1.The analysis of congenital anomalies in the lumbosacral area combined with the spondylolysis and the isthmic spondylolisthesis
The Journal of the Korean Orthopaedic Association 1994;29(2):465-474
The incidence of the spondylolysis is very low before five years but during the adolescence the incidence increase. The etiologic factors of spondylolisthesis are congenital and acquired. The acquired factors are traumatic and stress fracture. Then there are many congenital properties of the etiologic factors for the spondylolisthesis because several congenital anomalies are combined with spondyolysis or isthmic spondylolisthesis. But there are few articles about relationship between the spondylolysis or isthmic spondylolisthesis and the congenital anomalies around the lumbosacral area. The purpose of this particular study is to search the etiologic factors that increase the degree of the vertebral slippage and relationship between the spondylolysis or ishtmic spondylolisthesis around the lumbosacral area. The plain X-ray and computed tomograms were taken in the 48 patients and the 26 control group that have not chronic low back pain previously. The patients were divided into three groups, such as the spondylolysis, grade I spondylolisthesis, and grade II spondylolisthesis. The parameters measured from the plain X-ray were the incidence of congenital anomalies and degree of vertebral slippate. The parameters measured from the computed tomograms were fact angles and the degree of pseudodisc. Tropism were present for 5 cases, and 16 cases at L3-4 facets, 12 cases, and 22 cases at L4-5 facets, 10 cases, and 28 cases at L5-S1 facets in control and patients group. There was no correlation between the presence or absence of tropism and the vertebral slippage. The sacralization was related with the vertebral slippage but other congenital anomalies were not related to the degree of vertebral slippage. There was a increment of vertebral slippage according to the increase of facet angle, but the linear correlation was absent on regression analysis. So statistical significance was absent among the control group and 3 patients groups. And the vertebral slippage was not significantly different among the groups that were divided according to the difference of facet angle. There was a linear correlation between the degree of the pseudodisc and the degree of vertebral slippage of square=0.60 on regression analysis. At present study, there was a trend of increase of vertebral slippage according to increase of facet angle and presence of the sacralization. And there was a linear correlation between the degree of the pseudodisc and the vertebral slippage.
Adolescent
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Fractures, Stress
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Humans
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Incidence
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Low Back Pain
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Spondylolisthesis
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Spondylolysis
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Tropism
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Zygapophyseal Joint
2.Anterior Interbody Fusion in Spondylolisthesis
Nam Hyun KIM ; Chong Hyuk CHOI
The Journal of the Korean Orthopaedic Association 1988;23(3):789-806
Spondyliolisthesis is the major structural changes in the spine and is more directly related to the low back pain syndrome. The many operative techniques have been used but each of them had several disadvantage as well as advantage. Since the anterior lumbar fusion in spondylolisthesis was introduced by Carpener in 1932, many authors have reported the favorable results regard to anterior arthrodesis in spine. Ideally the system of spine fixation is mechanically efficient and anatomical restoration of deformed structure. The anterior interbody fusion is more satisfactory to this deal fixation of spine than any other surgical method. We reviewed the cases of fifty seven patients who underwent anterior interbody fusion with autoiliac bone grafts for spondylolisthesis and were followed for one to twelve years. 1. The most common type was isthmic type in 61% and the degenerative type was observed in 25%. 2. The fifty lumbar vertebra slipping was observed most commonly and in two patinets, L4 and L5 vertebra slipped simultaenously. 3. In radiological results, we obtained complete fusion of grafts to vertebra in 73%, incomplete fusion in 15% and absorption of graft noticed in seven patients(12%). 4. We obtained the favorable results in 84% patients clinically. 5. The clinical results was not correlated with roentgenografic evidence of union. 6. Anterior discectomy and arthrodesis with autoiliac bone graft was a safe procedure in grade I and II spondylolisthesis but in grade III, the procedure was not recommended. 7. The simple Knight-Kim back brace was satisfactory to immobilization after anterior interbody fusion without graft union failure.
