PURPOSE: To evaluate the clinical outcome and reliability of mixed bone in the process of posterior spinal fusion for the treatment of thoracolumbar spine fractures. In order to eliminate donor site morbidity which is linked to the use of autogenous bone graft, a new surgical procedure mixing autogenous bone chips that were obtained from local decortication of the posterior element of the spine with highly purified calf bone (Lubboc) is studied. MATERIALS AND METHODS: We followed up 9 patients who had undergone autogenous bone graft and 9 patients who had undergone mixed bone graft for more than 12 months out of 33 patients who underwent posterior spinal fusion for thoracolumbar spine fractures between July 1993 and July 1997. RESULTS: Radiographic results indicated solid bony union in 17 of 18 cases regardless of the graft materials. Based on each follow-up evaluation, it was found that the increase in kyphotic angle was related to elapsed time rather than to the type of graft materials. CONCLUSIONS: It appears that the new surgical method of bone graft with highly purified calf bone can be a reliable alternative for achieving stable posterior spinal fusion as long as bone chips large enough to fill the interlamina space can be obtained.
Follow-Up Studies ; Heterografts* ; Humans ; Spinal Fusion* ; Spine* ; Tissue Donors ; Transplants*

We examined 984 objects for exercise stress test, using CASE I(computer assisted system for exercise). They exercised according to Bruce's protocol, Among them, the mal were 613 and the female were 371. (Male:Female;17:1) The 5th and 6th decades occupied 61% of total objects. The purpose of test was evaluation of chest pain in 84% of total cases. The most frequent end point of test was dyspnea(42%) and chest pain was observed in 13% of total cases. Most of all objects above 8-9 METS. Positive results of exercise stress tert were obtained in 23%. As complications, ventricular tachycardia occurred in 7 cases, supraventricular tachycardia; 8, high degree VPB's; 6, sudden cardiovascular collapse;15, The complication rate was 0.36% but morbidity and mortality were 0. All complicated cases recoved spontaneously only by rest.
Chest Pain ; Electrocardiography* ; Exercise Test ; Female ; Humans ; Mortality ; Tachycardia, Supraventricular ; Tachycardia, Ventricular

The authors carried out various treatment modalities in 74 consecutive patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage and were admitted to the Department of Neurosurgery. Konkuk University Hospital, from Jan. 1991 to Dec. 1993. A variety of prognostic factors that influence mortality were observed. The locaton of hematoma was at the basal ganglia in 47 cases and at the thalamus in 27 cases. The prognosis gets poorer as the hematoma extended wider and deeper. The prognosis was unfavorable when the hematoma was over 30cc(P<0.001). The mortality rate was higher in cases with IVH than in cases without IVH(P<0.005). In cases with IVH, 19 cases(26%) showed dilated 4th ventricular hemorrage and higher mortality rate(P<0.001). Cases in which the GCS were less than 9 on admission showed higher mortality rate(P<0.0001). The mortality rate was also higher if the midline shift was more than 10mm on the initial brain CT scan(P<0.005). THe group where the unilateral or bilateral pupillary light reflex was unreactive(35cases) showed poorer prognosis than the group where the bilateral pupillary light reflex was reactive(P<0.0001). The ventriculocranial ratio(VCR), hydrocephalus, surrounding edema edema around the heamtoam, and treatment modality were not related to the prognosis. The significant prognostic factors in patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage were location and type of hematoma, whether or not the volume of hematoma is more than 30cc, IVH, dilated 4th ventricular hemorrhage, Graeb's score of more than 7, GCS of less than 9, midline shift of more than 10mm, and reactivity of pupillary light reflex.
Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Edema ; Ganglion Cysts* ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Prognosis ; Reflex ; Thalamus

The antihypertensive effects and serial changes of serum lipids were observed in 17 patients with essential hypertension, administered daily 30-60mg dose of Tripamide(Tripamol(R)) for 8 weeks. The results were as follows ; 1) After 8 weeks treatment, there is no change of serum total cholesterol, serum triglyceride and HDL-cholesterol were decreased by 3.2mg/dl(-1.9%) and 0.9mg/dl(-2.8%) respectively. The changes were not significant statistically. 2) After 8 weeks treatment, mean systolic and diastolic blood pressure were decreased by 11.2mmHg(-6.8%) and 7.7mmHg(-7.3%). 3) No significant side effect was observed during treatment except of 2 patients of mild headache and insomnia.
Blood Pressure ; Cholesterol ; Headache ; Humans ; Hypertension* ; Sleep Initiation and Maintenance Disorders ; Triglycerides

Postoperative adhesions that restrict tendon gliding are a major cause of failure after tendon repair and grafting in Zone II. Several experimental reports have claimed that exogenously administered sodium hyaluronic acid (HA) helps to prevent the adhesion formation after digital flexor tendon repair. However, some investigators reported that HA had no effect on prevention of adhesion. Effectiveness of HA was determined by using an experimental chicken model. HA and physiologic saline solution was injected into the tendon sheath after partial cut of flexor digitorum profundus tendon. On light microscopy, cut ends revealed infiltration of neutrophils with scattered monocytes, 1ymphocytes and eosinophils at the second postoperative day in both control and HA treated goup. At the sixth and eighth postoperative day, the wounds were healed with granulation tissues and adhered to the tendon sheath in control group. Two weeks after operation both control and HA treated group were adhered to the tendon sheaths, but milder in HA treated group than that of control. After three weeks, adhesion to the tendon sheath was marked in both groups. Scanning electron microscopic findings were consistent with light microscopy. As results of above experiments, HA had a significant effect on prevention of adhesion until post-operative S days, and after 2 weeks no difference between HA and control group. No histological difference in process of tendon healing was observed between HA treated and control groups.
Chickens ; Eosinophils ; Granulation Tissue ; Humans ; Hyaluronic Acid* ; Microscopy ; Monocytes ; Neutrophils ; Research Personnel ; Sodium ; Sodium Chloride ; Tendon Injuries* ; Tendons* ; Transplants ; Wounds and Injuries

