Great strides has been made in the past 20 years in the treatment of scoliosis. Treatment before scoliosis becomes severe eliminates the need for extensive surgery. Early detection of scoliosis by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 5,256 middle and high school students in Seoul, who were chosen arbitrarily, to determine the incidence rates of scoliosis, and following results were obtained. 1. Scoliosis was diagnosed on a combination of at least one positive physical sign and a lateral curvature more than 5 degrees on an antero-posterior standing X-ray. 2. The overall incidence of scoliosis was 4.68% (Male 0.74%, Female 6.43%). 3. Idiopathic scoliosis was found in 238 students, congenital scoliosis in 5, and paralytic scoliosis in 3. 4. The most common pattern of curvature was thoracic curve. 5. In the single curve right to left ratio was 2.1, but 8.4 in the upper curve of double curve. 6. Close observations were required for all the 246 students and treatment was required in 14 students who had more than 20 degrees, 9 students for Milwaukee brace, and 5 students for surgical correction.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mass Screening ; Scoliosis ; Seoul

No abstract available.
Choanal Atresia*

No abstract available.
Cryptorchidism* ; Incidence* ; Male ; Parturition*

Repetitive nerve stimulation (RNS) test was systematically performed in proximal and distal muscles of 142 cases with myasthenia gravis (MG) and 45 norrnal controls and then analyzed qualitatively. Diagnostic sensitivity was 75% based on abnorrnal decremental response in at least one muscle. The sensitivity increased from 56% in ocular MG to 96% in type Iib MG according to severity of disease. Higher diagnostic yield was noted in the orbiculans oculi in ocular MG and in the trapezius in gereralized MG. RNS test on proximal muscle showed a higher positive rate than that on distal muscles. When distal muscle testing was negative, there was an additional increase of 24% in proximal muscle testing. The posttetanic exhaustion (PTE) enhanced diagnostic sensitivitY as much as 8% in generalized MG. The posttetanic facilitation(PTF) and PTE were observed in 50% and 38% of generalized MG and were most prominent in MG with moderate severity. Five patterns on RNS findings were classified according to test paramcters. The most common response was the pattern which showed normal arnplitude of compound muscle action potential, decremental response at low rate stimulation, and PTF without PTE.
Action Potentials ; Muscles ; Myasthenia Gravis* ; Superficial Back Muscles

Injuries of the posterior cruciate ligament have almost universally been treated nonoperatively in the past due to indignity of this complex structure. Recent studies have shown new informations on the anantomical, histological, biomechanical characteristics of the Posterior cruciate ligament PCL), and thereby interest of reconstruction surgery is increasing. But intraarticular PCL reconstruction still remains one of the most challenging problems in knee surgery. Although, various types of graft and surgical techniques have been used for reconstruction, results of surgery has been variable. In this study, three different methods of graft fixation for PCL reconstruction are evaluated biomechanically to determine the effect on mechanical property of reconstructed PCL using 30 porcine knees. Grafts used in this study were bone-patellar tendon-bone fixed with interference screw and Achilles tendon tied with suture. Additionally, five original PCLs were also tested by Instron universal testing instrument to determine its mechanical proprety. Tensile test was performed at extended knee position. It was demonstrated that mechanical strength of bone-patellar tendon-bone graft is superior to that of Achilles tendon graft. All of the failures of bone-patellar tendon-bone graft and Achilles tendon graft occurred at tibial fixation site whereas original PCLs which failed at proximal midsubstance of ligament. In conclusion, tensile strength of Bone-patellar tendon-bone graft used for PCL reconstruction is higher than that of Achilles tendon but latter can be used in terms of as clinical meanings.
Achilles Tendon ; Bone-Patellar Tendon-Bone Grafts ; Knee ; Ligaments ; Posterior Cruciate Ligament* ; Sutures ; Tensile Strength ; Transplants*

Sequestration of disc herniation is important cause of failure of chemonucleolysis. It is important to recongnize this particular variety of disc herniation before considering enzymatic discetomy. Disc herniation were classified into three-anatomical categories. type I: Subligamentous Herniation type II: Extra-ligamentous Herniation type III: Free-extraligamentous Herniation, Sequestratid disc. one-hundred and eight-six cases of herniatid intervertebral disc were evaluated in Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University and in Department of Orthopedic Surgery, Inchon Christian Hospital from March 1982 to March 1988. The results of study are as follows; l. Among 186 patients, type III sequestrated disc patients were 32 cases(17.2%). 2. The ratio between male and female was about 2:l. 3. The duration of symptoms in type II,III were longer than type I. 4. On examination, the physical changes were more common in type III than in other types. Positive well leg rasing test was prominant finding especially in type III. 5. The myelographic findings, in type III, were irregularity of dural sac at the level of vertebra body both on obligue and lateral view. 6. The C-T findings, in type III, were irregular protruded disc, or caudal or cephalsd migrated disc materials.
Clinical Study ; Female ; Gangwon-do ; Humans ; Incheon ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Leg ; Male ; Orthopedics ; Spine

