Luque introduced new posterior spinal instrumentation by segmental sublaminar wiring for spinal deformity in 1976. This system initially developed for the treatment of paralytic scoliosis, but now its application was extended to treatment of other types of scolisis, spinal fractures and spondylolysthesis. Advantages of this system in scoliosis are better correction force and secure internal fixation enabling early ambulation without external support. Disadvantages include longer operation time, possibilities of epidural bleeding and dural laceration. Luque instrumentation in thoracic and lumbar spine fracture is an effective means of obtaining following goals: provide reduction, maintenance of alignment, restoration of stability, prevention of deformity, low pseudarthrosis rate and early mobilization without external support. Luque instrumentation were carried out in 5 cases at Dept. of O.S. at SNUH from Oct. 1983 to Feb. 1984 with excellent results. The average follow-up period was 7.4 months and there was no complication. Two cases of unstable thoracic and lumbar spine fractures were treated with Luque instrumentation with fusion. The use of double sublaminar wiring with Luque rods, two levels above and two levels below on area of fracture provided early stabilization to allow rehabilitation without external immobilization. Three cases of paralytic scoliosis underwent Luque instrumentation by a modification of the Galveston technique with fusion. Average preoperative curve was 110°(ranged from 101° to 126°). Immediate postoperative correction was 58.7°(46.6%) and average 7 months-following result was 56.3°(48.3%). Operation time averaged 6hr 7min and blood loss was averaged 12 pints. Those patients required instrumentation from the pelvis to middorsal segment, in an effort to control the curve and associated pelvic tilting. In early follow-up the author obtained remarkable correction in paralytic curves, and the pelvic obliquity were well corrected with a pelvis and provid ing with better sitting balance.
Congenital Abnormalities ; Early Ambulation ; Follow-Up Studies ; Hemorrhage ; Humans ; Immobilization ; Lacerations ; Pelvis ; Pseudarthrosis ; Rehabilitation ; Scoliosis ; Spinal Fractures ; Spine

In 1958, Jackson first reported on the use of proximal tibial osteotomy in the treatment of pain due to osteoarthritis of the knee joint. Subsequently, various osteotomy techniques have been reported. The varus deformity of the knee associated with osteoarthritis can be corrected by realigning the joint and thereby shifting the line of weight bearing to the compartment with preserved articular cartilage. This procedure has been found to relieve pain, improve function and arrest the progress of the condition. Twenty five cases of genu varum associated with osteoarthritis were treated by high tibial osteotomy at Dept. of O.S., Seoul National University Hospital, from July 1976 to June 1983. And the following results were obtained. 1. In a review of 25 high tibial osteotomies, excellent and good results were noted in 80% of the knees after average follow-up 2.9 years. 2. Postoperative valgus angles, ranging from 5° to 20°, were averaged to be 10.8°. 3. Though some authors indicate the obesity as one of risk factors, we obtained satisfactory results in 25 knees of obese patients.
Cartilage, Articular ; Congenital Abnormalities ; Follow-Up Studies ; Genu Varum ; Humans ; Joints ; Knee ; Knee Joint ; Obesity ; Osteoarthritis ; Osteotomy ; Risk Factors ; Seoul ; Weight-Bearing

To investigate in vivo reaction of newly developed glass ceramics, five milimeters of one proximal tibia of the rabbits were resected and the defect was replaced by ready-made glass ceramics cylinder of 5mm height. As a control, the other intact tibia was used in biomechanical study. Radiological examination was performed every 2 weeks postoperatively. Histological and electromicroscopic examinations were performed postoperatively at 2nd, 4th, 8th and 16th weeks. And fourpoint bending study was performed postoperatively at 8th and 16th week. Following findings were observed : On radiological examination, radiolucent line was seen around glass ceramic at 2-week X-ray. This line was obliterated gradually until 6-week X-ray. Remodelling of medullary cavity was noted from 6-week or 8-week X-ray, and was almost completed at 12-week X-ray. The glass ceramic was innocently incorporated into the host bone. On biomechanical examination, 8-week specimen was broken at 33% of break strength of control group and 16-week specimen was broken at 62%. On histological examination, in 2-weeks specimen, part of implanted glass ceramics was covered with new bone; in 4 weeks, implanted glass ceramics was surrounded by new bone and the surface was tightly bound to the new bone; in 8-week specimen, mature lamellated bone was showed and amount-of bone was increased. Based upon above findings, it was suggested that the glass ceramics was innocently incorporated into the host bone and revealed good biomechanical strength.
Ceramics ; Glass ; Rabbits ; Tibia

Objective: Peripheral arterial disease (PAD) reduces functional activity and increases the rate of cardiovascular death in the elderly. Our study aimed to determine whether the presence of PAD in stroke patients affected the progression of disability or death one year after discharge. Methods: From April 2012 to March 2013, consecutive first stroke patients above 50 years of age without known PAD were enrolled. PAD was defined as a low ankle-brachial index (less than 0.9) measured by an automatic device. Clinical data associated with the stroke were collected from medical records. Disability in stroke patients was evaluated with the modified Rankin scale (mRS) on discharge day and one year after the index stroke. Progression of disability was defined as an increase in mRS more than one level at one year. Results: Among the 526 patients, 238 had ischemic strokes and underwent ankle-brachial index (ABI) measurement. Of them, 192 patients were included. In univariate analysis, age, dyslipidemia, discharge mRS, low-density lipoprotein cholesterol, D-dimer, homocysteine, internal carotid artery stenosis, posterior cerebral artery stenosis, and PAD were factors associated with worsening mRS. After adjustment for these factors in the logistic regression analysis, PAD was an independent factor associated with worsening mRS. In the analysis of one-year mortality, patients with PAD had a higher death rate, but PAD was not an independent factor after adjusting for other variables. Conclusions: The presence of PAD in stroke patients suggests a chance of disability progression, but may not be a predictor of death after one year.
Atherosclerosis ; Peripheral arterial disease ; Stroke

