No abstract available.
Spondylolisthesis*

PURPOSE: The purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminally-placed bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). METHODS: Transluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 69+/-7 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (2-18 months). RESULTS: Primary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. CONCLUSIONS: Endovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard<0A397>) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed.
Acute Kidney Injury ; Anesthesia, Epidural ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Endoleak ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Artery ; Male ; Mortality ; Sepsis ; Spasm

No abstract available.
Humans ; Longitudinal Ligaments* ; Spine*

OBJECTIVE: To determine the efficacy of various posterior fusion techniques in managing C1/2 instability. PATIENTS AND METHODS: Retrospective review of patients undergoing C1/2 posterior fusioin was undertaken with the aim of determining the long-term outcome of the selected procedures. Forty-two patients requiring posterior atlantoaxial fusion for various pathologies were treated with various instruments for internal spinal fixation. Forty-two patients underwent 45 procedures from 1990 to 1997, with a mean follow-up of 2.7 years(range 8 months-7 years) RESULTS: The most common disease processes were odontoid fracture(12 patients), os odontoideum(13), and rheumatoid instability(7). Nineteen interspinous wirings, 17 transarticular screw fixations, 9 halifax clamp applications were performed. Three of Halifax fixation and 2 of wiring failed in long term follow up. Among of them, bony fusion was failed in 3 patients which consequently required reoperation. All transarticular screw procedures resulted in successful fusions. CONCLUSIONS: Transarticular screw fixatioin has several potential advantages compare to other procedures as a technique for C1/2 posterior arthrodesis.
Arthrodesis ; Follow-Up Studies* ; Humans ; Pathology ; Reoperation ; Retrospective Studies

We studied the effectiveness of serotonin 1a agonist(8 OH DPAT) on the 24 hour ionic lesion volume produced by permanent occlusion of the middle cerebral artery(MCAo) in rats. A 4-hour intravenous infusion of 30 micro mg/kg/hr of 8 OH DPAT were given starting at 10 minutes after occlusion. Tissue concentrations of Na, K, and water at infarct and peri-infarct zone were measured by atomic absorption spectroscopy and by wet-dry weight measurements 24 hours after occlusion. Compared with vehicle treatment, 8 OH DPAT treatment reduced tissue water accumulation by 10% and 55% in the frontopyriform cortex(L1) and frontoparietal cortex(L2), sodium accumulation by 20% at L1 and 47% at L2, potassium loss by 24% at L1 and 44% at L2, cell volume fraction loss by 24% at L1 and 47% at L2. Finally the treatment reduced overall lesion volume by about 37%. All these changes were statistically significant at p<0.05. Our findings suggest strongly that 8 OH DPAT is neuroprotective in the rat MCAo model of focal cerebral ischemia.
Absorption ; Animals ; Brain Ischemia ; Cell Size ; Infarction, Middle Cerebral Artery* ; Infusions, Intravenous ; Ischemia* ; Middle Cerebral Artery* ; Potassium ; Rats* ; Receptor, Serotonin, 5-HT1A* ; Serotonin* ; Sodium ; Spectrum Analysis

Essential hyperhidrosis is a condition with excessive secretion of sweat, which may be localized in any part of the body. Most common is palmar or plantar hyperhidrosis. Severe hyperhidrosis may cause serious psychological and occupational problems. Of the Numerous treatment recommended for this condition, only surgical removal of the sympathetic nerve supply seems permanently effective. Fifty-three patients were operated on for hyperhidrosis of the upper extrimity during the period from 1989 to 1992. Resection of the upper thoracic ganglia and the connecting sympathetic chain was carried out using a posterior approach. All hands of patients were dry immediately after the operation. During a follow up period of between three months to three years, there was no recurrence of palmar sweating. Fifteen of the patients showed compensatory hyperhidrosis in trunk, mild Hornor syndrome was noted in two cases. Most of the patients were satisfied with the surgical result.
Follow-Up Studies ; Ganglia ; Hand ; Humans ; Hyperhidrosis* ; Recurrence ; Sweat ; Sweating ; Sympathectomy*

No abstract available.
Religion and Medicine ; History of Medicine ; History, 19th Century ; History, 20th Century ; Hospitals ; Missionaries ; Physicians ; Diplomacy ; Republic of Korea

A 45-Year-old para 1-0-1-1 had submucosal myoma diagnosed by ultrasonogram and hysteroscopic examination. During 60 minutes hysteroscopic myomectomy, 8,000 ml of sorbitol-mannitol distention medium was used and 6,500 ml collected, resulting in a deficit of 1,500 ml. The patient received Ringer`s lactate 1,000 ml intravenously. Her urine output was 400 ml. Blood loss was 40 ml. After operation, hyponatremia(115 mEq/L) was developed and pulmonary edema was also diagnosed clinically at that time and later confirmed by chest radiograph. The judicious administration of diuretics and normal saline fluid replacement to prevent overcorrection to hypernatremia resulted in return of serum electrolytes to normal level and resolution of the pulmonary edema by postoperative day 1. We have experienced a case of pulmonary edema during hysteroscopic myomectomy with sorbitol-mannitol distention medium, which is presented with a brief review of literatures.
Diuretics ; Electrolytes ; Humans ; Hypernatremia ; Hyponatremia ; Lactic Acid ; Middle Aged ; Myoma ; Pulmonary Edema* ; Radiography, Thoracic ; Ultrasonography

The purpose of this study was to establish whether pre-injury administration of the methylprednisolone sodium succinate(MP) is effective for the treatment of acute spinal cord injury in rat, as it has ben demonstrated that high dose of MP is effective in the treatment of acute spinal cord injury. Spinal cord injury was made by dropping a rod weighing 10 gm from a height of 1.25, 2.5, and 5.0cm onto the rat spinal cord at T-10, which had been exposed via laminectomy. In order to determine the effectiveness, single dose of 5, 15 and 30mg/kg of MP was administrated at 10 minute before injury. The primary outcome was 24-hour spinal cord lesion volume estimated from spinal cord Na+ and K+ shifts. Surprisingly, we failed to find any statistically significant preventive effect compare to control vehicle. Until this result is clearfied, we recommend that acute pre-injury MP therapy be cautiously applied in operating room. The possible causes of this unexpected result are discussed.
Animals ; Laminectomy ; Methylprednisolone* ; Operating Rooms ; Rats ; Sodium ; Spinal Cord Injuries* ; Spinal Cord*

Intramedullary schwannomas without evidence of Von Recklinghausen's disease are extremely rare. We report a case of solitary intramedullary schwannoma of the dorsal spinal cord and review the literature on these rare neoplasms. The possible etiology of the tumor as well as wome difficulties encountered in the diagnostic procedure and treatment are discussed.
Neurilemmoma* ; Neurofibromatosis 1 ; Spinal Cord ; Spinal Cord Neoplasms ; Spine*