The treatment of fractures of the dens is controversial and the major controversy has centered on type II fracture of Anderson and D'Alonzo classification because of its high incidence of nonunion when they were treated by external immobilization like halo apparatus. The posterior arthrodesis of atlas and axis which has been recommended by many authors results in the limitation of rotation of neck. In an attempt to promote bone union and to eliminate functional impairment, the authors have treated 7 consecutive cases of type II dens fracture by direct screw fixation with one or two screws. Minimum follow up period was 15 months(Av. 20mos.). Ages were varied between 23 to 68 years. Amounts of displacement on arrival were more than 4mm in all. Ambulation was started from the day after operation with the external support. Bone union was observed in 6 cases within 3 months without limitation of rotation. One nonunion with losening of screw and one transient dysphagia were observed. The authors believe that the procedure has the advantages in bone union and neck motion, but it requires surgeon's experience and the modification of implant for secure fixation.
Arthrodesis ; Classification ; Deglutition Disorders ; Follow-Up Studies ; Immobilization ; Incidence ; Neck ; Walking

To study the relationship between the bone mineral density measured by DEXA and QCT methods and to study the factors influencing on the value, bone mineral density in 208 patients with low back pain were measured by the two methods and compared statistically. Ages were varied between 17 to 79(Av. 46.7) years and male and female were 86 and 122. The results of this are as follows; 1. The values of DEXA and QCT showed statistically significant relationship(γ=0.58) as a whole. And bone mineral density in L2, L3 and L4 showed no difference in both groups. 2. Bone loss by aging(per year) in male and female was 0.99% and 1.06% by DEXA, 0,99% and 1.41% by QCT. 3. Body height and weight showed no significant influence of the value in two methods. 4. In body mass index over 27.5, the value measured by QCT was influenced to be diminished while that of DEXA was not influenced. 5. The value by QCT was influenced to be diminished by the increase of age especially over 50 years old in both sex. While the value by DEXA was influenced to be lowered than expected in female over 50 years old. It is concluded that the methods of measurement of bone mineral density have their limitation depend on the age, sex and mass index.
Body Height ; Body Mass Index ; Bone Density ; Female ; Humans ; Low Back Pain ; Male ; Spine

It had heen emphasized the necessity for upper gastrointestinal endoscopic examinations in patients. Who has had gastrectomy and presents persisting gastrointestinal symptoms. This study was conducted to evaluate endoscopic findings and clinical symptoms in patients following gastrectomy. (continue...)
Gastrectomy* ; Humans

PURPOSE: We performed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. METHODS AND MATERIALS: One hundred and six patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (9 4%) and ranged from 1 month to 92 months (median; 6 months). RESULTS: The median age was 62 years old and male to female ratio was 104:2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was performed in 83%. Mean tumor dose delivered with curative aim was 58.6 Gy (55-70.8 Gy) and median duration o f the radiation therapy was 53 days. The median survival of all patients was 6 months and 1-year and 2-year overall survival rte was 27% and 12%, respectively. Improvement of dysphagia was obtained in most patients except fo 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32% (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30% respectively, while those of the nonresponder was 4 months and 0% respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 rnonths and 16% while those of the patients who could not tolerate regular diet was 3 months and 0%, respectively (p=0.004). The survival difference between the patients with 5 cm or less turnor length and those with more than 5 cm tumor length was rnarginally statistically significant (p=0.06). However, the survival difference according to the periesophageal invasion or mediastinal lymphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor length, and initial degree of dysphagia in a decreasing order. The complication was observed in 10 patients (9%). CONCLUSION: The survival outcome for advanced esophageal cancer patients treated by external be am radiotherapy alone was very poor, In the treatment of these patients, the brachytherapy and chemotherapy should be added to improve the treatment outcome.
Brachytherapy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Diet ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Female ; Follow-Up Studies ; Gastrostomy ; Humans ; Lymphatic Diseases ; Male ; Middle Aged ; Multivariate Analysis ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Thorax ; Tomography, X-Ray Computed ; Treatment Outcome

