OBJECTIVES: We performed anterior spinal fusion and instrumentation in treatment of spinal tuberculosis. The clinical results of this operation and metal-related complications were evaluated to determine the rationale of anterior instrumentation in active tuberculous lesion. METHODS: From July 1989 to February 1993, we treated twenty-one patients with spinal tuberculosis by radical resection of the tuberculous lesion and bone grafting, followed by anterior instrumentation using Zielke rod system. The changes in spinal deformity were measured from lateral spinal radiographs obtained preoperatively and postoperatively at 3 months, 6 months, 1 year, 2 years and final follow-up. The recurrence of infection and possible complications were also observed clinically and radiologically. RESULTS: The mean kyphotic angle was decreased preoperatively from 21 degrees to 16 degrees at final follow-up in patients with thoracolumbar tuberculous lesions. The mean deformity angle was corrected 7 degrees in thoracolumbar tuberculosis and 12 degrees in lumbar tuberculosis compared with the preoperative deformity angle. There was not any persistence or recurrence of infection possibly related to the instrumentation. All patients were allowed early ambulation with the aid of a light brace. CONCLUSION: The clinical and radiological results suggested that the anterior instrumentation seemed to be one of the rational approaches for providing immediate stability in treating severe spinal tuberculosis without any significant risk of persistence or recurrence of infection.
Bone Transplantation ; Braces ; Congenital Abnormalities ; Early Ambulation ; Follow-Up Studies ; Humans ; Recurrence ; Spinal Fusion ; Tuberculosis ; Tuberculosis, Spinal*

The posterior cruciate ligament is an anatomically and biomechanically complex structure. PCL injuries are reported to occur in 1-40% of acute knee injuries, with isolated PCL tear, less common than PCL tears combined with other Iigament injuries. Controversy exists concerning the geatment of the PCL injures. Recently, arthroscopic techniques of PCL reconstruction are becoming nore refined and reproducible. Between July 1993 and May 1995, 25 operations for PCL rupture were performed in our hospital. At the follow-up examinations we noted mild to moderate posterior instablilty which was not noted at the time of operation and during the immediate postoperative period. We reviewed type (if injuries, amplitude of initial posterior tibia1 translation, surgical techniques, which seemcd to be in relation ivith the postoperative instabilities. At final follow-up, the mean Lysholm knee score was 86 points, and the posterior tibial translation 6.5mm on posterior stress radiographs. The ligament augmentation device provided no benefit. The ideal positioning and fixation of the graft and protection of the graft from abrasion seemed to be important to get a good results.
Follow-Up Studies ; Knee ; Knee Injuries ; Ligaments ; Patellar Ligament* ; Posterior Cruciate Ligament ; Postoperative Period ; Rupture ; Transplants*

BACKGROUND: Although the topical application of glycolic acid (GA) could possibly exert some effects on the normal epidermal permeability function, the exact effects and its mechanism of action have not been well documented. OBJECTIVE: This study was conducted to investigate the effects of GA on the expression of epidermal cytokines and to clarify its chelation effect on the epidermal calcium ions, which are known to control the secretion of lamellar bodies. METHODS: After topical application of 70% GA aqueous solution on the flank of hairless mice, the expression of epidermal IL-1alpha and TNF-alpha was assessed and the change of epidermal calcium ions was evaluated. RESULTS: The results could be summarized as the following: (1) real time reverse transcriptase polymerase chain reaction and immunohistochemical staining studies showed increases in mRNA and protein expression of epidermal IL-1alpha and TNF-alpha; (2) the GA reduced intracellular calcium ion concentrations in vitro and resulted in the loss of epidermal calcium gradient in vivo. CONCLUSION: These results suggest that, like iontophoresis or sonophoresis, GA could influence the skin's barrier homeostasis, possibly by lowering the epidermal calcium ions.
Animals ; Calcium* ; Cytokines* ; Homeostasis ; Ions ; Iontophoresis ; Mice ; Mice, Hairless* ; Permeability ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; Tumor Necrosis Factor-alpha

PURPOSE: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. MATERIALS AND METHODS: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. RESULTS: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. CONCLUSION: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.
Anesthesia, General ; Arthroscopy ; Clavicle ; Hemorrhage ; Humans ; Length of Stay ; Range of Motion, Articular ; Scapula

No abstract available.
Classification* ; Risk Factors* ; Trophoblastic Neoplasms* ; Trophoblasts*

