A 56 year-old female presented with dysphagia 8 weeks ago and newly developed dysphonia 2 weeks ago. The radiology study and swallowing difficulty evaluation study revealed the esophagus and the posterior wall of the laryngopharynx to be severely compressed by the mass of the anterior 4th and 5th vertebral body of cervical spine. En bloc excisional biopsy of the bony mass was performed, which completely resolved the clinical symptoms. We report a rare case of osteochondroma occurring at the anterior portion of cervical spine leading to dysphasia and dysphonia with a review of relevant literature.
Aphasia ; Biopsy ; Deglutition ; Deglutition Disorders ; Dysphonia ; Esophagus ; Female ; Humans ; Hypopharynx ; Osteochondroma ; Spine

Since Luque introduced new posterior instrumentation by segmental sublaminar wiring for neuromuscular scoliosis in 1976, preliminary reports have been published regarding its use with Harrington rod or Luque rod for other types of scoliosis, traumatic lesions of the spine, and spondylolisthesis as well as for degenerative disorders and tumors. Its advantage includes rigid internal fixation which often obviates the requirement for postoperative immobilization and the significant correction of deformity. Disadvantages are longer operation time, increased blood loss and the risk of neurologic damage. Segmental spinal instrumentation was carried out using either Harrington rod or Luque rod in 30 cases of scoliosis; 16 in idiopathic scoliosis, 12 in paralytic scoliosis and 1 each in congenital scoliosis and neurofibromatosis, at the Department of Orthopedic Surgery, Seoul National University Hospital, for 3 years from January 1984 to December 1986, Twenty six cases had been followed for more than 1 year and following results were obtained. 1. In idiopathic scoliosis, average preoperative curve was 65.0 degrees and immediate postoperative curve was 27.9 degrees with 57.4% correction. There was 1.2 degrees loss of correction with an average follow-up of 19.5 months (14–28 months). 2. In papalytic scoliosis, average preoperative curve was 108.5 degrees and immediate postoperative curve was 55.5 degrees with 49.5% correction. There was little loss of correction with anaverage follow-up 24.5 months (13–38 months). 3. No neurological complication occurred as a result of sublaminar wiring. 4. Segmental spinal instrumentation is an effective method with an advantage of better correction, greater contouring of the spine to avoid flat back, and less external immobilization in the treatment of idiopathic or paralytic scoliosis without increased complication.
Congenital Abnormalities ; Follow-Up Studies ; Immobilization ; Methods ; Neurofibromatoses ; Orthopedics ; Scoliosis ; Seoul ; Spine ; Spondylolisthesis

Nineteen patients (twenty knees) with degenerative arthritis of knee treated by arthroscopic curettage were reviewed. Of the nineteen patients, there were eighteen females and one male ranging in age from 49 to 68 years (mean, 57 years). The mean follow up period was 18.2 months (range, 12 months to 21 months). Simple standing roentgenorgram and 99m-Tc bone scintigraphy were used to select the patients with medial compartment involvement only, less than 5 degree of varus deformity and sparing of patello-femoral joint. Knee scoring by Hospital for Special Surgery Formula showed improvement from the preoperative average 68 points to postoperative average 89.6 points (21.6 points increase) and 84.1 points (16.1 points increase) at 6 months and one year respectively. Arthroscopic curettage of knee, if done early in degenerative arthritis, not only can shorten hospital days and immobilization period but also can defer other major surgical treatments by promoting natural healing process and symptomatic relief.
Congenital Abnormalities ; Curettage ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Joints ; Knee ; Male ; Osteoarthritis ; Radionuclide Imaging

Enchondroma is a benign tumor mainly developed in the hand and uncommon in the foot. Even if it is in the foot, most are in the phalanges and distal metatarsals of the foot. Enchondroma in the calcaneus is very rare. A 44-year-old male suffered from left heel pain for several months, authors treated it with curettage and bone graft, it was histologically confirmed as an enchondroma in the calcaneus. The authors presented a rare case presentation of an enchondroma in the calcaneus with pain.
Adult ; Calcaneus ; Chondroma ; Curettage ; Foot ; Hand ; Heel ; Humans ; Male ; Metatarsal Bones ; Transplants

