The main goal of spinal surgery using implant is a rigid fixation to provide the stability until solid fusion will occur. Recently, various implant fixation devices have been introduced and transpedicular screw fixation is the usual method. In the past, we obtained the implant-related complications like screw failure and rod breakage after using the modified Harrington rod. However, we obtained good results after follow up over one year using TSRH instrument. We experienced spinal surgery using TSRH instrument in 42 cases since 1991 and followed from one year to 28 months with average 16 months. We analyzed the 28 cases and evaluated the implant-related problems. The results were as follows: 1. Among 28 patients, 10 patients were operated due to fracture and 9 patients operated due to spinal stenosis. 2. The male patients were 16 cases and the female were 12 cases. 3. The TSRH instruments provided the rigid fixation with three points clamping mechanism. 4. The cross-linking plate of TSRH was found to increase stiffness and strength. 5. There were no case of screw breakage. 6. In functional results by Kirkaldy-Willis; foriteria the excellent cases were 15, and the good were 2 cases.
Constriction ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Spinal Stenosis

The intramedullary nailing is one of the most available method in treatment of femoral shaft fracture. Since the development of Kuntscher naukl in 1940, new design such as Grosse-Kempf IM nailing became widely used by more applicable level of femoral shaft fracture. Therefore, complications of intramedullary nailing was rarely seen. The authors analysed complications in 7 cases of intramedullary nailing for treatment of femoral shaft fracture in Koryo General Hospital from Jan. 1991 to Jan. 1993., and the results were as follows; 1. The average age was 40.5 years and all patient's sex were male. 2. Among 7 cases, complications were delayed union in 4 cases, metallic failure in 2 cases and femoral neck fracture in 1 case. 3. Among 4 cases of delayed union, 3 cases treated by weight-bearing after dynamization and 1 case treated by bone graft after dynamization. 4. Metallic failure occurred in 2 cases, 1 case developed metallic corrosion in medullary canal, the other case developed metal failure at fracture. 5. Fomoral neck fracture in 1 case was treated by multiple Knowles' pins.
Corrosion ; Femoral Neck Fractures ; Fracture Fixation, Intramedullary ; Hospitals, General ; Humans ; Male ; Methods ; Neck ; Transplants ; Weight-Bearing

We analyzed an astigmatism and an uncorrected visual acuity in 235 eyes for 6 months following sutureless cataract surgery(167 eyes) with 5 mm(Group 1), 6 mm(Group 2), and 7 mm(Group 3) incision lengths at 2.5 mm posteriorly from the corneoscleral limbus, and shoelace sutured cataract surgery(68 eyes) with 7 mm(Group 4) incision length at 1 mm posteriorly from the corneoscleral limbus performed by one surgeon. In three groups of sutureless cataract surgery, the surgically induced corneal astigmatisms were stable after one month postoperatively, but decreasing the length of incision substantially reduced the astigmatic changes(p>0.05), the astigmatic swings(p>0.05) and the astigmatic ranges. In comparison to sutured cataract surgery with 7 mm incision length, sutureless cataract surgery with same incision length reduced the astigmatic changes(p<0.01), reduced the astigmatic swings(p<0.01) and narrowed the astigmatic ranges and also was stabilized earlier. The shorter the length of incision in sutureless cataract surgery, the higher the incidence of an uncorrected visual acuities of 20/40 or better(p>0.05) was noted. In comparison to sutured catarct surgery with 7 mm incision length, suture less cataract surgery with same incision length had higher incidence of an uncorrected visual acuities of 20/40 or better(p<0.01). The tesults indicate that smaller incision length in sutureless cataract surgery was associated with a lower surgically induced astigmatism(p>0.05) and a better uncorrected visual acuity(p>0.05). And sutureless cataract surgery rather than sutured cataract surgery was associated with a lower surgically induced astigmatism(p<0.01), an earlier stability, and a better uncorrected visual acuity(p<0.01).
Astigmatism ; Cataract* ; Incidence ; Sutures ; Visual Acuity

Hertel and Naugle exophthalmometers were used to compare the variability and reproducibility, produced by various observers. Five examiners measured fifty two eyes of twenty-six normal subjects each by using two different exophthalmometers, respectively. The average coefficient of variation among five measurements was 5.6% in the right eye, 5.2% in the left eye and 2.1% in base line by Hertel exophthalmometer. The average coefficient of variation measured by Naugle exophthalmometer was 1.9% in both eyes and 0.8% in pupillary distance. In conclusion, Naugle exophthalmometer showed less variability and better reproducibility; it is more appropriate for comparative exophthalmetry.
Reading*

