Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

Herpes zoster is a viral infection of the dorsal nerve root causing painful vesicular eruptions over the skin or mucous membrane of the affected nerve. It is less well known to the dermatologists that berpes zoster causcs bladder dysfunction when the zoster affects the lumbar and sacral spinal ganglia. The authors observed a case of herpes zoster involving the S 2~4 dermatomes, associated with bladder atony in a 58 year old male who had received rad.iotherapy and chemotherapy for his malignant Iymphoma of lymphocytic type. Conservative treatment with urinary catheterization and antibiotics resulted in complete recovery of the bladder function about 3 weeks later. He had also ichthyosiform skin lesions on his back and lower extremities which, by carefuI history and histopathological examination, proved to be acquired ichthyosis.
Anti-Bacterial Agents ; Drug Therapy ; Ganglia, Spinal ; Herpes Zoster* ; Humans ; Ichthyosis* ; Lower Extremity ; Lymphoma* ; Male ; Middle Aged ; Mucous Membrane ; Skin ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Catheterization ; Urinary Catheters

BACKGROUND: We compared factors associated with self-reported depression and, in particular, diagnosis and treatment of depressive symptoms in Korean adults. METHODS: The sample included 13,306 adults aged 19 years or older from the 2010 and 2011 Korea National Health and Nutrition Examination Survey (KNHANES V). Data were applied to the chi2 test and multivariate logistic regression analysis. RESULTS: The following characteristics of individuals are significantly associated with self-reported depression: female (vs. male, OR [odds ratio]=3.35), ages 50-59 years (vs. 60+, OR=1.45), economic status (low vs. high, OR=1.35; middle-low vs. high OR=1.29), unemployed (vs. employed, OR=1.23), education (elementary vs. college, OR=1.18; middle school vs. college, OR=1.27; vs. high school vs. college, OR=1.18), current smoking (vs. no, OR=1.19), high-risk alcohol consumption (vs. no, OR=1.18), perceived health (good vs. very good/excellent, OR=1.156; poor/fair vs. very good/excellent, OR=2.65), chronic disease (vs. no, OR=1.26), activity limitation due to health problems (vs. no, OR=1.74), and being in a sickbed during the past month (vs. not in a sickbed, OR=1.69). Living in a metropolitan area (vs. rural, OR=1.40) is significantly associated with greater odds of being diagnosed with depression. The odds of being treated for depression are lower for female (vs. male, OR=0.53). Greater odds of being treated for depression was seen for those with chronic conditions (vs. no, OR=1.73) and activity limitation due to health problems (vs. no, OR=2.05), as well as, those in a sickbed (vs. not, OR=1.88). CONCLUSIONS: Applying our findings, policy makers should address the lower rates of depression diagnosed in non-metropolitan areas to reduce regional variations, and also promote treatment in females.
Administrative Personnel ; Adult* ; Alcohol Drinking ; Chronic Disease ; Depression* ; Diagnosis* ; Education ; Female ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Smoke ; Smoking

PURPOSE: In order to assess the incidence and radiologic findings of herniation pit of the femur neck in Korean. IVlaterials and Methods:In 152 macerated femurs of 88 cadavers, and randomly selected 115 hips of 70 patients, the presence of herniation pit was determi ned by using fluoroscopy and radiography. It was then examined by CT for inspection of overlying surface and its opening was confirmed by inserting thin steal wire under the fluoroscopic guidance. RESULTS: Seventeen herniation pits in 15 macerated femurs of 13 cadavers were noted. (14.8%, 13/88). Two of 13 individuals showed bilaterality. All lesions were found only in males. Six herniation pit in 6 femurs of 6 patients (8.6%, 6/70) were also noted. All lesions were on anterosuperior aspect of. femur neck. Plain radiographs of macerated femurs revealed well marginated and thin sclerosis in 15 lesions. Of all 23 lesions, CTshowed cortical breakdown in 3, and overlying cortical thickening in 8. In 15 macerated femurs, roughed area of cortex was found in anterosuperior aspect of femur in all cases, and tiny openings(diameter less than 1 mm) related to cystic lesions were confirmed in 9 lesions. CONCLUSION: The incidence of herniation pits was 14.8% in 88 cadaver, and 8.6% in 70 patients. All were males.
Cadaver ; Femur Neck* ; Femur* ; Fluoroscopy ; Hip ; Humans ; Incidence* ; Male ; Radiography ; Sclerosis

No abstract available.
Dermatitis, Contact* ; Prurigo*

No abstract available.
Chondrosarcoma*

Apert described acrocephalosyndactyly as a clinical entity in 1906. At first he included a patient with craniofacial deformities combined with syndactyly of both the upper and lower extremities. This is a rare congenital disturbance in the growth of bone and soft tissue affecting principally the head, the hands and the feet. More than 200 cases have been reported in the world literature, and three cases in Korea. Authors experienced one case of the classic pattern of Apert's syndrome and treated surgically for syndsctyly.
Acrocephalosyndactylia ; Congenital Abnormalities ; Foot ; Hand ; Head ; Humans ; Korea ; Lower Extremity ; Syndactyly

