The methods of treatment of spondylolisthesis range from posterior fusion to instrumentation, and circumferential fusion. Combined anterior and posterior fusion with instrumentation had been carried out in one or two stages and satisfactory results were obtained in nighteen cases with follow-up period of one year to four years at department of orthopedic surgery of Ewha Womans University Hospital from 1987 to 1991. The results were as follows: 1. Of 19 patients, 7 patients were male and 12 patients were famale. 2. The isthmic type was 12 cases (63.1%) and the 5th lumbar vertebral involvement is common (12 cases, 63.1%). 3. The operative treatment was as follows: Posterior fusion with instrumentation was 8 cases, and anterior fusion with instrumentation was 11 cases. 4. The combined anterior and posterior fusion with instrumentation had been carried out in one stage operation at 8 cases, and two stage operation was done at 11 cases. 5. The average operation time was 3.0 hrs in one stage operation, 3.1 hrs in two stage operation, and the average amount of blood loss was 22cc/Kg in one stage, 17cc/Kg in two stage. 6. The satisfactory results were obtained in 19 cases, but there was no specific difference between one stage and two stage operation.
Female ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Spondylolisthesis

The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolar crest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.
Animals ; Blood Vessels ; Bone Marrow ; Cytokines ; Dental Cementum ; Dentin ; Electric Stimulation* ; Electricity ; Electrodes ; England ; Estrogens, Conjugated (USP) ; Hypercementosis ; Intercellular Signaling Peptides and Proteins ; Mandible ; Maxilla ; Needles ; Osteoblasts ; Osteogenesis ; Paraffin ; Periodontal Diseases ; Periodontal Ligament ; Periodontium* ; Rats ; Regeneration ; Tooth

OBJECTIVE: We aimed to examine the reliability and validity of the Korean Altman Self-Rating Mania Scale (K-ASRM) in a large sample of Korean non-clinical undergraduates. METHODS: Participants (n=1,091) filled out the K-ASRM with other self-report questionnaires assessing bipolarity, mood symptoms and affect. Reliability test, exploratory factor analysis and correlation analyses were conducted to examine its psychometric properties. RESULTS: The reliability of the K-ASRM was adequate (Cronbach’s α=0.73, item-to-total correlation 0.53–0.78) and the exploratory factor analysis yielded one factor of mania. The K-ASRM demonstrated significant associations with measures of hypomanic personality (r=0.33), lifetime history of hypomanic symptoms (r=0.23). Also, the K-ASRM was significantly correlated with positive affect (r=0.53), negative affect (r=−0.17) and depressive symptoms (r=−0.35). CONCLUSION: These results suggest preliminary possibility that the K-ASRM can be utilized as self-rating tool for mania in Korea as well as future directions for further validation.
Bipolar Disorder* ; Depression ; Korea ; Psychometrics* ; Reproducibility of Results

OBJECTIVE: To estimate the burden of cardiovascular disease attributable to the total suspended particulates (TSP) and sulfur dioxide (SO2) in Korea using the YLD (years lived with disability) measurement. METHODS: Congestive heart failure(CHF) and myocardial infarction (MI) were chosen as the main cardiovascular diseases whose causes are attributable to the TSP and SO2 levels. In order to calculate the YLD (years lived with a disability), the following parameters in the formula were estimated. : the incidence rate, the case fatality rate, The expected duration of a disability and the average age of onset were estimated. The expected duration of a disability and the average age of onset were calculated using the DISMOD method, as developed by the GBD researchers. The burden of cardiovascular disease due to TSP and SO2 was estimated using the number of years that the patient lived with a disability. RESULTS: The YLD of the CHF due to the TSP and SO2 was attributed to the TSP (94.4 person-year) and SO2 levels (35.0 person-year). The YLD of the MI due to the TSP and SO2 was attributed to the TSP (148.4 person-year) and SO2 levels(27.6 person-year). CONCLUSION: The YLD method employed in this study was appropriate for quantifying the burden of cardiovascular disease. Therefore, it would provide a rational basis for planning a national health policy regarding the disease burden of the risk factors in Korea.
Age of Onset ; Air Pollution ; Cardiovascular Diseases* ; Estrogens, Conjugated (USP) ; Health Policy ; Heart ; Humans ; Incidence ; Korea ; Mortality ; Myocardial Infarction ; Risk Factors ; Sulfur Dioxide* ; Sulfur*

