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

Coronary spasm may be induced by a variety of physiologic and pharmacologic stimuli but specific receptor blockade has not been consistently shown to prevent the attacks. Most patients with variant angina respond well to treatment with calcium antagonists and nitrates. A small proportion of patients are refractory to this therapy. We report a case of the patient with a 9-year-history of variant angina who has been refractory to high doses of calcium antagonists and nitrates. The repeated addition of clonidine was consistently effective in abolishing both symptoms and objective evidence of myocardial ischemia in this particular patient.
Calcium ; Clonidine* ; Humans ; Myocardial Ischemia ; Nitrates ; Spasm

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Echocardiography*

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

These are 2 cases report of the Characot-Marie-Tooth disease. One patient is a 21 year-old female with gait ataxia, foot drop, muscular atrophy in the both feet, pes cavus and equinovarus. On family history, her older and younger brothers and younger sister showed same symptoms and signs which is rather milder. On neurologic examination, there were atrophy, high arched feet, and steppage gait. There were decreased pain, temperature and touch sensation, and absence of position and vibration, and absence of DTR in lower extremities. On sensory nerve conduction velocity study, the amplitude of evoked action potential is very low. On motor NCV, there are markedly prolonged distal latency and markedly decreased conduction velocity. On EMG study, there are dencervated potentials at rest and reduced interference pattern at maximal contraction. The other patient is 62 year-old female with gait disturbance, foot drop, muscular atrophy in the both feet, pes cavus and equinovarus. On family history, her father, 2 younger brothers and her 3 nephews showed same degree or rather mild degree of symptoms and signs. The findings on physical, neurologic examination and EMG with NCV study are compatible with Charcot-Marie-Tooth disease.
Action Potentials ; Atrophy ; Charcot-Marie-Tooth Disease* ; Clubfoot ; Fathers ; Female ; Foot ; Foot Deformities ; Gait ; Gait Ataxia ; Humans ; Lower Extremity ; Middle Aged ; Muscular Atrophy ; Neural Conduction ; Neurologic Examination ; Sensation ; Siblings ; Vibration ; Young Adult

Carpal tunnel syndrome is most commonly applied to compression neuropathy of the median nerve at the wrist, and is the most cause of buring pain, numbness and tingling in the thumb, index and long fingers, and in the lateral half of the palm, with or without progressive atrophy of the thenar muscles. Fifteen symptomatic hands of 13 patients of the carpal tunnel syndrome managed and operated at the Department of Orthopedic Surgery Severance Hospital from Jan. 1972 to Mar. 1982 were analized in clinical aspect. l. Among 13 patients, 3 were male and 10 were female. 2. Nine patients (69.2%) were affected on dominant hand. 3. Average duration of the symptoms was 17 months. 4. In electromyographic study, conduction delay of the motor fiber of the median nerve was found in 11 cases(73.3%) and sensory fiber in 13 cases(86.6%). Fibrillation of the thenar muscles was found in 11 cases(73.3%). 5. Ten patients, 11 cases were followed up from 11 months to 9 years and 11 months and 72.8% was improved.
Atrophy ; Carpal Tunnel Syndrome ; Clinical Study ; Female ; Fingers ; Hand ; Humans ; Hypesthesia ; Male ; Median Nerve ; Muscles ; Orthopedics ; Thumb ; Wrist

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

Pheochromocytomas can arise wherever chromaffin cells are found, and most of them(90%) are in one or both adrenal glands. But they may be located anywhere along the sympathetic chain and rarely in aberrant sites. One of the common extra-adrenal sites from which these tumors can arise is a collection of para-aortic and para-ganglion cells around the origin of the inferior mesenteric artery. We experienced a case of extra-adrenal pheochromocytoma located at the organ of Zukerkandl in a 21-year-old female patient with abdominal colic and paroxysmal hypertension, whose symptoms and blood pressure returned to normal after successful surgical excision of the tumor.
Adrenal Glands ; Blood Pressure ; Chromaffin Cells ; Colic* ; Female ; Humans ; Hypertension* ; Mesenteric Artery, Inferior ; Pheochromocytoma* ; Young Adult

No abstract available.
Echocardiography, Doppler, Color* ; Mitral Valve Insufficiency*