Developmental Pattern and Treatment in Colon Diverticular Disease

PURPOSE: Colon diverticula has continuously increased in Korea. This study is to identify the changes in the developmental patterns of colon diverticula and in the methods of treatment. RESULTS: A total of 66 patients who were diagnosed colon diverticular disease and hospitalized at Red Cross Hospital from April 1994 to March 2005 were enrolled. This retrospective assessment was performed by analyzing the hospital records of clinical characteristics such as demographics (age, sex), physical findings, distribution of diverticula, diagnosis methods, applicable treatments depending on severity and the stage of the disease, and complications and recurrences with whether the patient underwent a emergency or an elective operation. RESULTS: The median age was 51.8 years, with 37 males and 29 females. Of the 66 cases, right-side colon diverticula was found in 47 cases, and left side in 15 cases. Transverse and descending colon diverticula occurred concurrently in 2 cases, with 2 entire colon cases. The median number of diverticula per patient was 4.6. Of the 29 operation cases, a right colectomy was done in 10 along with 6 appendectomy and diverticulectomy cases. Postoperative complications occurred in 7 patients, of these 6 occurred in patients who had undergone an emergency operation, and 1 in a patients who had undergone an elective operation; 6 in right colon diverticular disease, and 1 in left color diverticular disease. CONCLUSIONS: Colon diverticular disease has increased with noticeable increases in left side and both-sides diseases. A one-stage operation is mainly performed for surgical treatment while fewer undergo a two-stage operation. Post-operative complications occurred in 7 cases. Exact preoperative diagnosis and an elective operation that allows bowel preparation are regarded as more crucial factors than the extension of the operation in decreasing the developmental rate and the severity of postoperative complications.

Surgical Treatment of Instability of Upper Cervical Spine Associated with Trauma

With the aim of determining the outcome of surgery, a review of patients undergoing trauma-associated atrantoaxial arthrodesis. Between 1993 and 1997, 16 patients underwent 19 proceedures, with a follow-up period of between six and 29 months. The most common reasons for surgery were odontoid fracture(n=12), os odontoideum(n=1) procedure, and neurofibrimatosis type I(n=1). Ten posterior wiring, four Halifax clamp application, one anterior screw fixation of dens, two transarticular screw fixations, and one staged operation(anterior odontoiddectomy and posterior occipitocervical fusion) were performed. All patients has been surgically managed for about three months with a Halo-vest or rigid cervical neck collar, during which time three complications associated with operative procedures arose : Halifax clamp dislodgement, malunion and subluxation kyposis. In 15 of 16 patients, fusion was successful. In caes involving complicated atlantoaxial dislocation, the authors recommend postoperative Halo-vest immobilization for sucessful fusion after posterior C1-C2 wiring or Halifax clamping

Treatment of the Pyogenic Arthritis of Hip in Neonates and Infants / 대한정형외과학회잡지

Septic arthritis of hip is a serious problem. Delay in diagnosis and treatment can results in crippling. From September 1983 to May 1993, we have experienced 17 cases of pyogenic arthritis of the hip in neonates and infants. Ten cases were under the age of 1 month old, four were from 1 month to 2 months, and the rest of 3 cases were 11 months old with depicting high incidence in neonates within 1 month. Laboratory findings according to lag periods were as follows; The patients group (n=9) who visited within 3 days after symptom onset manifested high fever (over 38oC) in 2 cases only and 7 cases revealed normal or mild fever. The patients group (n=8) being seen later than 3 days showed high fever in most of cases. Leukocytosis was mostly unspecific in both groups. The average WBC counts tested on admission were 16,052/mm3, ESR 38.3mm/hr,and WBC count dropped to 11,264/mm3, ESR to 27.3 mm/hr after operation. Microbial culture was positive in 10 cases (58.8%), of which 4 were staphylococcus, 5 were streptococcus and 1 was ancinetobacter. Surgical drainage was done through the posterior approach. Long term follow up showed no recurrence and severe complications such as dislocation of head, avascular necrosis and osteomyelitis of proximal femoral metaphysis In conclusion, pyogenic arthritis of hip occurred more common in neonates less than month old and laboratory findings were not always accompanied by fever and hematologic changes especially when the symptom onset was less than 3 days.