In this study, the effect of systemic administration of kainic acid (KA) on the expression of inositol 1,4,5-trisphosphate receptor mRNA in the rat brain was investigated with in situ hybridization histochemistry. After the injection of KA in a convulsive dose (10 mg/kg i.p.), inositol 1,4,5-trisphosphate receptor mRNA was reduced significantly in dentate gyrus, cerebral cortex, and caudate-putamen and moderately in CA1-CA3 areas of hippocampus and cerebellum. In dentate gyrus, the expression of inositol 1,4,5-trisphosphate receptor mRNA was significantly decreased at 6 h, lowest level at 9 h, after that the expression was gradually recovered and returned to basal level at 72 h after KA injection. However, in the CA1-CA3 areas of the hippocampus, cerebral cortex, and caudate-putamen, the expression of inositol 1,4,5-trisphosphate receptor mRNA was abruptly decreased at 9 h and almost return to basal level at 24 h after KA injection. The significant repression of inositol 1,4,5-trisphosphate receptor mRNA in cerebellum was only found at 9 h after KA injection. But significant change of inositol 1,4,5-trisphosphate receptor mRNA was not found in the brains of rats treated with NMDA receptor blocker, MK-801, followed by KA injection. These observations suggest that the inositol 1,4,5-trisphosphate receptor is one of the genes whose expression can be altered by KA treatment and the NMDA receptor is related with this alternation.
Animals ; Brain* ; Cerebellum ; Cerebral Cortex ; Dentate Gyrus ; Dizocilpine Maleate ; Hippocampus ; In Situ Hybridization ; Inositol 1,4,5-Trisphosphate* ; Inositol* ; Kainic Acid* ; N-Methylaspartate ; Rats* ; Repression, Psychology ; RNA, Messenger* ; Seizures*

No abstract available.
Bone Marrow* ; Humans ; Leukemia* ; Peripheral Blood Stem Cell Transplantation*

OBJECTIVE: To evaluate the effect of donepezil on cognitive function in patients with brain injury who had cognitive impairment. METHOD: Twenty one subjects with brain injury (18 males,3 females) were enrolled and classified into two groups, experimental and control group. There was no significant difference between two groups in age, postonset duration, and level of education. For the experimental group, one tablelet of Aricept(R) (5 mg of donepezil per tablet) was administered daily for 6 weeks. The baseline and follow up cognitive assessments were performed before and 6 weeks after. Mini- mental Status Examination (MMSE), Computerized Neuropsychologic Test (CNT), Judgement of Line Orientation (JLO), and visuospatial Wechsler memory test were used for the assessment of cognitive function. RESULTS: In baseline study, two groups showed no difference in their cognitive function. After 6 weeks, the experimental group showed significantly higher performance in forward digit span, verbal learning test, backward visual span, visual learning test, non-verbal Wechsler memory test, and judgement of line orientaion than control group (p<0.05). CONCLUSION: These results suggested that the administration of Aricept(R) was beneficial in improving the cognitive func tion, especially verbal and visual memory and visuospatial perception in patients with brain injury.
Brain Injuries* ; Brain* ; Education ; Follow-Up Studies ; Humans ; Learning ; Memory ; Neuropsychological Tests ; Verbal Learning

We have relatively limited knowledge of symptomatic aspects of the postmenopause, rather than perimenopause. We tried to determine the factors associated with experiencing menopausal symptoms by Korean postmenopausal women. A total of 657 Korean women who underwent a natural menopause completed multiple questionnaires, which included questions regarding their attitudes to menopause, depressive symptoms, state anxiety, self-esteem, dyadic relationships, sociodemographic variables, and 11-item Menopause Rating Scale (MRS). Multiple regression analyses were performed to collectively examine the relative impact of each independent variable on the quality of life, as determined by the MRS. Decreased severity of menopausal symptoms was associated with more time spent in education, an employed status, a history of pregnancy, longer postmenopausal duration, positive attitudes to menopause, higher state anxiety, heightened self-esteem, and higher dyadic consensus. Increased severity of menopausal symptoms was also associated with absence of a partner, alcohol consumption, a history of hormone replacement therapy, a history of probable premenstrual dysphoric disorder, and increased severity of depressive symptoms. Sociodemographic characteristics, lifestyle factors, premenstrual dysphoric disorder, attitudes to menopause, a dyadic relationship with a partner, and the inner psychological status can be associated with the severity of menopause symptoms specifically in Korean postmenopausal women.
Adult ; Age Distribution ; Anxiety/*epidemiology/*psychology ; Comorbidity ; Depression/*epidemiology/*psychology ; Educational Status ; Employment ; Female ; Humans ; Incidence ; Korea/epidemiology ; Marital Status ; Middle Aged ; Postmenopause/*psychology ; Risk Assessment ; Risk Factors

BACKGROUND: Cerebral hypotension and desaturation can occur during shoulder surgery in the seated position. We evaluated the correlation of cerebral oxygen saturation (rSO2) using near infra-red spectroscopy (NIRS) and mean arterial pressures (MAP) (at the levels of the brain and heart). METHODS: Fifty patients, scheduled for the arthroscopic shoulder surgery in the seated position, were enrolled to monitor the rSO2, bispectral Index (BIS), and MAPs at the levels of the brain and heart. The values of each parameter were collected at 5 min after intubation, immediately after placing the patient in the sitting position, 5 min after the patient was seated, immediately after the surgical incision, and every 30 min after incision. RESULTS: A correlation between the cerebral rSO2 and the MAP at the level of brain were statistically significant. Cerebral rSO2 and MAP after a change of posture from supine to sitting position were significantly decreased, compared to the baseline value. CONCLUSIONS: Monitoring cerebral rSO2 and MAP at the level of brain can be helpful to detect the possibility of cerebral deoxygenation earlier.
Arterial Pressure ; Brain ; Heart ; Humans ; Hypotension ; Intubation ; Organothiophosphorus Compounds ; Oxygen ; Posture ; Shoulder ; Spectrum Analysis