Chronic compression or ischemia of the spinal cord in the cervical spine causes a clinical syndrome known as cervical myelopathy. Recently, a new term “degenerative cervical myelopathy (DCM)” was introduced. DCM encompasses spondylosis, intervertebral disk herniation, facet arthrosis, ligamentous hypertrophy, calcification, and ossification. The pathophysiology of DCM includes structural and functional abnormalities of the spinal cord caused by static and dynamic factors. In nonoperative patients, cervical myelopathy has a poor prognosis. Surgical treatments, such as anterior or posterior decompression accompanying arthrodesis, arthroplasty, or laminoplasty, should be considered for patients with chronic progressive cervical myelopathy. Surgical decompression can prevent the progression of myelopathy and improve the neurologic status, functional outcomes, and quality of life, irrespective of differences in medical systems and sociocultural determinants of health. The anterior surgical approach to the cervical spine has the advantage of removing or floating the intervertebral disk, osteophytes, and ossification of the posterior longitudinal ligament that compress the spinal cord directly. The posterior surgical approach to the cervical spine is mainly used for multisegment spinal cord compression in patients with cervical lordosis. In this review article, we addressed the pathophysiology, clinical manifestations, differential diagnosis, and treatment options for DCM.

No abstract available.

Osteoporosis is a metabolic bone disease characterized by decrease of bone matrix, resulting in generally reduced bone mass, and the diagnosis and grading of progression are assessed by many methods. There are Singh Index as a simplest method, for grading the trabecular pattern of the femur in pelvis anteroposterior X-ray, and the recently developed Dual Photon Absorptiometry which measures the bone mineral contents in the lumbar spine(L2-L4), femur neck, Ward's triangle and trochanteric area. Study for correlation between the Singh index and bone mineral contents measurements by Dual Photon Absorptiometry was performed in 36 normal Korean persons and 35 persons with osteoporosis. The results and conclusion were as follows; 1. A significant difference in bone mineral density at each area was noted between the control group and osteoporosis group. 2. A significant difference in Singh Index at each area was noted between the control group and osteoporosis group. 3. Positive correlation was noted between the mineral density and Singh Index. 4. We think Singh Index is a useful method in the diagnosis and grading of progression of osteoporosis.
Absorptiometry, Photon ; Bone Density ; Bone Diseases, Metabolic ; Bone Matrix ; Diagnosis ; Femur ; Femur Neck ; Humans ; Methods ; Miners ; Osteoporosis ; Pelvis

BACKGROUND: To evaluate the effect of preoperative fatty degeneration of deltoid and teres minor muscles on the clinical outcome in patient with reverse total shoulder arthroplasty (RTSA). METHODS: Nineteen patients with RTSA were enrolled. The mean follow-up period was 16.1 months. The fatty degeneration of three distinct parts in each deltoid and the teres minor muscle was measured using a preoperative magnetic resonance imaging. Postoperatively, the muscle strengths for forward elevation (FE), abduction (Abd), and external rotation (ER) were measured using a myometer at the last follow-up. The parameters for clinical outcome were Constant Score (CS) and Korean Shoulder Score (KSS). RESULTS: The number of cases was 10 in group 1 and 9 in group 2. The strength of FE and Abd were significantly higher in group 1 (p<0.001 and p<0.001, respectively), and the strength of ER was not different significantly between two groups (p=0.065). For the clinical outcome, both CS and KSS were higher in group 1 (p=0.002 and p=0.002, respectively). The number of patients in group A was 11, and group B was 8. Although there was not a significant difference in terms of FE and Abd between group A and B (p=0.091, p=0.238), ER was significantly higher in group A (p=0.012). We did not find a significant difference in the clinical scores (CS, p=0.177 and KSS, p=0.238). CONCLUSIONS: These findings suggest the importance of a preoperative evaluation of the fatty degeneration of deltoid and teres minor muscles for predicting postoperative strength and clinical outcome.
Arthroplasty* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Muscle Strength ; Muscles* ; Shoulder*

Juvenile xanthogranuloma is a congenital or perinatal tumor, 1 to 2 cm in diameter, usually located on the head. The extracutaneous lesions can occur on the eye, the lung, the epicardium, the oral cavity or the testicles. Subcutaneous form of juvenile xanthogranuloma has been reported very rarely in the literature. We report a unique case of a subcutaneous juvenile xanthogranuloma that showed 4 × 4 cm sized plaque and located on the extremity of 9-year-old girl.
Child ; Extremities ; Female ; Head ; Humans ; Lung ; Mouth ; Pericardium ; Testis ; Xanthogranuloma, Juvenile*

