The effects of hyperbaric oxygen on radiation cystitis have been reported in patients with radiation-induced hemorrhagic cystitis refractory to conventional therapy. Cessation of gross hematuria and reversal of cystoscopic bladder changes were seen in response to a series of hyperbaric oxygen therapy of 3 atmosphere absolute pressure for 2 hours. We report the experience of 2 cases of hyperbaric oxygen therapy for radiation-induced cystitis.
Atmosphere ; Cystitis* ; Hematuria ; Humans ; Hyperbaric Oxygenation ; Oxygen* ; Urinary Bladder

The septum formation(web) of bile duct is an uncommon disease. Its rarity and vague symptoms result in delayed diagnosis. However, the increased use of endoscopic retrograde cholangiopancreatography(ERCP) and percutaneous transhepatic cholangiography(PTC) have resulted in greater awareness of this entity and understanding of its natural history as well as an increased frequency of diagnosis. We have experienced 4 cases of common bile duct web, which were associated with stones in the bile duct, confirmed by operation.
Bile Ducts ; Common Bile Duct* ; Delayed Diagnosis ; Diagnosis ; Natural History

BACKGROUND: Thalium 201(TI-201) has been a widely applied myocardial perfusion agent for the detection of coronary artery disease. however its low emission energy and long half-life make this agent suboptiomal for the examination of coronary artery disease. To circumvent the physical limitation of TI-201, a group of technetium 99m-labeled isonitril complex has been developed. Our study was done to examine the value of SPECT with 99mTc-HexaMIBI in estimating myocardial perfusion in patients with myocardial infarction. METHODS: We evaluated the sensitivity of SPECT with 99mTc-HexaMIBI in 29 patients with acute myocardial infarction. We also compared the severity and vascular territory of abnormal perfusion on SPECT scanning with severity of coronary artery stenosis, values of serum enzyme and sites in ECG. RESULTS: 1) There were 26 patients(90%) who showed perfusion defect, and 3 patients(10%) who showed normal perfusion in myocardial SPECT. The 3 patients with normal perfusion demonstrated non Q-wave infarction of ECG. 2) Among 23 patients performed coronary argiography, there were 19 patients(82%) who showed positive findings on myocardial SPECT and luminal narrowing above 50% on coronary angiogram, and there were 3 patients(13%) who showed significant coronary artery stenosis in spite of negative myocardial SPECT. 3) The grade of perfusion defect showed no significant difference between groups undergone thrombolytic therapy and groups not undergone thrombolytic therapy. 4) There was good correlation between the site of perfusion defect on SPECT and the site of infarction on ECG. CONCLUSION: We conclude that SPECT with 99mTc-HexaMIBI is a promising non invasive test for simultaneous diagnosis of myocardial infarction and evaluation of perfusion defect.
Coronary Artery Disease ; Coronary Stenosis ; Diagnosis ; Electrocardiography ; Half-Life ; Humans ; Infarction ; Myocardial Infarction* ; Perfusion ; Phenobarbital ; Technetium ; Technetium Tc 99m Sestamibi* ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon*

No abstract available.

Far lateral disc herniation(FLDH) with compression of the nerve root as it exits through the foramen has been a recognized entity for a number of years. Failure to diagonose and precisely localize these herniations can lead to unsuccessful surgical exploration or exploration of the innocent interspace. If these herniation are diagnosed, they often cannot be adequately exposed by the classic minline hemilaminectomy approach. A partial or complete unilateral facetectomy to expose these herniations can lead to vertebral instability or contribute to continued postoperative back pain. The authors present 5 patients who were diagnosed as having far lateral lumbar disc herniations from 1988 to 1990. Two of these were at L4-5 level, two at L5-S1 level and one at L3-4 level and all were over 60 years old. High resolution CT scan appeared to be the best study and the paramedian muscle splitting microsurgical approach, done in 3 cases, was found to be the most direct and favorable anatomical route to FLDH for vertebral stability and minimal postoperative back pain.
Back Pain ; Humans ; Middle Aged ; Tomography, X-Ray Computed

Anterior cervical discectomy and fusion (ACDF) is currently the standard treatment for cervical disc disease. Some patients wish to be treated with a less invasive method, because of their social/physical situations. Here we present one method of treatments for socially/physically active patients. Three patients had triceps weakness and mild posterior neck pain. The offending lesions were at the C6-7 level. All were middle-aged soldiers with families. If conventional ACDF were performed, they would have to retire from the military according to the regulation. They had to be able to perform military drills after the treatment if they were going to be able to keep their jobs. Because of their social/physical situations, all wanted to choose method with that they could treat the disease and keep their jobs. For these reasons, the posterior cervical endoscopic discectomies were performed. Ruptured fragments were successfully removed in all. The arm pain improved by more than 90% in two patients by 7 days and in the other patient by 2 months, respectively (excellent outcome by Macnab's criteria). None of the operations caused instability. All of the patients are currently able to successfully perform their military drills without difficulty. The posterior cervical endoscopic discectomy may be a promising alternative for the physically/socially active patients.
Adult ; Cervical Vertebrae/radiography/*surgery ; *Diskectomy ; Endoscopy ; Humans ; Intervertebral Disk/radiography/surgery ; Magnetic Resonance Imaging ; Male ; Severity of Illness Index ; Tomography, X-Ray Computed ; Treatment Outcome

