A cross-sectional survey was conducted to determine the prevalence rate of scoliosis in elementary, middle and high school boys in May 1988. The study population included 1,393 male students in Pusan ; 463 students of 4th grade in two elementary schools, 543 students of 1st grade in one middle school and 387 students of 1st grade in one high school. The students of elementary school were screened with inspection by two physicians at the same time and the students of middle and high schools were screened with both inspection by the same physicians and 70mm chest X-ray. Positive students in any one of the two screening tests were measured for height and body weight and asked for the shoulder side on which he carries the school bag. The angle of curvature on X-ray film was measured by Cobb's method. The number of positive students in any one of the two tests were 15(3.2%) in elementary schools, 174(32.0%) in middle school and 92(23.8%) in high school. However, positive rates in both tests were only 2.2% for the middle school students and 2.6% for the high school students and among these students 1.1% out of total middle school students and 2.3% of high school students had a curvature equal to or greater than 5 degrees of Cobb's angle on 70mm chest X-ray film. There was a statistically significant association between the direction of spinal curve and the shoulder side on which one carries school bag among positive students in both screening tests (p<0.05). Mean height and body weight of 281 positive students in any one of two screening tests were compared with the Korean standard for the same age. Mean weight of elementary school students was nearly the same as the standard weight but the height was slightly shorter than the standard. However, both mean height and weight of the middle school students were lower than the standard while those of the high school students were higher. The prevalence rate of scoliosis for the 2nd 3rd grades of high school is presumed to be higher than that of the 1st grade of high school and the rate for girls will be even higher than the rate for boys of the same age. Thus, scoliosis seems to be an important school health problem. To prevent scoliosis, it is recommended to reduce the weight of school bag, educate the students to keep a right posture and exercise periodically.
Body Weight ; Busan* ; Cross-Sectional Studies* ; Female ; Humans ; Male ; Mass Screening ; Posture ; Prevalence* ; School Health Services ; Scoliosis* ; Shoulder ; Thorax ; X-Ray Film

No abstract available.
Anencephaly* ; Autopsy*

Dermatofibrosarcoma protuberans (DFSP) is a rare, distinctive cutaneous tumor, which consists of spindle shaped ceils arranged in densely packed interlacing bundles with the storiform or cartwheel pattern. Histologically, it resembles deep growing dermatofibroma, nodular fasciitis, neurofibroma and neural sheath tumors. DFSP is one of t.he connective tissue tumors which is difficult. to diagnose histologically as well as clinically. Recently, the immunochemical staining with a monoclonal antibody to CD34 is reported to give assistance in the clear differential diagnosis of DFSP from other fibrous or neural tumors. Herein, three cases of DFSP were stained by immunohistochemical staining with S-100 protein, vimentin, factor VIII and anti-CD34 antibody in order to assess the use of anti-CD34 in the differential diagnosis of DFSP.
Connective Tissue ; Dermatofibrosarcoma* ; Diagnosis, Differential ; Factor VIII ; Fasciitis ; Histiocytoma, Benign Fibrous ; Neurofibroma ; S100 Proteins ; Vimentin

Ten emhalmed cadaveric adult bony hemipelvis specimens were ohtained to evaluate the configuration of the posterior column of acetabulum and to find a safe path for screw placement into it as well as to report on the morphological data of the ischial tuherosity and to determine the most optimaI technique for ischial tuberosity screw placement for open reduction and internal fixation of posterior acetabular fracture. Cadaveric studies were performed analyzing icm cross-sections through the acetabulum for the purpose of studying the anatomical configuration of the danger zone. The plane of the cross-section was perpendicular to the posterior column. Each cross-section had the medial boundary ot the acetabulum projected onto the posterior column. By analysing the projections on the posterior column, the exact configuration of the danger zone was determined. In this study, the average width of the posterior column at the mid-acetabular Ievel was 3.9cm. Computed tomography scan of the acetabulum yielded valuable int'ormation regarding screw placement in the posterior column. The average width, height and depth of the ischial tuberosity were 25.7 mm, 33. 1 mm and 31.7mm, respectively. The average angles hetween the posterior and medial aspects and hetween the posterior and lateral aspects of the ischial tuherosities were 79.5degreesand 111.5degrees, respectively. The entry point of the screw should be Smm or 10mm medial to the lateral margin of the ischial tuherosity and the screws should be directed 35-40degrees, 45-50degrees and 50-55degrees caudally at the level of the inferior acetahular margin and lcm and 2cm below it, respectively. to obtain the most favorable bony purchase.
Acetabulum* ; Adult ; Cadaver ; Humans

