STUDY DESIGN: We analyzed the segmental mobility of the lumbar spine after anterior stabilization in the thoracolumbar spinal fractures, and the data were compared with those obtained from an asymptomatic control group. OBJECTIVE: To determine the effects of anterior stabilization on the unfused segments of the lumbar spine. SUMMARY OF LITERATURE REVIEW: Spinal fusions are commenly used to stabilize unstable motion segments and to help the maintenance of correction afforded by the instrumentation applied in surgery for spinal deformity or injuries. How the presence of the fusion effects upon the remaining infused spine is not well understood. MATERIALS AND METHODS: We measured the segmental deformations of the lumbar spine radiologically, from maximum flexion to maximum extension, right and left maximum lateral bending, in 20 asymptomatic volunteers( the control group ) and 30 patients who had the anterior stabilization of the thoracolumbar spinal fractures(the study group). We assessed the percentage of segmental deformations which were obtained by multipling one hundred after the segmental deformation value was divided by the total lumbar deformation value. We made the comparison between the White and Panjabi's results and the control group, between the control group and the study group, between the segmental deformations and the percentage of segmental deformations. RESULTS: In the control group , the segmental deformations were smaller than those of the corresponding segmenus in the White and Panjabi's results. In the flexion-extension rotation of the lumbarspine, the segmental deformations had a tendency to increase from cephalad to caudal in the controland study group. In the residual lumbar spinal mobility, the segmental deformations of the study group had decreased rather than those of the control group. Especially the segmental deformation below the juxtafused segment had increased more than those of the corresponding segment of the control group in the right lateral bending rotation. The residual lumbar spinal mobility tended to decrease from T12 vertebral stabilization to L2 vertebral stabilization. CONCLUSION: The unfused segments had accommodated a greater percentage of segmental deformations in spite of diminishing the segmental deformations in comparison with those of the corresponding control subjects. It suggests that the greater percentage of segmental deformations predisposes to early degeneration of unfused segments.
Congenital Abnormalities ; Humans ; Spinal Fractures* ; Spinal Fusion ; Spine

No abstract available.
Lung*

Purpose: The aim of this study was to compare the short-term outcomes of two-dimensional (2D) and three-dimensional (3D) laparoscopic surgery for total extraperitoneal (TEP) primary inguinal hernia repair. Methods: This was a single-center, retrospective, observational database study of 38 patients who underwent laparoscopic TEP inguinal hernia repair from March 1, 2019 to August 30, 2019 at Kyung Hee University Hospital at Gangdong in Seoul, Korea. Results: There was no significant difference in sex ratio, age, or body mass index between the two groups. The 2D group had two patients with direct hernia and 18 patients with indirect hernia. The 3D group had five patients with direct hernia, 11 patients with indirect hernia, and two patients with femoral hernia. The mean operation time was 38.2 minutes in the 2D group compared with 37.2 minutes in the 3D group. There was no severe intraoperative bleeding in either group. During the operation, peritoneal tearing occurred in 12 out of 20 patients in the 2D group compared with five out of 18 patients in the 3D group (p = 0.02). The average length of hospital stay was 1.3 days in both groups. The numeric rating scale score was 3.3 and 3 in the 2D group and the 3D group, respectively. In the 2D group, two patients revisited the outpatient clinic because of the postoperative occurrence of seroma and varicocele. Conclusion A 3D laparoscopic surgery is feasible and safe for inguinal hernia repair and showed less peritoneal tearing compared with 2D laparoscopic surgery for primary inguinal hernia repair.

