STUDY DESIGN: This biomechanical study was designed to perform flexibility tests in multiple loading directions to compare the stabilizing effects of supplemental hook or pedicle screw fixation on short segment pedicle instrumentation system. OBJECTIVE: To compare biomechanical flexibilities of short segment pedicle instrumentation constructs added by hook or pedicle screw fixation in an unstable calf spine model. SUMMARY OF BACKGROUND DATA: Short segment pedicle instrumentation is using recently for the surgical treatment of the unstable burst fractures of the thoracolumbar spine, but a high incidence of early screw tai lure in short segment pedicle instrumentation has reported. MATERIALS AND METHODS: Ten fresh frozen calf spines (T10-L3) were loaded with pure uncosstrained moments in flexion, extension, axial rotation, and lateral bending directions. A maximum moment of 6.4 Nm was achieved in 5 steps using dead weights. After removal of L1 vertebral body, testing was performed on intact specimens first and then each specimen after laminar hook or pedicle screw insertion on the short segment pedicle instrumentation of ISOLA implant. Any kinds of graft material or transfixation device were not used to make the worst possible case of instability of an injured spine. Three different fixation methods were instrumented. These included: (1) one level aboye and one level below with pedicle screw, (2) 2 levels above with pedicle screw and hook and one level below with pedicle screw, and (3) 2 levels abode and one level below with pedicle screws. RESULTS: At the level of corpectomy, all fixation methods significantly reduced motions in flexion, extension, and lateral bending as compared to the intact motion (P<0.001). The differences between all constructs were not statistically significant. The addition of a hook or screw on the short segment pedicle screw construct was not significantly reduced the flexibi lite as compared to the short segment pedicle screw construct. Axial rotational motions in groups I, II, and III were similar with each other and with intact motion as well and there were no significant statistical difference. The addition of the hook or screw on the short segment pedicle construct showed more stability as compared to the pedicle screw construct, but statistical difference was not. The addition of hook or screw on the short segment pedicle screw construct showed similar stability in all motions with each other. At the level above corpectomyl all tested fixation methods did not improve the axial rotational stability beyond the intact case, but reduced flexion, extension, and lateral bending motions significantly (p<0.001). The addition of hook or screw on the short segment pedicle screw construct showed significant stability in all motions (p<0.001) as compared to the short segment pedicle screw construct and their stabilities were similar with each other. CONCLUSIONS: All fixation methods showed more stabilities in all motions than normal specimen. The addition of pedicle screw on the short segment pedicle screw constructs are more stable than the addition of hook, but there was no statistical difference. Adding one level of fixation cranial to the fracture using pedicle screws or hooks may be necessary to decrease the rate of clinical failure and to enhance the stability of the construct with short segment pedicle instrumentation
Incidence ; Pliability ; Spine ; Transplants ; Weights and Measures

For evaluation on the histopathologic studies and age distribution of the testicular tumors in the Taegu area, the inguinal orchidectomized materials were collected at the Department of Pathology, College of Medicine, Yeungnam University, and the analyzed results were as follows: 1. In total of 11 cases of orchidectomized materials, germ cell tumors are 10 cases (90.9%). In germ cell tumors according to the histologic types, seminoma was 5 cases (45.5%), and embryonal carcinoma, 3 (27.2%). 2. The highest age incidence of the group is 20th and 30th, and the next, 50th and 10th.
Age Distribution ; Carcinoma, Embryonal ; Daegu* ; Incidence ; Neoplasms, Germ Cell and Embryonal ; Pathology ; Seminoma ; Testicular Neoplasms ; Testis*

