Many believe the reduction in the number of mobile segments causes an increased strain in the unfused segments, predisposing them to early degeneration. This degeneration of the adjacent segment could be a cause of low back pain after spinal fusion. The clinical manifestations supporting the increased stress of the unfused segments are the significant incidence rates of spondylolisthesis, spondylolysis acquisita and spinal stenosis. However, there was a paucity of reports in the literature on the histological observation at the adjacent, unfused sgements. Therefore, the purpose of this study was to observe the histological changes of the unfused, mobile segments following fixation in the cat spine. The cat lumbar spines from L6 to L7 were fixed posteriorly with acrylic cement and wires. Histological and histochemical observation of the upper adjacent segment were performed after H-E, trichrome, reticulin and Safranin-O staining at postoperative 6 and 12 months, respectively. The results were as follows: 1. There were mild degenerative changes in the intervertebral disc, but no evidence of definitive degeneration in the articular cartilage of the facet joints at postoperative 6 months in the spinal fixation group. 2. The marked degenerative changes of the intervertebral disc were shown at postoperative 12 months in the spinal fixation group. Of 5 cats sacrificed at 12 months, 3 cats had irregular configuration of the fiber's arrangement of the annulus fibrosus. 3. At postoperative 12 months in the spinal fixation group, marked degeneration was noted on the articular cartilage of the adjacent facet joints. Through this study, it is clarified that degenerativce changes of the intervetebral disc and facet joint at the adjacent segments will develop after certain period of time following spinal fusion. Especially the facet joints of the adjacent, unfused segment were found to be most vulnerable to the adverse effects. This may be responsible for the back pain in the future after spine fusion.
Animals ; Back Pain ; Cartilage, Articular ; Cats* ; Incidence ; Intervertebral Disc ; Low Back Pain ; Reticulin ; Spinal Fusion ; Spinal Stenosis ; Spine* ; Spondylolisthesis ; Spondylolysis ; Zygapophyseal Joint

In 1933 Shope described an infectious papilloma of wild cattontail rabbits. Shope rabbit papilloma is a virus-induced epidermal neopIasm indigenous to western cottontail rabbits and readily transmissible to domestic rabbits by inocuiation with an cell-free extract of wild cottontail papilloma. Shope papilloma induced in the domestic rabbits may spoataneously, remain benign, or progress to carcinoma. Kidd et al. (1936) noted that the regression is not correlated with the titer of virus neutralizing antibody. The possibility that papilloma regression is brought about by a mechanism anaIogous to that operating in allograft rejection was suggested by kidd et al. (1938) with the view of the histological resemblance between papilloma regression and rejection of allografted tissue. That regression is mediated by an immune mechanism is strongly indicated by the findings of Evans et al.(1962) that the proportion of rabbits showing regression is substantially increased by vaccination of rabbits with their own papilloma tissue or with papilloma tissue from another rabbits. McMichael (1967) demonstrated that suppression of regression was achieved by use of large doses of corticosteroid. The effect of 5-fluorouracil on human warts was mentioned as being effective by Goldman et al. (1963). In Korea resinous extract from Paulownia coreana has long been used empirically in the treatment of human warts. In this investigation effects of dexamethasone administration on the development and the spontaneous regression of Shope papillomas in domestic rabbits were studied. At the same time, observations were made to evaluate the comparative effectiveness of topical application of 5% 5-fluorouracil ointment and resinous extract from Paulownia coreana on Shope papilloma in the domestic rabbit. The results are summarized as follows: l. Administration of dexamethasone significantly reduced the spontaneous regression of Shope papillomas in domestic rabbits by 12 weeks after virus inoculation. 2. Topical application of 5% 5-fluorouracil ointment on Shope papillomas cured the tumors by 4 weeks of drug application. However, similar treament with resinous extract from Paulownia coreana was without any demonstrable effects. 3. Marked losses of body weights became manifest in dexamethasone treated rabbits. 4. Reinoculation of Shope papilloma virus into 2 rabbits whose papillomas had regressed 3 months ago failed to produce papillomas.
Allografts ; Antibodies, Neutralizing ; Body Weight ; Cottontail rabbit papillomavirus ; Dexamethasone* ; Fluorouracil ; Humans ; Korea ; Papilloma* ; Rabbits ; Tumor Virus Infections ; Vaccination ; Warts

