A simple technique for transpedicular screw fixation of L5 is presented. This percutaneous screwing allows up-and-in screw placement without excessive lateral stretching and lessens the length of incision.
Spine*

A simple technique for transpedicular screw fixation of L5 is presented. This percutaneous screwing allows up-and-in screw placement without excessive lateral stretching and lessens the length of incision.
Spine*

Congenital hypertrophic pyloric stenosis is the most common intra-abdominal disease required surgery during the first few months of life. The expression of pyloric stenosis is dependent upon the genetic influence of ancestors affected with the disease, as well as unknown environmental influences in the postnatal period. Pyloric stenosis has been reported in multiple sibs in a family, which suggests the genetic influence on the expression of this disease. Until now, the genetic influence is thought a sex-modified polygenic or multifactorial background which facilitates the expression of a common dominant gene. We experienced a case of congenital hypertrophic pyloric stenosis in a two siblings. The siblings suffered projectile vomiting for 2~4 days at 16 days old of age and 15 days old of age. After we confirmed the diagnosis by upper gastrointestinal series and abdominal sonogram, the Fredet-Ramstedt pyloromyotomy was done successfully. This case suggests the genetic influence on the expression of this disease.
Diagnosis ; Genes, Dominant ; Humans ; Pyloric Stenosis ; Pyloric Stenosis, Hypertrophic* ; Siblings* ; Vomiting

The current paper reports on a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy child. Sinusitis is a common and benign condition in most pediatric cases. Because of the widespread use of antibiotics, intracranial extension of pediatric sinusitis is rarely seen today; however, complications (e.g., cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema) are potentially life threatening. A 15-year-old right-handed male presented with a 3-day history of fever, headache, and left-sided palsy. Computed tomography revealed right-sided subdural empyema with right frontal sinusitis and maxillary sinusitis. A postoperative inpatient neurological consultation was requested 2 months post-surgery due to motor function deficits. The results suggested that early and accurate diagnosis of subdural empyema leads to prompt treatment and a favorable outcome for the patient.
Adolescent ; Anti-Bacterial Agents ; Brain Abscess ; Cavernous Sinus Thrombosis ; Central Nervous System ; Child* ; Diagnosis ; Empyema, Subdural* ; Fever ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Humans ; Inpatients ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Meningitis ; Orbit ; Paralysis ; Sinusitis*

Cytogenetic techniques were used to detect specific chromosomal losses and / or stuctural changes in 6 meningioma cell population of 11meningioma patients. Polymorphic DNA markers were uti.lized to investigate the loss of constitutional heterozygosity on chromosomes 8. 17 and 22 in 9 meningioma cell population of 1l meningioma patients. As a result, 5 cases(M-2.4,5.9, and 10) represented 45. XX. -22 or 45, XY.-22 as stem line. In addition to chromosome 22, other chromosomes were lost randomly. In one case(M-3) normal karyotypic pattern was oberved. The 9q+ structural change was also noted in case M-2. This structural change was thought to be the chromosomal involvement secondary to the loss of chromosome 22 in meningioma. Retentions of constitutional heterozygosity on chromosomes 8 and 17 were found in all cases. Loss of constitutional hererozygosity on chromosome 22 were found at Hind m RFLP of v-sis in cases M-1 and M-7. EcoRI RFLP of v-sis in case M-1. Bgl II RFLP of v-sis case M-1. Xba I RFLP of v-sis in cases M-6. M-9 and M-11. And EcoRI RFLP of bcr in all cases. Rearrangement of chromosome 22 in case M-1 was detected on the Xba I RFLP of v-sis as extra band(3.14kb). The reduction to hemizygosity on chromosome 22 was one important step in tumorigenesis of meningioma. Monosomy 22 might operate at the primary level of tumor initiation. Random losses of other chromosomes or structural changes as 9q+ were postula!ed to be related to tumor development.
Carcinogenesis ; Chromosomes, Human, Pair 22 ; Cytogenetic Analysis ; Cytogenetics* ; Genetic Markers ; Humans* ; Meningioma* ; Monosomy ; Polymorphism, Restriction Fragment Length

OBJECTIVE: We report six patients with traumatic intracerebellar hematomas between 1997 and 2003 at our hospitals. METHODS: Each data about patients' clinicoradiologic findings, management, and outcomes, which were retrospectively reviewed. RESULTS: All patients had skull fracture on occiput and five patients with large hematomas(three cm or greater) were operated on. In the results of surgery, three patients were good outcome but two patients were fatal due to compression of brain stem. One patient with small hematoma (1.5cm) was treated conservatively and recovered. CONCLUSION: In our cases, the clinical course and prognosis of traumatic intracerebellar hematoma were grave. The results of this study support that early diagnosis based on strict observation in patients with occipital fracture will lead to best results.
Brain Stem ; Craniocerebral Trauma ; Early Diagnosis ; Hematoma* ; Humans ; Prognosis ; Retrospective Studies ; Skull Fractures

OBJECTIVE: The lack of anatomical knowledge for the anterior cervical microforaminotomy is liable to injure the neurovascular structures. The surgical anatomy is examined with special attention to the ventral aspect exposed in anterior cervical microforaminotomy. METHODS: In 16 adult formalin fixed cadaveric cervical spine, the author measured the distances from the medical margin of the longus colli to the medical wall of the ipsilateral vertebral artery and the angle for the ipsilateral vertebral artery. The distances from the lateral margin of the posterior longitudinal ligament to the medial margin of the ipsilateral medial wall of the vertebral artery, to the ipsilateral dorsal root ganglion was measured too. RESULTS: The distance from the medial margin of the longus colli to the ipsilateral vertebral artery was 13.3~14.7mm and the angle for the ipsilateral vertebral artery was 41~42.5 degrees. The range of distance from the lateral margin of the posterior longitudinal ligament to the ipsilateral vertebral artery was 11.9~16.1mm, to the ipsilateral dorsal root ganglion was 11.6~12.9mm. CONCLUSION: These data will aid in reducing neurovascular injury during anterior cervical approaches.
Adult ; Cadaver ; Formaldehyde ; Ganglia, Spinal ; Humans ; Longitudinal Ligaments ; Spine ; Vertebral Artery