The clinical and pathologic features, including prognostic factors and survival data, were analyzed for 23 patients with intracranial ependymoma treated surgically at the Seoul National University Hospital during the years 1979 to 1990. The age at diagnosis ranged from 2 months to 55 years(mean : 14.9 years). The male to female ratio was 10:13. Fifteen patients(65%) were under the age of 15. The tumors of twenty one patients(91%) were located infratentorially. The adjusted overall 5-year-survival rate of infratentorial ependymomas was 77% excluding 4 cases of surgical mortaltiy(Kaplan-Meier method). The period of follow-up ranged from 2 to 70 months. No correlation was possible between 5-year-survival rate and extent of tumor, age group(below and above 6 years), extent of removal, or pathologic grading. Clinical or pathological evidence of spinal metastasis was not found.
Diagnosis ; Ependymoma* ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Seoul

OBJECTIVES: The authors present a retrospective analysis of 14 patients treated for spinal cord hemangioblastoma (SCH) between Dec. 1986 and Mar. 2000. This study was conducted to evaluate and compare the difference of the functional outcomes associated with the extent of surgical removal of SCH. METHODS: Eleven patients were male and three patients were female. Their mean age was 37.2 years that ranged from 19 to 62 years. Preoperative magnetic resonance(MR) imaging of the spine was performed in all cases, and preoperative angiography in eleven cases. They were followed from 15 months to 161 months(median follow-up period, 47 months), and we investigated the change of neurological symptoms and functional outcomes with radiological features, especially on MR imaging. RESULTS: Six patients were accompanied by von Hippel-Lindau disease, and three of them had multiple CNS tumors. Thirteen patients had intramedullary tumor, and the remaining one had extradural. Syringomyelia around the tumor was observed in ten cases. All patients underwent surgical removal, and gross total removal(GTR) was achieved in ten cases. Preoperative embolization was performed in four cases. In four patients who were treated with preoperative embolization, intraoperative loss of blood was minimal and GTR was possible. One patient developed a transient swallowing difficulty postoperatively without permanent postoperative neurological deficits. In three of four patients in whom GTR was not possible, their functional outcomes were worsened postoperatively. The functional status at discharge was improved in seven patients, stationary in four patients, and worse in three. At the last follow-up(15-161 months), one of four patients who had been stationary at discharge showed improvement but, the rest did not show any change. All patients who showed neurological improvement were patients with GTR, and the patients with GTR had significant better outcome than those without GTR(p=0.015). CONCLUSION: Surgical treatment, and especially, GTR is considered as treatment of choice for spinal cord hemangioblastoma. Preoperative embolization may prevent intraoperative bleeding and improve surgical outcome.
Angiography ; Deglutition ; Female ; Follow-Up Studies ; Hemangioblastoma* ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Cord* ; Spine ; Syringomyelia ; von Hippel-Lindau Disease

To evaluation effectiveness of internal anastomosis and facial-hypoglossal anastomosis the medical records of 29 patients with facial nerve injury in the course of operation for acoustic neurinoma were reviewed. In 8 patients, the interrupted facial nerves were anastomosed at the end of tumor operation, and facial-hypoglossal anastomoses were performed in 20 patients. One patient underwent facial-hypoglossal anastomosis 6 months after internal anastomosis. All the patients had been treated from January 1983 to March 1993 and were followed up for more than 1 year. After primary internal anastomoses, 7 patients resulted in symmetric face at rest and only one failed to show improvement of facial muscle tone. The mean time to the first evidence of facial reinnervation was 5.3 months. In 20 patients with facial-hypoglossal anastomosis, improvement of facial muscle tone was demonstrated in 19 patients and in one patient there was no improvement. Thirteen cases(68%) showed facial symmetry at rest and 5 of them could close their eyes completely. The first evidence of reinnervation was noted between 3 and 12 months after anastomosis with a mean of 6.3 months. The anastomoses were performed between 8 days and 22 months after injury of the facial nerve, and the time to reinnervation after anastomosis was significantly influenced by the duration of nerve injury(P=0.0439). Primary internal anastomosis revealed better recovery of facial muscle function compared with facial-hypoglossal anastomosis(P=0.0299).
Acoustics* ; Facial Muscles ; Facial Nerve Injuries* ; Facial Nerve* ; Humans ; Medical Records ; Neuroma, Acoustic*

No abstract available.
Chordoma*