Peroperative Administration of Epidural Morphine for postoperative Analgesia in Spinal Surgery (A double blind study) / 대한정형외과학회잡지

These days, the epidural administration. of morphine is commonly used for postoperative pain re lief because even small amount of morphine (3mg) is enough to have an effect on specific opiates receptors of the spinal canal. We report a prospective double blind study of the efficacy of a single epidural dose of morphine on pain after spinal decompression. Postoperative pain was assessed by a linear analogue pain score and by the additional require ment for systemic analgesics. The results obtained are as follows:l. In spinal decompression, the adminitration of epidural morphine is easy, effective and safe because the epidural space has been already exposured during operation. 2. After operation the epidural route of morphine administration will give pain relief for up to 12 hours excellently. 3. When epidural morphine is given at the time of operations, the use of systemic analgesics is much reduced. 4. The side effects of epidural morphine are much reduced due to the small amount of morphine required. This simple procedure is recommended as an effective and safe method of reducing postoperative pain.

Gaucher's Disease: A Report of Two Cases in Homozygous Twins / 대한정형외과학회잡지

Gaucher's disease is an uncommon metabolic disorder, which was first described by Gaucher in 1882, characterized by accumulation of distinctive Gaucher's cells in the reticuloendothelial system such as spleen, liver, and bone marrow. The great majority of cases have been reported in Jews, and others in negros and orientals. We are presenting two cases in homozygous twins in Korea, whose clinical manifestations are hepatosplenomegaly and bone lesions due to expansion of involved bones.

Treatment of Complete Acromioclavicular Separation by Coracoclavicular Wiring / 대한정형외과학회잡지

Acromioclavicular joint injuries are frequently seen with the recent increase of traffic and industrial accidents. The treatment of complete separation of the acromioclavicular joint has been, and is still, a subject of controversy. In view of a recent trend, anatomical reduction of acromioclavicular joint, and rigid internal fixation method is preferable, especially in type 3 injury. We operated on 16 cases of complete acromioclavicular separation by the technique of coracoclavicular wiring from March 1983 to Feb. 1987. The following results were obtained. 1. The functional results were excellent; 12 cases(75%), good; 3 cases(19a%), and fair ; 1 cases(6%). 2. The complications include wire reakage ; 1 case(6%), bony erosion ; 3 cases(19%) and subluxation, 1 case(6%). 3. The advantages of coracoclavicular wiring. 1) Avoids violation of acromioclavicular joint but does not restrict rotation of the clavicle. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy under local anesthesia. 5) This method corresponds to the coracoclavicular ligment biomechanically. Therefore, coracoclavicular wiring is thought to be a good operative method in the treatment of complete acromioclavicular separation.