Pedicle screw systems are stronger than previously used Harrington instruments. The systems have been thought to provide sufficient stability to the thoracolumbar burst fractures by merely short segment fusion. Currently some authors reported the metal failure and the loss of correction after the short segment instrumentations. Thirty-nine patients with thoracolumbar burst fractures underwent the long segment pedicle screw instrumentation and anterior interbody fusion at Ewha University Hospital from January 1991 to October 1993. Of these patients, thirty-two were reviewed in an attempt to analyze the result of the operation technique. The mean follow-up was 26 months. L1 was the most common level and twenty patients had neurologic deficits. The anterior decompression and interbody fusion were performed 2 weeks after the posterior instrumentation. We encouraged early ambulation with TLSO brace as soon as possible. Bony union was obtained in all cases and completed at an average 4.4 months after the operation. The average preoperative kyphosis, 17.4 became 3 after the operation and it was measured 4.2 at the final follow-up. The average correction loss was 1.2. Of the twenty patients with neurologic deficit, ten improved by one Frankel grade and four improved by two grades. Postoperative complications were three cases of the donor site pain. There was no metal failure. These data suggest that the long segment pedicle screw instrumentation and anterior interbody fusion are able to provide sufficient stability and the recommendable procedure for the thoracolumbar burst fractures than short segment instrumentation.
Braces ; Decompression ; Early Ambulation ; Follow-Up Studies ; Humans ; Kyphosis ; Neurologic Manifestations ; Pedicle Screws ; Postoperative Complications ; Spine ; Tissue Donors

The purpose of this study was to assess the impact of diabetes mellitus and fibroblast growth factor(FGF) on healing process of nerve defect in rat. Sixty-three adult female Wistar rats weighing between 200 and 250g were divided into a control group(32) and a diabetic group(31). To make diabetic rats, Streptozotocin(50mg/kg) was injected into tail vein after dissolution in saline solution. Each group was further divided into two subgroups respectively, FGF and non-FGF, according to the filling material of the silicone tube. A 5mm segmental defect was made at right sciatic nerve. Both proximal and distal nerve ends were connected with 9mm long silicone tube with internal diameter of 1.57mm. The defect was filled with 10ul FGF(recombinant bovine basic-fibroblast growth factor: final concentration 400ng/ml)-collagen solution(FGF group) or 10ul collagen(Vitrogen 100: final concentration 2.4mg/ml) solution(non-FGF group). After 2 and 4 weeks, electromyographic studies including the latency and the amplitude of action potentials in soleus muscle of the operated limb were checked. After the sacrifice, the regenerated nerves were examined histologically after toluidine blue staining. Cross-sectional area, the number of myelinated axons, non-neuronal cells and vessels were recorded at mid-chamber cross section. Statistical analysis was carried out with the results. From these results, it would be suggested that diabetes mellitus retarded the healing process of sciatic nerve defect in rat, however FGF prompted and accelerated the healing process both in control and diabetic groups so as to overcome the adverse effect of diabetes mellitus.
Action Potentials ; Adult ; Animals ; Axons ; Diabetes Mellitus ; Extremities ; Female ; Fibroblast Growth Factors ; Fibroblasts ; Humans ; Muscle, Skeletal ; Myelin Sheath ; Rats ; Rats, Wistar ; Sciatic Nerve ; Silicon ; Silicones ; Sodium Chloride ; Tail ; Tolonium Chloride ; Veins

BACKGROUND: In recent years, Acinetobacter baumannii isolates acquired resistance to cefepime have increased significantly. The aim of this study was to survey the prevalence of PER-1 extendedspectrum beta -lactamase (ESBL)-producing A. baumannii isolates in a University Hospital, Busan, Korea. METHODS: Antimicrobial susceptibilities were tested by the disk diffusion method, and double disk synergy test was performed for screening of ESBL-production. MICs were determined by agar dilution method. The isoelectric points of beta -lactamases were determined by isoelectric focusing. Transferability of cefepime-resistance were tested by conjugation. blaPER-1 and blaPER-2 alleles were detected by PCR, and the DNA sequences of amplified products were determined by using the dideoxy-chain termination method. RESULTS: Among 51 clinical isolates of A. baumannii intermediate or resistant to cefepime, 10 isolates (19.6%) showed positive results in double disk synergy test. PCR-based experiments detected blaPER-1 gene in all the 10 isolates. All the isolates contained three beta -lactamase bands: pI 5.3, 7.9, and 9.4. MICs of ampicillin, piperacillin, cephalothin, cefoxitin, cefoperazone, ceftazidime, cefotaxime, cefepime, and aztreonam were >256 mg/L, respectively, and them of imipenem were 8-16 mg/L. CONCLUSION: The prevalence of PER-1-producing A. baumannii strains in Busan was less than that of in Seoul. But an outbreak of infection caused by this strain in an intensive care unit shows that spread of PER-1-producing A. baumannii strains can be anticipated in a near future. Prevention of hospital infection by these resistant microorganisms are needed.
Acinetobacter baumannii* ; Acinetobacter* ; Agar ; Alleles ; Ampicillin ; Aztreonam ; Base Sequence ; Busan* ; Cefoperazone ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Cephalothin ; Cross Infection ; Diffusion ; Imipenem ; Intensive Care Units ; Isoelectric Focusing ; Isoelectric Point ; Korea* ; Mass Screening ; Piperacillin ; Polymerase Chain Reaction ; Prevalence* ; Seoul

