A clinical study of spinal tuberculosis was made on 81 patients, who had been treated at the Department of Orthopedic Surgery, Seoul Red Crose Hoapital, during the 4 years period from January 1974 to December 1977. The results obtained were as follows; 1) The patients have been increased since 1977. 2) The ratio of male to female was not significant, but the age distribution showed a peak incidence in the third decade. 3) The lumbar spine was most commonly involved, being in 43.4% of the cases, while the dorsal spine occupied 27.7%. Considering the age, however, the dorsal spine was most commonly involved in the children as compared to the lumbar spine in the adults 4) In 84.2% of the patients, chemotheraphy was begun prior to operation and in 57.8% for a period less than 4 weeks. 5) The major associated tuberculous lesions elsewhere and complications were pulmonary tuberculosis in 28.4% paraplegia in 27.2% and draining sinus or buldging mass over body surface in 21.0%. 6) The number of involved vertebral bodies was higher in children than in adults. 7) Paraplegia presented a peak incidence in the second decade (42.9%). The number of vertebral bodies involved and the extent of destruction and kyphotic angulation were more severe in the paraplegic group than in the nonparaplegic group. 8) In the paraplegic group, thoracic, cervico-thoracic, and thoraco-lumbal spines comprised 71.8% of the cases. In our experience, the paraplegic group of early onset was better than that of late onset in regard to prognosis for recovery. 9) 22 patients who had complete or incomplete paraplegia had a variety of pathological lesions in or near the spinal canal. The most, common lesion was a sequestrum or a sequestrated disc.
Adult ; Age Distribution ; Child ; Clinical Study ; Female ; Humans ; Incidence ; Male ; Orthopedics ; Paraplegia ; Prognosis ; Seoul ; Spinal Canal ; Spine ; Tuberculosis, Pulmonary ; Tuberculosis, Spinal

Tarsal tunnel syndrome consist of a complex of symptoms affecting the foot and is thought to be due to a compression neuropathy of the posterior tibial nerve within the fibro-osseous tunnel that lies beneath the flexor retinaculum on the medial side of the ankle. A case of tarsal tunnel syndrome caused by neurilemoma of the posterior tibial nerve was treated at the Department of Orthopedic Surgery, Seoul Red Cross Hospital. The patient had complained of pain and paresthesia on the plantar aspect of the left foot for one and half years before admission. Pain and paresthesia were almost completely improved after removal of the mass by intraneural lysis.
Ankle ; Foot ; Humans ; Neurilemmoma ; Orthopedics ; Paresthesia ; Red Cross ; Seoul ; Tarsal Tunnel Syndrome ; Tibial Nerve

PURPOSE: We performed this study to describe the findings of MR Myelography(MRM) of herniated disc disease, spinal stenosis and spinal tumor and to evaluate the usefulness of the MRM in comparison to MRI. MATERIALS AND METHODS: MRI and MRM were performed in 31 patients with herniated disc disease(12 patients), spinal stenosis(11 patients) and spinal tumor(8 patients). MRI and MRM were done with 1.5-T Signa MR, using fat suppressed heavily T2-weighted fast spin echo technique. We retrospectively analyzed MRM images about the thecal sac indentation, compression or displacement of the nerve root, extent and degree of narrowing of spinal canal, relationship between spinal tumor and spinal cord. MRM findings were compared with MRI in all cases. RESULTS: In 18 herniated disc cases of 12 patients, focal filling defect with cutoff or displacement of the nerve root in eight cases of paracentral herniated disc was seen. Cutoff and displacement of the nerve root were more clearly delineated on MRM than rvlRI. In the patients of spinal stenosis(11 cases), hourglass deformity of the thecal sac or complete spinal block of the subarachnoid space was clearly demonstrated. The extent and severity of spinal stenosis were more accurately evaluated on MRM than MRI. MRM finding of intramedullary tumor(3 cases) was enlargement of spinal cord. Five cases of intradural extramedullary tumor showed intradural filling defect, which caused contralateral displacement of the spinal cord with meniscus sign on inferior margin of the mass. CONCLUSION: MRM shows characteristic findings of herniated disc disease, spinal stenosis and spinal tumor. MRM yields excellent definition of the thecal sac, nerve roots and nerve root sleeves in relation to herniated disc and may be more accurate in evaluation of the degree and extent of spinal stenosis than MRI.
Congenital Abnormalities ; Constriction, Pathologic ; Humans ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging ; Myelography* ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Spinal Diseases ; Spinal Stenosis ; Subarachnoid Space

