Morphologically, kyphosis is devided into two groups, pure kyphosis and kyphoscoliosis, according to whether or not scoiiosis is combined. Or kyphosis can be devided into round kyphosis or angular kyphosis. The examples of round kyphosis are Scheuermanns kyphosis or ankylosing spondylitis. Acute angular kyphosis are of congenital kyphosis or old healed tuberculosis. The purpose of surgical correction of fixed kyphosis is to correct deformity as well as to prevent or to recover from paraplegia. The operation also improve respiratory and digestive function by diminishing compression of abdomen. However, the correction of this deformity is more dangerous in eliciting paraplegia than any other spinal deformity. In considering surgical correction of kyphosis we have to decide which approach is the best for that particular patient at that particular time. Usually majority of patient need combined anterior and posterior approach. The extent of fusion depends upon the flexibility of the kyphosis. Anterior fusion should encompass at least the rigid and inflexible portion of the kyphosis as determined by the hyperextension x-ray of the spine. Posterior fusion should encompass the full extent of the kyphosis. The purpose of this study is to report our results for surgical correction and to find the operative procedure which shows the best result. We hereby report surgically corrected 14 cases of fixed kyphosis who were hospitalized here from April 1988 to February 1995.
Abdomen ; Congenital Abnormalities ; Humans ; Kyphosis* ; Paraplegia ; Pliability ; Scheuermann Disease ; Spine ; Spondylitis, Ankylosing ; Surgical Procedures, Operative ; Tuberculosis

The traditional treatment for the femoral shaft fractures in children is closed reduction by continuous traction, usually for 2–3 weeks, until the fracture has achieved partial stability, followed by spica cast immobilization. Fifty three cases, from 3 to 10 years of age, has been treated with closed reduction and immediate application of hip spica csst; all of them were closed fractures of femoral shaft and were not associated with head, abdominal, or vascular injuries. Any angulations in excess of acceptable ranges were corrected with wedging the cast; any overridings in excess of acceptable ranges were corrected by skeletal traction for 1 week, followed by incorporation of the pin to the cast. The resultant overriding and angulation of fragments were within acceptable ranges, and complications were not significant.This method of treatment not only is likely easy in nursing care and comfortsble to the patients but also has some advantages of short stay in the hospital, better utilization of hospital beds, and costsaving. This immediate hip spica cast immobilization seems to be a good method of treatment for the femoral shaft fracture in children.
Child ; Clinical Study ; Fractures, Closed ; Head ; Hip ; Humans ; Immobilization ; Methods ; Nursing Care ; Traction ; Vascular System Injuries

The goals of orthopaedic management of pelvic ring injuries are to achieve anatomical reduction and secure fixation of fragment and mobilize the patient as early as possible. Previously, pelvic ring injuries have been treated by a wide variety of conservative methods. Their application, however, necessitated a prolonged period of recumbency with associated likelyhood for many complications and did not facilitate accurate reduction and stabilization of most types, resulting in pelvic deformity, non-union and late sacroiliac joint instability. During the past decade, experience with techniques of external and internal fixation of the pelvis has grown and the goals of the methods include provision for sufficient pelvic stability in satisfactory position so that immediate postoperative bed-to-chair transfers can be undertaken and complications due to prolonged recumbency and pelvic deformity can be markedly reduced. We reviewed 47 cases of unstable pelvic ring injuries treated at the depatment of orthopaedic surgery, Dongkang Hospital from January 1984 to December 1987, and the results were as follows ;1. The highest incidence was in the 4th decade and sex ratio between male and female was 1.6:1 2. The most common cause of injury was traffic accident (68.2%) followed by falling down accident (19%) 3. Associated injuries occurred in 28 cases (60%): injuries of the extremities were most common (30%) followed by head injury (13%) and genitourinary tract injury (11%). 4. According to classification of Pennal et al, lateral compression injury was most common (51.1%). Bucholz Group II injury was 57% of all and Group III, 43%. 5. Operative methods, with which 21 cases were treated, were anterior external fixation with AO apparatus or symphyseal plating in Bucholz Group II injuries ; and external fixation, internal fixation (anterior and/or posterior) or both, in Group III injuries. 6. Advantages of operative treatment of unstable pelvic ring disruptions were, by giving stability, early mobilization; easy care of associated injuries, open wounds and nursing; prevention of possible complications of prolonged recumbent position; rapid reduction of pain; and prevention of late complications such as lumbosacral or pelvic pain and gait disturbance.
Accidental Falls ; Accidents, Traffic ; Classification ; Congenital Abnormalities ; Craniocerebral Trauma ; Early Ambulation ; Extremities ; Female ; Gait ; Humans ; Incidence ; Male ; Nursing ; Pelvic Pain ; Pelvis ; Sacroiliac Joint ; Sex Ratio ; Wounds and Injuries

