Authors analyzed the results of treatment in 49 cases of medulloblastoma who had been operated upon at the Seoul National University Hospital from January 1972 to June 1987. There were 2 cases(4%) of postoperative mortality(death within postoperative one month) and 13 cases of late moratlity. The 3-year overall survival rate was 49.3% and 3-year disease-free survival rate was 48.5%. The risk period of recurrence was about 2 years after surgery. The 3-year survival rate was significantly better in "grow total resection" group, "radiation dose more than 50 Gy" group, and group II(23 cases operated after July 1982) (p<0.05). The rate of posterior fossa recurrence was lower in "gross total resection" group for the patients who received posterior fossa irradiation of more than 50 Gy.
Disease-Free Survival ; Humans ; Medulloblastoma ; Prognosis* ; Recurrence ; Seoul ; Survival Rate

The purpose of this study was to compare the marginal fit of provisional restorations by differentiating the removal time and setting temperature during resin polymerization. After mixing autopolymerizing methyl metharcrylate resin, the material was placed in a preformed resin shell crown. The crown was seated on a die with 1mm shoulder margin. Crowns were removed after 3,4,5,6 minutes and polymerization was continued under the following conditions : 25degrees C air,30degrees C, 40degrees C, 50degrees C,60degrees C,70degrees C water. After polymerization, the crown was sectioned. The marginal & occlusal discrepancies were measured. The mean marginal discrelpancies at 3 minutes, 4 minutes, 5 minutes and 6 minutes of removing time were 96.6micrometer,84.6micrometer, 86.7micrometer and 105.6micrometer.The mean occlusal discrepancies at 3 minutes, 4 minutes, 5 minutes and 6 minutes of removing time were 106.7micrometer, 89.3micrometer, 98.6micrometer and 127.7micrometer.There was significant difference between 4 minutes group and 6 minutes group in occlusal discrepancies. The mean marginal & occlusal discrepancies for crowns polymerized in 25degrees C air were 98.2micrometer and 124.1micrometer. The crowns polymerized in 50degrees C water demonstrated the smallest marginal & occlusal discrepancies. The mean value of marginal & occlusal discrepancies in 50degrees C water were 73.1micrometer and 77.5micrometer. These values were smaller than that of 25degrees C air.There were significant differences in the occlusal discrepancies between 25degrees C air and water conditions of 50degrees C water (alpha=0.05) but, no significant differences in marginal discrepancies. There was no significant difference in the interaction between time and temperature. 4 minutes waiting time & 50degrees C water polymerizing condition produces the best fit at the margin of the provisional crown.
Crowns* ; Polymerization* ; Polymers* ; Shoulder ; Water

We report a rare case of delayed cement displacement after balloon kyphoplasty in patient with Kummell's desease. A 78-year-old woman with Kummell's desease at T12 level received percutaneous balloon kyphoplasty. Two months after surgery, the patient complained of progressive severe back pain. Computed tomographic scans revealed a breakdown of the anterior cortex and anterior displacement of bone cement. Although this complication is very rare, it is likely to occur in treatment of Kummell's desease accompanying anterior cortical defect.
Aged ; Back Pain ; Displacement (Psychology) ; Female ; Humans ; Kyphoplasty

The effects of epidural bupivacaine with and without epinephrine and morphine on mat-ernal blood pressure, newborn Apgar scores, and duration of analgesia were compared in 40 parturients during Cesarean section and post operative periods. Patients in group 1(n= 16) received 0.5% bupivacaine 27cc and group 2(n=10) recelved bupivacaine with epinephrine, group 3 (n= 10) received bupivacaine with morphine 3mg, and those in group 4(n= 10) received bupivacaine with epinephrine and morphine 3mg. Maternal hypotension occured less frequently in group 2 than in group 1 (p<0.001). Apgar scores were equally good (more than 8) all four groups. Duration of analgesia was longer in group 2(199.50+/-70.73min) than in group 1(133.50+/-50. 11min) but significantly longer in group 3(471.50+/-174.90) and in group 4(684.00+/-276. 92min) . It is concluded that adding epinephrine and morphine to bupivacaine during epidural anesthesia in the normal parturient has no adverse effects on either mother or neonate; and that it significantly prolongs the duration of analgesia and decreases the incidence of maternal hypotension.
Analgesia ; Anesthesia, Epidural* ; Blood Pressure ; Bupivacaine* ; Cesarean Section ; Epinephrine* ; Female ; Humans ; Hypotension ; Incidence ; Infant, Newborn ; Morphine* ; Mothers ; Obstetrics* ; Pregnancy

