No abstract available.

Most cases of spondylolisthesis are asymptomatic and successfully managed with conservative treatment. Operation was performed in 20% of symptomatic cases having severe back pain, neurological symptoms and or progressive slipping. Although surgical treatments are divided into decompression and fusion, various methods were tried frorn simple Gill's resection to posterior and/or anterior fusion with instrumentation in case of severe slipping. The authors reviewed 49 cases of symptomatic spondylolisthesis, who were surgically treated, and well followed up at Kang-Nam St. Mary's Hospital during past 6 years from January, 1981, to June, 1987. l. Among 49 cases, 23 were isthmic type and 26 were degenerative in nature, and 40 were females. 24 patients(92.3%) of degenerative type were female over 4th decade. Mean age was 47.9 years. 2. The most common site of involvement was L4–5 intervertebral space(25 cases,; 51.0%). 17 cases(73.9%) of isthmic thpe were involved in L5-Sl intervertebral space, and 21 cases (80.8%) of degenerative type were involved L4–L5 intervertebral space. 3. The symptoms were low back pain, intermittent claudication and sciatica in order of incidence. 4. The average slipping measured by Taillard method was 19.5%, and Meyerding's grade I slipping(69.3%) was the highest in the percentile incidence. The average degree of slipping in isthmic type(23.6%) was greater than that of degenerative type(16.4%). 5. Myelogram mainly showed complete or near complete block in degenerative type and ventral indentation in isthmic type. C–T myelogram showed mainly central stenosis in degenerative type, and nerve root compression in isthmic type. 6. In 9 cases,anterior fusions were done ; 5 degenerative and 4 isthmic. In 37 cases, decompression and posteriolateral fusions were done with or without instrumentation ; instrumented in 11 cases. 7. Clinically, the results were judged as excellent in 16 cases(32.7%), good in 26 cases(53.1 %), fair in 6 cases(12.2%), poor in 1 case(2.1%). Thus, 42 cases(85.8%) were considered satisfactory. The satisfactory results were obtained in 77.8% of anterior interbody fusion cases, 88 5% of posterolateral fusion cases, 90.7% of decompression and posterolateral fusion with instrumentation cases. There was no appreciable difference in clinical results between isthmic and degenerative types. 8. There were no changes in slipping in 35 cases(71.5%), Partial reduction were possible in 13 cases(28.5%), and further splipping developed in a patient who had decompression surgery alone. Among 46 cases of vertebral fusion, complete fusion was obtained in 43 cases(93.5%) within one year. 9. Solid anterior spondylodesis was obtained in all the cases of degenerative type, while in 2 cases(50%) of the isthmic type, graft crumbled with redisplacement and delayed fusion. Through the results, it is concluded that posterior instrumentation may not be essential for the successful spondylodesis in cases of posterolateral fusion, since there was no statistical significance in the results between the instrumented and non-instrumented, and isthmic type and degenerative type, and that anterior interbody fusion is best indicated for the treatrment of the degenerative type and not for the isthmic type. Therefore, if anterior interbody fusion is chosen for the successful treatment of isthmic type, a certain type of internal fixator should be combined.
Back Pain ; Clinical Study ; Constriction, Pathologic ; Decompression ; Female ; Humans ; Incidence ; Intermittent Claudication ; Internal Fixators ; Low Back Pain ; Methods ; Radiculopathy ; Sciatica ; Spinal Fusion ; Spondylolisthesis ; Transplants

Fractures significantly involving the weight-bearing articular surface and the overlying metaphysis of the distal tibia have deserved notoriety as a severe and challenging subject of ankle injuries. It was not until 1963 that the AO group developed principles for open reduction and internal fixation of pilon fracture. But recently, limited internal fixation of the joint surface combined with external fixation may avoid the soft tissue complications associated with formal open reduction and internal fixation. We have treated 22 cases of tibial pilon fracture with biologic principle. The mean follow-up period was two years ranging from one to three years. According to the Riiedi and Allgower classification, three cases were type I, five cases were type II, and fourteen cases were type III Biologic treatment includes combination of internal and external fixation, external fixation alone, or plating was done with careful soft tissue dissection, limited stripping of fracture fragments, and indirect reduction technique. Radiographic results were assessed by Burwell and Charnley criteria. Three cases of type I, three cases of type II and seven cases of type III pilon fractures obtained good anatomic radiographic results. We also assessed the functional results by Mast and Teipner criteria. Three cases of type I, three cases of type II, six cases of type III pilon fractures obtained good functional outcome. We believed that combination of internal and external fixation provides the patient who has a markedly displaced pilon fracture and diaphyseal comminution with the best chance of good clinical result and minimal risks. As such, we believe biologic treatment is excellent for these injuries.
Ankle Injuries ; Classification ; Follow-Up Studies ; Humans ; Joints ; Tibia ; Weight-Bearing

