No abstract available.
Peritoneal Lavage*

STUDY DESIGN: The treatment of a stable fracture around thoracolumbarjunction is a controversial subject. OBJECTIVES: To evaluate the result from long term follow-up of the stable spinal fracture around thoracolumbar junction according to the operation, osteoporosis and in situ extension bar, respectively. SUMMARY OF BACKGROUND DATA: The thoracolumbar junction is a transitional zone in which the kyphotic angle of thoracic spine is continued to the lordotic angle of lumbar splne. So it is prone to be injured biomechanically, and the stability of the spine around thoracolumbar junction is not determined yet. METHODS: We studied retrospectively 105 cases of the stable fracture around thoracolumbar junction from January 1985 to December 1995. The criteria of the stability were a compression fracture by Denis F., a bursting fracture without involvement of posterior column, a neural enchroachment of bony fragment below 30%, fracture without subluxation or dislocation in spinal junction. RESULTS: The most common cause was traffic accident and, the first lumbar vertebrate was common site. Below 30% of initial compression, the progression was not exceded 5% in operative group. But in nonoperative group, anterior compression was more progressed than initial compression over 5%. The degree of anterior compression was affected by osteoporosis and in situ extension bar just after injury. CONCLUSIONS: We suggest an anterior compression abode 30% in spinal body of thoracolumbar junction for an additional operative indication. The prognosis may be affected by osteoporosis and in situ extension bar.
Accidents, Traffic ; Dislocations ; Follow-Up Studies* ; Fractures, Compression ; Osteoporosis ; Prognosis ; Retrospective Studies ; Spinal Fractures ; Spine ; Vertebrates

Orthodontic tooth movement in response to orthodontic force results from actions of osteoclasts and osteoblasts in the cell level. Convincing evidence has now been provided to support the view that osteoclasts are derived from mononuclear cells that originate in the bone marrow or other hematopoietic organs and they migrate to the bones via vascular routes. Nitric oxide(NO), which accounts for the biological properties of endothelium-derived relaxmg factor(EDRF), is the endogenous stimulator of soluble guanylate cylase. The discovery of the formation of nitric oxide(NO) from L-arginine in mammalian tissues and its biologioal roles has, in the last 7 years, thrown new light onto many areas of research. Data from experiments in vitro showed that N-metyl-L-arginine(L-NMA) and L-nitro-L-arginine(L-NAME) are competitive inhibitors of nitric oxide synthase. This study suggest that the multinucleated cells in our culture have characteristics of osteoclasts and that the potential bone cell activity of nitric oxide in vitro may be mediated in part by stimulation of marrow mononuclear cells to form osteoclast-like cells. Bone marrow cells were obtained from tibia of 19-days old chick embryo. After sacrifice, tibia was quickly dissected and the bone were then split to expose the medullary bone. The cells were attached for 4 hours and the nonadherent cells were collected. Marrow cells were cultured in 96-well plate in medium 199. To examine the number of TRAP-positive multinucleated cells(MNCs), 10(-8) M Vit-D3 and various concentration of L-NMA and L-NAME were added at the beginning of cultures and with each medium change. After 7 days of culture, tartrate-resistant acid phosphatase(TRAP) staining was performed for microscopic evaluation. Cells having more than three nuclei per cell were counted as MNCs. The observed results were as follows; 1. 1,25-dihydroxyvitamine D3 stimulated the osteoclast-like multinucleated cells in cultures of chick embryo bone marrow. 2. Nitric oxide synthase inhibitors(NOSI ; N-NMA, N-NAME) stimulated the osteoclast-like cells in cultures of chick embry bone marrow. 3. 1,25-dihydroxyvltamine D3 and nitric oxide synthase inhibitors did not appear to have additive effect on the generation of TRAP-positive MNCs. These results suggest that nitric oxide synthase inhibitors may stimulate the osteoclast-like multinucleated cell formation and fusion in cultures of chick bone marrow.
Animals ; Arginine ; Bone Marrow ; Bone Marrow Cells ; Chick Embryo ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Osteoblasts ; Osteoclasts ; Tibia ; Tooth Movement