OBJECTIVES: Hemophilia B has been known to result from more than 500 kinds of mutations. And it is difficult to find out a mutation specific for each family. Therefore, linkage analysis of DNA polymorphism within or near the factor IX gene has been frequently used in the clinical practice for molecular genetic diagnosis of hemophilia B. But the ethnic variation makes more difficult to apply useful markers in Caucasian population. To investigate the usefulness of the MseI and HhaI polymorphism in Korean population, we analysed the MseI and HhaI polymorphism. METHODS: Forty-five normal Korean and thirteen parents of the hemophilia B patients, using PCR and restriction enzyme analysis. RESULTS: The heterozygosity rate of MseI polymorphism was 49.7% and that of HhaI polymorphism was 25.5%. CONCLUSION: These data indicated that PCR-based analysis of MseI and HhaI polymorphism of factor IX was useful in molecular genetic diagnosis of hemophilia B in Korean population.
Diagnosis* ; DNA* ; Factor IX* ; Hemophilia A* ; Hemophilia B* ; Humans ; Molecular Biology* ; Parents ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Restriction Mapping

Central retinal artery occlusion occurs rarely as a complication of spine surgery in prone position, but is quite tragic. The suggested cause are hypotensive anesthesia and increased external ocular pressure by headrest, sand bag or others. We experienced a case of left central retinal artery occlusion(CRAO) after surgery of C4-5 fracture-dislocation using a horseshoe headrest and report this case.
Anesthesia ; Prone Position ; Retinal Artery Occlusion ; Retinal Artery ; Spine

No abstract available.
Disability Evaluation* ; Spinal Fractures*

We evaluated the ability of selective suture cutting to reduce postoperative astigmatism due to tight corneo-scleral(C-S) suture in 65 eyes undergone posterior chamber lens implantation. Under operating microscope, two-planned beveled C-S incision was made from 10:00 position to 2:00 position. At the end of operation. C-S wound was sutured at 11:20 position and 12:40 position with 8-0 Vicryl(R), 'X'-shaped suture at 10:40 position. 12-o'clock, and 1:20 position with 10-0 nylon. We cut the C-S suture with 26G disposable needle under slit lamp after local anesthetics(Alkaine(R)) instillation. Keratometric and refractive measurements were obtained before and at selective intervals(group A:4-6 weeks, group B:7-9 weeks, Group C:10-12 weeks) after surgery. Our analysis demonstrated the followings: 1. Remained astigmatism below 1.5 Diopter at 4th week after selective suture cutting were 87.5% in group A, 86.5% in group B, 83.8% in group C. 2. complications due to suture cutting were C-S wonnd disruption(cutting at 5th week after surgery), mild anterior chamber reaction(cutting at 8th week after surgery), and aganinst-the-rule astigmatism(average 1.25D iopter, Group A:18.8%, Group B:13.5%, Group C:16.7%). 3. Selective suture cutting at postoperative 7-9th weeks can correct the postoperative astigmatism.
Anterior Chamber ; Astigmatism* ; Cataract Extraction* ; Cataract* ; Needles ; Nylons ; Sutures* ; Wounds and Injuries

Epiblepharon is characterized by horizontal fold of skin adjacent to lid margin. It is a common congenital anomaly, especially in Orientals. In comparison with it, entropion is characterized by an absent lid crease and an inward rolling of the entire eyelid margin. The incidence of the latter was not reported but it was said to be very rare. Not with standing that, congenital entropion has been diagnosed more frequently than epiblepharon in Korea. Supposing that the cases diagnosed as entropion in Korea might fall under the category of epiblepharon on the basis of the authors' clinical experience, the clinical evaluation of the 190 cases operated under the diagnosis of congenital entropion at Seoul National University Hospital from January 1976 to May 1986 was done. The result was that 147 cases(77.4%) were thought to be epiblepharon. So more careful examination might be necessary in diagnosing epiblepharon or entropion in Orientals.
Diagnosis ; Entropion ; Eyelids ; Incidence ; Korea ; Seoul ; Skin

We compared the visual outcome after phacoemulsification through the scleral pocket incision between non-diabetic patients and diabetic patients, and studied the factors influencing the visual outcome and postoperative complications in diabetic patients. retrospectively. The subjects operated by one of the authors were composed of 277 non-diabetic patients (277 eyes) and 90 diabetic patients (113 eyes). An average of the best corrected visual acuities at postoperative 8 weeks was lower in diabetic patients than that in non-diabetic patients, but there was no statistically significant difference between diabetic patients who had no or background diabetic retinopathy and non-diabetic patients. In diabetic patients the visual outcome was significantly related with severity of diabetic retinopathy, duration of the diabetes, and insulin dependency, but not related with the rupture of posterior capsule during surgery. Among the complications there were posterior capsule rupture (10.6%), hyphema (7.8%), posterior capsular opacity (4.9%), and posterior synechiae (4.9%).
Diabetic Retinopathy ; Humans ; Hyphema ; Insulin ; Phacoemulsification* ; Postoperative Complications ; Retrospective Studies ; Rupture ; Visual Acuity