The frozen section technique is a means of intraoperative pathological diagnosis, and a procedure of great value to the surgeon. This method should be accurate, rapid and reliable. This method serves useful purposes, such as determining the presence of tumor, its type (especially whether it is benign or malignant), the adequacy of a biopsy of a suspected lesion, and the conditions of the surgical margins. But, it bears many disadvantages, the most of which is the danger of incorrect diagnosis. We studied the indications, the limitations, and the accuracy of the frozen section method and the materials studies was total of frozen section diagnosis of 809 cases was 98.1% with 0.5% of false negative, 0% of false positive 0.5% of incorrect histological diagnosis or grading errors, and 0.9% of deferred cases. The tissues submitted were lymph node, gastrointestinal tract, skin subcutaneous tissues in decreasing oder of frequency. The false positive case is not present, while the false negative cases were 4.
Biopsy ; Diagnosis ; Frozen Sections* ; Gastrointestinal Tract ; Lymph Nodes ; Methods ; Pathology, Surgical* ; Skin ; Subcutaneous Tissue

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

No abstract available.
Malaria*

PURPOSE: The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. MATERIALS AND METHODS: Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring, SPGR MRI, and SPECT subtraction with MRI co-registration. RESULTS: The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH (60.0%) and three bilateral hemispheric CH (12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1%). The basal ganglia hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). CONCLUSION: The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.
Basal Ganglia* ; Cerebellum* ; Epilepsy, Temporal Lobe* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Perfusion ; Seizures ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon

About 40% of patients with diabetes mellitus develops to diabetic nephropathy, and these patients show increment of glomerular filtration rate and renal volume at early phase. 99mTc-DMSA SPECT (single photon emission computed tomography) can measure a functional renal volume because 99mTc- DMSA it is taken up by the viable proximal tubular cells located in the renal cortex. To evaluate the renal volume in early diabetic nephropathy, we compared functional renal volume between diabetic patients and control, renal transplantation donor. 99mTc-DMSA was injected intravenously and SPECT was done after 2 hours in 15 diabetic patients, 18 renal transplantation donors, and 2 patients with end stage renal disease due to chronic glomerulonephritis. In diabetic patients with creatinine clearance more than 30ml/min and proteinuria, right and left renal volume were 247+/-22ml/BSA(m2), 256+/-37ml/BSA (m2), which were greater than those of diabetic patients with normal renal function and without proteinuria, or renal transplantation donors(P<0.05). In conclusion, we measured the functional renal volume by 99mTc-DMSA SPECT. Renal volume of diabetic patients with proteinuria were larger than the volume of control group or diabetic patients with normal renal function and without proteinuria. 99mTc-DMSA SPECT was thought to be useful test a for the measurement of functioning renal volume.
Creatinine ; Diabetes Mellitus* ; Diabetic Nephropathies ; Glomerular Filtration Rate ; Glomerulonephritis ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Proteinuria ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tissue Donors ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal*

Clinical and histopathological studies were made on 202 cases of malignancy of cervix, that were visited to the Department of Obstetrics and Gynecology, Yeungnam University Hospital, during 5 years from 1983 to 1987. The results were summarized as follows. 1. Malignancies of the uterine cervix were 10% of total female malignancies. 2. Among 202 cases, 195 cases (96.5%) were squamous cell carcinoma, in which 60 cases (30.0%) of carcinoma in situ, 9 cases (4%) of microinvasive, and 126 cases (62.5%) of invasive carcinoma were included. 3. The average age of the patients with squamous cell carcinoma was 49.4 years old; In case of carcinoma in situ, it was 43.8, microinvasive, 40.0, invasive 52.1 years old. 4. Clinical symptoms of the patient with squamous cell carcinoma in order of frequency were as follows; vaginal bleeding (47.5%), abnormal cytology (15.4%), and abnormal vaginal discharge (9.4%). 5. Duration of the chief complaints was most commonly less than 6 months (73.2%), and the average duration was 3.8 months. 6. The most common age of marriage was between 19 to 22 years old (46.5%). The average was 21.5 years old. 7. The gravity was 51.5% in 5-8 times, and average 6.2 times. The parity was 61.9% in 1-4 times, and average 3.9 times. 8. The subdivision of 126 cases of invasive carcinoma was made according to FIGO stage classification, stage I, 40 cases (31.8%), stage II, 54 cases(42.9%), stage III, 11 cases (8.7%), and stage IV, 8 cases (6.3%). 9. The histologic subtypes of invasive squamous cell carcinoma were distributed as follows; large cell keratinizing type, 25 cases (19.8%), large cell nonkeratinizing type, 101 cases (80.2%). 10. In the cytologic diagnosis, class I was 2 cases (1.9%), class II was 16 cases (15.1%), class III was 33 cases (31.1%), class IV was 31 cases (29.3%), class V was 24 cases (24.6%). 11. The frequency of lymph node metastasis was 7.5% in stage I, and 11.1% in stage II.
Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Classification ; Daegu* ; Diagnosis ; Female ; Gravitation ; Gynecology ; Humans ; Lymph Nodes ; Marriage ; Neoplasm Metastasis ; Obstetrics ; Parity ; Uterine Hemorrhage ; Vaginal Discharge

