• Title/Summary/Keyword: Segmental

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The Effect of Recombinant Human Growth Hormone on Growth in Children with Nephropathy Receiving Long-term Steroid Therapy (장기간의 스테로이드 치료를 받고 있는 신병증 환아에서 Recombinant Human Growth Hormone의 효과)

  • Kim, Se-Jin;Kim, Sun-Kyoung;Kim, Sung-Do;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.142-151
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    • 2006
  • Purpose : Growth retardation is one of the serious problems in children with nephropathy requiring long-term steroid therapy. We observed the efficacy and safety of recombinant human growth hormone(rhGH) on the growth in children with long-term steroid therapy. Methods : We studied 60 children(male 47, female 13) with nephropathy who received rhGH(1 U/kg/week) for more than 0.5 years($1.39{\pm}1.12$). Their mean age was 11.0 years($11.17{\pm}2.62$). They received steroid therapy from January 1987 through July 2005, and the mean duration of steroid therapy was $4.32{\pm}2.97$ years. Among the patients, there were 32 nephrotic syndrome, 9 IgA nephropathy, 4 mesangial proliferative glomerulonephritis, 4 focal segmental glomerulosclerosis, 2 Henoch $Sch\ddot{o}nlein$ nephritis, 2 Alport syndrome and 7 other cases. Data were gathered on the growth parameters, such as growth velocity, height standard deviation score(SDS), IGF-1, IGFBP-3, bone mass density(BMD) and general chemistry changes. Results : Height velocity increased significantly with rhGH therapy from $3.29{\pm}1.95$ to $8.66{\pm}3.75$(cm/yr) and height SDS decreased from $-0.72{\pm}0.93$ to $-1.04{\pm}0.86$ at one year after steroid therapy but increased to $-0.55{\pm}0.96$ at one year after rhGH administration(P<0.05). BMD improved from $0.71{\pm}0.14$ to $0.79{\pm}0.15g/cm^2$(P<0.05). IGF-1 increased from $445.09{\pm}138.01$ to $506.62{\pm}181.31ng/mL$(P<0.05). IGFBP-3 decreased from $4073.75{\pm}700.78$ to $3933.61{\pm}789.25ug/L$ numerically, but there was no statistically significant difference(P=0.533). Conclusion : The administration of rhGH in the short stature patients who received long-term steroid therapy showed improvement in growth parameters such as SDS, growth velocity, and BMD without significant side-effects or changes in the biochemical parameters.

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Results of Segmental Resection and Reconstruction of the Trachea for Obstructive Tracheal Lesions (기관 폐쇄 병변에서 시행된 기관 절제 및 재건술에 대한 결과)

  • 김명천;박주철;조규석;유세영;김범식
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.792-798
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    • 1998
  • Background: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. Materials and methods: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. Results: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. Conclusion: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.

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Antegrade Interlocking Intramedullary Nailing in Humeral Shaft Fractures (상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Kim, Sin-Ki
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.1-6
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    • 2010
  • Purpose: To evaluate the results and complications of antegrade intramedullary interlocking nailing in humerus shaft fractures. Materials and Methods: We evaluated the clinical outcomes, radiologic results and complications in 47 patients with humerus shaft fracture treated with antegrade intramedullary interlocking nailing, and followed up until bony union. Bony union was confirmed by serial plain radiographs and the clinical outcomes were assessed according to the ASES scoring system. Results: Bony union was confirmed in 41 (87.2%) out of a total 47 patients, and the mean union period was 14.5 weeks. Major complications were as follows: 6 non-union, 3 delayed union, 2 intraoperative posterior cortex fracture in the distal humerus and 2 permanent shoulder pain, including 1 case of adhesive capsulitis. The clinical outcomes were as follows: 29 excellent, 11 good, 4 fair and 3 poor. Satisfactory outcomes were demonstrated in 40 patients (85.1%). Conclusion: Anterograde intramedullary interlocking nailing as treatment for humerus shaft fracture showed satisfactory bony union and clinical outcomes. It is considered an efficacious treatment, especially in patients with associated injury, such as multiple fractures and segmental fracture.

