No abstract available.

No abstract available.
Brain Stem Infarctions*

Moderate to severe unilateral ptosis has previously been treated with levator resection or frontalis sling and cosmetic double fold in the opposite eyelid. This method often resulted in undesirable asymmetrical lid lag phenomenon in down gaze. From December 1991 to December 1994, we treated 65 cases of unilateral ptosis with frontalis sling or levator resection, and simultaneously cosmetic frontalis sling have been performed in the unaffected normal eyes of 41 patients and cosmetic double fold have been performed in the unaffected normal eyes of 11 patients. After 6 months of operation, authors survey the patients content. The number of cases of content were 4(36.36%) in 11 cosmetic double fold group and 31(75.6%) in 41 cosmetic frontalis sling group. The content after cosmetic frontalis sling was higher than cosmetic double fold. Asymmetrical lid lag phenomenon on downward gaze which is inevitable complication postoperatively was reduced by means of cosmetic frontalis sling of unafeected normal eye in unilatral ptosis. The authors expect that the patient will be more satisfied with the result of symmetrical lid lag in down gaze after cosmetic frontalis sling of unaffected normal eye in aesthetic aspect.
Eyelids ; Humans

Tracheobronchial injury is a rare but potentially fatal complication of blunt chest trauma. Delays in diagnosis may occur because the signs are nonspecific and these injuries are infrequent. This case report describes a patient who experienced blunt chest injury with a resulting left main bronchus rupture that was not initially diagnosed. The most challenging aspect of reconstruction surgery for tracheobronchial rupture is to design an effective ventilation method during operation that does not interfere with surgical exposure and allows adequate ventilation. Communication with the surgical team and careful planning of all surgical details are important. We review our experience, the ventilation technique and anesthetic problem encountered in the patient undergoing bronchial reconstruction.
Bronchi* ; Diagnosis ; Humans ; Rupture* ; Thoracic Injuries ; Thorax* ; Ventilation

No abstract available.
Diagnosis*

OBJECTIVE: This prospective study evaluated the ability of indirect 16-row multidetector CT venography, in comparison with Doppler sonography, to detect deep vein thrombosis after total hip or knee replacement. MATERIALS AND METHODS: Sixty-two patients had undergone orthopedic replacement surgery on a total of 30 hip joints and 54 knee joints. The CT venography (scan delay time: 180 seconds; slice thickness/increment: 2/1.5 mm) and Doppler sonography were performed 8 to 40 days after surgery. We measured the z-axis length of the beam hardening artifact that degraded the image quality so that the presence of deep vein thrombosis couldn't be evaluated on the axial CT images. The incidence and location of deep vein thrombosis was analyzed. The diagnostic performance of the CT venograms was evaluated and compared with that of Doppler sonography as a standard of reference. RESULTS: The z-axis length (mean +/- standard deviation) of the beam hardening artifact was 4.5 +/- 0.8 cm in the arthroplastic knees and 3.9 +/- 2.9 cm in the arthroplastic hips. Deep vein thrombosis (DVT) was found in the popliteal or calf veins on Doppler sonography in 30 (48%) of the 62 patients. The CT venography has a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 90%, 97%, 96%, 91% and 94%, respectively. CONCLUSION: The ability of CT venography to detect DVT was comparable to that of Doppler sonography despite of beam hardening artifact. Therefore, CT venography is feasible to use as an alternative modality for evaluating post-arthroplasty patients.
Adult ; Aged ; Aged, 80 and over ; *Arthroplasty, Replacement, Hip ; *Arthroplasty, Replacement, Knee ; Artifacts ; Female ; Humans ; Leg/*blood supply ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Venous Thrombosis/etiology/*radiography/*ultrasonography

