There are many hypotheses of spinal instability after trauma and the concept had been recently changed from 2-column concept by Holdsworth to 3-column concept by Francis Denis & McAfee and also there are controversies about the operative management of the unstable thoracolumbar spine fractures and fracture-dislocations. So we tried to find some relationship between the spinal instability and the effect of the stabilization operation for the fractures and fracture-dislocations in the thoracolumbar spine in this study. Totally 53 cases that stabilization operation had been performed for the unstable fractures and fracture-dislocations of the thoracolumbar spine at Yonsei University Hospital, including Yongdong hospital, from March, 1973 to October, 1984 and followed up over 6 months, were reviewed. 1. Majority of the patients (84.9%) was in an active age group (20–49 years of his age) and more common in males. 2. The first lumbar vertebra was most commonly involved segment (43.3%) and falling from a height was the most common cause of injuries (50.9%). 3. Injuries to the anterior, middle and posterior column of the spine (58.5%) was the most common mechanism of injury according to the classification by Francis Denis and McAfee. 4. The wedged deformity of the involved segment over 50% was usual (71.7%) and mean wedged deformity was 57% of the height of the vertebral body and most commonly associated fractures besides the body itself was laminae fractures (46.5%). 5. Seventy eight percent of the angular deformity was corrected after Luque rod instrumentation and 76%, after Harrington rod instrumentation, 68%, after posterior wiring, 58%, after anterior decompression and anterior interbody fusion. 6. Forty twa point seven percent of the displacement in anteroposterior plain X-ray film and 58.8% in the lateral film were corrected by Luque rod instrumentation and 39.5% in anteroposterior film and 44.3% in the lateral film were corrected by Harrington rod instrumentation. 7. No significant differences in the recovery of the neurologic signs were found according to the method of surgical treatments. 8. So Luque rod or Harrington rod instrumentation is now recommended for obtaining the spinal stability as a method of surgical treatment in the unstable thoracolumbar spine fractures and fracture-dislocations.
Accidental Falls ; Classification ; Congenital Abnormalities ; Decompression ; Humans ; Male ; Methods ; Neurologic Manifestations ; Spine ; X-Ray Film

BACKGROUND: This study was conducted to compare the clinical and radiological outcomes of the locking hook plate fixation (HP) technique and the single tight rope (TR) technique applied for acute high-grade acromioclavicular (AC) joint separations. METHODS: Between 2009 and 2014, 135 consecutive patients with acute AC joint separation Rockwood types III, IV, and V were subjected to surgical reconstruction. One hundred fourteen patients (84.4%) were available for retrospective evaluation. Of them, 62 and 52 were treated using the single TR group and clavicular HP group techniques, respectively. The visual analogue scale, Constant, American Shoulder and Elbow Surgeons (ASES), and Taft scores were used for clinical assessment. Postoperative shoulder range of motion was also assessed. An anteroposterior radiograph of the coracoclavicular distance (CCD) was obtained to evaluate the radiographic signs of recurrence. RESULTS: The TR group patients had better Constant, ASES, and Taft scores than the HP group patients. The loss of reduction in terms of the CCD did not differ between groups. Subacromial osteolysis was observed in 34.6% of the cases in the HP group. However, there were no significant differences in the clinical outcomes between the patients with and without osteolysis in the HP group. Subcoracoid osteolysis, drill tunnel widening, and metal displacement were observed in 3.2%, 22.6%, and 4.8% of the cases in the TR group, respectively. CONCLUSIONS: The single TR technique was relatively more effective at treating acute high-grade AC joint injuries than the HP fixation technique (level of evidence: therapeutic; retrospective comparative study, Level III).
Acromioclavicular Joint* ; Dislocations* ; Elbow ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Surgeons

