No abstract available.
Arthritis, Rheumatoid* ; Elbow Prosthesis* ; Elbow*

The authors carriod out lumbodorsal fasciotomy on six cases of paralytic scoliosis with pelvic obliquity. In our experience, in those older children and adolescents with paralysis in whom scoliotic curve is not severe and is more or less static, correction and maintenance of the correction can be achieved by lumbodorsal fasciotomy without resorting to spine fusion. While it is a common practice to leave a mild and static curve uncorrected, even a mild degree of scoliosis, when associated with pelvic obliquity, abduction contracture of the hip, instability of the other hip and leg length discrepancy, is a major problem in paralytic patients. Initial results indicate that lumbodorsal fasciotomy, combined with contralateral Soutters or Campbells fasciotomy if necessary, is a simple and effective method in correcting these deformities and restoring balance and function.
Adolescent ; Child ; Congenital Abnormalities ; Contracture ; Health Resorts ; Hip ; Humans ; Leg ; Methods ; Paralysis ; Scoliosis ; Spine

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*

Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered failure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is successful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical insurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician preferred pros and 17.7 percent cons ,but 38 percent of practicing pharmacist preferred pros and 45.5 percent cons. And pharmacist know better the content of functional division between physician and pharmacist, practicing emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist preferred generic name (44.0%, 89%) mostly, but physician preferred brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the governmental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the government should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.
Commerce ; Daegu* ; Surveys and Questionnaires ; Humans ; Insurance ; Pharmacists* ; Pharmacy ; Postal Service ; Prescriptions ; Surveys and Questionnaires ; Socioeconomic Factors

Bone materials diggd up from the Haemi nameless martyrdom holy place burial sites were severely broken into fragments of various size, clay matrix filled the bone marrow cavities, grass roots were spreaded into the periosteum and the fragments were very soft enough to be flaken. To make permanent specimens, bony fragments impregnated within unsaturated polyester resin with catalyzer MEKP, promotor 8% cobalt octoate, and UV absorber. Permanent specimens were so very transparent that all the macroscopic structures can be observed, and they were hard enough not to be broken or cracked. This method of preserving bony fragments is considered to be used in archaeologic preservation and in making teaching materials of various human organs or tissues.
Bone Marrow ; Burial* ; Cobalt ; Humans ; Methods ; Periosteum ; Poaceae ; Polyesters ; Teaching Materials

PURPOSE: This study was performed in order to investigate the effects of various particle preparations on NF-kappaB and c-Jun/AP-1 activity in osteoclast precursor cells. MATERIALS AND METHODS: Osteoclast precursor cells isolated from C57BL mice were treated with PMMA (polymethylmethacrylate) spheres, polystyrene, titanium particles, and retrieved metal particles from failed cementless total hip replacements. NF-kappaB and c-Jun/AP-1 DNA binding activities were analyzed using electrophoretic mobility shift assays (EMSA). RESULTS: Commercially available PMMA and polystyrene spheres routinely showed negativity on endotoxin assays, but titanium particles and retrieved metal particles consistently showed positivity. PMMA spheres, with a maximal response noted at 30 minutes with an optimal concentration of 0.6 mg/ml, were potent stimulator of NF-kappaB and c-Jun/AP-1 activity in osteoclast precursor cells. Other particles (polystyrene, titanium, metal retrievals) also activated transcription factor NF-kappaB and c-Jun/AP-1 compared to controls. Endotoxin removal from retrieved metal particles diminished the biologic effect by approximately 40%. CONCLUSION: Particles of various compositions and sizes (PMMA, polystyrene, titanium, and retrieved metal particles) activated the NF-kappaB and c-Jun/AP-1 signaling pathways. This suggests that NF-kappaB and c-Jun/AP-1 may have important roles in the pathogenesis of periprosthetic osteolysis.
Animals ; Arthroplasty, Replacement, Hip ; DNA ; Electrophoretic Mobility Shift Assay ; Mice ; Mice, Inbred C57BL ; NF-kappa B ; Osteoclasts ; Osteolysis ; Polymethyl Methacrylate ; Polystyrenes ; Titanium ; Transcription Factors

BACKGROUND AND OBJECTIVES: Even short-term treatment with angiotensin converting enzyme inhibitor in essential hypertension has been known to improve left ventricular (LV) diastolic function, LV hypertrophy (LVH), and aortic stiffness. The purpose of this study was to examine the effects of angiotensin II receptor antagonist (Losartan) on LV diastolic function, LVH, and aortic stiffness in essential hypertension. MATERIALS AND METHODS: Twenty-three hypertensive patients who were aged over 50 years, previously untreated, and without cardiac, renal, neurologic disease, or diabetes, were studied. Before and 12 weeks after monotherapy with Losartan 50 mg q.d., (1) supine arterial blood pressure by sphygmomanometry, (2) interventricular septum and LV posterior wall thickness, and LV end-diastolic dimension by M-mode echocardiography, (3) mitral peak E and A wave velocity by doppler echocardiography, (4) pulse wave velocity (PWV) in the descending aorta from aortic arch to the bifurcation by doppler echocardiography, were done. RESULTS: Twelve weeks after treatment, systolic blood pressure was lowered from 168.2+/-3.5 mmHg to 142.9+/-2.9 mmHg (p<0.05), diastolic blood pressure from 98.52.4 mmHg to 87.51.3 mmHg (p<0.05). Peak E/A ratio was increased from 0.75+/-0.04 to 0.82+/-0.04 (p<0.05). LV mass was decreased from 267.5+/-15.8 g to 235.6+/-12.6 g (p<0.05), and LV mass index from 166.8+/-8.0 g/m2 to 146.9+/-6.0 g/m2 (p<0.05). However, there were no significant change in PWV (from 7.18+/-0.10 m/sec to 7.23+/-0.30 m/sec, p>0.05), compliance (from 1.31+/-0.04 to 1.34+/-0.12, p>0.05), and compliance index (from 0.16+/-0.01 to 0.15+/-0.01, p>0.05). CONCLUSION: Short-term treatment with Losartan decreases blood pressure, improves LV diastolic function and LVH, but not aortic stiffness.
Angiotensin II* ; Angiotensins* ; Aorta, Thoracic ; Arterial Pressure ; Blood Pressure ; Compliance ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension ; Hypertrophy ; Losartan* ; Peptidyl-Dipeptidase A ; Pulse Wave Analysis ; Receptors, Angiotensin ; Vascular Stiffness* ; Ventricular Function, Left*

