Since Hadra first used metalic internal fixation in the human spine with wire loop in 1895, various implants have been used. Knodt rod was designed on the principle that the distraction produced a localized flexion attitude in the area to be fused, thus increasing the size of the intervertebral foramina and decreasing the risk of intraforaminal encroachment on the nerve root. We have performed the posterolateral fusion with or without Knodt rod as a primary procedure in spondylolysis and spondylolisthesis of lumbar spine, which required arthrodesis of more than one level. For period of 8 1/2 years' from Sep. 1977 to Apr. 1986, 12 cases of diseased spine were treated with posterolateral fusion without Knodt rod, and 13 cases were treated with posterolateral fusion using Knodt rod. We compared with two groups, and the following results were obtained. 1. Solid bony fusion was 100% in posterolateral fusion with Knodt rod, and 92% without Knodt rod. 2. An average period of post-operative immobilization was 2 months in cases with Knodt rod, and 2.5 months without Knodt rod. 3. In posterolateral fusion with Knodt rod, 4 cases with the root symptoms were all improved. In posterolateral fusion without Knodt rod, 6 cases with root symptoms, were all improved. But in 1 case without the root symptoms, developed the root symptoms. 4. No significant changes in radiologic evaluation were found between posterolateral fusion with Knodt rod and without Knodt rod. 5. Post-operative complications developed in 4 cases (31%) with Knodt rod, and 6 cases (50%) without Knodt rod. 6. Clinically, the satisfactory results were 100% with Knodt rod, and 83% without Knodt rod.
Arthrodesis ; Humans ; Immobilization ; Spine ; Spondylolisthesis ; Spondylolysis

After amputation of the extremities, many patients developed problematic sequelae such as loss of function, cosmetic point of view, and psychiatric problems. For period of eleven yesrs from 1976 to 1986, we performed amputation of the fingers in 461 persons, and problematic sequelae were noted in 181 cases of 105 persons. The results were as follows : 1. Causes of the amputation were trauma, infection, burn, frost bite, tumors, and vascular diseases in that order of frequency. 2. Problematic sequelae of the fingers were scar contracutre, scanty soft tissue, neuroma, bony spur formation, deformities, hypersensitivity, ulceration, phantom pain, and depression in that order of frequency. 3. Problematic sequelae in amputation of the fingers could be classified as functional, cosmetic and psychiatric problems. In most instances, the primary concern of a particular patient was amputation itself, and this kind of psychiatric problems should be taken into consideration in the treatment of the amputated fingers.
Amputation ; Burns ; Cicatrix ; Congenital Abnormalities ; Depression ; Extremities ; Fingers ; Humans ; Hypersensitivity ; Neuroma ; Phantom Limb ; Ulcer ; Vascular Diseases

BACKGROUND: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. METHODS: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. RESULTS: The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. CONCLUSIONS: We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.
Blood Pressure ; Blood Volume ; Ear ; Heart Rate ; Horner Syndrome ; Humans ; Lidocaine ; Oxygen ; Spectrum Analysis ; Stellate Ganglion

A prospective study was initiated to compare maternal serum concentration of CA-125 during the first trimester of normal and abnormal pregnancies. Serum specimens were obtained from 87 women with a normal intrauterine pregnancy and 47 women with abnormal pregnancies which were ended in spontaneo abortion or pathologically confirmed to be missed abortion. In normal pregnancies, the mean serum CA-125 concentrations were increased significantly from amenorhea 6 weeks (139.838.7 IU/ml), and were higher statistically than the values tested in the same weeks of abnormal pregnancies. In abnormal pregnancies serum CA-125 concentations were relatively lower than those of normal pregnancies. But these differences were not statistically significant except the values tested in amenorhea 6weeks. So serum levels of CA-125 may not be proved useful in monitoring of early pregnancies outcome.
Abortion, Missed ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy* ; Prospective Studies

BACKGROUND: Caudal block is useful when anesthesia for surgery or treatment for chronic pain is needed, but this procedure has a failure rate of up to 25% even when it performed byan experienced physician. This high failure rate is usually due to improper needle placement. METHODS: After gaining approval of the ethics committee, 46 patients received caudal blocks under ultrasound guidance; these were performed after the anatomical structures in the sacral hiatus had been measured with ultrasound. All these procedures were performed by the same anesthesiologist. The position and direction of the needle were identified using fluoroscopy by injecting a radio-opaque contrast through the needle. The time taken from thelidocaine injection to verification of the needle was measured and the planned nerve block was then carried out. RESULTS: All cases of needle insertion into the sacral canal under ultrasound guidance were successful. The average duration of the procedure and the trial count were 134.1 +/- 10.1 seconds and 1.2 +/- 0.1, respectively. In 12 of the 46 cases (26%), the needle deviated either left or right in the sacral canal, so the direction of the needle had to be adjusted. The distance between two cornua, the depth of the sacral hiatus and the thickness and length of the sacrococcygeal ligament were 17.1 +/- 0.4, 3.9 +/- 0.3, 2.3 +/- 0.1 and 24.9 +/- 0.9 mm, respectively. CONCLUSIONS: Ultrasound guidance can increase the success rate of inserting a needle into the sacral canal. However, even when ultrasound is used, the needle can deviate either left or right in the sacral canal.
Anesthesia ; Chronic Pain ; Ethics Committees ; Fluoroscopy ; Humans ; Ligaments ; Needles* ; Nerve Block ; Ultrasonography*

