1.Nasal Bone Fractures : Evaluation with Thin-section CP.
Chan Sup PARK ; Chang Hae SUH ; Eul Hye SEOK ; Won Kyun CHUNG ; Ui Suk BYUN
Journal of the Korean Radiological Society 1995;33(2):197-203
PURPOSE: To determine the value of thin-section CT in the diagnosis of nasal bone fractures. MATERIALS AND METHODS: We evaluated the thin-section CT scans of 40 patients with nasal bone fracture. CT scans were obtained with both axial and coronal planes, 1.5mm collimation with 2mm interval, and 9.6cm field-of-view. The axial scan plane was kept parallel to the orbitomeatal line from the nasion to the lower limit of the nose and the coronal plane was kept perpendicular to the axial plane. The data were reconstructed with bone algorithm. Nasal bone fracture was classified into 1 of 3 types on thin section CT:(I) simple fracture;(ll) simple fracture with displacement;(III) comminuted fracture. Associated facial bone injuries were also evaluated Simple radiographs of nasal bone were reviewed for comparison. RESULTS: Six patients had simple fracture, 10 patients had simple fracture with displacement, and 24 patients had comminuted fracture. Twenty-six patients had associated facial bone injuries which included fracture of nasal septum (n=15), fracture of frontal process of maxilla (n=9), fracture of ethmoid (n=6), widening of nasofrontal suture (n=5), and fracture of nasolacrimal duct (n=2). In 15 of 40 patients, CT could identify nasal bone fractures not detected on simple radiographs. CONCLUSION: Thin-section CT is a valuable aid in the evaluation of nasal bone fracture for accurate identification, nature, and combined facial injury.
Diagnosis
;
Facial Bones
;
Facial Injuries
;
Fractures, Comminuted
;
Humans
;
Maxilla
;
Nasal Bone*
;
Nasal Septum
;
Nasolacrimal Duct
;
Nose
;
Sutures
;
Tomography, X-Ray Computed
2.A clinical study of the tibial condylar fractures.
Won Sang PARK ; Seok Woo LEE ; Young Soo BYUN ; Chang Yong HUR
The Journal of the Korean Orthopaedic Association 1993;28(1):253-263
No abstract available.
3.Two Cases of Anterior Urethral Valve.
Young Joon BYUN ; Chang Hee HONG ; Jong Hyun KIM ; Chul Kyu CHO ; Hye Kyung HAN ; Sang Won HAN
Korean Journal of Urology 2000;41(7):897-900
No abstract available.
4.Mandibulotomy, A Surgical approach for Oral cancer: Its Complications and contributing factors.
Seong Kyu BYUN ; Eun Chang CHOI ; Won Se PARK ; Eui Woong LEE ; In Ho CHA
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2000;26(4):422-426
We reviewed 56 patients who received mandibulotomy at Yonsei medical center between 1989 and 1999. We also analysed the complications associated with mandibulotomy and its contributing factors. The complications occur in 16 patients(28.6%) and are classified into two categories; intraoperative and postperative complications. Nonunion was observed in 5 patients and osteoradionecrosis in 5. The patients who received preoperative radiation therapy were more tend to develop nonunion and osteoradionecrosis. This study suggests the benefits of mandibulotomy as a surgical approach to oral cancer: 1. Paramedian osteotomy was recommended for preservation of neurovascular bundle and ease of surgical access. 2. By using thin saw blade, reapproximation was improved with minimal bone loss. 3. osteotomy on anterior mandible which lies outside the usual portals of radiation therapy decreases the incidence of osteoradionecrosis.
Humans
;
Incidence
;
Mandible
;
Mouth Neoplasms*
;
Osteoradionecrosis
;
Osteotomy
5.A Case of Lymphomatoid Papulosis with Atypical Clinical Manifestation.