Reverse total shoulder arthroplasty (RTSA) is an effective surgical method for rotator cuff tear arthropathy, irreparable cuff tear, complex fracture of the proximal humerus, and revision after anatomical total shoulder arthroplasty. As the scope of application and the number of trials have increased recently, there have been reports of scapular notching, glenoid loosening, infection or peri-scapular fractures. On the other hand, there are no reports of concomitant fractures of the coracoid and acromion after RTSA. The authors experienced two cases with concomitant fractures of the coracoid and acromion after RTSA. This paper reports these cases with a literature review and discusses the causes.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of implant removal of percutaneous short segment fixation after vertebral fracture consolidation in terms of motion preservation. METHODS: Between May 2007 and January 2011, 44 patients underwent percutaneous short segment screw fixation due to a thoracolumbar burst fracture. Sixteen of these patients, who underwent implant removal 12 months after screw fixation, were enrolled in this study. Motor power was intact in all patients, despite significant vertebral height loss and canal compromise. The patients were divided into two groups by degree of osteoporosis : Group A (n=8), the non-osteoporotic group, and Group B (n=8), the osteoporotic group. Imaging and clinical findings including vertebral height loss, kyphotic angle, range of motion (ROM), and complications were analyzed. RESULTS: Significant pain relief was achieved in both groups at final follow-up versus preoperative values. In terms of vertebral height loss, both groups showed significant improvement at 12 months after screw fixation and restored vertebral height was maintained to final follow-up in spite of some correction loss. ROM (measured using Cobb's method) in flexion and extension in Group A was 10.5degrees (19.5/9.0degrees) at last follow-up, and in Group B was 10.2degrees (18.8/8.6degrees) at last follow-up. Both groups showed marked improvement in ROM as compared with the screw fixation state, which was considered motionless. CONCLUSION: Removal of percutaneous implants after vertebral fracture consolidation can be an effective treatment to preserve motion regardless of osteoporosis for thoracolumbar burst fractures.
Follow-Up Studies ; Humans ; Methods ; Osteoporosis ; Range of Motion, Articular

Background: Supracondylar humerus (SCH) fractures in children have been traditionally categorized according to the Wilkins-modified Gartland classification scheme, which is solely based on the degree of displacement. As this classification does not consider fracture patterns in the coronal or sagittal plane, the relationship between the fracture pattern and prognosis in SCH fractures remains unclear.Therefore, the purpose of this study was to evaluate the relationship between the fracture level and prognosis of pediatric SCH fractures. Methods: Medical records and radiographs of 786 patients with SCH fractures who underwent surgical treatment between March 2004 and December 2017 were reviewed. A total of 192 patients were included in this study. Anteroposterior elbow radiographs taken at the time of injury were evaluated to obtain the level of fracture. Functional outcomes were evaluated based on modified Flynn grading at the last follow-up. Results: Of 192 patients included in this study, 24 (12.1%), 148 (74.8%), and 20 (10.1%) had fractures in zone 1 (metaphyseal-diaphyseal area), zone 2 (between zones 1 and 3), and zone 3 (metaphyseal-epiphyseal area), respectively. There were significant differences in age at the time of injury (p = 0.011), direction of fracture displacement (p = 0.014), and loss of carrying angle (p < 0.001) between fractures in zone 3 and those in zone 1 or zone 2. Zone 3 fractures and classic zone 2 fractures also showed significant difference in outcomes, with zone 3 fractures having more unsatisfactory outcome than classic zone 2 fractures (p = 0.049). Conclusions For SCH fractures, varus deformity of the elbow was more common in zone 3 (metaphyseal-epiphyseal area) than in the other zones. Thus, pediatric orthopedic surgeons should be mindful of the possibility of cubitus varus deformity when treating SCH fractures in zone 3. A thorough postoperative follow-up is required.

OBJECTIVE: The purpose of this study was to determine whether screw fixation without bone fusion in patients with a low lumbar burst fracture has satisfactory outcomes. METHODS: Twelve patients that underwent screw fixation without bone fusion for a low lumbar burst fracture (L3-5) between 2006 and 2009, were included in this study. Motor power was intact despite severe canal compromise in all. Surgical procedures included postural reduction for 2 days and screw fixation without bone fusion. Imaging and clinical findings, including level of the involved vertebra, vertebral height, canal compromise, clinical outcomes, and related complications were analyzed. RESULTS: Mean follow-up was 23.1+/-11.0 months. Mean pain score (visual analogue scale) prior to surgery was 7.8+/-2.0 and this decreased to 1.8+/-1.0 at final follow-up. In 5 patients, open screw fixation by midline skin incision was performed and 7 patients underwent percutaneous screw fixation at one level above, one level below the fractured vertebra and fractured level itself. The proportion of canal compromise at the fractured level improved significantly from 60% to 30% at final follow-up (p<0.001). Mean preoperative vertebral height loss was 31.0%, and improved to 20.5% at final follow-up, though this improvement was not statistically significant (p<0.001). No neurological aggravation related to neural injury was observed. CONCLUSION: Short segment pedicle screw fixation without bone fusion can be an effective and safe operative technique for the management of selected low lumbar burst fractures.
Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Skin ; Spine

Foreign bodies in the maxillofacial area are not commonly seen. If occurred, the immediate removal of foreign bodies is recommended to avoid further complications. The most important thing is a exact localization of foreign bodies using X-rays such as plain radiography, computed tomography, magnetic resonance imaging and ultrasound before treatment. During removal of foreign bodies, tissue should be dissected carefully and complete exploration of the whole wound required.
Foreign Bodies* ; Magnetic Resonance Imaging ; Radiography ; Ultrasonography ; Wounds and Injuries

