The thoracolumbar fracture and fracture-dislocations are ever increasing today as the traffic accidents and industrial accidents frequently occur. But the controversy as to the relative values of early surgical instrumentation and conservative means has continued for well over a decade. The duration of this dispute without final resolution suggests an absence of significant differences in the results of surgical and non-surgical method. The purpose of this study is to review the results of conservative treament for 132 patients with thoracolumbar fracture and fracture-dislocations, who were admitted and treated at Yonsei University Severance Hospital from January, 1980 to December, 1984. And we obtained following results. l. In cases of stable fracture without neurologic deficit, especially when the wedging deformity of vertebral body is below 50%, it seems to be better to treat conservatively; that is, immediate postural reduction and after 2 or 3 weeks of bed rest, to start ambulation with back brace or cast. 2. In cases of stable fracture with neurologic deficit, operative treament is necessary when the frac-fragment is protruded into the spinal canal and neural compression sign is evident. But if not so, attempt to treat by conservative means may be done. 3. In cases of unstable fracture without neurologic deficit, it is more retional to treat conservatively by bed rest for a suffient time and then wearing back brace or cast. If the spinal deformity is so severe that it needs spinal fusion, the operation can be performed later on. 4. In cases of unstable fracture with neurologic deficit, spinal instrumentation and fusion do nothing to enhance neural recovery but are done to provide anatomic spinal alignment and stability to allow early the patient mobilization and rehabilitation.
Accidents, Occupational ; Accidents, Traffic ; Bed Rest ; Braces ; Congenital Abnormalities ; Dissent and Disputes ; Humans ; Methods ; Neurologic Manifestations ; Rehabilitation ; Spinal Canal ; Spinal Fusion ; Spine ; Surgical Instruments ; Walking

No abstract available.
Aneurysm, False* ; Blood Pressure Monitors* ; Blood Pressure* ; Compression Bandages* ; Humans ; Radial Artery*

No abstract available in English.
Clinical Study

Buerger's disease was first identified in 1908 by Leo Buerger as a distinct clinicopathological entity, which causes severe pain and necrosis on distal parts of the extremities and occurs especially in young male adults. In spite of many treatment modalities, it is not completely cured but results in amputation in the long run. So, we studied a total of 120 cases of Buerger's disease, who were admitted at Yonsei University, Severance Hospital from Jan., 1975 to June, 1985 and we obtained the following results. 1. All the patients were male and majority of them were under 40 years of age (69.2%). 2. 118 cases were smokers and 2 cases were non-smokers. 3. The initial symptoms were resting pain, necrosis, and color change in descending order of frequency. 4. Diagnoses were made mainly by angiogram(75.8%) and most common site of obstruction was popliteal artery (49.4%). 5. After sympathectomy and angioplasty, there was temporary relief of symptoms, but none showed good results after long term follow up. As a result, amputations were performed after sympathectomy in 47 cases(39.2%), of which 36 cases(76.6%) received that surgery within 2 yeas after sympathectomy. 6. The pressure index not only helps diagnose the disease but also is a very useful method to objectively assess the severity of the initial symptoms and postoperative results.
Adult ; Amputation ; Angioplasty ; Clinical Study ; Diagnosis ; Extremities ; Follow-Up Studies ; Humans ; Male ; Methods ; Necrosis ; Popliteal Artery ; Sympathectomy ; Thromboangiitis Obliterans

The term "choristoma" is used to describe a mass of histologically normal tissue presenting in an aberrant site. The authors have experienced a case of lingual osseous choristoma in a 17-year-old female patient, which was totally removed and followed up for 12 months without any evidence of recurrence or developments to other disease.
Adolescent ; Choristoma* ; Female ; Humans ; Recurrence

The increase in size of lymph node on Ct scan is the single most important finding of lymphadenopathy. The purpose of this study was to evaluate the size of mediastinal lymph nodes in patients with idiopathic pulmonary fibrosis with no evidence of malignancy or current infection. CT scans of 70 patients (16 with conventional CT and 54 with high-resolution CT) were assessed for lymph node size and locations. The duration of symptoms, and the extent and patterns of the parenchymal lung disease on CT scans were correlated with lymph node enlargement. In 54 of 70 patients, more than one lymph nodes were larger than 1-1.5cm. The prevalence of mnode enlargement increased significantly with a longer duration of symptom (p=0.001), larger extent of the disease (p=0.043), and with a greater proportion of honeycomb pattern (p=0.0344). Right paratracheal, subcarinal, right tracheobronchial, and paraesophageal nodes were the most common sites of nodes enlargement. In conclusion, mediastinal lymph node enlargement is common in patients with idiopathic pulmonary fibrosis and is more frequently seen in patients with a longer duration of clinical symptoms, greater extent of the disease, and with a larger proportion of honeycomb pattern.
Humans ; Idiopathic Pulmonary Fibrosis* ; Lung Diseases ; Lymph Nodes* ; Lymphatic Diseases ; Prevalence ; Tomography, X-Ray Computed*

