Transpedicular Screw fixation and Harrington distraction rod are effective means of managing unstable thoracolumbar fracture and fracture dislocation. The authors analysed the 52patients who were treated with above 2methods from March 1986 to February 1993. The results were as follows: 1. Most of patients were in 5th decade compare to younger group and most common cause of injury was fall down, but traffic accident is increasing. 2. The most commonly involved sites were T12and L1 vertebrae and most common type of injury is bursting fracture. 3. Postoperative anterior and posterior column of vertebrae body correction rate were 35.0%/34.4% in ISF group and 29.3%/27.9% in Harrington group. Postoperative correction loss rate were 0.13/0.04 in ISF group and 0.06/0.04 in Harrington group. 4. Postoperative correction of kyphosis angle were average 18 in ISF goup and average 15° in Harrington group. Loss of correction angle was average 23° in ISF group and average 4.4° in Harrington group. 5. Range of spinal fixation was average 3.1 segments in ISF group and average 6.2 segments in Harrington group. 6. There was no significant difference in neurologic recovery between ISF group and Harrington group. The patients who had been recovered neurologically more than 1 grade were 28.6% in Harrington group and 29.2% in ISF group. 7. ISF has some benefit in spnal vertebral body height correction and in maintenance of correction compare to Harrington group. Nevertheless disadvantages of ISF group such as long operative time and possibility of cord compression by pedicular screw, ISF has advantages of almost anatomical reduction and the least spinal fusion.
Accidents, Traffic ; Body Height ; Dislocations ; Humans ; Kyphosis ; Operative Time ; Spinal Fusion ; Spine

Mesenteric fibromatosis is a rare nonmetastasizing fi brous tumor, characterized by fibroblastic proliferation without evidence of inflammatory response or definite neoplasia. It appears at any age, but mainly in the second to fifth decades as incidence of two to four desmoid tu mor cases per 1 million people per annum. It is pseudoen capsulated and locally invasive and has a tendency to recur, but metastases are rare. It is more frequent with Gardner's syndrome(adenomatosis coli) in which 50% of them will appear as mesenteric fibromatosis. Trauma, especially that of previous surgery, has been associated with the subsequent development of desmoid tumor. The treatment of choice is a wide margin resection of the tumor. we experienced a case of mesenteric fibromatosis without Gardner's syndrome 2 years after appendectomy in a 31-year old man and recurred at 21 months after resection and report with a review of literatures. 6
Adult ; Appendectomy* ; Fibroblasts ; Fibroma* ; Fibromatosis, Aggressive ; Gardner Syndrome ; Humans ; Incidence ; Neoplasm Metastasis

Roberts syndrome is an autosomal recessive disorder accompanied by limb defects, craniofacial abnormalities, pre-and postnatal growth retardation. Patients with Roberts syndrome have characteristic premature separation of heterochromatin of many chromosomes and abnormalties in celldivision cycle. We have experienced a case of Roberts syndrome in an immature neonate The patients showed characteristic clinical features of multiple, severe facial mid-line clefts, and tetraphoco-amelia. The brief review of the literlature was made.
Craniofacial Abnormalities ; Ectromelia ; Extremities ; Heterochromatin ; Humans ; Infant, Newborn

PURPOSE: To evaluate the cause and surgical outcome of extensor pollicis longus rupture after distal radius fractures. MATERIALS AND METHODS: Nineteen cases in which the patients underwent surgical treatment for rupture of the extensor pollicis longus after distal radius fractures were followed for more than one year. Among the nineteen cases, fourteen extensor pollicis longus ruptures occurred after conservative treatment, four occurred after closed reduction with K-wire fixation, and one occurred after open reduction and internal fixation with a plate. All cases were treated by extensor indicis proprius transfer. RESULTS: Extensor pollicis longus ruptures were caused by K-wire irritation in two, by a protruding screw tip in one, and by a callus in one. In the conservative treatment group, tendon ruptures were diagnosed at an average of 3.1 months (0.7~17). Tendon ruptures were detected in the surgical treatment group at an average of 12.8 months (1~48). All the patients showed favorable recovery of the extension capability of the thumb at the final follow-up. CONCLUSION: The main cause of extensor pollicis longus rupture after distal radius fracture was ischemic damage. Therefore, during the surgery, the length and direction of screws and K-wires should be fixed carefully to avoid such damage. Distal radius fracture also requires careful observation of the extensor pollicis longus during follow-up. Furthermore, extensor indicis proprius transfer is considered to be an effective method for extensor pollicis longus rupture.
Bony Callus ; Follow-Up Studies ; Humans ; Radius ; Radius Fractures ; Rupture ; Tendons ; Thumb

