The main goals of surgical teatment of thoracolumbar vertebral fractures are to achieve reduction, stability and early, painless mobilization. A further aim is to avoid late malposition and to preserve mobility and lordosis. The main disadvantage of Harrington instrumentation and similar methods are that this device fixate five to seven vertebrae. The Cotrel-Dubousset(C-D) instrumentation provides a stable construct for fixation of spine fracture. The advantages of C-D pedicle screw for thoracolumbar spinal fractures are that compression or distraction force can be applied in the same rod and used to achieve anatomical reduction of spinal fractures and rigid fixation can be obtained with short instrumentation. The C-D instumentation was done for 15 unstable thoracolumbar spinal fractures at Seoul Red Cross Hospital from January, 1988 to January, 1990. The results were as follows. 1. The most common cause of the spine fracture was fall down, and majority are within 20-40 old age. 2. The most common involved site was T12 and Ll vertebrae (66.7%). 3. The most common type of injury was burst fracture by according to Denis classification(60%). 4. The complication was developed mostly in neurological deficient patient. 5. The advantage of the C-D instrumentation: (1) rigid and short osteosynthesis of spine fracture, (2) compression or distraction force can be applied in the same rod, (3) early mobilization with a brace is possible. 6. The rigid fixation can be obtained.
Animals ; Braces ; Early Ambulation ; Humans ; Lordosis ; Pedicle Screws ; Red Cross ; Seoul ; Spinal Fractures ; Spine

Bone remodeling is characterized by the coupling of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. The process is tightly regualted at the local level by an incompletely known netwotk of peptide and non-peptide fators. Nitric oxide(NO), synthesized by nitric oxide synthetase(NOS) from L-arginine, is becoming recognized as an important bioregualtory molecule in a variety of tissue, but little is known about its possible role in periodontal tissue. The purpose of this study is to investigate the expression of nitric oxide synthetase(NOS) in inflamed gingiva and the effects of cytokine on the expression of NOS protein. The expression of NOS in gingival tissue was evaluated by immunohistochemical staining for NOS1, NOS2, NOS3. The effect of cytokine on the expression of NOS in human periodontal ligament cells and osteoblast-like HOS cells by western blot analysis. Further, we studied that NO functions in periodontal ligment cells as a regulatory molecule. PDL cells incubated with NOS inhibitor and donor. The protein expression, type I collagen & non-collagenous protein, nitrate production and cell proliferation were evaluated The results were as follows. 1. NOS1, NOS2, NOS3 was rarely distributed in healthy gingiva, but stronger stained in gingival epithelium, endothelial cells, and mononuclear cells of inflammed gingiva. 2. The cytokine stimulated NOS1, and NOS3 protein were not inducing or inhibitory effect to compared with control in PDL and HOS cells. 3.Incubation of cells with combination of TNF-alpha, IFN-gamma, LPS result in a time dependant increase in NOS2 expression, reaching a maximal level after 24 hours of stimulation. 4. The osteonectin protein inhibitory effect of NMA, inhibitor of NOS, was reversed by Larginine in dose dependant manner. 5. NMA decreased cell proliferation and nitrate production, but the inhibitory efffect of NMA was also prevented by the NO donor, sodium nitropruiside. These results suggest that exogenously synthesized NO was playing a stimulating effect on cell proliferation or on non-collagenous protein expression. Therefore NO have an important role in mediation of localized bone destruction associated inflammatory bone disease such as periodontitis
Arginine ; Blotting, Western ; Bone Diseases ; Bone Remodeling ; Bone Resorption ; Cell Proliferation ; Collagen Type I ; Endothelial Cells ; Epithelium ; Gingiva ; Humans ; Negotiating ; Nitric Oxide Synthase* ; Nitric Oxide* ; Osteogenesis ; Osteonectin ; Periodontal Ligament ; Periodontitis ; Sensitivity and Specificity* ; Sodium ; Tissue Donors ; Tumor Necrosis Factor-alpha

