Fetal echocardiography is used by means of decleration of fetal cardiac anaztomy, to estabilish the diagnosis of congenital heart disease in utero. We attemped fetal echocardiography to ninty three pregnant women after intra uterine period 24 weeks, and estimated cardiac circumference, cardiac axis, pulmonary atery root diameter, arortic root diameter, diameter of inferior vena cava, diameter of superior ve studied how these estimates associate with following gestational na cava, and fractional shortening of ventricles. We ages. Cardiac axis was on the average 37.28 degree and cardiac apex was located in anterior left side of chest area. Aortic root diameter was 0.227 GA-0.043mm (GA=gestational age) at systolic phase, 0.203 GA+0.421mm at diastolic phase. Pulmonaly root diameter was 0.271 GA-0.029mm at systolic phase, 0.251 GA-0.067mm at diastolic phase. Thoracic aorta diameter was 0.195 GA+0.109mm at systolic phase, 0.198 GA+0.794mm at diastolic phase. Fractional shortening was 0.24 (1 Standard Deviation=0.11) in right ventricle, 0.23(1 SD=0.154) at left ventricle, and so ratio of right and left ventricle was 1.04(1 SD=0.51). Once normal fetal cardiac anatomy is understood, structural defects and/or alternation of function can be evaluated antenatally.
Aorta, Thoracic ; Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Female ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Pregnant Women ; Thorax ; Vena Cava, Inferior

Acute mobile thrombus of the abdominal aorta after chemotherapy is a very unusual finding, which can be a potential source of arterial embolism. We report here on a case of an acute mobile aortic thrombus with renal infarction. We successfully treated the patient with hybrid operation-open surgical and endovascular approach. Our case shows that hybrid treatment using wire-directed balloon catheter thrombectomy is a feasible, minimally-invasive treatment for a mobile aortic thrombus.
Angioplasty ; Aorta ; Aorta, Abdominal ; Catheters ; Chimera ; Embolism ; Humans ; Infarction ; Thrombectomy ; Thrombosis

Epiblepharon is frequently encountered n oriental eyelid, especially in children. It is characterized by a horizontal fold of redundant skin and abundant orbicularis muscle near lid margin, which the lashes vertically, or posteriorly towards the eye. Surgical therapy of epiblepharon in correcting the trichiasis includes lid bracing sutures, burried sutures, skin resection, a Hotz procedure or its modification, and a Jones procedure. In our opinion, these procedures are not sufficient, because these procedures will not correct the epicanthal folds. Epicanthal folds have been a one of the characteristics of Asian over 50 percents of population in Japan and South Korea, and it either reduce the aesthetic result of the double-eyelid procedure or make the correction of the entropion and epiblepharon difficult. Although many surgical procedures are available to eliminate epicanthal folds, scarring on the medial canthus is in still and obstacle for surgeons to overcome. From January of 1998 to October of 1998, we used half z-plasty procedures in 5 cases to correct epicanthal folds in epiblepharon. There were few complications in our series. We believe that half z-plasty can get a good result in the correction of epibolepharon and oriental epicanthal folds.
Asian Continental Ancestry Group ; Braces ; Child ; Cicatrix ; Entropion ; Eyelids ; Humans ; Japan ; Korea ; Skin ; Sutures ; Trichiasis

PURPOSE: To evaluate the results of antegrade interlocking intramedullary nailing for complex fractures of the proximal and midshaft of the humerus. MATERIALS AND METHODS: We retrospectively analyzed the clinical and radiologic results in 11 cases, which were treated by antegrade interlocking intramedullary nail. We assessed clinical outcomes according to ASES scoring system and radiological result. RESULTS: All cases had bony union and the mean union period was 14.7 weeks. Postoperative complications were 1 loss of fixation, 2 proximal protrusion of nail and 2 temporary shoulder pain. A case with loss of fixation was treated open reduction and refixation and had union at 14 weeks postoperatively. The mean ASES score was 85.9 and the clinical outcomes were 4 excellent, 5 good, 1 fair and 1 poor. CONCLUSION: Intramedullary nailing for complex fractures of the proximal and midshaft of the humerus can offer a reliable treatment option.
Fracture Fixation, Intramedullary ; Humerus ; Nails ; Postoperative Complications ; Retrospective Studies ; Shoulder Pain

