Thirty-two consecutive patients with spondylolisthesis associated with displacement in varying degrees were operated by the Steffee procedure. Slippings more than Meyerding Grade III were reduced by modified Schollner technique:destabilization of the slipped segement, local distraction with spinal elevator and completion of reduction with a cork screw force pulling backward. Autogenous bone and Pyrost were added to get solid fusion. The authors reviewed thrity-two cases of symptomatic lumbar spondylolisthesis which were operated since March in 1987 at Kangnam Sacred Heart Hospital, Hallym University and the followings were obtained. 1. There were 17 males and 15 females, and the age of the patients was 44.2 years in average ranging from 19 to 66 years. 2. The types of spondylolisthesis were isthmic defect at 19 levels in 18 cases and degenerative in 14 cases. The level of the lesion was L5-Sl in 17 cases, L4-5 in 15 cases and L2-3 in 1 cases. 3. The clinical symptoms were low back pain, radiating pain, intermittent claudication, and motorsensory deficit in order of incidence. 4. Preoperatively, the degree of slinpping was Meyerding Grade I in 18, Grade III in 12 and Grade Ill in 3 cases. The slipping was reduced to nearly anatomic position in 13 cases and Grade I in 20 cases. The average slipping measured by Taillard method was changed from 23.4% preoperatively to 5% postoperatively. 5. Clinically, the results were judged as excellent in 13(13%) cases, good in 16(50%) cases and fair in 3(9%) cases according to Kim's criteria. 6. Postoperative complications were leg pain in 3 cases and "stress transfer" in 1 cases.
Elevators and Escalators ; Female ; Heart ; Humans ; Incidence ; Intermittent Claudication ; Leg ; Low Back Pain ; Male ; Methods ; Pedicle Screws ; Postoperative Complications ; Spine ; Spondylolisthesis

Pedicled bone flap raised from the volar aspect of lower end of the radius, pedicled by the pronator quadratus has been used for the treatment of scaphoid nonunion and Kienbock's disease. From July 1991 to Jan. 1992, authors performed this procedures for 3 cases of Kienbock's disease. Patients were 2 cases in the left hand, l case in the right hand. There was no critial trauma history. Age at operation were 25, 37 and 57 years. All patients were in Stage I in 2 cases and stage II-A in 1 case of Lichtman's radiologic classification. Preoperative grip powers were 11%, 38%, 63% and pinch powers were 20%, 41%, 61% of that of normal opposite hand. Follow up periods were 28, 31 and 33 months. At last follow up roentgenographic finding shows no progression of necrosis of lunate, new bone formation, decreased sclerosis, and joint space were preserved in all cases. The fuctional results at the last follow up were as follows. Pain during motion was markedly diminished in all patients. Grip power were 57%, 89% and 96% and pinch powers were 68%, 83% and 100% of that of normal opposite hand with use of calibrated Jamar dynamometer which showes significant increase than preoperative state. The ranges of motion of wrist were as follows. Volar flexion were 40, 45 and 80 degree. Dorsiflexion were 10, 20 and 45 degree. Ulnar deviation were 10, 20 and 30 degree. Radial deviation were 10, 25 and 30 degree. This viable bone graft with blood supply gives very satisfactory clinical results.
Classification ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Joints ; Necrosis ; Osteogenesis ; Osteonecrosis ; Radius ; Sclerosis ; Transplants ; Wrist

OBJECTIVE: The aim of the present study was to investigate the effects of nitric oxide synthase (NOS) inhibitor on MK-801-elicited behaviors in rats in an attempt to elucidate the participation of NO in the pathophysiology of schizophrenia and to identify the possibility of NOS inhibitor's antipsychotic property. METHODS: Male Sprague-Dawley rats, weighing 250-300g, were given MK-801 in order to know behavioral changes induced by MK-801. Next time, animals were pretreated with Nomega-nitro-L-arginine (L-NA) as a NOS inhibitor and haloperidol before administration of MK-801, respectively. Separate behavioral rating scales were introduced for quantifying MK-801-induced locomotor activity, stereotyped behaviors and ataxia in order that these behaviors might be assessed independently. Animals were observed for 30 seconds and scored once every 10 min. during a period of 1 hour. RESULTS: 1) Locomotor activity and stereotyped behavior were significantly increased by MK-801 in rats. 2) Locomotor activity and stereotyped behavior were significantly diminished by pretreatment with haloperidol. 3) Locomotor activity and stereotyped behavior were also significantly diminished by pretreatment with L-NA. CONCLUSIONS: These findings suggest that NO may, in part, mediate behavioral changes induced by MK-801, and that inhibitors of NOS may have antipsychotic action.
Animals ; Ataxia ; Dizocilpine Maleate ; Haloperidol ; Humans ; Male ; Motor Activity ; Nitric Oxide Synthase* ; Nitric Oxide* ; Rats* ; Rats, Sprague-Dawley ; Schizophrenia ; Stereotyped Behavior ; Weights and Measures

