No abstract available.
Aneurysm*

No abstract available.
Fracture Fixation*

No abstract available.
Tracheoesophageal Fistula*

Klippel-Feil syndrome is characterized by congenital fusion of cervical vertebrae with a wide range of associated anomaly. The authors present a 50-year-old Klippel-Feil syndrome patient with a minor trauma followed progressive quadriparesis. He had typical radiologic findings of type II Klippel-Feil syndrome and presented progressive myelopathy due to cord compression at foramen magnum level with cervical instability. The patient underwent craniocervical decompression and fusion. The authors reviewed the pertinent literatures and discussed this rare syndrome.
Cervical Vertebrae ; Decompression ; Female ; Foramen Magnum ; Humans ; Klippel-Feil Syndrome* ; Middle Aged ; Quadriplegia* ; Spinal Cord Diseases

A basal cell carcinoma developed in the forehead of a 57-year-old man at the scar site from a blunt trauma that happened 10 months previously. The patient had never been noted to have premalignant or other malignant skin lesions. The significance of injury in the etiology of basal cell carcinoma is discussed.
Carcinoma, Basal Cell* ; Cicatrix* ; Forehead ; Humans ; Middle Aged ; Skin

OBJECTIVES: The purpose of this study was to find the differences of temperamental characteristics of Korean children according to family environment and developmental history. METHODS: 1) The mothers whose children had been educated at twenty-five Samsung Child Care Centers nationwide participated in the survey using Parent Temperament Questionnaire for Children (PTQ) and the Child Development Questionnaire (CDQ). 2) The temperament of 1,175 children whose mothers completed PTQ were classified into 5 diagnostic clusters (Easy, Intermediate Low, Intermediate High, Difficult, Slow-To-Warm-Up) according to the method proposed by Fullard et al. 3) The results of classification were compared and analysed statistically according to each CDQ parameters. RESULTS: Statistically meaningful difference in the distribution of temperamental clusters were found in the CDQ parameters such as birth order of children, number of intimate friends, children's relationship with their peers, children's relationship with their siblings, children's relationship with their parents, type of milk feeding, motor development of children during 2 years after birth, motor development during from age 2 to 5, stranger anxiety, present health state of children, and relationship between parents. After all, the proportion of Easy type was greater in the children who were first-born, or who had good relationship with their peers or family, fast motor development, mild stranger anxiety, good health condition, or good relationship between each parent. CONCLUSION: This study shows that the distribution of temperamental cluster was significantly different in several parameters of family environment and developmental history of Korean children. The children with fast development, good interpersonal relationship or favorable family environment are more likely to be the Easy type.
Anxiety ; Birth Order ; Child Care ; Child Development ; Child* ; Classification ; Friends ; Humans ; Milk ; Mothers ; Parents ; Parturition ; Surveys and Questionnaires ; Siblings ; Temperament*

To evaluate the result of diathermic capsulotomy for phacoemulsification in hypermature intumescent cataracts, we retrospectively studied 34 patients(35 eyes) who were operated from January 1995 to February 1997. Central corneal endothelia cell counts were taken preoperatively and 2 months postoperatively by non-contact specular microscopy and endothelial cell loss(%) was calculated. The anterior capsular radial tear occurred in 24 eyes(68%), posterior capsular rupture occurred in 1 eye(2.9%) and the percentage of postoperative endothelial cell loss was 6.45(+/-7.27)%. The high rate of anterior capsular radialtear was due to altered mechanical integrity of the diathermic capsulotomy edge. But the thermal effect on the corneal endothelium was minute. Based on these findings, the diathermic capsulotomy for phacoemulsification in hypermature intumescent cataracts is very useful technique.
Cataract* ; Cell Count ; Endothelial Cells ; Endothelium, Corneal ; Microscopy ; Phacoemulsification* ; Retrospective Studies ; Rupture

