Arbash, Mahmood Ali;Parambathkandi, Ashik Mohsin;Baco, Abdul Moeen;Alhammoud, Abduljabbar
Asian Spine Journal
/
v.12
no.6
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pp.1053-1059
/
2018
Study Design: Retrospective review. Purpose: To detect the effect of cannulated (poly-axial head) and solid (mono-axial head) screws on the local kyphotic angle, vertebral body height, and superior and inferior angles between the screw and the rod in the surgical management of thoracolumbar fractures. Overview of Literature: Biomechanics studies showed that the ultimate load, yield strength, and cycles to failure were significantly lower with cannulated (poly-axial head) pedicle comparing to solid core (mono-axial head). Methods: The medical charts of patients with thoracolumbar fractures who underwent pedicle screw fixation with cannulated or solid pedicle screws were retrospectively reviewed; the subjects were followed up from January 2011 to December 2015. Results: Total 178 patients (average age, $36.1{\pm}12.4years$; men, 142 [84.3%]; women, 28 [15.7%]) with thoracolumbar fractures who underwent surgery and were followed up at Hamad Medical Corporation were classified, based on the screw type as those with cannulated screws and those with solid screws. The most commonly affected level was L1, followed by L2 and D12. Surgical correction of the local kyphotic angle was significantly different in the groups; however, there was no significant difference in the loss of correction of the local kyphotic angle of the groups. Surgical correction of the reduction in the vertebral body height showed statistical significance, while the average loss of correction in the reduction of the vertebral body height was not significantly different. The measurement of the angles made by the screws on the rods was not significantly different between the cannulated (poly-axial head) and solid (mono-axial head) screw groups. Conclusions: Solid screws were superior in terms of providing increased correction of the kyphotic angle and height of the fractured vertebra than the cannulated screws; however, no difference was noted between the screws in the maintenance of the superior and inferior angles of the screw with the rod.
Khan, M.S.;Shook, G.E.;Asghar, A.A.;Chaudhary, M.A.;Mcdowell, R.E.
Asian-Australasian Journal of Animal Sciences
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v.10
no.5
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pp.505-509
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1997
Data were from four institutional herds and four field data collection centers involved in a progeny testing program for Nili-Ravi buffaloes in Pakistan. The REML with a single trait animal model, employed on 2,353 lactations, from 901 daughters of 66 sires, gave a heritability estimate of 0.18 for milk yield with repeatability (between lactations) of 0.43. Estimated milk yield was highest at 65 months of age for the first parity and 81 months for later parities. Correction factors for age at calving, standardized to 60 months in the second and later parities, were developed.
The experience with operative treatment for total correction of Fallot at the department of Thoracic and Cardiovascular Surgery, Keimyung University Dong San Medical Center from July 1980 to July 1984 was reviewed. There were 37 males and 12 females and their ages ranged from 3 years to 30 years, with the average age of 12.2 years. Sixty nine point four percent of patients were younger than 15 years of age. The most frequent type of right ventricular outflow stenosis was the combined type [pulmonary valvular and infundibular stenosis] containing 41 patients [83.7%] and there were 9 deaths in this group. The major associated lesions included Patent foramen ovale in 20 patients [40.8%], Atrial septal defect in 7 patients [14.3%], Left superior vena cava in 4 patients [8.2%], Right sided aortic arch in 2 patients [4.1%] and Patent ductus arteriosus in 11 patient [2.0%]. The pulmonary valvotomy was performed in 41 patients and patch graft reconstruction of the right ventricular outflow tract was performed in 23 patients. In 11 patients the monocusp patches were used. Thirty-five patients [71.4%] had the right bundle branch block postoperatively. There were 11 postoperative deaths with hospital mortality rate of 22.4% and the leading causes of death were low output syndrome, bleeding, and cerebral embolism.
The purpose of this study was to assess the rural women's general status in relation with low back pain. This survey was done after teaching them the prevention and treatment of low back pain with Meckenzie Method. 84 rural resident women including rural life guidance. The results were as follows. 1. The average age of rural were $35{\sim}50$ years old and the guidance's age were $21{\sim}25$ years old. The educational level of rural women were highest in primary school(46.67 %) and the home extension worker were college education(83.67 %). 2. 75 % of rural woman complained low back pain while 17.33 % of the home extension worker had back pain. 3. The home extension worker feel the necessity of the education in low back pain(100 %) while 88.89 % of the rural woman agreed. 4. All the rural women and the home extension worker had the concept of back pain and its prevention(100 %). 5. After this education, the confidence in prevention and treatment were each 78.79 % with rural women and 91.84 % with home extension worker. 6. The necessity for the treatment of low back pain were : first, the correction of posture, second, the activity posture correction, third, the supportive roll of back curve. 7. There were no statistical significant outcome specifically.