The increasingly successful results of hair restoration surgery in the last years have developed the interest and the confidence of patients and it is the most frequently performed esthetic surgery among male patients. Currently, various kinds of techniques for hair restoration surgery including hair transplantation, scalp reduction, and scalp flaps are performed in our clinic. Among these, hair transplantation is the basic and the most popular procedure, which can be performed not only by itself but also in conjunction with other procedures. 123 consecutive cases of hair transplantations were peformed from Jan. 1995 to Feb. 1996 for male pattern baldness, traumatic alopecia, and female pattern baldness under out patient base. The authors introduced a new classification for male pattern baldness, which are the type M, O, C, U, M-O, and C-O after alphabet to make simple and easy for clinical application. The ancillary procedures were scalp reduction, preauricular flap, and scalp expansion. An ellipsis of hair bearing scalp taken from the occipital area was sliced into slit-, mega-, mini-, and micro-grafts. The survival rate of the grafts was over 90% with minimal complications. This hair transplantation technique enabled us to achieve a good density and more natural looking hair with avoidance of cobble stoning and apparent scar.
Alopecia* ; Cicatrix ; Classification ; Hair* ; Humans ; Male* ; Scalp ; Surgery, Plastic ; Survival Rate ; Transplants

BACKGROUND: Hydration, the water content of the stratum corneum, is an important factor in both the appearance and the barrier function of the skin. Many non-invasive methods have been developed in order to assesa the hydration state of the skin and the effect of various moisturizers. The hydrometer and carneometer are commercially available instruments which are widely used in dermatologic research. OBJECTIVE: Our purpose was to compare the measuring usefulnes of both instruments on normal subjects with a wide range of hydration states of the hornylayer. METHODS: We measured the conductance with the hydrometer and the capacitance with the corneometer in various hydrating eonditions and compared both insruments. RESULTS: Conductance had a non linear correlation with capacita ice. Capacitance measured with the corneometer had a high sensitivity to moisture in a wide range of hydration levels. On the other hand, conductance guaged with the hydrometer showed a few sensitivity to moisture at a low level. When the hydretion level was measured after a moiturizer was added, 10 % urea cream showed a sharp increase by 256% in terms of conductanae, and H-base by 97.8%. Mineral oil decreased by 41.5% and petrolatum by 62% respectively. On the other hand, when measured in terms of capacitance under the same conditions as above, 38.9 increase in 10% urea cream, 19.3% increase in H-base, 20% decrease in mineral oil, and 43.5 % decrease in petrolatum were reported. Conductance showed a higher hygroscopicity and a lower water holding capacity than capacitance did. When the measurement of the moisture level iri virious parts of the human body is performed, the corneometer provided us with more stable alies than the hydrometer. While the hydrometer can not the available and appropriate under the condition of insulation, the corneometer can measure moisture levels even down at the depth of 250mm. When measured after the oily surface of the forehead was cleansed with soft tissue, conductance and capacitance revealed higher values of moisture levels than before the eleanin. However, there is no statistical significance in these values. CONCLUSION: The hydrometer is a more appropriate tool for the measurement of moisture at a high level, and the corneometer at a low moisture level. The hydrcmeter is a more sensitive method of measuring the increase and the decrease in the moisture level.
Forehead ; Hand ; Human Body ; Ice ; Lasers, Gas ; Mineral Oil ; Petrolatum ; Skin* ; Urea ; Water ; Wettability