Synovial Sarcoma is a very rare and highly malignant tumor. It is prevalent near the joints. Its peak incidence is from 3 rd to 6 th decade. It occurs almost at the upper and lower extremities and is also called as Sarcomesothelioma, Synovial Endothelioma, Malignant Synovioma and Synovioma. Three cases of Synovial Sarcoma which was treated at the department of Orthopedic Surgery, Seoul Red Cross Hosp. from 1968 to 1977 was reported.
Incidence ; Joints ; Lower Extremity ; Orthopedics ; Red Cross ; Sarcoma, Synovial ; Seoul

PURPOSE: To assess the usefulness of MRI in preoperative diagnosis of congenital anorectal malformation MATERIALS AND METHODS: MR findings of 11 cases with surgically proved anorectal malformations were retrospectively reviewed and compared with operative findings, according to the level of atresia, the development of sphincter muscle, fistula and associated anomalies of other organs. RESULTS: Four of 11 cases were low type of anorectal atresia, 3 cases were intermediate type, and 3 cases were high type. There was one case of Currarino triad with low type of anorectal stenosis. MRI demonstrated the levels of atresia correctly in all cases and revealed fistulas in all high type of anomalies. Degrees of the development of the sphincter muscles were good in all cases of low types and fair in a case of intermediate type and an anorectal stenosis, whereas the development was poor in 2 cases of intermediate type and all 4 cases of high type. The associated anomalies in anorectal malformation were renal agenesis, congenital hip dysplasia and sacral defect with presacral teratoma in Currarino triad. CONCLUSION: MRI was a simple and useful study to confirm the level of atresia, fistula and associated anomalies in the diagnosis of the congenital anorectal malformation.
Constriction, Pathologic ; Diagnosis ; Fistula ; Hip Dislocation, Congenital ; Magnetic Resonance Imaging ; Muscles ; Retrospective Studies ; Teratoma

Purpose: The Eyelike K-flex Aspheric® (Koryoeyetech, Seoul, Korea) is manufactured in 0.25-diopter (D) intervals, which allows the target refractive error after surgery to be achieved. We here evaluate the refractive power outcomes. Methods: We retrospectively studied 95 eyes of 72 patients who underwent cataract surgery with implantation of the Eyelike K-flex Aspheric®. Refractive error was measured at 1 and 2 months postoperatively (33 eyes of 27 patients) and compared to that of patients fitted with 0.50-D-interval lenses (62 eyes of 49 patients). Results: At 1 month postoperatively, the mean absolute error between the spherical equivalent and planned value was 0.33 ± 0.28 and 0.41 ± 0.39 D in the 0.25- and 0.50 D-interval lens groups, respectively (p = 0.318). At 2 months postoperatively, the respective values were 0.21 ± 0.15 and 0.34 ± 0.29 D (p = 0.009). Conclusions The Eyelike K-flex Aspheric® shows excellent refractive predictability; use of 0.25-D-interval intraocular lenses close to the target refractive power allows the desired spherical equivalent to be achieved.

Purpose: The Eyelike K-flex Aspheric® (Koryoeyetech, Seoul, Korea) is manufactured in 0.25-diopter (D) intervals, which allows the target refractive error after surgery to be achieved. We here evaluate the refractive power outcomes. Methods: We retrospectively studied 95 eyes of 72 patients who underwent cataract surgery with implantation of the Eyelike K-flex Aspheric®. Refractive error was measured at 1 and 2 months postoperatively (33 eyes of 27 patients) and compared to that of patients fitted with 0.50-D-interval lenses (62 eyes of 49 patients). Results: At 1 month postoperatively, the mean absolute error between the spherical equivalent and planned value was 0.33 ± 0.28 and 0.41 ± 0.39 D in the 0.25- and 0.50 D-interval lens groups, respectively (p = 0.318). At 2 months postoperatively, the respective values were 0.21 ± 0.15 and 0.34 ± 0.29 D (p = 0.009). Conclusions The Eyelike K-flex Aspheric® shows excellent refractive predictability; use of 0.25-D-interval intraocular lenses close to the target refractive power allows the desired spherical equivalent to be achieved.