BACKGROUND: Cellular phone has become a necessary device for communicating in hospitals. Cellular phones contaminated with bacteria may serve as a fomite in the transmission of pathogens by the hands of medical personnel. We investigated the bacterial contamination of cellular phones used by medical personnel in a tertiary hospital. METHODS: Culture swabs were obtained from 101 cellular phones and 99 anterior nasal cavities from medical personnel using cellular phones. The swabs were inoculated on blood agar, MacConkey agar, mannitol salt agar, and enterococcal broths containing 6microgram/mL vancomycin for 48 h at 37degrees C. The bacteria were identified on the basis of colony morphology, gram staining characteristics, catalase test, coagulase test, and DNase test; Microscan (Siemens, USA) was used for the identification of enterococci. RESULTS: Of the 101 cellular phones, 13 were contaminated with Staphylococcus aureus (including 4 methicillin-resistant S. aureus [MRSA]), 61 with coagulase-negative staphylococci (CoNS) (including 38 methicillin-resistant CoNS), 27 with Micrococcus spp., 11 with diphtheroids, 67 with Bacillus spp., and 4 with viridans streptococci. No gram-negative bacilli were isolated. Nasal swabs yielded 36 S. aureus, including 9 MRSA. Only 1 of 9 cellular phones used by the MRSA carriers was contaminated with MRSA. CONCLUSION: Cellular phones used by some medical personnel were contaminated with pathogens such as S. aureus or MRSA. Although, the clinical implications of pathogens isolated from cellular phones have not been fully investigated, pathogens could be transmitted by the hands of medical personnel who are cellular phone users.
Agar ; Bacillus ; Bacteria ; Catalase ; Cellular Phone ; Coagulase ; Deoxyribonucleases ; Disinfection ; Fomites ; Hand ; Hand Hygiene ; Mannitol ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Micrococcus ; Nasal Cavity ; Staphylococcus aureus ; Tertiary Care Centers ; Vancomycin ; Viridans Streptococci

PURPOSE: In this study we attempted to find the value of mast cell index as a diagnostic purpose of the interstitial cystitis (IC) MATERIALS AND METHODS: We compared clinical symptoms and the mast cell index in the IC and chronic cystitis patients. 16 cases of the IC patients, determined by Parson's criteria, were monitored. Under the spinal anesthesia and bladder overdistension with pressure of 60-80cmH2O, bladder wall was checked under cystoscopy. The biopsies of the bladder mucosa and detrusor muscle were obtained. The mast cell index was estimated under light microscope(x400 magnification) after it was stained with toluidine blue. RESULTS: In the IC patients, there was significant correlation between the bladder capacity and mast cell index(p <0.01). Seven patients with 100-199ml bladder capacity range had mast cell index of 62.94+/-3.66, and 8 patients in 200-299ml range had 44.78+/-9.12 mast cell index. In relation between the frequency of nocturia and mast cell index, frequency of 1-2 nocturia patients had mast cell index of 53.75+/-11.45(8 cases), 3-4 nocturia had 44.82+/-8.42(5 cases), 4 or more nocturia had 60.13+/-17.94 mast cell index(3 cases). 10 patients with urgency had 46.41+/-10.29 mast cell index, while 6 patients with no urgency problem had 61.73+/-9.92. 9 patients with lower abdominal pain had mast cell index of 51.37+/-11.79, while 7 patients with lower abdominal pain had 53.16+/-11.79. In comparison between the IC and chronic cystitis, there was significant difference between them. In IC, mast cell index was 52.09+/-12.49 and in chronic cystitis, mast cell index was 23.51+/-7.10(p <0.01). CONCLUSIONS: In this study, the results were showed that there is no direct correlation of mast cell index with nocturia, urgency and lower abdominal pain in IC patients, however there is inverse relationship between mast cell index and the bladder capacity, and we also found significant mast cell index differences between the IC and chronic cystitis. Therefore, we suggest that mast cell index is one of the pathological characteristics of IC and useful method to diagnose the interstitial cystitis.
Abdominal Pain ; Anesthesia, Spinal ; Biopsy ; Cystitis ; Cystitis, Interstitial* ; Cystoscopy ; Humans ; Mast Cells* ; Mucous Membrane ; Nocturia ; Tolonium Chloride ; Urinary Bladder

PURPOSE: To assess the indication and effect of screw fixation in the transverse patellar fractures. MATERIALS AND METHODS: We analysed the results of 14 transverse patellar fractures fixed with screws from January 1991 to May 2005. Mean follow-up period was 47 months (range, 12~143 months). We analysed the radiologic union, operation time, ROM and postoperative Lysholm score. RESULTS: All fractures healed uneventfully. The mean displacement was decreased from 2.2 mm preoperatively to 0.3 mm postoperatively (p=0.001, Wilcoxon signed rank test). The mean operation time was 34 minutes (range, 20 to 60 minutes). Normal range of motion was achieved in 13 knees (92.9%). Average Lysholm score was 95.9 at final follow-up. CONCLUSION: Screw fixation seemed to be useful for treatment of transverse patellar fracture even in comminuted fractures with large fragments. The advantage of this technique was the preservation of extensor mechanism, simplicity, short operation time and good cosmesis.
Follow-Up Studies ; Fractures, Comminuted ; Knee ; Patella ; Reference Values