BACKGROUND: "Rebuild-up" phenomenon, induced by hyperventilation, is a characteristic finding on EEG in children with Moyamoya disease. Its mechanism, however, remains obscure. In this study, we examined the relationship between cerebral lesions on MRI, stenosis or occlusion of cerebral vessel on cerebral angiography, and EEG findings in children with Moyamoya disease. METHODS: We have reviewed medical records of 33 patients, who were confirmed as Moyamoya disease by cerebral angiography at Asan Medical Center. EEG and brain MRI were carried out in all subjects. RESULTS: 1) Epidemiologic data were : the male to female ratio was 1:1.1; highest rate(90.7%) of onset in age group below 10 years; mean age at clinical onset was 7.4 years; average diagnostic interval from clinical onset to diagnosis was 1.9 years. 2) The most common initial and recurrent or residual symptoms were motor deficit. 3) The most common site of occlusion or stenosis of cerebral vessel on cerebral angiography was anterior cerebral area(>97%) and the most common cerebral infarction area on brain MRI was anterior cerebral area, too. 4) The hyperventilation(for 3 minutes) on EEG were carried out in 25 patients and the prolonged build-up or rebuild-up phenomenon was observed in 13 patients(52%). 5) The prolonged build-up or rebuild-up phenomenon on EEG was observed in 6 of 15 patients who were occlusion of cerebral vessel, and in 7 of 10 patients who were stenosis of cerebral vessel on angiography. CONCLUSION: 1) The background slowings on EEG maybe suggestive of the infarction stage of Moyamoya disease in children. 2) The prolonged build-up or rebuild-up phenomenon might indicate the preinfarction stage of Moyamoya disease in children.
Angiography ; Brain ; Cerebral Angiography ; Cerebral Infarction ; Child ; Chungcheongnam-do ; Constriction, Pathologic ; Diagnosis ; Electroencephalography ; Female ; Humans ; Hyperventilation ; Infarction ; Magnetic Resonance Imaging ; Male ; Medical Records ; Moyamoya Disease*

No abstract available.

An axial-pattern flap can be transferred as the free-flap and has many merits over a random-pattern local flap. However, this has limitations of available vascular architecture and donor site. To overcome these problems, many types of prefabricated flaps have been designed using vascular bundles. It is possible to convert a random-pattern flap to a neovascularized axial-pattern flap by transferring a vascular pedicle. In an attempt to study the effects of prefabrication using vascular bundles, the survival rate between random-pattern flap and prefabricated axial-pattern flap was compared in this study. The rabbits were divided into two groups. The control group was consisted of the random-pattern flap and the prefabricated group was consisted of the prefabricated axial-pattern flap using femoral vascular pericles of rabbits. Femoral vascular pedicles were transferred under the 5x5cm lower abdominal flaps without any perivascular tissue. Three weeks later, random-pattern flaps were elevated without any axial vascular pedicle and prefabricated flaps were elevated based on the transferred femoral vascular pericles. The survival rate of the flaps in the control group and experimental group was 67.37% and 98.87% respectively. Based on the result of t-test there was significant difference between two groups. According to these results, it is concluded that prefabricated flap using transferred vascular pedicle was more effective than random-pattern flap. We think that this technique is versatile for wound repair and for use in other aspects of plastic and reconstructive surgery.
Humans ; Plastics ; Rabbits* ; Survival Rate ; Tissue Donors ; Wounds and Injuries

To identify the efficacy of laparoscopic cholecystectomy, we retrospectively analyzed 600 cases of laparoscopic cholecystectomy who were treated at the Department of Surgery, Chung Ang University from September 1990 to December l992. We intentionally divided periods into 3 groups to observe the frequency of morbidity and mortality, early and late complications, duration of operation and postoperative hospitalization with accumulaton of surgical experiences and techniques. The most prevalent age group was 6th decades, male to female ratio was 1: 1.47 and associated diseases were hypertension, obesity, pulmonary tuberculosis in order of frequency and previous abdominal operations were appendectomy, TAH, C-section in order of frequency. The duration of operation was 38.6 minutes and postoperative hospitalization was 6.2 days. The most frequent pathologic diagnosis was chronic cholecystitis. The postoperative complications were noted in 15 cases(2.5%) including 5 cases of bleeding 4 cases of bile leakage. The number of patients who needed parenteral narcotics was decreased in later peiod. According to oral cholecystogram, opacification correlated with duration of operation of laparoscopic cholecystectomy.
Appendectomy ; Bile ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Diagnosis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Hypertension ; Intention ; Male ; Mortality ; Narcotics ; Obesity ; Postoperative Complications ; Retrospective Studies ; Tuberculosis, Pulmonary