Absorption
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Arthrodesis
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Braces
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Diskectomy
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Humans
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Immobilization
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Low Back Pain
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Methods
;
Spine
;
Spondylolisthesis
;
Transplants
3.Macrodactylism Associated with Neurofibroma of the Medial nerve: A Case Report
The Journal of the Korean Orthopaedic Association 1971;6(3):265-268
Macrodactyly is a rare congenital malformation characterized by an increase in the size of all the elements or structures of a digit or digits. The phalanges, tendons, vessels, subcutaneous fat, finger nails, and skin are all enlarged, but the metacarpals are not affected. The condition is most frequently found in the index and long fingers, and its etiology remains unexplained. Macrodactylism associated with neurofibroma of the median nerve in the left middle finger, in a 13 year old girl, is presented with a review of the literature, and diagnosis was confirmed by pathological examination. Chief complaints were enlargement of the left middle finger and a soft tissue mass in the left palm since birth. There was no change in motor and sensory function of the hand. X-ray showed enlargement of phalanges and a diffusely enlarged soft tissue shadow in the middle finger. We performed epiphysiodesis of the proximal, middle and distal phalanges of the left middle finger with exploration of the left median nerve to the wrist joint. An enlarged fibromatous median nerve, left side, was found with very large abundant fat lobules around it.
Diagnosis
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Female
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Fingers
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Hand
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Humans
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Median Nerve
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Metacarpal Bones
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Neurofibroma
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Parturition
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Sensation
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Skin
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Subcutaneous Fat
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Tendons
;
Wrist Joint
4.A Study of Electrodiagnostic Changes after Decompression of Chronic Cauda equina compression in dogs.
Chong Hyuk CHOI ; Nam Hyun KIM
The Journal of the Korean Orthopaedic Association 1997;32(1):163-176
The purposes of this study were to detect the indices of evaluating for degree of compression and to detect the indices of recovery after decompression in different time intervals in the animal model of 50 percent compression of the cauda equina, through the examination of neurologic status and electrodiagnosis. Twenty-one male dogs, weighing between nine and eleven kilogram, were used. Three experimental groups were studied. One group (5 dogs) served as controls. In the other groups, the cauda equina was constricted by 50 percent to produce chronic compression, and decompression was done after 2 weeks compression in one group and 4 weeks compression in another group. The dogs in which the cauda equina had been decompressed at 2 weeks, showed the recovery of sensory evoked potentials at 2 weeks after decompression and bulbocavernosus reflexes at 4 weeks. The dogs in which the cauda equina had been decompressed at 4 weeks, showed the recovery of sensory evoked potentials and bulbocavernosus reflexes at 4 weeks after decompression. In both groups of the cauda equina compression, motor evoked potentials were partially recovered by 6 weeks after decompression. The initial neurological deficits in both groups were improved by 6 weeks. The cauda equina revealed that the epidural scar tissue in compressed site was more severe in 4 weeks compression group. But the substance of the cauda equina did not have any pathological changes in gross examination. Microscopically, neural tissue was showed the normal appearance without pathological changes in all groups. In conclusions, the early decompression of cauda equina revealed that the onset of recovery was more faster and the amplitude of recovery was larger comparing with delayed decompression in electrodiagnostic test. Also, the surgical decompression itself was helpful to improve the electrodiagnostic changes around 4 weeks after decompression. Sensory evoked potential was improved at the first and motor evoked potentials was recovered after disappearance of the claudication.
Animals
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Cauda Equina*
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Cicatrix
;
Decompression*
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Decompression, Surgical
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Dogs*
;
Electrodiagnosis
;
Evoked Potentials
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Evoked Potentials, Motor
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Humans
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Male
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Models, Animal
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Polyradiculopathy
;
Reflex
5.Treatment of Bone Tumors Around the Shoulder Joint by Tikhoff
Soo Bong HAHN ; Nam Hyun KIM ; Nam Hong CHOI
The Journal of the Korean Orthopaedic Association 1990;25(1):24-30
The Tikhoff-Linberg procedure is a limb-sparing surgical option to be considered for bony and soft tissue tumors in and around the proximal humerus and shoulder girdle. The authors reported 6 cases of the Tikhoff-Linberg procedure for tumors around the shoulder Joint at the Department of Orthopedic Surgery of Severance Hospital from March 1988 to August 1989. 1. The 6 cases were composed of 2 osteogenic sarcoma, 2 chondrosarcoma, 1 chondroblastoma, and 1 giant cell tumor cases. 2. The tumors were completely removed by the Tikhoff-Linberg procedure without amputation or disarticulation of the upper extremity. 3. The distal clavicle, upper humerus and or parts or all of the scapula were resected. 4. The Tihkoff-Linberg procedure was performed for patients whose tumors did not involve the neurovascular bundle in the axilIa. 5. The function of the hand and forearm after the Tihkoff-Linberg procedure are near normal in all cases. 6. The Tikhoff-Linberg procedure would be recommended as a limb-sparing operation for tumors around the shoulder joint that were required wide resection without disarticularion or forequarter of the upper extremities.
