Dissecting aortic aneurysm is an emergency condition which requires prompt diagnosis and management. From January 1992 to December 1996, 54 patients were admitted to our department. Patients were categorized according to the Stanford classification of aortic dissection and investigation of the clinical records utilized the retrospective method. Male constituted the majority, according for 38(70.4%) of the total number of patients, whereas females accounted for 16(29.6%). Mean age was 52.1+/-2.2 years old (range:25~82). Clinical findings included chest pain in 46 cases(85.2%), renal failure in 11(20.4%), aortic insufficiency in 10(18.5%) and stroke in 9(16.7%). Predisposing factors were hypertension in 48 cases(88.9%), Marfan's syndrome in 5(9.3%) and diabetes mellitus in 1(1.8%). 21 patients(type A:12, type B:9) underwent surgical treatment. There were three(2 in type A and 1 in type B) deaths in the surgical treatment group and nine(5 in type A and 4 in type B) deaths in the medical treatment group. These results reflect our current policy in the management of dissecting aortic aneurysm.
Aortic Aneurysm* ; Causality ; Chest Pain ; Classification ; Diabetes Mellitus ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hypertension ; Male ; Marfan Syndrome ; Renal Insufficiency ; Retrospective Studies ; Stroke

The binding activities of 6 plant lectins were studied in a total of 6 cases of Ewing's sarcoma of the bone, using the avidin-biotin-peroxidase complex (ABC) method on paraffin embedded material. The lectins used in this study were Ricinus communis agglutinin I (RCA I), Concanavalin A (Con-A), Peanut agglutinin (PNA), Wheat germ agglutinin (WGA), Ulex europeus I (UEA I), and Soybean agglutinin (SBA). However, no specific lectin, which showed consistent binding activity in the majority of Ewing's sarcoma cells was identified, in 5 of 6 cases, intracytoplasmic RCA I binding cells were occasionally observed, at somewhat regular intervals, among the neoplastic cell nests. Con-A stains were also positive in 4 cases, but the numbers of Cona-A binding cell were fewer than that of positive cell with RCA I, With PNA, WGA, UEA I, and SBA virtually no tumor cells were stained. These findings suggest that all Con-A positive cells and a part of RCA I binding cells are probably stromal macrophage-histiocytes, which are incorperated in neoplastic cells. And remaining RCA I positive cells seem to be either a kind of differentiating neoplastic cells or supporting cells having close correlation with the neoplastic cells.

A Paralytic hip with subluxation or dislocation may be treated by any of the ischial seat brace, hip fusion, muscle or tendon transfer, and more recently Pembertons or Salters osteotomy. 61 hips on 45 cases have been reconstructed, by one or combination of various procedures at Seoul National University Hospital during the 7 year period from October 1963 to October 1970. Follow-up results of these hips were evaluated by the reporters' according to the criteria of both functional and mechanical stability. Of the 43 cases with known results 9 rated Undetermined, 2 Fair, 5 Good, and 27 Excellent. Analysis of the 27 Excellent cases suggests that the most satisfactoy results can be obtained when the hips are attacked by concomitant functional(muscle or tendon transfer) and mechanical (Pembertons or Salters osteomy) stabilizations. In our experience, a combination of muscle or tendon transfer and an arthroplasty of Pemberton or Salter type can be carried out at the same setting, and at the same time results in better and more permanent rehabilitation of the hip than either muscle or tendon transfer or arthroplaty alone and often eliminates braces and the need for hip fusion, and thus a flail hip can be functionally salvaged. Our approach has become more aggressive in recent years, and we sometimes do not hesitate radical operations in children below 5 years of age or in convalescent stage of poliomyelitis in order to prevent further progression of hip deformities. More recently, Sharrards posterior transplantation of the iliopsoas tendon, originally described for reconstruction of paralytic hips in meningomyelocele, was carried out in 4 cases of residual poliomyelitis and we are satisfied with the initial results.
Arthroplasty ; Braces ; Child ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Hip ; Humans ; Meningomyelocele ; Osteotomy ; Poliomyelitis ; Rehabilitation ; Seoul ; Tendon Transfer ; Tendons

Before impression making in the fixed restorations or other prosthesis, hemostatic solutions are used for hemostasis and moisture control. Hemostatic solutions effectively control bleeding but their major ingredients, acid removes smear layers which are formed in the tooth preparation, exposes the dentinal tubular orifices which are occluded by smear layers, makes dentinal tubular fluid displace more easily to the various external stimulus, and according to the hydrodynamic theory, consequently causes dentin hypersensitivity. To know the effect of hemostatic solutions on dentin permeability, coronal dentin discs, 1 mm in thickness, were prepared from extracted third molars free from decay and wear, and a spilt chamber device was used. Hydraulic conductance values and SEMs, which were measured before and after treatment with Astringedentr , Altract and Epri-dent , were compared and analyzed. The following conclusion were drawn : 1. Hydraulic conductance values which wee measured after the treatment of hemostatic solutions were increased in all groups(p<0.05). 2. %change values of hydraulic conductance were compared but no significant difference was found among the three hemostatic solutions(p<0.05). 3. on SEM observations of all groups, after treatment smear layers were removed and dentinal tubular orifices were partially exposed. on the basis of these conclusions, the reckless use of hemostatic solutions should be restricted, and when in use, various methods should be considered to protect dentin.
Dentin Permeability* ; Dentin Sensitivity ; Dentin* ; Hemorrhage ; Hemostasis ; Hydrodynamics ; Molar, Third ; Prostheses and Implants ; Tooth Preparation