No Abstract Available.
Carpal Tunnel Syndrome* ; Collagen* ; Humans ; Ligaments*

Ganglion is the most common soft tissue tumor which occurs mainly in hand, but it can also occur in any part of the extremity. It is not always necessary to excise the tumor because it seldom cause symptoms severe enough to take operation. We reviewed the patients with ganglion treated surgically. Exculding the cases which were operated under local anesthesia and Bakers cyst, 42 patients were treated surgically from 1983 to 1992. Females were 33, and males 9. Average age at the time of operation, was 40 years (16 to 67). All the cases were analysed retrospectively in terms of surgical indication, anatomical location, size, duration of symptoms, relationship between recurrence and size, and complication. The average duration of follow-up was 1 year 7 months, ranging from 1 year to 4 years. The causes of operation were, cosmetic problem in 6996 (29 cases); pain in 19% (8 cases); and both comesis and pain in 12% (5 cases). The locations were, wrist in 4696 (19 cases); knee 29% (12 cases); foot 12% (5 cases); hand 7% (3 cases); forearm 2% (1 case); ankle 2% (1 case); and elbow 296 (1 case). The size of mass was less than 2.5 cm in 30 cases (71%), and more than 2.5 cm in 12 (29%). (Total average of size was 2.4 cm)The average duration of symptoms were 28 months (1 month 15 years). The recurrence was found in 7 cases: 3 of them (10%) occurred among 30 cases the diameter of which was less than 2.5 cm, and other four (33%) occurred among 12 cases, larger than 2.5 cm. There were no other complications.
Anesthesia, Local ; Ankle ; Elbow ; Extremities ; Female ; Follow-Up Studies ; Foot ; Forearm ; Ganglion Cysts ; Hand ; Humans ; Knee ; Male ; Recurrence ; Retrospective Studies ; Wrist

No abstract available.
Forearm* ; Humerus*

In clinical surgery, there are frequent needs for communication between the house staff and the attending physician in an emergency situation. It's often insufficient for the house staff to make a decision through the information which is delivered in the form of only voice through the telephone line. To overcome the limitation of voice communication, we have designed an emergency teleradiology system which can be used for emergency surgical and medical decision making. The system can transmit the high quality images of CT, MRI, and other X-ray data using a PC attached to a modem through the conventional telephone line. Progressive transmission adopted in the system enables us to efficiently utilize the band-width of telephone line which is typically very low. The iterative residual coding/decoding algorithm compresses various medical images effectively, and thus fast-transmission of images date helps the house staff to perceive the status of emergent patient and make a fast and correct decision about the patient. The system also satisfies design requirements such as low-cost, ease of operation and interactive image communication including voice. 'Teleradiology system' proposed in this paper has been installed and operated in the emergency care unit of Severance Hospital, and as a result, it is effective in the emergency situations.
Decision Making ; Emergencies ; Emergency Medical Services ; Humans ; Internship and Residency ; Magnetic Resonance Imaging ; Modems ; Telephone ; Teleradiology* ; Voice

The effects of chimeric monoclonal antibodies (cMAbs), prostaglandin E, (PGE,), and indomethacin (INDO) on antibody-dependent cellular cytotoxicity (ADCC) against human squamous cell carcinoma of head and neck (SCCHN) cell line were examined. Using the PCI-50 SCCHN cell line as target and normal human peripheral blood mononuclear cells as effector, ADCC was enhanced by the treatment of cMAbs (1.25 p,g/ml), but was inhibited by exogenous PGE (5 X 10' M). The effects of cMAb and PGE were dose-dependent. Maximal suppression of activity occured when PGE was present during the entire 4-hr 'Cr-release assay period, whereas pretreatment of effector cells with PGE had minimal inhibitory effect after washing. These results indicate that decreased ADCC seen with SCCHN targets treated with PGE is related to post-binding events, such as binding of effector and target cells. Pre-treatment of effector cells with INDO (1 ug/ml) resulted in restoration of NK activity which was inhibited by PGE. Our in vitro results suggest that INDO can increase tumor cell killing by the reversal of the suppression for many imrnune functions by PGE.
Antibodies, Monoclonal ; Antibody-Dependent Cell Cytotoxicity ; Carcinoma, Squamous Cell* ; Cell Line ; Head* ; Homicide ; Humans* ; Indomethacin ; Neck* ; Prostaglandins E

In pediatric living-related liver transplantation, preoperative evaluation of the recipient is important for surgical planning, while the accurate diagnosis of postoperative complications is essential for graft salvage. Multiplanar and three-dimensional imaging using multi-slice spiral CT can be used for preoperative vascular imaging, as well as for evaluating postoperative complications. In this essay, we describe the usefulness of multi-slice CT, combined with a variety of different reconstruction techniques, for the preoperative evaluation of transplant recipients. In addition, we demonstrate the multi-slice CT findings of postoperative complications, including vascular stenosis or thrombosis, bile duct leak or stricture, and extrahepatic fluid collection.
Child ; Humans ; Liver/*blood supply/*radiography ; *Liver Transplantation ; *Living Donors ; Postoperative Complications/radiography ; Preoperative Care ; Tomography, Spiral Computed/*methods