Endovascular treatment of isolated bilateral common iliac artery aneurysm (CIAA) requires salvage of at least one internal iliac artery to prevent complications such as ischemic buttock claudication. We treated a case of bilateral CIAAs using an internal iliac branched stent graft. We report a case of a 58-year-old man who presented with bilateral CIAAs. The left internal iliac artery was occluded with coil embolization. The right internal iliac artery was saved by using a branched stent graft. The aneurysms were excluded with conventional endovascular aneurysm repair. Completion angiography showed technical success. Follow up computed tomography angiogram at three months showed complete exclusion of bilateral CIAAs, no endoleaks, and patent right internal iliac artery. There was no pelvic ischemic complication. We treated successfully a case of isolated bilateral CIAAs using an iliac branched stent graft.
Aneurysm* ; Angiography ; Blood Vessel Prosthesis* ; Buttocks ; Embolization, Therapeutic ; Endoleak ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Iliac Artery* ; Middle Aged

Phrenic nerve palsy is a well-known complication following cardiac surgery in children. The incidence is approximately 1~2%. In infants and young children, it often causes a life-threatening respiratory distress. They must be treated with mechanical ventilation in the ICU. Many patients with phrenic nerve injury who is impossible to wean from a ventilator are candidates of diaphragmatic plication. Diaphragmatic plication is performed to restore the normal pulmonary parenchymal volume by replacing the diaphragm to its proper location. This is a case of 2-months-old infant who had phrenic nerve palsy after the removal of cavernous lymphangioma of the chest. He underwent 4 operations to remove the mass and to have pericardiotomy. We tried to wean him from the ventilator but failed several times in the ICU. After 4th operation, right diaphragmatic elevation was noted from the chest X ray. Phrenic nerve palsy was confirmed with fluoroscopy and he underwent diaphragmatic plication on 42 days after his 4th operation. Three days after the diaphragmatic plication, weaning was successfully carried out.
Child ; Diaphragm ; Fluoroscopy ; Humans ; Incidence ; Infant* ; Lymphangioma* ; Paralysis* ; Pericardiectomy ; Phrenic Nerve* ; Respiration, Artificial ; Thoracic Surgery ; Thorax ; Ventilators, Mechanical ; Weaning*

OBJECTIVE: To evaluate the effect of height and tilt adjustable keyboard tray on work-related musculoskeletal pain in visual display terminal (VDT) workers. METHOD: Twenty-one VDT workers, who had myofascial pain in upper trapezius (UTZ) and extensor carpi radialis longus (ECRL) or brevis (ECRB) during VDT work, were randomly assigned to a control (n=10) that used conventional keyboard or experimental group (n=11) that used height and tilt adjustable keyboard tray. A pretest assessed the visual analog scale (VAS), pain threshold of UTZ and ECRL or ECRB, and grip and tip pinch strength as well as upper extremity function index (UEFI). Post-test was conducted 1 month later. Additionally, differences in working posture between the two groups were evaluated. RESULTS: For the UTZ, the decrease of VAS (p<0.05) and increase of pain threshold (p<0.01) in experimental group were significantly greater than control group after 1 month. Increase of right grip strength (p<0.01) and UEFI (p<0.05) in the experimental group were significantly larger than control group. Experimental group showed lower keyboard height (p<0.01) and smaller elbow angle (p<0.01) as well as more anterior tilted keyboard angle (p<0.01) than the control group. CONCLUSION: Application of height and tilt adjustable keyboard tray seems to affect the working posture, thus reduce the work-related musculoskeletal pain of UTZ as well as enhance the strength of right grip strength and upper extremity function in VDT workers. Additionally, anterior keyboard tilting may help to reduce wrist extension in low keyboard height which contributes to decreasing UTZ muscle tension.
Computer Terminals ; Elbow ; Hand Strength ; Muscle Tonus ; Musculoskeletal Pain* ; Pain Threshold ; Pinch Strength ; Posture ; Superficial Back Muscles ; Upper Extremity ; Visual Analog Scale ; Wrist

