In the treatment of spinal disorder, the introduction of pedicle screw system is an innovation in modern spinal surgery. This kind of new instrumentation provides correction, adjustment, stabilization, firm fixation and short segment fusion. Everybody should know that these complexities of instrumentation will increase the rated of complications, especially postoperative infection. Postoperative infections continue to be a source of frustration for patients and surgeons, and can lead to significant postoperative difficulties. So we analysed the postoperative infection from the 284 cases we operated on during the September 19S8 to August 1992 and obtained following results: 1. There were 17 cases(6.0%) of postoperative infection. Among them Scases(2.8%) were deep infection. 2. Average fused segments were 3.64 and 2. 96 in deep infection and control group respectively. 3. Staphylococcus aureus was the most frequent organism. Other recurring organisms were St. epidermidis, Enterobacter cloacae and so on. Many patients had multiple organisms. 4. Most significant risk factors for postoperative infection were obestity and prolonged surgery. 5. Just preoperative prophylactic antibiotic administation is more valuable than no prophylaxis and too early administration. 6. Postoperative acute deep infection is is not as easily diagnosed. The clinical manifestation such as sudden increase in pain at the operative site is the most valuable sign. 7. Maintaining the instrumentation in place, continuous irrigation system and the appropriate parenteral antibiotics were the choice of treatment.
Anti-Bacterial Agents ; Clinical Study ; Enterobacter cloacae ; Frustration ; Humans ; Pedicle Screws ; Risk Factors ; Spine ; Staphylococcus aureus ; Surgeons

Partial closure of an epiphyseal plate can reduce growth in length and cause angular deformationof the bone. The bone bridge between the epiphysis and the metaphysis, which inhibits growth, can be removed operatively, leaving a cavity, and improvement of the deformity by normal growth is then possible. Previous study have shown that silastic or bone cement diminished both the angular deformity and growth retardation to a highly significant degree. In the present study we wanted to test whether indomethacin and iliac apophysis as an interposition material could prevent bone bridge recurrence following operative removal in adolescent rabbits. It was designed by the concept that cartilage(iliac apophysis) has a specific inhibitory effect on bone formation and indomethacin inhibits bone resorption and bone formation in both heterotopic and orthotopic bone in rabbits. The following experimental groups were designed. Group 1 (N = 7) control group; no interposition material Group 2 (N = 7) iliac apophysis as an interposition material Group 3 (N = 7) only bone wax as an interposition material Group 4 (N = 7) bone wax with administration of indomethacin 10mg/kg/day The results of the study are as follows: 1. In control group, an osseous bridge were revealed as early as 2 to 3 weeks, and this bridging was found consistently in all control groups for the duration of the study. 2. The gmup using iliac apophysis as interposition material was found ineffective for prevention of the formation of epiphyseometaphyseal bone bridge. It was probably resulted from difficulty of its taking from iliac bone. 3. The group using administration of indomethacin after application of bone wax reduced both the angular deformity and growth retardation to a highly significant degree. From the results, it is recommended administration of indomethacin after insertion of silastic or bone cement as an interposition meterial in the elimination of transphyseal closure after physeal damage.
Adolescent ; Bone Resorption ; Congenital Abnormalities ; Epiphyses ; Growth Plate ; Humans ; Indomethacin ; Osteogenesis ; Rabbits ; Recurrence

We reviewed 23 patients of injury to the spine who were under 15 years of age and treated at Wonju Christian Hospital from January, 1978 to December, 1987. The patients were classified into 3 different categories, that were frsctures(17 cases), dislocations(3cases), and fracture-dislocation(3 cases). We analyzed the cause of injury, sexage distribution, treatment and neurological injuries. The results were as follows : l. Among the 23 cases, there were 16 boys(70%) and 7 girls(30%). The mean age was 11 years of age, and ages of active period, that is 10 to 15 years of age, were most common, 17 cases(74%). 2. The most common cause of injury was fall from a height, 13 cases(57%). The most common location of injury was cervicsl spine, 10 cases(43%) and among these cases, injury to upper cervical portion(C1–C3) was more common than lower cervical portion(C4–C7). 3. The cases of multiple compression fracture were 6 patients(26%), and all cases were located thoracic or thoraclumbar junction. 4. Most cases were stable spinal injury, 18 cases(78%), and the most common mechanism of injury were compreesion injuries due to hyperflexion, 15 cases(65%). 5. The most common associated injury was head injury, 9 cases(39%), and associated neurological complications were in 4 cases, 3 cases of these were recovered. We could ascertain that the prognosis of children spinal cord injury is better than that of adult. 6. Restoration of the height of the involved vertebral bocy occurred in all but one compression fractures of vertebral body. 7. There were 3 cases of epiphyseal injury, 2 of these were epiphyseal separations of odotoid process of atlas, the other was fracture of lumbar vertebral apphysis. 8. All but two were treated conservatively and the results were good. In stable spinal injury, we considerded that the duration of treatment was 4 to 6 weeks.
Adult ; Child ; Clinical Study ; Craniocerebral Trauma ; Fractures, Compression ; Gangwon-do ; Humans ; Prognosis ; Spinal Cord Injuries ; Spinal Injuries ; Spine