PURPOSE: The purpose of this study was to report the sonographic findings of neonatal coccygeal abscess,previously not described. MATERIALS AND METHODS: Eighteen neonates (5-18 days old) presented with swelling in thecoccygeal area and by either open drainage (n=13) or follow-up after antibiotic therapy (n=5), this was diagnosedas coccygeal abscess. We retrospectively reviewed the size, shape, location, echo pattern and marginalcharacteristics of the abscesses, as seen on sonography, as well as their intradural content and relationship withthe spine. Additional MR images (n=5) were separately reviewed. RESULTS: Mean longest diameter of the abscesseswas 1.5cm (range, 0.8-2.3); they were oval or round and located in the subcutaneous fat layer. Echogenicitycompared with surrounding fat varied: in nine patients it was isoechoic, and in nine, hypoechoic. Internalechogenicity was homogenous in 14 patients and heterogeneous in four, and in seven cases, the margin of theabscess was well demarcated. Intradural structure and bony spines were normal, and the possibility of spinaldysraphism, could thus be excluded. All cases except one were correctly diagnosed by sonography and clinicalfindings; on sonography, the echogenicity of one lesion was exactly the same as that of lipoma, and it was thusmisdiagnosed. In cases where sonography revealed an isoechoic mass, the use of MR excluded the possibility oflipoma. Three of five cases showed marginal or diffuse enhancement on contrast enhanced MR images. CONCLUSION: Coccygeal absesses were confined to the subcutaneous fat layer and were either iso- or hypoechoic compared. withsurrounding fat. In neonates, abscess formation in the coccygeal area is possible, and coccygeal abscess shouldtherefore be included in the differentiation of coccygeal masses.
Abscess* ; Coccyx ; Drainage ; Follow-Up Studies ; Humans ; Infant, Newborn* ; Lipoma ; Retrospective Studies ; Spine ; Subcutaneous Fat ; Ultrasonography*

Hepatoblastoma is a primary embryonic liver tumor usually found in children. It extremely rarely occurs in adults. We report a case of hepatoblastoma in a 56 year old man with chronic hepatitis B of 10years duration. Laboratory investigation of the patient on admission showed a marked elevation of alpha-fetoprotein in serum. Ultrasonography and Computerized tomography scan revealed a primary tumor, 6x7cm in size, in the right lobe. The tumor removed by a right lobectomy. Complete removal of the tumor is the treatment which is potentially curative provided that lesion is confined within the liver capsule. The literature revealed and a case of this tumor reviewed.
Adult* ; alpha-Fetoproteins ; Child ; Hepatitis B, Chronic ; Hepatoblastoma* ; Humans ; Liver ; Middle Aged ; Ultrasonography

BACKGROUND: The peritoneal catheter of the continuous ambulatory peritoneal dialysis(CAPD) is patients' lifeline. A significant number of complications and catheter failures in CAPD are due to mechanical problems. We describe our retrospective experience with CAPD focusing on the rate of catheter displacement and survival according to the site of catheter tip placement in 70 cases of CAPD in Kyunghee University Hospital between November 1994 and February 2000. METHODS: We describe our retrospective experience with CAPD focusing on the rate of catheter displacement and survival according to the site of catheter tip placement in 70 cases of CAPD in Kyunghee University Hospital between November 1994 and February 2000. RESULTS: Among 70 cases of CAPD, 46 cases were right pelvic cavity tip placement and 24 cases were left. Causes of chronic renal failure(CRF) were diabetes mellitus in 29 cases(63%), hypertension in 13 cases (28%), glomerulonephritis in 4 cases(9%) in right pelvic cavity catheter tip placement and diabetes mellitus in 13(54%), hypertension in 10(42%), renal tuberculosis in 1 case(4%) left pelvic cavity catheter tip. There were no difference in causative diseases of CRF between both groups. Incidence of CAPD catheter tip displacement were 17.4%(8/46) at right and 4.2%(1/24) at left catheter(p=0.01). Methods for treatment of displacement were fluoroscopic brushing, laparoscopic manipulation and operation. Of the 9 cases, 5 case were received fluoroscopic brushing, 3 case were laparoscopic manipulation and 1 case was received operation. Other complication were peritonitis, catheter obstruction, hernia, death. Overall survival of catheter were 65%(30/46) at right and 71 %(17/24) at left catheter(p=NS). CONCLUSION: The incidence of CAPD catheter tip displacement was higher with catheter tip at the right pelvis than left(p=0.01). But there is no difference in the catheter survival.
Catheter Obstruction ; Catheters* ; Diabetes Mellitus ; Glomerulonephritis ; Hernia ; Hypertension ; Incidence ; Pelvis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Retrospective Studies ; Tuberculosis, Renal