Statistical observation was made on 809 in-patient in the Department of Urology, College of Medicine, Hanyang University from May 3, 1972 to December 31, 1976.
Humans ; Inpatients ; Urology

The authors report a rare case of gunshot injury to the head by a nail-gun which was treated by stereotactic surgery. In the case, a 23-year-old male patient, presented with semicomatose mentality and decerebrated rigidity. The large nail was located in the 3rd ventricular area in the mid-line with vertical stature. The entry point was identified 1cm anterior to the coronal suture line and just lateral to the sagittal suture line. The foreign body was removed stereotactically with the guidance of gluoroscope. But the died of initial severe brain damage.
Brain ; Craniocerebral Trauma ; Foreign Bodies ; Head* ; Humans ; Male ; Sutures ; Young Adult

Conventional radiographs and simple CT scans fail to provide accurate information about the structural integrity of a fracture site. In recent years, special 3-dimensional CT scanning has been progressively developed, and we applied this technique to thoracolumbar compression fractures. Posterolateral spinal fusion with iliac bone graft was attempted in all patients; Comparative pre- and post-operative change in these fractures was then an-alysed, using 3-dimensional CT. The results of this study suggest that this imaging is a useful non-invasive technique to assess compression fracture and determine prognosis.
Fractures, Compression* ; Humans ; Prognosis ; Spinal Fusion ; Tomography, X-Ray Computed ; Transplants

OBJECTIVE: To explore the clinical value of postoperative follow-up examination of F-wave and H-reflex in patients with lumbosacral radiculopathy and to clarify optimal timing of follow-up examination. METHOD: The subjects were 17 patients with unilateral lumbosacral radiculopathy caused by disc herniation. In patients with the L5 radiculopathy, F-waves were obtained from extensor digitorum brevis and six parameters including minimal latency per height were used. In patients with the S1 radiculopathy, H-reflexes were obtained from gastrocnemius and amplitude and minimal latency were used as parameters. These parameters were evaluated preoperatively and postoperatively at week 1, 3, 6. These changes of the parameters and clinical findings were related. RESULTS: The parameters of peroneal F-wave and tibial H-reflex showed significant improvement at 3 weeks and 6 weeks after surgery. The improvements of these parameters were not related with clinical improvement at 1 week after operation, but these were significantly related with improvement of pain and muscle weakness at 3 weeks after operation. CONCLUSION: These findings suggested that follow-up examination of F-wave and H-reflex were valuable for objective assessment of lumbosacral radiculopathy after operation and the optimal timing for follow-up study was 3 weeks after operation.
Follow-Up Studies* ; H-Reflex* ; Humans ; Muscle Weakness ; Radiculopathy*

PURPOSE: We wanted to study the precise anatomical location of the branches of the pelvic plexus from the sacral root to the cavernous nerve. MATERIALS AND METHODS: We performed microdissection on the pelvises from 4 male formalin fixed cadavers under a Zeiss surgical microscope and we traced the location of the branches of the pelvic plexus at a magnification of 6x. RESULTS: The configuration of the pelvic plexus was an irregular diamond shape rather than rectangular. It was located retroperitoneally on the lateral wall of the rectum 8.2 to 11.5cm from the anal verge. Its midpoint was located 2.0 to 2.5cm from the seminal vesicle posterosuperiorly. A prominent neurovascular bundle (NVB) was located on the posterolateral portion of the apex and the mid portion of the prostate. The pelvic splanchnic nerve (PSN) joined the NVB at a point distal and inferior to the bladder-prostate (BP) junction. The PSN components joined the NVB in a spray-like distribution at multiple levels distal to the BP junction. The distance from the membranous urethra to the NVB was 0.5 to 1.2cm. We also found multiple tiny branches on the anterolateral aspect of the prostate apex. CONCLUSIONS: In contrast to the usual concept, the NVB was much wider above the mid portion of the prostrate and it supplied multiple tiny branches on the anterolateral aspect of the prostate. The PSN branches arose from the more posteroinferior area of the pelvic plexus. Therefore, we recommend a more anterior dissection of the lateral pelvic fascia for nerve sparing radical prostatectomy. If surgeons plan a nerve graft after radical prostatectomy, they should consider this neuroanatomy for obtaining a successful outcome.
Cadaver ; Diamond ; Fascia ; Formaldehyde ; Humans ; Hypogastric Plexus* ; Male ; Microdissection ; Neuroanatomy ; Pelvis ; Prostate ; Prostatectomy ; Rectum ; Seminal Vesicles ; Splanchnic Nerves ; Transplants ; Urethra