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

OBJECTIVE: Over the last few years there has been growing concern about bulimia nervosa in Korea, but there was only a few clinical study, especially about outcome and predictors. CBT combined with pharmacotherapy has been recognized as the most effective short-term treatment modality, but there was nonresponders. The purpose of this paper is to examine the factors that influence treatment response and outcome in patients with bulimia nervosa. The identification of prognostic factors in bulimia nervosa will help clinicians to deliver the most appropriate type of initial treatment to patients. METHOD: The subjects were 62 patients from the outpatients of Mind & Mind psychiatric clinic, who had been previously evaluated by EDI-2 and MMPI. The sociodemographic data, disease progress, past history, family history, BMI, EDI-2 and MMPI were variables assessed. All patients received a 12-week course of CBT combined with pharmacotherapy (fluoxetine 20-60mg/d). Responders and non-responders group ware compared with each variables. Responders were defined as patients who had maximum symptom frequencies of three or less during the last 4 weeks of treatment. RESULT: Among 62 patients, responders were 32 and non-responders were 30. There was no difference in sociodemographic variables such as age, education level, job, marriage. As a result of comparing the two groups, non-responders were differentiated by their higher frequency of binge eating vomiting, history of suicide attempt, family history of psychiatric illness and use of laxatives or diuretics. And among the subscale of EDI-2, there were significant high scores in bulimia, ineffectiveness, interoceptive awareness. CONCLUSION: The findings suggest that frequency of binge eating, vomiting, history of suicide attempt, family history of psychiatric illness, and use of laxatives or diuretics could be prognostic factors in patients with bulimia nervosa.
Bulimia Nervosa* ; Bulimia* ; Diuretics ; Drug Therapy ; Education ; Humans ; Korea ; Laxatives ; Marriage ; MMPI ; Outpatients ; Suicide ; Vomiting

Separation anxiety (SA) is a serious behavioral problem in dogs. In this study, salivary cortisol was studied to determine if the owner's odor or voice could reduce SA in dogs. Twenty-eight dogs with SA were divided into three groups: group 1 (control), group 2 (with owner's clothes during the separation period; SP) and group 3 (a recording of the owner's voice was played during SP). The dog's saliva was collected after the owner and their dog were in the experimental room for 5 min (PRE). The dog was then separated from the owner for 20 min and saliva collected four times at intervals of 5 min (SP1-4). Finally, the owner was allowed back into the room to calm the dog for 5 min, after which saliva was collected (POST). Evaluation of salivary cortisol concentrations by ELISA revealed that the ratios of SP1 concentration to PRE or POST concentrations were significantly higher in group 1 than in group 2 or 3. Additionally, the concentrations of SP1-PRE and SP1-POST among groups differed significantly. These findings indicate that the owner's odor or voice may be helpful to managing stress in dogs with SA.
Acoustic Stimulation* ; Animals ; Anxiety, Separation* ; Clothing ; Dogs* ; Enzyme-Linked Immunosorbent Assay ; Hydrocortisone* ; Odors ; Physiology ; Problem Behavior ; Saliva ; Voice

A retrospective analysis was made of 20 patients with pineal region tumors who were treated at the Department of Neurosurgery, Capital Armed Forces General Hospital between May of 1987 and March of 1993. We performed ventriculo-peritoneal shunt in 17 patients with obstructive hydrocephalus. Tissue diagnosis was obtained in 7 patients before irradiation and 13 patients underwent irradiation without histological diagnosis. Among 7 biopsy-proven cases, 5 were germinoma, one was mixed germ cell tumor and another one was astrocytoma. The response to irradiation and tumor marker study revealed that 13 patients who did not have tissue diagnosis seemed to be germinomatous, non-germinomatous germ cell tumors and endodermal sinus tumor. So, the following results were obtained. 1) The patients were all young males. 2) The main presenting symptoms and signs were headache, vomiting and papilledema. 3) The tumors were mainly presented as a round well-enhancing masses with calcification. 4) Based on the classification of pineal tumor, germinoma was predominant tumor type. 5) The extrapineal metastasis was found in 5 cases(25.0%). 6) The tumor marker (alpha-FP or HCG) was positive in 5 cases(25.0%). 7) Germinoma showed excellent prognosis after the irradiation.
Arm ; Astrocytoma ; Classification ; Diagnosis ; Endodermal Sinus Tumor ; Germinoma ; Headache ; Hospitals, General ; Humans ; Hydrocephalus ; Male ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal ; Neurosurgery ; Papilledema ; Pinealoma ; Prognosis ; Radiotherapy ; Retrospective Studies ; Ventriculoperitoneal Shunt ; Vomiting

