Cervical Cord Decompression Using Extended Anterior Cervical Foraminotomy Technique

OBJECTIVE: At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure. METHODS: Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images. RESULTS: In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was 9.77 mm2 (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability. CONCLUSIONS: Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed.

Ganglioglioma in Brainstem : Case Report and a Review of Literatures

Ganglioglioma is an infrequent tumor of the central nervous system (CNS); mostly supratentorial region. But, they can occur anywhere in the central nervous system such as brainstem, cerebellopontine angle (CPA), thalamus, optic nerve and spinal cord. Although it occurs rarely, ganglioglioma should be included in the differential diagnosis of a posterior fossa mass because early recognition is important for treatment and patient counseling.

A Case of high-Frequency Oscillatory Ventilation / 대한마취과학회지

Neonates with severe respiratory distress syndrome who require high levels of assisted ventilation have a high mortality and morbidity rate. Morbidity is mainly composed of bronchopulmonary dysplasia which is a result of air leak syndrome(ALS), oxygen toxicity. Even with unsolved controversy, there is a possibility that high-frequency oscillatory ventilation would decrease the development or progression of ALS in infants with severe respiratory distress syndrome. ALS is defined as pulmonary interstitial emphysema or gross air leak such as pneumothorax. We experienced HFOV to be effective in the treatment of newborn infant with pneumothorax.

Anesthetic Management of Corrective Operation of Tracheal Stenosis / 대한마취과학회지

A 34 year old male patient underwent emergency operation of tracheal resection and primary end-to-end anastomosis to correct of tracheal stenosis following tracheostomy. On admission, a No. 3 Magill plastic Portex tracheostomy tube had been placed in the previous tracheostomy opening. Stenotic narrowing was noted 4 cm above carina. Despite of severe narrowing of the lesion, anesthetic course was uneventful with nitrous oxide, oxygen and halothane by controlled respiration and serial blood gas analyses. Postoperative courses were also favorable with adequate respiratory cares. It is mandatory to perform serial blood gas analyses for the management of corrective operation on tracheal stenosis.

Refraction in School Children

611 children (297 boys and 314 girls) of a primary school were determined under 2% cyclogyl. (1) Among 611 children, refractive error was 70.46 % and emmetropia. 29.54 %. (2) As to the distribution of refractive errors, 72.47 % were hyperopic and 27.53 % myopic Hyperopia was more common than myopia. (3) Hyperopic refractive error was increased until 7 years of age. Since then it has been decreased 8.74 % yearly. Myopic refractive error has been increased 8.14 % yearly since 8 years of age. (4) The refractive errors were more frequent in women (37.81) than men (32.65 %) (5) Refractive errors were numerous around the age of 11. (24.77 %). (6) The degree of refractive errors varied, but in the great majority was less than 3 diopters. (7) As to the type of astigmatism; 59.42 % were with the rule and 39.94 % were against the rule.