The transarterial embolization procedures have been performed in a total of 38 patients with head and necklesions, including 5 carotid-carvernous fistulas, 1 internal carotid aneurysm, 10 meningiomas, 16 nasopharyngealangiofibromas, 1 post-traumatic epistaxis and 5 other vascular tumors, over the 18 months-period. Six cases of C-Cfistulas and ICA aneurysm were treated with the detachable balloon catheter technique. The meningiomas, angiofibromas and all other lesions were embolized with superselection of the branches of the external carotidartery such as the internal maxillary, the middle meningeal, the ascending pharyngeal, the facial or otherbronches, using Berenstein superselective catheters of conventional angiographic catheters. The PVA(polyvinylalcohol foam) and/or Gelfoam particles were used as embolic materials in these cases. Most of the lesions weresuccessfully embolized with minor transient complications such as pain, headache, vomitting, fever and etc. But in4 cases occurred the serious complications; one cerebral hemorrhage, two cerebral infarctions, and one acutelaryngeal edema. The selection of the embolic materials and the catheters, and the complications are brieflydiscussed.
Aneurysm ; Angiofibroma ; Catheters ; Cerebral Hemorrhage ; Cerebral Infarction ; Edema ; Epistaxis ; Fever ; Fistula ; Gelatin Sponge, Absorbable ; Head ; Headache ; Humans ; Meningioma ; Neck

The goal of total knee replacement is to relieve pain, to stabilize joint movement and to correct deformity. It is indicated for patients with rheumatoid arthritis, osteoarthritis and severe post-traumatic arthritis. The author analyzed 71 patients(106 cases), who received the PFC type of total knee replacement from August 1992 and the results were as follows; 1. Among the 71 patients, male was 8 patients and female was 63 patients whose average age was 56 years and average follow up period was 24 months, ranged from 8 months to 3 years 8 months. 2. Rheumatoid arthritis was the most common cause with 31 patients(56 cases) followed by osteoarthritis with 39 patients(49 cases). There was also one patient(1 case) that showed bony union of the knee due to old tuberculosis. The average duration of the illness was 12 years and the average weight of the patients was 57.7kg. 3. Flexion contracture decreased from an average of 21 degrees to 5 degrees after the operation. The range of motion increased from an average of 92 degrees before the operation to 117 degrees afterwards in cases of rheumatoid arthritis and decreased slightly from 108 degrees to 106 degrees in cases of osteoarthritis. 4. The tibiofemoral angle was corrected from an average 1.5 degrees varus before the operation to an average 6.7 degrees valgus after operation. Eighty seven percent of patients with rheumatoid arthritis showed valgus deformity and seventy eight percent of degenerative osteoarthritis patients showed varus deformity preoperatively. 5. Radiographically, the joint line position shifted an average 2.3mm in rheumatoid arthritis and an average 0.3mm in osteoarthritis. The component position, the femoral flexion was an average 89.6 degrees in the anteroposterior view, an average 87 degrees in the lateral view. 6. The thickness of the patella measured in the operating room of 61 cases was an average 21mm and after resection of patella, the remaining bone measured an average of 13.6mm. 7. To achieve soft tissue balance, 29 patients(33 cases) underwent medial stripping and 23 patients(30 cases) had patella lateral release. 8. The Insall Knee Rating Score was used to evaluate the results. The results were 69 cases excellent, 33 cases good, 3 fair and 1 poor. Ninety two percent of the patients had good or excellent results in average 24 months follow-up. 9. The complications consisted of one case of delayed deep infection, one case of patellar subluxation and one case of supracondylar fracture of the femur.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Female ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Operating Rooms ; Osteoarthritis ; Patella ; Range of Motion, Articular ; Tuberculosis

The antiphospholipid syndrome is characterized by arterial thrombosis, venous thrombosis, pregnancy wastage, and thrombocytopenia associated with a persis tently positive lupus anticoagulant and/or moderate to high positive anticardiolipin antibodies(IgG or IgM). The antiphospholipid antibodies have been detected in many medical conditions, but the antiphospholipid syndrome (APS) has mainly been restricted to the primary antiphospholipid syndrome and APS associated with systemic lupus erythematosus. Rarely, the APS has been reported in other autoimmune disorders in the literature. We describe a woman with a limited form of scleroderma and the APS manifested by complete occlusion of left axillary artery with probable thrombotic occlusive nature, thrombocytope nia, prolonged aPTT, and persistently positive lupus anticoagulant.
Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Axillary Artery ; Female ; Humans ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Pregnancy ; Scleroderma, Limited* ; Thrombocytopenia ; Thrombosis ; Venous Thrombosis

We report a case of acute intermittent porphyria presenting with variable symptoms and signs such as hypertension, polyneuropathy, syndrome of inappropriate secretion of antidiuretic hormone and cerebral infarction. A 47 year-old female patient entered hospital with abdominal pain followed by generalized seizure. She was diagnosed to have acute intermittent porphyria in consequence of Watson-Schwartz test and δ-ALA in 24 hours urine. She was managed with conservative treatment but died of respiratory failure.
Abdominal Pain ; Cerebral Infarction ; Female ; Humans ; Hypertension ; Polyneuropathies ; Porphyria, Acute Intermittent* ; Respiratory Insufficiency ; Seizures

