We present a prospective, randomized study of acute burst fracture of the thoracolumbar spine. Forty-one patients were treated either by anterior decompression and stabilization with Kaneda device or by posterior distraction instrumentation using the A-O fixateur interne. The mean follow up was 21 months. The result were as follows; 1. The mean preoperative kyphotic angle was 19.2° in those patients treated by anterior surgery and 21.4° in those patients treated by posterior surgery. At last follow-up the mean correction in kyphotic angle was 13.2° in the anterior group and 9.2° in the posterior group. There is no statistically significant difference between those two groups. 2. The mean preoperative midsagittal diameter of the canal compromise 47.4% in anterior group and 49.3% in posterior group. Postoperatively, this was reduced to 2.5% and 7.9%. There is a statistically significant difference between these two groups(P < 0.05). 3. The mean preoperative canal enchroachment 52.)% in anterior group and 47.6% in posterior group. Postoperatively, this was reduced to 3.2% and 6.0%. There is a statistically significant difference between these two group(P < 0.05). 4. Neurologic recovery was 81% in posterior surgery and 85% in anterior surgery. The improvement in Frankel grade was 1 grade in average, and showed no difference between two groups. 5. There was two cases of pedicle screw breadage in posterior group and one case of pyothorax in anterior group but no early or late vascular or neurologic complication.
Decompression ; Empyema, Pleural ; Follow-Up Studies ; Humans ; Pedicle Screws ; Prospective Studies ; Spine

Gangweon-do is known to be highly endemic area of sparganosis more than other provinces in Korea. A seroepidmiologic examination for the detection of anti-Spirometra erinacei plerocercoid IgG in serum was carried out in normal inhabitants in Hongcheon-gun, Gangweon-do. Sere were tested by enzyme-linked immunosrobent assay (ELISA) for the anti-sparganum antibodies. Positive rate for anti-sparganum antibody in 719 adults was 3.3%. Data of the questionnaire for 24 ELISA positive inhabitants revealed that 20 had a history of eating raw meat of snakes, 24 had a history of eating frogs, and 24 had a history of drinking stream water. Two positive cases had a past history of sparganosis. Two positive cases showed current symptoms of sparganosis. The data revealed that ELISA would be useful to find infected cases among normal inhabitants at sparganosis-endemic areas.
Adult ; Aged ; Aged, 80 and over ; Animals ; Antibodies, Helminth/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin G/*blood ; Korea/epidemiology ; Male ; Middle Aged ; Seroepidemiologic Studies ; Sparganosis/*epidemiology ; Spirometra/*immunology

Usually the condition of ipsilateral fracture of femur and tibia is called floating knee, it is termed applied to the flail knee joint segment. The key point of the treatment is focused to the early restoration of the knee function. We experienced 86 consecutive cases during the period from March 1978 to February 1991 in Yonsei University Wonju College of Medicine. Among them, 51 cases(above 16 years old) were analysed with the mean follow up period of 2.1 years(1.2-5.6 years). The results obtained were as follows: 1. Main cause of these fractures is traffic accident. Among them, the pedestrian accident is more than in-car accident. 2. The cases of open fracture were 13 cases (25.5%) in femur and 31 (60.8%) in tibia. The degree of open fracture was more severe in tibia. 3. There were 2 cases (3.9%) of fat embolism syndrome preoperatively. 4. At an average 25 months follow up after injury, the good and excellent result of the group 1 and 3 was 85.2%, and the group 2 and 4 was 71.4% by Karlström and Olerud criteria. 5. At the last follow up examination, the mean loss of range of motion of the knee was 5.6° in group 1 and 3, 10.9° in group 2 and 4(P < 0.05). 6. The operative treatment of the both side is better than case of one side operation and other side conservative treatment.
Accidents, Traffic ; Clinical Study ; Embolism, Fat ; Femur ; Follow-Up Studies ; Fractures, Open ; Gangwon-do ; Knee ; Knee Joint ; Range of Motion, Articular ; Tibia