PURPOSE: To evaluate the efficacy of chemical peeling using 83% alcohol in patients with conjunctival nevus. METHODS: Chemical peeling using 83% alcohol was performed in 13 patients (13 eyes) who were clinically diagnosed with benign conjunctival nevus. Effects of procedure and recurrence were analyzed by retrospectively reviewing medical records. After topical anesthesia, conjunctival nevus was eliminated by rubbing with an alcohol-soaked cotton ball. Conjunctival nevus close to corneal limbus was removed by 15th blades of scalpel. RESULTS: A total of 13 patients, 8 males, and 5 females had a, mean age of 27 years (12-54 years). Eights of the eyes were right eyes, and 5 were left eyes. No recurrence was detected in any patient during the follow-up period (mean 54 months), and there were no cases of conjunctival scar, granuloma, or permanent conjunctival injection. All patients were satisfied with the cosmetic outcome of chemical peeling. CONCLUSIONS: Chemical peeling using alcohol for conjunctival nevus is a non-invasive technique and has benefits such as no intraoperative hemorrhage, low recurrence rate, easy method, and good cosmetic results. Based on these, this procedure is a good method for eliminating conjunctival nevus.
Anesthesia ; Cicatrix ; Female ; Follow-Up Studies ; Granuloma ; Hemorrhage ; Humans ; Limbus Corneae ; Male ; Medical Records ; Nevus* ; Recurrence ; Retrospective Studies

The aquatic quality of the Naktong river after two of three months in June, 1991 with phenol spillage from a electrical factory in Kumi was investigated. The samples were collected at six sites of the Naktong river basin and Kachang and Kongsan lakes. Phenol was not detected from all water samples. Turbidity was very much increased to the down stream in the Naktong river. The BOD and COD values exceeded the 2nd grade(3 mg/l) of the Korean standard quality of Environmental Water Act at the all sampling sites of the Naktong river. Especially, the value of COD at Kaejin (12.5 mg/l) was poorly classified as to the 5th grade of water class for the environmental quality standards. Organophosphorous pesticides such as parathion, malathion, fenitrothion and diazinon were investigated but not detected. Diazinon was only detected at the Ilson bridge(1.42 ppb), Okkye stream(6.95 ppb), Waekwan bridge(0.32 ppb), Gangjung reservior(0.13 ppb), Kaejin(0.05 ppb). Of the carbamates such as carbanyl, isoprocarb and cabofuran, the carbofuran was detected all sites except tap water, and Kachang and Kongsan lakes. The content of heavy metals such ans Cd, Pb, Zn, Fe, Mn, Hg were not exceeding for drinking water standards at the all sampling region, but only mecury was detected from Okkye stream(0.018ppb) and Kaejin(0.09ppb). In the regions of Kachang and Kongsan lakes, the content of heavy metals were lower than that of reservoir of Naktong river.
Carbamates ; Carbofuran ; Diazinon ; Drinking Water ; Fenitrothion ; Gyeongsangbuk-do* ; Korea* ; Lakes ; Malathion ; Metals, Heavy ; Parathion ; Pesticides ; Phenol* ; Rivers* ; Water ; Water Quality

Intracranial hypotension is characterized by a postural headache which is relieved in a supine position and worsened in a sitting or standing position. Although less commonly reported than postural headache, sixth nerve palsy has also been observed in intracranial hypotension. The epidural blood patch (EBP) has been performed for postdural puncture headache, but little is known about the proper timing of EBP in the treatment of sixth nerve palsy due to intracranial hypotension. This article reports a case of sixth nerve palsy due to spontaneous intracranial hypotension which was treated by EBP 10 days after the onset of palsy.
Abducens Nerve ; Abducens Nerve Diseases ; Blood Patch, Epidural ; Headache ; Intracranial Hypotension ; Paralysis ; Post-Dural Puncture Headache ; Supine Position

PURPOSE: Few studies are available on the role of female urethral length (UL) and anterior vaginal wall thickness (AVWT) in stress urinary incontinence (SUI). The aim of this study was to evaluate the usefulness of characterization of female UL and AVWT associated with SUI. MATERIALS AND METHODS: Between May 2006 and October 2006, a total of 53 women with or without SUI were included in this study. Twenty-three women with SUI and 30 healthy volunteers serving as controls underwent transvaginal ultrasound with use of a 7.5MHz transrectal probe. Measurement comprised UL and three portions of AVWT classified as proximal, middle, and distal according to the location against the urethra. RESULTS: The women's median age was 51.1 (range: 30-73) years. The UL (mm, mean+/-SD) was significantly shorter in women with SUI than in women without SUI (28.7+/-2.8 vs 31.2+/-4.5, respectively, p=0.02). The AVWT of women with SUI (mm, mean+/-SD) was 16.2+/-2.8 in the proximal, 10.7+/-1.9 in the middle, and 9.3+/-2.0 in the distal portion, and those of women without SUI were 16.8+/-3.2, 10.1+/-1.8, and 6.9+/-1.3, respectively. Distal AVWT was significantly thicker in women with SUI than in women without SUI (p=0.01). There were no significant differences in AVWT or UL between pre- and postmenopausal women. A significant positive correlation was found between advancing in age and decrease in UL (p=0.03). Body mass index and parity showed no correlation with UL or any AVWT (p>0.05). CONCLUSIONS: These results suggest that women with shorter UL and thicker distal AVWT are likely to have SUI. Furthermore, UL was shorter in older women.
Body Mass Index ; Female ; Humans ; Parity ; Urethra ; Urinary Incontinence

No Abstract Available.
Forehead*