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

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

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*

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*

This study represents the immune reaction pattern of gastric carcinoma, based on the morphologic characteristics of regional lymph nodes in the cases of stomach carcinomas. The materials were obtained from the resected specimens from 100 carcinoma patients. We chose Tsakraklides' method in classification of the structure of lymph node, which are as follows: lymphocyte predominance, germinal center predominance, unstimulated and lymphocyte depletion. The incidence was as follows: lymphocyte predominance 45, germinal center predominance 32, unstimulated 21 and lymphocyte depletion 2. In the lymph nodes of peptic ulcer, lymphocyte predominance pattern was most common. The reactivity of lymph nodes is suppressed proportionally to the severity of cancers, thus the advanced case of cancer exhibited lymphocyte depletion pattern which suggests exhaustion of immune reaction. The lymphocyte predominance pattern was frequent in superficial type and expanding type of gastric carcinoma. The cancer metastasis of lymph node in lymphocyte predominance was smaller than the other type of lymph nodes, while metastasis increased progressively higher with the orders as following: lymphocyte predominance, germinal center predominance, unstimulated and lymphocyte depletion.
Incidence ; Neoplasm Metastasis

A 79-year-old man with balanitis circumscripta plasmacellularis(BCP), presenting as an erythematous constricting band of the inner surface of the prepuce encircling the penile shaft is described. The biopsy specimen of the lesion showed, in addition to the typical histologic findings of BCP, increased fibrosis and decreased amount of elastic fibers which correlate well with our clinical observations. Electron microscopic examination revelaed no viral particles or elastic fibers. Immunohistologically, IgG was found to be the major immunoglobulin class in the plasma cellular inf iltrate.
Aged ; Balanitis* ; Biopsy ; Elastic Tissue ; Fibrosis ; Humans ; Immunoglobulin G ; Immunoglobulins ; Male ; Plasma ; Virion

Bezoyl peroxide, a powerful oxidizing agent, has been uaed topically in the treatment of acne vulgaris as a cream or lotion and has been shown to he effective for this codition. In 1972 Fulton emphaaized the importance of the vehicles used to obtain. maximum potential of benzoyl peroxide and for this, the gel formulation has been examined in many clinical trials. The present study was undertaken to evaluate the therapeutic effect of Fanoxyl 2.5, a 2.5% . benzayl peraxide gel, in patients with acne vulgaris. A total of 31 patients entered this study at the Departrnent of Dermatology, Jeoul National University Hospital rluring 3 rnanths period, from Decemher, 1978 through February, 1979, All patienta were instructed to apply Fanoxyl 2.5' on their affected areas once or twice a day and the nurnber of lesions on two or three t fixed areas were counted before and onee weekly after initation of the treatment. The reaults observed in the 3I patients were as follaws; 1. The percentage decrease in total nurnber of lesions in 4 weeks after treatment was 56.9%. 2. The authors could follow up for 6 weeks in 6 cases. In 6 case, the mean percentage in total number of lesions in 6 weeks after treatment was 81.7%. 3. Clesed and open eomedones were gradually eliminated; and their numbers were decreased in 4 weeks after treatment by 46.5% and 56.8% respeetiveIy. The papules were rapidly eliminated and their numbers were decreased in 4 weeka, after treatment by 79.8%. 4. Although most patients felt a mild burning sensation and tightness at the begining of the treatment, only a minority of the patients complained of discomfort due to pain(l case), erytherna(l case), tightness(2 cases),burning sensation (1 case), scaling(1 case). But all were tolerable without taking any specific measures or discontinuance of application. In one case, contact dermatitis developed after 4 weeks treatment. The authors concluded through this experiment that Panoxyl 2.5' (2.5% benzoyl peroxide gel) is a very effective local therapeutic agent in the treatment of acne vulgaris patients.
Acne Vulgaris* ; Benzoyl Peroxide* ; Burns ; Dermatitis, Contact ; Dermatology ; Follow-Up Studies ; Humans ; Sensation