STUDY DESIGN: The indications of the lumbosacral spinal fusion has been very controversial. The posterior lumbar interbody fusion has the popularity of the spinal fusion: coaption of large surface areas of cancellous bone without shear forces, anatomic restoration and maintenance of more normal dimensions of the joint space, total discectomy as preparation for the fusion, and the accomplishment of better neural decompression without creating instability of the spine. OBJECTIVES: To evaluate the long-term results of the surgical management of degenerative lumbar disease by the modified transdiscal posterior lumbar interbody fusion technique using cancellous chip graft were analyzed. SUMMARY OF LITERATURE REVIEW: The disadvantages of classical posterior lumbar interbody fusion has a injury of nerve root by extensive retraction with the insertion of peg grafts into the disc space, compression of root by graft retropulsion, inadeguate removal of annulus fibrosus and end plates from excessive bleeding from venous plexus of spinal canal and from vertebral cancellous bone. MATERIALS & METHOD: Author's 43 cases who had transpedicular instrumentation and modified transdiscal PLIF using cancellous chip graft since 1989 in the Department of Orthopedic Surgery, Korea University Hospital were analyzed, retrospectively. After preparation of the interspace has been complete by total discectomy, removal of the cartilaginous end plates and perforation of the cortical plates using the ring curette, cancellous chip grafts are inserted into the interspace with the Funnel technique. The structural success of each fusion was documented by sequencial radiographs. The criteria for fusion included: homogenous amalgamation of the fusion mass and vertebral bodies, trabeculation, mass configuration, and no motion demonstrable by hyperflexion studies. The results obtained were as follows: 1. Stable fusion was obtained in 39 patients(91%) at post-operative 6 months. 2. Clinically no patient developed neurologic deficit after fusion and 41 patients (95.3%) had good results by Gill's criteria. 3. No significant complications influencing operative result were observed except minor complications such as paralytic ileus, transient dysuria and superficial infection. 4. In conclusion, modified transdiscal PLIF procedure using cancellous chip graft showed excellent clinical and radiological results to achieve spinal fusion and the procedure is technically feasible and should be considered more widely employed.
Decompression ; Diskectomy ; Dysuria ; Hemorrhage ; Humans ; Intestinal Pseudo-Obstruction ; Joints ; Korea ; Neurologic Manifestations ; Orthopedics ; Retrospective Studies ; Spinal Canal ; Spinal Fusion ; Spine ; Transplants*

PURPOSE: To evaluate the MR findings of knee injuries in skiing and to explain the mechanism of injury with MR findings. MATERIALS AND METHODS: We reviewed MR findings of 18 patients with history of knee injuries in skiing. The MR images were evaluated retrospectively to identify the ligament injuries, bone lesions and meniscal injuries. RESULTS: Ligament injuries were seen in 16 patients, bone contusions in 16 patients, meniscal lesions in two patients. The most common group of injury was anterior cruciate ligament (ACL) and roedial collateral ligament (MCL) injuries with bone contusion on posterior lip of the lateral tibial plateau (LTP). The second common group of injury was isolated ACL injury with bone contusions on the lateral fernoral condyle (LFC) and posterior lip of the LTP. We considered that the mechanism of injury of the former group may be correlated with the valgus torque with secondary anterior displacement of the tibia and the latter group may be correlated with the pivot shift phenomenon. CONCLUSION: MR may play an important role in the diagnosis of knee injuries in skiing and its findings may explain the mechanism of injury.
Anterior Cruciate Ligament ; Collateral Ligaments ; Contusions ; Diagnosis ; Humans ; Knee Injuries* ; Knee* ; Ligaments ; Lip ; Retrospective Studies ; Skiing* ; Tibia ; Torque