BACKGROUND: Hydration, the water content of the stratum corneum, is an important factor in both the appearance and the barrier function of the skin. Many non-invasive methods have been developed in order to assesa the hydration state of the skin and the effect of various moisturizers. The hydrometer and carneometer are commercially available instruments which are widely used in dermatologic research. OBJECTIVE: Our purpose was to compare the measuring usefulnes of both instruments on normal subjects with a wide range of hydration states of the hornylayer. METHODS: We measured the conductance with the hydrometer and the capacitance with the corneometer in various hydrating eonditions and compared both insruments. RESULTS: Conductance had a non linear correlation with capacita ice. Capacitance measured with the corneometer had a high sensitivity to moisture in a wide range of hydration levels. On the other hand, conductance guaged with the hydrometer showed a few sensitivity to moisture at a low level. When the hydretion level was measured after a moiturizer was added, 10 % urea cream showed a sharp increase by 256% in terms of conductanae, and H-base by 97.8%. Mineral oil decreased by 41.5% and petrolatum by 62% respectively. On the other hand, when measured in terms of capacitance under the same conditions as above, 38.9 increase in 10% urea cream, 19.3% increase in H-base, 20% decrease in mineral oil, and 43.5 % decrease in petrolatum were reported. Conductance showed a higher hygroscopicity and a lower water holding capacity than capacitance did. When the measurement of the moisture level iri virious parts of the human body is performed, the corneometer provided us with more stable alies than the hydrometer. While the hydrometer can not the available and appropriate under the condition of insulation, the corneometer can measure moisture levels even down at the depth of 250mm. When measured after the oily surface of the forehead was cleansed with soft tissue, conductance and capacitance revealed higher values of moisture levels than before the eleanin. However, there is no statistical significance in these values. CONCLUSION: The hydrometer is a more appropriate tool for the measurement of moisture at a high level, and the corneometer at a low moisture level. The hydrcmeter is a more sensitive method of measuring the increase and the decrease in the moisture level.
Forehead ; Hand ; Human Body ; Ice ; Lasers, Gas ; Mineral Oil ; Petrolatum ; Skin* ; Urea ; Water ; Wettability

PURPOSE: The conventional surgical treatment for patients with potentially curable low rectal cancer is abdominoperineal resection. Recently there has been increasing interest in the use of preoperative radiation therapy and sphincter-saving procedure as primary therapy for selected low rectal cancers. We report our institutional experience with this approach. METHODS: From 1995 to 1997, Twelve patients with resectable distal rectal cancer were offered sphincter-saving procedure, excluding the patients whose pretreatment tumor presentation demonstrated fixation to anal sphincter or puborectalis muscle. The distance from the anal verge to the distal tumor margin at initial diagnosis ranged from 1 to 5 cm. Patients received a median 50.4 Gy and chemotherapy Surgery was carried out 4 to 8 weeks after radiation. RESULTS: No patient had toxic reaction that required interruption of chemoradiation. Four patients (33%) had complete pathologic response, but one patient with complete clinical response had residual cancer. Seven patients underwent hand-sewn coloanal anastomosis and five patients transanal excision en bloc. All patients were able to successfully undergo a sphincter-saving procedure. With a mean follow-up of 23 months (range, 6~32), the authors noted no recurrence or complication. Sphincter function was good in 92%. Daily bowel movements was two (range, 1~10). CONCLUSION: Preoperative chemoradiation appears promising in terms of better patient compliance, lesser toxicity, and downstaging tumor, making the sphincter-saving procedure feasible in carefully selected cases. Surgical resection remains essential to confirm and to achieve complete clinical remission. The results of preoperative chemoradiation and sphinctersaving procedure are encouraging, but more experience is needed to determine whether this approach ultimately has similar local control and survival rate compared to standard surgery.
Anal Canal ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm, Residual ; Patient Compliance ; Rectal Neoplasms* ; Recurrence ; Survival Rate