The study was undertaken to assess the ventricular system of the brain in normal korean adults on the base ofCT. The computerized tomographic examinations of 334 Korean adults between ages of 15 to 50 years, performed atSeoul National University Hospital, were evaluated. The known to be a reliable indicator of the ventricular size.This ratio was measured at the level of the lateral, third and fourth ventricles respelctively. The shape of thequardigeminal and suprasellar cistern was analyzed. The resuls are as follows; 1. The cerebroventricular ratios ofthe lateral ventricle at the level of the widest bifrontal and bicaudate diameters were 0.30±0.04 and 0.14±0.02,respectively. The lateral ventricle was asymmetric in 12.6%, of which the left side was usually larger than theright. 2.There was correlation between the cerebroventricular ratio and age, i,e., with increase of age, the C-Vratio increased slightly. 3. The cerebroventricular ratio of the third ventricle was 0.03±0.01. 4. Thecerebroventricular ratio of the fourth ventricle in width and height was 0.14±0.02 and 0.10±0.03, respectively.The anteroposterior position index of the fourth ventricle was 0.42±0.04. 5. The quadrigeminal cistern showedU-shape in 23.4%. 6. The suprasellar cistern showed pentagonal shape in 61.1%, round in 28.4% and hexagonal in10.5%. 7. There was no significant difference between male and female according to the above results.
Adult ; Brain ; Female ; Fourth Ventricle ; Humans ; Lateral Ventricles ; Male ; Third Ventricle

Transcatheter infusion of absolute ethanol was applied clinically in 3 cases of artificial embolization; 25yrsold female with bilateral renal angiomyolipoma, 19yrs old female with right paralumbar liposarcoma and 25 yrs oldmale with hypernephroma of right kidney. Selective or subselective manual infusion was made and 9 to 22cc of pureethanol was delivered in a speed of 1 to 2cc per second. The sclerosing effect of absolute ethanol was potent.However, all 3 cases revealed mild post-emboliaztion syndrome.
Angiomyolipoma ; Carcinoma, Renal Cell ; Ethanol ; Female ; Humans ; Kidney ; Liposarcoma

197 spine CTs were performed from 29th, March 1982 to 7th March, 1984. Among them, 39 patients preoperatively diagnosed as herniated nucleus pulposus ar bulging disc with CT and myelography were operated. 43 disc spaces ofdisc disease were analysed in true positive and false negative cases. Finally the accuracy, sensitivity and specifictiy of spine CT and myelography ar calculated. The resuslts are as follows; 1. The CT findings of disc diseases are in order of frequency, asymmetrical obliteration of epidural fat (82%), ventral indentation orcompression on dural sac(72%), focal protrusion of disc(64%), root changs
Constriction, Pathologic ; Humans ; Hypertrophy ; Intervertebral Disc Displacement ; Methods ; Myelography ; Spine ; Vacuum ; Zygapophyseal Joint

Thirty-six patients (24 with oral cavity or oropharynx cancers and 12 larynx cancers) were prospectively examined with computed tomography (CT) to determine its value in staging the primary tumor and to compare with the clinical staging. The CT staging agreed with the clinical staging in 50% (12/24) of the oral cavity or oropharynx cancers and in 67% (8/12) of the larynx cancers. The CT upgraded the clinical staging in 29% (7/24) of the oral cavity or oropharynx tumors and in 33% (4/12) of the larynx cancers, whereas the CT downgraded the clinical staging in 21 % (5/24) of the oral cavity or oropharynx cancers. There is no downgrade on CT in larynx cancer. The post-surgical confirmation was not made in most of the cases. The possible causes of disagreement between the CT and the clinical staging, and the diagnostic value of the CT in evaluation of the primary tumor in oral cavity, oropharynx and larynx were discussed.
Head and Neck Neoplasms ; Head ; Humans ; Laryngeal Neoplasms ; Larynx ; Mouth ; Oropharyngeal Neoplasms ; Oropharynx ; Prospective Studies

Fity-four patients with head and neck cancers were prospectively examined with the CT to determine its valuein staging cervical lymph nodes metastases and to compare with the clinical staging. The CT staging agreed withthe clinical staging in 61%(33/54), upgraded the clinical staging in 22%(12/54) and downgraded in 17%(9/54). Thepost-surgical confirmation was made in only 11 patients, The possible causes of disagreement between the CT andthe clinical staging, and the diagnostic value of the CT in the evaluation of the cervical nodes metastases werediscussed.
Head and Neck Neoplasms ; Head ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Prospective Studies

Eighty-eight patients who presented with a variety of head and neck symptoms were examined with intravenous oritraarterial digital subtraction angiography (IV or IA DSA), using the DSA equipment developed by Seoul NationalUniversity Hospital. A grading system was used to evaluate the ability of DSA to answer specific diagnsoticquestions. Diagnostic information without need of further study was obtained in 71% with IV DSA, in 86% withaortic arch DSA and in 81% with selective arterial DSA, showing a total of 79% of diagnostic accuracy with DSA. Itis concluded that IV DSA is useful in the evaluation of the cervical carotid and vertebral arterial disease, andpituitary mass lesion, while IA DSA is useful in the evaluation of the cervical carotid and vertebral arterialdisease, and pituitary mass lesion, while IA DSA is useful in the evaluation of most of the intracranial lesions,spinal arteriography and intra-arterial embolization. DSA is both an accurate and safe imaging modality in thestudy of head and neck diseases.
Angiography ; Angiography, Digital Subtraction ; Head ; Humans ; Neck ; Seoul