No abstract available.
Hyperostosis, Cortical, Congenital*

No abstract available.

No abstract available.
Spine*

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

Henoch-Sch nlein purpura is a small-vessel vasculitis characterized by palpable purpura, abdominal pain, hematuria and arthralgia. Joint involvement occurs in 2/3 of the cases and the joint symptoms are misapprehended as an orthopaedic problem because they are often severe and occurs before characteristic purpura. It has been reported that the joint symptoms can be improved without any sequelae. But, recently some authors suggest that severe joint destruction can occur when combined with rheumatoid arthritis and the patients are FILA-DR4 positive. So, the regular follow-up for joint symptoms and screening test for the risky patients having possibility for progression of arthritis are required. In order to increase the attention of the orthopaedic surgeons on this disease and study the progression of joint symptoms, possibility of development of screening test for the risky patients and the characterisitics of the disease, we analyzed the 58 patients of Henoch-Sch nlein purpura. The following results were obtained. Among 58 patients 34 cases were male and 25 cases were female, 5 to 10-year-old children were affected more frequently and the disease occurs frequently in spring and winter season. Joint symptoms developed in 22/58 patients(37.9%) and occurs before characteristic purpura in 5/22 patients(22.7%) among the joint symptom-developed patients. Knee and ankle were affected in most patients and the inflammatory signs such as high fever, leukocytosis and elevated ESR were accompanied with joint symptom, so it resembled the symptoms and signs of pyogenic arthritis. Most of the patients recovered without remaining sequelae but 9 patients(15.5%) among joint symptom-developed patients complained repeated attacks of arthralgia. The HLA B27 were all positive in those patients. So, it was assumed that the joint symptom in Henoch-Sch nlein purpura has a correlation with genetic environment and through the broad prospective study, the HLA typing can be a screening test for the risky group prone to suffer from repeated attack or aggravation of arthritis.
Abdominal Pain ; Ankle ; Arthralgia ; Arthritis ; Arthritis, Rheumatoid ; Child ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Histocompatibility Testing ; Humans ; Joints* ; Knee ; Leukocytosis ; Male ; Mass Screening ; Purpura* ; Seasons ; Vasculitis

No abstract available.
Thyrotropin*

STUDY DESIGN: A retrospective study OBJECTIVES: To evaluate postoperative muscle damage after microendoscopic discectomy (MED) and open discectomy (OD), using analysis of serum creatine phosphokinase (CPK) levels. SUMMARY OF LITERATURE REVIEW: Paravertebral muscle damage after retraction during posterior lumbar surgery can cause postoperative back pain. Serum CPK level is elevated in these patients and may indicate postoperative muscle damage. MATERIALS AND METHODS: We examined 35 cases with MED (group 1) and 11 cases with OD (group 2). Serum CPK levels were checked preoperatively and postoperatively at day 1 and day 3. We analyzed intra-group and inter-group differences in CPK levels according to sex, age, and operation time. Surgical outcomes were evaluated with a visual analog scale (VAS) preoperatively and 1 year postoperatively. RESULTS: CPK levels at postoperative 1 day were increased significantly and decreased significantly at postoperative 3 day in both groups (p<0.05), with levels in group 1 significantly lower than in group 2 (p<0.05). There were no differences in CPK levels according to sex, age, or operation time, except between the 3rd and 5th decades of age at postoperative 1 day in group 2. VAS was significantly different in intra-group analysis (p<0.05) with no significant differences in intergroup analysis. CONCLUSIONS: MED induced a lower increase in serum CPK than OD with similar VAS outcomes. MED results in less postoperative muscle damage than OD, with similar surgical outcomes.
Back Pain ; Creatine Kinase* ; Creatine* ; Diskectomy* ; Humans ; Retrospective Studies ; Visual Analog Scale

