Anterior cervical microforaminotomy is the one of surgical options for treating cervical spondylotic lesions manifested by radiculopathy or myelopathy. This minimally invasive surgical procedure is gaining popularity due to the recent trends of avoidance of spinal fusion resulting in loss of the physiologic spinal motion and developing a future adjacent segment syndrome. Although the spinal fusion still remains a gold standard procedure for degenerative cervical spinal diseases, the eager for maintaining the function of the motion segment is another issue for contemporary spinal surgeons. Anterior cervical microforaminotomy is a target-oriented operation that decompresses the nerve root or spinal cord without destruction of the spinal anatomical functional unit. Unlike to other procedures including total or partial resection of the intervertebral disc, this surgical procedure removes only a small part of the uncovertebral joint or vertebral body. Through this narrow corridor, adequate decompression of the nerve root or spinal cord can be achieved while preserving functional motion. Technical variations of the original anterior cervical microforaminotomy have been continuously developed to minimize the concerns for the postoperative disc height loss and instability. As of now, the anterior cervical microforaminotomy and its technical variations have been proved to be an excellent procedure for treating the cervical spondylotic radiculopathy from literatures review. But the long-term clinical results and the efficacy of the procedure for cervical myelopathy still remain to be seen.
Decompression ; Intervertebral Disc ; Joints ; Radiculopathy ; Spinal Cord ; Spinal Cord Diseases ; Spinal Diseases ; Spinal Fusion

Biliary atresia is a surgical disease of infancy with a very poor prognosis usually attributed to the rarity of surgically correctable case. This paper presents a case of incorrectable type of biliary atresia 50 days old Direan female infant who were subjected to the Modified Kasai Operation She had shown good bile excretion after surgery but developed recurrent fever, severe hypocalcemia and roentgenographically prover rickets during the follow up periods. She died 7 months after the operation.
Bile ; Biliary Atresia* ; Female ; Fever ; Follow-Up Studies ; Humans ; Hypocalcemia ; Infant ; Prognosis ; Rickets

Bilateral hypoplasia of the internal carotid arteries is a rare condition. The authors experienced two cases of bilateral hypoplasia of the internal carotid arteries. In one case, a 46-year-old female patient, presented with subarachnoid hemorrhage. Internal carotid angiograms showed right hypoplastic internal carotid artery and left agenetic internal carotid artery. An aneurysm, believed to be the source of the subarachnoid hemorrhage, took origin from the trunk of the basilar artery. In another case, a 48-year-old male, presented with semicomatous mentality. Brain CT demonstrated intracranial hemorrhage on the parasylvian area, and high density on the basal cistern, quadrigerminal cistern and temporal horn of left lateral ventricle. Initially, aortic arch injection did not visualized the origin of the common carotid arteries. It revealed only the vertebral arteries and both external carotid artery originating from each vertebral artery. A selective left vetebral artery study demonstrated a communication between the hypertrophied basilar artery and the posterior cerebral arteries. The anterior and middle cerebral vessels, in turn, were opacified through the circle of Willis, via the posterior communicating arteries. In addition, an aneurysm, believed to be the sourse of the subarachnoid hemorrhage, took origin from the posterior cerebral artery. The cases of the bilateral hypoplasia of internal carotid artery with intracranial aneurysm are reported as above, together with literature review.
Aneurysm ; Animals ; Aorta, Thoracic ; Arteries ; Basilar Artery ; Brain ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal* ; Circle of Willis ; Collateral Circulation ; Female ; Horns ; Humans ; Intracranial Aneurysm* ; Intracranial Hemorrhages ; Lateral Ventricles ; Male ; Middle Aged ; Posterior Cerebral Artery ; Subarachnoid Hemorrhage ; Vertebral Artery

The authors report the problems of treatment in 37 consecutive cerebralarteriovenous malformations(AVM's) who underwent embolization, operation, combined treatment, or conservative care. The preoperative embolization is an integral part of the multidisciplinary treatment protocol for patients with cerebral AVM's. Life threatening intracerebral hematoma caused by bleeding from AVM's will be managed effectively with stereotactic Urokinase irrigation for urgently reducing the increased intracranial pressure and getting a time to change emergent to elective surgery. We also discussed the problems along the management of cerebral AMV's.
Clinical Protocols ; Hematoma ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations* ; Intracranial Pressure ; Urokinase-Type Plasminogen Activator

BACKGROUND: Colorectal cancer is the third most common cancer in the world and the fourth most common cancer in Korea. The incidence of colorectal cancer is increasing steadily in Korea. In some countries, mortality rates have started to decline, and survival rates have increased. The survival rates of colorectal cancer is increasing due to early detection and to advances in adjuvant therapy. METHODS: This analysis studied colorectal cancer patients who had been operated on at Eul-Ji Medical college Hospital from Jan. 1991 to Dec. 1996. We analyzed the 5-year survival rate according to age, sex, duration of symptoms, stage, resectability, and histopathologic differentiation by the Kaplan- Meier method. RESULT:Age (p=0.482), sex (p=0.394), duration of Symptoms (p=0.346), and tumor location (p=0.685) did not appear to be statistically significant as prognostic factors. The 5-year survival rates according to the Dukes' stage were as follows:stage A (100%), stage B (77.7%), stage C (47.4%), and stage D (0.0%). The 5-year survival rates showed 8.2% in palliative resected cases and 67.2% in radical resected cases. In 139 radically resected adenocarcinoma cases, the 5-year survival rates were 73.4% of the highly differentiated cases, 67.6% of the moderately differentiated cases, and 35.7% of the poorly differentiated cases (p=0.043). CONCLUSION:Early diagnosis, well differentiation, and radical resection were significant as prognostic factors in our result. We could confirm that early diagnosis and radical resection are necessary to increase the survival rate in patients with colorectal cancer.
Adenocarcinoma ; Colorectal Neoplasms* ; Diagnosis ; Early Diagnosis ; Humans ; Incidence ; Korea ; Mortality ; Survival Rate*

