For the evaluation of the clinical and radiologicaI result in the surgical reduction and internal stabilization of the fracture-dislocations in the thoracic and lumbar area, the authors analysed the 39 patients who were treated with Harrington instrumentation supplemented by segmental sublaminar wiring and were follow up 24 months in average. l. Indications for the operation were: compression type with more than 50% of body wedging, bursting type with less than 30% of canal involvement without cord injury, fracture-dislocation type with instability and any type with complete cord injury. 2. Amount of fusion were 6 segments in 25 cases, 7 segments in 11 cases, 5, 8 and 10 segments in 1 case each. 3. Among 31 cases whose lumbar segment were involved in fusion, numbers of movable lumbar motion segments were three or less in 26 and two or less in 8. 4. Angular deformity were changed from 27 preoperatively to 8 postoperatively and to 12 at the end of follow up. Wedging amount of anterior vertebral height were 53% preoperatively, 23% postoperatively and 27% at the end of follow up. 5. External support were applied for 4 months in 35 cases; Taylor brace in 22, TLSO in 10 and body cast in 3. Ambulation was started within a week according to the general status. 6. Solid bony union were observed in 38 cases within 4 months period. Dislodgement of instrumentation and deep infection in one each patient were observed as operative complications. 7. Among 21 cases with cord injury symptoms, 18 cases with complete type showed no neurological recovery, but 3 cases with incomplete type showed complete recovery. It is concluded that the Harrington instrumentation with sublaminar wiring is an effective method of reduction and stabilization for the fracture and dislocations of the thoracic and lumbar spine. On the other hand, the operation is an extensive procedure with significant involvement of lumbar motion segments.
Braces ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Hand ; Humans ; Methods ; Spine ; Walking

Surface ECG findings in 29 patients with left isomerism were reviewed. Among the total 46 wave axis distributions, 25(54%) were abnormal axis, not originated from sinus node. Congenital atrioventricular block was found in 2 children. 6 patients showed the bradycardia and junctional escape rhythm intermittently or persistently. 4 of them, not related with heart surgery, were much older than 2 patients who showed these ECG findings after heart surgery. These ECG findings suggested the possibility of occurrence of sinus node or subsidiary pacemaker dysfunction in the patients with left isomerism, especially in the older patients. So we thought that electrophysiologic evaluation is necessary in some patients with left isomerism.
Atrioventricular Block ; Axis, Cervical Vertebra ; Bradycardia ; Child ; Electrocardiography* ; Humans ; Isomerism* ; Sinoatrial Node ; Thoracic Surgery ; United Nations

No abstract available.
Spine*

No abstract available.

Intraosseous neurogenic tumors are rare and have been reported most commonly in the mandible, possibly because of the long course of the mental nerve within this bone. They have also been reported very rarely in a vertebra. We experienced a case of intraosseous neurilemmoma arising from the body of the first lumbar vertebra, which resulted in paraplegia. The tumor was removed completely through anterior and posterior approaches by staged operation. Postoperative course was uneventful and paraplegia was recovered within three months postoperatively.
Mandible ; Neurilemmoma ; Paraplegia ; Spine

18 humerus fractures in multiple injured patients were treated by closed intramedullary Ender nailing from June 1987 to June 1988. Follow-up over 3 months were obtained for 11 patients(11 fractures) and results were as follows : 1. Male was 10 in 11 cases and age was widely distributed to that of active life. 2. Trauma was the main cause of injury. 3. Ender nails were inserted through retrograde of entry in 6 cases and antegrade in 5 cases. 4. Coaptation splint was removed at postop. 3rd day and active joint exercise was started. 5. The average time of initial callus formation was post injury 19.2 days and that of solid periosteal callus bridge formation was post injury 7.5 weeks. 6. Early joint exercise, early mobilization of patient, ease of general care, small amount of blood loss, etc. were thought to be the adventages of closed Ender intramedullary nailing for humerus fractures especially in multiple injured patients.
Bony Callus ; Early Ambulation ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Humerus ; Joints ; Male ; Splints