Dural shunts are vascular communications in which blood flows through small meningeal branches of the carotid arteries to enter the venous circulation near the cavernous sinus. The clinical characteristics of 13 eyes[12 patients] with dural cavernous sinus fistula are described. Of these patients, 84.6%[11 eyes]were women with dilated conjunctival and episcler-al vessels, exophthalmos, retinal hemorrhage and venous engorgement, elevation of intraocular pressure, swelling of lid and orbital area, limited eye movement and diplopia, and bruit, in order of frequency. Decreased vision had occurred in only 1 eye, due to central retinal vein obstruction during follow-up periods after embolization. CT or MRI scan showed the enlargement of the extraocular muscle and superior ophthalmic vein. Two eyes had resolved spontaneously. Ten eyes of dural cavernous sinus fistula had the resolution of clinical symptoms after carotid angiography with embolization. The complications after embolization had occurred in one eye with transient sensory deficit of face.
Angiography ; Carotid Arteries ; Cavernous Sinus* ; Diplopia ; Exophthalmos ; Eye Movements ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Hyperemia ; Intraocular Pressure ; Magnetic Resonance Imaging ; Orbit ; Retinal Hemorrhage ; Retinal Vein ; Veins

To evaluate the diagnostic efficacy of dacryoscintigraphy, we examined Hones dye test and dacryoscintigraphy in 24 eyes of 18 patients who were suspected to have junctional block in lacrimal drainage system. Among 18 eyes that were negative to Jones I dye test, 3 showed punctal stenosis and 6 typical pattern of lax lid and 2 partial obsturction of nasolacrimal duct on dacryoscintigraphy. In evaluation of lacrimal drainage system, physiological aspect is as important as anatomical information since lacrimal pumping action of lid and tear flow as well as the patency of lacrimal passage contribute to the lacrimal drainage. Compared to Jones dye test, dacryoscintigraphy is more useful with certain advantages : It gives less discomfort to patients, provides anatomical information and does not depend on examiner`s skills.
Constriction, Pathologic ; Drainage* ; Humans ; Nasolacrimal Duct

A etiologic analysis of 94 cases of the paralysis of the third, fourth, and sixth cranial nerves was made. There were 42 cases(44.7%) of sixth nerve paralysis. 39 cases(41.5%) of third nerve paralysis. 5 cases(5.3%) of fourth nerve paralysis and 8 cases(8.5%) of multiple cranial nerve paralysis. The most common cause was head trauma(46 cases). Other etiologic factors were undetermined(23 cases), neoplasm(5 cases), vascular desease(6 case), aneurysm(5 cases) and others(9 cases). The recovery rates of sixth, third, and fourth cranial nerve paralysis were 52%, 41%, 20%, respectively.
Abducens Nerve ; Cranial Nerves ; Head ; Oculomotor Nerve Diseases ; Paralysis ; Strabismus* ; Trochlear Nerve

These days, the epidural administration. of morphine is commonly used for postoperative pain re lief because even small amount of morphine (3mg) is enough to have an effect on specific opiates receptors of the spinal canal. We report a prospective double blind study of the efficacy of a single epidural dose of morphine on pain after spinal decompression. Postoperative pain was assessed by a linear analogue pain score and by the additional require ment for systemic analgesics. The results obtained are as follows:l. In spinal decompression, the adminitration of epidural morphine is easy, effective and safe because the epidural space has been already exposured during operation. 2. After operation the epidural route of morphine administration will give pain relief for up to 12 hours excellently. 3. When epidural morphine is given at the time of operations, the use of systemic analgesics is much reduced. 4. The side effects of epidural morphine are much reduced due to the small amount of morphine required. This simple procedure is recommended as an effective and safe method of reducing postoperative pain.
Analgesia ; Analgesics ; Decompression ; Double-Blind Method ; Epidural Space ; Methods ; Morphine ; Pain, Postoperative ; Prospective Studies ; Spinal Canal

Aneurysmal bone cyst uncommonly involves the pubic bone and tends to grow eccentrically and thin out overlying cortex. In the following case report, a 19-year-old male patient visited out hospital, because of dull pain in his left groin. He was diagnosed as aneurysmal bone cyst originated from the superior pubic ramus by CT guided needle biopsy. Transcatheter arterial embolization was effective in the treatment of this lesion such as complete consolidation after the procedure. At present, 2 years follow-up, no problem was noted at weight bearing as well as hip function or recurrence.
Aneurysm ; Biopsy, Needle ; Bone Cysts ; Follow-Up Studies ; Groin ; Hip ; Humans ; Male ; Pubic Bone ; Recurrence ; Weight-Bearing ; Young Adult

There are many difficult problems of reduction and its maintaining in the treatment of unstable intertrochanteric fractures. Especially, in cases of elderly patients with marked osteoporosis, prolonged immobilization brings more serious complication. In order to solve these problems, in cases of unstable intertrochanteric fractures with large lesser trochanteric fragment, we have carried out anatomical reduction and rigid internal fixation with compression hip screw and additional transfixation screw on posteromedial fragment. The unstable fractures have been convrted into the stable fractures by transfixation screw. We analyzed the 1 1cases with additional transfixation screw and they showed good results in one year follow up.
Aged ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans ; Immobilization ; Osteoporosis