Pagets disease has been well known disease in western countries, but it is extremely rare in orient and no case has been reported in Korea yet. It is a chronic osseous disease affecting middle and late life, characterized by progressive skeletal deformities which consist of excessive resorption and abnormal regeneration. We experienced a case of Paget's disease in a 57-year old man with involvement of pelvis, femur and skull, and confirmed with open biopsy.
Biopsy ; Congenital Abnormalities ; Femur ; Korea ; Pelvis ; Regeneration ; Skull

Paralytic scoliosis is a disease characterized by its long severe curve and the continuous progression of the deformity even after cessation of growth. It is also resistent to conservative treatment and more patients require surgical treatment than those with idiopathic or congenital curvature. Patients suffer from marked limitation of normal activities in walking and sitting due to imbalanced paralysis of trunk muscles and pelvic obliquity. The indication for the conservative treatment with Milwaukee brace allowing for skeletal growth in a straight alignment is much limited and surgical correction and fusion are almost always indicated even in a young age. This paper was aimed to review our experience with ninteen patients with paralytic scoliosis who were treated with various methods of preoperative corrections and surgery from Jan. 1970 to Dec. 1981 and the following results were obtained. 1. The average age when scoliosis was observed was 7.7 years but the average age of surgery was deferred to 17.7 years. 2. No treatment had been done until most of the patients could no longer maintain balanced posture in sitting and walking due to collapsing spine and marked pelvic obliquity. 3. The causes of paralysis were poliomyelitis in 15 cases, meningocele in two, cerebral palsy and Charcots disease in each one. 4. Preoperative average degree of scoliosis was 107.8° and the final correction was 47.9°(44.4%) with loss of correction 3.6° (3.4%) after 5.6 years of follow-up in average. 5. The more severe the curve was, the more flail was the spine and the more correction could be obtained. 6. Preoperative correction was performed for 16 cases and Harrington instrumentation and posterior fusion were performed for all cases except one meningocele with defect of posterior element in which Dwyer instrumentation was indicated. 7. Breakage of Harrington rod was observed in two cases 1.3 and 3.8 years postoperatively but no problem arose from it in seven and two years of follow-up respectively. 8. Significant pelvic obliquity was observed in seven cases, which were treated by Harrington instrumentation with sacral bar or sacral hook and posterior fusion extended to sacrum.
Braces ; Cerebral Palsy ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Meningocele ; Muscles ; Paralysis ; Poliomyelitis ; Posture ; Sacrum ; Scoliosis ; Spine ; Walking

Congenital kyphoscoliosis is an abnormal curvature of spine that is due to presence of vertebral anomalies which cause an imbalance in the longitudinal growth of the spine. Congenital kyphoscoliosis is often rigid and its correction can be difficult. It is often resistant to conservative treatment and more patients require surgical treatment than those with idiopathic curvature. The indication for the conservative treatment with Milwaukee brace is much limited. Largely Milwaukee brace is a delaying tactic to correct the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 49 patients with congenital scoliosis, kyphosis and kyphoscoliosis who were treated surgically with various methods of preoperative correction, from Jan. 1968 to Dec. 1983, in special reference to new classification, proposed for common application to both kyphosis and scoliosis, and following results were obtained. 1.The average age when scoliosis was observed was 6.9 years, but the average age of surgery was deferred until 15.2 years. 2. The distribution of curve pattems were 1 cervicothoracic, 24 thoracic, 12 thoracolumbar, 7 lumbar and 1 lumbosacral curve in 45 scoliotic curves and 13 thoracic, 13 thoracolumbar and 4 lumbar curves in 30 kyphotic curves. The average degrees of deformity were most severe in thoracolumbar curves both in kyphosis and scoliosis. 3. The new morphological classification, which could be applicable to both kyphosis and scoliosis, was proposed. The type of unsegmented bar with contralateral hemivertebra was most common both in kyphosis and scoliosis. 4. Preoperative average degrees of scoliosis was 58.7 degrees and final correction was 20.6 degrees (35.1%) with loss of comection of 3.7 degrees (6.3%). Preoperative average degrees of kyphosis was 63.7 degrees and final correction was 20.1 degrees (42.5%) with loss of correction of 7.0 degrees (11.0%). 5. The surgical method with anterior and posterior fusion was the best treatment of severe kyphoscoliossis, in the aspect of final correction and loss of correction. 6. The lumbar curve was most amenable to treatment with the best final correction and the least loss of correction.
Braces ; Classification ; Congenital Abnormalities ; Humans ; Kyphosis ; Methods ; Scoliosis ; Spinal Curvatures ; Spine