BACKGROUND: Hemodilution reduces the concentration of clotting factors in blood and this may induce some degree of impairment of coagulation. But there are some evidence that hemodilution may induce a hypercoagulable state. The goal of this study is to investigate the changes of coagulation status during progressive hemodilution. METHODS: Whole Blood was diluted by 10% increment to 80% with 0.9% normal saline. At each 10% dilution blood coagulation status was analysed using thrombelastography (TEG) and was compared with that of an undiluted control specimen obtained concurrently from the same patients. RESULTS: Hemodilutions up to 40% decrease r and K times and increase values of MA and angle. Hemodilutions more than 70% increase r and K times and decrease values of MA and angle. CONCLUSIONS: Hemodilutions up to 40% increase coagulability and hemodilutions more than 70% decrease coagulability of whole blood in vitro.
Blood Coagulation ; Hemodilution* ; Humans ; Thrombelastography

PURPOSE: To evaluate the usefulness of double injection of a vasoactive drug in penile Doppler ultrasonography for the diagnosis of vasculogenic impotence. MATERIALS AND METHODS: Eighty-four consecutive cases (bilateral sides) of 42 patients with suspected vasculogenic impotence were included in our study. We used computed sonography (Acuson, USA), with a 7 MHz linear array transducer. After the first intracavernosal injection of the vasoactive drug (10 ug of prostagladin E1), peak systolic velocity (PSV) and end diastolic velocity (EDV) were measured three times. According to mean PSV and EDV, the patients were classified into four groups : arteriogenic impotence (AI;N=29), venogenic impotence (VI;N=28), AI associated with VI(N=14), and normal(N=13).After the second injection, PSV and EDV were remeasured, using the same method. Mean velocities of the first injection were compared with those of the second, and the paired t-test was used to analyze the results. the extent to which patients were reclassified after the scecond injection we noted. RESULTS: In all four groups, PSV measured after the second injection was significantly different from PSV after the first (p=0.0001, 0.0001, 0.0010, 0.0072); except in the normal group, EDV measured after the second injection was not different from EDV after the first (P=0.9815, 0.0654, 0.0950, 0.0057). After the second injection, the numbers of patients reclassified into other groups were as follows : AI, 11 (38%); VI, 6 (21%); AI associated with VI, 11 (79%); normal, 1 (8%). CONCLUSION: Double injection of a vasoactive drug affected PSV, and therefore, appears to be a useful adjunctive procedure for the evaluation of patients in whom classification based on the results of the first injection is difficult.
Classification ; Diagnosis ; Erectile Dysfunction ; Female ; Humans ; Impotence, Vasculogenic ; Male ; Transducers ; Ultrasonography, Doppler*

Although several reference values of the cavernosal arterial flow velocity were reported for defining the normal vascular condition including good arterial inflow and corporal venoocclusive function, still we have some confusions and limitations to interpret the results because of lack of standardization of some various factors relating to performing duplex scanning. Here in, we evaluated the effect of cavernosal arterial location that is measured by Doppler spectrum on the values of blood flow velocity. 36 patients with suspecting vasculogenic impotence entered the study. Color duplex sonography was performed in all patients. We obtained velocity measurements at 3 to 8 min intervals in both cavernosal arteries for at least 20 min after injection of PGE1 10ug. The cavernosal artery peak systolic flow velocity (PSV) and end diastolic flow velocity (EDV) were measured at two portions. the base over the ascending portion of cavernosal artery( 'Proximal') and midshaft( 'Distal') of the penis in each session. We classified the patients based on the results of Proximal values of duplex parameters into normal(maximal PSV>30 cm/sec and minimal EDV<5cm/sec throughout the study; NL group: n=8), arterial insufficiency with or without venous incompetency(maximal PSV< 25cm/sec; AI group: n=l2) and venous incompetency without arterial insufficiency(maximal PSV>30cm/sec and minimal EDV>5cm/sec; VI group n= 16). When we compared PSV values between two portions of measurement in each group all the Distal PSV values were significantly lower than Proximal(p<0.06) in NL and VI group, but no statistical difference was noted in PSV values of AI group(p>0.05). If we considered only Distal values for patient grouping 63% of VI group and 50% of NL group had maximal PSV values less than 25cm/sec that would be reclassified into arterial insufficiency. On the other hand, resistance index(RI) values remained unchanged regardless of measurement location in all groups. With the above results we can conclude that there is an obvious difference of blood flow velocities between two portions of measurement(Proximal vs Distal) and Proximal value is more reliable than Distal when we diagnose with previously reported normal reference value (PSV>30-35cm/sec).
Alprostadil ; Arteries ; Blood Flow Velocity ; Erectile Dysfunction ; Female ; Hand ; Humans ; Impotence, Vasculogenic ; Male ; Penis ; Reference Values

