OBJECTIVE: This study is to evaluate the efficacy of dorsal short-segment fixation in unstable thoracolumbar junction fractures. METHODS: The cases of 20 patients who underwent dorsal short-segment fixation were reviewed retrospectively. Clinical outcomes were analysed using Sonntag's pain level, work status, and neurological scale according to the modified Frankel classification. Radiological outcomes were analysed using Mumford's anterior body compression(%), canal compromise ratio, and Cobb's kyphotic angle. RESULTS: At the latest clinical follow-up (average=14.6 months), there were 19 (95.0%) in group I and 1 patient (5.0%) in II in pain level35). The postoperative work status were 17 (85.0%) in group I, 2 patients (10.0%) in II, and 1 patient (5.0%) in V. Surgery brought to improve the neurologic status. In success group (19 cases, 95%), the average canal compromise ratio was reduced from 0.57 (+/-0.07) to 0.05 (+/-0.08) (P<0.05), the average anterior body compression (%) was reduced from 41% (+/-17) to 18% (+/-14) (P<0.05), and the average preoperative kyphotic angle was 20.0 degrees (+/-9.0), and corrected to 5.7 degrees (+/-7.1) postoperatively, and progressed to 7.8 degrees (+/-6.2) at the latest follow-up. There was a case of implantation failure in an elderly osteoporotic patient. CONCLUSION: Although there are limitations in the patient number and follow-up period, the present study favors dorsal short-segment fixation for selective cases in unstable thoracolumbar junction fractures.
Aged ; Classification ; Follow-Up Studies ; Humans ; Retrospective Studies

Desmoplastic fibromas are rare intraosseous bone tumors. They are benign but locally aggressive and frequently found in the long bones and mandible. We report radiographic and histopathologic finding of a case desmoplastic fibroma involving right temporal skull bone. A 53-year-old woman presented at our hospital complaining of continuous right side headaches for a year. Simple skull X-ray film showed 3 x 2.5 cm lytic lesion with mild sclerotic margin on right temporal area. A large craniectomy 1cm lateral to margin was fashioned. The resected mass showed encapsulated mass colored white gray. Histologic diagnosis was compatible with that of a the desmoplastic fibroma. There was no evidence of recurrence during the 15months of follow-up period.
Diagnosis ; Female ; Fibroma, Desmoplastic* ; Follow-Up Studies ; Headache ; Humans ; Mandible ; Middle Aged ; Recurrence ; Skull* ; Temporal Bone ; X-Ray Film

No abstract available.
Anoxia* ; Neurons*

BACKGROUND: There are several reports on outbreaks of V. paraphaemolyticus enteritis, however, these are only complicated cases or microbiologic surveillance in marine environment. We experienced an outbreak associated with eating flavored crabs and investigated the magnitude of the outbreak on a large scale located in Inchon. METHOD: We took medical history and stool cultures from patients with diarrhea, visited the Inha University Hospital from September 14 to September 30, 1998. Pulsed-field gel electrophereis of isolates from stool culture performed to identify the relation. We counted the number of diarrheal patients visited the emergency rooms of 5 other general hospitals and 9 private clinics in Inchon from August 16 to September 30, 1998. We bought 6 crabs and 2 flavored crabs at a nearby market and cooked 6 crabs flavored at our hospital. Cultures from the flavored crabs stored at a refrigerator were done daily for consecutive 5 days. RESULTS: The outbreak began on September 5 and ended on September 29, 1998. The numbers of patients visiting ERs of 6 general hospitals and private clinics during outbreak were estimated 1,033 and 4,530, respectively. All 8 crabs revealed Vibrio spp., but identification up to species level was not possible. Pulsed-field gel electrophoresis of 12 isolates showed different patterns and suggested different sources. CONCLUSION: In 1998, an outbreak estimated more than 5,000 patients of V. parahaemolyticus enteritis occurred in Inchon, Korea. Because the magnitude of food-associated enteritis is enormous, that surpass the number which we assumed from clinical practice, early report and prompt investigation of such cases are necessary.
Diarrhea ; Disease Outbreaks ; Eating ; Electrophoresis, Gel, Pulsed-Field ; Emergency Service, Hospital ; Enteritis* ; Hospitals, General ; Humans ; Incheon* ; Korea* ; Vibrio parahaemolyticus* ; Vibrio*

