The deformed and rigid spine presenting moderate to severe kyphosis and scoliosis results in a restriction of function of the lung best characterized spirographically by a reduction in vital capacity. When the lesion involves the thoracic spine, restriction of function is more marked. Spinal deformities such as kyphosis and scoliosis develop from various causes. Tuberculous spondylitis, a main cause of kyphosis and scoliosis, is increasingly found in Korea. Cardiorespiratory dysfunction caused by spinal deformity poses another problem besides the spinal deformity perse. To perform therapeutic measures such as Harrington instrumentation, with or without preoperative localizer cast and halofemoral traction, as well as anterior interbody fusion, evaluation of pulmonary function and arterial gas analysis preoperatively is helpful to prevent and reduce postoperative cardiorespiratory failure or complications. The authors have reviewed the results of arterial gas analyses and pulmonary function tests on 35 cases of scoliosis and 60 cases of kyphosis done at the Department of Orthopedic Surgery, Seoul National University Hospital, from January 1975 to February 1978. The results were as follows: 1. Average degree of scoliosis in 35 cases was 89; vital capacity 60% of normal, and maximum breathing capacity 72%. Average degree of dorsal spine kyphosis in 38 cases was 93.5; vital capacity 38%, and maximum breathing capacity 73% Average degree of lumbar spine kyphosis of 22 cases was 79; vital capacity 77%, and maximum breathing capacity 84%. 2. Static values for pulmonary function such as vital capacity and dynamic values such as maximum breathing capacity hed a significant negative correlation with the severity of scoliosis and kyphosis. 3. Decrease in vital capacity due to scoliosis and kyphosis correlated positively with decrease in maximum breathing capacity. 4. Arterial oxygen saturation had a significant negative correlation with the severity of scoliosis and kyphosis.
Congenital Abnormalities ; Korea ; Kyphosis ; Lung ; Orthopedics ; Oxygen ; Respiration ; Respiratory Function Tests ; Scoliosis ; Seoul ; Spine ; Spondylitis ; Traction ; Vital Capacity

The authors did a clincal analysis of 95 cases of the osteomyelitis. Among them 72 were hematogenous in origin: 12 were secondary to open fracture: 6 were direct extension from adjascent soft tissue infection: 5 were complicated after open reduction of fracture, who were treated at Dept. of Orthopedics of Catholic Medical College for past 3 years from 1968 to 1971. Through this study following result were obtained: 1. Most of the patient were under age of 16 Years, In acute hematogenous osteomyelitis, over 80% of patient were under age of 12 years. Males were more frequently affected than females. 2. Generally, femur, tibia and humerus were most frequently affected than the others. In acute osteomyelitis, distal femur and proximal tibia were the most frequent site of involvement. 3. In acute osteomyelitis, early decompression, like drilling or fenestration operation gave more satisfactory result than the simple soft tissue drainage. Immediate surgical intervention with massive antibiotics administration is stressed without hesitation when diagnosis is made. The group treated within a week after onset gave relatively good result in this series. 4. Primary closure of the wound in acute osteomoelitis were considered not to be the good method which is usually adopted as procedure in the chronic type. 5. In the chronic osteomyelitis, continuous tube irrigation after saucerization was adopted when the bony defect is large. Primary closure of the wound were adopted in the case when surgical defect is small in size less than 4cm in diameter. 6. Treatment of the osteomyelitis complicated after open reduction of the fracture were generally treated with focal curettage and removal of fixative device when clinical union is evident, also fixative devices were out even in the group which were not united clinically but redisplacement is expected not to take place. In this group external support was given until fracture healing. Bony window was also made for drainage when cavitary change develped around the tip of nail.
Anti-Bacterial Agents ; Curettage ; Decompression ; Diagnosis ; Drainage ; Female ; Femur ; Fracture Healing ; Fractures, Open ; Humans ; Humerus ; Male ; Methods ; Orthopedics ; Osteomyelitis ; Soft Tissue Infections ; Tibia ; Wounds and Injuries