Intracranial venous infarction and drainage alteration are rare clinical events developing after intracranial operation. Immediate anticoagulation has been recommended to restore the alteration of the intracranial venous drainage. However, for the venous drainage alteration or infarction developed just after intracranial operation, the bleeding tendency induced by the anticoagulation should be considered. We report a case of successfully managed cortical venous infarctions developed immediately after intracranial operation using low molecular weight heparin.
Drainage* ; Hemorrhage ; Heparin, Low-Molecular-Weight* ; Infarction

BACKGROUND AND PURPOSE: Periodic lateralized epileptiform discharges (PLEDs) are defined as spikes or sharp waves occurring at an approximately regular interval. PLEDs are subdivided into PLEDs proper and PLEDs plus in Reiher's classification, but since this does not sufficiently reflect the pleomorphism of PLEDs, we propose a new subclassification scheme of PLEDs, and discuss the relationship between them and clinical prognoses. METHODS: Thirty-seven patients who had at least two available EEGs were included in this study. Each patient had structural brain lesions identified in brain CT/MRI: 237 EEGs from 37 patients were reviewed and the patterns of PLEDs were classified by electroencephalographic characteristics based on Reiher's classification. PLEDs proper of class 3 were subclassified into four categories: (1) simple, (2) benign, (3) vigorous, and (4) suppressed. RESULTS: Most of the PLEDs that started with the vigorous or suppressed pattern of class 3 evolved into the simple or benign pattern of class 3 and subsequently changed into class 1 or class 2, finally intermingling with the neighboring background waves. PLEDs that started with the benign or simple pattern of class 3 rapidly changed into class 1 or 2. Patients showing the benign or simple pattern of class 3 exhibited a better clinical prognosis. CONCLUSIONS: PLEDs have five distinctive classes, and over time they evolve from malignant PLEDs plus to benign PLEDs proper before finally disappearing. It appears that those of class 3 have more diverse patterns, with the vigorous and suppressed patterns being the more malignant forms of PLEDs in this class.
Brain ; Classification* ; Electroencephalography ; Humans ; Prognosis

BACKGROUND: Application of PEEP increases lung volume and improves oxygenation. High PEEP levels may cause alveolar overdistension or barotrauma. It was hypothesized that there will be an effect of level of PEEP on respiratory resistance and an effect of ventilatory mode on respiratory compliance. This study aimed to investigate the effects of ventilation modes and levels of PEEP on respiratory mechanics during controlled ventilation under general anesthesia. METHODS: In 14 mechanically ventilated patients without cardiopulmonary symptoms and signs, we measured the respiratory mechanics using the inspiration interrupter technique during a constant flow. Dynamic and static compliance, airway resistance, visco-elastic tissue and total respiratory system resistance were calculated at 0, 5, 10, 15, and 20 cmH2O of positive end-expiratory pressure (PEEP) in VCV mode, VCV with inspiratory pause mode, and PCV mode, respectively. RESULTS: The dynamic compliance of the PCV mode was higher than that of the VCV mode. The highest static compliance was at 10 cmH2O PEEP. At 20 cmH2O PEEP, pulmonary compliance was decreased and the tissue resistance was increased. CONCLUSIONS: These results suggest that the respiratory mechanics including respiratory resistance should be monitored for applying PEEP. Further studies on clinical condition such as acute lung injury and ARDS were needed.
Acute Lung Injury ; Airway Resistance ; Anesthesia, General* ; Barotrauma ; Compliance ; Humans ; Lung ; Oxygen ; Positive-Pressure Respiration ; Respiration, Artificial ; Respiratory Mechanics* ; Respiratory System ; Ventilation*