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

BACKGROUND: Hypotension occurs frequently after epidural anesthesia. Intravenous fluid or vasopressors are among treatment methods to many suggested causes. This study was undertaken retrospectively to determine if the age, weight and height of parturients are related to the local anesthetic dosage in epidural anesthesia for the cesarean section, and if the dosage of local anesthetic influence the change of blood pressure and the requirement of fluid or epherine. METHODS: Sixty-nine parturients were studied by reviewing patients' anesthetic records. During lumbar epidural anesthesia to T4 sensory level, all patients were monitored with mean arterial blood pressure, and prevented from hypotension by administration of Ringer's lactated solution. But if hypotension has been sustained in spite of rapid fluid loading, intermittent ephedrine was injected. We studied the correlation of local anesthetic dosage, decrement of mean blood pressure and total required intravenous fluid volume, and difference of these variables between cases using ephedrine and not using. RESULTS: The volume of local anesthetic to achieve a T4 sensory level was 21.20 3.81ml, which did not correlate with age, weight and height, and did not influence the decrease of mean blood pressure and the volume of administered fluid. But the patients (n=30) who needed ephedrine were adminstered significantly larger dose of the local anesthetic and showed more decrease in the mean blood pressure than those (n=39) who did not. CONCLUSIONS: The dose requirement of local anesthetic during epidural anesthesia for the cesarean section is not determined by the age, weight and height of parturients. But when larger dose of local anesthetic is administered, the patients seem to be more hypotensive and need ephedrine as well as intravenous fluid administration.
Anesthesia, Epidural* ; Arterial Pressure ; Blood Pressure ; Cesarean Section* ; Ephedrine* ; Female ; Humans ; Hypotension ; Pregnancy ; Retrospective Studies

No abstract available.

No abstract available.
Biofeedback, Psychology* ; Electric Stimulation*

The present study was performed to evaluate the clinical effects following local application of 30% minocycline strip(polycaprolactone), 2% minocycline gel(hydro-carbon gel) and 12% minocycline strip(polylactide, Minodent) to augment scaling and root planing in patients with chronic adult periodontitis. Forty teeth with periodontitis were enrolled in the study anddistributed into 4 groups including control group. All patients performed standardized oral hygiene instructions and mechanical debridement at the beginning of the study and then each local delivery drugs were inserted into periodontal pocket in each groups. Examinations regarding plaque index(PI), papillary bleeding index (PBI), probing pocket depth (PPD) were carried out at 0, 2, 4 weeks. All experimental groups showed statistically significant differences between baseline and 2 and 4 weeks in every clinical indices. Especially, 30%minocycline strip and Minodent group showed a significant improvement in PBI at 2 weeks and in PPD at 2 and 4 weeks. In conclusion, highly bio-resorbable Minodent delivered subgingivally as an adjunct to scaling and root planing induces better clinical effects for periodontal health than 2% minocycline gel and control group.
Adult ; Male ; Female ; Humans

Pressure transmission ratio (PTR; A urethral pressure/A bladder pressure x 100) is obtained during cough profile and has been extensively used in pre and postoperative evaluation of patients with genuine stress urinary incontinence. The purpose of this study is to evaluate which urodynamic parameters are most effective for the decision of success after Burch operation in patients with genuine stress urinary incontinence. Twenty-one women with genuine stress urinary incontinence were evaluated urodynamically both before and after Burch operations. The patients` age was 49.5+/-7.51 and parity, 3.1+/-1.5. Mean follow up period was 8.7 months after operations (range 3-36 months). Dynamic and static urethral pressure profilometry were measured with microtip transducer catheter pre and postoperatively. The preoperative and postoperative functional urethral length (2.76+/-0.48 vs 2.75+/-0.47cm, p>0.05) and maximal urethral closure pressure (71.9+/-15.7 vs 72.8+/-15.2cmH20, p>0.05) showed no significant changes after eighteen successful Burch procedures. The PTR at the points of MUCP (maximal urethral closure pressure) was significantly improved after eighteen successful surgeries (85.9+/- 10.9 vs 113.4+/-13.5%, p<0.001). Three women who remained incontinent, showed no improvement in PTR (76.3+/-4.16 vs 86.7+/-8.5%, p>0.05). The reasons for successful surgical treatment of stress urinary incontinence are not related to any changes in functional urethral length or maximal urethral closure pressure. However, the comparison of preoperative and postoperative PTR is helpful and objective in determining the adequacy of surgical correction of anatomical defect associated with genuine stress urinary incontinence.
Catheters ; Cough ; Female ; Follow-Up Studies ; Humans ; Parity ; Transducers ; Urinary Bladder ; Urinary Incontinence* ; Urodynamics

No abstract available.
Female ; Granulosa Cells* ; Interferon-alpha* ; Rodentia*

BACKGROUND: Calcipotrol, topical vitamin D analogue, has been demonstrated to have an effect for the treatment of psoriasis with good tolerability. It is required to have comparative studies with the other topical agents which are widely used for the treatment of psoriasis. OBJECTIVE: Our purpose is to compare calcipotriol with desoxymethasone ointemtn in their therapeutic efficacy and ability to affect dermal inflammatory cellular events. METHODS: This study was a randomized, double blind, right/left comparison over 8weeks in 10 patients. The ointments were applied twice daily to the lesions of psoriasis. Clinical efficacy, as measured by the Psoriasis Area and Severity Index(PASI) was assessed at 2, 4, 6 and 8weeks after starting treatments. The changes in the numbers of dermal immunocytes were assessed on frozen and paraffin-embedded sections by using immunohistochemical stain methods before and after the treatemtns. RESULTS: Reduction of PASI was statistically significant at all time points for both of the treatments (P<0.01) but there was no significant defference between the two treatment modalities. At the completion of 8 weeks of treatments, the mean PASI reduction was 65 percents and 67 percents for calcipotriol and desoxymethasone ointments, respectively. On immunohistochemical staining, the numbers of LCA and HLA-DR positive cells were decreased significantly(P<0.05), and IL-2R and CD4 positive cells were not significaltly reduced in each group after the treatment. CONCLUSION: Calcipotriol ointment was as effective as desoxymethasone ointment, judged by the PASI and the dermal inflammatory cellular events on immunohistochemical staining.
Dermatitis, Atopic ; Desoximetasone* ; HLA-DR Antigens ; Humans ; Ointments* ; Psoriasis* ; Vitamin D

PURPOSE: The purpose of this study was to identify factors influencing life satisfaction for mothers with children in elementary school. METHODS: Participants were 243 mothers with a child in first and fifth degree of one elementary school in G city. Data were collected from March 20 to April 9, 2010. The instruments used were Satisfaction with Life Scale, Parent Satisfaction Scale, Korean ADHD Rating Scale, Parenting Alliance Inventory and Scale for Measuring Family Strengths. The data were analyzed using SPSS/WIN 14.0 computer program and included one-way ANOVA, Scheffe back-testing, Pearson's correlation coefficients and stepwise multiple regression. RESULTS: The life satisfaction of the mothers showed significantly positive correlations with parent role satisfaction, spousal support, and family strengths and negative correlations with ADHD. Significant predictors of life satisfaction for mothers with children in elementary school were spousal support and sharing of value systems, and these variables explained 37.0% of the variance in life satisfaction. CONCLUSION: The results of this study indicate that improvement of spousal support and sharing of the family value system should be helpful in promoting life satisfaction for mothers with children in elementary school.
Child* ; Humans ; Mothers* ; Parenting ; Parents

No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*