This study was performed by the necessity of objective information upon change of pulmonary function after surgical correction of spinal deformity in scoliotic patients. It is relatively well known that deformity of spinal curvature affects the pulmonary functions, especially lung volume or vital capacity, due to restriction of the thoracic cage. It is carried out the comparative study between preoperative and postoperative pulmonary functions in thirty two cases of thoracic scoliosis, all who were treated with Harrington instrumentation and posterior fusion at Department of Orthopedic Surgery, Seoul, National University Hospital from 1969 to 1983. The age distribution of patients was from 6 years to 21 years and female was more involved two times than male. Following observations were obtained: Following observations were obtained: 1. Pre-and postoperative angle of scoliosis were 77.5° and 39.2° with correction rate of 48.2%. 2. Preoperative vital capacity was 64.2% and postoperative value was 74.8%, 2 years and 2 months after operation in average. 3. Postoperative vital capacity was significantly increased compared to preoperative value in patients with scoliosis (p<0.05). 4. Ther was no definite pattern of obstructive pulmonary disease in patients with scoliotic deformity.
Age Distribution ; Congenital Abnormalities ; Female ; Humans ; Lung ; Lung Diseases, Obstructive ; Male ; Orthopedics ; Respiratory Function Tests ; Scoliosis ; Seoul ; Spinal Curvatures ; Vital Capacity

Stabilization of the unstable spine created by the posterior decompression is as important as the decompression itself in the treatment of spinal stenosis. The purpose of this study is to evaluate the effectiveness of C-D pedicle screw fixation in stabilization after lumbar decompression, in reduction of spondylolisthesis and in restoration of the lumbar sagittal curvature. C-D pedicle screw fixation was performed in 102 spinal stenosis patients after posterior lumbar decompression and fusion during the period from March 1987 to December 1988. Their age ranged from 15 to 72 years with an average of 49.1 years. There were 34 males and 68 females. The follow up was from 6 to 21 months with an average of 12.5 months. The causes of spinal stenosis were degenerative in 50 patients, spondylolisthesis in 39, iatrogenic in 9 and degenerative lumbar scoliosis in 4. Objective clinical results showed significant improvement of claudication, SLR limitation, motor weakness, sensory and DTR changes in most patients. Following results were obtained from the study of C-D pedicle screw fixation after posterior decompression in lumbar spinal stenosis.1. C-D pedicle screws provide the secure fixation that allows early ambulation and shorter hospital stay. 2. C-D pedicle screws enable the reduction of spodylolisthesis at the time of posterior stabilization. 3. C-D pedicle screw fixation is successful in the restoration and maintenance of sagittal curvature of the lumbar spine. 4. C-D pedicle screw fixation enables the correction of scoliosis at the time of posterior decompression.
Decompression ; Early Ambulation ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Pedicle Screws ; Scoliosis ; Spinal Stenosis ; Spine ; Spondylolisthesis

No abstract available.
Epinephrine* ; Skin* ; Transplants*

No abstract available.
Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Thyroid Function Tests* ; Thyroid Gland*

We present a series of 97 patients with spinal cord injury. Those patients were treated at Soonchunhyan University Chonan Hospital during six-year-period(January 1986-December 1992), and followed up for at least 3 months. They were divide into four groups ; complete-surgical, complete-conservative, partial-surgical, and partial-conservative. Male to female ratio was 3.6:1, and the peak age was the fifth decade. Passenger's traffic accident(46%) was the most common cause of injury and fall/slip(39%) followed next. Level of spinal injury was cervical in 51%, thoracic in 29%, lumbar in 13%, and others in 7%. Type of injury was fracture-dislocation in 31%, dislocation in 19%, compression fracture in 19%, burst fracture in 18%, cord injury without bony lesion in 7%, and others in 7%. Cord injury was complete in 36 patients(37%) and partial in 61 patients(63%). Surgery was performed in 20 patients with complete cord injury and 34 patients with partial injury. Majority of operations were performed for spinal stability, and posterior instrumentation was the most commonly used operative method. The mean neurotrauma motor index on admission was 44.1 in the complete-surgical group, 39.5 in complete-conservative group, 70.1 in partial-surgical group, and 63.2 in partial-conservative group. It improved to 52.5, 50.3, 90.4, 80.3 at 3 months, and 53.4, 51.7, 91.8, 82.0 at final examination(mean follow-up period was 182.2 days), respectively. The mean values of the final index were higher in the surgically treated groups than the conservatively treated groups, but these differences were not statistically significant(student t-test p>0.1) The mean recovery rate was 14.2% in the complete-surgical group, 17.7% in complete-conservative group, 66.1% in partial-surgical group, and 46.1% in partial-conservative group at 3 months. It improved to 16.6%, 19.3%, 70.0%, and 48.7% at final examination, respectively. The mean recovery rates were higher in the partially injured groups than the completely injured groups(student t-test, p<0.01), regardless the methods of treatment. The final neurotrauma motor index was significantly(regression analysis, p<0.01) related to the initial index except the partial-surgical group. Neurotrauma motor index was a useful method for assessing the injury severity, comparing the recovery rate and predicting prognosis.
Chungcheongnam-do ; Dislocations ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Male ; Prognosis* ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries

