SCI in the rabbit.
Animal ; Bone Density* ; Electric Stimulation Therapy* ; Hindlimb* ; Male ; Paralysis/therapy* ; Paralysis/metabolism* ; Rabbits

STATEMENT OF PROBLEM: Titanium has many advantages of high biocompatibility, physical porperties, low-weight, low price and radiolucency, but it is incompatible with conventional dental porcelain due to titanium's oxidative nature. Many previous studies have shown that they used the method of sandblast for surface treatment prior to porcelain application, the researchs are processing about the method of acid etching or surface coating. PURPOSE: The purpose of this research is to study the effect on bond strength between titanium and porcelain when using macro-surface treatment and micro-surface treatment and macro and micro surface treatment . MATERIAL AND METHOD: In this study, we evaluated the bond strength by using 3-point bending test based on ISO 9693 after classified 7 groups - group P : polished with #1200 grit SiC paper, group SS : sandblasted with 50 micrometer aluminum oxides, group LS : sandblasted with 250 micrometer alumium oxides, group HC : treated with 10 % hydrochloric acid, group NF : treated with 17% solution of fluoric acid and nitric acid, group SHC : treated with 10 % hydrochloric aicd after sandblsting with 50 micrometer alumium oxides, group SNF : treated with 17 % solution of fluoric acid and nitric acid. RESULTS: Within the confines of our research, the following results can be deduced. 1. Group SS which was sandblasted with 50 micrometer aluminum oxides showed the highest bond strength of 61.74 MPa and significant differences(P<0.05). The bond strengths with porcelain in groups treated acid etching after sandblasting decreased more preferable than the group treated with sandblasting only. It gives significant differences(P<0.05). 2. After surface treatments, the group treated with sandblasting showed irregular aspect formed many undercuts, in the SEM photographs. The group treated with hydrochloric acid had the sharp serrated surfaces, the group treated with the solution of fluoric acid and nitric acid had the smooth surfaces, the group with sandblasting and hydrochloric acid had irrigular and porous structure, the group with sandblasting and the solution of fluoric acid and nitric acid had craterlike surfaces. But all of the groups treated with acid etching was not found and undercut. CONCLUSION: In above results, average surface roughness increase, bond strength also increase, but surface topographs influences more greatly on bond strengths.
Aluminum ; Dental Porcelain ; Hydrochloric Acid ; Nitric Acid ; Oxides ; Titanium

OBJECTIVE: The purpose of this study was to investigate the clinical feasibility of FDG-PET scan in selection of patients with pelvic recurrence of cervical cancer for surgical treatment. METHODS: From Jun. 2001 to Oct. 2002, whole body FDG-PET scan findings were compared with findings of CT, MRI, and pathologic reports in 24 patients with pelvic recurrence of cervical cancer. PET scan was obtained with a GE Advance PET scanner, beginning at 60 minutes after injection of 370-555 MBq (10- 15 mCi) of 18F FDG. Regional scan was also obtained if needed. Uptake exceeding 2.5 SUV was determined as a positive finding. RESULTS: Among these 24 patients, 10 patients had metastatic lesions at pelvic lymphnodes (4), para- aortic lymphnodes (3), mediastinal lympnnodes (1), lung (4), and bone (1). Among 14 patients with no metastasis, 10 patients underwent surgical treatment but the operations were abandoned in 2 patients due to lymphnodes metastasis and pelvic peritoneal spreads that confused as normal FDG uptake of the intestines pre- operatively. Among 8 patients whom the operation was completed, 3 patients received pelvic exenteration, 2 patients received CORT, and 3 patients received LEER. CONCLUSION: FDG-PET is clinically feasible in selection of patients with pelvic recurrence of cervical cancer for surgical treatment.
Humans ; Intestines ; Lung ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pelvic Exenteration ; Positron-Emission Tomography ; Recurrence* ; Uterine Cervical Neoplasms*