Purpose: The aim of this study was to compare the short-term outcomes of two-dimensional (2D) and three-dimensional (3D) laparoscopic surgery for total extraperitoneal (TEP) primary inguinal hernia repair. Methods: This was a single-center, retrospective, observational database study of 38 patients who underwent laparoscopic TEP inguinal hernia repair from March 1, 2019 to August 30, 2019 at Kyung Hee University Hospital at Gangdong in Seoul, Korea. Results: There was no significant difference in sex ratio, age, or body mass index between the two groups. The 2D group had two patients with direct hernia and 18 patients with indirect hernia. The 3D group had five patients with direct hernia, 11 patients with indirect hernia, and two patients with femoral hernia. The mean operation time was 38.2 minutes in the 2D group compared with 37.2 minutes in the 3D group. There was no severe intraoperative bleeding in either group. During the operation, peritoneal tearing occurred in 12 out of 20 patients in the 2D group compared with five out of 18 patients in the 3D group (p = 0.02). The average length of hospital stay was 1.3 days in both groups. The numeric rating scale score was 3.3 and 3 in the 2D group and the 3D group, respectively. In the 2D group, two patients revisited the outpatient clinic because of the postoperative occurrence of seroma and varicocele. Conclusion A 3D laparoscopic surgery is feasible and safe for inguinal hernia repair and showed less peritoneal tearing compared with 2D laparoscopic surgery for primary inguinal hernia repair.

Osteonecrosis of the femoral head usually affects young or middle-aged adults and frequently leading to femoral head collapse and hip arthritis. This review reports the updated treatments of the disease.

Cerebral vasospasm is one of most serious complication after subarachnoid hemorrhage due to aneurysmal rupture and a very important cause affecting to prognosis. The most reliable diagnostic assessment of cerebral vasospasm is angiography, but this is limited to perform because of complications such as neurological deficits or death, especially to repeat studdy. It seems likely that assessment of evoked elective, a much simpler and safer than the repeated study of angiography, will be of use in following the condition of patients with clinical vasospasm following SAH. In order to study relationship between clinical vasospasm and electrical activity, we traced SSEP from upper extremity by median nerve stimulation and lower extremity by posterior tibial stimulation which manifest the neurophysiologic function of cerebral ischemia. MN(Me-dian n.) and PTN(Posterior tibial n.)were performed simultaneously. Over 2 years period (1986 through 1988), 41 patients were performed SSEP and evaluated the relationship between SSEP and clinical or angiographic vasospasm in patients of SAH.
Aneurysm ; Angiography ; Brain Ischemia ; Humans ; Lower Extremity ; Median Nerve ; Prognosis ; Rupture ; Subarachnoid Hemorrhage ; Upper Extremity ; Vasospasm, Intracranial

PURPOSE: To report a case of nasal-type NK/T cell lymphoma occurring in the sphenoid and ethmoid sinuses of an orbital apex syndrome patient. CASE SUMMARY: A 61-year-old male patient visited our hospital for the impairment of vision in the right eye for the previous month, and for right-side blepharoptosis, pain around the eyeball, and limitation of extraocular movement in the right eye for three days earlier. In MRI (magnetic resonance image) and CT (computed tomography), shades with vague boundaries were observed in the right sphenoid and ethmoid sinuses, and open biopsy and decompression were performed for the lesions. After the surgery, the vision of the right eye increased, and improvement was observed in the right blepharoptosis, the pain around the eyeball, and in the limitation of motility of the extraocular muscle in the right eye. The patient was diagnosed with nasal type NK/T cell lymphoma in biopsy, and radiotherapy and chemotherapy were performed.
Biopsy ; Blepharoptosis ; Decompression ; Ethmoid Sinus ; Eye ; Humans ; Lymphoma ; Male ; Middle Aged ; Muscles ; Orbit ; Vision, Ocular