Cardiotoxicity is a well-known complication following treatment with anthracyclines. However, they are still widely used in chemotherapy for breast cancer, lymphoma, leukemia, and sarcoma, among others. Patient clinical characteristics, such as age, sex, comorbidities, anthracycline dose and infusion schedule, and the combined anti-cancer agents used, are diverse among cancer types. It is difficult to recommend guidelines for the prevention or management of anthracycline-induced cardiotoxicity applicable to all cancer types. Therefore, anthracycline-induced cardiotoxicity remains a major limitation in the proper management of cancer patients treated with an anthracycline-combined regimen. Efforts have been extensive to determine the mechanism and treatment of anthracycline-induced cardiotoxicity. Because cardiotoxicity causes irreversible damage to the myocardium, prevention is a more effective approach than treatment of cardiotoxicity after symptomatic or asymptomatic cardiac dysfunction develops. This article will review the pathophysiological mechanisms of anthracycline-induced cardiotoxicity and strategies for protecting the myocardium from anthracycline.
Anthracyclines ; Appointments and Schedules ; Breast Neoplasms ; Cardiotoxicity* ; Comorbidity ; Doxorubicin ; Drug Therapy ; Humans ; Leukemia ; Lymphoma ; Myocardium ; Sarcoma

The present study examines the effects of orthodontic treatment of surgically exposed impacted upper canines or ectopically erupted upper canines to periodontal condition and whether various opening procedures have significant difference in postoperative periodontal status. The subjects included 23 orthodontic patients(7 men, 16 women) with unilateral upper canine impaction treated either with closed eruption technique(group I), with apically positioned flap procedure(group II), and those with canines ectopically erupted through keratinized gingiva(group III). In each subject, the ectopic canine was orthodontically aligned, and changes in periodontal tissue were assessed by measuring keratinized gingival width, attached gingival width, probing depth and bone probing depth. In all three groups, the width of keratinized gingiva was preserved while showed no signs of detrimental periodontal condition such as gingival recession. In all three groups, no significant difference in periodontal pocket depth from control was observed. The width of attached gingiva was significantly greater in patients treated with apically positioned flap procedure(group II) than in patients on other groups.
Cuspid* ; Gingiva ; Gingival Recession ; Humans ; Male ; Periodontal Pocket

Case Report Conjunctival malignant melanoma is a rare disease. Especially it is extremely rare before thirties and after eighties. In our country, several cases of malignant melanoma in conjunctiva of adult reported, but no case in child. We have experienced a case of malignant melanoma in bulbar conjunctiva occurring in a 4-year-old boy. We reviewed the available literatures regarding this disease.
Adult ; Child* ; Child, Preschool ; Conjunctiva ; Humans ; Male ; Melanoma* ; Nevus ; Rare Diseases

BACKGROUND AND OBJECTIVES: Although pediatric tracheostomy is a useful procedure to secure airway, post-tracheostomy complications sometimes have significant detrimental effects on pediatric patients. Among the complications, post-tracheostomy tracheal stenosis is one of the major late sequelae, which may be preventable by adequate surgical technique. The objective of this study is to investigate the degree of post-tracheostomy tracheal stenosis after applying new modification of tracheostomy: surgical dilatational tracheostomy (SDT) in a growing animal model. SUBJECTS AND METHOD: Seven Newzealand White rabbits were divided into three groups: SDT (n=3), surgical conventional tracheostomy with vertical cartilage incision (SCT)(n=3), and control (n=1). Each rabbit underwent tracheostomy by assigned procedures on the first day. On day 8, they were decannulated. On day 15, their tracheas were harvested. We examined the gross findings and histologic changes of each tracheal segment at the level of stoma. We analyzed three parameters: the quotient of the stomal and non-stomal segment in sagittal diameter, coronal diameter, and cross sectional area. RESULTS: The frameworks of cartilages at the level of stoma were more distorted in the SCT group. Histologic examination also showed buckling of the anterior tracheal wall, loss of cartilage, infiltration of many polymorphonuclear neutrophils and marked in-growth of fibrous tissue in SCT group. Sagittal, coronal diameters and cross sectional areas were affected more severely after SCT than after SDT. CONCLUSION: We found no significant risk of post-tracheostomy tracheal stenosis for the SDT in a growing animal model. Therefore, SDT might be useful in the management of pediatric patients who require short-term tracheotomy. Further study of SDT should be investigated in children in a clinical setting.
Animals* ; Cartilage ; Child ; Dilatation ; Humans ; Models, Animal* ; Neutrophils ; Rabbits ; Trachea ; Tracheal Stenosis* ; Tracheostomy* ; Tracheotomy