Recurrent episode of meningitis in infants and children frequently constitute a frustrating and distressing, both in determination of course and treatment. The authors are reporting a infected case of congenital dermal sinus with dermoid cyst in the subarachnoid space of cauda equina and conus medullaris which was cured after complete removal of cyst and sinus tract.
Cauda Equina ; Child ; Conus Snail ; Dermoid Cyst ; Humans ; Infant ; Meningitis ; Spina Bifida Occulta* ; Subarachnoid Space

No abstract available.
Humerus*

We checked and analysed the clinical and radiological status of the upper extremities of 142 baseball player in childhood and adolescence. The results of this study were as follow:1. The oreder of frequency of pain locations in the upper extremities was elbow, shoulder, and then wrist joint. 2. There was colse relationship between elbow pain and career, but not in shoulder and wrist area. 3. The characteristics of shoulder or wrist pain were diffuse and vague nature, but elbow pain was located in medial aspect. 4. The cubitus valgus and limited elbow ROM in throwing side were found in pitchers or older careers. 5. All players showed cortiocotrabecular hypertrophy of humerus, and high incidence of medial epicondylar changes were noticed with career increased. 6. Main bony changes: Shoulder
Adolescent ; Baseball ; Elbow ; Epiphyses ; Growth Plate ; Humans ; Humerus ; Hypertrophy ; Incidence ; Joints ; Shoulder ; Upper Extremity ; Wrist ; Wrist Joint

Study of 22 cases with the pseudospondylolisthesis established that it occurred more frequently in the older women, and far more frequently at the L4 level, as same results as reported by others. The slipping occurred as a result of degenerative disease of the articular process and facet joint, but it never exceeded 25% in this series. This study was performed to recognize the stability of the lumbosacral joint by the measurement of the anterior and posterior vertical heights(deformity) of the body of the L5 vertebra and lumbosacral angles in our cases. We also attempted to observe whether the facet angle changes at the involved level was meaningful or not. Result : lumbosacral angles in the our patients with pseudospondylolisthesis were increased greater than normal, so lumbar lordosis was less than normal. The body of the L5 vertebra was not as wedged anteroposteriorly as it normally was. The contour of the body of the L5 vertebra resembled rectangle shape. The pedicle-facet angles were increased at involved level, but this measurement was not correctly demonstrated on the plain roentgenograms. Conclusion : The stability of the lumbosacral joint in the patients with pseudospondylolisthesis was increased due to rectangle shape of the body of the L5 vertebra and less lumbar lordosis. The pedicle-facet angles at the involved level were increased, but not correct diagnostic values.
Animals ; Female ; Humans ; Joints ; Lordosis ; Spine ; Zygapophyseal Joint

We report a case of irreducible atlantaxial dislocation with spinal cord injury. The patient was a 36-year-old man who suffered from the sudden onset of shallow respiration and severe motor weakness after slip down. We have performed the one-stage operation, the transoral decompression, reduction and posterior interspinous wiring with bone fusion. Three weeks after surgery, the reduction state and posterior wiring procedure were failed, due to severe osteoporotic change. So, we have performed second operation, the transarticular facet screw fixation and occipito-cervical fixation with Steinmann pin, from which good postoperative stability and neurological improvements, were obtained.
Adult ; Decompression* ; Dislocations* ; Humans ; Osteoporosis ; Respiration ; Spinal Cord Injuries* ; Spinal Cord*

The authors studied 22 patients with delayed traumatic intracerebral hematoma (DTICH) who had been admitted to Hanyang University Hospital from March 1987 to February 1988. The results of the study were summerized as follows : 1) DTICH occurred most frequently on frontal and temporal lobe and closely associated with contusion of the brain at initial brain computed tomographic scan. 2) 20 cases of DTICH discovered within 10 days after trauma and remained 2 cases occurred at 20 day and 30 day, respectively. 3) The prognosis of DTICH was mostly affected by the neurological status at admission and good results of the surgery was obtained from the patients operated within 48 hours. 4) It was though that closed observation of the neurological status, repeated computed tomographic scanning and prevention of the systemic insults such as hypoxia and hemorrhagic shock would be improved the clinical outcome of the DTICH.
Anoxia ; Brain ; Contusions ; Craniocerebral Trauma ; Hematoma* ; Humans ; Prognosis ; Shock, Hemorrhagic ; Temporal Lobe