Fat embolism is one of a rare catastrophic complication after multiple fraetures and extensive soft tissue injury. Many hypothesis on its pathogenesis has been postulated by many writers, still its exact pathogenesis, definite diagnostic criteria and treatment is not established. Nowadays fat embolism is considered as a respiratory insufficiency syndrome, even disseminated intravascular coagulation rather than isolated phenomena after extensive trauma of musculoakeletal system. Respiratory failure associated with fat embolism is a major cause of death, but is usually seIf-limited and is responsive to intensive treatment. Monitoring of blood gas is required for early diagnosis and respiratory supportive treatment with continued monitoring is necessary until resolution. The writers experienced six cases of fat embolism, at the Department of Orthopedic Surgery, Seoul National University Hospital for the period of three years from June 1974 till May 1977. Respiratory support, parenteral steroid and low molecular weight dextran with other supportive measure was a mainstay of treatment. Of six cases, five was recovered without sequalae and one was expired four days after trauma.
Cause of Death ; Dextrans ; Disseminated Intravascular Coagulation ; Early Diagnosis ; Embolism, Fat ; Molecular Weight ; Orthopedics ; Respiratory Insufficiency ; Seoul ; Soft Tissue Injuries

No abstract available.
Urology*

Serum lipids and lipoproteins were determined in 70 patients with hypertension, 40 patients with cerebral infarctions, and 41 patients with cerebral hemorrhage. The results were compared with findings in 64 healthy controls. The results are as follows; 1) Total cholesterol, VLDL-cholesterol, LDL cholesterol and total cholesterol/HDL-cholesterol ratio were significantly higher in patients with hypertension or cerebral infarction than in control group, but HDL-cholesterol showed no significant difference. 2) In Patients with cerebral hemorrhage, total cholesterol, LDL-cholesterol and HDL-cholesterol were higher than in normal controls. Total cholesterol/HDL-cholesterol ratio was within the limits of normal. It is possible that the susceptibility to cerebral infarction is the result of high total cholesterol/HDL cholesterol ratio rather than low HDL cholesterol. But our study suggests that hyperlipoproteinemia plays a minor role in the development of cerebral hemorrhage.
Cerebral Hemorrhage ; Cerebral Infarction ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hyperlipoproteinemias ; Hypertension* ; Lipoproteins

A case of the brain death confirmed by isotope angiogrphy is described. Isotope angiography is a simple and noninvasive technic compared to carotid angiography, and is recommended as a reliable test for the diagnosis of brain death.
Angiography* ; Brain Death* ; Brain* ; Diagnosis

A case of the brain death confirmed by isotope angiogrphy is described. Isotope angiography is a simple and noninvasive technic compared to carotid angiography, and is recommended as a reliable test for the diagnosis of brain death.
Angiography* ; Brain Death* ; Brain* ; Diagnosis

No abstract available.
Thumb*

No abstract available.
Ocular Motility Disorders* ; Tuberculosis, Meningeal*

The study wasdesigned for the evaluation of diagnostic usefulness of standard electro-oculography (EOG) battery in differentiating the vertigo of central origin from that of peripheral one. Twelve patients of definite posterior fossa lesion proved by MRI or CT scan were selected as a central group and fourteen patients of peripheral vestibulopathy as a peripheral group. Using our laboratory standard methods of EOG battery, age-matched normal valuse of bithermal caloric responses(fixation supperssion, vestibular paresis, and directional preponderance) and the gains of pursuit and optokinetic nystagmus were obtained. Abnormal vestibular paresis was found in 21 patients of the peripheral group, but in only one patient of the central. Directional preponderance did not show significant difference between the peripheral and central group (p<0.01). In peripheral group, the fixation suppression index (percent change in slow-phase velocity with visual fixation during the period of maximum intensity of caloric nystagmus) was 56.8+8.3%, p>0.01). However, failure of fixation suppression was noted in eleven patients of central group and its mean value of 92.6+7.3%, which was significant statistical difference compared with peripheral and control group (p<0.01 respectively). Defective suppression of caloric nystagmus was more remarkable when the direction of caloric nystagmus was induced toward the lesion site. Such findings were demonstrated in six patients of eight patients with definits unilateral cerebellar hemispheric lesions. In addition, the gains of pursuit and optokinetic nystagmus were significantly reduced in the patients showing defctive fixation suppression compared with whom showed normal pattern of fixation suppression (p<0.01). Therefore, fixation suppression, vestibular paresis, and the gains of pursuit and optokinetic nystagmus would be useful diagnostic paremeters in differntiaging the vertigo of central origin from that of the peripheral.
Electrooculography ; Humans ; Magnetic Resonance Imaging ; Nystagmus, Optokinetic ; Nystagmus, Physiologic ; Paresis ; Tomography, X-Ray Computed ; Vertigo*