Treatment of the Tibia Shaft Fractures with Ender Nails (Ender Nail을 이용한 경골간부 골절의 치료)

  • Kim, In-Ki;Lee, Dong-Chul;Seo, Jae-Sung;Ahn, Myun-Whan;Kim, Se-Dong;Ahn, Jong-Chul
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.130-136
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    • 1992
  • Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their enumerous complications. Thirty patients with fractures of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to November 1991. The following results were observed. 1. The average age was 37.3 years and the number of male was three times of the female. The most common cause was traffic accident. 2. Twenty cases out of thirty one were closed fractrure and the remaining 11 were open. The comminuted and segmental fractures were 18(57.7%) in number and the most common fracture site was the middle one third(53%). 3. Average interval from injury to operation was 7.6 days and 19 cases showed associated injuries. 4. The mean duration of the bone union was 18.9 weeks and 2 cases showed the delayed union. 5. Twelve complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.

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Effect of Different Types of Dietary Fat on Renal Functions in Aged Rats (식이 지방의 종류가 흰쥐의 노화 과정 중 신장 기능에 미치는 영향)

  • 김화영
    • Journal of Nutrition and Health
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    • v.31 no.3
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    • pp.253-262
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    • 1998
  • This study was performed to investigated the effect of dietary fat sources on renal senescence in aged rats. Seventeen month old male Sprague-Dawley rats were divided into 3 groups according to urinary protein excretion. Four month old rats were used as a control group. The rats were fed one of three different experimental diets ; 20% beef tallow, 20% corn oil 20% fish oil diet. They were fed experimental diets ad libitum for 16 weeks . The results are summarized as follows. Serum lipid concentrations were higher in aged rats than in control rats, with the beef tallow group showing the highest level, followed by the corn oil and fish oil groups. Old rats showed higher HDL and lower LDL levels than the control groups. Age and dietary fat had no effect on VLDL. GFR for the both age groups were increased with experimental period with the beef tallow group showing the highest value. Urinary protein excretion was also increased with experimental period in both age groups. There was a large increase in urinary protein in old rats that were fed beef tallow and corn oil, but not in old rats fed fish oil. On the contrary , the effect of dietary fat on urinary protein was not found in control groups. There was individual susceptibility in the effect of dietary fat on urinary protein. Old rats fed beef tallow with high initial urinary protein showed highest increase, but , the change was not significant in rats with a low initial value . It was also found that the increase was kept low in rats of the fish oil group with high initial urinary protein. The corn oil group showed in between values. There were no differences in urine and renal tissue concentrations of TXB2 . Aged rats showed a tendency of having higher urinary PGE2 excretion and lower renal cortex content. Since higher PGE2 excretion was reported to be associated with decreased renal function, this might suggest that the aged rats show renal function reduction. Light microscopic examination showed that glomerular segmental sclerosis, mesangial matrix expansion and tubular atrophy were more frequently present in aged rats, and that these changes were more significant in the beef tallow group, followed by corn oil and fish oil groups. The percentage of urinary protein excretion was increased in aged rats in association with increased glomerular sclerosis and mesangial matrix . This change could be partly due to a change in eicosanoids metabolism . Therefore, modification of dietary fat could affect the eicosanoids metabolism in kidney and renal senescence.

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Radiographic Findings and Atelectasis in Children Admitted to Hospital with Acute Asthma (입원한 천식 환아들의 흉부 방사선 소견과 무기폐)

  • Jung, Yoo-Jin;Jung, Hye-Jin;Lee, Kyung-Yil;Lee, Won-Bae;Yang, Dong-Hurn
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.519-523
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    • 2002
  • Purpose : We aimed to evaluate the abnormalities of chest radiographs including atelectasis in children who were admitted with bronchial asthma. Methods : We retrospectively analyzed the 357 chest radiographs and the clinical and laboratory features of the 144 children with asthma, who were admitted at Daejoen St. Mary's Hospital from April 1994 to May 1998. Results : Clinical and laboratory characteristics were as follows : male to female ratio, 2.1 : 1; mean age, 4.8 years of age; mean numbers of admission, 2.5; mean hospitalization, 5.0 days; mean IgE, 387 IU/mL; mean eosinophil count, $362/mm^3$. In the abnormal findings of the 357 radiographs, there were 314 cases(88.0%) of hyperinflation, pulmonary infiltration 35.0%, atelectasis 5.3% and pneumomediastinum 0.3%. All(19) cases of atelectasis were observed in the right lung field with mostly segmental and lobular distribution, except one with lobar involvement. Atelectasis was predominant in males and those under 2 years of age. There was a tendency that the right upper lung was more involved under two years while the right lower lung was more involved over seven years of age. Conclusion : Radiographs of children admitted to hospital with bronchial asthma showed abnormal findings including pneumonia or atelectasis(5.3%). These abnormal findings can help to determine other therapeutic modalities in addition to asthma treatment.

