Angiographic findings were analysed in 22 cases of coronary occlusive disease which were selected from 50 cases of coronary arteriographies done in Department of Radiology, Seoul National Un iversity Hospital from September, 1981 to August, 1984. There were 16 cases of single vessel disease, in which 12 were LAD involvement and 4 were RCA involvement, 2 cases of two vessel and 4 cases of three vessel disease. Site, degree and extent of stenotic involvement in those occlusive coronary diseases were anal ysed with review of literature for selective coronaryarteriography. Since coronary arteriography is the final and accurate examination for the evaluation of occlusive coronary arterial disease, it is expected to be widely used for the diagnosis of occlusive coronary arterial disease which is rapidly increasing recently in this country.
Angiography ; Coronary Disease ; Diagnosis ; Seoul ; United Nations

9 cases of criss-cross heart anomaly, diagnosed by angiography from April, 1979 to Feb. 1985 at Seoul National University Hospital were reviewed. The results were as follows: 1. Of 9 cases, 6 cases were male and 3 cases werefemale and the age ranged from 2 months to 16 years of age. 2. Of 9 cases, 7 cases were concordant (D-loop) and 2cases were discordant (L-loop). segmental approaches are 2 cases of SDD(TGV) and each one case of SLD(TGV),SDD(DORV), SDL(DORV), SDD(DOLV), SLL(corrected TGV), and normal one. 3. Associated anomalies are small sized rightventricle (7 cases), especially inflow tract and sinus portion, pulmonary outflow tract obstruction(5 cases),VSD(9 cases), ASD( 7 cases), PDA(2 cases) and visceroatrial situs solitus was observed in all 9 cases but 1dextrocardia.
Angiography ; Crisscross Heart ; Humans ; Male ; Seoul

No abstract available.
Child* ; Hair* ; Humans

BACKGROUND: The surgical management of papillary thyroid cancer is not only controversial with regard to the surgery of the thyroid gland itself but also with regard to the management of regional lymph nodes. The presence of regional lymph node metastasis is not related to the prognosis, but affects the local recurrence rate, and a reoperation in the central neck is technically more difficult than a primary procedure. The central neck lymph node dissection is mandatory during the primary operation in order to reduce lymph node recurrence in the central neck and to avoid reoperation, but there is question about the necessity of lymph node dissection contralateral to the primary tumor when it is confined to one lobe only. METHODS: Thus, we analyzed the central neck lymph node metastasis of 80 patients with papillary thyroid cancer who underwent a total thyroidectomy and central neck dissection. RESULTS: For the 53 patients with the primary tumor confined to one lobe and with a clear opposite lobe, the rate of contralateral paratracheal lymph node metastasis was 26%, and for the 19 patients with a microcarcinoma in opposite lobe, the rate of contralateral paratracheal lymph node metastasis was 63%. However, it was difficult to identify the microcarcinoma in the opposite lobe based on the gross finding during the operation. As a result, the overall probability of contralateral lymph node metastasis was 36% when the primary tumor was grossly confined to on lobe. The mass size did not correlated with the rate of contralateral lymph node metastasis. CONCLUSIONS: The bilateral node dissection appears to have been appropriate in every case of advanced papillary thyroid cancer as far as the complication rates could be maintained acceptably low.
Humans ; Lymph Node Excision ; Lymph Nodes* ; Neck Dissection ; Neck* ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Reoperation ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy

