With porcine vertebrae, the static and dynamic holding power of the pedicle screws under various conditions were measured to understand the biomechanical nature of the transpedicular screw fixation in spine. The objectives of the present study were; (1) to find the correlation between the insertion depth of the screw and the resulting holding power, (2) to determine the effect of bone cement augmentation on the screw fixation in a loosened hole, and (3) to assess the load-sharing mechanism between the cortical and the cancellous one surrounding the screw in this fixational system. The geomorphological characteristics of each porcine vertebra was measured directly with a micro-caliper. The bone mineral density of the specimens was also measured. Material with screw was holded in the fixed cross head of material testing system(Autograph E-10T). Testing force was applied and graph was obtained in the chart record. The results of the static pull-out tests in this study showed that there was a statistically-significant positive correlation between the screw diameter and the pull-out resistance(p < 0.05). The strength of the fixation did not actually increase as much as the insertion depth of the screw increased in these tests(r=0.457). In low-cycle fatigue tests, the increased number of cycles was required to clinical failure in the deeper-inserted crews. Considering the mechanical failure, a statistically-significant positive correlation between the failure cycle and the insertion depth was observed in both deep and shallow insertion groups(p < 0.05). Nonpressurized PMMA augmentation appeared to restore the ability of the screws to withstand pullout loading of the original value. On the effect of the cortical and cancellous bone, the most important factor was the cortical bone of the entrance near the screw.
Bone Density ; Fatigue ; Head ; In Vitro Techniques ; Pedicle Screws ; Polymethyl Methacrylate ; Spine

Acute vestibular syndrome (AVS) is characterized by the rapid onset of dizziness/vertigo accompanied by nausea/vomiting, gait unsteadiness, and nystagmus lasting a day or more. Some patients with AVS have potentially dangerous central etiologies. AVS caused by central etiologies without significant other neurologic deficit, so called pseudo-vestibular neuritis (pseudo-VN), could be difficult to be differentiated from acute vestibular neuritis. In addition to imaging studies, bedside oculomotor examination-head impulse test, nystagmus and test of skew)-is essential to identify patients with pseudo-VN. Among several central causes of AVS, brain tumor is extremely rare. We report a case of vascular tumor involving the anterior inferior cerebellum with AVS presentations.
Brain Neoplasms ; Cerebellum ; Gait ; Humans ; Neuritis ; Neurologic Manifestations ; Nystagmus, Pathologic ; Vertigo ; Vestibular Neuronitis

PURPOSE: The efficacy of stenting for the right-side colonic malignant obstruction is unknown. The purpose of this study was to evaluate the safety and feasibility of self-expandable metallic stent insertion for the right-side colonic malignant obstruction and its clinical benefits. METHODS: We retrospectively reviewed clinical data from 460 patients who underwent right hemicolectomy for right-side colon cancer from January 2006 to January 2014 at Korea University Anam Hospital. Twenty four patients who developed malignant obstruction in the right -side colon were identified and analyzed. RESULTS: Self-expandable metallic stent insertion was attempted in 14 patients, and initial technical success was achieved in 13 patients (92.9%). No immediate stent-related complications were reported. Complete relief of obstruction was achieved in all of the 13 patients. Eleven patients who failed stenting underwent emergency operation. All of the 13 patients with stent underwent laparoscopic surgery and only one case was converted to open. Only three patients in the emergency group underwent laparoscopic surgery but one was converted. Operative time and number of retrieved lymph nodes did not differ between the two groups. Postoperative hospital stay (9.8+/-3.2 in stent group vs. 16.3+/-10.9 days in emergency group, p=0.082) tended to be shorter in the stent group. Estimated blood loss (38.5+/-138.7 in stent group vs. 381.8+/-411.9 in emergency group, p=0.010) and duration for resuming diet (3.2+/-2.2 in stent group vs. 6.6+/-7.0 days in emergency group, p=0.017) were significantly better in the stent group. CONCLUSION: Self-expandable metallic stent appears to be safe and feasible in the right-side colonic malignant obstruction. It facilitates minimally invasive surgery and may result in better short-term surgical outcome.
Colon* ; Colonic Neoplasms ; Diet ; Emergencies ; Humans ; Korea ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Operative Time ; Retrospective Studies ; Stents* ; Surgical Procedures, Minimally Invasive

Blue rubber bleb nevus syndrome is a rare disorder that is characterized by multiple recurrent vascular malformations, such as hemangioma, and these primarily involve the skin and the gastrointestinal tract. It may also involve the brain, liver, lungs, and skeletal muscles. A 14-year-old female visited our hospital with a chief complaint of dizziness; upon examination, we found multiple recurrent hemangiomas on the skin and gastrointestinal tract. We were able to diagnose her as suffering from blue rubber bleb nevus syndrome and we treated her with methylprednisolone (2 mg/kg/day for 1 month and 1 mg/kg/day for additional 3 months). We report on this case along with a review of the literature.
Adolescent ; Female ; Gastrointestinal Neoplasms/*diagnosis/therapy ; Hemangioma/*diagnosis/therapy ; Humans ; Nevus, Blue/*diagnosis/therapy ; Skin Neoplasms/*diagnosis/therapy ; Syndrome