Laser assisted in situ keratomileusis(LASIK) is a widely used technique for correcting high myopia. Its technical methods and excellent clinical results are well known, but its potential risk on the corneal endothelium are poorly known. We used specular microscope to underwent LASIK for the correction of myopia. The mean preoperative refraction was ?4.5 diopters (range, -10.00 to -23.50 diopters.). The average endothelial cell densities were 2,817+/-205 cells/mm2 (mean +/-SD) preoperatively and 2,789+/-211 cells/mm2 3 months postoperatvely, corresponding to fall of 28 cells/mm2. This fall in endothelial cell density was not statistically significant (P>0.05). But significant correlation between the change in cell density and the residual corneal thickness was found(P>0.05). These results suggest that LASIK is a predictable and safe method for correcting high myopia, but care is recommended when doing deep corneal ablation. Long term follow-up may be needed to confirm its safety.
Cell Count ; Endothelial Cells ; Endothelium, Corneal ; Follow-Up Studies ; Keratomileusis, Laser In Situ ; Myopia

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis*

Circulating tumor cells (CTCs) are defined as tumor cells circulating in the peripheral blood of patients. CTCs have long been regarded as an attractive research topic. Because of recent technological advances, it is now possible to detect CTCs in the bloodstream. Interestingly, CTCs are present in both of patients with metastatic disease and early stage localized disease in patients with breast cancer. An assay detecting CTCs seems to have significant future potential value in the clinical management of breast cancer as a prognostic marker, monitoring treatment response and selecting target therapy. This review addresses the technical overview of detection methods, possible clinical application and future direction of CTCs research.
Breast ; Breast Neoplasms ; Humans ; Neoplastic Cells, Circulating

No abstract available.
Tetanus*

We evaluate the psychosocial characteristics and primary reason for electing operation in myopic patients who were candidates for photorefractive keratectomy (PRK). The questionnaire data were collected on PRK patients and compared them with similar group of myopia. Most of the PHK patients were unmarried female in their twenties. The most striking demographic chracteristic of PRK sample was that the high proportion of them was highly educated office worker with high socioeconomic status. They were in possession of extroversive character rather than introversive one. They thought that their visual acuity was very serious, and preferred wearing contact lens for visual correction. The most important reason for undergoing PRK was avoiding inconveniences of contact lens or glasses. The other reasons were improving vision, improving appearance, and hoping to change life style with better vision. They were afraid of unpredictability of visual recovery and occurrence of complications, after operation, The results of this study may help analyze the factors that influence the success of PRK and patient's satisfaction.
Eyeglasses ; Female ; Glass ; Hope ; Humans ; Life Style ; Myopia ; Photorefractive Keratectomy* ; Surveys and Questionnaires ; Single Person ; Social Class ; Strikes, Employee ; Visual Acuity

No abstract available.

No abstract available.
Intestinal Atresia*

In recent study, exercise hypertension is associated with a lower adjusted mortality rate and is likely to a good prognostic sign, although its clinical significance is uncertain. The purpose of this investigation was to study exercise hypertensive reaction and to search its related factors. From June. 1st to Aug. 31st 1996, 108 males, mean age 41.5years(range, 20~70) attended the exercise stress test as volunteers during checking-up of health & disease at Health Service Center of Kwang-ju Christian hospital. The exercise stress test using stationary leg bicycle was done until the examiner were exhausted, at which we measured peak exercise systolic blood pressure & Pulse rate. The results are shown as follows. Exercise hypertension was present in 22 subjects(20.0% ). Including age, body mass index, RPE scales at 70% maximal heart rate, rate of level of elevation of heart rate during exercise, no significant related factors associated with exercise hypertension was present by the discriminant analysis. Multivariate regression analysis demonstrated that exercise-induced increase in systolic blood pressure was positively correlated with only resting systolic pressure(r=0.101, p less than 0.01). RPE(Rating of Perceived Exertion) scales was 18.05+/-1.31 when pulse rate of the examiner was reached to 70% of rnaximal heart rate(220-age (years) ). In conclusion, no significant related factor associated with exercise hypertension was presents, but exercise-induced increase of systolic blood pressure was positively correlated with only resting systolic pressure.
Blood Pressure ; Body Mass Index ; Exercise Test ; Gwangju ; Health Services ; Heart ; Heart Rate ; Humans ; Hypertension* ; Leg ; Male ; Mortality ; Volunteers ; Weights and Measures