No abstract available.
Aneurysm

No abstract available.
Spondylosis*

No abstract available.
Child* ; Humans ; Nephrotic Syndrome*

No abstract available.
Child* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

We Reviewed 10 hypertensive children with pheochromocytoma retrospectively and the following results were obtained. 1) Out of 10 patients, 7 were male and 3 female. Age ranged from 5.5 years to 13.8 years and their median age was 9.9 years. 2) They complained of sweating, lethargy, headache. or chest pain and so on. Hypertension were noticed in all patients. Heart murmurs were detected in 7 patients and hypertensive retinopathy in 70%. 3) The three cases arised at extraadrenal gland and bilaterality was seen in 3 patients. In the view of diagnosis, abdominal sonography, computerized tomography and urine VMA test revealed the sensitivity of 100%. But MIBG scan showed 60% in sensitivity. 4) Waiting for operation, their hypertension were controlled by adrenergic blockers or calcium channel blockers. They received tumorectomy successfully except one who was in hypertensive state after operation and followed up through OPD. In conclusion high suspicion for the existence of pheochromocytoma from the clinical manifestations should be entertained in any pediatric patients and biochemical and imaging studies were mandatory. Furthermore, for the accurate localization of tumors, several imaging studies should be collaborated.
3-Iodobenzylguanidine ; Adrenergic Antagonists ; Calcium Channel Blockers ; Chest Pain ; Child* ; Diagnosis ; Female ; Headache ; Heart Murmurs ; Humans ; Hypertension ; Hypertensive Retinopathy ; Lethargy ; Male ; Pheochromocytoma* ; Retrospective Studies ; Sweat ; Sweating

No abstract available.
Hemolytic-Uremic Syndrome*

STUDY DESIGN: We classified adult isthmic spondylolisthesis based on the findings of postmyelographic CT scanning. OBJECTIVES: To propose a new classification that could be used as a useful guideline when evaluating the patient with adult isthmic spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Morphologic changes of the spinal canal and its neural contents in the adult patient with isthmic spondylolisthesis and their relations to radiological variables have not been well described in literature. MATERIALS AND METHODS: 32 adult patients with one level isthmic spondylolisthesis underwent myelography followed by CT scanning. Based on these findings, we classified each patient with four morphologic criteria; 1. dural station I or ll by the location of dural sac, 2. non-compression or compression type by the existence of lateral compression of dural sac. 3. root station I or ll by the location of nerve root, 4. hook or smooth type by the shape of spinal canal. Subsequent statistical analyses to assess the relationships between our newly developed classification and clinical variables were tested by SPSS software. RESULTS: Dural station correlated positively with percent slip(rpb=0.39; p=0.026). Patient age was closely related to the lateral compression(rpb=0.54, p<0.01) which consequently decreased transverse diameter of dural sac(rpb=-0.68, p<0.01). Both dural station and lateral compression were important in the prediction of the extent of the dural involvement. Root station of the smooth type correlated positively with percent slip(reb=0.47: p=0.038), while that of the hook type did not. Consequently, nerve root of the hook type entered neural foramen under the pedicle, whereas that of the smooth type entered at various locations depending on the degrees of percent slip. Depth of lateral recess was significantly less in the hook type than in the smooth type(p<0.01). Stretching of the nerve root, produced by posterior migration of the nerve root, was observed only in the smooth type. CONCLUSIONS: We strongly recommend the use of our classification because it is easy to apply and has a high correlation with radiological variables.
Adult* ; Classification* ; Humans ; Myelography* ; Spinal Canal* ; Spondylolisthesis* ; Tomography, X-Ray Computed*

No abstract available.
Child* ; Glomerulonephritis, Membranous* ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans