No abstract available.
Echocardiography, Doppler* ; Heart Defects, Congenital*

STUDY DESIGN: Sixteen patients with congenital kyphoscoliosis were evaluated the clinical and radiological results according to the treatment method. OBJECTIVES: To provide a guideline for surgical treatment of congenital kyphoscoliosis SUMMARY OF LITERATURE REVIEW: Congenital kyphoscoliosis is an abnormal coronal and sagittal curvature of spine that is caused by the presence of vertebral anomalies, which causes a significant deformity and disability. Correction of the deformity is challenging and accompanied by high risk of complications. Many methods of operative treatment were recommended with various results. MATERIALS & METHODS: We reviewed 16 patients of congenital kyphoscoliosis who were operated from 1984 to 1997, and follow-up periods were over 12 months in all. The average age of surgery was 12 years (ranged from 4 to 20 years). Nine cases were operated by excision of quadrant hemivertebra through combined anterior & posterior approach and 6 cases were treated only by posterior instrumentation and one underwent posterior on bloc spondylectomy. RESULTS: The type of curves were thoracic in 5, thoracolumbar in 9, lumbar area in 2 patients. Average angle of kyphosis was 55 degree preoperatively, 25 degree postoperatively, and 39 degree at the follow up study. Average angle of scoliosis was 48 degree, 22 degree, and 27 degree, respectively. In 9 cases corrected by excision of quadrant hemivertebra; kyphotic angle was changed from 62degrees preoperatively, to 22degrees postoperatively and to 36 degree at the end of follow up study, while scoliotic angle was changed from 47degrees, to 12degrees and to 21degrees, respectively. In 6 cases corrected by posterior instrumentation kyphotic angle was changed from 52degrees preoperatively, to 33degrees postoperatively and to 48degrees degree at the follow up study, while scoliotic angle was changed from 53degrees, to 33degrees and to 37degrees, respectively. CONCLUSION: Excision of quadrant hemivertebra through combined anterior and posterior approach or posterior instrumentation were resulted in significant loss of correction during the remaining growth period due to the secondary change of adjacent vertebrae. So, to obtain better correction and to reduce the recurrence of deformity, more aggressive approach including the concept of three dimentional osteotomy involving the upper and lower adjacent curve may be considered.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteotomy ; Recurrence ; Scoliosis ; Spine

No abstract available.
Child* ; Humans

Sternoclavicular joint posterior dislocations are considered a very uncommon, and type of injury where if esophagus or airway injury occurs behind the clavicle, it poses a high risk to the patient. In addition, if epiphyseal fracture occurs as a result of the sternoclavicular joint posterior dislocation, surgical treatment is often required. However, in the absence of a complete ossification of the clavicle, it is difficult to differentiate between a simple dislocation and epiphyseal fracture-dislocation solely based on simple radiographs or computed tomography scans. In this case report, the authors present a case in which a sternoclavicular joint posterior dislocation was diagnosed in a 14-year-old male athlete. The case report discusses how the posterior dislocation without epiphyseal fracture was diagnosed using an ultrasound and subsequently treated with successful outcomes using manual reduction. The case report presents our findings along with discussion that includes a literature review of relevant research.
Adolescent* ; Athletes ; Clavicle ; Dislocations* ; Esophagus ; Humans ; Male ; Sternoclavicular Joint* ; Ultrasonography*

Under the extreme change of the environment, animals react physiologically to adapt to the stress and secrete catecholamines. Cold exposure is a kind of the environmental stress. Author tried to determine the amount of catecholamines in rat urine as a parameter of physiological response to cold stress. Urinary catecholamine was measured by using HPLC with fluorescence detector, coation exchange column prepacked with Bio-Rex 70 and ammonium pentaborate as catecholamine eluent. The amount of dopamine in normal state rat urine was 42.0 ng, but under the low temperature of 5 degrees C, the dopamine amount was increased to 221.25 ng/5 ml. Above findings are suggesting that catecholamine secretion, especially dopamine, increase in the stressful condition such as cold exposure.
Ammonium Compounds ; Animals ; Catecholamines ; Chromatography, High Pressure Liquid ; Dopamine ; Fluorescence ; Rats*

Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.
Arthritis, Rheumatoid ; Arthroplasty ; Congenital Abnormalities ; Humans ; Osteoporosis ; Rotator Cuff ; Shoulder Joint* ; Shoulder*

The authors report the experience of twenty patients of transpedicular Zielke instrumentation after anatomical reduction of the spondylolisthesis. Anstomical reduction was done with the aid of temporary application of Harrington distraction rod, and the reduced segment was fixed with transpedicular Zielke instrumentation. And, anterior interbody fusion was supplemented in a single stage operation. Follow up period was between 13 to 25 months after operation with the average of 19 months. 1. The age of the patients was 38 years in average ranging from 11 to 61 years. 2. Types of the spondylolisthesis were spondylolytic type in 11 cases, degenerative type in 6 cases, dysplastic type in 1 case and pathologic type in 2 cases. 3. The level of the lesion were L5-Sl in 12 cases, L4-5 in 7 cases and L3-4 in 1 case. 4. Pre-operative clinical feature included low back pain in 95%, radiating pain in 65%, and neurological claudication in 45%. 5. The average percentage of slippage was changed from 24% preoperatively to 6% postoperatively and to 8% at the final follow up. The initial correction rate was 75% and the amount of correction loss during the follow up period was 11% in average. 6. Slip angle was changed from 3°preoperatively to −3°poetoperatively and to 0°at the end of follow up. In the 12 cases with local kyphosis, average slip angle of 14°preoperatively was improved to 2°postoperatively, and to 7°at the end of follow up. 7. Bony fusion was obtained in 19 cases within 4 to 6 months. 8. There were 2 cases of metal failure with considerable loss of reduction ; one patient with pathologic spondylolisthesie due to active tuberculous spondylitis required re-operation and another patient showed fusion eventually in the redisplaced position. Other complication included 1 transient dysuria, 1 ileus and 2 meralgia paresthetics. 9. Clinical symptoms were improved in 95%. Follow up result of the operation according to Gill's criteria were excellent 65%, good 25%, fair 5%, and poor 5%.
Dysuria ; Follow-Up Studies ; Humans ; Ileus ; Kyphosis ; Low Back Pain ; Spondylitis ; Spondylolisthesis

In these days, computing environment turns to web environment and a lot of hospitals build information system. A medical services through the web provide patients and doctors with convenience and help experts to communicate with each other. Initially, web provided static text information, but nowadays needs of interactivity between client and server is increasing. In order to diagnose heart diseases, we use 12 channel ECG, stress ECG, holter ECG, etc. These data are a lot of correlation with each other but there are little system managed them with integration. To enhance management efficiency and share medical information, it is necessary to develop integrated ECG management system based the web. In this paper, we use common object request broker architecture(CQRBA) to implement the system. The CORBA is to apply object oriented concept to web. We can implement application easily and reduce costs to maintain and repay because server objects and client objects exist independently. We developed a System to integrate these data using network and to raise management efficiency. we focus on the performance of object web and the implementation of ECG management system based on the web.
Electrocardiography* ; Heart Diseases ; Humans ; Information Systems

No abstract available.
Pyelonephritis, Xanthogranulomatous* ; Wilms Tumor*

PURPOSE: The success rate of endoscopic dacryocystorhinostomy has been increasing with the development of better instruments and techniques. We conducted this study to evaluate the clinical results of endoscopic dacryocystorhinostomy using a Microdebrider, which has also been used for functional endoscopic sinus surgery. METHODS: We selected 76 patients (with a total of 84 affected eyes) who had been diagnosed with a nasolacrimal duct obstruction. These patients underwent an endoscopic dacryocystorhinostomy using a Microdebrider, which removed both nasal mucosa and lacrimal sac mucosa and also trimmed the margins of the ostotomy site. We assessed patients' outcomes on an anatomical basis using a dye test and endoscopy, which were used to define the anatomical success. We also arbitrarily defined functional success as whether the subjective epiphora was absent. At a four to 18 month follow-up, we monitored the clinical course to examine any recurrent episodes. RESULTS: The symptoms were alleviated in 72 eyes, with a primary success rate of 85.7%. On nasal endoscopy, a functional failure was seen in four eyes. In these four eyes, the orifice was narrowed by the presence of either granulation tissue or conjunctivochalasis. By contrast, surgical outcomes were the anatomical failure in eight eyes. In these eight eyes, the orifice was obstructed by the presence of granulation tissue as well as the adhesion of nasal mucosa. CONCLUSIONS: Endoscopic dacryocystorhinostomy using a Microdebrider enabled us to make the large fistula while minimizing the damage of adjacent tissue. It might be the recommended surgery that reduces the complications and enhances the success rate.
Treatment Outcome ; Retrospective Studies ; Miniaturization ; Middle Aged ; Male ; Lacrimal Duct Obstruction/*surgery ; Humans ; Follow-Up Studies ; Female ; Equipment Design ; *Endoscopy ; Debridement/*instrumentation ; Dacryocystorhinostomy/*methods ; Aged ; Adult ; Adolescent