Exploration of the injured brachial plexus is very hard due to the close approximation with other vital structures and the anatomic complexity. It is essential to identify the exact level and type of traumatic brachial plexus injury (BPI) to decide the appropriate surgical approach for the injury and to infer the postoperative prognosis. However, it can be difficult to image the brachial plexus because of the anatomic properties. The purpose of this study is to analyze the diagnostic value of MRI according to various planes of the level and the type of the traumatic BPI. In sixty patients with traumatic BPI, whose diagnosis was confirmed by clinicopathological and surgical findings, the preoperative MRI films were reread retrospectively. Brachial plexus injuries were divided into two groups of preganglionic BPI and postganglionic BPI, and then postganglionic BPI was divided into 3 subgroups of Zone I, Zone II and Zone III by major adjacent structures such as scalenus anterior muscle and pectoralis minor muscle. The accuracy of MRI was investigated with the confirmed diagnosis on axial, sagittal and coronal planes. In preganglionic BPI, the accuracy of MRI was 96% on axial plane and it was statistically significant compared to sagittal and coronal planes. In postganglionic BPI, the accuracy of MRI was 100% on sagittal plane and 86% on coronal plane in Zone I, but it was not significant statistically. In Zone II and III the accuracy of MRI were 89% and 80% on sagittal plane, and 61% and 60% on coronal plane, but it was not significant statistically. In conclusion, the MRI can provide useful guidance to diagnose preganglionic and postganglionic BPI. Axial imaging is considered better for preganglionic lesion and sagittal imaging for postganglionic BPI, but it demands further study on larger number of subjects with traumatic RPI.
Brachial Plexus* ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Prognosis ; Retrospective Studies

A case of vesicorectal fistula, which occurred in 23 year-old male Korean soldier due to external violence was presented and literature was briefly reviewed.
Fistula* ; Humans ; Male ; Military Personnel ; Violence ; Young Adult

A clinical observation of the bladder and urethral injuries was made in the army hospital from Jan. to Dec 1968. The results were obtained as follow; 1. The bladder and urethral injuries were 2.3% of all patients treated in the hospital in the last year. 2 The bladder and urethral injuries were 23 cases of the automobile accidents, excluding 3 cases of expulsive injuries and 2 cases of falling accidents 3. The bladder and urethral injuries associated with fracture of pelvic bone were 32.1%, especially 80% in the pubic ramus fracture. 4. The incidence of urethral injury was higher than bladder injury. 5. The complications were urethral stricture (80%). impotence and etc.
Automobiles ; Erectile Dysfunction ; Hospitals, Military ; Humans ; Incidence ; Male ; Pelvic Bones ; Urethral Stricture ; Urinary Bladder*

A case of epidermal cyst arising from the frenulum of the penis in an eighteen year-old male was presented with review of literatures.
Epidermal Cyst* ; Humans ; Male ; Penis*

No abstract available.
Child* ; Humans ; Infant*

To provide a guideline of accurate diagnosis and proper methods of treatment of meningioma, the most common benign intracranial tumor, the author studied 57 cases of meningioma who had been diagnosed and operated at the Department of Neurosurgery, Inje Medical College, Paik Hospital, Pusan from July, 1983 to June, 1988. The results were as followings. 1) The ratio of male to female was 1 to 2.2 and 31.6% of the 57 patients were in the 5 th decade of age and 29.8% in the 6 th decade. 2) The predilection sites were parasagittal and falx(33.3%), convexity(26.3%) and sphenoid ridge (21.1%) areas. The most frequent histological type was meningotheliomatous type(47.4%) which was followed by transitional(15.8%) and fibroblastic(10.5%) type. 3) The common initial clinical features were headache(29.3%), visual disturbance(24.6%), seizure(22.8%) and motor weakness(10.5%). In radiologic diagnostic tests, there were abnormal findings in 47.4% on plain skull X-ray, the possibility of diagnosis as the meningioma was 91.2% by means of brain CT scan only, which was regarded as the most accurate and safe method. 4) The extent of operation were total(84.2%), subtotoal(12.3%) and partial(3.5%) removal, The surgical outcome were excellent(49.1%) and good(29.8%). 5) The preoperative embolization of feeding artery was effective to reduce the operative bleeding, and the CO2 laser was thought to be effective surgical tool to remove the meningioma, with its unique properties of non-mechanical bloodless evaporation of tumor and minimalizing of brain edema.
Arteries ; Brain ; Brain Edema ; Busan ; Diagnosis ; Diagnostic Tests, Routine ; Female ; Hemorrhage ; Humans ; Lasers, Gas ; Male ; Meningioma* ; Neurosurgery ; Skull ; Tomography, X-Ray Computed