CT was done 81 times on 63 proven malignant maxillary sinus tumors for 3 years from Feb.1979 to May 1982 atSeoul National University Hospital. Pre-treatment CT were 54 and post-treatment CT were 31 on 28 patient. Theresult were as follows; 1. The most frequent histopathologic diagnosis was 44 cases (69.8%) of squamous cellcarcinoma. Others were 5 cases (7.9%) of adenoid cystic carcinoma, 3 cases (4.8%) of olfactory neuroblastoma, 3cases (4.8%) of malignant lymphoma, 2 cases (3.2%) of melanoma, 2 cases (3.2%) of malignant fibrous histiocytoma,a rhabdomyosarcoma, a basal cell carcioma, a fibrosarcoma and a metastatic carcinoma from thyroid follicular adenocarcinoma. 2. The CT findings in 54 untreated malignant maxillary sinus tumors were sinus opacification, softtissue mass, and bone destruction in all cases. Other findings were fat plane obliteration (70%),osteosclerosis(59%), bone erosion and displacement (46%), low densities within soft tissue mass (27%), and airdensitis wiithin soft soft tissue mass (27%), and air densities within soft tissue mass(13%). 3. The value of pre-treatment CT in malignant maxillary sinus tumors were outlining the disease process especially soft tissuesuch as orbit, infratemporal fossa, pterygopalatine fossa, nasopharynx, pterygoid fossa and intracranialextension, and CT is the choice of diagnostic modality to determine the prognosis and the therapeutic planning insurgery and/or radiotherapy. 4. Post-treatment CT is also helpful to evalute the change in tumor size andpost-treatment complication.
Adenocarcinoma, Follicular ; Carcinoma, Adenoid Cystic ; Diagnosis ; Esthesioneuroblastoma, Olfactory ; Fibrosarcoma ; Humans ; Lymphoma ; Maxillary Sinus ; Melanoma ; Nasopharynx ; Orbit ; Prognosis ; Pterygopalatine Fossa ; Radiotherapy ; Rhabdomyosarcoma ; Thyroid Gland

Intentional delay of aftercoming siblings in multiple gestation is an infrequent occurrence in obstetrics. After delivery of an immature twin, conventional treatment calls for induction and delivery of the aftercoming sibling. However, several case reports have documented the feasibility of an expectant management. And also, as in our case, an aggressive treatment consisting of cerclage, tocolysis, and broad-spectrum antibiotics has been shown to prolong pregnancy. We experienced an unavoidable delivery of a nonviable first twin after premature rupture of membranes at 16 weeks' of gestation. The placenta was left undisturbed. Twin B was confirmed to be alive within the intact second sac. Tocolysis was started and cervical cerclage was done directly after delivery of twin A. Pregnancy was successfully prolonged, which enabled the second fetus to remain in utero and grow for another 145 days. To our knowledge, this was the longest interval between deliveries in a twin pregnancy reported in the literature. A healthy 3,050 gm male was delivered by cesarean section at 37 weeks' of gestation. Below we present this case in detail and discussed with respect to the aggressive approach undertaken to prolong gestation.
Anti-Bacterial Agents ; Cerclage, Cervical ; Cesarean Section ; Female ; Fetus ; Humans ; Male ; Membranes ; Obstetrics ; Placenta ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Siblings ; Tocolysis ; Twins*

Our experience of surgical management of 20 adrenal tumors was present during the period from June, 1988 to May, 1993. The results of clinical study were as follows ; 1. Average age of patients was 40.9 years with the highest incidence in sixth decade occupying 40% and male to female ratio was 1:1 and right to left ratio was equal also. 2. The adrenal tumors consist of 8 adrenocortical adenoma( including 3 primary aldosteronisms and 1 Cushing syndrome), 4 adrenocortical carcinoma(including 1 Cushing syndrome), 7 pheochromocytomas and l neuroblastoma. 3. The 11 functioning adrenal tumors( including 4 adrenocortical adenomas, 1 adrenocortica1 carcinoma and 6 pheochromocytomas) showed specific symptoms and signs and the majority symptom and sign of the 9 non-functioning adrenal tumors( including 4 adrenocortical adenomas, 3 adrenocortical carcinomas, 1 neuroblastoma and 1 pheochromocytoma) showed abdominal discomfort and pain. 4. For initial diagnosis of the adrenal tumors, USG, CT, MRI and angiography are reliable but IVP was reliable in large adrenal tumor 5. The surgical approaches were transperitoneal in 18 patients and retroperitoneal in 2 patients and postoperative surgical complication occurred in 3 patients of transperitoneal approaches that were prolonged ileus, spleen injury and pancreatic injury with pleural effusion.6. The tumor masses were 12gm to 4,000gm in weight (mean: 616gm). The adrenal benign and malignant tumor were significantly different in weight ( 120gm : 1817gm).
Adrenocortical Adenoma ; Adrenocortical Carcinoma ; Angiography ; Diagnosis ; Female ; Humans ; Ileus ; Incidence ; Magnetic Resonance Imaging ; Male ; Neuroblastoma ; Pheochromocytoma ; Spleen