Objective: To evaluate the efficacy and safety of 8 weeks of resistance circuit training in people with paraplegia due to spinal cord injury. Methods: Participants were randomized into experimental and control groups. Although the intensity and sequence of movements of the exercise programs were identical in both groups, the resting time between sets was limited to 1 minute in the experimental group. In the control group, the participants were allowed to rest until they were comfortable. Both groups received 8 weeks of training twice per week. Before and after the program, muscle mass, body fat percentage, fat mass, blood pressure, heart rate, muscle strength and muscular endurance were evaluated, and 6-minute propulsion test was conducted. Additionally, the safety of the program was assessed. Results: Twenty-two individuals with paraplegia were enrolled (11 in each group). After the training program, the experimental group showed a significant decrease in the resting blood pressure and improvement in the upper extremity muscle mass, strength, and endurance (p<0.05). Each variable showed significant inter-group differences (p<0.05). Furthermore, none of the participants showed autonomic adverse events, musculoskeletal side effects, or discomfort. Conclusion The results show that resistance circuit training programs with short resting intervals are superior to the usual resistance exercise programs in improving the blood pressure and physical strength and are safe for people with upper thoracic level injuries at T6 or higher.

OBJECTIVES: This study examined the color changes of a resin composite with different shades upon exposure to water with different pH. MATERIALS AND METHODS: Nanohybrid resin composites (Filtek Z350XT, 3M ESPE) with four different shades (A2, A3, B1, and B2) were immersed in water with three different pH (pH 3, 6, and 9) for 14 day. The CIE L*a*b* color coordinates of the specimens were evaluated before and after immersion in the solutions. The color difference (DeltaE*) and the translucency parameter (TP) were calculated using the color coordinates. RESULTS: DeltaE* ranged from 0.33 to 1.58, and the values were affected significantly by the pH. The specimens immersed in a pH 6 solution showed the highest DeltaE* values (0.87 - 1.58). The specimens with a B1 shade showed the lowest DeltaE* change compared to the other shades. TP ranged from 7.01 to 9.46 depending on the pH and resin shade. The TP difference between before and after immersion in the pH solutions was less than 1.0. CONCLUSIONS: The resulting change of color of the tested specimens did not appear to be clinically problematic because the color difference was < 1.6 in the acidic, neutral, and alkaline solutions regardless of the resin shade, i.e., the color change was imperceptible.
Composite Resins* ; Hydrogen-Ion Concentration* ; Immersion* ; Water

We report case of a 14-year-old girl with systemic lupus erythematosus who initially presented with acute lupus pneumonitis. She had a 4-week history of exertion for the past 4 weeks, and was transferred from a regional hospital due to abnormality on chest radiographs. Chest radiographs revealed bilateral infiltration and pleural effusion on both lower lung fields. We assumed her to be infected and prescribed antibiotics. The response to antibiotics was ineffective, and viral, bacterial, and mycobacterial cultures were negative. Antinuclear and anti-dsDNA antibodies in serum were positive. The open lung biopsy revealed diffuse alveolar damage. She was diagnosed as having acute lupus pneumonitis in systemic lupus erythematosus and recovered gradually after receiving corticosteroids. Acute lupus pneumonitis may be considered even though interstitial lung involvement in systemic lupus erythematosus is relatively rare in pediatric practice and its diagnosis is difficult.
Adolescent ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Antibodies ; Biopsy ; Humans ; Lung ; Lung Diseases ; Lupus Erythematosus, Systemic ; Pleural Effusion ; Pneumonia ; Thorax

PURPOSE: Chlamydia trachomatis (C. trachomatis) is the most prevalent etiology of sexually transmitted diseases and also a cause of respiratory infections in infants. The purposes of this study were to determine the epidemiology, presentation, and laboratory findings of C. trachomatis respiratory infection, and to investigate its severity and hospital courses. METHODS: Between February 2002 and January 2010, we enrolled infants younger than 6 months admitted to Gil Hospital with a diagnosis of acute bronchiolits and pneumonia. Clinical findings and demographic data were reviewed in all patients. Basic laboratory examinations included white blood cell and eosinophil count. C. trachomatis was detected by enzyme immunoassay for C. trachomatis specific immunoglobulin M. RESULTS: Of 1,708 patients, C. trachomatis was detected in 142 (8.3%). The incidence increased from 2002 to 2009 and was higher in spring. C. trachomatis infection was distinguished by less fever (p<0.01) and more crackle (p<0.05) on auscultation, and strongly correlated with eosinophilia (P=0.01). The severity and clinical course of C. trachomatis infection was similar to those of infections by the other etiologies. CONCLUSION: C. trachomatis is prevalent among infants younger than 6 months with a diagnosis of acute bronchiolits and pneumonia. We must consider C. trachomatis as the etiologic agent in infantile respiratory infections and must make more effort to detect C. trachomatis.
Auscultation ; Chlamydia ; Chlamydia trachomatis ; Eosinophilia ; Eosinophils ; Fever ; Humans ; Immunoenzyme Techniques ; Immunoglobulin M ; Incidence ; Infant ; Leukocytes ; Pneumonia ; Respiratory Sounds ; Respiratory System ; Respiratory Tract Infections ; Sexually Transmitted Diseases

A case of 51-year-old woman with a malignant solitary pulmonary nodule (SPN) that exhibited no growth over a period of 4 years is reported. Surgical wedge resection revealed an adenocarcinoma upon intra-operative frozen ex-amination. The operation was completed with a right upper lobectomy and complete lymphadenectomy. The authors recommend an early surgical procedure for any SPNs due to risk factors for developing lung cancer.
Adenocarcinoma* ; Female ; Humans ; Lung Neoplasms ; Lymph Node Excision ; Middle Aged ; Risk Factors ; Solitary Pulmonary Nodule*