A survey was conducted to determine the extent of intestinal parasite infection in Bat Dambang, Cambodia in March 2004. A total of 623 fecal specimens was collected from kindergarten and schoolchildren and examined using the formalin-ether sedimentation technique. The overall infection rate of intestinal parasites was 25.7% (boys, 26.2%; girls, 25.1%), and the infection rates of intestinal helminthes by species were as follows: Echinostoma sp. 4.8%, hookworm 3.4%, Hymenolepis nana 1.3%, and Rhabditis sp. 1.3%. The infection rates of intestinal protozoa were; Entamoeba coli 4.8%, Giardia lamblia 2.9%, Iodamoeba butschlii 1.4%, Entamoeba polecki 1.1%, and Entamoeba histolytica 0.8%. There were no egg positive cases of Ascaris lumbricoides or Trichuris trichiura. All children infected were treated with albendazole, praziquantel, or metronidazole according to parasite species. The results showed that intestinal parasites are highly endemic in Bat Dambang, Cambodia.
Adolescent ; Age Factors ; Animals ; Cambodia/epidemiology ; Child ; Feces/parasitology ; Female ; Helminthiasis/*epidemiology ; Helminths/isolation & purification ; Humans ; Intestinal Diseases, Parasitic/*epidemiology ; Male ; Protozoa/isolation & purification ; Protozoan Infections/*epidemiology

Adie's tonic pupil usually consists of mydriasis, defect in accommodation. Poor or absent light reflex, and tonic near reflex, It is usually unilateral, but rarelY observed bilaterally. The pupillary abnormalities often accompany areflexia, which is called Adie syndrome collechvely, Other autonomic dysfunction especially hypohidrosis. Are rarely reported in association with Adie syndrome. We recently experienced 2 cases of bilateral Adie's pupils in 2 women, one of whom had hypohidrosis, and the other had areflexia. So we report 2 cases with bilateral Adie's pupils with a review of literature.
Adie Syndrome ; Female ; Humans ; Hypohidrosis ; Mydriasis ; Reflex ; Tonic Pupil*

Visual evoked potentials (VEP's) were studied in 19 children with surgically verified sellar or parasellar masses (7 craniopharyngioma, 3 optic chiasmal glioma, 3 granuloma, 1 hematoma, 1 arachnoid cyst, 1 medulloblastoma, 1 pituitary adenoma, 1 Rathke's cleft cyst and 1 germ cell tumor). Abnormalities consistent with visual pathway dysfunction were recorded in 17 patients (89%). Absent responses or poor wave formations were noted in 7 patients and delayed P1 latency in 10 patients. Two patients, one with intrasellar Langerhans' cell granuloma and the other with pituitary adenoma, had normal evoked potentials. The incidence and the degree of abnormalities in VEP's roughly correlated with the visual acuity. Postoperative VEP's were recorded in 5 patients and showed improvement in 4 patients. VEP's might be helpful for postoperative follow-up in children with sellar or parasellar masses.
Arachnoid ; Child* ; Craniopharyngioma ; Evoked Potentials ; Evoked Potentials, Visual* ; Follow-Up Studies ; Germ Cells ; Glioma ; Granuloma ; Hematoma ; Humans ; Incidence ; Medulloblastoma ; Optic Chiasm ; Pituitary Neoplasms ; Visual Acuity ; Visual Pathways

Unverricht-Lundborg disease(Baltic myoclonus) is one of the major causes of progressive myoclonus epilepsy. It is characterized by stimulus sensitive myoclonic seizure, generaized tonic-clonic seizure, generally synchronous polyspike and wave discharges on EEG and absence of severe or early dementia. It has usually been described in the countries around the Baltic area. But recently, it is regarded as the most common form of progressive myoclonus epilepsy in the other countries as well. We report, with the review of the literature, two patients who showed the typical features of this disorder.
Dementia ; Electroencephalography ; Humans ; Myoclonic Epilepsies, Progressive ; Seizures ; Unverricht-Lundborg Syndrome*