PURPOSE: Bipolar hemiarthroplasty of the hip has been used as a treatment modality for displaced femoral neck and intertrochanteric fractures in elderly patients, inflammatory and degenerative diseases of the hip, osteonecrosis of femoral head and limb salvage procedure after tumor resection. Because of the intrinsic stability of the biarticular structure, it is also used for treatment of recurrent dislocation after total hip replacement arthroplasty. However, despite its intrinsic stability, dislocation does occur even after bipolar hemiarthroplasty, and poor prognosis after the dislocation has been reported. So, we tried to investigate the incidence, risk factors, treatment and preventive methods of dislocation after bipolar hemiarthroplasty. MATERIALS AND METHODS: We reviewed 138 patients and 138 bipolar hemiarthroplasties retrospectively to analyze the incidence, timing, risk factors, treatment and preventive methods of the dislocation. RESULTS: The incidence of dislocation was 5.8% (8/138). Female gender, intertrochanteric fracture, pre-existing neuromuscular disorders including cerebrovascular accident, long period of pre-operative and postoperative immobilization were statistically significant (P<0.05) as a risk factor. Related muscular weakness was the most significant predisposing factor for dislocation. CONCLUSIONS: In order to prevent dislocation after bipolar hemiarthroplasty performed in the patients with above risk factors, we must try and encourage early operation, early ambulation, muscle strengthening exercise and application of abduction hip brace.
Aged ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Braces ; Causality ; Dislocations* ; Early Ambulation ; Female ; Femur Neck ; Head ; Hemiarthroplasty* ; Hip Fractures ; Hip* ; Humans ; Immobilization ; Incidence ; Limb Salvage ; Muscle Weakness ; Osteonecrosis ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke

No abstract available.
Adenylyl Cyclases* ; Graves Disease* ; Humans ; Thyroid Gland*

BACKGROUND: Reperfusion of ischemic myocardium is clinically encountered during thrombolytic therapy of acute myocardial infarction, percutaneous transluminal coronary angioplasty(PTCA), and coronary artery bypass graft(CABG). Reperfusion results in endothelial dysfunction characterized by a reduced release of endothelium-derived relaxing factor(EDRF) in animal studies. Studies with experimental animals have emphasized the role of oxygen free radicals and lipid peroxidation in pathophysiology of reperfusion injury and myocardial stunning. The object of this study is to determine whether endothelial dysfunction was developed after open heart surgery and to evaluated the role of oxygen free radical and lipid peroxidation in reperfusion injury. METHODS: The study group was comprised 13 patients who underwent open heart surgery(male/female : 2/11, mean age : 43+/-4 year, Atrial septal defect in 4, Ventricular septal defect in 1, Mitral regurgitation in 2, Tetralogy of Fallot in 1, and Aortic stenosis and Regurgitation with Mitral stenosis in 5 patients). The endothelial function was evaluated with the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the continous infusion of acetylcholin, from 10(-9) to 10(-6) molar concentration to the coronary artery and intracoronary injection of 200microg nitroglycerin after acetylcholine infusion. The infusion study was performed before and 10 days after surgery. For analysis of the role of oxygen free radical and lipid peroxidation in reperfusion injury, blood samples for malondialdehyde and neutrophil respiratory burst test(hydrogen peroxide amount of neutrophils) were obtained in pre-declamping of aorta and 5 min, 10 min, and 20 min after declamping of aorta from coronary sinus. RESULTS: 1) The vasoconstrictor response to acetylcholine, 10(-9) to 10(-6)M concentration, at proximal and distal left anterior descending coronary artery, were increased significantly in post-operation infusion study but there was no singnificant difference in vasodilator response to nitroglycerin. 2) The mean absorbance value of malondialdehyde(MDA) in pre-declamping and 5min, 10min, and 20min after reperfusion were 96+/-12, 73+/-12, 89+/-11 and 77+/-12, respectively. There was no significant difference in plasma MDA level and hydrogen peroxide amount of neutrophils after reperfusion(aortic declamping). CONCLUSION: These data suggest that endothelium dependent vascular relaxation is impaired in patients with open heart surgery and post-ischemic reperfusion injury may be responsible for the abnormal response. But we did not determine the role of lipid peroxidation and oxygen free radical in reperfusion injury.
Acetylcholine ; Animals ; Aorta ; Aortic Valve Stenosis ; Coronary Artery Bypass ; Coronary Sinus ; Coronary Vessels ; Endothelium ; Free Radicals ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hydrogen Peroxide ; Lipid Peroxidation* ; Malondialdehyde ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Molar ; Myocardial Infarction ; Myocardial Stunning ; Myocardium ; Neutrophils ; Nitroglycerin ; Oxygen* ; Plasma ; Relaxation ; Reperfusion Injury* ; Reperfusion* ; Respiratory Burst ; Tetralogy of Fallot ; Thoracic Surgery* ; Thrombolytic Therapy