The authors have experienced a case of an arachnoid cyst within the cervical canal. The patient suffered from right upper extremity pain and numbness for 1 month. On cervical MRI, intradural extramedullary mass was detected. A total laminectomy of C5, C6 and C7 was performed. We could diagnose by radiological and pathological findings.
Arachnoid* ; Humans ; Hypesthesia ; Laminectomy ; Magnetic Resonance Imaging ; Spinal Canal* ; Upper Extremity

The authors have experienced a case of an arachnoid cyst within the cervical canal. The patient suffered from right upper extremity pain and numbness for 1 month. On cervical MRI, intradural extramedullary mass was detected. A total laminectomy of C5, C6 and C7 was performed. We could diagnose by radiological and pathological findings.
Arachnoid* ; Humans ; Hypesthesia ; Laminectomy ; Magnetic Resonance Imaging ; Spinal Canal* ; Upper Extremity

BACKGROUND: A laparoscopic cholecystectomy has many clinical advantages and is now recognize as the choice for treatment for gallstones. However a laparoscopic cholecystectomy is often not feasible or is converted to the conventional open method in patients with acute cholecystitis because of surrounding adhesion, tissue edema, and high postoperative complications. Lately, good clinical results have been reported by many authors for a percutaneous cholecystostomy followed by a laparoscopic cholecystectomy in the management of acute cholecystitis. METHODS: Between January 1996 and March 1997, 56 acute cholecystitis patients were surgically treated in our institution. Thirteen patients underwent percutaneous drainage followed by a laparoscopic cholecystectomy (Group I). Also a laparoscopic cholecystectomy without a prior percutaneous cholecystostomy was attempted in 43 patients (Group II). RESULTS: There were no differences in the age and the sex distributions, the chief complaints on admission, and the severity of inflammation between the two groups. The only significant difference was the wall thickness of the gallbladder on postoperative pathologic examinations, 4.7 mm for Group I and 6.2 mm Group II (p=0.038). For the patients in Group I, percutaneous drainage of the gallbladder continued for 5.4 days on average, and the cholecystectomy was usually performed about 15 days later. A laparoscopic cholecystectomy was possible in 10 patients (76%) in Group I, but had to be converted to the open method in 3 patients. In Group II, only 17 patients (39.5%) out of 43 underwent a successful laparoscopic cholecystectomy. In other words, the open conversion rate was 24% in Group I and 60.5% in Group II. The wall thicknesses of the gallbladder excised laparoscopically were 3.98 mm and those of the conventionally removed gallbladder were 6.96 mm on average. This difference in the wall thickness was statistically significant (p=0.013) and was the only factor related with the open conversion rate. CONCLUSIONS: We think that a laparoscopic cholecystectomy performed several days after percutaneous drainage of the gallbladder to eliminate acute inflammation may be recommended for management of acute cholecystitis patients with severe clinical symptoms and ultrasonographic findings of marked gallbladder dilatation or pericholecystic fluid collection.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Cholecystostomy* ; Dilatation ; Drainage ; Edema ; Gallbladder ; Gallstones ; Humans ; Inflammation ; Postoperative Complications ; Sex Distribution ; Tissue Adhesions

The authors encountered a case of gliosarcoma with hemorrhage arising in the left frontotemporal lobe of a 34-year old woman who five months previously had undergone surgery for an ICH in the same lobe. On CT brain scan, we could a slight hyperdense tumor with irregular enhancement could be detected, and perilesional edema and obvious mass effect were also noted. The tumor was firm and surgically,its margine was somewhat poor. On pathologic and histochemical study, the presence of a gliosarcoma was confirmed.
Adult ; Brain ; Brain Neoplasms ; Edema ; Female ; Gliosarcoma* ; Hemorrhage* ; Humans

Cervical pregnancy is one of most rare form of ectopic pregancy in which the blastocyst implants within the cervical canal below the internal os of uterine cervix. Most cervical pregnancy result in early spontaneous abortion, complicated by severe hemorrhage frm the eroded blood vessels within the cervix. Because of fear of rofuse hemorrhage, abdominal hysterectomy has been historically considered the standard therapy. However, a number of new therapies have been aimed at uterine preservation, conservative treatment is highly desirable for young women who want to be pregnancy in the future. Methotrexate has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of a cervical preganncy that was successfully managed with methotrexate and leucovorine.
Abortion, Spontaneous ; Blastocyst ; Blood Vessels ; Cervix Uteri ; Cytochrome P-450 CYP1A1 ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Leucovorin ; Methotrexate* ; Pregnancy*