PURPOSE: To evaluate the effects and usefulness of fiuroscopy guided celiac ganglion block after marking of needle path with CT scan. MATERIALS AND METHODS: Celiac ganglion block with 100% ethyl alcohol was performed in 50 cancer patients who were inoperable and had intractable abdominal pain. Duration and degree of pain relief after the procedure and its complication were analyzed. RESULTS: Early pain relief was observed in 98% and long term relief in 68% without serious complication. CONCLUSION: Fluoroscopy guided celiac ganglion block after marking of needle path with CT scan was a safe and valuable procedure in relieving intractable pain in terminal cancer patients and reduced the time in the CT room.
Abdominal Pain ; Ethanol ; Fluoroscopy* ; Ganglia, Sympathetic* ; Humans ; Needles ; Pain, Intractable ; Tomography, X-Ray Computed

PURPOSE: It is to report the efficacy and safety of an argon laser photocoagulation which was the treatment modality for retinopathy of prematurity. METHODS: From March 1996 to December 1999, on 69 prethreshold retinopathy of prematurity, they were series of observations following periods of two to five days, one week, two weeks, four weeks, three months and one year time respectively. RESULTS: We noticed the regressions in 84 prethreshold retinopathy of prematurity cases as well. CONCLUSIONS: The report emphasized the advantages of the argon laser photocoagulation which reduce the risk from a general anesthesia by applying a topical anesthesia, and the safety of using laser technique of convenience to apply and minimize the tissue damages of the lesions. It also described the preferable consequent results following the early treatment with divided applications on the prethreshold cases.
Anesthesia ; Anesthesia, General ; Argon* ; Light Coagulation ; Ophthalmoscopes* ; Retinopathy of Prematurity*

PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA. RESULTS: A total of 240 patients, with a mean age of 76.7 ± 5.2 years, were enrolled. Ninety-five patients (39.6%) were classified as "high-risk" and 99 patients (41.3%) as having postoperative complications. The univariate analysis indicated that risk factors for postoperative complications were age, American Society of Anesthesiologists physical status classification, serum hemoglobin, carcinoembryonic antigen, cancer stage, and "high-risk" status. The multivariable analyses indicated that "high-risk" status (odds ratio, 2.107; 95% confidence interval, 1.168–3.804; P = 0.013) and elevated preoperative carcinoembryonic antigen (odds ratio, 2.561; 95% confidence interval, 1.346–4.871, P = 0.004) were independently associated with postoperative complications. A multivariable analysis of the individual CGA domains indicated that high comorbidities and low activities of daily living were significantly related with postoperative complications. CONCLUSION: A preoperative CGA indicating "high-risk" was associated with major postoperative complications in elderly patients who underwent surgery for colorectal cancer. Thus, using the CGA to identify elderly colorectal-cancer patients who should be given more care during postoperative management may be clinically beneficial.
Activities of Daily Living ; Aged* ; Carcinoembryonic Antigen ; Classification ; Colorectal Neoplasms* ; Comorbidity ; Geriatric Assessment* ; Humans ; Korea ; Postoperative Complications ; Prospective Studies ; Risk Factors ; Tertiary Care Centers

STUDY DESIGN: A retrospective observational and case control study. PURPOSE: To identify appropriate treatment options according to the types of surgical site infections (SSI) in instrumented posterior lumbar interbody fusion (PLIF). OVERVIEW OF LITERATURE: There has been no agreement or consensus with regard to this matter. METHODS: Thirty-two consecutive SSIs were included and followed for more than one year. The elapsed time to diagnosis (ETD) according to the type of SSI was analyzed. The treatment options for each type and consequent clinical results were reviewed. The risk factors of removing the implants were analyzed. RESULTS: There were 6/32 (19%) superficial incisional, 6/32 (19%) deep incisional, and 20/32 (62%) organ/space infection cases (SII, DII, and O/SI, respectively) (p=0.002). ETD was 8.5+/-2.3 days in SII, 8.7+/-2.3 days in DII, and 164.5+/-131.1 days in O/SI (p=0.013). All cases of SII and DII retained implants and were treated by repeated irrigation and secondary closure. Among O/SIs, 10/20 were treated conservatively. Nine out of ten underwent posterior one stage simultaneous revision (POSSR) and in one case, the cage was removed anteriorly. Those who had ETDs longer than 3 months showed a significant risk of implant removal (p=0.008, odds ratio [OR]=40.3). The Oswestry disability index (ODI) improved from 47.3% to 33.8% in SII, from 55.0% to 32.3% in DII, and from 53.4% to 42.1% in O/SI (p=0.002). There was no difference among the three groups (p=0.106); however, there was a partial correlation between ETD and final ODI (r=0.382, p=0.034). CONCLUSIONS: Latent O/SI was the most common type of SSI in PLIF. In cases of SII and DII, early aggressive wound management and secondary closure was effective and implant removal was not necessary. In some cases of O/SI, implant removal was unavoidable. However, implant removal could be averted by an earlier diagnosis. POSSR was feasible and safe. Functional outcomes were improved; however, disability increased as ETD increased.
Case-Control Studies ; Consensus ; Diagnosis ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Wounds and Injuries