PURPOSE: Having been disappointed with standard anticoagulation therapy for acute deep vein thrombosis (DVT) in lower extremity, we started catheter-directed thrombolytic therapy. And the aim of this study was to evaluate the effects on venous function of catheter-directed thrombolytic therapy by noninvasive venous tests such as Air plethysmography (APG) and duplex ultrasonography. METHOD: 36 patients with DVT of less than 3 weeks after development into two groups according to treatment modality:Group 1; catheter-directed thrombolysis with Urokinase followed by low-molecular weight heparin (LMWH) and coumadin therapy (n=19, men; 11, women; 8, mean age 47.6 years), Group 2; conventional anticoagulation with LMWH followed by coumadin therapy (n=17; men; 12, women; 5, mean age 47.1 years). The results of lytic therapy were examined by complete phlebography on time of removal of catheter. The location and extent of thrombotic changes were followed-up with duplex scan and venous function was examined with APG. RESULT: Complete clot resolution by lytic therapy was obtained in 12 cases out of 19 cases (63.2%) in Group 1. The residual thrombi at follow-up around 1 year were detected in 4 cases in Group 1, in 11 cases in Group 2. APG parameters that were significantly different (P<0.05) between the two groups were the venous filling index:(Group 1; 1.63+/-1.36 ml/sec, Group 2; 2.66+/-1.58 ml/sec), residual volume fraction (Group 1; 27.54+/-17.40%, Group 2; 49.19+/-20.45%) and outflow fraction (Group 1; 37.79+/-7.05%, Group 2; 32.36+/-6.31 %). The parameters of APG and ultrasonography in Group 1 revealed lesser degree of reflux and smaller amount of residual thrombi. CONCLUSION: Catheter-directed thrombolytic therapy shows better results in complete resolution rate of the acute DVT, reducing remnant thrombi, and preserving venous function such as venous filling index, residual volume fraction and outflow fraction. APG and duplex scanning seem to be useful methods for a complete follow-up evaluation of limbs with DVT.
Catheters ; Extremities ; Female ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Lower Extremity* ; Male ; Phlebography ; Plethysmography ; Residual Volume ; Thrombolytic Therapy ; Ultrasonography ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis* ; Warfarin

We have expierenced a rare case of coloboma of the lower lid combined with epidermoid ine lusion cyst. We removed the epidermoid inclusion cyst and repaired the coloboma with ocr a new techniqe using a triangular flap and achieved satisfactory result. We reviewed the literatures and discused this rare case.
Coloboma*

No abstract available.
Arteries* ; Infarction* ; Spinal Cord Vascular Diseases ; Spinal Cord*

