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*

A malformation of azygos and hemiazygos system were observed from the cadaver for anatomy practice in College of Medicine, Chungnam National University. The observing results were as followings ; Hemiazygos vein was connected with left superior vena cava and drained into coronary sinus, which engorged enough to fill up with blood about 20cc to 30cc. Communicating pathway from hemiazygos vein to azygos veln wasn't found the diameter of left brachiocephalic vein was very small, about 2mm to 3mm. And, the diameter of left internal jugular vein was smaller than that of right infernal jugular vein. In this case, the azygos and hemiazygos system ceased its development at early embryologic stage(around 7 week embryo) and didn't progress into next stage.
Brachiocephalic Veins ; Cadaver ; Chungcheongnam-do ; Coronary Sinus ; Jugular Veins ; Veins ; Vena Cava, Superior

BACKGROUND: Thyroid status in uremia is still inconclusive due to the complexicity of the system. No single pathogenetic event may explain the thyroid function abnormalities in end stage renal disease (ESRD). Defects at all levels of the hypothalamic-pituitary-thyroid axis have been identified. Regarding the thyroid dysfunction in ESRD it is well recognized that the TSH response to TRH is blunted and serum concentrations of thyroid hormones are decreased in patients with ESRD. Whether or not on maintenance hemodialysis. Restoration of renal function with renal transplantation resulted in normalization of all parameters of thyroid function with exception of blunted TSH response to TRH. We evaluated the long-term changes of the thyroid function in 10 patients to know whether the thyroid function and the hypothalamo-pituitary axis were improved with the recovery of the renal function under maintenance low-dosage steroid administration after renal transplantation. METHODS: These tests were performed during the morning in the fasting state in 10 ESRD patients before, 1 month and 6 years after renal transplantation (RT). Thyroid function tests. Serum T3, T4 were measured by RIA kit and serum TSH was measured by IRMA kit. TRH stimulation test. Serum blood samples were obtained 0, 30, 60, 90, 120 min after TRH (400microgram) administration. Statistical analysis. All grouped data were expressed as mean+/-SD. Student t-test was used to assess the statistical difference between any two means. RESULTS: 1) The mean basal level of serum T3 was reduced in ESRD patients (53.6+/-33.2ng/dL) and increased to the low normal level 1 month after RT (87.8+/-25.4ng/dL), improved to the normal level 6 years after RT (116.3+/-28.8ng/dL). 2) The mean basal level of T4 was within normal range before RT (5.9+/-1.1microgram/dL), after 1 month (6.2+/-1.2microgram/dL) and after 6 years (6.5+/-1.4microgram/dL) of RT. 3) The mean basal level of TSH was within normal range before RT (2.0+/-1.2microU/mL), after 1 month (1.1+/-0.7microU/mL), and after 6 years (0.7+/-0.5microU/mL) of RT. Rut the mean TSH level of 6 years of RT was significantly decreased within the normal range. 4) In ESRD the TSH response to TRH was blunted, had a diminished peak and delayed fall before RT. After 1 month of RT, the TSH response to TRH was persistently blunted, however showed more rapid fall of TSH. After 6 years of RT, the TSH response to TRH normalized, but the absolute level of TSH and the peak level of TSH to TRH were less than before and after 1 month of RT. CONCLUSIONS: The abnormalities of thyroid hormones in uremic patients were improved partially after 1 month of RT and almost completely after 6 years of RT. But the level of T3H and the peak level of TSH to TRH were low within normal range, these results may be a direct consequence of low-dosage and long-term glucorcorticoid administration.
Axis, Cervical Vertebra ; Fasting ; Follow-Up Studies* ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Reference Values ; Renal Dialysis ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Hormones ; Uremia

INTRODUCTION: This study was performed to evaluate the diagnostic usefulness of simultaneous determination of 3 tumor markers {serum carcinoembryonic antigen(CEA), squamous cell carcinoma antigen (SCC Ag) and neuron specific enolase(NSE)} in lung cancer patients. METHOD: In 113 patients with primary lung cancer(70 with squamous cell carcinoma, 30 with adenocarcinoma, 13 with small cell carcinoma) and 103 patients with benign lung diseases, serum CEA and NSE were measured by enzyme immunoassay, and SCC Ag was measured by microparticle enzyme immunoassay. RESULTS: 1) The mean serum levels of 3 tumor markers were significantly higher in lung cancer groups than benign lung disease groups respectively(p=0.001). 2) In squamous cell carcinoma, the SCC Ag was elevated in 67%, in adenocarcinoma CEA was elevated in 77% and in small cell carcinoma NSE was elevated in 77%, but there were no significant differences according to the stage of each cancer cell types. 3) CEA was the most sensitive marker, but nonspecific to cancer types. SCC Ag was less sensitive than other markers, but more specific toward squamous cell carcinoma, and NSE was more specific to primary lung cancer. 4) As the number of positive tumor markers was increased, the relative possibility of lung cancer was also increased. If two markers were positive, it increased to 77%, and if three markers were positive it increased to 90%. CONCLUSION: The simultaneous measurement of serum CEA, SCC Ag and NSE would provide additional information for the diagnosis of lung cancer.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Immunoenzyme Techniques ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Neurons ; Biomarkers, Tumor*