Tuberculous spine has high incidence in children. Many cases of the tuberculous spine are complicated by deformities of the spine and disability such as paraplegia, cardio-plumonary dysfunction, and also early death. There are now several reports on the pulmonary dysfunction due to spinal deformities such as scoliosis and kyphoscoliosis, but there are few papers on the pulmonary function of patients with the tuberculous spine and kyphosis in children. This article is a report on the study of chest excursion in 70 kyphotic children and of the pulmonary function in 10 cases of severe kyphotic patients with collapsing tuberculous spine. The following results are obtained through the study: 1) Chest excursion was evidently diminished in the cases of moderate and severe thoracic, and severe lumbar involvement. The remainders were nearly within normal limits. 2) The study revealed that the chest excursion and the radiological kyphosis has a very gradually sloped negative correlation in thoracic involvement. 3) Pulmonary function in the severe kyphotics who had the curve over 50 degree were revealed as follows; a) Over 50 percent of the cases had diminished vital capacity. That is, over-all average was 67.7 percent of normal capacity. Especially inspiratory reserve volume was diminished, it was 63.7 percent of normal. Maximum breathing capacity was 68.8 percent of normal. b) Tidal volume, timed vital capacity, minute ventilation rate and O2 consumption were within normal limits or nearly normal.
Child ; Congenital Abnormalities ; Forced Expiratory Volume ; Humans ; Incidence ; Inspiratory Reserve Volume ; Kyphosis ; Paraplegia ; Respiration ; Scoliosis ; Spine ; Thorax ; Tidal Volume ; Ventilation ; Vital Capacity

Tuberculosis of the spine still remains as an important problem and also have high incidence in children in Korea. Many cases of the tuberculous spine are complicated by deformities of the spine and disability such as paraplegia, incordination of the cardio-pulmonary function and also result in early death. For the treatment of the tuberculous spondylitis following measure should be considered. First, eradication of the tuberculous lesion by conservative treatment or combined surgery, secondly, prevention of the deformity of the spine. Lastly, care for physical and psycological or emotional changes, and care for cardio-pulmonary dysfunction which develops after establishment of spinal deformity. Authors also attempted to analyse the kyphotic changes of the tuberculous spine of 70 children who were ambulating treatment at Pusan University Hospital and Pusan Charity Hospital, and obtained the result as follows; 1. Lower thoracic and upper lumbar were mostly involved. Nearly all cases of the new involvement of adjacent vertebra within 18 months. Only 4 cases now involvement occured after 18 months. 3. Kyphosis aggrevated grossly in 61.3% of cases. Most of them were apparent within 18 months but the changes developed after 18 months in 4.23% of cases. 4. In measuring the radiological kyphosis, Salters angle usually more simpler one than the internal gibbus angle. 5. Salters angle was larger involved than the internal gibbus angle except in mild and severe cases of the lumbar and lumbosacral involvement. Increase of kyphosis was 13.6 degree by internal gibbus angle and 16.3% by Salters angle. Kyphosis increased after 18 months were 3.1 degree by internal gibbus angle and 5.0 degree by Salters angle. 6. Radiological kyphosis changed in all stages and at least we should consider the changes of the kyphosis could be measured. 7. By the Kawakamis spinometer, the compensatory curvature, the posture of the patient and state of the kyphosis could be measured. 8. The compensatory curvature measured by Kawakamis spinometer were as follows: a) compensatory curvature in decrement in mild or morderate degree of cases, changed lumbar only or both cervical and lumbar curvature. b) compensatory curvature in increment in severe thoracic involvement changed both cervical and lumbar curvature, or cervical one only, the value in the cervical one was larger than that in the lumbar curvature.
Busan ; Charities ; Child ; Congenital Abnormalities ; Humans ; Incidence ; Korea ; Kyphosis ; Paraplegia ; Posture ; Spine ; Spondylitis ; Tuberculosis

Commonly used internal devices to fix the stable and unstable intertrochanteric fractures are fixed nail plate (Jewett nail, Holt nail), sliding nail plate (compression hip screw) and intramedullary device (Ender, Harris nail). The choice of internal device is influenced by the general coditions of patients, the pattern of fracture and the personal preference of surgeon. There are many reports that sliding nail plate appears to give better result than fixed nail plate because the latter device leads to high failure rate. Twenty nine unstable intertrochanteric fractures treated with Jewett nail plate (group I) and sliding compression hip screw (group II) between 1981 and 1988 were reviewed after minimal twelve months follow up. Group I comprised of fourteen cases, Group II, of fifteen. There were seventeen males and twelve females. The ages ranged from thirty-two to seventy-eight years, the average age being 57.8 years. Eighteen cases were caused by slip down; eight, traffic accident; and three, fall down. The average operation time was 124 minutes in group I and 148 minutes in group II. The average amout of blood loss was 1024cc in group I and 1040cc in group II. The average time to union was 13 weeks in group I and 12.9 weeks in group II. In Jewett nail plate fixed group, there were three complication; one coxa vara, and superior migration of nail, and one subcapital fracture and one superficial wound infection. In sliding compression hip screw group, one was complicated with coxa vara. Above results suggest that the use of Jewett nail plate in unstable intertrochanteric fracture could be got good results with method using compression hip screw.
Accidents, Traffic ; Coxa Vara ; Female ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans ; Male ; Methods ; Wound Infection