This is a report of 15 consecutive cases of petroclival lesions performed by transpetrosal approach over five years. Pathologies from these cases include 13 cases of tumors and two cases of aneurysms. All cases of tumors were over 4.5cm in size. Two cases of very low-lying basilar bifurcation aneurysms and one case of facial schwanoma extended to the petrosal tip and temporal fossa were operated with anrerior transpetrosal approach, where as nine cases of petroclival tumor which was localized in the posterior fossa were operated via posterior transpetrosal approach. Of these nine cases, one case with lower clival extension was removed totally by adding a retrosigmoid dural opening. Remaining three cases extended to the Meckel's cave or cavernous sinus were operated by combined anterior-posterior transpetrosal approach. Of the 12 cases done with posterior transpetrosal or combined approach, nine cases with preserved serviceable hearing were approached by retrolabylinthine technique and remaining three cases without preservation of serviceable hearing were operated via retrolabylinthine technique. Total removal was achieved in 9 of 13 tumor cases. Of two cases, aneurysmal neck of the first case was clipped completely but was clipped together with right posterior cerebral artery in second case. There was no operative mortality. Immediate postoperative neurological dysfunction were appered in 12 cases. These were significantly improved by the time of follow up examination. Permanent postoperative dysfunction was present in 6 cases, hemiparesis in 2, facial paralysis in 2 and hearing impairment in 2 cases. These results suggest that when selecting the surgical approach to the petroclival lesions, the size, location, extent of the lesion and preoperative status of the hearing were important factors to be considered. We recommend combined anterior-posterior transpetrosal approach for the complex lesions in the petroclival area which extends into the middle fossa(Meckel's cavum or cavernous sinus). Also, we recommend combining with retrosigmoid dural opening or a far lateral type of suboccipital exposure in cases of complex petroclival lesions involving the entire clivus or foramen magnum. In cases with brain stem invasion by tumor, vascular encasement or cavernous sinus invasion without cranial nerve involvement, we recommend subtotal resection of the tumor and radiosurgery to prevent permanent postoperative sequele.
Aneurysm ; Brain Stem ; Cavernous Sinus ; Cranial Fossa, Posterior ; Cranial Nerves ; Facial Paralysis ; Follow-Up Studies ; Foramen Magnum ; Hearing ; Hearing Loss ; Mortality ; Neck ; Paresis ; Pathology ; Posterior Cerebral Artery ; Radiosurgery

Congenital tracheal stenosis is very rare, but it leads to life threatening obstruction in infancy and childhood. Recently, we experienced two cases of congenital tracheal stenosis, involving half of the distal trachea. We adopted slide tracheoplasty procedure proposed by Peter Goldstraw. Tracheoplasty was performed by dividing the stenosis at midpoint, incising the proximal and distal narrow segments vertically on opposite anterior and posterior surfaces, and sliding these together. On case 1, the patient is now doing well. On case 2, the patient succumbed due to anastomotic disruption at postoperative day 4.
Constriction, Pathologic ; Humans ; Trachea ; Tracheal Stenosis*

Proximal cerebrospinal fluid shuntmalfunction due to ventricular catheter occlusion remains the most common sourceof the shunt problem. The position of the hole-bearing segment of the catheter affects the long term patency of the ventricular catheter of a cerebrospinalfluid shunt.Placementof thissegmentnear thechoroidplexus or injured ependyma increases the probability of obstruction. Accurate locationof ventriculoperitoneal(V-P)shunt tip inrelation to foramen Monro canbe well establishedby plain radiographyregardless of agesor sizes and shapes of head dueto the fact that foramen Monro tothe spatial matrix of the skull is constant. Of 147patients who underwentV-P shunt operations, 49(33.3%)patients had more thanone operations. Radiologicgradingof theventricularcatheterposition is compared betweensingle operatedgroup andreoperated group.Single operated group showed excellentin 33.6%, good41.8%, poor 24.4%of accuracy rateof catheter tip position. Incases ofreoperation, placement ofcatheter tipresulted in excellent 12.5%, good21.8%, and poor 65.6%.These results indicatethat accurate location of ventricular catheter tip affects favorably to the patency of V-P shunt.
Catheters ; Cerebrospinal Fluid ; Ependyma ; Head ; Skull ; Ventriculoperitoneal Shunt*

A nerve ganglion cyst is characterized by the accumulation of a mucoid substance in or around the nerve, which leads to the formation of a pseudocyst. This 53-year-old man presented with left foot drop of three-year duration, using magnetic resonance imaging, 3-cm ganglion cyst of the peroneal nerve was preoperatively diagnosized. Surgical exploration disclosed a lobulated cystic mass filled with gelatinous material, and the lesion was completely resected. No connection with the knee joint was found, and postoperative recovery of motor function was good. The authors describe a case of intraneural ganglion cyst of the peroneal nerve which illustrates the value of MR in diagnostic imaging.
Diagnosis* ; Diagnostic Imaging ; Foot ; Ganglion Cysts* ; Gelatin ; Humans ; Knee Joint ; Magnetic Resonance Imaging* ; Middle Aged ; Peroneal Nerve*

A nerve ganglion cyst is characterized by the accumulation of a mucoid substance in or around the nerve, which leads to the formation of a pseudocyst. This 53-year-old man presented with left foot drop of three-year duration, using magnetic resonance imaging, 3-cm ganglion cyst of the peroneal nerve was preoperatively diagnosized. Surgical exploration disclosed a lobulated cystic mass filled with gelatinous material, and the lesion was completely resected. No connection with the knee joint was found, and postoperative recovery of motor function was good. The authors describe a case of intraneural ganglion cyst of the peroneal nerve which illustrates the value of MR in diagnostic imaging.
Diagnosis* ; Diagnostic Imaging ; Foot ; Ganglion Cysts* ; Gelatin ; Humans ; Knee Joint ; Magnetic Resonance Imaging* ; Middle Aged ; Peroneal Nerve*

Pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals is a rare and complex lesion in which great morphologic variability exists regarding the sources of pulmonary blood flow. We report a case of this disease with no true central pulmonary arteries in a 9-month-old-boy successfully treated by one-stage complete unifocalization and repair from a midline sternotomy approach.
Heart Septal Defects, Ventricular* ; Pulmonary Artery ; Pulmonary Atresia* ; Sternotomy