Recently posterior stabilization with various instrumentation and fusion has been used for fractures of the thoracolumbar spine involving anterior and middle columns. However, these methods are sometimes inadequate to gain anatomical reduction and complete decompression especially in burst fractures. So anterior decompression and interbody fusion were frequently added as a second operation. Biomechanically a rigid anterior spinal instrument such as kaneda device can provide enough anterior decompression through partial or total corpectomy and adequate correction of kyphosis as an one stage operation. We have experienced 27 cases of Kaneda instrumentation via anterior approach for thoracolumbar fracture, most of them were burst fractures, from Jan. 1989 to June 1990. Of there 27 cases, 12 were followed up at least 1 year and reviewed. The results were as followed: l. Anterior spinal approach using Kaneda instrumentation provided sufficient anterior neural decompression and adequate correction of kyphotic deformity. It eliminates the second posterior procedure in most cases and enhances early solid union. Simultaneously, it allows early mobilization of patient with an application of brace. 2. Post-operative courses were eventful in most cases except a case of pathological fracture. 3. This procedure seemed to be one of the most suitable method for the treatment of burst fractures of the thoracolumber region. 4. Complications by Kaneda device itself were not developed in the early evaluation stage. However, on longer follow-up study over 1 year revealed some complications including 2 cases of screw breakage and one lateral wedging deformity.
Braces ; Congenital Abnormalities ; Decompression ; Early Ambulation ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Kyphosis ; Methods ; Spine

PURPOSE: To determine the levels of antioxidant minerals in serum of normal subjects and patients with cataract. METHODS: Concentrations of antioxidant minerals such as selenium, manganese, copper, zinc were measured with atomic absorption spectrophotometer (AAS) 4110ZL in serum of 45 normal subjects (group 1) and 34 patients (group 2) with cataract, and Cu/Zn ratio was calculated. RESULTS: Serum concentrations of copper were 108.9 +/- 5.48 (male) and 106.9 +/- 5.25 microgram/dl (female) in group 1, 100.9 +/- 5.87 (male), 105.6 +/- 3.68 microgram/dl (female) in group 2, respectively. For zinc they were 105.8 +/- 7.33 (male) and 103.7 +/- 4.24 microgram/dl (female) in group 1, 80.0 +/- 5.78 (male) and 95.1 +/- 6.18 microgram/dl (female) in group 2, respectively. Zn/Cu ratio were 0.98 +/- 0.02 (male) and 1.05 +/- 0.08 (female) in group 1, 1.58 +/- 0.29 (male) and 1.19 +/- 0.09 (female) in group 2, respectively. CONCLUSIONS: Serum zinc concentration in male was significantly lower in cataract patients than in normal subjects (p<0.01). Cu/Zn ratio was lower in cataract patients than in normal subjects in male, but not in female. Further nutrional survey is necessary to determine the relationship between level of antioxidant minerals and development and progression of cataract.
Absorption ; Cataract* ; Copper ; Female ; Humans ; Male ; Manganese ; Minerals* ; Selenium ; Zinc

Purpose: To study the appropriateness of rabies post-exposure prophylaxis (rPEP) for children with animal bite who visited the emergency department (ED). Methods: The study enrolled children younger than 18 years with animal bite who visited the National Medical Center ED between January 2014 and October 2017. The children’ electronic medical records were retrospectively reviewed. Data for analysis included age, sex, body parts bitten by animals, species of animals, regions where animal bites occurred, history of recent antibiotics therapy and tetanus vaccination, and justification by the 2017 Guidelines for Rabies Control in Korea and implementation of rPEP. In children who underwent unjustified rPEP or did not undergo justified one, we recorded their guardians’ opinion for or against rPEP. Results: Of the 63 enrolled children, rPEP was justified for 38 children by the Korean guidelines. Of the 38 children, 35 actually underwent rPEP. Among the remaining 3 children, 2 did not undergo the prophylaxis as per the guardians’ requests. Among the 25 children whose rPEP was not justified, 8 underwent the prophylaxis. Of these 8 children, 7 did based on the guardians’ requests. Conclusion In this study, inappropriate rPEP was usually affected by the guardians’ requests, regardless of the criteria for such prophylaxis. Thus, their requests for or against rPEP should be discussed with emergency physicians who are aware of the relevant criteria to prevent occurrence of rabies or unnecessary use of medical resources.

The coronary arteries are also subject to congenital anomalies of both minor and major consequence. Hemodynamically significant primary anomalies of the coronary arteries are those which alter myocardial perfusion. There are four major types : coronary artery fistula, origin of the left voronary artery from the pulmonary artery, congenital coronary stenosis or atresia and origin of the left or right coronary artery from the opposite sinus of Valsalva with subsequent passage of the vessel between the aorta and right ventricular infundibulum. Minor anomlies are the variation of the origin of the coronary arteries from the aorta with normal distal circulation. We can see more coronary anomalies associated with congenital cardiac anomalies, probably representing a circulatory response to the primary intracardiac defect. We present a total of 76 cases of congenital coronary anomalies, reviewing 3946 cases of angiocardiography or selective coronary arteriography, performed during last 8 years at Sejong General Hospital.
Angiocardiography ; Angiography ; Aorta ; Arteries ; Coronary Stenosis ; Coronary Vessels* ; Fistula ; Hospitals, General ; Perfusion ; Pulmonary Artery ; Sinus of Valsalva