Phase and Amplitude Image were developed to overcome the subjective nature of interpretation for cinematic endless loop display of radionuclide gated blood pool scan. To evaluate the usefulness of color coded phase image in coronary artery disease, we conducted a clinical study with coronary angiography and phase image in 23 patients, and compared the results of those studies. 1) The results of coronary angiography revealed normal coronary artery in 6, 1 vessel disease in 11, 2 vessel disease in 4, and 3 vessel disease in 2 patients. 2) Color-coded Phase Image revealed abnormal phase area in 2/2(100%) of 3 vessel disease patients and in 3/4(75%) of 2 vessel disease patients, in 5/11(45%) of 1 vessel disease patients, and only 1/6(16%) of normal coronary artery. 3) Among the patients who disclosed abnormal phase image, 5 patients of 2-or3-vessl disease revealed abnormal phase through whole left ventricular area, but 3 patients with right coronary artery lesion and 2 patients with left antrior descending artery lesion showed localized abnormal phase area, infero-apical and anterior portion respectively, which were in accord with each coronary lesion. We concluded that the phase image may be useful in evaluation of the regional wall motion abnormalities in the patients of coronary artery disease. Further studies seem to be neccessary to clarify the sensitivity and specificity of the phase image in the each disease entity group.
Arteries ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Sensitivity and Specificity

PURPOSE: Stress urinary incontinence (SUI) commonly occurs in women, and it causes enormous impact on quality of life. Surgery, drugs, and exercise have been recommended for the treatment of this disease. Among these exercise is also known to be effective for relieving thesymptoms of SUI, however, the efficacy and underlying mechanisms of exercise on SUI are poorly understood. In the present study, we investigated the effect of treadmill exercise on abdominal leak-point pressure and neuronal activity in the medial preoptic nucleus (MPA), ventrolateral periaqueductal gray (vlPAG), and pontine micturition center (PMC) following urethrolysis in rats. MATERIALS AND METHODS: Adult female Sprague-Dawley rats, weighing 250+/-10 g (9 weeks old), were used in this study. After having undergone transabdominal urethrolysis to induce SUI, the rats were divided into three groups (n=6 in each group): a sham operation group, an SUI-induced group, and an SUI-induced and treadmill exercise group. The rats in the exercise group performed treadmill running for 30 min once a day starting 2 weeks after the induction of SUI and continuing for 4 weeks after surgery. For this study, determination of abdominal leak point pressure and immunohistochemistry for c-Fos in the brain were performed. RESULTS: Induction of transabdominal urethrolysis significantly reduced the abdominal leak point pressure, thereby contributing to the induction of SUI. In contrast, abdominal leak point pressure was significantly improved by treadmill exercise. The expression of c-Fosin the MPA, vlPAG, and PMC, the brain areas relating to micturition, was enhanced by the induction of SUI, whereas treadmill exercise significantly suppressed SUI-induced c-Fos expression, suggesting that neuronal activation in the micturition centers was suppressed by treadmill exercise. CONCLUSION: The present results suggest that treadmill exercise may be an effective therapeutic modality for ameliorating the symptoms of SUI.
Adult ; Animals ; Brain ; Exercise Test ; Female ; Humans ; Immunohistochemistry ; Neurons ; Periaqueductal Gray ; Quality of Life ; Rats ; Rats, Sprague-Dawley ; Running ; Salicylamides ; Urinary Incontinence ; Urination

Somatosensory evoked potential(SSEP) has been recorded during 31 operations for intracranial aneurysm. We had monitored the SSEP in each stage of aneurysm surgery(preoperative, anesthetic induction, dura opening, temporary vascular occlusion, aneurysm neck clipping and 30 minute after aneurysm neck clipping). Temporary occlusion of intracranial arteries have performed in 21 cases. In cortical amplitude of more than 50% as compared with induction was considered to be "significant" SSEP change. Eleven out of 21 cases of temporary vascular occlusion showed significant decrease of amplitude. Three out of 4 cases with flat wave had new neurologic deficits postoperatively. We studied the relationship between SSEP changes and postoperative neurologic deficit and concluded as follows: 1) The monitoring of amplitude of SSEP may help control the duration and number of application in temporary clipping during aneurysm surgery. 2) Decreased in amplitude with temporary clipping, especially flat wave, is a strong suggestion of the postoperative neurologic deficit. These results indicate that monitoring of SSEP during aneurysm surgery would be helpful to reduce the incidence of postoperative neurologic deficits.
Aneurysm* ; Arteries ; Incidence ; Intracranial Aneurysm ; Neck ; Neurologic Manifestations