In our review of 36 hematogenous osteomyelitis nine cases were subacute form. Distal tibia was the most commonly involved location(four of nine patients). According to the modified Robert's classification cross-physeal lesions were the most common type(four of nine patients). In most of the cases the clinical findings and laboratory data were not much helpful for current diagnosis. Four patients had radiographic findings similar to those of tumors such as Ewing' s sarcoma, osteoid osteoma or bone cyst. Magnetic resonance imaging was useful in the identification of early lesions. In three patients Staphylococcus aureus was isolated by bacterial culture of biopsy specimen. In the remaining six patients diagnosis was made by histological evaluation. All patients except one were treated by curettage and antibiotics. In the other patient the disease showed a tendency of spontaneous healing without operative intervention and antibiotics. Cross-physeal lesion seemed to be a typical finding of the subacute osteomyelitis.
Anti-Bacterial Agents ; Biopsy ; Bone Cysts ; Child ; Classification ; Curettage ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Osteoma, Osteoid ; Osteomyelitis ; Retrospective Studies ; Sarcoma ; Staphylococcus aureus ; Tibia

The methods of treatment of spondylolisthesis range from posterior fusion to instrumentation, and circumferential fusion. Combined anterior and posterior fusion with instrumentation had been carried out in one or two stages and satisfactory results were obtained in nighteen cases with follow-up period of one year to four years at department of orthopedic surgery of Ewha Womans University Hospital from 1987 to 1991. The results were as follows: 1. Of 19 patients, 7 patients were male and 12 patients were famale. 2. The isthmic type was 12 cases (63.1%) and the 5th lumbar vertebral involvement is common (12 cases, 63.1%). 3. The operative treatment was as follows: Posterior fusion with instrumentation was 8 cases, and anterior fusion with instrumentation was 11 cases. 4. The combined anterior and posterior fusion with instrumentation had been carried out in one stage operation at 8 cases, and two stage operation was done at 11 cases. 5. The average operation time was 3.0 hrs in one stage operation, 3.1 hrs in two stage operation, and the average amount of blood loss was 22cc/Kg in one stage, 17cc/Kg in two stage. 6. The satisfactory results were obtained in 19 cases, but there was no specific difference between one stage and two stage operation.
Female ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Spondylolisthesis

Kyphotic deformity of thoracic or lumbar spine is generally developed as a consequence of Scheuerman's kyphosis, ankylosing spondylitis, congenital kyphosis, tuberculous kyphosis, spinal tumor, senile kyphosis, trauma and extensive laminectomy etc. The method of treatment is usually conservative. However, in severe kyphosis, gross abnormaility and neurologic complications, and the compression of cardiopulmonary system are resulted and then surgery may be indicated. Since the report of spinal osteotomy by Smith-Peterson, several treatment options have been reported. Despite improved techniques for treating spinal kyphotic deformities, correction of severe and acutely angled deformities are less effective and resulting many complications. We propose the use of a new method of posterior closing spinal osteotomy for the treatment of severe and acutely angled kyphotic deformity to minimize the complications and for effective correction. We report the technique and results of this method in two cases of tuberculous kyphosis and a case of ankylosing spondylitis.
Congenital Abnormalities ; Kyphosis ; Laminectomy ; Methods ; Osteotomy ; Spine ; Spondylitis, Ankylosing

No abstract available.
Ankle Fractures* ; Ankle*

No abstract available.
Cysticercosis* ; Spine*

From retrospective review of 111 tibial fractures treated by interlocking intramedullary nailing, 38 operative errors in 28 cases(25%) were included in this study. The errors were classified into two categories. The first category included eighteen errors that related to fracture reduction; nine angular malalignments, four failures in closed nailing to open the fracture site, two peroneal nerve palsies, two shortenings of tibial length(more than 1cm), and one rotational malalignment. The second category comprised twenty errors that related to the nailing itself; eight protrusions of proximal nail tip, five overdistractions of fracture gap (more than 3mm), four additional fragmentations, two mistakes in interlocking screw insertion, and one ankle joint injury by the distal nail tip. Functional results of those 28 cases at the last follow-up(average, 17.5 months; range, 9 to 29 months) were excellent or good in only 60.8 per cent, while the control group treated by adequate operative technique showed excellent or good results in 92.8 per cent.
Ankle Joint ; Fracture Fixation, Intramedullary ; Paralysis ; Peroneal Nerve ; Retrospective Studies ; Tibial Fractures

