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.
Ganglion Cysts* ; Paralysis* ; Peroneal Nerve*

No abstract available.
Rectal Neoplasms*

During the rehabilitation period, traumatic fracture of the lower extremity in chronic spinal cord injured patients may be occur frequently. In the past, conservative treatment with pillow or plaster splinting was advocated by many clinician, but its treatment is still controversial. This paper presents our experience with fracture of 20 patients(5.7%) of total 350 patients who had spinal cord injuries from Jan. 1980 to Mar. 1987 at Korea Veterans Hospital. The results were as follow. 1. The incidence of fracture was not related to age, sex, type and duration of spinal cord injury. 2. The most common cause of fracture was insignificant trauma(94%). 3. The distribution of fracture was in the following order of frequency;supracondyle of femur (20%), shaft of femur (20%), shaft of tibis (16%). 4. The methods of treatment-Twenty cases were treated by conservative treatment and eleven cases were treated by operative treatment in following order; paster splint with well padded; 9 cases (20%), pillow splint; 4 eases (13%), plate and screw; 3 cases (10%). 5. Total 11 cases of complications were 8 cases in conservative treatment and 3 cases in operative treatment. 6. The duration of bone union was average 10 weeks in nonoperative treatment and average 10.2 weeks in operative treatment. Treatment should strive to achieve fracture healing with minimal danger to the patient and should cause little or no interfrence with patient's daily routine.
Femur ; Fracture Healing ; Fractures, Bone ; Hospitals, Veterans ; Humans ; Incidence ; Korea ; Lower Extremity ; Rehabilitation ; Spinal Cord Injuries ; Spinal Cord ; Splints

We investigated the effect of alpha-adrenergic and cholinergic receptor agonists on Ca2+ current in adult rat trigeminal ganglion neurons using whole-cell patch clamp methods. The application of acetylcholine, carbachol, and oxotremorine (50 muM each) produced a rapid and reversible reduction of the Ca2+ current by 17+/-6%, 19+/-3% and 18+/-4%, respectively. Atropine, a muscarinic antagonist, blocked carbachol-induced Ca2+ current inhibition to 3 +/- 1%. Norepinephrine (50 muM) reduced Ca2+ current by 18 +/- 2%, while clonidine (50 muM), an alpha2-adrenergic receptor agonist, inhibited Ca2+ current by only 4 +/- 1%. Yohimbine, an alpha2-adrenergic receptor antagonist, did not block the inhibitory effect of norepinephrine on Ca2+ current, whereas prazosin, an alpha1-adrenergic receptor antagonist, attenuated the inhibitory effect of norepinephrine on Ca2+ current to 6 +/- 1%. This pharmacology contrasts with alpha2-adrenergic receptor modulation of Ca2+ channels in rat sympathetic neurons, which is sensitive to clonidine and blocked by yohimbine. Our data suggest that the modulation of voltage dependent Ca2+ channel by norepinephrine is mediated via an alpha1-adrenergic receptor. Pretreatment with pertussis toxin (250 ng/ml) for 16 h greatly reduced norepinephrine- and carbachol-induced Ca2+ current inhibition from 17 +/- 3% and 18 +/- 3% to 2 +/- 1% and 2 +/- 1%, respectively. These results demonstrate that norepinephrine, through an alpha1-adrenergic receptor, and carbachol, through a muscarinic receptor, inhibit Ca2+ currents in adult rat trigeminal ganglion neurons via pertussis toxin sensitive GTP-binding proteins.
Acetylcholine ; Adult ; Animals ; Atropine ; Carbachol ; Clonidine ; GTP-Binding Proteins ; Humans ; Neurons ; Norepinephrine ; Oxotremorine ; Pertussis Toxin ; Pharmacology ; Prazosin ; Rats ; Receptors, Muscarinic ; Trigeminal Ganglion ; Yohimbine