PURPOSE: To investigate the in vivo proton MR spectra of the bile of human gallbladder in its normal and diseased states and to compare the findings between the two groups. MATERIALS AND METHODS: In vivo proton MRS was performed in 88 subjects comprising 33 healthy volunteers, 41 patients with gallstone, and 14 with distal common bile duct obstruction. For this, a clinical 1.5T system with a body coil and STEAM (STimulated Echo-Acquisition Mode) was used. We analyzed the MR spectra of normal and diseased gallbladder biles and tried to categorized the findings according to the significant peaks occuring within consistent ranges of chemical shift. We also compared the spectral patterns between normal and dis-eased bile. RESULTS: Proton MRS showed four significant major peaks in normal and diseased human bile: peak 1 at 0.8 - 1.4 ppm, peak 2 at 3.2 -3.4 ppm, peak 3 at 3.9 -4.1 ppm, and peak 4 at 5.2 -5.4 ppm. In each group, peak 1 was most frequent(healthy volunteers, 91%, patients with gallstone, 100%, patients with distal common bile duct obstruction, 93%), but as compared with normal bile (peak 2, 36%, peak 3, 33%), in patients with gall-stone, peak 3 was more frequently seen (46%), and in those with distal common bile duct obstruction, peaks 2 (64%) and 3 (64%) were most frequent. According to the significant peak, each MR spectra was categorized as follows: pattern I: peak 1; pattern II: peaks 1 and 2; pattern III: peaks 1 and 3; pattern IV: peaks 1, 2, and 3; pattern V: peaks 1 and 4; pattern VI: peak 3. In normal bile, the common MR spectral patterns were I (36%), II (27%), III, IV, VI, and V, in decreasing order of frequency. In patients with gallstone, however pattern I (44%) and pattern IV (34%) predominated, while in those with distal common bile duct obstruction, pattern IV (57%) CONCLUSION: The spectra of normal and diseased gallbladder bile obtained by in vivo proton MR spectroscopy varied, with some differences in spectral patterns between both groups.
Bile ; Common Bile Duct ; Gallbladder* ; Gallstones ; Healthy Volunteers ; Humans ; Magnetic Resonance Spectroscopy* ; Protons* ; Steam ; Volunteers

Autoimmune diseases are occasionally associated with other autoimmune diseases in the same patients. Graves disease has been associated with systemic rheumatic diseases including systemic lupus erythematosus (SLE). The diagnosis of Graves disease in patients with SLE is well known, especially in adults, but few case reports have involved children and adolescents. We report a 14-year-old female who presented with Graves disease, proteinuria, arthralgia, decreased complement, and positive antinuclear antibody and who was diagnosed with SLE. Renal biopsy revealed class IV lupus glomerulonephritis. These clinical, laboratory, and histological findings indicate that class IV lupus nephritis may be associated with Graves disease. This possibility should be borne in mind when following patients with Graves disease in order to avoid any delay in the diagnosis and treatment of serious systemic autoimmune diseases such as SLE.
Adolescent ; Adult ; Antibodies, Antinuclear ; Arthralgia ; Autoimmune Diseases ; Biopsy ; Child ; Complement System Proteins ; Female ; Graves Disease ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Proteinuria ; Rheumatic Diseases

Autoimmune diseases are occasionally associated with other autoimmune diseases in the same patients. Graves disease has been associated with systemic rheumatic diseases including systemic lupus erythematosus (SLE). The diagnosis of Graves disease in patients with SLE is well known, especially in adults, but few case reports have involved children and adolescents. We report a 14-year-old female who presented with Graves disease, proteinuria, arthralgia, decreased complement, and positive antinuclear antibody and who was diagnosed with SLE. Renal biopsy revealed class IV lupus glomerulonephritis. These clinical, laboratory, and histological findings indicate that class IV lupus nephritis may be associated with Graves disease. This possibility should be borne in mind when following patients with Graves disease in order to avoid any delay in the diagnosis and treatment of serious systemic autoimmune diseases such as SLE.
Adolescent ; Adult ; Antibodies, Antinuclear ; Arthralgia ; Autoimmune Diseases ; Biopsy ; Child ; Complement System Proteins ; Female ; Graves Disease ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Proteinuria ; Rheumatic Diseases

Vertebral hemangioma is the most common benign spinal tumor. It is usually asymptomatic and extraosseous extension causing spinal cord compression with neurologic symptoms is rare. Pre-operative angiography and embolization should be done for definite diagnosis and prevention of excessive blood loss during the operation. In author's case, pre-operative angiography was done for diagnosis, but unfortunately embolization procedure was not available. We performed intra-operative vertebroplasty with polymethylmethacrylate(PMMA) for the prevention of excessive blood loss during the operation and the maintenance of postoperative stability.
Angiography ; Diagnosis ; Hemangioma* ; Neurologic Manifestations ; Spinal Cord Compression* ; Spinal Cord* ; Vertebroplasty*