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*

BACGROUND: The accuracy and efficiency of a job performed by hospital employee can be linked directly with patients' health and life. It is considered that their irregular work and stress are relatively high as compared with other workplaces. In this article we tried to look into how job stress, working environment and factors of life-style influence sleep problems in hospital employees. METHODS: This research was conducted among 248 workers of a hospital in Busan on April, 2002. Sleep problems were categorized into insomnia, sleep deprivation, daytime sleepiness and snoring on the basis of the factor analysis of 11-item questions. The job stress was proposed by Karasek, etc., and measured by 14-item modified questions. The statistical analysis was conducted using Chi-square test and multiple logistic regression analysis. RESULTS: Statistically insomnia, sleep deprivation and daytime sleepiness showed a significant increase in women (OR:2.1/2.69/3.16) and shift workers (OR:4.67/3.28/1.98) and snoring showed a significant increase in obesity (OR:5.0) and smokers (OR:2.34). CONCLUSION: This research showed that many hospital employees perceive sleep disorders as critical. Especially, work shift seemed to be an important risk factor for sleep disorders.
Busan ; Female ; Humans ; Logistic Models ; Obesity ; Prevalence* ; Risk Factors ; Sleep Deprivation ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Snoring

Pheochromocytoma remains one of the great challenges to anesthesiologists during anesthesia and postoperative period. Virtually all anesthetic agents and techniques have been used with success but associated with a high rate of transient intraoperative arrhythmia and hypertension. We now report one case who was given thoracic epidural block and neuroleptic anesthesia for resection of right adrenal and presacral pheochromocytoma. Blood pressure and heart rate were stable during induction, tumor manipulation and postoperative intensive care unit with out the use of vasodilating or antiarrhythmic druas. While this report describes only one encouraging case, the potential advantages of thoracic epidural & general anesthesia in pheochromocytoma appear to warrant the further trial.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Heart Rate ; Hypertension ; Intensive Care Units ; Pheochromocytoma* ; Postoperative Period

No abstract available.
Anemia, Hypoplastic, Congenital*

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*

As modern society becomes increasingly complex, there has been a steady increase in violence, as well as in automobile and industrial accidents. This has resulted in an increased incidence of facial injuries, including mandibular fractures. Many methods have been advocated to achieve reestablishment of normal feature and function. The choice generally depends upon such factors as location of the fractures, displacements, status of the dentition and favorability of the fracture line. Many cases of mandibular fracture are treated by intermaxillay fixation using an arch bar or bite block(acrylic splint)for rapid bone union and minimal displacement. However, there had been some problems, such as discomfort to patients, limitation to eating and weight loss, poor oral hygiene, and temporomandibular joint ankylosis. As a consequence, we have modified the shape of the acrylic splint and method of fixation for circum-mandibular fixation instead of intermaxillary fixation. Acrylic splints are rigid, strong, easily adjusted and repaired, translucent, lightweight and well tolerated by the oral mucosa. The splints are properly secured to each tooth and bind all the teeth together as a single unit. Authors have used modified acrylic splints as tools of circum-mandibular fixation in 12 cases of mandibular symphysis and body fracture from May 1997 to August 1998, achieving the results of very good occlusal relationship, oral hygiene and comfort to patients.
Accidents, Occupational ; Ankylosis ; Automobiles ; Dentition ; Eating ; Facial Injuries ; Humans ; Incidence ; Mandibular Fractures* ; Mouth Mucosa ; Oral Hygiene ; Splints* ; Temporomandibular Joint ; Tooth ; Violence ; Weight Loss