PURPOSE: To quantify the cardiac dose reduction during breathing adapted radiotherapy using Real-time Position Management (RPM) system in the treatment of left-sided breast cancer. MATERIALS AND METHODS: Twenty-two patients with left-sided breast cancer underwent CT scans during breathing maneuvers including free breathing (FB), deep inspiration breath-hold (DIBH), and end inspiration breath-hold (EIBH). The RPM system was used to monitor respiratory motion, and the in-house self respiration monitoring (SRM) system was used for visual feedback. For each scan, treatment plans were generated and dosimetric parameters from DIBH and EIBH plans were compared to those of FB plans. RESULTS: All patients completed CT scans with different breathing maneuvers. When compared with FB plans, DIBH plans demonstrated significant reductions in irradiated heart volume and the heart V25, with the relative reduction of 71% and 70%, respectively (p < 0.001). EIBH plans also resulted in significantly smaller irradiated heart volume and lower heart V25 than FB plans, with the relative reduction of 39% and 37%, respectively (p = 0.002). Despite of significant expansion of lung volume using inspiration breath-hold, there were no significant differences in left lung V25 among the three plans. CONCLUSION: In comparison with FB, both DIBH and EIBH plans demonstrated a significant reduction of radiation dose to the heart. In the training course, SRM system was useful and effective in terms of positional reproducibility and patient compliance.
Breast Neoplasms* ; Cardiac Volume ; Feedback, Sensory ; Heart ; Humans ; Lung ; Patient Compliance ; Radiotherapy* ; Respiration* ; Tomography, X-Ray Computed

We compared radiologically two groups of total hip prostheses, 36 porous-coated and 51 hydroxyapatite-coated, which had been implanted in 87 hips of 73 patients with avascular necrosis of the femoral head. Radiographs were taken at postoperative 1 year and 2 year, and used to compare various radiological parameters between the two groups. For the acetabular side radioluscent line and osteolysis were evaluated, and for the femoral side radioluscent line, osteolysis, stress shielding. endosteal new bone formation, subsidence and cortical hypertrophy were evaluated; their location was identified according to the zones described by DeLee and Charnley for the acetabulum and according to those described by Gruen et al for the femur. In both groups there was no subsidence. In terms of osteolysis, stress shielding and cortical hyper-trophy there was no significant difference between the two groups throughout the period. Radioluscent line in the acetabulum was more common around the porous-coated cup, but was focal and not progressive. The rate of radioluscent line in the femur was a little higher around hydroxyapatite-coated stem especially in zone 5. Endosteal new bone formation was excellent in both groups, but was more extensive around hydroxyapatite-coated stem. This study suggests that hydroxyapatite coating play a certain role in terms of bony ingrowth.
Acetabulum ; Durapatite* ; Femur ; Head ; Hip ; Hip Prosthesis ; Humans ; Hypertrophy ; Necrosis ; Osteogenesis ; Osteolysis

Articular cartilage have dual functions of shock absorber and bearing surface in a moving joint. Articular cartilage is avascular, so the chondrocytes in mature adult must receive their nourishment solely from synovial-fluid perfusion, and it is known that alteration of synovial-fluid perfusion causes degeneration of articular cartilage. Now, in orthopedic fields, the corrective cast immobilization and traction is in popular use. In order to study the cartilage changes induced by this long-term cast immobilization and traction, compression-immobilization and condylar resection of knee joint in rabbits were performed, and weekly histoiogic examinations of articular cartilage up to 5 weeks were followed. The observations were as follows: 1. Degenerative changes of articular cartilage were observed respectively with compression-immobilization and condylar resection, and the severity of the histologic changes appeared to be proportional to the duration of compression-immobilization and condylar resection. 2. Earlier degenerative changes of articular cartilage in condylar resection group than in compression-immobilization group were noted, and this earlier degenerative changes in condylar resection group suggests that hemarthrosis may play a role in cartilage degeneration. 3. Histologically unchanged calcific cartilage zone and mildly hypertrophied subchondral bone were noted in compression-immobilization group, but vascular invasion to calcific cartilage zone and subchondral osteoporosis were noted in condylar resection group.
Adult ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Hemarthrosis ; Humans ; Immobilization ; Joints ; Knee Joint ; Knee ; Orthopedics ; Osteoporosis ; Perfusion ; Rabbits ; Shock ; Traction