PURPOSE: There is a controversy about whether the use of polymethylmethacrylate (PMMA) in orthopedic reconstructive surgery can increase the possibility of cardiovascular dysfunction. This study was undertaken to determine if cemented hemiarthroplasty is safe for treating femoral neck fracture in patients with ischemic heart disease. MATERIAL AND METHODS: Between March 1999 and February 2004, we performed cemented hemiarthroplasties for displaced femoral neck fractures in 158 consecutive patients. This retrospective study consisted of 44 patients with ischemic heart disease (group 1) and 58 age matched control patients (group 2). We compared the mortality rate, the incidence of deep vein thrombosis (DVT), pulmonary embolism, cerebrovascular disease, dislocation and deep infection, the amount of postoperative blood loss and the grade of cementation according to the schema of Barrack on the radiograph between the two groups. RESULTS: No difference was found in the perioperative mortality rate, the deep infection rate, the incidence of DVT or pulmonary embolism, the newly developed heart ischemic events or brain hemorrhagic lesions between the two groups. But there was a greater incidence of dislocation related to weakness from past brain ischemic lesion and the newly developed brain ischemia in group 1 than in group 2 (p<0.05). More importantly, six patients in group 1 had transient symptoms of dyspnea, signs of hypotension and bradycardia within two days postoperatively, which raises suspicions of embolic phenomenon, even though this was not confirmed. CONCLUSION: Close and careful observations should be done for the occurrence of dislocation related to previous brain ischemia, or newly developed brain ischemic lesion or embolic phenomenon. Appropriate thromboprophylaxis is necessary in patients with ischemic heart disease after cemented hemiarthroplasty for the treatment of femoral neck fracture.
Bradycardia ; Brain ; Brain Ischemia ; Cementation ; Dislocations ; Dyspnea ; Femoral Neck Fractures* ; Femur Neck* ; Heart ; Hemiarthroplasty* ; Humans ; Hypotension ; Incidence ; Mortality ; Myocardial Ischemia* ; Orthopedics ; Polymethyl Methacrylate ; Postoperative Hemorrhage ; Pulmonary Embolism ; Retrospective Studies ; Venous Thrombosis

The purpose of tracheotomy is to obtain secure airway for difficult airway management and long-term lung ventilation. Tracheotomy is an invasive procedure with the possibility of severe complications, but it is the last choice for difficult airway management. To perform tracheotomy is difficult in patients with anatomically distorted trachea, screened trachea by mass, fibrosis or adhesion and obesity. We report the experience of successful tracheotomy in the patient of severely distorted airway due to previous surgeries with the aid of the light illumination of fiberoptic bronchoscope.
Airway Management ; Bronchoscopes* ; Fibrosis ; Humans ; Lighting ; Lung ; Obesity ; Trachea ; Tracheotomy* ; Ventilation

PURPOSE: The prognosis for primary gallbladder cancer is very poor. Because of the lack of specific symptoms, late diagnosis, advanced stage, and ineffective treatment are typical. The purpose of the present study was to investigate the early diagnostic factors that improve the survival rate, by comparing a preoperatively diagnosed group with a postoperatively diagnosed group. METHODS: This study was a clinical analysis of our surgical experience with primary gallbladder carcinomas during the 6 years from 1992 to 1997 at Chung-Ang University in Korea. RESULTS: The incidence of gallbladder carcinomas was 0.6% of the 6132 biliary-tract operations performed during the 6 years (suspected group: unsuspected group=15:23). The sex ratio of males to females was 1 to 2.46 with female predominance. Primary GB cancer was seen most commonly in patients in their 50s and 60s, and this group accounted for 68.4% of the entire group and had a median age of 65 years. The most common clinical manifestation was right upper abdominal pain in 27 cases (71.1%). The duration of the illness in preoperatively suspected patients was much shorter than that for intraoperatively or only pathologically diagnosed patients (p=0.046) As for diagnostic methods, ultrasound and abdominal CT scans were performed, and the preoperative diagnostic accuracies were 31.6% and 69.3%, respectively. The patients were grouped according to the staging system of Nevin et al. The five stages were classified as follows: stage I (suspected group-0 cases; unsuspected group-2 cases), stage II (1 case; 5 cases), stage III (1 case; 2 cases), stage IV (7 cases; 9 cases), and stage V (6 cases; 5 cases). Adenocarcinoma was the most common type of gallbladder cancer (32 cases: suspected group-10 cases; unsuspected group-22 cases), followed by squamoadenocarcinoma (3 cases: 2 cases/1 case), neurogenic carcinoma (1 case: 1 case/0 cases), histiocytoma (1 case: 1 case/0 cases), and papillary carcinoma (1 case: 1 case/0 cases). The total cumulative 1-year, 2-year, and 3-year survival rates were 67.7%, 37.6%, and 12.1%, respectively (suspected: 46.2%, 15.4%, and 0%; unsuspected: 71.4%, 52.9%, and 23.2%). The cumulative survival rates for patients in the unsuspected group were higher than those for patients in the suspected group (p=0.008). CONCLUSION: The survival rate of the preoperatively unsuspected group was better than that of the suspected group. The survival improvement depended the invasion by the gallbladder carcinoma. We suggest that the survival rate should be improved by early detection of the gallbladder carcinoma and on extended operation. Conclusively, further evaluation of patients with etiologic factors should be done, more specific exams (CT or MRI) should be evaluated, and an acceptable operation should be done.
Abdominal Pain ; Adenocarcinoma ; Carcinoma, Papillary ; Delayed Diagnosis ; Early Diagnosis* ; Female ; Gallbladder Neoplasms ; Gallbladder* ; Histiocytoma ; Humans ; Incidence ; Korea ; Male ; Prognosis ; Sex Ratio ; Survival Rate ; Tomography, X-Ray Computed ; Ultrasonography