A 47-year-old man had suffered oscillopsia associated with palatal myoclonus for 10 years. High-field magnetic resonance imaging (MRI) revealed a cryptic vascular malformation within the "Guillain-Mollaret triangle" which was thought to be the responsible lesion.
Brain Stem/*abnormalities/pathology ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Myoclonus/*etiology

STUDY DESIGN: This is a retrospective study. OBJECTIVES: The purpose of this study is to decrease the frequency of the postoperative complications and to improve the postoperative clinical outcomes for the elderly patients with lumbar spinal stenosis. Summery of Literature REVIEW: Many controversies exist about postoperative complication and its influencing factors in the elderly patients suffering with lumbar spinal stenosis. MATERIALS AND METHODS: We reviewed the hospital records of 213 patients who underwent decompression and posterolateral fusion between February 1, 1998 and December 31, 2003 to treat their degenerative lumbar spinal stenosis. This study was performed, to assess and compare the postoperative complications and clinical outcomes of surgical management for the patients over 65 years (Group A) and the patients between 50-64 years (Group B). All the patients had at least a 1-year follow-up evaluation. The factors that could have influenced the complications that resulted within 12 weeks after the operation were evaluated and statistically analyzed. RESULTS: Postoperative complications occurred in 62 patients of Group A and in 40 patients of Group B, of which the major complications occurred in 10 patients of Group A and in 1 patient of Group B and minor complications occurred in 52 patients of Group A and in 39 patients of Group B. A statistical relationship between diabetes and major complications was observed in Group A (p=0.005). While any relationship between age and the frequency of complication in each group was not found, Group A had a higher frequency of major complication than did Group B (p=0.004). CONCLUSIONS: Surgeon should be vigilant about postoperative complications in elderly patients suffering with diabetic mellitus.Elderly patients with diabetic mellitus should be made aware that they are at an increased risk for postoperative complications because of their fragility.
Aged ; Decompression ; Follow-Up Studies ; Hospital Records ; Humans ; Postoperative Complications* ; Retrospective Studies ; Spinal Stenosis*

STUDY DESIGN: This is a retrospective study. OBJECTIVES: This study examined the MRI findings, injury mechanism, clinical findings, and prognosis of a spinal cord injury without radiographic abnormality (SCIWORA) in adults with a normal spinal canal. SUMMARY OF LITERTURE: Most reports on SCIWORA deal with the pediatric age group. However, there are few reports on the MRI findings, clinical features and outcomes in adult patients with cervical SCIWORA. MATERIALS AND METHODS: The hospital records of 753 patients, who were treated for cervical spine injury between February 1, 1994 and July 31, 2004, were reviewed. This study included the 10 subjects with no fractures or dislocation on the plain roentgenograms or cord compression caused by degenerative change or disc herniation on MRI corresponding to the location of the cord lesion. All the patients had at least a 2-year follow-up evaluation. The relationships between the MRI findings, neurological findings and outcomes were evaluated. RESULTS: The MRI findings revealed 7 cases with cord contusion, 3 cases with cord edema, 3 cases with gliosis and 3 cases with syrinx formation at the follow-up. The injury mechanism was hyperextension and hyperflexion in 7 and 3 cases, respectively. The initial motor function scores of ASIA in the edema and contusion groups was 60.7 and 43.9, respectively. At the last follow-up, the motor function scores of ASIA in the edema and contusion groups were 90 and 70.3, respectively. The Frankel grade improved by 1.3 and 1.1 in the edema and contusion groups, respectively. CONCLUSIONS: In patients with SCIWORA, the MRI findings correlated well with the clinical picture and were of prognostic significance. The cord edema group showed better clinical features than the contusion group, and prognosis was relatively good in both groups. A further careful evaluation, such as MRI, is still needed to determine the appropriate treatment for spinal cord injuries without radiographic abnormalities.
Adult* ; Asia ; Contusions ; Dislocations ; Edema ; Follow-Up Studies ; Gliosis ; Hospital Records ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Retrospective Studies ; Spinal Canal ; Spinal Cord Injuries* ; Spinal Cord* ; Spine