After von Rokitansky's description in 1984 of a calcified chronic subdural hematoma, the number of such lesions has reached so far a total of 108. The majority of patients reported have been children and young adults. On review of the literature, elderly patients reported over the age of sixty five years are only 5, so far as we know. A 68-year-old Korean male with a calcified chronic subdural hematoma is reported. He was admitted to our department because of a status epilepticus. During Korean war (1950), abut 37 years before admission, he had been suffered from a blunt head injury, but mistreated then, and afterwards th had several episodes of convulsion. Neurological examination on admission revealed only a drowsy consciousness and mild papilledema on the left. Plain skull X-ray films and brain CT scan demonstrated a left sided biconvex type of intracranial calcification. A left frentoparietal craniotomy was performed. After opening the dura mater, the thickened outer membrane, the subdural hematoma and the thin bone like plate were removed thoroughly. Content of the subdural hematoma was brown muddy substance. In the eight months following the operation, the generalized seizure did not appear. Postoperative CT scan demonstrated complete re-expansion of the brain parenchyme.
Aged* ; Brain ; Child ; Consciousness ; Craniotomy ; Dura Mater ; Head Injuries, Closed ; Hematoma, Subdural ; Hematoma, Subdural, Chronic* ; Humans ; Korean War ; Male ; Membranes ; Neurologic Examination ; Papilledema ; Seizures ; Skull ; Status Epilepticus ; Tomography, X-Ray Computed ; X-Ray Film ; Young Adult

PURPOSE: We evaluated the short term results after treatment of cam type femoroacetabular impingement (FAI) by arthroscopy. MATERIALS AND METHODS: We evaluated the clinical and radiological results of arthroscopically treated cam type FAI in patients who had failed conservative treatment with hip pain, with at least 12 months follow-up, from November 2010 to December 2012. There were 19 males and six females. Mean age of patients was 32.9 years (19-57 years) and mean follow up period was 17.2 months (13-31 months). We analyzed the alpha angle, head neck offset, visual analogue scale (VAS), and modified Harris hip score (MHHS). RESULTS: Mean alpha angle improved from 64.8degrees to 39.9degrees and mean head neck offset also improved from 0.8 to 7.6 mm. Peripheral longitudinal and radial fibrillated labral tear was the most common in the anterosuperior quadrant. Damage to acetabular cartilage was identified in 14 patients. Mean VAS improved from 6.3 to 0.9 and mean MHHS improved from 51.7 to 73.6. Complications associated with the operation included three cases of femoral head articular cartilage injury, two cases of pudendal nerve injury, and two cases of lateral femoral cutaneous nerve injury. CONCLUSION: Although the short term results for arthroscopically treated cam type FAI were satisfactory, care must be taken to reduce the complications associated with arthroscopy and long term follow is needed in order to determine whether or not it can reduce osteoarthritis of the hip.
Acetabulum ; Arthroscopy ; Cartilage ; Cartilage, Articular ; Female ; Femoracetabular Impingement* ; Follow-Up Studies ; Head ; Hip ; Humans ; Male ; Neck ; Osteoarthritis ; Pudendal Nerve

A retrospective study of 135 injured cervical spine patients who admitted to Soonchunhyang University Hospital between Jan 1, 1989 and May 31, 1994 was conducted. The major results were as follows: 1) The incidence was highest in fourth decade and average age was 39 years old. The ratio of male to female was 3.5:1. 2) Traffic accident(67%) was the most common cause of cervical spine injury, and passenger car accident(55%) was the most frequent cause among them. 3) In 111 patients, 141 cases of radiographic abnormalities were found and vertebral body fracture(57%) was the most common lesion among them. SCIWORA(spinal cord injury without radiographic abnormality) patients were seven. High cervical spine(C1-2) injury was 36 cases (26%) and lower cervical spine(C3-7) injury was 105 cases(74%). The most common involved level of injured vertebrae was C2(23%) followed by C5(22%), C6(20%). The anterior dislocation of body was more common than the posterior one, and C5-6 dislocation was the most common among them. The compressive flexion(40%) and distractive flexion(29%) injuries were more common among types of the lower cervical injuries. 4) The associated injuries were head injury, long bone fracture, chest injury, visceral injury and mutiple contusion & laceration, and head injury was the most common among them. 5) According to Franekel's grade, the rates of neurologic improvement were 23%, 47% and 14% in total cases, operated and non-operated patients respectively. There was statistical significance in the difference between the improvement of Frankel's grade of operated and those of non-operated patients(p<0.02). 6) In 101 patients(75%) conservative treatment was performed. Of 34 patients(25%) were operated, 23 patients were performed anterior approach and 11 were done posterior approach. 7) The common complications were respiratory disorder, bed sore, and urinary tract infection, in order of frequency and the rate of complication was 33%. 8) Mortality rate during hospitalization was 5%, and the common causes were pneumonia and septicemia.
Adult ; Contusions ; Craniocerebral Trauma ; Dislocations ; Female ; Fractures, Bone ; Hospitalization ; Humans ; Incidence ; Lacerations ; Male ; Mortality ; Pneumonia ; Pressure Ulcer ; Retrospective Studies ; Sepsis ; Spine* ; Thoracic Injuries ; Urinary Tract Infections