Clinical Experiences and Usefulness of Cervical Posterior Stabilization with Polyaxial Screw-Rod System

  • Hwang, In-Chang;Kang, Dong-Ho;Han, Jong-Woo;Park, In-Sung;Lee, Chul-Hee;Park, Sun-Young
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.311-316
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    • 2007
  • Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.

A Multi-center Clinical Study of Posterior Lumbar Interbody Fusion with the Expandable Stand-alone Cage($Tyche^{(R)}$ Cage) for Degenerative Lumbar Spinal Disorders

  • Kim, Jin-Wook;Park, Hyung-Chun;Yoon, Seung-Hwan;Oh, Seong-Hoon;Roh, Sung-Woo;Rim, Dae-Cheol;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.251-257
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    • 2007
  • Objective : This multi-center clinical study was designed to determine the long-term results of patients who received a one-level posterior lumbar interbody fusion with expandable cage ($Tyche^{(R)}$ cage) for degenerative spinal diseases during the same period in each hospital. Methods : Fifty-seven patients with low back pain who had a one-level posterior lumbar interbody fusion using a newly designed expandable cage were enrolled in this study at five centers from June 2003 to December 2004 and followed up for 24 months. Pain improvement was checked with a Visual Analogue Scale (VAS) and their disability was evaluated with the Oswestry Disability Index. Radiographs were obtained before and after surgery. At the final follow-up, dynamic stability, quality of bone fusion, interveretebral disc height, and lumbar lordosis were assessed. In some cases, a lumbar computed tomography scan was also obtained. Results : The mean VAS score of back pain was improved from 6.44 points preoperatively to 0.44 at the final visit and the score of sciatica was reduced from 4.84 to 0.26. Also, the Oswestry Disability Index was improved from 32.62 points preoperatively to 18.25 at the final visit. The fusion rate was 92.5%. Intervertebral disc height, recorded as $9.94{\pm}2.69\;mm$ before surgery was increased to $12.23{\pm}3.31\;mm$ at postoperative 1 month and was stabilized at $11.43{\pm}2.23\;mm$ on final visit. The segmental angle of lordosis was changed significantly from $3.54{\pm}3.70^{\circ}$ before surgery to $6.37{\pm}3.97^{\circ}$ by 24 months postoperative, and total lumbar lordosis was $20.37{\pm}11.30^{\circ}$ preoperatively and $24.71{\pm}11.70^{\circ}$ at 24 months postoperative. Conclusion : There have been no special complications regarding the expandable cage during the follow-up period and the results of this study demonstrates a high fusion rate and clinical success.

Can the Zero-Profile Implant Be Used for Anterior Cervical Discectomy and Fusion in Traumatic Subaxial Disc Injury? A Preliminary, Retrospective Study

  • Kim, Tae Hun;Kim, Dae Hyun;Kim, Ki Hong;Kwak, Young Seok;Kwak, Sang Gyu;Choi, Man Kyu
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.574-581
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    • 2018
  • Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

Properties of a Thermosetting Epoxy Composite : Effect of Isothermal Physical Aging (에폭시 열경화 복차재료의 성질 : 등온물리시효의 효과)

  • 이종근;윤성호
    • Polymer(Korea)
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    • v.25 no.3
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    • pp.359-366
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    • 2001
  • Isothermal physical aging of a glass fiber/epoxy composite was examined at different aging temperatures ($T_a$) and degrees of conversion (monitored by the glass transition temperature, $T_g$) by means of the TBA torsion pendulum technique. The range of aging temperature was from 10 to $130^{\circ}C$ : the conversion was systematically changed from $T_g$=$76^{\circ}C$ to $T_g$=$177^{\circ}C$ (fully crosslinked). The effect of isothermal physical aging was manifested as perturbations of the modulus and mechanical loss vs. temperature in the vicinity of $T_a$ for all conversions. The rate of isothermal physical aging determined from the change of modulus with aging time at fixed aging temperature decreased and then increased with increasing conversion below T$_{a}$=9$0^{\circ}C$. There exists a superposition in aging rate vs. ($T_g$ -$T_a$) by shifting horizontally and vertically. This implies that the physical aging process is independent of the change of chemical structure as conversion proceeds. It has been found that water absorbed at the aging temperature below $70^{\circ}C$ during isothermal physical aging lowers the apparent aging rate. It is due to the absorbed water molecules forming strong polar interactions with hydroxyl group on network chain and reducing the segmental mobility during the physical aging.g.

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