BACKGROUND: Although the first coronary Wallstent implantation ushered in a new era in interventional cordiology with the purpose of circumventing the two major limitations of coronary balloon angioplasty, early acute occlusion and late restenosis, the previous investigators have reported a high rate of subacute occlusion after Wallstent implantation. However, recent studies have reported a low incidence rate of subacute closure and restenosis using the newly modified coronary Less Shortening in aortocoronary vein grafts. The present study reports the immediate results of the Less Shortening Wallstent Implantation for 21 diffuse native coronary lesions in 20 patients. METHODS: Twenty patients were enrolled at the Yonsei Univ. Cardiovasular Center of medical College, Yonsei University in Seoul, Korea from March 1996 through May 1996. The specific angiographic criteria for enrollment included at least 75% diameter stenosis, according to the estimate of two investigatior ; a lesion that was 20mm or more in lenght and a vessel diameter of at least 2.5mm. Bail-out procedure was performed in the case of abrupt closure or threatened closure, defined as a dissection and over 50% residual stenosis of the artery. RESULTS: The coronary Less Shortening Wallstents were successfully implanted in the 21 diffuse coronary lesions(more than 20mm in length) of the 20 patients(pts), including 7 pts of acute myocardial infarction, 11 pts of unstable angina, and 2 pts of stable angina. Angiographic results after Less Shortening Wallstent were 3.0+/-0.3mm in minimal luminal diameter(MLD), 6.7+/-10.8% diameter stenosis(DS) comparing with pre-stent implantation MLD and DS, respectively, 0.3+/-0.4mm and 89.9+/-8.4%. During the in-hospital phase, no major cardiac event occurred except 2 cases of transmural myocardial infarction, including one of stent thrombosis and one of side branch occlusion, despite of inclusion of 7 cases of threatened occlusion in the long lesion. The peristent spasms were observed in 11 among 21 lesions, although long term significance of peristent spasm is not defined. The relative risk for peristent spasm were 10 times higher when larger stents(expanded stent diameter/reference artery diameter>1.7) were implanted. There was no peristent spasm when stents of which expanded stent diameter 1.4 times smaller than reference artery size ware used. CONCLUSION: The results of this introductory study suggest that new Less Shortening Wallstent may reduce the requirement of multiple stent in the long lesion and a lower rate of thrombotic occusion in comparison to its prototype. Further large scale long term follow-up study is needed to evaluate the role of new Less Shortening Wallstent.
Angina, Stable ; Angina, Unstable ; Angioplasty, Balloon, Coronary ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Disease* ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Myocardial Infarction ; Phenobarbital ; Research Personnel ; Seoul ; Spasm ; Stents ; Thrombosis ; Transplants ; Veins

OBJECTIVE: To assess the static balance under the virtual moving surround (VMS) in healthy young and elderly adults. METHOD: There were twenty four healthy young adults and thirty nine healthy elderly aged 60 and older. Each group was tested with forceplate during quite standing with eyes opened, closed and under the VMS for static balance. The VMS was stimulated with a head-mounted display (HMD). The parameters for static balance were total sway path distance and area. RESULTS: All static balance parameters of healthy elderly were significantly increased in all conditions when compared with parameters of young adults. In the young adults and elderly, total sway path distance and sway area were significantly different under the VMS. In the healthy elderly, total sway path distance and sway area were significantly increased under the VMS as much as eyes closed. CONCLUSION: In the healthy adults, the VMS could provoke the significant postural sway during static standing. VMS can be used as a tool to evaluate and treat of the patients with static balance dysfunction.
Adult ; Aged ; Humans ; Young Adult

Wilson`s disease is a hereditary disorder in hepatic excretion of copper that results in toxic accumulations of the metal in liver, brain and other organs. Though there have been some reports of Wilson's disease with hepatic, neurologic, psychiatric symptoms, or hemolytic anemia, a case of Wilson's disease with abnormal secretion of pituitary hormones is, to our best knowledge, the first report in Korea. We report a case of Wilson`s disease with abnormal secretion of pituirary hormones, chronic active hepatitis with feature of early cirrhosis and hemolytic anemia in 18-year-old man showing delayed puberty. And also we describe a case of successful desensitization to penicillamine in a penicillamine hypersensitivity.
Adolescent ; Anemia, Hemolytic ; Brain ; Copper ; Fibrosis ; Hepatitis, Chronic ; Hepatolenticular Degeneration ; Humans ; Hypersensitivity ; Korea ; Liver ; Penicillamine ; Pituitary Hormones* ; Puberty, Delayed