Young Min PARK ; Sung Woo CHOI ; Dae Gyoo BYUN ; Baik Kee CHO ; Won HOUH ; Chang Suk KANG
Korean Journal of Dermatology 1994;32(2):305-311
We report herein a case of lymphomatoid papulosis showing atypical clinical manifestations. A 54- year-old man had had recurrent erythematous necrotic papules and nodues, numbering more than 200 lesions at the most aggravated time, on the trunk, extremities, buttok, and face for the last twenty years. Recently, he complained of tender swelling on the neck, axillae, and inguinal lymph nodes accompanied by mild fever and gerneral weakness. We had performed thorough examinations including biopsy from the skin lesions, lymph node, and bone marrow to detect some evidences of transforming to malignant lymphoma, but found no evidence of malignant lymphoma except aneuploidy on DNA histogram. The patients showed proinpt response to methotrexate 10-30mg par week wit,hout showing distinct side reactions to the accurvulated dose of 780mg for the last 16 months.
Aneuploidy
;
Axilla
;
Biopsy
;
Bone Marrow
;
DNA
;
Extremities
;
Fever
;
Humans
;
Lymph Nodes
;
Lymphoma
;
Lymphomatoid Papulosis*
;
Methotrexate
;
Neck
;
Skin
6.A Case of Delayed Hemolytic Transfusion Reaction with Acute Renal Failure Caused by Anti-E Antibody.
Mun Su KANG ; Jai Won BYUN ; Chang Ok YOON ; In Soon KIM
Korean Journal of Blood Transfusion 1999;10(2):221-227
A delayed hemolytic transfusion reaction (DHTR) is the result of delayed anamnestic alloantibody response four to fourteen days after transfusion of apparently compatible blood. Most DHTRs are very mild and may not be recognized clinically. Some are manifested only by anemia. Only a few cases are severe enough to induce a massive hemolytic reaction followed by frank renal failure. Recently, we experienced a case of DHTR with acute renal failure (ARF) due to anti-E. A 21-year-old woman received compatible four units of packed red cells after right artificial total hip replacement arthroplasty due to juvenile rheumatoid arthritis. She had a history of transfusion 4 years ago. Fourteen days after the transfusion, she showed a fall in hematocrit, hemoglobinuria and a positive indirect antiglobulin test, and accompanied by ARF. Anti-E was identified in the patient's serum by antibody screening and identification test at that time. She recovered from ARF after hemodialysis with conservative management. However, eventually, she died due to disseminated intravascular coagulopathy.
Acute Kidney Injury*
;
Anemia
;
Arthritis, Juvenile
;
Arthroplasty
;
Arthroplasty, Replacement, Hip
;
Blood Group Incompatibility*
;
Coombs Test
;
Female
;
Hematocrit
;
Hemoglobinuria
;
Humans
;
Mass Screening
;
Renal Dialysis
;
Renal Insufficiency
;
Young Adult
7.CO2 Laser Effect on blood Vessel Repair and Coagulative Ability.
Soon Kwan CHOI ; In Chang LEE ; Jae Won DO ; Won Han SHIN ; Bark Jang BYUN ; In Soo LEE
Journal of Korean Neurosurgical Society 1985;14(1):49-60
Lasers have used safely to and in the resection of highly vascular tumors or arteriovenous malformation. As far as blood vessel coagulation, arteries up to 2mm in diameter and veins up to 3mm in diameter can be reliably sealed with the Nd-YAG laser, and lesser size of vessels can be coagulated with the CO2 laser. Another advantage of laser is to be a useful tool for small vessel repair or anastomosis without microsuture technique. The aim of this experiment was to investigate intensity and duration of exposure with the CO2 laser for vessel coagulation and repair. 36 rats weighing 200 to 250 gm, were used in this study. For vessel coagulation of extracranial arteries and veins, power density between 10 and 50 watts/cm2(W) was applied with handpiece, and for vessel repair or anastomosis 2 W was applied with micromanipulator. The results obtained were as follows : 1) The artery was perforated immediately over 10 W with 0.5 seconds of exposure of smaller focal beam. 2) The artery was constricted in its diameter in defocused beam with 30-40 W, and perforated with 50 W. 3) The lower limit of venous coagulation was 15 W, 0.5 sec. of exposure and 2 mm of focal beam diameter. 4) The lower limit or arterial coagulation was 10 W, 5 sec. of exposure, 4 mm of focal beam diameter, and exposure time was reduced to 3 sec. at 20 W. 5) The repair or anastomosis of artery was accomplished with 2 W, 0.05 sec. of exposure of 0.2 mm of focused beam by 6 times of delivery, and the delivery times could be successfully reduced to half under the overlying thin blood clot film on the anastomosis site of the artery. 6) In the histological examination, the entire layer of coagulated vessel wall on the laser delivered side disclosed marked constriction and destruction. On the anastomosis site, re-endothelialization began from 3 days, and completed by 2 weeks after operation.