The pattern reversal visual evoked potential(PRVEP) and flash electroretinogram(flash ERG) were performed in 22 patients with optic atrophy. Patients with ophthalmologic problems other than optic atrophy or with systemic disorders were excluded from the analysis The results are as follows: 1. In the 41 eyes of patients with optic atrophy, 39 of them showed abnormal PRVEP, in which all the eyes had no consistent waveform except in one patient 2 eyes with delayed P1 latency. 2. 13 eyes were abnormal in both PRVEP and flash ERG but no eye was abnomnal in flash ERG only 3, Regarding the flash ERG examination, 13 eyes were abnomlal. Of these, there was a period of 1 to 2 years for 1 eye's disease, a period of 2 to 5 years for another eye' disease and after 5 years 11 eyes were diseased. Therefore, it showed that the longer the duration of disease lasted, the more flash ERG abnormalities developed. 4. The abnormalities of PRVEP haxe no significant relationship with the duration of the disease.
Evoked Potentials, Visual* ; Humans ; Optic Atrophy*

PURPOSE: Bone graft is essential for successful spinal fusion. So, we clinically assessed the effect of uniting grafted autologous bone. MATERIALS AND METHODS: Retrospective analysis is performed on 46 patients who had grade I or II, one segmental, degenerative spondyloiisthesis according to Meyerding classification and treated operatively by posterolateral fusion with posterior decompression and autologous iliac bone graft from January 1991 to June 1996. We got the data from simple anteroposterior, lateral, flexion- extension X-ray film at preoperative, postoperative and last follow-up period, and from clinical results at last OPD follow-up according to Kirkaldy-Willis criteria. We compared the union of grafted autologous bone with clinical results using X2-test. We also compared preoperative spinal instability, with/without instrumentation and intraoperative reduction with the union of grafted autologous bane and clinical results. RESULTS: There was high significant correlation (P=0.000) between the union of grafted autologous bone and clinical results statistically, CONCLUSIONS: This results suggest that the union of grafted autologous bone was an important factor in determing clinical results.
Classification ; Decompression ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Fusion ; Spondylolisthesis* ; Transplants* ; X-Ray Film

A retrospective study was performed in 37 patients who underwent innominate osteotomy for the treatment of Legg-Calve-Perthes disease. The majority of the patients (81%) were more than 6 years old, and the mean age was 7 years and 6 months. Thirty five hips were Catterall group III or IV, and 2 hips that had clinical and radiological "head at risk" signs were group II. The time interval between surgery and the final follow-up ranged from 2 to 6 years with a mean of 3 years and 10 months. Twenty five of 37 patients had good clinical results, and radiographs showed that the sphericity of the femoral head in the older age (> 8 years) group was poorer, which demonstrated a similar pattern to the clinical results in this age group. We conclude that innominate osteotomy is a safe and effective procedure in severe Legg-Calve-Perthes disease and this operation should be carefully selected as a treatment method in the appropriate age group.
Age Factors ; Child ; Child, Preschool ; Female ; Human ; Legg-Perthes Disease/*surgery ; Male ; *Osteotomy

Schizencephaly, first described by Yakovlev and Wadsworth in 1946, is a rare congenital anomaly characterized by gray matter-lined clefts that extend through the entire cerebral hemisphere, from the ependymal lining of the lateral ventricle to the subarachnoid space. Clinically, patients with schizencephaly present motor dysfunction such as hemiparesis, seizures, and variable developmental delay. Absence of septum pellucidum, gray matter heterotopia, polymicrogyria, and hypoplasia of optic nerves were also frequently found to be associated with schizencephaly. We experienced a case of open-lip schizencephaly in a one-day-old male infant with wide, tense fontanel, which was confirmed by MRI.
Cerebrum ; Humans ; Infant ; Lateral Ventricles ; Lip* ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development* ; Optic Nerve ; Paresis ; Seizures ; Septum Pellucidum ; Subarachnoid Space ; Transcutaneous Electric Nerve Stimulation