PURPOSE: To evaluate differential points of patterns of clustered microcalcification between malignant(n=17) and benign(n=46) lesions on mammogram MATERIALS AND METHODS: We retrospectively and prospectively evaluated mammograms of surgically confirmed 63 patients showing clustered microcalcifications. Area, density, number, size, shape of calcification were evaluated along with associated mass and parenchymal distortion. RESULTS: Malignant calcifications were more variable in size(14/17, 77% vs 25/46, 53%) and shape(l 1/17, 64. 8% vs 13/46, 28.2%) than benign counterparts. Pepper, fine granular, branching, comma, tadpole and wormiform calcification were observed in malignant lesion with statistical significance. The malignant calcifications showed more faint(12/17, 70.5% vs 23/46, 50%), irregular margin(17/17, 100% vs 19/46, 42%) and they were usually associated with parenchymal distortion(16/17, 94% vs 9/46, 20%) and ill-defined masses(10/17, 58.9% vs 12/46, 26.1%). CONCLUSION: Clustered microcalcifications with variable size and shape, faint or irregular margin, parenchymal distortion, ill-defined masses seen on mammography, suggest malignancy.
Humans ; Larva ; Mammography ; Prospective Studies ; Retrospective Studies

The authors presented a case of gastroschisis with a pedunculated gallbladder embedded in hepatic tissue. The patient was born after fullterm gestation. Due to extensive abdominal wall defect, she succumbed 3 days after birth. There was a pedunculated mass measuring 2.5x1.5x1.5 cm between the liver and distended stomach without any attachment to the liver. The pedicle of the mass was connected to the common bile duct. Cut surface revealed that the mass was an accessory hepatic lobe encircling the gallbladder. The histologic feature of both accessory liver and gallbladder was markedly altered probably due to vascular obstruction. We could find only a single similar case in literlature. That case was associated with Beckwith syndrome and ours was associated with large atrial spetal defect, large patent ductus arteriosus, accessory spleen as well as gastroschisis. The common feature of abdominal wall defect might be a predisposing factor.

Two cases of vertebra plana due to eosinophilic granuloma were experienced and successfully treated by anterior fusion of the involved spines at the department of Orthopedic Surgery in Seoul National University Hospital. Literature on the subject was reviewed.
Eosinophilic Granuloma ; Granuloma ; Orthopedics ; Seoul ; Spine

Hemangioma in peripheral nerves is a very rare condition. Two such conditions are experienced. One case aceompanied by nerve symptom was observed in ulnar nerve and was operated on by extirpation of the tumor including the nerve and was followed by nerve grafting. The other case involved the median nerve had no signs of nerve irritation and was also treated by tumor extirpation.
Hemangioma ; Median Nerve ; Peripheral Nerves ; Transplants ; Ulnar Nerve

Many difficult problems are encountered in the treatrnent of infected nonunion of long bone. To solve these difficult fractures, authors adopted an active approach-thorough debridement of the infected and necrotic soft tissue and bone, rigid internal fixation with autogenous cancellous bone graft and opening of the wound to ensure continuous drainage until union of the fracture. Authors treated 28 cases of infected nonunions with this method from Mar. 1980 to Feb. 1989, and the results are as follows ;1. Femur(54%) and tibia(43%) were most frequently involved sites. 2. Most of the cases(86%) were treated by rigid internal fixation and cancellous bone graft. 3. In most cases(64%), infection was controlled spontaneously by the time of bony union, but in 5 cases which showed persistent drainage, implant removal controlled the problem, and residual soft tissue and bony defect were solved by Papineau's technique or musculocutaneous flap. 4. Revision was required in 5 cases(18%) because of insercure fixation. 5. Union could be obtained in average 4.8 months, and infection could be controlled in all except 1 case.
Debridement ; Drainage ; Methods ; Myocutaneous Flap ; Transplants ; Wounds and Injuries

Ninety cases of meniscus injury were treated by arthroscopic meniscetomy between March, 1988 and March, 1992. Eighty four cases were treated by arthroscopic partial, 5 cases by subtotal, and 1 case by total meniscectomy. All cases were followed up for more than 1 year. The results were as follows. 1. The ratio of male to female was 57 to 31, and that of right to left was 52 to 38. 2. There were 41 cases of medial meniscus and 49 cases of lateral meniscus. Longitudinal tears were 35 cases (39%), oblique tears were 20 cases (22%), horizontal tears were 15 cases (17%), and radial tears were 9 cases (10%). There was no difference in the shape of tear between medial and lateral meniscus. 4. The most common associated injury was anterior cruciate ligament tear. 5. The Tapper and Hoover scale was used to record the clinical results, and satisfatory results (exellent and good)were in 86% of cases.
Anterior Cruciate Ligament ; Clinical Study ; Female ; Humans ; Knee ; Male ; Menisci, Tibial ; Tears