BACKGROUND: The diagnostic significance of ECG ergonovine test and the incidence of vasospastic angina in patients with chest pain are still uncertain. METHODS: From May 1998 to June 1999, 133 consecutive patients with chest pain were admitted for diagnostic coronary angiography. ECG ergonovine provocation tests were performed in 64 patients who have a clinical history suggesting vasospatic angina, including 27 of 28 patients with vasospastic angina documented electrocardiographically, or who's coronary angiographic findings could not be explained by their clinical history. Ergonovine was administered intravenously in incremental dose of 0.05, 0.1, 0.2, 0.3, 0.4 mg up to total cumulative dosage of 1.0mg during coronary angiography(41 cases), in the exercise laboratory(21 cases) or both(2 cases). RESULTS: Of 133 patients with chest pain, vasospastic angina was documented in 32(24%), unstable angina in 52(34%), stable angina in 10(8%), and others in 39(29%). Angiography demonstrated coronary spasm in 4 additional patients as well as 22 patients with vasospastic angina documented electrocardiographically, but ergonovine tests in the exercise laboratory showed positive response in 5 of 6 patients with vasospastic angina documented. Among the 25 patients with coronary spasm proved angiographically during ergonovine test, ECG findings at the time of coronary spasm were ST segment elevation in 21(84%), depression in 1(4%) and no change in 3(12%) patients, who had branch vessel spasm, 3 vessel spasm or incomplete spasm on coronary angiogram. Of the 31 patients with vasospastic angina who underwent ergonovine tests, positive response occurred in 24(77%) after a cumulative dose of < or = 0.4mg and in additional 3(10%) after the higher dose of >0.4mg. However the other 4(13%) had no ECG changes even after the higher dose(>0.4mg) of ergonovine. CONCLUSION: This results suggest that vasospastic angina appear to be a common cause of chest pain, and ECG ergonovine test with high dose can improve diagnostic sensitivity but cannot detect some patients with vasospastic angina.
Angina, Stable ; Angina, Unstable ; Angiography ; Chest Pain ; Coronary Angiography ; Depression ; Electrocardiography* ; Ergonovine* ; Humans ; Incidence ; Spasm

PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*

STATEMENT OF PROBLEM: A tenderness of the dentin after tapering of teeth for dental prosthesis is a common phenomenon. In practice, the alternative desensitizer may be used for minor pain after tapering of teeth. PURPOSE: In this study, the desensitizers were used to investigate the affect decreasing of shear bond strength according to the use of various cement, such as resin, Glass Ionomer, and phosphate cement. MATERIAL AND METHOD: Three different desensitizers were used on this study. Compositions of two dentin desensitizers were HEMA(hydroxyethylmethacrylate) and glutaraldehyde. The other one is oxalic acid. Three dentin desensitizers applied on 12 degrees taper teeth. Then, Ni-Cr crowns were bonded with Resin cement, Zinc Phosphate (ZPC) cement and Glass Ionomer (GIC) cement. 120 human premolar teeth were used for specimens. The specimens were divided into four group as the reference and the empirical each with thirty specimens, then further divided into 12 group according to type of desensitizers and cement types. The shear bond strength were measured by Instron multi task instrument. RESULTS: According to the result, the measured shear bond strength in order from the weakest to the strongest in general was ZPC, Resin, and GIC. And it is found that the application of desensitizers on dentin surface does not affect the shear bond strength. CONCLUSION: Dentin desensitizers that alleviate or prevent a dentin tenderness, usually contains HEMA and glutaraldehyde compounds. Such desensitizers are widely used in clinical studies. By applying the dentin desensitizer on the exposed dentin surface, the dentin capillary are blocked and periodontal membrane and cementum can not be drawn in pulp cavity. Since HEMA and glutaraldehyde may cause harm to the pulp cavity, an alternative desensitizer was developed.
Bicuspid ; Capillaries ; Crowns ; Dental Cements* ; Dental Cementum ; Dental Prosthesis ; Dentin* ; Glass ; Glutaral ; Humans ; Membranes ; Oxalic Acid ; Resin Cements ; Tooth ; Zinc

PURPOSE: To investigate the influence of cryptorchidism on the testicular volume and gender identity of young men within a community. MATERIALS AND METHODS: Of 27,202 men, aged 20 years, within the community, a 10% sampling fraction was randomly selected, of which 2,080 (a response rate 77.0%) agreed to participate in the study. All volunteers underwent a standard evaluation, including a detailed medical history and physical examination. To evaluate the influence of cryptorchidism on gender identity, we used the Bem Sex Role Inventory (BSRI) in the men without testicular disease, but who were observed to have cryptorchidism on physical examination, or had a history of operation for cryptorchidism. RESULTS: Of the participants, 38 (1.8%) were observed to have cryptorchidism, or had a history of operation for cryptorchidism (right; 15, left; 21, bilateral; 2). Of these patients, 29 had a history of operation, with a mean age at the time of operation of 8.9+/-3.9 years, ranging from 2 to 19 years. Of the 36 patients with unilateral cryptorchidism, the contralateral testicular volume of the men that underwent an orchiopexy was no different to that of those that underwent an orchiectomy or that had no operation at all. Comparing the masculinity and femininity scores, using the BSRI between the orchiopexy and normal groups, the masculinity score of the orchiopexy group was lower than that of the normal group. CONCLUSIONS: Our results demonstrate that a delayed orchiopexy does not improve the growth of the testicular volume on the affected side, or the masculine identity, in men with unilateral cryptorchidism. In addition, these findings suggest that there is a need to increase the awareness related to cryptorchidism amongst all parties involved in the health care of children.
Adolescent* ; Child ; Cryptorchidism* ; Delivery of Health Care ; Femininity ; Gender Identity* ; Humans ; Male ; Masculinity ; Orchiectomy ; Orchiopexy ; Physical Examination ; Prevalence ; Testicular Diseases ; Testis ; Volunteers