Vertebral pedicle screws have been widely used for secure posterior spinal fixation. When postoperative CT scan films were made, the blurring of pedicle screws were observed and we could not figure nut the exact diameter of screw and canal encroachment. There is no information in the difference hetween actual diameter and measured diameter of pedcile screws in CT yet. In this study, we try to find out partial voiume averaging artifact of pedicle screws made of stainless steel and titanium. Partial volume averaging artifact occurs when the shape of an object changes within the thickness of the CT slice or when a relatively small object is only partially included within the slice. Four pig cadaveric spinal column including 6 vertebrae each were prepared and CT scans were performed after insertion of C-D screws(stainless steel) to the left and TSRH screws(titanium) to the right pedicle. Another CT scans were performed after insertion of C-D screws to the right and TSRH screws to the left pedicle. The third CT scans were made after removal of all the pedicle screws. Actual C-D screw diameter was 6mm and CT scanned diameter was 8. I 6+/-0.66mm. Actual TSRH diameter was 6.5 mm and CT scanned diameter was 6.59+/-0.34mm. In conclusion, stainless steel has more partial volume averaging artifact than titanium. Safety margin of pedicle screw made of stainless steel is about 2mm and that of titanium is about 1 mm.
Artifacts ; Cadaver ; Nuts ; Spine ; Stainless Steel* ; Titanium* ; Tomography, X-Ray Computed*

We Studied 48 patients(62 hips) who were performed hip arthroplasties at the Department of Orthopaedic Surgery, Soonchunhyang University hospital from February 1990 to August 1992. The purpose of the present study was to compare canal filling ratio and clinical results of cases treated by cementless femoral stem with 19 Harris Galante(straight stem), 23 Anatomic(curved stem) and 20 Multilock (straight stem). The follow-up periods ranged from 12 months to 36 months. We assessed canal filling at metaphysis, mid-stem and distal canal, and clinical results according to canal filling. The results were as follows ; 1. The average filling ratio of the medullary canal by each type of stem in the coronal plane were as follows. Harris Galante ; 80. 5%, Anatomic ; 79. 4%, Multilock; 79. 8% in metaphysis. Harris Galante ; 88. 7%, Anatomic ; 88. 3%, Multilock ; 87. 3% in mid-stem. Harris Galante ; 95. 1%, Anatomic 90. 2%, Multilock ; 94. 5% in distal canal. At distal canal, the average canal filling of Harris Galante and Multilock were more excellent than Anatomic in coronal plane. 2. The average filling ratio of the medullary canal by each type of stem in the saggital plane were as follows. Harris Galante ; 64. 0%, Anatomic 69. 6%, Multilock ; 68. 6% in metaphysis. Harris Galante ; 79. 6%, Anatomic; 84. 5%, Multilock; 80. 2 in mid-stem. Harris Galante ; 78. 3%, Anatomic ; 82. 6%, Multilock ; 84. 5% in distal canal. At mid-stem, the average canal filling of Anatomic was more excellent than Multilock and Harris Galante. At metaphysis and distal canal, the average canal filling of Anatomic and Multilock were more excellent than Harris Galante in saggital plane. 3. The average Harris's hip scores of each type of stem at the final follow-up was 89. 9 in Harris Galante, 90. 3 in Anatomic and 91. 9 points in Multilock. There was no significance statistically(p>0.05). 4. The correlation between the average canal filling and thigh pain was not statistically significant (p>0. 05).
Arthroplasty ; Follow-Up Studies ; Hip ; Thigh

BACKGROUND: Survivors of childhood cancers are recommended to receive revaccinations after chemotherapy, although the universally recommended vaccination schedule for such children has not been established. We evaluated immune response following post-chemotherapy vaccinations in childhood cancer survivors.METHODS: The study included 59 patients who survived at least 5 years after completion of chemotherapy without evidence of recurrence. The patients received hepatitis-B virus (HBV) and measles, mumps, and rubella (MMR) vaccines 1 year after finishing chemotherapy according to our institutional protocol. Immune response to HBV and MMR vaccines was measured and seropositivity and factors hindering immune response to HBV and MMR vaccines were analyzed.RESULTS: The seropositivity for HBV was 88%; with a higher rate in patients with non-hematologic malignancies (100%, 18/18) than those with hematologic malignancies (78.3%, 18/23) (P=0.05) and reciprocally associated with the duration of chemotherapy (P=0.0043). The seropositivity for MMR viruses was 61%, 37% and 83% respectively, showing significantly lower response to mumps and was not different between hematologic malignancy group and non-hematologic malignancy group. Unlike HBV, the duration of chemotherapy did not affect seropositivity for MMR viruses. Ten children who failed to be immune to any of the MMR viruses received booster vaccination which resulted in seropositivity of 60% (3/5), 56% (4/9), 100% (2/2) respectively.CONCLUSION: Longer duration of chemotherapy and underlying hematologic malignancies were adversely associated with achieving immune response to HBV vaccine, but not to MMR vaccine. Our results also underline the need for booster vaccinations in non-responders to vaccinations post-chemotherapy.
Appointments and Schedules ; Child ; Drug Therapy ; Hematologic Neoplasms ; Hepatitis B virus ; Humans ; Immunization, Secondary ; Measles ; Measles-Mumps-Rubella Vaccine ; Mumps ; Recurrence ; Rubella ; Survivors ; Vaccination ; Vaccines