Idiopathic arterial hypertension, termed "essential" or "neurogenic", is a common generalized cardiovascular syndrome comprised of a sequence of pathologic changes and accommodations. Although an extensive literature exists concerning that, the primary etiology has been unclear yet. However, Jannetta and coworkers have reported a possible etiological connection between essential hypertension and intraoperatively observed neurovascular compression of the ventrolateral medulla at the level of the root entry zone of the ninth and tenth cranial nerves on the left, recently. They have also introduced one of new therapeutical concept for essential hypertension by microvascular decompression(MVD) of offending vessels. Based on Jannetta and coworker's hypothesis, the authors have made some operations for the control of hypertension. Seven essential hypertensive patients have been underwent retromastoid craniectomy and MVD in the left ventrolateral medulla between July 1992 and June 1993. Five of them showed multiple episodes of intracerebral hemorrhages, one was an intractable hypertension case and the other one had a left hemifacial spasm with essential hypertension. The most common offending vessel was the posterior inferior cerebellar artery and it had been confirmed during operation. Postoperatively, in three cases, blood pressure was lowered to normal without medications. Of remaining four cases, blood pressure was significantly improved in one and slightly improved in three. There were no major complications in patients with surgery and no poor outcomes. These results indicate that the MVD for essential hypertension is relatively safe procedure and alternative choice as one of the management of intractable essential hypertension, repeated hypertensive intracerebral hemorrhages and left cranial nerve hyperfunction disorders combined with essential hypertension.
Arteries ; Blood Pressure ; Cerebral Hemorrhage ; Cranial Nerves ; Hemifacial Spasm ; Humans ; Hypertension* ; Intracranial Hemorrhage, Hypertensive ; Microvascular Decompression Surgery* ; Vagus Nerve

Variations of spinal nerue compositions, which giue rise to the variable motor and sensory component, occured at the terminal branches of brachial plexus. This study performed to investigate the spinal nerve compositions of the main terminal branches of the brachial plexus in 32 sides of Korean adults. The main terminal branches contained the musculocutaneous, median, ulnar, radial and axillary nerves. The obtained results were as follows. The spinal nerve compositions of musculocutaneous nerve appeared as two types. The most frequent type was composed of C5, C6 and C7 at 75.0%. The mean diameter of C5 and C6 was 1.68+/-0.21 mm and 1.66+/-0.40 mm, respectively. The median nerve appeared as two types. The most frequent type was composed of C6, C7, C8, T1 components at 87.5%. The mean diameter of C7 was the thickest at 2.64+/-0.48 mm and C5 was most thin at 0.28+/-0.04 mm. The ulnar nerve appeared as four types. The most frequent type was comprised with C7, C8 and T1 at 75.0%. In the mean diameter, C8 was the thickest with 2.64+/-0.57mm and T1 was most thin with 0.06+/-0.56 mm. The radial nerve appeared as four types. The most frequent type was comprised from C5 to T1 at 43.7%. In the mean diameter, C7 was the thickest at 2.70+/-0.52 mm. The axillary nerve appeared as two types. The frequentest type was comprised with C5, C6 and C7 at 56.2%. In the mean diameter, C6 was the thickest at 1.73+/-0.56 mm. From the obtained results, spinal nerve compositions of the main terminal branches of the brachial plexus were more variable than the description of the anatomic textbook.
Adult ; Brachial Plexus* ; Humans ; Median Nerve ; Musculocutaneous Nerve ; Radial Nerve ; Spinal Nerves ; Ulnar Nerve

Superior mesenteric artery syndrome (SMAS) is a rare clinical disease. SMAS is defined as the entrapment of the third portion of the duodenum by the aorta and the superior mesenteric artery. A 14-year-old male patient was admitted to the local hospital for an emergency appendectomy under general anesthesia. In the process of inducing general anesthesia, massive pulmonary aspiration of gastric contents and bile juice occurred by accident. After surgery, he was transferred to our hospital due to severe ARDS. The gastroduodenoscopy observations, CT, and clinical symptoms, were indicative of SMAS. Surgery was considered because medical conservative treatment of SMAS was ineffective. SMAS was confirmed on the surgical fields. We report our experience with a review of the relevant literature because this condition can be associated with serious complications during general anesthesia.
Adolescent ; Anesthesia, General* ; Aorta ; Appendectomy ; Bile ; Duodenum ; Emergencies ; Humans ; Male ; Mesenteric Artery, Superior* ; Pneumonia, Aspiration* ; Superior Mesenteric Artery Syndrome*