Following the Korean War, presence of foreign troops in Korea, economic difficulty and changing moral Standards have brought about the development of concentrations of prostitutes around army camps known as "villes". The problems with venereal disease among the prostitutes living in the villes and consequently among soldiers has been a problem which has perplexed both American and Korean health authorities. Research into the problems and efforts to solve the V.D. problem have yielded only fragmentary results. Fortunately, with the cooperation of the U.S. Army Research and Development Group, an extensive research project has been undertaken to determine the root causes and best methods to prevent venereal disease in the villes around American military installations. The villes around large military installations were selected as the target of this research. In particular, the Pyeongtaek ville, the Gunsan "Silver Town" area and the "Texas Town" area of Busan were studied. The study took two years, from April, 1973 to March, 1975. Microbiological and serological studies were undertaken to determine the venereal disease infection rate and the efficacy of different antibiotics both in treatment and in sensitivity tests. In addition to the microbiological and serological studies other factors related to venereal diseases control such as social environment, health facilities, knowledge of venereal disease and its control were studied. The following results were obtained. 1. An overall gonorrheal morbidity rate of 14.1% was found among the 1,282 girls studied. This shows e rather dramatic rise compared to other studies. The majority of the increase is attributed to an actual increase of the V.D. rate, but more precise methods of isolation and culture using Thayer-Martin media also contributed to the increase recorded. 2. In Pyeongtaek, a gonorrhea morbidity rate of 5.39/0 (endocervical), the lowest in any of the villes was recorded. The Pyeongtaek police of enforced hospitalization until cure was effected tended to eliminate contact with infected girls and also make the girls more aware of and concerned about prevention of venereal disease. The Texas town prostitutes in Busan had a 15.5% (endocervical) morbidity rate, the highest of any of the areas. This might be attributed to sexual contact with many foreign sailors. 3. In culturing for gonorrhea, it was found that rectal as well as cervical cultures are necessary. Rectal cultures revealed 71 cases(39.2% to total positive cases) some of which were negative by endocervical culture, and endocervical cultures yielded 181 positives among the 1,282 cases surveyed. 4. A total of 988 serological tests for syphilis were carried out. By the V.D.R.L. method, 11.5% reactive cases were recorded, Kolmer C-F showed 5.9% reactive and RPCF test showed a 4.3% reactive rate. The RPR card test was used to retest 151 persons who were demonstrated to be V.D.R.L. (in prostitutes and general entertainers) reactive and confirmatory reactive results were shown in 74.0% of the cases. The FTA-ABS test was done on 57 RPCF tes/; reactive cases and showed confirmatory reactive results in 96.5% of the cases. It was concluded that the RPR card test, although it is less sensitive than the V.D.R.L test was both simple and effective for use in mass screening. However it is suggested that RPR card test rectors be reconfirmed using either the RPCF test or the FTA-ABS test. 5. Penicillin treatment failed to cure 40% of the gonorrhea patients in clinical tests and 16% of the strains used in the sensitivity tests showed resistance to penicillin. Therefore, penicillin was judged to be rather ineffective against gonorrhea. Ampicillin, however, is still quite effective, and spectinomycin was the most effective antibiotic against gonorrhea. 6. The socio-medical study of prostitutes revealed that their average age 25.5 years and the average number of years of education was 6. 8, implying the completion of primary school. Living conditions were generally poor, for example, in Pyeongtaek, 37% of the girls did not have running water and depended on well water. Data on the toilet facilities revealed that 78% of the prostitutes living in the control area in Wanweoldong, Busan were still using traditional Korean privy style toilets, and in Pyeongtaek 91% also were using privy toilets. Over two-thirds of the prostitutes only bathed once or twice a week. Therefore, improvement of living conditions was considered a critical problem. 7. Generally speaking, the girls had some know/edge of syphilis and gonorrhea and the measures necessary to prevent these diseases. However, over half of the girls abused antibiotics in venereal disease treatment and prevention attempts and only 65% of them required their partner to use a condom. Therefore, much improvement is needed in this area. 8. A survey of knowledge about contraceptive measures showed that 96% of the girls had good knowledge about oral contraceptives, 90 knew about condoms and 88% had knowledge of the douche method. In actual practice however, 95% of the girls used the douche method and 62% used condoms for contraception.
Ampicillin ; Anti-Bacterial Agents ; Baths ; Busan ; Condoms ; Contraception ; Contraceptives, Oral ; Education ; Female ; Fluorescent Treponemal Antibody-Absorption Test ; Gonorrhea ; Gyeonggi-do ; Health Facilities ; Hospitalization ; Humans ; Jeollabuk-do ; Korea* ; Korean War ; Mass Screening ; Military Personnel ; Penicillins ; Police ; Running ; Serologic Tests ; Sex Workers* ; Sexually Transmitted Diseases* ; Social Conditions ; Social Environment ; Spectinomycin ; Syphilis ; Texas ; Toilet Facilities