Pathoanatomical Factors Responsible for Femoral Shortening in Legg-Calve-Perthes Disease / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to determine the relative contributions made by pathoanatomical factors responsible for femoral shortening in Legg-Calve-Perthes disease (LCPD), and to devise a method of reducing the amount of residual shortening based on a better understanding of its pathoanatomy and developmental pattern in LCPD. MATERIALS AND METHODS: We measured shortening of three anatomical components, namely, the femoral epiphysis, neck, and diaphysis on the teleoroentgenograms of 106 LCPD patients, comprised of 35 children with active disease, 24 in the healing stage, and 47 at skeletal maturity. RESULTS: The proportional contributions made by these 3 anatomical components to residual shortening at skeletal maturity were; 20% by the epiphysis (epiphyseal flattening), 53% by the neck (physeal growth retardation), and 27% by the diaphysis (underuse atrophy). These contributions differed according to disease stage and shortening severity. Mean diaphyseal shortening was 3.9 mm at skeletal maturity, but this increased to 5.8 mm when only patients with severe shortening (20 mm or more) were included. CONCLUSION: Our findings suggest that diaphyseal shortening is likely to be minimized by the implementation of limb exercise programs.

Responsible Factors for Femoral Shortening in Piglet Legg-Calve-Perthes Disease Models / 대한정형외과학회잡지

PURPOSE: To know the proportional contribution of causative factors to the femoral shortening in Legg-Calve-Perthes disease. MATERIALS AND METHODS: In twenty piglets, 4 to 5 weeks old, vascular supply to the capital femoral epiphysis was interrupted by ligating the femoral neck containing the epiphyseal artery. RESULTS: Mean femoral shortening in piglets sacrificed at 4 weeks after devascularization was 7.4 mm. In detail, the shortening was 2.5 mm (34%) in the epiphysis and 4.9 mm (66%) in the neck and diaphysis. Mean femoral shortening in piglets sacrificed at 8 weeks after operation was 12.1 mm. The distribution of shortening was 4.6 mm (38%) in the epiphysis and 7.5 mm (62%) in the neck and diaphysis. Mean femoral shortening in piglets sacrificed at 20 weeks after operation was 20.7 mm. The distribution of shortening was 4.0 mm (19%) in the epiphysis and 16.7 mm (81%) in the neck and diaphysis. CONCLUSION: We determined the proportional contribution to the residual shortening according to the causative factors.

Measurement of Skin Temperature Alteration Caused by Smoking Using Digital Infrared Thermal Imaging

Digital infrared thermal imaging(DITI) has been proposed as a diagnostic aid in patient with many disease entities, such as the cardiovascular, the neurologic, the musculoskeletal diseases and so on. Supporters of thermography state that normal patients have the normal thermograms and abnormal patients have the abnormal thermograms. The purpose of this study was to determine how much a cigarette will affect skin temperature change in the course of normal day's smoking. Twenty one healthy smokers(mean age, 27.4+/-5.1 years old) and fourteen nonsmokers(mean age, 24.4+/-1.6 years old) took parts in the study. All were male. The cigarette consumption averaged 14.0 per day. Smokers maintained their smoking habit in the ambient temperature before on initial measurement and smoked a cigarette in the controlled laboratory room. Measurements were taken for 5 minutes, 1 hour and 2 hours afterward. The skin temperature of the face, the both palms and the both soles was measured using Dorex digital infrared thermal imaging system. In all sessions, the skin temperature was higher on the face and lower on the sole. There were no significant differences of skin temperature on both sides of body in all subjects(p>0.05). The skin temperature of all measured parts was significantly lower in the smoking group before and 5 minutes after smoking(p0.01).

Spontaneous Thoracolumbar Spinal Cord Infarction: A case report

Vascular disease of the spinal cord occurs less frequently than of the brain, and its incidence is not known. Case reports of spinal cord infarction are uncommon, especially ones with spontaneous causes. We experienced one case with a spontaneous spinal cord infarction in the territory of the Adamkiewicz artery. In this case, the clinical pictures were characterized by sudden onset of paraplegia, bilateral radicular pain, dissociated sensory loss below the level of infarction and sphincter dysfunction. Neuroradiological investigation and CSF analysis ruled out compressive or infectious lesions. Selective spinal angiography revealed an occlusion of the Adamkiewicz artery. The patient had a substantial recovery over a period of weeks with intensive rehabilitation treatments.