PURPOSE: A composite of aluminum and vanadium (Ti-6Al-4V) is one of the most common compositions of titanium-based alloys. Unfortunately, vanadium has been found to cause adverse reactions. We evaluated the effects of vanadium containing titanium alloy (Ti-6Al-4V) on an osteoblast-like cell line (SaOS-2). MATERIALS AND METHODS: We studied the biologic and morphologic responses of SaOS-2 cell to Ti alloy with grit blasting and Ti coated Ti alloy with grit blasting. We performed energy-dispersive x-ray spectroscopy (EDS) and scanning electron microscopy (SEM) investigations and performed a cell proliferation assay, ALP activity, and cell migration assay of SaOS-2 cells. RESULTS: The morphologic assessment of cells through SEM showed that the two surfaces were covered with similar amounts of small slender osteoblast like cells. The amount of proliferation, ALP activity and the migration extent of SaOS-2 cells on the surfaces of each group were not statistically different. CONCLUSION: We used a grit-blasted Ti-coated Ti alloy, coated using electron beam deposition, and a grit-blasted Ti alloy to evaluate the toxicity of Ti-6Al-4V on SaOS-2 cell. Compared with pure titanium, the vanadium-containing Ti-alloy did not show an adverse effect on SaOS-2 cells.
Alloys ; Aluminum ; Cell Line ; Cell Migration Assays ; Cell Proliferation ; Electrons ; Microscopy, Electron, Scanning ; Osteoblasts ; Spectrum Analysis ; Titanium ; Vanadium

Hydroxyapatite particle(HA) impregnated polymethylmethacrylate(PMMA) bone cement was fabricated in order to induce bony tissue ingrowth into the pores left behind by the resorption of the HA. The amount of HA was 0, 10, and 30% by weight. After mixing the HA with bone cement it was cast in a 4mm inside diameter glass under(10mm long). Each specimen was cut into half and used for in vitro and in vivo experiment. Diametral and compressive mechanical test were made to evaluate it's mechanical properties. SEM(scanning electron microscope) and ESCA(electron spectroscopy for chemical analysis) were used to evaluate the surface characteristics of the specimen. Push-out test and histologic studies were made after implanting the specimens for 6 weeks in the distal portion of rabbit femur. The mechanical test results show that the average flexural and diametral strength decreased linearly with the increased amount of HA significant(p < 0.05). The SEM and qualitative analysis using ESCA of the implant specimens showed no definite exposure of HA particles due to PMMA covering the surface. The surface of the implanted specimens were ground for histologic comparative analysis and the halves of each sample were decalcified. The interfacial shear strength of the implanted specimens showed significant increases in the 30% HA specimens compared with the 0% ones but the 10% specimens did not show any difference. However, there was also no statistically significant(p>0.05) difference between nondecalcified and decalcified specimens in each 10% and 30%, although the latter showed higher interfacial shear strength. Histologic observation showed little evidence of bone ingrowth into HA, but not remarkable. In conclusion, this study could not confirm the earlier results of the bone particle impregnated bone cement without surface grinding since the HA particles were not exposed at the surface by casting it into a glass tube.
Durapatite ; Femur ; Glass ; In Vitro Techniques ; Polymethyl Methacrylate ; Shear Strength ; Spectrum Analysis

The Ewing's sarcoma comprises approximately less than 10 percent of malignant bone tumors and 5 percent of allbone tumors, occures in almost all bones of the body, and presents a widely divergent roentgenographicmanifestations. The tarsal bones are involved only 2 percent in the Ewing's sarcoma. Two cases experienced byauthors and ten cases published in literatures of Ewing's sarcoma of the tarsal bone were analizedretrospectively. The result were as follows; 1. Of tarsal bones, the calcaneus was 7 cases, the talus 4 cases,cuneiform 1 case. 2. Female was affected more commonly than male, the ratio being 4 to 1 in the tarsal bones. 3.About sixty percent of total case in the tarsal bones had evidence of diffuse sclerotic pattern. All the cases ofthe talus had evidence of diffuse sclerotic pattern. 4. The diseases to be considered in differential diagnosisare as follows: avascular necrosis, tuberculous osteomyelitis, osteosarcoma, and pyogenic osteomyelitis. 5. Thediffuse sclerosis radiographically showed a close relation with dead bone resulting from avascular necrosis due totumor infiltration histologically. Periosteal reactive new bone and osteoid deposition on the dead bone were alsocorrelated with diffuse sclerosis. 6. Because it is difficult to differentiate sclerotic lesions in the tarsalbones by radiographic methods alone, all such lesions should be subject to biopsy as early as possible.
Biopsy ; Calcaneus ; Female ; Humans ; Male ; Necrosis ; Osteomyelitis ; Osteosarcoma ; Sarcoma, Ewing ; Sclerosis ; Talus ; Tarsal Bones