No abstract available.
Anemia, Hypoplastic, Congenital*

We analyzed the prognostic factors, such as sex, age, tumor shape, number, 1ocation, size, TNM stage, WHO grade, modified Bergkvist grade, treatment modality, cytology, type of progression, mitotic activity index(MAI), volume corrected mitotic index(M/V index) and pathologic grade, in a chort of 83 advanced transitional cell carcinoma of bladder who was followed for more than 3 years. N stage of TNM,WHO grade, modified Bergkvist grade and pathologic stage were related to mitotic indices(p<0.05), but cytology was related to MAI only (p<0.05).In univariate analysis of prognostic factors, sex, N and M stage of TNM, progression type, MAI & M/ V index and pathologic stage were related to 5-year survival during follow up. Multivariate analysis of prognostic factors, which were significantly related in univariate analysis, identified MAI as the most important factor(p<0.05), followed by M/V index, N stage of TNM, sex, M stage of TNM and progression type. The result show that advanced transitional cell bladder tumors can be efficiently categorized into prognostic groups by quantitative mitotic frequency analysis.
Carcinoma, Transitional Cell ; Follow-Up Studies ; Mitotic Index* ; Multivariate Analysis ; Prognosis* ; Sex Factors ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Oocytes* ; Pregnancy* ; Spermatozoa*

This studly was perormed 10 define the role of compulerized quantitative analysis in ewalualion for overexpression of p53 by immunohistochemistry. Total and ladeled cells wers counted automatically using commercially available software for color-image analysis. In 16 uterine cerwical carcinomas, the p53 ladeling index calculted bycomputerized5quantitatiwe analysis was 9.22%+/-8.70% and by visual analysis 5.90+/-6.51%. The present results suggest that the computerized quantitative analysis may be valuadle in objective interetation of immunohistochemical expression of p53 and reliable than conventional ways of visual analysis.
Cervix Uteri* ; Female ; Immunohistochemistry

BACKGROUND: There is concem about the rising incidence of skin cancer. However, few articles have reported the change in the clinical and epidemiological aspects of skin cancer. OBJECTIVE: We performed this study in order to clarifiy the recent changes in cutaneous premalignant and malignant lesions. METHODS: A statistical analysis was made using 101 cases of cutaneous premalignant lesions and 205 cases of ma]ignant tumors out of a total number of 20,175 new outpatients that visited the Department of Dermatology at the Seoul National University Hospital during a 6 year period(1990-1995). RESULTS: The frequency of premalignant lesions was 0.50% and that of malignant tumors was 1.02%. The frequency showed an increasing tendency compared to previous reports. In the premalignant lesion cases, actinic keratosis was most common and represented a figure of 82.2%. Among the malignant tumors, basal cell carcinoma was most frequent at 24.4%. Age, sex and anatomical site distribution of basal cell carcinoma, malignant melanoma was no different. The mean age of squamous cell carcinoma was greater than in previous reports and main preceding lesions were actinic keratosis and cheilitis. The frequency of lymphoma was markedly increased but the reason for this remains to be determined. CONCLUSION: Our findings showed the continous increasing incidence of skin cancers and emphasize the need for public eduacation, early diagnosis and proper treatment.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheilitis ; Dermatology ; Early Diagnosis ; Humans ; Incidence ; Keratosis, Actinic ; Lymphoma ; Melanoma ; Outpatients ; Seoul ; Skin Neoplasms ; Statistics as Topic*