Amputation
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Chondroblastoma
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Chondrosarcoma
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Clavicle
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Disarticulation
;
Forearm
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Giant Cell Tumors
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Hand
;
Humans
;
Humerus
;
Orthopedics
;
Osteosarcoma
;
Scapula
;
Shoulder Joint
;
Shoulder
;
Upper Extremity
6.CT findings of fibromatosis.
Hak Nam KIM ; Yeon Hwa CHOI ; Hyun Jun SHIN
Journal of the Korean Radiological Society 1991;27(2):281-285
No abstract available.
Fibroma*
7.A computer analysis on the condylar path of balancing side in mandibular lateral movement.
Dong Hyun LEE ; Dae Gyun CHOI ; Nam Soo PARK
The Journal of Korean Academy of Prosthodontics 1993;31(4):549-564
No abstract available.
8.Pathological Laughing and Crying: Pathophysiology and Treatment.
Ji Hyun KIM ; Beom Woo NAM ; Jin Yong CHOI
Korean Journal of Psychosomatic Medicine 2013;21(2):93-98
Pathological laughing and crying(PLC) is a condition that is characterized by episodic, brief, contextually inappropriate, uncontrollable outbursts of laughing and/or crying. It can be observed in patients with various neurological disorders. PLC often causes distress in interpersonal functioning and activities for patients and their families. PLC can be recognized easily with proper understanding of the condition and its nature. Also it generally shows good response to various pharmacological treatments. This review aims to encourage the diagnosis and treatment of PLC by providing definition and clinical presentation of PLC, analysis of its pathophysiology and various current treatment options.
Crying*
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Diagnosis
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Humans
;
Nervous System Diseases
9.A study on the mandibular moments according to antero-posterior placement of pivot on lower natural dentition.
Hyun Shick LEE ; Nam Soo PARK ; Dae Gyun CHOI
The Journal of Korean Academy of Prosthodontics 1993;31(3):394-410
No abstract available.
Dentition*
10.Effects of Saponin on Osteoporosis Induced by Ovriectomy in Rats
Chong Hyuk CHOI ; Nam Hyun KIM ; Hwan Mo LEE
The Journal of the Korean Orthopaedic Association 1995;30(4):808-816
Osteoporosis is defined as a pathologic condition that there occurs no change in the chemical composition of the bone, while bone resorption is abnormally increased, compared with osteogenesis, leading to a decrease in bone amount. Though many varieties of therapy have been tried, no definitely effective method has been found. Ginseng saponin is an importanat component of Korean ginseng and many studies have been performed for investigating its effectiveness. But there has been no report on saponin effects to osteoporosis. The purpose of this studies is to find out the effect of saponin in osteoporosis induced by ovariectomy in rats. For the study, 30 rats underwent sham operation(group I) and 90 rats were ovariectomized. In group ll (30 rats), only ovariectomy was performed. In group III (30 rats), 50mg/kg/day ginseng saponin was administered per oral route and group IV (30 rats) was administrated 150mg/kg/day saponin. All the rats were sacrificed at the 16th week. The sections of the femoral shaft were stained using Villanueva bone stain and the sections of the tibia were stained with hematoxylin-eosin. The femoral shaft and metaphyseal region were applied to compression device for measurements of bone consistency. The effect of saponin increased weight of the femur. The cross sectional area and cortical area of the femoral shaft were significantly higher in 50mg saponin group(group III) than osteoporosis group. But there was no significant difference in the size and number of osteoclast and the percentage of trabecular bone between saponin group(group III ,IV)and osteoporosis group. In the biomechanical test, the consistency of cortical bone was significantly increased in 50mg saponin group than osteoporosis group. In conclusion, saponin had an effect on experimental osteoporosis induced by ovariectomy in rats. As though its precise mechanism was unknown, we considered that its action mechanism was due to osteoblastic activity resulting in a correction of bone mass deficit in osteoporotic rats.
Animals
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Bone Resorption
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Female
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Femur
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Methods
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Osteoblasts
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Osteoclasts
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Osteogenesis
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Osteoporosis
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Ovariectomy
;
Panax
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Rats
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Saponins
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Tibia