Thirteen guinea pigs and 23 rabbits were challenged with 300 metacercariae of Clonorchis sinensis each and the recovery of adult worms and egg counts in feces were compared at 11-13 weeks post-infection in guinea pigs and at 7-9 weeks post-infection in rabbits. The recovery rate of adult worm was 23.5 percent in guinea pigs and 20.l-30.5 percent in rabbits. The mean E.P.G. of these animals in above period of infection was 106 in guinea pigs and 121 in rabbits. When one hundredth of E.P.G. was expressed as X and the number of adult worms as Y, the relationships between X and Y were as follows; Y=0.8X+10.8 in guinea pigs and Y=0.7X+6 in rabbits.
parasitology-helminth-trematoda ; Clonorchis sinensis ; guinea pig ; rabbit ; egg

This case was an acquired aplastic anemia patient who required a major operation for excision of a mediastinal mass. The authors previewed that the coagulation abnormalities would be developed due to major operation. Thus we decided to monitoring the coagulation function using the thromboelastography during the perioperative period and checked the complete blood count, concommitantly. The total blood volume lost during operation was 1800 ml, so we gave him a transfusion of 10 U's of platelet concentrate, 10 U's of pheretic platelet rich plasma and 5 U's of whole blood. The thromboelastography was a good guide that helped us to avoid excessive treatment of the coagulation abnormalities. We concluded that the thromboelastograhy was a reliable and effective monitoring system at the intraoperative coagulation management.
Anemia, Aplastic* ; Anesthesia, General ; Blood Cell Count ; Blood Platelets ; Blood Volume ; Humans ; Perioperative Period ; Platelet-Rich Plasma ; Thrombelastography

No abstract available.
Biofeedback, Psychology* ; Electric Stimulation* ; Pelvic Floor* ; Urinary Incontinence*

This study was performed to evaluate the clinical significance of SCC as a tumor marker in patient with squamous cell carcinoma of the cervix. We measured the serum levels of SCC by radioimmunoassay in patient with invasive squamous cell carcinoma of cervix to determine the prognostic value, correlation with the presence of lymph node metastasis, response to treatment, and those value in the early detection of recurrence after treatment. The result was: 1) In 117 of 174 patients with cervical cancer, the pretreatment positive rate of SCC was 47.0%(57/117). In each stage, the stage Ia was 25.0%, Ib 26.3%, IIa 56.0%, 62.6%, III 57.1%, IV 100%, and the recurrent case was 37.5%. 2) In 79 of 174 patients with cervical cancer, the pretreatment positive rate of SCC was 44,0%(30/69) in no evidence of malignancy patients, but 60.0%(6/10) in recurrent or permanent patients(p>0.05), 3) In 133 of 174 patients with cervical cancer, the posttreatment positive rate of SCC was 2.6%(3/117) in no evidence of malignancy patients, but 50.0%(8/16) in recurrent or permanent patients(p<0.05). 4) In 48 patients of 174 with cervical cancer who underwent radical hystrectomy, the positive rate of SCC was 71.4%(5/7) in pelvic lymph node positive patients but 19,5%(8/41) in pelvic lymph node negative patients(p<0.05). We concluded that the pretreatment SCC level was not effective as a prognostic value, but well correlated with pelvic lymph node metastasis, and serial measurements of serum levels of SCC provided a reliable clue for early detection of recurrence or progression of disease, so it may be useful for monitoring cervical carcinoma patient.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Radioimmunoassay ; Recurrence ; Uterine Cervical Neoplasms

No abstract available.
Torticollis*

A clinical study was made on 12 cases of neonatal Group B beta-hemolytic streptococcal (=GBS) meningitis, who were admitted to the department of pediatrics, Dong-San Hospital, Keimyung University during the period of 3 years from Aug 1989 to Jul 1992. The following results were obtained: 1) GBS was cultured in 12 cases (57.1%) among 21 neonatal meningitis admitted during the same period. 2) Male and female ratio was 1.4:1, and 4 cases had early-onset and 8 cases had late-onset. 3) In 6 (50%) out of 12 cases, obstetric factors were noted, including premature rupture of membrane (2 caes), premature delivery(1 case), asphyxia (1 case), cesarean section (1 case) and maternal toxemia (1case). 4) The clinical manifestations were fever (91.7%), lethargy and poor feeding (83.3%),vomiting and irritability (50%), convulsion and bulging fontanel in order. 5) Associated diseases were GBS sepsis (8 cases), pneumonia (2 cases), hyperbilirubinemia (2 cases), etc. 6) Cerebrospinal fluid findings were increased cells(250-12600/mm3), decreased sugar (1-11), increased protim (220-678mg%) and the CBC differential ratio was less than 1.0 in all cases. 7) Overall survival rate was 83.3% with 75% in early-onset disease, and 87.5% in late-onsetdisease. 8) The acute neurologic complications were noted in 5 cases (45.5%) including subdural hemorrhage, brain swelling and cerebral infarction.
Asphyxia ; Brain Edema ; Cerebral Infarction ; Cerebrospinal Fluid ; Cesarean Section ; Female ; Fever ; Hematoma, Subdural ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Lethargy ; Male ; Membranes ; Meningitis* ; Pediatrics ; Pneumonia ; Pregnancy ; Rupture ; Seizures ; Sepsis ; Survival Rate ; Toxemia

No abstract available.
Kinetics* ; Wrist*