No abstract available.
Weaning*

Here, we report a case of newly diagnosed diabetes, with concurrent pancreatic cancer manifested as hyperglycemic crisis, and aggravated by urinary tract infection. We summarize the initial clinical manifestations and pertinent laboratory, radiologic, and clinical findings in an elderly patient with hyperglycemic emergency. A review of the documents involving pancreatic tumors and hyperglycemic hyperosmolar state, which is an acute complication of diabetes mellitus, is presented. In the absence of other identifiable conditions, it is reasonable to speculate that some factor (or factors) produced by the tumor had a role in the metabolic decompensation. In addition, this discussion should be more carefully considered in the aged people group.
Aged ; Diabetes Mellitus ; Emergencies ; Humans ; Pancreatic Neoplasms ; Urinary Tract Infections

PURPOSE: In general, sinusitis in children is diagnosed by clinical symptom and paranasal sinus x-ray. Sinus plain x-rays in children is simple, inexpensive, and speedy. However, it requires proper interpretative techniques, because different development of each sinus, soft tissues overlying sinuses and bony structure require precise diagnosis. This study was conducted to compare plain x-rays with OMU CT scans. METHODS: From September 1996 through August 1997, thirty nine patients who were diagnosed as sinusitis based on clinical symptoms and plain x-rays at the pediatric department of Seoul Adventist Hospital were studied. Water's view, Caldwell's view and lateral view were taken for the plain x-rays with concurrent OMU CT scans prior to treatments. RESULTS: Ten cases (25.6%) out of 39 patients showed posterior nasal drip and fourteen cases (35.9%) showed nasal obstruction. Twelve cases (30.8%) were related to allergic diseases and seven cases (58.3%) among these 12 cases were bronchial asthma. Sensitivity of plain x-ray were 88.5+/-12.9% for maxillary sinuses, and 59.9+/-13.65% for ethmoidal sinuses. CONCLUSION: When maxillary sinusitis is suspected, plain X-ray for maxillary sinuses is enough to diagnose sinusitis, but for ethmoidal sinuses it may be underestimated or overestimated in comparison with OMU CT scan. Ethmoidal sinusitis requires careful diagnosis and follow-up because it plays important roll for chronic sinusitis due to its structure. Therefore, we recommends OMU CT scan to diagnose paranasal sinusitis of children with plain X-ray.
Asthma ; Child* ; Diagnosis ; Ethmoid Sinusitis ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; Nasal Obstruction ; Seoul ; Sinusitis* ; Tomography, X-Ray Computed*

The scabies mite is an ectoparasite, which is able to infest humans. The incidence of scabies decreased during the past 20 years in Korea. However, the incidence is likely to increase again, and may be delayed or missed diagnosis recently. Its clinical presentation is typical, although in a host with compromised immune system, like the mentally retarded and elderly patients, the clinical presentation may be altered. Because a delay in diagnosis may induce rapid spread of the scabies mite, immediate diagnosis and treatment are necessary. We report two cases of scabies in elderly patients from different nursing homes. These patients were transferred to our center for treatment of pneumonia and chronic renal disease. They revealed pruritus and skin rashes after the treatment of further underlying diseases. We consulted to a dermatologist because of worsening symptoms, despite an application of medication with antihistamine and topical steroid, scabies was diagnosed. The symptom improved with topical 1% gamma-benzene hexachloride, an effective scabies drug. We suggest that geriatrists should suspect scabies who presents with pruritus that is persistent or resistant to conventional treatment, especially patients transferred from nursing homes.
Aged ; Chronic Disease ; Exanthema ; Humans ; Immune System ; Immunocompromised Host ; Incidence ; Korea ; Lindane ; Mentally Disabled Persons ; Mites ; Nursing Homes ; Pneumonia ; Pruritus ; Renal Insufficiency, Chronic ; Scabies

Nemaline myopathies, originally reported as a type of congenital myopathy, are clinically and genetically heterogenous diseases. Clinically, nemalin myopathies can be divided into infantile, juvenile and adult forms, and genetically, into autosomal dominant and recessive. There are several reports on nemalin myopathy in Korea, all juvenile forms, but not adult or infant form. In contrast to juvenile form, the adult congential nemalin myopathy is characterized by rather selective acute or subacute respiratory dysfunction in adult age with sporadic or autosomal recessive inheritance. Here, we report the first case of an adult form of nemalin myopathy, whose symptoms were rapidly developed at the age of 32. Therefore, nemalin myopathy can be included in the differential diagnosis for the unexplainable respiratory failure in adult age.
Adult* ; Diagnosis, Differential ; Humans ; Infant ; Korea ; Muscular Diseases ; Myopathies, Nemaline* ; Respiratory Insufficiency ; Respiratory Muscles* ; Wills