PURPOSE: This study was aimed to analyze the incidence and the anatomical distributions of HME (Hereditary Multiple Exostoses) on upper limbs and its related change in alignment of the upper limbs in HME patients. MATERIALS AND METHODS: Thirty eight patients who had been diagnosed HME between 2001 and 2009, were categorized into two groups; (1) group A (1-2 involvements); (2) group B (> or =3 involvements). We checked the carrying angle, VAS (Visual Analogue Scale), limitations in daily activities, cosmetic satisfaction according to the number of exostoses invasion. RESULTS: Among the 38 patients, 23 patients (43 cases) had exostoses in the upper limbs. The locations of exostoses in the upper limbs were proximal humerus in 33 cases (30%), distal ulna in 31 cases (28.2%), and distal radius in 24 cases (21.8%). The carrying angle of group A and B was 10.7degrees, 13.8degrees, VAS was 1.3, 3.5, and the limitations in daily activities was 7.3, 6.6 of 8 points. The cosmetic satisfactory cases were 13 and 10 cases, respectively. CONCLUSION: The deformity in upper limbs was observed in 65% of the HME patients. As the number of invasion increases, carrying angle and VAS were increased but limitations in daily activities and cosmetic satisfaction were decreased.
Congenital Abnormalities ; Cosmetics ; Exostoses ; Exostoses, Multiple Hereditary ; Humans ; Humerus ; Incidence ; Lifting ; Radius ; Ulna ; Upper Extremity

BACKGROUND: The end-tidal carbon dioxide (ETCO2) is defined as a partial pressure of carbon dioxide at the end of an exhaled breath. And it has been found to correlate with cardiac output during cardiopulmonary resuscitation (CPR) in animal model. The purpose of this study is to determine that the assessment of ETCO2 could provide a highly sensitive predictor of return of spontaneous circulation (ROSC) during CPR. METHODS: Prospective, observational study was performed from Oct 1996 to Mar 1997 at the Severance hospital. All patients were endotracheally intubated and connected immediately to mainstream capnography sensor. We measured ETCO2 with Escort II model 20100 monitor(Medical Data Electronics, Inc, USA). It works on the principle of nondispersed infrared absorption with radiometric single beam optics. RESULTS: This study included 70 patients (52 were men) with a mean age of 54+/-15 years. ROSC was obtained in 43 patients. The initial ETCO2 averaged 15.5 +/-8.2 mmHg in survivors and 6.5+/-5.3 mmHg in nonsurvivors (p<0.01), and during the first 20 minutes of CPR, the maximal ETCO2 averaged 29.7+/-10.3 mmHg in survivors and 10.2+/-8.9 mmHg in nonsurvivors (p<0.01). ETCO2 was not significantly different in relation to initial rhythm, survival time after ROSC and possible cause of arrest. There is no cutoff value of ETCO2 satisfying greater than 90% of both sensitivity and specificity in predict ROSC. When maximal ETCO2 was less than 12 mmHg, we observed sensivity of 100% in predicting ROSC. CONCLUSION: Our results demonstrate that ETCO2 measurement represents a valuable, noninvasive, and clinical tool for monitoring patients during CPR.
Absorption ; Capnography ; Carbon Dioxide* ; Carbon* ; Cardiac Output ; Cardiopulmonary Resuscitation* ; Humans ; Models, Animal ; Observational Study ; Partial Pressure ; Prospective Studies ; Sensitivity and Specificity ; Survivors

No abstract available.
Burns* ; Humans

No abstract available.
Amniotic Fluid* ; Animals ; Embryonic Structures* ; Female ; Humans* ; Mice*

No abstract available.
Amniotic Fluid* ; Animals ; Embryonic Structures* ; Female ; Humans* ; Mice*

No abstract available.
Humans ; Inpatients*