PURPOSE: To obtain magnetization transfer ratio(MTR) of the annulus fibrosus and nucleus pulposus and to assess the feasibility of utilizing the changes of these MTRs as an early indicator of disk degeneration. MATERIALS AND METHODS: MR images of lumbar spine with magnetization transfer(MT) technique in 42 patients were obtained. spin echo techniques (600/14) with same TR/TE with 1KHz off-resonance saturation were employed in 1.0T MR system. MTRs were calculated in two regions, anterior annulus fibrosus and nucleus pulposus, and the results were compared between the normal and degenerative disks, from grade I to IV, on T2-weighted images. RESULTS: MTRs of the nucleus pulposus were 17.6% in the normal disks, and 26.7%, 28.4%, 29.1%, 29.7% in degenerative disks, from grade I to IV, respectively, with a significant difference(P<0.05). On the other hand, MTRs in the annulus fibrosus were 30.2% in the normal disks and 31.5%, 33.2%, 32.1% and 35.6% in degenerative disks, from grade I to IV, respectively, without significant difference. CONCLUSION: Since MTRs are significantly higher in degenerative nucleus pulposus than those of the normal disks, increased MTRs in the nucleus pulposus can be used as an early sign of the degeneration of the nucleus pulposus.
Hand ; Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging* ; Spine

Aplasia cutis congenita is a rare disorder characterized by localized or generalized absence of skin at birth. The various hypothesis and classification are proposed. Type V in Frieden's classification, which is associated with fetus papyraceus or placental infarcts, occurs as a large cutaneous defect on the trunk and extremities. We experienced the patient had skin defect affecting the lower abdomen symmetrically, with no family history of the any disorders or chromosomal anomalies and associated anomalies. A twin fetus was died in utero. We report a case of aplasia cutis congenita associated with fetus papyraceus with the review of the associated literatures.
Abdomen ; Classification ; Ectodermal Dysplasia* ; Extremities ; Fetus ; Humans ; Parturition ; Skin ; Twins

External fixation is regarded as the treatment of choice for type 2 and 3 open tibial fractures. However, external fixation alone, especially of an unstable fracture, can be complicated by high incidence of malunion, delayed union, loss of reduction, refracture, and pin-tract infection. Some surgeons tried to treat such problems by secondary intramedullary nailing, but they came to different results. The purpose of the present study is to eveluate our experience with secondary intramedullary nailing after external fixation of 6 cases of type 3B open tibia fractures and 1 case of type 3B femur fracture. These cases were followed for more than 13 months and the following results were obtained. 1. The external fixation had been maintained for an average of 62 days. 2. The mean interval between removal of the external fixator and intramedullary nailing was 23 days. 3. Antibiotics was injected for 2 weeks after removal of external fixator. 4. Reamed intramedullary nailing with static interlocking were done in all 13 cases. 5. Deep infections developed in 2 cases, one case which had been pin-tract infection was around intramedullary nail and the other in fracture site. 6. All cases were healed ultimately and average union time after nailing was 9 months.
Anti-Bacterial Agents ; External Fixators ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Incidence ; Surgeons ; Tibia ; Tibial Fractures

No abstract available.
Acetabulum* ; Osteotomy*

No abstract available.
Animals ; Brain* ; Carbon Monoxide* ; Carbon* ; Rats*

31 cases of general anesthesia for total hip replacement which were performed at K.N.U. hospital from 1980 to 1982 were measured blood pressure, blood loss, hemoglobin, and hematocrit before, during, and after operation. Blood pressure were monitored right before and at 1, 3, 5 and 8 min intervals after the insertion of the acrylic cement into the acetabulum and the femur. There was a tendency to decrease in blood pressure at 3 min after the insertion of acrylic cement in to the femur. The blood loss during and duration of 36 hrs after halothane anesthesia revealed tendency to decrease compared with the enflurane and ether. Hemoglobin and hematocrit values taken on before, during, and the 1st day after operation did not show and changes.
Acetabulum ; Anesthesia ; Anesthesia, General* ; Arthroplasty, Replacement, Hip* ; Blood Pressure ; Enflurane ; Ether ; Femur ; Halothane ; Hematocrit

The employment of segmental pedicle screw instrumentation has greatly enhanced the correction of scoliotic deformity. However there is still much controversy on the ability of the system to correct the rotational deformity. This prospective study with 12 idiopathic throacic scoliosis patients subjected to segmental pedicle screw instrumentation was performed to determine the effect of the system on the rotational deformity of idiopathic throacic scoliosis. In addition to the standing films to measure the magnitude of scoliotic curvatures, preand postoperative CT were utilized for the measurement and comparison of angle of rotation relative to the sagittal plane(RAsag.), relative rotation with reference to the upper and lower end vertebrae(RAend), relative rotation with reference to the sacrum(RAsac.), frontal translation(TF) and sagittal translation(TS) for the apical vertebrae. Despite the high correction rate obtained in the frontal plane(average 71.1%) and normalization of sagittal contour, the rotational corrections were statistically insignificant in all parameters and showed no significant correlation to the correction of the curvatures nor horizontal plane displacement as represented by the frontal and sagittal displacement. In conclusions, the segmental pedicle screw instrumentation with rod derotation does not produce significant derotation by itself.
Congenital Abnormalities ; Employment ; Humans ; Prospective Studies ; Scoliosis* ; Spine

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.
Basal Ganglia* ; Brain ; Brain Edema ; Brain Ischemia* ; Cerebral Infarction ; Cerebrum ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Prognosis* ; Stroke, Lacunar ; Thalamus* ; Thromboembolism ; Tomography, X-Ray Computed

BACKGROUNDS/AIMS: Hepatic portal venous gas (HPVG) is a rare condition, with poor prognosis and a mortality rate of up to 75%. Indications for surgical and non-surgical management of HPVG including associated complications and mortality remain to be clarified. METHODS: From January 2008 to December 2014, 18 patients with HPVG diagnosed through abdominal computed tomography (CT) imaging were retrospectively identified. Clinical symptoms, laboratory data, underlying diseases, treatment, and mortality rate were analyzed. Patients were classified into 2 groups: surgical management recommended (SR, n=10) and conservative management (CM, n=8). The SR group was further subdivided into patients who underwent surgical management (SM-SR, n=5) and those who were managed conservatively (NS-SR, n=5). RESULTS: Conditions underlying HPVG included mesenteric ischemia (38.9%), intestinal obstruction (22.2%), enteritis (22.2%), duodenal ulcer perforation (5.6%), necrotizing pancreatitis (5.6%), and diverticulitis (5.6%). In terms of mortality, 2 patients (40%) died in the SM-SR group, 1 (12.5%) in the CM group, and 100% in the NS-SR group. Higher scores from Acute Physiology and Chronic Health Evaluation (APACHE) II predicted the mortality rates of the NS-SR and CM groups. CONCLUSIONS: Identification of HPVG requires careful consideration for surgical management. If surgical management is indicated, prompt laparotomy should be performed. However, even in the non-surgical management condition, aggressive laparotomy can improve survival rates for patients with high APACHE II scores.
APACHE ; Diverticulitis ; Duodenal Ulcer ; Enteritis ; Humans ; Intestinal Obstruction ; Ischemia ; Laparotomy ; Mortality ; Pancreatitis ; Prognosis ; Retrospective Studies ; Survival Rate

No abstract available.
Conus Snail* ; Hemangioblastoma*