BACKGROUND: As the problems of medical malpractices become a very serious social issue, it is necessary to increasingly relate law to medical practice and evaluate medical services. However, it is not easy to legally call someone to account, as medical services are highly specific, especially anesthetic management. Anesthesiologist can expect to be involved in legal action alleging malpractice, either as a defendant or expert witness. METHODS: The anesthetic informed consent form was examined at 42 general hospitals in the Republic of Korea. The chief physician of the department of anesthesiology and pain medicine was asked for the anesthetic informed consent form they used in clinical anesthetic practice, and then what constitutes adequate informed consent analyzed. RESULTS: All of the hospitals were using informed consent forms, but 42.9% of the hospital used a specific form to describe the complications or risks associated with anesthetic management. In 71.4% of hospitals, the anesthesiologists or anesthetic residents explained the anesthetic risk, but 28.6% of hospitals the anesthetic complications were explained by nurses or surgeons. In 76.2% of hospitals, the anesthetic risks were explained to both the patients and parents, but in 23.8% these were explained to parents only. CONCLUSIONS: We propose a new anesthetic informed consent form for adequate explanation and agreement to legal requirements.
Anesthesiology ; Consent Forms ; Expert Testimony ; Hospitals, General ; Humans ; Informed Consent* ; Jurisprudence ; Malpractice ; Parents ; Republic of Korea

A double-blind trial of the efficacy of propranolol hydrochloride a new beta adrenergic blocking agent, in the prophylactic treatment of angina pectoris was conducted in 9 patients. Through the trial period of 8 weeks to more than 26 weeks, the patients received propranolol and placebo for equal period. Following are the results. 1. The effective dose of propranolol hydrochloride in the prophylactic treatment of angina pectoris was 80 mg to 120 mg per day. 2. The effectiveness of propranolol hydrochloride was manifested by a reduction in frequency of pain to 40.7%, in nitroglycerin comsumption to 38.8% and by an increase in exercise tolerance. 3. Obseved side effects were transient nausea, vomiting and bradycardia, which were improved with reduction in drug dosage. 4. Further clinical and experimental information may be necessary in order to assess the long-term effects of propranolol hydrochloride.
Angina Pectoris* ; Bradycardia ; Exercise Tolerance ; Humans ; Nausea ; Nitroglycerin ; Propranolol* ; Vomiting

PURPOSE: To evaluate the clinical results of a unilateral balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures (VCFs). MATERIALS AND METHODS: Twenty patients, 23 cases of osteoporotic VCFs who failed to respond to nonoperative treatments and who were confirmed by a consultant radiologist, were enrolled in this study. Times between injury and operation varied from 2 weeks to 2 months. All patients except two (18 female, 2 male patients), were female, and mean patient age was 71.7 (58-82) years. Follow-ups were conducted at least 12 months (12-27, mean 18.3). All patients underwent unilateral balloon kyphoplasty. Roentgenographic assessments were perform to evaluate fractured vertebra restoration and reduction loss. A ten-point visual analogue scale was used to measure pre- and postoperative pain severity. RESULTS: Preoperative anterior, middle and posterior heights of vertebra bodies were 57.8%, 66.1% and 85.3% of normal at presentation and these increased to 76.2%, 80.1%, 88.7% respectively at immediately after operation and at last follow-up, heights of each portion were 74.4%, 78.6%, 87.3%. Mean preoperative kyphotic angles of 17.6 degrees at presentation improved to 8.9 degrees at immediately after operations and to 9.1 degrees at last follow-ups. Loss of reduction was 1.8%, 1.5%, 1.4% and 0.2 degrees. Mean pain scores were 8.5 before surgery, 2.5 immediately after operations and 2.7 at last follow-ups. Statistical analysis showed a significant decrease in kyphotic angle (p=0.03) but VAS scores were no different (p=0.056). Anterior, middle and posterior body height was decreased with a statistical significance between two period (p<0.001). PMMA leakage occurred in 3 cases, but they did not cause neurologic deficits. CONSLUSION: Balloon kyphoplasty using a unilateral approach is a good treatment method for osteoporotic vertebral compression fractures and an alternative to the substitute bilateral approach.
Body Height ; Consultants ; Female ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Kyphoplasty* ; Male ; Neurologic Manifestations ; Osteoporosis ; Pain, Postoperative ; Polymethyl Methacrylate ; Spine