In this review, we discuss in detail our current procedure for treating craniosynostosis using multidirectional cranial distraction osteogenesis (MCDO). The MCDO method allows all phenotypes of skull deformity to be reshaped by distraction osteogenesis, except in patients who are 5 months of age or younger and patients with posterior cranial vault problems. We report the results of clinical data of 36 children with craniosynostosis who underwent MCDO between 2005 and 2014 in our institute. This method has the following benefits, such as a high flexibility of reshaping, shorter treatment period and less invasive secondary intervention. We also discuss the other distraction osteogenesis techniques that are used to treat craniosynostosis and compare them with MCDO. The preferred procedure for correction of craniosynostosis may depend on the patient's age, the extent of deformity, and the extent of correction achievable by surgery. We can arrange the combinations of various methods according to the advantage and disadvantage of each technique.
Between January 1984 and December 1986, sixty nine patients, aged 16 months to 25 years [mean age 10.05*6.40 years], underwent total correction of tetralogy of Fallot in Kyungpook national university hospital. In 66 hospital survivors, 30 patients were followed up for 12 to 48 months [mean 30.10*10.26 months]. These 30 patients were classified in two groups, TAP [transannular patch] and Non-TAP group. There were 9 patients in TAP group, and 21 in Non-TAP group. There were no significant differences between two groups in terms of age at operation, follow up duration, ACC time, and bypass time. All patients were evaluated by two dimensional echocardiography, Doppler echocardiography, standard 12-lead electrocardiography, and plain chest X-ray. Right ventricular systolic pressure, pulmonary arterial systolic pressure, pressure gradient between the right ventricle and the pulmonary artery, presence or absence of pulmonary regurgitation and its grading, fractional shortening of the left ventricle, and Qp/Qs in case of remnant ventricular septal defect were obtained by echocardiographic examination. Cardiothoracic ratio was measured by plain chest film, and ventricular dysrrhythmia was detected by electrocardiogram. Comparing the data between two groups, there was significant difference in incidence of postoperative pulmonary regurgitation [p< 0.05], 100%[9/9] in TAP group and 47.6 %[10/21] in Non-TAP group, but all the regurgitations were not severe. There were no significant differences in other comparisons, despite of higher incidence of cardiomegaly in TAP group [CT ratio: 59.3*5.3% VS 54.7*6, 4 %].
The author analyzed 99patients with VSD weighting less than 10kg of body weight who underwent surgical correction from 1981 to 1992 at cardiovascular department of Hanyang University hospital. Patients occupied 29.3% of total cases who were underwent surgical corrections for congenital heart diseases during that time. Of the 99 patients, 51 patients were male [52%] and 48 patients[48%] were female. Age ranged from 28 days to 36 months with mean age of 13.6 months. Mean body weight was 7.53kg. According to Kirklin`s anatomical classification, type II defect was most common [61.6%]. Associated anomaly was found in 48 patients [48.5%]. Patent foramen ovale was most commonly associated cardiac anomaly [14.1%] and followed by atrial septal defect [12.1%], patent ductus arteriosus [10.1%]. Cardiac catheterization data were analyzed. The most common range of Qp/Qs, Rp/Rs, Pp/Ps were above 3.0, 0.1 - 0.25, and above 0.75 respectively. Among the indications of surgical correction, there were pulmonary hypertention in 69 patients, congestive heart failure in 44 patients, frequent respiratory infection in 47 patients, growth retardation in 33 patients. The most common surgical approach and method for VSD closure were right atriotomy[48.3%] and dacron patch closure[93.3%]. Complication rate was 13.1% [13 cases], and overall mortality was 17.1% [17 cases]. The cause of death consisted of low cardiac output syndrome[11 cases], acute renal failure[3 cases], sepsis[2 cases] and pulmonary insufficiency[1 case] in order of frequency.