PURPOSE: MR findings of the spinal metastasis and the tuberculosis are well known, but sometimes it might be difficult to differentiate these lesions. Therefore we reviewed and analyzed the MR findings which would be useful for the differentiation. MATERIALS AND METHODS: T1- and T2-weighted spin echo images and gadolinium-enhanced Tl-weighted images were obtained with 1. 5T and 1. 0T superconductive MR imager. We reviewed MR findings in 16 cases of spinal metastases and 24 cases of spinal tuberculosis in terms of signal intensity, contrast enhancement pattern, disc space involvement, spinal canal compressing feature and paraspinal soft tissue mass. RESULTS: The signal intensities of both lesions were hypointense on T1WI and hyperintense on T2WI except those of the metastatic lesions from the prostatic carcinoma. Heterogeneous enhancement was noted in 63% of metastasis, whereas peripheral rim enhancement was noted in 83% of spinal tuberculosis(p (.001). Spinal canal compression by collapsed vertebra was only noted in spinal metastasis, and that by paraspinal soft tissue was noted in both spinal metastasis and tuberculosis(p (.001). Disc space invasion was noted in 19% of spinal metastasis and 88% of spinal tuberculosis. Spinal tuberculosis was common at lower thoracic spine(T10) and typically involved two or more adjacent vertebral bodies(96%). CONCLUSION: The important differential point between spinal metastasis and tuberculosis was the enhancement pattern, involvement of two or more contiguous vertebral bodies and the feature of spinal canal compressing. The secondary importance was the disc space involvement pattern.
Neoplasm Metastasis* ; Spinal Canal ; Spine ; Tuberculosis ; Tuberculosis, Spinal*

OBJECTIVE: The purpose of this study was to evaluate the results obtained in patients who underwent staged 360-degree fusion with posterior fusion following anterolateral fusion for unstable thoracolumbar burst fractures. METHODS: The authors performed 360-degree fusion for thoracolumbar burst fractures in 21 patients between 2006 and 2010. We reviewed the medical records and follow-up data including pre- and postoperative neurological status, spinal canal compromise, segmental kyphotic angulations, complications, visual analogue scale (VAS) pain scores, and revision surgery rates. RESULTS: The mean computed tomography-measured preoperative spinal canal compromise was 55.9+/-20.7%. The segmental kyphotic deformity measured 20.2+/-4.4degrees preoperatively and had been corrected to 4.5+/-2.8degrees postoperatively. The mean vertebral body height loss of 57.4+/-6.9% improved significantly to 1.2+/-0.7% at the final follow-up examination. The mean preoperative VAS pain score of 8.2+/-0.8 improved to 1.5+/-0.6 at discharge. There were no cases of vascular complication, neurological deterioration, or revision surgery. CONCLUSION: Unstable burst fracture of thoracolumbar spine managed by staged posterior fusion and anterolateral interbody fusionis effective for kyphosis correction, significant canal decompression, pain reduction, maintaining stabilization and neurological improvement.
Body Height ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Medical Records ; Spinal Canal ; Spinal Fractures ; Spinal Fusion ; Spine

OBJECTIVE: Epidural venous varicosity (congestion of the epidural vein) is rarely introduced as an influential factor of clinical symptoms. However, there are several studies suggesting that epidural venous varicosity results in neurologic symptoms. We would like to highlight evidence that epidural venous varicosity results in neurologic symptoms and the relation between epidural venous varicosity and neural structure observed during the surgery. Based on our experiences, we also propose a new classification of epidural venous varicosity. METHODS: 29 patients with symptomatic lumbar stenosis received microsurgical decompression via partial hemilaminectomy. The authors retrospectively reviewed all recorded intraoperative pictures and categorized patterns of venous varicosities with relationship to neural structures. RESULTS: Type A is conditions in which epidural veins are dilated but located parallel to the nerve root on the lateral side of the nerve root and thus do not compress the nerve root. Type B is conditions in which varices are located on the anterior lateral side of the nerve root to compress the nerve root. Type C is conditions in which varices are encircled around the nerve root and compressing the nerve root. CONCLUSION: Epidural venous varicosity is observed in most lumbar stenosis patients with clinical symptoms. Of the types, the types of epidural venous varicosity compressing nerve structures were Type B and Type C. All epidural venous varicosities were removed regardless of classification during operations. Most patients showed relief in clinical symptoms after the operation. We thought to epidural venous varicosity as a factor that causes clinical symptoms of lumbar stenosis.
Constriction, Pathologic ; Decompression ; Decompression, Surgical ; Epidural Space ; Humans ; Intermittent Claudication ; Neurologic Manifestations ; Radiculopathy ; Retrospective Studies ; Spinal Stenosis ; Varicose Veins ; Veins