Animals
;
Arteries
;
Arteriovenous Malformations
;
Blood Vessels*
;
Constriction
;
Lasers, Gas*
;
Lasers, Solid-State
;
Rats
;
Veins
8.Factors Predicting the Need for Shunting in Patients with Aneurysmal Subarachnoid Hemorrhage - Univariate Analysis and Logistic Regression Analysis -.
Hyung Ki PARK ; Bum Tae KIM ; Jae Chil CHANG ; Sun Chul HWANG ; Sung Jin CHO ; Won Han SHIN ; Soon Kwan CHOI ; Bark Jang BYUN
Journal of Korean Neurosurgical Society 1999;28(10):1459-1466
OBJECTIVE: Chronic hydrocephalus is one of the major complications following aneurysmal subarachnoid hemorrhage(SAH). However the incidence and predicting factors requiring shunting after SAH is not precisely known. The authors investigated the incidence of chronic hydrocephalus, timing of shunting procedure, and factors to predict the need for shunting in patients with aneurysmal SAH. PATIENTS AND METHODS: A series of 209 patients admitted to our institute from January 1993 to December 1997, who presented with SAH and underwent craniotomy for aneurysm clipping were studied retrospectively. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after initial hemorrhage and that required shunting. The author divided study group into shunt group(SG, n=20) and non-shunt group(NSG, n=189). Patients were evaluated based on following factors: age, sex, history of hypertension and diabetes mellitus, consciousness at admission, Hunt-Hess grade, the presence of intracranial hemorrhage, Graeb's score, bifrontal index(BFI), Fisher grade, amount of SAH, location of aneurysm, time of aneurysm clipping, rebleeding, and vasospasm. RESULTS: The incidence of chronic hydrocephalus was 9.6%(20/209). The timing of the shunting procedure ranged from 16 days to 150 days after initial hemorrhage with the average being 77(+/-37)days. In a univariate analysis with chi-square test, age, consciousness, Hunt-Hess grade, amount of SAH, BFI, Fisher grade, and Graeb's score were significantly related with the need for shunting(p<0.05). In a multivariate logistic regression analysis, odds ratio was calculated for each variables. If the odds ratio of below 60 year of age was 1.0 then that of above 61 was 5.4(p<0.001). If the odds ratio of alert/drowsy was 1.0 then that of stupor/coma was 4.4(p<0.05). If the odds ratio of 0 of Graeb's score was 1.0 then that of 1-10 was 4.3(p<0.05). If the odds ratio of amount of SAH below score 3 was 1.0 then that of above score 4 was 1.8. If the odds ratio of BFI below 30 was 1.0 then that of above 31 was 1.1. CONCLUSION: The development of chronic hydrocephalus after aneurysmal SAH is multifactorial, but should be strongly suspected in patients with older age, decreased level of consciousness or IVH at admission. The patients require a shunt from 2 weeks to 5 months from the time of their initial hemorrhage.
Aneurysm*
;
Consciousness
;
Craniotomy
;
Diabetes Mellitus
;
Hemorrhage
;
Humans
;
Hydrocephalus
;
Hypertension
;
Incidence
;
Intracranial Hemorrhages
;
Logistic Models*
;
Odds Ratio
;
Retrospective Studies
;
Subarachnoid Hemorrhage*
9.Cerebellar Cortical Artery Dissection Technique for the Preservation of Operative Fields during Microvascular Decompression for Hemifacial Spasm: Technical Note.