This report describes three cases of large arteriovenous malformation which were removed totally with two stage operation. When a large arteriovenous malformtaion had to be removed, prediction of profuse bleeding and brain swelling could be made. We clipped large feeding arteries and arteires and made a cleft around the AVM during the first operation, and the progressive reduction of the shunt flow by clipping the dominant peduncles on after the other diminished the risk of profuse bleeding and brain swelling. 7 to 10 days later, we removed AVM totally as the second operation. All three lesions were resected by microsurgical techniques, and the results were excellent. The rationale for the two stage operation for large cerebral AVM is discussed.
Arteries ; Arteriovenous Malformations ; Brain Edema ; Hemorrhage ; Intracranial Arteriovenous Malformations*

Intracranial aneurysms are usually regarded as congenital in origin but their etiology is unknown. The occurrence of familial aggregation of intracranial aneurysm is rare but well documented, and suggests a hereditary basis for some intracranial aneurysms. We experienced two cases of intracranial aneurysm in monozygotic twin brothers and reviewed literatures.
Humans ; Intracranial Aneurysm* ; Siblings ; Twins, Monozygotic*

We analyzed the 43 cases of the posterior fossa tumors at the Busan Paik Hospital, Inje Medical College from January 1980 to December 1986. The posterior fossa tumors included 12 cases of cerebellar astrocytoma, 10 cases of acoustic neurinoma, 5 cases of medulloblastoma, 5 cases of brain stem glioma, 2 cases of meningioma, 2 cases of hemangioblastoma, 2 cases of tuberculoma, 1 case of glioblastoma multiforme, 1 case of oliodendroglioma, 1 case of rhabdomyosarcoma, 1 case of glomus jugulare tumor and 1 case of arteriovenous malformation. The posterior fossa tumors were occupied on the cerebellar hemisphere in 18 cases, the cerebellar vermis in 8 cases, the cerebellar pontine angle in 12 cases and the brain stem in 5 cases. The 25 cases out of the 43 cases of the posterior fossa tumors were accompanied with hydrocephalus. The 10 cases received the radiation therapy and/or the chemotherapy after operation. After treatment of the posterior fossa tumors, 52.6% favorable outcome, 34.2% unfavorable outcome and 13.2% mortality were estimated.
Arteriovenous Malformations ; Astrocytoma ; Brain Stem ; Busan ; Drug Therapy ; Glioblastoma ; Glioma ; Glomus Jugulare Tumor ; Hemangioblastoma ; Hydrocephalus ; Infratentorial Neoplasms* ; Medulloblastoma ; Meningioma ; Mortality ; Neuroma, Acoustic ; Rhabdomyosarcoma ; Tuberculoma

Author reviewed the 31 cases of multiple intracranial aneurysms clinically from January 1981 to July 1987, at Inje College Busan Paik Hospital. The results obtained were as follows: 1) The incidence of multiple intracranial aneurysm was 7.8%. In most cases(94%), the number of aneurysm was two. 2) Approximately over 70% of patients were 6th and 7th decades, male to female ratio was 1:3.4. 3) The location of multiple intracranial aneurysms was in order, on the opposite side(39%), on the same side(26%), one in the midline and one on the side(29%). The location of indivisual aneurysms was in order, P-com. A(36%), MCA(25%), A-com. A(17%), ICA(13%). 4) The site of the ruptured aneurysm was determined by CT finding(55%), focal mass effect and spasm in angiography(29%), and others. The accurary was 97%. The possibility of rupture at each location was A-com. A(73%), P-com. A(57%), ICA(38%), MCA(31%). 5) 12 cases among them were treated with one-stage operation and 9 cases with two-stage operation. The post-operative favorable outcome was estimated in 13 cases(54%), the surgical mortality was 13%. There was no statistical difference between two groups.
Aneurysm ; Aneurysm, Ruptured ; Busan ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Rupture ; Spasm