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

We have analyzed clinical results of forty-five patients who had spondylolisthesis which were operated using transpedicular screw fixation devices (CD or Steffee VSP system) between June, 1987 and March, 1992 at the department of Orthopedic Surgery of Kwang-ju Christian Hospital. Simultaneously we compared the postoperative results between two groups. The results were as follows: 1. The ratio of man and woman was 1: 2.2 and mean age was 44.3 years (44.8 years in degenerative type and 42.5 years in isthmic type). 2. The most common level was L4 on L5 and two-third of all cases were isthmic type. 3. The clinical results were satisfactory in 91% (41 cases) according to anthors modified evaluation system. There was no significant difference between degenerative and isthmic type. 4. The mean % of slip was improved from 23.3% preoperatively to 7.4% postoperatively and the mean slip angle was improved from 3.5 degrees preoperatively to-5.4 degrees postoperatively. 5. The devices which were used for operation were C-D instrument in 21 cases and Steffee VSP system in 23 cases. There was no difference in radiographic examinaton and clinical result between two groups. 6. The anterior fusion was done for 9 active young patients. The results were significantly satisfactory. 7. We consider the transpedicular fixation system is the most recommandable method of treatment for spondylolisthesis in providing excellent reduction of slippage and maintenance of reduction with rigid fixation device.
Female ; Gwangju ; Humans ; Methods ; Orthopedics ; Spondylolisthesis

No abstract available.
Pre-Eclampsia*

Of the drugs developed to prevent and treat osteoporosis, bisphosphonate has played a very important role in preventing osteoporotic fractures. However, case reports describing atypical femoral fractures in patients using long-term bisphosphonates have emerged. The majority of atypical femur fractures occurs in the lateral aspect of the subtrochanteric or femur diaphysis, which is explained by accumulation of tensile stress in these areas. Although the superior cortex of the femur neck withstands maximum tensile stress, to our knowledge, there have been only two reports (three cases) of atypical femoral neck fracture. In addition, none of those case reports revealed detailed pathology related to suppressed bone turnover rate. We encountered an incomplete femoral neck fracture and diagnosed it as “atypical” on the basis of the patient’s lack of trauma and medication history and pathological findings. For patients with groin pain, minimal or no trauma, and a history of long-term bisphosphonate use, an atypical femoral neck fracture should be considered.

STUDY DESIGN: A retrospective study OBJECTIVES: To examine the influence of cervical spondylosis on an acute cervical spinal cord injury. SUMMARY OF LITERATURE REVIEW: There are no reports on the relationship between cervical spondylosis and acute cervical spinal cord injuries. MATERIALS AND METHODS: Twenty six patients who underwent operative treatment for acute cervical injuries with spinal cord injury were evaluated. The mean age and follow-up period was 58 years and 2.2 years, respectively. The evaluation was performed by examining the causes of the injuries, and the classification of fractures according to the presence of cervical spondylosis. This study compared the degrees of postoperative neurological recovery with motor index score in the groups with and without cervical spondylosis. RESULTS: Cervical cord injuries were more prevalent in the group 60 years and older; 17 cases vs. 9 cases in the group under 60 years. Eleven (65%) and 6 (35%) cases in the group 60 years and older had sustained a high and low energy injury, respectively. In contrast, mostly high energy injuries (8 in 9 cases) were encountered in the group under 60 years of age. A low energy injury could cause a acute cervical cord injury in the group 60 years and older, who also had cervical spondylosis. In those cases, previous cervical spondylosis might be one of the etiologic factors. CONCLUSIONS: The cases with cervical spondylosis in the group 60 years and older tended to show incomplete cord injury and good postoperative neurological recovery when they had sustained cervical cord injuries.
Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Cord ; Spinal Cord Injuries ; Spondylosis

STUDY DESIGN: Retrospective study. OBJECTIVES: Whether osteoporotic vertebral fracture is associated with obesity is under debate. Therefore, this study aims to determine the relationship between osteoporotic vertebral fracture and body mass index (BMI) by comparing it with other types of osteoporotic fractures. SUMMARY OF LITERATURE REVIEW: Several authors have reported the factors that predict the risk of osteoporotic vertebral fracture in individuals with obesity, but the objective risk factors are still controversial. MATERIALS AND METHODS: A retrospective study was conducted on postmenopausal women, including 100 people with osteoporotic vertebral fractures, 104 with femur neck fractures, 107 with distal radius fractures, and 103 with osteoporosis or osteopenia but without fractures. The BMI was calculated and bone mineral density (BMD) test was administered within 3 days after injury. For each type of fracture, the relationships with age, height, weight, BMI, and BMD were investigated. The relationship with the number of osteoporotic vertebral fractures according to BMI was also evaluated. RESULTS: In comparing osteoporotic vertebral fractures and osteoporotic non-vertebral fractures, there were no significant differences in the relationship with age, height, or BMD (p>0.05). Osteoporotic vertebral fractures showed a statistically higher average weight and BMI, compared to other osteoporotic non-vertebral fracture groups (p<0.05). Among those with osteoporotic vertebral fractures, the number of fractures did not show a significant relationship with BMI (p=0.177). CONCLUSIONS: In osteoporotic vertebral fracture patients, compared to groups with other types of osteoporotic fractures, average weight and BMI were higher.
Body Mass Index* ; Bone Density ; Bone Diseases, Metabolic ; Female ; Femoral Neck Fractures ; Humans ; Obesity ; Osteoporosis ; Osteoporotic Fractures ; Radius Fractures ; Retrospective Studies ; Risk Factors

No abstract available.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Porokeratosis*

Both death certificates and postmortem examination certificates are used as proof of death. These certificates sometimes contain erroneous information but how frequently they do so is unknown. In particular, only a few studies have measured the accuracy of the cause and manner of death on Korea death documents. In this study, we compared the cause and manner of death on both kinds of certificates with those on autopsy reports to determine the frequency of errors, and to identify way to improve the accuracy of these certificates. In 2012, 528 autopsies were requested of out institute, and certificates were submitted in 241 of the cases. The manner of death was classified as natural, unnatural, or unknown. The cause of death in the autopsy report matched that on the death certificate in 37 of 63 cases (58.7%), and the manner of death matched in 40 of 63 cases (63.5%). The cause of death in the autopsy report matched that on the postmortem examination certificate in 62 of 178 cases (34.8%), and the manner of death matched in 74 of 178 cases (41.6%). Death certificates and postmortem examination certificates are important documents. We identified many incorrect reports of causes and manners of death on both kinds of documents, especially the postmortem death certificates. These inaccuracies are presumably due to a lack of forensic information and education, as well as lack of interest on the part of medical doctors.
Autopsy* ; Cause of Death ; Death Certificates* ; Education ; Korea