The transarterial embolization procedures have been performed in a total of 38 patients with head and necklesions, including 5 carotid-carvernous fistulas, 1 internal carotid aneurysm, 10 meningiomas, 16 nasopharyngealangiofibromas, 1 post-traumatic epistaxis and 5 other vascular tumors, over the 18 months-period. Six cases of C-Cfistulas and ICA aneurysm were treated with the detachable balloon catheter technique. The meningiomas, angiofibromas and all other lesions were embolized with superselection of the branches of the external carotidartery such as the internal maxillary, the middle meningeal, the ascending pharyngeal, the facial or otherbronches, using Berenstein superselective catheters of conventional angiographic catheters. The PVA(polyvinylalcohol foam) and/or Gelfoam particles were used as embolic materials in these cases. Most of the lesions weresuccessfully embolized with minor transient complications such as pain, headache, vomitting, fever and etc. But in4 cases occurred the serious complications; one cerebral hemorrhage, two cerebral infarctions, and one acutelaryngeal edema. The selection of the embolic materials and the catheters, and the complications are brieflydiscussed.
Aneurysm ; Angiofibroma ; Catheters ; Cerebral Hemorrhage ; Cerebral Infarction ; Edema ; Epistaxis ; Fever ; Fistula ; Gelatin Sponge, Absorbable ; Head ; Headache ; Humans ; Meningioma ; Neck

No abstract available.

No abstract available.
Knee*

The goal of total knee replacement is to relieve pain, to stabilize joint movement and to correct deformity. It is indicated for patients with rheumatoid arthritis, osteoarthritis and severe post-traumatic arthritis. The author analyzed 71 patients(106 cases), who received the PFC type of total knee replacement from August 1992 and the results were as follows; 1. Among the 71 patients, male was 8 patients and female was 63 patients whose average age was 56 years and average follow up period was 24 months, ranged from 8 months to 3 years 8 months. 2. Rheumatoid arthritis was the most common cause with 31 patients(56 cases) followed by osteoarthritis with 39 patients(49 cases). There was also one patient(1 case) that showed bony union of the knee due to old tuberculosis. The average duration of the illness was 12 years and the average weight of the patients was 57.7kg. 3. Flexion contracture decreased from an average of 21 degrees to 5 degrees after the operation. The range of motion increased from an average of 92 degrees before the operation to 117 degrees afterwards in cases of rheumatoid arthritis and decreased slightly from 108 degrees to 106 degrees in cases of osteoarthritis. 4. The tibiofemoral angle was corrected from an average 1.5 degrees varus before the operation to an average 6.7 degrees valgus after operation. Eighty seven percent of patients with rheumatoid arthritis showed valgus deformity and seventy eight percent of degenerative osteoarthritis patients showed varus deformity preoperatively. 5. Radiographically, the joint line position shifted an average 2.3mm in rheumatoid arthritis and an average 0.3mm in osteoarthritis. The component position, the femoral flexion was an average 89.6 degrees in the anteroposterior view, an average 87 degrees in the lateral view. 6. The thickness of the patella measured in the operating room of 61 cases was an average 21mm and after resection of patella, the remaining bone measured an average of 13.6mm. 7. To achieve soft tissue balance, 29 patients(33 cases) underwent medial stripping and 23 patients(30 cases) had patella lateral release. 8. The Insall Knee Rating Score was used to evaluate the results. The results were 69 cases excellent, 33 cases good, 3 fair and 1 poor. Ninety two percent of the patients had good or excellent results in average 24 months follow-up. 9. The complications consisted of one case of delayed deep infection, one case of patellar subluxation and one case of supracondylar fracture of the femur.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Female ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Operating Rooms ; Osteoarthritis ; Patella ; Range of Motion, Articular ; Tuberculosis

The clinical studies were performen on 304 patients with heart disease who had been received corrective heart surgery at Kosin Medical Center from July, 1984 to December, 1991. The results were as follows: 1) Out of 304 patients, 162 cases (53.3%) were male and 142 cases (46.7%) were female and sex ratio was 1.15:1. 35 cases (11.5%) had clinical cyanosis and 269 cases (88.5%) had no evidence of cyanosis. 2) As age distribution of patients, under 2 years, 3~5 years, 6~10 years, 11~15 years, 16~18 years consist of 22.0%, 26.0%, 29.0%, 16.1% and 6.9%, respectively. 3) As disease distribution, out 304 patients, ventricular septal defect (57.9% of all) was the most common disease, and then atrial septal defect (13.2%), tetralogy of Fallot (11.2%), patent ductus arteriosus (9.9%) and pulmonic stenosis (5.3%), in their order. 4) As sex distribution of each disease, ventricular septal defect, atrial septal defect and tetralogy of Fallot were more common in male and patent ductus arteriosus and pulmonic stenosis were more common in female. 5) The most frequent cardiac anomaly associated with ventricular septal defect and atrial septal defect was pulmonic stenosis. In the case of subarterial ventricular septal defect, aortic insufficiency was associated in 13.3%. 6) Respiratory problems (11.3%), tricuspid regurgitation (9.5%), arrhythmia (6.2%) and congestive heart failure (5.8%) were the major complications after surgery. 7) Case fatality reat was 4.4%. Mortality rate in ventricular septal defect, tetralogy of Fallot and tricuspid atresia were 1.7%, 20.6% and 100%, respectively, Majority (75.0%) of expired patients were died within 24 hours after sugery and the cause of death was hypoxia due to low cardiac output syndrome.
Age Distribution ; Anoxia ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Cause of Death ; Cyanosis ; Ductus Arteriosus, Patent ; Female ; Heart Diseases* ; Heart Failure ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Male ; Mortality ; Pulmonary Valve Stenosis ; Sex Distribution ; Sex Ratio ; Tetralogy of Fallot ; Thoracic Surgery ; Tricuspid Atresia ; Tricuspid Valve Insufficiency