No abstract available.
Ligaments*

The purpose of this article is to report on the first known Korean case of Susac syndrome. An 18-year-old female came to our clinic reporting blurred vision of the left eye for 2 days. She also complained of decreased hearing with tinnitus of the right ear and mild headache. She was previously healthy and had no remarkable medical history. Best-corrected visual acuity was 20 / 50 in the left eye and 20 / 20 in the right eye. An axiomatic triad of ocular, cochlear, and neurologic involvement was observed in the patient. Fluorescein angiography showed branched retinal arterial occlusions in the left eye. A sudden right sensorineural hearing loss was observed on audimetry. Magnetic resonance images showed a hyperintense lesion in the white matter around the corpus callosum. The patient was treated with high doses of systemic corticosteroids, and no neuropsychological sequelae were observed. This is the first case report of Susac syndrome in Korea. In cases of retinal arterial occlusion with hearing loss or neuropsychological symptoms, Susac syndrome should be suspected.
Adolescent ; Diagnosis, Differential ; Female ; Fluorescein Angiography ; Fundus Oculi ; Hearing ; Hearing Loss, Sensorineural/*diagnosis/physiopathology ; Humans ; Magnetic Resonance Imaging ; Retinal Artery Occlusion/*diagnosis/physiopathology ; Susac Syndrome/*diagnosis/physiopathology ; Visual Acuity

Total hip arthroplasty in patients with chronically dislocated hips poses many challenging technical problems. Abnormal relationship of bones and soft tissues occurs in chronic complete dislocation of the hip (grade IV, Crowe's classification). Problems in placing the acetabular component in the true acetabulum include, first how to cover the acetabular component sufficiently, second how to fix it securely and last how to avoid excessive stretching of the neurovascular structures such as the sciatic nerve. The authors have introduced a technique of one stage distal femoral shortening in order to avoid excessive stretching of the neurovascular structures. From December 1988 to May 1996, the total hip arthroplasties combined with one stage distal femoral shortening were carried out in chronic complete dislocation of 44 hips (grade IV, Crowe's classification) and followed-up more than two years. This method has several advantages: It preserves wide and healthy proximal metaphysis of the femur, does not need greater trochanteric osteotomy, and provides many chances to choose the appropriate stem size and shape, especially in cementless total hip arthroplasty.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Dislocations ; Femur ; Hip Dislocation* ; Hip* ; Humans ; Osteotomy ; Sciatic Nerve

The treatment of choice for post-intubation tracheal stenosis is partial tracheal resection and end-to-end anastomosis. The surgical treatment of tracheal restenosis that results from unsuccessful repair of post-intubation tracheal stenosis is not easy. Failed reoperation results in permanent tracheostomy and loss of voice. If the first operation fails, about 4~6 months of period for resolution of inflammatory reaction, edema, and fibrosis is needed. The exact evaluation of the patient's status is necessary and success rate of reoperation for the appropriate candidates is over 90%. We report the results of treatment in two cases of tracheal restenosis that resulted from unsuccessful repair of post-intubation tracheal stenosis with review of literatures.
Edema ; Fibrosis ; Reoperation ; Tracheal Stenosis* ; Tracheostomy ; Voice

OBJECTIVE: Radiation injury includes radiation necrosis and apoptosis. Though some of its mechanism in brain are reported, those in spinal cord are not determined yet. The purpose of this study is to see whether nimodipine, one of calcium channel blockers, is effective for the prevention of high dose irradiation-induced apoptosis in the rat spinal cord. METHODS: Forty eight Sprague-Dawley rats were divided into four experimental groups, such as non-treated group(control group) after 5Gy and 10Gy irradiation(n=24), and nimodipine-treated group after 5Gy and 10Gy irradiation(n=24). Each group was divided by irradiation doses. After the drug was administered, the spinal cord was exposed to 5Gy and 10Gy dose of gamma rays using Ir-192. All spinal cord underwent histological examination at 4 hours, 8 hours, 12 hours after irradiation to evaluate the number of apoptotic cells. Apoptotic cells were detected by TUNEL assay, and determined by direct visual counting at x200, magnification RESULTS: In nimodipine-treated group, apoptotic cell counts were reduced significantly, compared to that of control group after irradiation(p < 0.05). CONCLUSION: These results suggest that nimodipine treatment may have effects on the prevention of radiationinduced apoptosis. If it could be established that calcium channel blockers inhibit radiation injury, they might be useful in radiation therapy.
Animals ; Apoptosis* ; Brain ; Calcium Channel Blockers ; Cell Count ; Gamma Rays ; In Situ Nick-End Labeling ; Necrosis ; Nimodipine* ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord*

Endovascular aneurysm repair is a minimally invasive, durable and effective alternative to open surgery for treatment of abdominal aortic aneurysms (AAA). However, in patients who do not have an adequate sealing zone, open surgical repair is required, which may increase mortality and morbidity. An alternative treatment in patients with challenging anatomy is the so-called "chimney graft" technique. Here, we describe a case using the chimney graft technique for treatment of juxtarenal type I endoleak followed by a previous conventional stent graft insertion to the AAA with good results.
Aneurysm ; Angioplasty ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak* ; Humans ; Mortality ; Transplants