Lipoma Arborescens is rarely encountered in hip joint. This term was first used by Mueller in 1838, to describe a fatty trmor of the knee which presented branched villous-like projection. The etiology is unknown, Suggests its probable reationship to tuberculosis, rheumatoid arthitis, trauma, chronic inflammation, diabetes mellitus and degenerative arthritis. It frequently involves knee joint, hand, wrist, foot, ankle, tendon sheath and hip joint. It usually presents bilaterally. Their nonspecific symptoms and signs are mild pain, joint swelling with minimum effusion, festriction of joint motion, redness, local heating and crepitus. We experienced a case of lipoma arborescens of hip joint, which was treated by synovectomy with excision of lesion.
Ankle ; Arthralgia ; Diabetes Mellitus ; Foot ; Hand ; Heating ; Hip Joint ; Hip ; Hot Temperature ; Inflammation ; Joints ; Knee ; Knee Joint ; Lipoma ; Osteoarthritis ; Tendons ; Tuberculosis ; Wrist

OBJECTIVE: This study was carried out to help the comprehensive rehabilitation of cervical cord injuries by measuring propulsion force and endurance on their wheelchair hand- rims, predicting the differences between neurological levels and analysing the factors which contributed to maintain the wheelchair propulsion force. METHOD: The BTE work simulator was used on 17 cervical cord injuries to test the force and endurance during wheel chair propulsion. The 141 large wheel of BTE work simulator and standard wheelchair which was removed handrims was used for simulating wheelchair propulsion. Wilcoxon rank sum test was used to compare force and endurance among the groups. RESULTS: The wheelchair propulsion force and endurance showed significant differences between neurological levels and types of the life style. The lower the level, the higher the strength and endurance (p<0.001). The wheelchair propulsion force of cervical cord injuries showed statistically significant differences between those with and without jobs (p<0.05). The outdoor wheelchair users and wheelchair propulsion exercise group showed significantly high maximum isometric strengths compared to the indoor users and the only ROM exercise group, respectively (p<0.05). CONCLUSION: During the rehabilitation period cervical cord injured persons need the wheelchair propulsion exercise using BTE work simulator to improve the quality of life.
Humans ; Life Style ; Quality of Life ; Rehabilitation ; Wheelchairs*

In spinal cord injury, various options exist for the management of the neurogenic bladder. For the management of neurogenic bladder, urethral stent was placed under a cystoscopic guidance as one day procedure. Urethral stents were inserted in a T12 spinal cord injured patient who had recurrent urinary tract infections and a vesicoureteral reflux (VUR) and a T3 spinal cord injured patient who had a detrusor-sphincter dyssynergia. In the first case, recurrent urinary tract infection and VUR were resolved after the stenting. In the second case, urethral stent was removed because of the failure of continuous drainage. Because of its easily reversible nature, the urethral stent can be adopted for use in pateints as an option of neurogenic bladder management.
Ataxia ; Drainage ; Humans ; Spinal Cord Injuries* ; Spinal Cord* ; Stents* ; Urinary Bladder, Neurogenic* ; Urinary Tract Infections ; Vesico-Ureteral Reflux

STUDY DESIGN: The authors retrospectively analysed the recovery of clinical symptoms after surgical treatment of lumbar HIVD. OBJECTIVES: To investigate the incidence of clinical symptoms, the recovery rate and time after surgical treatment and the difference between L4-5 and L5-S1 lesion. SUMMARY OF LITERATURE REVIEW: There are many reports concerning the clinical result of surgical treatment for the HIVD. They usually describe the result as excellent, good, fair and poor. We can't get any information about the recovery rate and recovery time of each clinical symptom from the reports . MATERIALS AND METHODS: Thirty-eight patients were treated by one level open discectomy from march 1991 to december 1995, The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocol. RESULTS: In preoperative examination, SLR was positive in 82%, motor deficit in 76%, sensory deficit in 74%, DTR change in 50%, and radiating pain in 100%. The recovery rate of SLR was 96.8%, motor deficit ; 93.6%, sensory deficit ,78.6%, DTR change ; 21% and radiating pain ,84.2%. The average recovery time of SLR was 3.4 months, motor deficit ; 1.9 months, sensory deficit ; 5.3 months, DTR change ; 4.1 months and radiating pain ; 3.2 months. Motor and sensory deficit was more frequent in L4-5 lesion but DTR change was usually noted in L5-S1 lesion. The recovery rate and time showed no great difference between the two level. CONCLUSIONS: The recovery rate was higher in SLR, motor deficit and radiating pain rather than sensory deficit and DTR change. The recovery time was fastest in radiating pain but variable nature was noted in sensory deficit. Above results may be helpful to explain the prognosis of the lumbar HIVD.
Diskectomy ; Humans ; Incidence ; Prognosis ; Retrospective Studies