Aniridia is a relatively rare congenital anomaly and its incidence is about 1:100, 000.Main features of aniridia include congenitally partial or nearly complete absence of the iris and hypoplasia of optic disc and fovea. It is almost bilateral and occurred as an autosomal dominant trait.However, some patients develop both sporadic nonfamilial aniridia and Wilms 'tumor, and another group of patients is transmitted as an autosomal recessive trait. We observed aniridia in two generations, as mother and two daughters. They had cataract, nystagmus, neovascularization of corneal margin and pannus formation, as well as aniridia.We also found hypoplasia of optic disc and fovea in mother. We have operated on mother with phacoemulsified lens aspiration and posterior chamber IOL implantation in both eyes consecutively.The postoperative visual acuity following lens extraction improved, but was not corrected. In addition, intraocular pressure decreased.
Aniridia* ; Cataract ; Family Characteristics ; Humans ; Incidence ; Intraocular Pressure ; Iris ; Mothers ; Nuclear Family ; Visual Acuity

The thirty eight newborn infants with periventricular leukomalacia who were admitted to the neonatal intensive care unit of Gil General Hospital from March 1, 1988 to June 30, 1991, were investigated for ultrasonographic findings, risk factors and neurological outcome. The results were as follows: 1) There were 38 cases of PVL including 21 echogenic flarings and 17 cystic PVL's. 2) Mean birth weight was 2,250 gm and mean gestational age was 35 week. 3) Mean detection timing was 4th day in echogenic flarings and 18th day in cystic PVL's. 4) PVL's were located in the parietal region in 1 case and fronto-parieto-occipital in 3 cases. 5) Mean cyst size was 6 mm. 6) Multiple logistic regression analysis for the risk factors of PVL showed that low birth weight, apnea and seizure were the most significant contributing factors (p<0.05). 7) In the follow-up study of cystic PVL's, 7 cases showed improvement, 7 cases developed into multicystic encephalomalacia and 3 cases developed into atrophy. 8) Neurodevelopmental outcome of cystic PVL's showed nomal; 6.2%, minor neurodevelopmental defect; 43.8%, major neurodevelopmental defect; 31.2% and death; 18.8%. 9) Neurosonographic predictability for neurodevelopemental sequelae by cystic PVL's showed sensitivity; 63.6%%, specificity; 98.0%, positive predictive value; 92.8% and accuracy; 88.2%. 10) Major neurodevelopmental defect was more frequent, cyst size being larger and location being more extensive (p<0.05).
Apnea ; Atrophy ; Birth Weight ; Encephalomalacia ; Follow-Up Studies ; Gestational Age ; Hospitals, General ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Leukomalacia, Periventricular* ; Logistic Models ; Rabeprazole ; Risk Factors* ; Seizures ; Sensitivity and Specificity