BACKGROUND: Cerebral white matter lesions(WMLs), such as leukoaraiosis, may be related to damage from cerebral ischemia and may also be associated with the degenerative process. The apolipoprotein E (APOE) 4 allele is a risk factor for degenerative diseases, such as Alzheimer`s disease, and ischemic brain damage through acceleration of atherosclerosis. No study has been performed regarding WMLs and APOE genotype in Korea. We investigated the association between WMLs and APOE among Koreans. METHODS: Brain MRI was performed in 225 subjects(ages 61 to 85 years) without neuropsychiatric disease randomly selected from the Ansan Health Cohort Study. WMLs observed on 225 MRI scans were rated in terms of severity by 2 raters. All study subjects underwent APOE genotyping. RESULTS: WMLs were observed in 109(48.4%) of subjects. In the subjects with WMLs, the distribution of APOE genotypes was 0.9% for epsilon 2/epsilon 2, 11.0% for epsilon2/epsilon3, 1.8% for epsilon2/epsilon4, 61.5% for epsilon3/epsilon3, 22.9% for epsilon3/epsilon4, and 1.8% for epsilon4/epsilon4, respectively. The distribution of APOE genotypes did not differ between subjects with and without WMLs. CONCLUSION: These data suggest that there is no association between WMLs and APOE genotypes in Koreans.
Acceleration ; Alleles ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Brain ; Brain Ischemia ; Cohort Studies ; Genotype ; Gyeonggi-do ; Korea ; Leukoaraiosis ; Magnetic Resonance Imaging ; Risk Factors

No abstract available.

Non-ketotic hyperglycemia (NKH) is often related to various types of epileptic seizures. However, aphasic seizures associated with NKH have been rarely reported. A 60-year-old diabetic woman was admitted with language disturbance. She presented recurrent motor aphasia and EEG demonstrated ictal rhythmic discharges initiated from left frontal lobe. The seizures disappeared after introduction of carbamazepine and successful control of serum glucose. She remained seizure-free for three months after discharge. We report a case of NKH, manifested by aphasic seizures.
Aphasia, Broca ; Carbamazepine ; Electroencephalography ; Epilepsy ; Female ; Frontal Lobe ; Glucose ; Humans ; Hyperglycemia ; Middle Aged ; Seizures

PURPOSE: This study was carried to examine the temporal trend and geographical distribution of the childhood cancers in Taegu and Kyungpook province and to postulate an etiological hypothesis for development of the childhood cancer. METHODS: A total of 799 childhood cancer patients whose addresses were either Taegu or Kyungpook province were diagnosed at 5 major hospitals in Taegu from January 1982 to December 1996. The types, sexes, years, and frequencies of the childhood cancer and regional distributions were analyzed, based on the hospital records of these patients. RESULTS: The most common childhood cancer was leukemia that accounted for 49.2% of all childhood cancer cases and it was followed by CNS tumor (12.3%), lymphoma (8.4%), neuroblastoma (7.4%), Wilms tumor (3.9%), retinoblastoma (3.4%), rhabdomyo sarcoma (2.7%), bone tumor (2.4%), embryonal carcinoma (1.9%), hepatoblastoma (1.3%) and others (7.1%). Male to female ratio of the cases was 1.5:1. The changes of the annual incidence rates over 15 years in Taegu and Kyungpook area were not consistently increasing but rather variable. Cancer incidence rate of Taegu was significantly higher than that of Kyungpook province (P<0.005). The incidence rates of industrialized cities around Taegu were significantly higher than those of agricultural regions of northern Kyungpook (P<0.05). CONCLUSION: Geographical difference in cancer incidence rate suggested that certain environmental factors may be associated with the childhood cancer. To identify such factors an analytical epidemiologic study is warranted. For the analytical epidemiologic study, a detailed history of residential area and occupational history of parents should be recorded uniformly for all the new childhood cancer cases.
Carcinoma, Embryonal ; Daegu* ; Epidemiologic Studies ; Epidemiology ; Female ; Gyeongsangbuk-do* ; Hepatoblastoma ; Hospital Records ; Humans ; Incidence ; Leukemia ; Lymphoma ; Male ; Neuroblastoma ; Parents ; Retinoblastoma ; Sarcoma ; Wilms Tumor

Metabolic encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome is characterized by encephalopathy mimicking acute stroke, which is rarely observed in adulthood. We present a case of a female who presented with several neurologic deficits and diagnosed with MELAS syndrome. Brain magnetic resonance imaging (MRI) showed acute lesions mimicking stroke, which were not compatible with specific vascular territories. Magnetic resonance spectroscopy showed lactate peaks in both symptomatic and asymptomatic area. Single proton emission computed tomography (SPECT) shows hyperperfusion in the same area. On follow-up image, MRI lesion nearly disappeared and hyperperfusion on SPECT changed into hypoperfusion. We discuss the clinical characteristics and image findings of our patient.