Purpose: The aim of this study was to determine the association between stigmatism and amblyopia. Methods: It was a hospital based, cross-sectional retrospective study conducted in Nepal Eye Hospital. Medical record of amblyopic children aged 13 years or younger from were reviewed. Children with amblyopic eyes due to simple astigmatism were included. Relation between depth of amblyopia with magnitude and types of astigmatism, orientation of axis was determined. Out of 139 amblyopic eyes of 82 children, 93 were simple myopic astigmatism and remaining 42 were simple hyperopic astigmatism. Results: Mean age of patients was 7.38±2.61 years. Visual acuity improved by at least one line in Snellen chart in 4/5th of eyes after astigmatic correction. Moderate amblyopia was found to be present in 45% eyes while severe amblyopia in 16% of eyes. With the rule astigmatism was found to be present in 88% eyes. Mean astigmatism was 2.47±0.98D and majority of eyes (67.7%) had high astigmatism. Depth of amblyopia was not associated with magnitude of astigmatism (p > 0.05) but number of lines improved with astigmatic correction was correlated with the magnitude of astigmatism (p < 0.001). Risk of amblyopia is more in high myopic astigmatism. Conclusion: Presenting age of amblyopic children was late in Nepal. Depth of amblyopia was not associated with magnitude of astigmatism.
Purpose: Age estimation is often used in the identification of living persons. Various methods are used for age estimation using teeth, and there are many studies on the methodology. But the study of changes in the social aspects of age estimation with the passage of times is still insufficient. Therefore, the purpose of this study is to analyze the age estimation cases in the social aspects and to investigate the changes of age estimation cases in Jeollabuk-do. Methods: From January 2008 to December 2015, 76 cases of age estimation were collected. The collected data were organized and analyzed. The distribution of patients by age and year, the difference between alleged and registered age, the purpose of age estimation, and regional distribution were examined. In addition, we compared the previous study which analyzed the age estimation cases in Jeollabuk-do from 2000 to 2007. Results: According to the distribution by age, the age distribution was the largest in the 50s and 60s, with 69.8%. The most reason to correct age was related to welfare benefits (38.2%), and most of the people who corrected for welfare benefits were over 50 years old. The age correction for purpose of welfare benefits existed every year during the study period. As the result of comparison with previous study, total number of age estimation cases was decreased very sharply, and distribution by age group was also changed. Conclusions: Changes in age estimation cases were observed when compared to the previous study. A significant decrease in the total number of age estimation cases was observed, but the number of age estimation in the 50s did not decrease. Although the total number of age estimation requests decreases, age estimation in the elderly are likely to persist. Thus, it is necessary to study new age estimation methods suitable for the elderly.
Objectives : Burst fracture of the lower lumbar spine(L3-L5) is rare and has some different features compare to that of thoracolumbar junction. Lower lumbar spine is flexible segments located deeply, and has physiologic lordosis. All of these contribute to making surgical approach difficult. Generally, lower lumbar burst fracture is managed either anteriorly or posteriorly with various fixation and fusion methods. But there is no general guideline or consensus regarding the proper approach for such lesion. We have tried to find out the influencing factors for selecting the surgical approach through the analysis of lower lumbar burst fractures treated for last 4 years(1994.3-1998.3). Method : This study includes 15 patients(male : 10, female : 5, age range 20-59 years with mean age of 36.7 years, L3 : 8 cases, L4 : 5 cases, L5 : 2 cases). Patients were classified into anterior(AO) and posterior operated(PO) groups. We investigated clinical findings, injured column, operation methods, and changes in follow-up radiologic study (kyphotic angle) to determine the considerable factors in selecting the surgical approaches. Results : There were 5 AO and 10 PO patients. Anterior operation were performed with AIF with Kaneda or Z-plate and posterior operation were done with pedicle screw fixation with PLIF with cages or posterolateral fusion. Canal compression was 46.6% in AO and 38.8% in PO. The degree of kyphotic angle correction were 10.7 degree(AO) and 8.5 degree(PO), respectively. There was no statistical difference between anterior and posterior operation group. All patients showed good surgical outcome without complications. Conclusion : Anterior operation provided good in kyphotic angle correction and firm anterior strut graft, but it difficulty arose in accessing the lesions below L4 vertebra. While posterior approach showed less correction of kyphotic angle, it required less time and provided better results for accompanied adjacent lesion and pathology such as epidural hematoma. The level of injury, canal compression, biomechanics, multiplicity, and pathology are considered to be important factors in selection of the surgical approach.
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