There are a number of published reports aimed at clarifying the effect of hormonal contracept -ives upon the quantity and quality of breast milk during postpartum and lactation periods. As to the volume of milk produced by breast feeding mothers, many authors seem to have agreed on a decrease as an established pattern in the periods following regular administration of oral contraceptives containing estrogen in varying dosage. The quality of milk following administration of hormonal contraceptives, however, remsins a controversial issue. Korea's experience in oral contraceptive is rather a brief one, but use of Eugynon has been widespread and frequent since this hormonal contraceptive was introduced into the national program in 1967. The authors have reviewed the potential significance of data concerning regular use of an oral contraceptive as affecting lactation, and have sought to clarify the interrelationship between the administration of Eugynon and quantity and quality of breast milk from mothers contracepting. with Eugynon in different periods following confinement. A total of 85 women, who were at different periods following deliveries, have been divided into, two groups, one comprising 28 women regularly taking oral pills and the other (57 women) not resorting to hormonal contraceptives if they were contracepting at all. 1. Milk Volume. In view of the possible influence of suckling on the amount of milk produced, efforts were made in this study to standardize the technique by extracting breastmilk by applying manual pressures on one side of the maw-nae, While the nipple on the other side was being sucked by the mother's own baby. The effetct of an exogenic ovarian hormone on the quantity as well as quality of breastmilk is generally understood to be inapparent until the drug is administered to women whose milk secreting function has been normalized. ") In the present study, it was observed that the decrease in the ammount of milk obtained from mothers in the periods following the 4th cycle of oral contraceptives or thereafter has turned out to be statistically insignificant. This result conforms i.u the findings by Tubari and others. It is assumed that it takes at lest 2 to 3 cycles of use before mammary glands are functionally adjusted to the use of exogenic hormonal contraceptives. 2. Specific Gravity and Composition of Milk There was no noticeable change in the protein and chloride content following continuous administration of ore.l contraceptives, while meaningful changes were observed in fat (increase) and calcium (decrease up to the 5th cycle use) contents. Also, there was a rather significant decrease in the specific gravity in the period following administration of the first cycle of the oral contraceptive. The findings from the present study partially conforms the results published by Ramadan and others, who reported that little change was noticed in the contents of total solids. ash, chlorides and lactose in the breast milk of women who had taken 4 cycles of ovosiston, although in our study lactose was not measured. Ramaden, however, reported that fat content did increase in the same milk, as in our study. A definitive conclusion, however, could not be made unless measures are taken to rule out the physiological changes of the maternal body affecting the composition of milks.
Breast Feeding ; Calcium ; Chlorides ; Contraceptive Agents ; Contraceptives, Oral ; Estrogens ; Ethinyl Estradiol-Norgestrel Combination ; Female ; Health Resorts ; Humans ; Lactation* ; Lactose ; Mammary Glands, Human ; Milk ; Milk, Human ; Mothers ; Nipples ; Postpartum Period ; Specific Gravity