Spinal epidural hematoma is a rare complication of epidural anesthesia and most commonly associated with intraoperative or postoperative anticoagulant administration. We describe the case of an acute thoracolumbar epidural hematoma at the T12-L4 level complicated by cauda equina syndrome, which occurred after placement of spinal epidural catheter for anesthesia and anticoagulant therapy for acute myocardial infarction developed postoperatively. In our experience, the spinal epidural catheterization and anticoagulant therapy may potentially increase the risk of epidural hematoma formation.
Anesthesia ; Anesthesia, Epidural* ; Catheterization ; Catheters ; Cauda Equina* ; Hematoma* ; Hematoma, Epidural, Spinal ; Heparin* ; Myocardial Infarction ; Polyradiculopathy*

PURPOSE: This study was performed to evaluate the results of surgical treatment of Nirschl procedure for intractable lateral epicondylitis of the elbow. MATERIALS AND METHODS: We retrospectively reviewed the functional records of surgically treated 21 cases from the 196 cases of lateral epicondylitis, which had been followed up at least 12 months from March 2000 to May 2003. Surgery was generally considered to be indicated if six months of conservative treatments since the first diagnosis had led to no improvement of the symptoms. The patients were evaluated by assessing of Pain Analog Scales (PAS) score. The objective outcomes of all patient after surgery were investigated according to the criteria by Roles and Maudsley. RESULTS: The mean PAS score followed up for 12 months postoperatively, had indicated significant improvements (p<0.001): 0.31 points (range, 0-2) at rest, 1.22 points (range, 0-3) at daily activities, and 2.25 points (range, 0-5) at sports and occupational activities. According to the Roles and Maudsley scores, there were 12 excellent, 7 good, 2 fair from the total of 21 cases; therefore, 19 (90%) cases showed the satisfactory results. CONCLUSION: The surgical treatment using the Nirschl procedure for intractable lateral epicondylitis of the elbow is considered as one of recommendable methods for the cases of no response at the conservative treatment.
Diagnosis ; Elbow ; Humans ; Retrospective Studies ; Sports ; Weights and Measures

A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*

PURPOSE: To report the clinical data and visual outcomes after treatment of patients with dysthyroid optic neuropathy (DON). METHODS: We retrospectively reviewed the medical records and orbital images of 40 patients (65 eyes) with DON and analyzed the visual outcomes after treatment with intravenous steroids pulse therapy, radiotherapy and orbital decompression. RESULTS: The study included 21 men and 19 women, with 10 (25%) being diabetic patients. Visual field test results revealed defects in 88.7% of DON eyes; afferent pupillary defects in 63.2%; reduced color vision in 78.5%; and abnormal visual evoked potentials in 84%. Orbital imaging showed moderate to severe apical crowding in 95% of the orbits and intracranial fat prolapse in 24.2%. Median best corrected visual acuity improved from 0.4 to 1.0 after one year of treatment (p < 0.001). We noted more improvement in vision with the use of decompressive surgery than with non-surgical methods (p < 0.05). Recurrences occurred in 7 patients who had not received orbital radiotherapy. CONCLUSIONS: Visual field defects and apical crowding seen on orbital imaging were the most sensitive indicators for the detection of DON. Treatment with intravenous steroids pulse therapy, radiotherapy and orbital decompression effectively improved visual outcomes in cases of DON.
Adult ; Aged ; Combined Modality Therapy ; *Decompression, Surgical ; Diabetes Complications ; Evoked Potentials, Visual ; Female ; *Graves Ophthalmopathy/pathology/surgery/therapy ; Humans ; Male ; Middle Aged ; Pulse Therapy, Drug ; Pupil Disorders ; *Radiotherapy ; Recovery of Function ; Recurrence/prevention & control ; Retrospective Studies ; Steroids/*administration & dosage ; Visual Acuity ; Visual Fields ; Young Adult

No abstract available.
Female ; Pregnancy ; Pregnancy, Tubal*

No abstract available.
Olivopontocerebellar Atrophies*