A clinical study was performed on 940 cases of essential hypertension observed at Dept. of Internal Medicine of Seoul National University Hospital during a period of last seven years from 1971 to 1977. The followings were the results: 1. The incidence of hypertensive patients was 13.8% among all medical in-patients and 68.2% among all cardiac in-patients. 2. The highest occurence was observed in sixth decade and accounted for 34.2% of all cases and least occurence was in second decade of life which accounted for 0.6% of all cases. No difference was found in age distribution between both sexes. The male to female ratio was 1.2:1. 3. The mean value of blood pressure was 178.1+/-21.8/107.4+/-12.3 mmHg and tended to increase with age at least over the decades from second to seventh and there was tendency to decrease after the eighth decade. No paticular difference in blood pressure levels was found in both sexes. 4. The most outstanding symptom was headache which was found in 51.5% of all cases. Dizziness, dyspnea and palpitation were the next orders in frequency. There was a general trend of the the subjective symptoms which were more pronounced in younger than older patients. 5. Hypertensive retinopathy was found in 83.3% of all cases. Hypertensive retinopathy of K-W grade II was found in 36.1% of all cases and was the most frequent finding among the Keith-Wagener grades. Malignant hypertension of K-W grade IV was found in 4.2% of all cases and the largest numbers were between the fourth and fifth decade of life. 6. The abnormal retinal finding was found to be rather proportional to the blood pressure levels. 7. Albuminuria was detected in 56.2% of all cases and it was more frequent in male than in female patients. 8. The appearance of albuminuria seemed to have a close correlation with hypertensive retinal change and blood pressure levels. 9. Electrocardiographic abnormalities were associated in 71.9% of all cases. The most frequent association among electrocardiographic abnormalities was left ventricular hypertrophy which accounted for 45.2% of all cases. There was the reverse correlation between the normal electrocardiogram and degree of blood pressures. The finding of left ventricular hypertrophy and degree of blood pressures were closely correlated. 10. Cerebrovascular accident, renal failure, congestive heart failure and atrial fibrillation were four major complications. It was recorded in 26.5%, 10.4%, 5.4% and 2.0% of all cases respectively. The complications were common in men than in women. 11. Renal failure, congestive heart failure and myocardial infarction were closely corelated with hypertensive retinopathy.
Age Distribution ; Albuminuria ; Atrial Fibrillation ; Blood Pressure ; Dizziness ; Dyspnea ; Electrocardiography ; Female ; Headache ; Heart Failure ; Humans ; Hypertension* ; Hypertension, Malignant ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Incidence ; Internal Medicine ; Male ; Myocardial Infarction ; Renal Insufficiency ; Retinaldehyde ; Seoul ; Stroke

No abstract available.
Biliary Tract* ; Lymphatic Diseases*

PURPOSE: Laparoscopic approaches to the anterior abdominal wall are difficult because of the inherent limitations of laparoscopic surgery. METHODS: A 25-year-old young female visited to our hospital with an incidentally-found palpable abdominal mass. Computed tomography revealed a 7-cm round enhancing mass arising from the left posterior rectus sheath. The patient underwent laparoscopic excision of the inner mass arising from the anterior abdominal wall. RESULTS: The operation lasted for 45 minutes and there was no measurable bleeding during the procedure. Pathological assessment revealed that the tumor was a DTF 7.0 cm in size. The patient was discharged on the second postoperative day in good condition, and is currently being followed on a routine basis for surveillance without adjuvant therapy. CONCLUSION: Laparoscopic approach for the anterior abdominal wall tumor could be feasible in select patients. This minimally-invasive approach helps to ensure good cosmetic outcomes and quality of life.
Abdominal Wall* ; Adult ; Female ; Fibroma* ; Fibromatosis, Abdominal ; Hemorrhage ; Humans ; Laparoscopy ; Quality of Life

No abstract available.
Humans ; Immunosuppression ; Mycobacterium chelonae*

We report a case of dedifferentiated liposarcoma of retroperitoneum as a recurrent form in a 41 year old male. The patient received a extirpation for retroperitoneal mass and diagnosed as myxoid liosarcoma 4 years ago. The patient experienced 3 recurrences over a period of 4 years and diagnosed as myxoid liposarcoma in the second, third recurrence also. Histologically, the mass was composed of several clearly distinct elements : well differentiated liposarcoma, myxoid liposarcoma, myxoid malignant fibrous histiocytoma, poorly differntiated sarcoma, and fibrosarcoma. Immunohistochemically, S-100 protein was expressed in the area of spindle cell sarcoma, well differentiated liposarcoma, and malignant fibrous histiocytoma but alpha-1-antichymotrypsin was only expressed in the area of myxoid malignant fibrous histiocytoma.

No abstract available.
Graft Survival ; Humans ; Renal Artery ; Tissue Donors ; Transplants