STUDY DESIGN: A prospective clinical study with radiologic assessment was conducted. OBJECTIVES: To analyze the height changes of the intervertebral disc and neural foramen and width changes of the neural foramen after anterior lumbar interbody fusion and posterior fixation in the lumbar spine. SUMMARY OF LITERATURE REVIEW : Anterior lumbar interbody fusion distracts the height of the intervertebral disc and neural foramen and the width of the neural foramen. MATERIALS AND METHODS: Minimal anterior lumbar interbody fusion and posterior fixation were performed in 20 cases from January 1999 to January 2001. The measuring factors were the height of the anterior and posterior discs, and the height and width of the neural foramen, measured with a caliper in 1mm reconstructive, computed tomography, sagittal images before and 6 months after anterior lumbar interbody fusion. The factors were independently measured by three different persons. RESULTS: The height of the anterior and posterior discs was increased by mean 32.2% and 40.5%, respectively. The height of the right and left neural foramen was increased by mean 15.7% and 18.3%, respectively. The width of the superior, middle and inferior neural foramen was increased by mean 20.6%, 30.3% and 38.6%, respectively. There were significant increases in all measuring factors after minimal anterior lumbar interbody fusion. CONCLUSIONS: Minimal anterior lumbar interbody fusion significantly increased the height of the anterior and posterior intervertebral discs, and the height and width of the neural foramen, and produced neural decompression.
Decompression ; Humans ; Intervertebral Disc* ; Prospective Studies ; Spine*

No abstract available.
Allografts*

Simple bone cyst is a benign bone tumor occurring most frequently in the long bone. The pathogenesis is not yet fully known and there is no established mode of optimal treatment. In 1979, Scaglietti reported favorable results in the treatment of simple bone cyst with steroid injection. We have studied 23 cases of curettage with bone graft and 13 cases of steroid injection in 39 cases of histologically proven simple bone cyst in the department Orthopedic Surgery at College of Medicine Yousei University dating from Jan, 1970 to Jan. 1989. In 1 case out of 23 cases, there was no improvement in curettage with bone graft, and this cases was treated with steroid injection. There were 4 cases which did not receive any treatment except cast immobilization. In this case, the patient refused further treatment. The mean follow up period was 20.1 months and the results and conclusions were as follows:1. The average age of patients was 17.9 years, and incidence under 20 years was 74.4% The male to female ratio was 1.6 to l. 2. Twenty three cases were treated with curettage with bone graft. The average age of patients was 16.1 years, and there were 4 cases of recurrence of simple bone cyst (17.3% ). 3. Thirteen cases were treated with steriod injection. The average age of patient was 12.1 years, and there was 1 case of recurrence of simple bone cyst(7.6%). There were 6 cases who were completely healed after one steroid injection, 3 cases after 3 injections, 1 case after 4 injection, and 3 cases who had a maximun of 5 injections. 4. The difference was statistically significant from equality (p<0.05). The steroid injection method is a more simple and a more safe procedure than curettage with bone graft, and can be done at the Out-Patient Department. Steroid injection may be repeated in persisting and recurrent simple bone cyst.
Bone Cysts ; Curettage ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Incidence ; Male ; Methods ; Orthopedics ; Outpatients ; Recurrence ; Transplants

BACKGROUND AND OBJECTIVES: The human vestibule is known to be able to induce cervical muscle potential secondary to strong acoustic stimulations. This reflex is assumed to originate in the saccule, and is called "vestibular evoked myogenic potentials" (VEMP). The responses consist of alternatively positive and negative successive waves (p13-n23). This study was designed to evaluate the clinical significance of VEMP. MATERIALS AND METHOD: We studied the difference among the latencies of p13, n23 and the amplitudes among the 10 normal volunteers, 5 patients with sudden sensorineural hearing loss and 10 patients with vestibulopathy. And we compared the result of the caloric test and VEMP in patients with vestibulopathy. RESULTS: In the normal group, VEMP was detected in all and all of the sudden sensorineural hearing loss patients showed VEMP both in the affected and unaffected side. In unilateral vestibulopathy patients, VEMP were present in the unaffected side but not in the affected side. The difference between the amplitudes and latencies were not found in those cases where VEMP was detected. In vestibulopathy patients, VEMP were well correlated with the result of the caloric tests. CONCLUSION: We confirmed that VEMP is originated from the vestibule, not from cochlea. VEMP could provide itself as an addition method for testing the vestibule.
Acoustics ; Caloric Tests ; Cochlea ; Healthy Volunteers ; Hearing Loss, Sensorineural ; Humans ; Reflex ; Saccule and Utricle

BACKGROUND: So many electronic devices have been introduced in the operating room. However, little was known about the hazards of electromagnetic fields (EMF) to the human body. We have studied about how much the anesthesiologists are exposed to EMF. METHODS: In 19 operating rooms of our hospital, the intensity of magnetic fields was measured by an ELF (Extremely low frequency) field strength measurement system. The distances were 30 cm, 50 cm and the anesthesiologist's proximity to the monitoring devices. RESULTS: The average strength of 19 operating rooms were 2.22 +/- 1.13 mG at 30 cm from the monitors, 1.29 +/- 0.84 mG at 50 cm and 1.00 +/- 0.78 mG at the anesthesiologist's stand. CONCLUSIONS: We found that in some of our operating rooms the exposure to EMF was measured above Sweden's TCO limit which has been accepted as the EMF radiation rule for computer monitors. Although the hazards of EMF have not been definitely confirmed yet, the effort not to be exposed to EMF should be considered by anesthesiologists.
Electromagnetic Fields* ; Human Body ; Magnetic Fields ; Magnets* ; Operating Rooms*