To obtain wider versatility and greater reach in microsurgical lumbar discectomy, modified procedure has been performed on 263 patients in 1979-1983. It consisted of a smaller midline incision, removal of lateral half of the spinous process, partial but sufficient microdrilling of the lamina, use of a modified slender Taylor retractor, flavotomy, preservation of epidural adipose-areolar tissue etc. Particularly a slender Taylor-Chung retractor offered yielding surgical opening and therefore secured free of pituitary forceps to every direction. The microsurgical results including 72 bisegmental and 8 trisegmental discectomies were compared with those of standard operations of same number performed by same surgeon in 1972-1979, for the good contrast. Mean blood loss per operation was 94 ml with the standard discectomy and 46 ml with microsurgery. Dural tear occured in 17 cases undergoing standard operation and in 3 undergoing microsugery. The mean time until return to duty was 8.6 weeks with standard, compared with 4.2 weeks. In the microsurgical group, 3 patients had postoperative discitis while 2 had in the standard. In this series, the results of microsurgery surpasses the standard in the convalescent phase. Major advantages of this modified microsurgical technique were its ability to secure the greater reach to remove disc material as much as possible and to preserve the integrity of normal tissue better.
Discitis ; Diskectomy* ; Humans ; Microsurgery ; Surgical Instruments

The mean values of the height, depth and lateral shifting of the spinous processes and the height of the intervertebral disc spaces of 100 patients were measured in the lumbar region. The application of microsurgical techniques in the operation for lumbar disc herniation clearly reduced the overall surgical trauma suffered by patient, but the spinous process might disturb the insertional course and multidirectional activities of the pituitary forceps due to a very small skin incision. The purpose of this study was to prove the relationships between intervertebral disc space and spinous process in the lumbar region. The results were as follows; 1) The height of the intervertebral disc space from L3-4 to L5-S1 intervertebral disc space was 12.63mm, 12.57mm and 11.71mm respectively. 2) The depth of the spinous process from L3 to L5 was 28.87mm, 27.87mm and 23.97mm respectively. 3) The lateral shifting of the spinous process from midline to the right side was 4.39mm, 4.35mm and 4.01mm at L3, L4 and L5 spinous process respectively and to the left side was 3.61mm, 3.70mm and 3.69mm at L3, L4 and L5 spinous process respectively. Conclusively, the lower part of the spinous process was overlapped above the intervertebral disc space at L3-4, L4-5 and L5-S1 intervertebral disc space. About 4mm of the lateral shifting of the spinous process was protruded to both right and left side in the insertional course(about 2-3cm) of the pituitary forceps. The spinous process might disturb the multidirectional activities and perpendicular insertion of the pituitary forceps. So, the removal of the spinous process to the midline was recommended to perform the complete removal of disc materials in microlumbar discectomy.
Diskectomy ; Humans ; Intervertebral Disc* ; Lumbosacral Region ; Skin ; Surgical Instruments

The lumbar sympathectomy was performed for the treatment of 25 patients with Buerger's disease. 80% of patients received lumbar sympathectomy achieved improvement of clinical symptoms and signs. The lumbar sympathectomy had good results in following cases: 1) Patients with resection of L1 sympathetic ganglion which was performed completely, anatomically and widely. 2) Patient received operation within the 6th months of initial occurrence of symptoms. 3) Patients which main symptoms were rest pain, coldness and numbness. In case of resection which was included of L1 sympathetic ganglion, postoperative skin temperature measured on medial aspect of tibia was higher than normal side about 1degrees C. The prognosis was poor in patients which ulceration and necrosis were previously existed. Stop smoking must be preceded for the treatment of Buerger's disease.
Ganglia, Sympathetic ; Humans ; Hypesthesia ; Necrosis ; Prognosis ; Skin Temperature ; Smoke ; Smoking ; Sympathectomy* ; Thromboangiitis Obliterans* ; Tibia ; Ulcer

The authors present 43 cases of intracranial acute epidural hematomas(EDH's) managed by close observation. In each of 43 cases, the following criteria were met:1) the patient was conscious soon after head injury;2) the volume of hematoma was under 30ml(10ml in case of posterior fossa EDH's);3) there was no severe effacement of basal cistern or 4th ventricle;4) there was no associated intradural lesion;5) the patient showed neither cerebral herniation nor cardiorespiratory abnormalies. Of the 43 patients, 31(72%) showed no hematoma enlargement, and showed rsolution of hematoma on computerized tomography(CT) scans over a period of 4 to 11 weeks. Repeat CT scans within 24 hours of initial CT revealed enlargement of EDH in 12 of 43 patients(28%), of these 12 EDH's, 5 were reabsorbed spontaneously from 6 to 10 weeks, and 7 were evacuated surgically. All patients recovered without morbidity except one who had craniotomy during observation. There was no specific location of EDH which was indicated or contraindicated for conservative treatment. Factors that influence outcome include the age of patient, initial CT finding, cerebrospinal fluid(CSF) leakage, the use of mannitol, and recovery from shock. Hematoma enlargement did not always accompany deterioration of consciousness, therefore repeat CT scans within 24 hours is strongly recommended.
Consciousness ; Craniotomy ; Head ; Hematoma* ; Humans ; Mannitol ; Shock ; Tomography, X-Ray Computed