A tender, non-healing ulcer of 3 months' duration developed on the tongue tip of a 51-year-old male with active pulmonary tuberculosis. Acid-fast bacilli were grown in the tissue and sputum cultures. The patient was anergic to PPD skin test before the treatment and IL-2 productivity was significantly decreased. Sections from the tongue tip showed ulceration, infiltration of neutrophils and tuberculoid granulornas accompanying caseation necroses in the dermis. The ulcer healed after administration of anti-tuberculosis medication for 2 months.
Dermis ; Efficiency ; Humans ; Interleukin-2 ; Male ; Middle Aged ; Necrosis ; Neutrophils ; Skin Tests ; Sputum ; Tongue* ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

197 spine CTs were performed from 29th, March 1982 to 7th March, 1984. Among them, 39 patients preoperatively diagnosed as herniated nucleus pulposus ar bulging disc with CT and myelography were operated. 43 disc spaces ofdisc disease were analysed in true positive and false negative cases. Finally the accuracy, sensitivity and specifictiy of spine CT and myelography ar calculated. The resuslts are as follows; 1. The CT findings of disc diseases are in order of frequency, asymmetrical obliteration of epidural fat (82%), ventral indentation orcompression on dural sac(72%), focal protrusion of disc(64%), root changs
Constriction, Pathologic ; Humans ; Hypertrophy ; Intervertebral Disc Displacement ; Methods ; Myelography ; Spine ; Vacuum ; Zygapophyseal Joint

Thirty-six patients (24 with oral cavity or oropharynx cancers and 12 larynx cancers) were prospectively examined with computed tomography (CT) to determine its value in staging the primary tumor and to compare with the clinical staging. The CT staging agreed with the clinical staging in 50% (12/24) of the oral cavity or oropharynx cancers and in 67% (8/12) of the larynx cancers. The CT upgraded the clinical staging in 29% (7/24) of the oral cavity or oropharynx tumors and in 33% (4/12) of the larynx cancers, whereas the CT downgraded the clinical staging in 21 % (5/24) of the oral cavity or oropharynx cancers. There is no downgrade on CT in larynx cancer. The post-surgical confirmation was not made in most of the cases. The possible causes of disagreement between the CT and the clinical staging, and the diagnostic value of the CT in evaluation of the primary tumor in oral cavity, oropharynx and larynx were discussed.
Head and Neck Neoplasms ; Head ; Humans ; Laryngeal Neoplasms ; Larynx ; Mouth ; Oropharyngeal Neoplasms ; Oropharynx ; Prospective Studies

Fity-four patients with head and neck cancers were prospectively examined with the CT to determine its valuein staging cervical lymph nodes metastases and to compare with the clinical staging. The CT staging agreed withthe clinical staging in 61%(33/54), upgraded the clinical staging in 22%(12/54) and downgraded in 17%(9/54). Thepost-surgical confirmation was made in only 11 patients, The possible causes of disagreement between the CT andthe clinical staging, and the diagnostic value of the CT in the evaluation of the cervical nodes metastases werediscussed.
Head and Neck Neoplasms ; Head ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Prospective Studies

Eighty-eight patients who presented with a variety of head and neck symptoms were examined with intravenous oritraarterial digital subtraction angiography (IV or IA DSA), using the DSA equipment developed by Seoul NationalUniversity Hospital. A grading system was used to evaluate the ability of DSA to answer specific diagnsoticquestions. Diagnostic information without need of further study was obtained in 71% with IV DSA, in 86% withaortic arch DSA and in 81% with selective arterial DSA, showing a total of 79% of diagnostic accuracy with DSA. Itis concluded that IV DSA is useful in the evaluation of the cervical carotid and vertebral arterial disease, andpituitary mass lesion, while IA DSA is useful in the evaluation of the cervical carotid and vertebral arterialdisease, and pituitary mass lesion, while IA DSA is useful in the evaluation of most of the intracranial lesions,spinal arteriography and intra-arterial embolization. DSA is both an accurate and safe imaging modality in thestudy of head and neck diseases.
Angiography ; Angiography, Digital Subtraction ; Head ; Humans ; Neck ; Seoul