BACKGROUND/AIMS: This study was to evaluate the frequency and the course of the adverse effects of AZA/6-MP in Korean patients with inflammatory bowel disease (IBD). METHODS: Medical records of the patients with IBD treated with AZA/6-MP at Severance hospital from June 1996 to September 2006 were retrospectively analyzed. RESULTS: A total of 133 patients were studied. Male to female ratio was 1.3:1. The mean age was 31.7+/-10.9 year. Adverse effects included leukopenia occurred in 75 cases (56.4%), nausea/vomiting in 32 cases (24.1%), arthralgia in 6 cases (4.5%), hepatitis in 6 cases (4.5%), skin rash in 4 cases (3.0%), herpes zoster in 3 cases (2.3%), and headache in 1 case (0.8%). Most of leucopenia (58.7%) developed within 3 months after maximal tolerated dose of AZA/6-MP and nausea/vomiting frequently occurred within 3 months after start of AZA/6-MP treatment. Thirty-eight patients (28.6%) required the discontinuation of medication due to adverse effects. CONCLUSIONS: Leukopenia was the most common adverse effect of AZA/6-MP treatment. Leukopenia and nausea/vomiting developed frequently in the early period of treatment of AZA/6-MP in patients with IBD. AZA/6-MP should be used cautiously to scrutinize bone marrow suppression.
6-Mercaptopurine/*adverse effects/therapeutic use ; Adolescent ; Adult ; Azathioprine/*adverse effects/therapeutic use ; Behcet Syndrome/drug therapy/etiology ; Cohort Studies ; Drug Therapy, Combination ; Female ; Humans ; Immunosuppressive Agents/*adverse effects/therapeutic use ; Inflammatory Bowel Diseases/*drug therapy/etiology ; Leukopenia/chemically induced ; Male ; Middle Aged ; Retrospective Studies ; Time Factors

No abstract available.
Breast* ; Tuberculosis*

Pertutaueous transluminal angioplasty is the treatment of choice for renovascular hypertension in cases due to the renal vascular occlusion which is not severe enough to pass dilatation catheter. The advantages of percutaneous transluminal angioplasty are the use of local anesthesia, its noninvasiveness without surgical risk, feasibility of repetition and shorter hospital days compared with surgical methods. We are presenting a case of renovascular hypertension due to atherosclerosis cured by percutaneous transluminal angioplasty with the review of literatures.
Anesthesia, Local ; Angioplasty* ; Atherosclerosis ; Catheters ; Dilatation ; Hypertension, Renovascular*

A survey was conducted to study perception and attitudes of health workers towards health centers activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predomina1itly female(62.3%); had college education(60. 3%); 'and held medical and nursing positions(39.6%), technicians(30.6%) and. public health/administrativc positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker (47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Th controi, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the .urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; pefsonnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive 'perceptions, particularly' to those areas as further training needs 'and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.
Aged ; Budgets ; Child ; Child Health ; Chronic Disease ; Daegu ; Surveys and Questionnaires ; Delivery of Health Care ; Health Education ; Health Priorities ; Health Services ; Humans ; Hypertension ; Job Satisfaction ; Local Government ; Mental Health ; Nursing ; Oral Health ; Personnel Management ; Politics ; Professional Autonomy ; Rehabilitation ; Sanitation ; School Health Services ; Urban Health*

Tuberculosis verrucosa cutis is a warty form of cutaneous tuberculosis. It is a paucibacillary disorder caused by external reinfection of mycobacteria into the skin of previously sensitized individuals with moderate to strong cell-mediated immunity. Inoculation arises at sites of minor wounds, or rarely from the patient's sputum. Tuberculosis verrucosa cutis begins as a small papule and grows slowly by peripheral expansion, sometimes reaching a size of several centimeters or more in diameter. For definitive diagnosis of cutaneous tuberculosis, the demonstration of Mycobacterium tuberculosis is essential. However, the laboratory diagnosis of paucibacillary cutaneous tuberculosis is very difficult owing to the poor sensitivity of routine available methods. Herein, we report two cases of tuberculosis verrucosa cutis definitively confirmed by mycobacterial culture in Korean patients who had received bacille Calmette-Guerin vaccination earlier in life.
Clinical Laboratory Techniques ; Diagnosis ; Humans ; Immunity, Cellular ; Mycobacterium tuberculosis ; Skin ; Sputum ; Tuberculosis* ; Tuberculosis, Cutaneous ; Vaccination ; Wounds and Injuries