Bum Tae KIM ; Su Bin IM ; Jae Chil CHANG ; Won Han SHIN ; Soon Kwan CHOI ; Bark Jang BYUN
Journal of Korean Neurosurgical Society 1998;27(11):1533-1536
It is important to obtain a good exposure of the root exit zone(REZ) of the facial nerve during microvascular decompression(MVD) for hemifacial spasm(HFS). For this purpose, authors dissected cerebellar cortical artery in addition to exposing the proximal portion of lower cranial nerves. During MVD for HFS, surgeons frequently meet a cerebellar cortical artery along the inferolateral aspect of cerebellar hemisphere. It is usually hemispheric branch of anterior inferior cerebellar artery(AICA) or posterior inferior cerebellar artery(PICA). It is reason that authors have dissected the outside arachnoid membrane attached pia mater of cerebellar cortical artery with a arachnoid knife or microscissor but preserve the inside arachnoid membrane attached dura mater. Microsurgical retractor is placed inferolaterally between cerebellar cortical artery and cerebellar hemisphere and elevated from the floor of the posterior fossa. The subarachnoid cisterns over the lower cranial nerves are opened with sharp dissector and wide operative fields and good exposure of REZ of facial nerve is obtained.
Arachnoid
;
Arteries*
;
Cranial Nerves
;
Dura Mater
;
Facial Nerve
;
Hemifacial Spasm*
;
Membranes
;
Microvascular Decompression Surgery*
;
Pia Mater
10.Diffusion-Weighted MR Imaging in Animal Model with Acute Ischemic Brain Infarction: Evaluation of Reversible Brain Injury.
Woo Mok BYUN ; Han Won CHANG ; Ihn Ho CHO ; Jung Sang HAH ; Eon Gi SUNG
Journal of the Korean Radiological Society 2001;44(4):405-410
PURPOSE: To determine whether the analysis of abnormally high signal intensities in ischemic tissue, as revealed by diffusion-weighted MR imaging (DWI) can be used to evaluate reversible brain lesions in a cat model of acute ischemia. MATERIALS AND METHODS: Ten cats were divided into two groups of five (Group I and Group II), and in all animals the middle cerebral artery was temporarily occluded. Group I underwent T2-DWI 30 minutes after occlusion, and Group II 120 minutes after occlusion. In both groups, DWI was performed one hour and 24 hours after reperfusion (at one hour, non-T2-weighted; at 24 hours, T2-weighted). Both occlusion and reperfusion were monitored by 99m TC-ECD brain perfusion SPECT. All animals were sacrificed 24 hours later and their brain tissue was stained with TTC. Signal intensity ratios (SIR, signifying average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region) of the two groups, as seen on DWI were compared. The percentage of hemispheric lesions occurring in the two groups was also compared. RESULTS: SIR after occlusion of the middle cerebral artery was 1.29 in Group I and 1.59 in Group II. Twenty-four hours after reperfusion, SIR in Group I was higher than in Group II (p<0.01). After occlusion and reperfusion, the percentage of hemispheric lesions in Group I was less than in Group II. For the latter, the percentage of these lesions revealed by TTC staining and T2-weighted imaging was 48% and 59%, respectively, findings distinctly different from those for Group I. In addition, in group I, infarction was revealed by neither TTC staining nor T2-weighted imaging (p<0.01). CONCLUSION: The use of DWI to evaluate signal intensity ratios can help determine whether or not brain injury after temporary cerebral ischemia is reversible.
Animals*
;
Brain Infarction*
;
Brain Injuries*
;
Brain Ischemia
;
Brain*
;
Cats
;
Infarction
;
Ischemia
;
Magnetic Resonance Imaging*
;
Middle Cerebral Artery
;
Models, Animal*
;
Perfusion
;
Reperfusion
;
Tomography, Emission-Computed, Single-Photon