PURPOSE: To evaluate the enhancement patterns revealed by dual-phase CT, and other characteristic features of nodular hepatic involvement of malignant lymphoma, and to determine the usefulness of this imaging modality in the differentiatial diagnosis of hepatic masses. MATERIALS AND METHODS: Seven cases that pathologically confirmed as nodular hepatic involvements of malignant lymphoma among patients who underwent dual-phase CT for the staging or follow-up of malignant lymphoma, and two that confirmed as primary lymphoma among patients who underwent dual-phase CT for differential diagnosis of nodular hepatic masses were evaluated. There were eight cases of non-Hodgkin 's lymphoma (NHL) and one of Hodgkin 's disease(HD). The findings were analysed in terms of the number, size, and contour pattern of the masses, the enhancement pattern seen on dual-phase CT, and whether or not the vascular structure of the mass was normal. RESULTS: Primary lymphomas were present in two patients(single mass, n=1; multiple nodules, n=1) and secondary lymphomas in seven (single mass, n=6; multiple nodules, n=1). The maximum size of main masses was mean 5.1(range, 2-12) cm, and the contor was smooth in three cases, ill-defined in three and lobulated in three. During the early phase, five patients showed homogeneous low attenuation, and heterogeneous enhancement was observed in four. During the late phase, three of the five showed peripheral enhancement and the other two showed the same low attenuation, while two of the four showed central low attenuation, one showed iso attenuation, and one showed heterogeneous enhancement. In four of the patients whose main mass was larger than the mean, vascular shadow passed through the mass (left portal vein, n=2; branches of the right portal vein, n=1; and branches of the hepatic artery, n=1). CONCLUSION: Where dual-phase CT demonstrated nodular hepatic involvement of malignant lymphoma, contrast enhancement varied and so differentiation from other hepatic masses such as metastatic adenocarcinoma and hepatocellular carcinoma was therefore difficult. Homogeneity and a lack of necrosis, even though a mass is large and has a smooth well-defined contour, no capsulation and normal vasculature, may suggest the nodular hepatic involvement of malignant lymphoma.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Hepatic Artery ; Humans ; Lymphoma ; Necrosis ; Portal Vein

Three-dimensional surgical accuracy between virtually planned and actual surgical movements of the maxilla in two-jaw orthognathic surgery.

Three-dimensional surgical accuracy between virtually planned and actual surgical movements of the maxilla in two-jaw orthognathic surgery.

PURPOSE: We observed the short-term outcome and associated complications of transscleral diode laser photocoagulation (TSDL) for acute proliferative retinopathy of prematurity (ROP) to evaluate the efficacy and safety. METHODS: 20 eyes of 10 infants with acute ROP were treated with transscleral diode laser photo-coagulation through conjunctiva by a single surgeon. Anatomical results and postoperative complications were main outcomes. Follow-up ranged from 11 to 40 weeks. RESULTS: In 1 eye (5%), there was a macular temporal dragging. In 19 eyes (95%), regression occurred after a single laser treatment with a flat retina. No significant anterior or posterior segment complications were occurred, even though there was a small amount of preretinal hemorrhage in 1 eye after laser photocoagulation. CONCLUSIONS: The results suggest that transscleral diode laser photocoagulation is a safe and effective alternative to cryotherapy or transpupillary diode laser photocoagulation in the treatment of ROP.
Conjunctiva ; Cryotherapy ; Follow-Up Studies ; Hemorrhage ; Humans ; Infant ; Lasers, Semiconductor* ; Light Coagulation* ; Postoperative Complications ; Retina ; Retinopathy of Prematurity*

OBJECTIVE: Morphometric data on dorsal cervical anatomy were examined in an effort to protect the nerve root near the lateral mass during posterior foraminotomy. METHODS: Using 25 adult formalin-fixed cadaveric cervical spines, measurements were taken at the lateral mass from C3 to C7 via a total laminectomy and a medial one-half facetectomy. The morphometric relationship between the nerve roots and structures of the lateral mass was investigated. Results from both genders were compared. RESULTS: Following the total laminectomy, from C3 to C7, the mean of the vertical distance from the medial point of the facet (MPF) of the lateral mass to the axilla of the root origin was 3.2-4.7 mm. The whole length of the exposed root had a mean of 4.2-5.8 mm. Following a medial one-half facetectomy, from C3 to C7, the mean of the vertical distance to the axilla of the root origin was 2.1-3.4 mm, based on the MPF. Mean vertical distances from the MPF to the medial point of the root that crossed the inferior margin of the intervertebral disc were 1.2-2.7 mm. The mean distance of the exposed root was 8.2-9.0 mm, and the mean angle between the dura and the nerve root was significantly different between males and females, at 53.4-68.4degrees. CONCLUSION: These data will aid in reducing root injuries during posterior cervical foraminotomy.
Adult ; Axilla ; Cadaver ; Female ; Foraminotomy ; Humans ; Intervertebral Disc ; Laminectomy ; Male ; Spinal Nerve Roots ; Spine