Withdrawn: Spinal Abnormalities Associated with Marfan Syndrome

This article was withdrawn by the authors' request.

Withdrawn: Spinal Abnormalities Associated with Marfan Syndrome

This article was withdrawn by the authors' request.

Spinal Abnormalities Associated with Marfan Syndrome / 대한척추외과학회지

STUDY DESIGN: This is a retrospective review on the spinal abnormalities in Marfan syndrome. OBJECTIVES: To analyze clinical and radiological features of the spine in Marfan syndrome. SUMMARY OF LITERATURE: Scoliosis & kyphosis are common spinal abnormalities in Marfan syndrome. Other spinal abnormalities associated with Marfan syndrome are rarely reported in the literature. MATERIALS AND METHODS: The spinal abnormalities which can be associated with Marfan syndrome were analyzed in 32 patients who were diagnosed as Marfan syndrome. Coronal and sagittal curvatures on whole spine standing film were evaluated with Cobb's method. Uncommon spinal abnormalities which can be associated with this syndrome, such as spondylolisthesis and dural ectasia were also evaluated. RESULTS: Scoliosis was identified in 18 of 32 patients(56.3%). The mean scoliotic angle was 26 degrees and thoracic curve was most common. Thoracic kyphosis, lumbar lordosis and thoracolumbar kyphosis were measured as 27 degrees +/- 13 degrees ( 0 degrees ~ 53 degrees), -42 degrees +/- 13 degrees( -10 degrees ~ -70 degrees ) and 9 degrees +/- 12 degrees ( -5 degrees ~ 4 5 degrees) respectively. Spondylolisthesis was present in two cases(6.3%), one of which was 15% slip and the other was 50% slip. Two cases of dural ectasia were confirmed with MRI. CONCLUSION: Marfan syndrome showed high incidence of scoliosis(56.3%) and thoracolumbar kyphosis(50%). The frequency of spondylolisthesis was only slightly higher than that in the general population. The dural ectasia is a common but little known abnormality. Therefore it has a significant diagnostic value without clinical importance. In Marfan syndrome, we should keep these common and uncommon spinal abnormalities in mind.

The Role of Platelet-derived Growth Factor in Regeneration of Pasteurized Osteochondral Graft in Rabbits / 대한정형외과연구학회지

Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.

Operative Treatment Using Minimized Internal Fixation and Tension Band Technique on Proximal Humeral Fracture / 대한정형외과학회잡지

Most proximal humeral fractures respond satisfactorily to simple conservative treatment, but operative treatment is recommended in cases where poor results are anticipated by prolonged immobilization, or because of severe displacement and comminution. We used a minimal internal fixation and tension band technique in severely displaced and comminuted cases to achieve firm fixation and avoid subacromial impingement. Passive range of motion of the involved shoulder began within the first postoperative day and active range of motion exercise was encouraged as soon as possible within the first postoperative week. Between February 1996 and November 1997, we operated using this technique on 15 patients ranging in age from 16 to 71 years (average 52). Follow-up averaged 13 months. During the follow-up period, all patients except one patient, had a active full range of motion on the affected limb. According to the evaluation on the 10 patients who had follow- up periods over 12 months by Hawkins rating scale of shoulder function, 6 patients had achieved a good result and 4 patients had achieved a fair result at the last follow up. In conclusion, tension band technique with minimal internal fixation could afford sufficient fracture stability to allow early, aggressive rehabilitation. As a method of internal fixation on a proximal humerus fracture, this technique may have particular advantages in elderly osteoporotic patients.