The purpose of this study was to investigate the psychological characteristics of mothers of children with disabilities. This study was performed under the hypotheses that, at the initial diagnosis of the children's disabilities, (1) the mothers suffered from serious psychological distress; (2) the more severe the child's disability was, the more serious the mother's psychological distress was; and that (3) the mother's psychological distress might be resolved within 8 weeks of rehabilitational interventions. The results were as follows: 1) mothers of children with disabilities showed significant (p<0.05) somatization, depression, anxiety, hostility, and phobic anxiety more so than the control group; 2) there was no significant difference in T scores of 9 dimensions of the Symptom Checklist-90-Revision (SCL-90-R) of the mothers at the initial diagnosis of children's disabilities according to severity of child's disability; 3) there was no significant difference in T scores of 9 dimensions of SCL-90-R in mothers of children with disabilities between at initial evaluation and after 8 weeks of rehabilitational interventions. In conclusion, : 1) mothers of children with disabilities suffered from serious psychological distress at the initial diagnosis of their child's disability; 2) the severity of the child's disability had little influence on the degree of the mother's initial psychological distress; 3) this distress did not resolve with only 8 weeks of rehabilitational interventions. Therefore, effective rehabilitational programs should provide sufficient opportunities for repeated follow-up interviews which offer not only adequate information on the children's disabilities but also psychological support for the mothers.
Adult ; Affective Symptoms/etiology/psychology ; *Child ; Child, Preschool ; Developmental Disabilities/diagnosis/rehabilitation ; *Disabled Persons/rehabilitation ; Female ; Human ; Infant ; Male ; Mothers/*psychology ; Time Factors

In the treatment of meniscal injury of the knee joint, it has been known that the result of partial meniscectomy to prevent degenerative change of the knee joint after meniscectomy. However the result of lateral discoid meniscectomy is controversial between partial and total meniscectomy. In the treatment of lateral discoid meniscal injury, Fujikawa and Dickhaut reported the better results with partial meniscectomy than total resection, but Ikeuchi and Kobayashi reported the better results with total meniscectomy. The purpose of this paper is to compare the results of arthroscopic partial and total meniscectomy. Five hundred ninety-five patients with meniscal injury was treated by meniscectomy between January, 1983 and December, 1994 at the department of orthopaedic surgery, Soonchunhyang Univ. Hospital. 119 patients of all were done lateral discoid meniscectomy had no other combined findings. Wr wrre able to follow up 42 patients(44 cases) of 84 patients with interview and/or questionnaire. WR analysed the 44 cases and summarized the results as follow: 1) A discoid lateral meniscus was presented in 20.0% of all meniscal resection. 2) Postoperative click sound was presented in 7 cases of 25 cases(28.0%) with partial meniscectomy and in 5 cases of 19 cases(26.3%) with total meniscectomy. Giving way was presented in 2 cases(8.0%), 1 case(5.3%) and Locking in 1 case(4.0%), 0case(0.0%) respectively. 3) In the post operative. Pain, no pain and mild pain were presented in 88.0% of partial meniscectomy and in 94.8% of total meniscectomy. 4) In the degree of activity level, “same before symptoms was developed(no symptom)”. was presented in 84.0% of partial meniscectomy and in 84.2% of total meniscectomy. 5) In the return to work, all patients returned to original job with/without limitation. 6) In the knee rating scale of Ikeuch, excellent or good was presented 72.0% of partial meniscectomy and in 89.5% of total meniscectomy. 7) Roentgenologic degenerative changes were more presented after total than partial meniscectomy. We concluded that the total meniscectomy is better than the partial meniscectomy in the symptom and functional results, but long term follow up secondary degenerative change must be followed.
Arthroscopes ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Menisci, Tibial ; Return to Work

The importance of neuropathy in the pathogenesis of foot lesions has been well recognized in diabetes. Blood flow in ischemic limbs has been extensively investigated but the circulation of limbs affected by peripheral neu ropathy has received little attention. Some studies on blood flow in peripheral neuropathy have shown a remarkable increase in resting flow, transcutaneous venous oxygen tension, and vascularity, along with loss of the spontaneous variations which occur normally with sympathetic activity of the foot in patients with diabetes. The aim of present study is to find out the effects of somatic and autonomic nervous function in early change of blood flow of foot in diabetic patients, We have studied fifty-one patients of non-insulin-dependent(type II) diabetes with no history of hypertension of diabetic foot ulcers. The evidence of neuropathy was screened by nerve conduction studies and sympathetic skin response of both lower extremities. Blood flow of dorsalis pedls and posterior tibial arteries was measured by portable doppler machine and presented as pressure index(ankle-to-arm systolic pressure ratio). The patients with sympathetic dysfunction showed significant decrease in pressure index compared to normal control and diabetic patients with normal sympathetic function, suggesting that changes of the blood flow occur in diabetic patients with sympathetic dysfunction.
Blood Pressure ; Diabetic Foot ; Extremities ; Foot* ; Hemodynamics* ; Humans ; Hypertension ; Lower Extremity ; Neural Conduction ; Oxygen ; Peripheral Nervous System Diseases ; Skin ; Tibial Arteries ; Ulcer