PURPOSE: The purpose of the study is to investigate the correlation between the symptoms and the incidence of anatomical variant without mucosal abnormality. MATERIALS AND METHODS: Out of 892 patients with CT performed for the evaluation of sinus disease symptoms between March 1991 and March 1993, we observed the anatomic variations in 82 symptomatic patients without mucosal abnormality(male:female=43:39, mean age 36. 4 years). The control group included 88 patients with facial bone CT performed for the evaluation of trauma during the same period while patients with recent paranasal sinusitis were excluded. (male:female=76:12, mean age 22. 4 years). The scouis were performed with 5-ram section thickness from posterior margin of sphenoid sinus to anterior margin of posterior ethmoid and then with 3 mm thickness from anterior margin of posterior ethmoid to anterior margin of frontal sinus. The artatomic variations included nasoseptal deviation, concha bullosa, Hailer cells, Agger nasi cells, etc. RESULTS: The anatomic variations were demonstrated in 71 our of 82 symptomatic patients(86. 5%), whereas they were seen 26 of 88 patients(29. 5%) in control group. CONCLUSION: Our data suggest that there is a possible causal relationship between anatomic variations and symptomas. Even though without accompaning mucosal abnormalities, anatomic variations could contribute simply to its symptomas. ^natomic variants may obstruct or narrow the airway, leading to turbulating air flow or interrupting ucociliary movement, and finally may produce a series os symptoms.
Facial Bones ; Frontal Sinus ; Humans ; Incidence ; Sinusitis ; Sphenoid Sinus

Transurethral laser induced thermotherapy by Prostalase is a new modality being evaluated for the treatment of BPH. We performed transurethral laser induced thermotherapies on 30 patients from April 1993 to December 1993. After treatment, 27 patients of them were followed up (urinary retention in 13 cases, non-urinary retention in 14 cases). Mean age of patients was 72 year-old. Prostalase in system was run for 40 minutes with single session without anesthesia. We evaluated patients with Boyarsky symptom score, urine flow rate. volume of residual urine, prostatic volume. Mean Boyarsky symptom score decreased from 16.5 to 7.8 for a 52.7% improvement on non-retention group, mean Boyarsky symptom score decreased from 16.7 to 6. 2 for a 62.8% improvement on retention group at 6 months after treatment. Mean peak flow rate increased 84.7% from a preoperative average of 7.2ml/s to 13.3ml/s at 6 months on non- retention group, mean peak flow rate increased 61.7 % from a postoperative 1-month average of 10.2ml/s to 16.5ml/s at 6 months on retention group. Prostatic volume decreased 22.4 % from a preoperative average of 37.5gm to 29.1 gm at 3 months on non-retention group, prostatic volume decreased 23.5% from a preoperative average of 42.0gm to 32.1gm at 3 months on retention group. There have been no urinary tract infection or retrograde ejaculation. Acute urinary retention occurred in 2 patients, gross hematuria in 1, urinary incontinence in 1. Our study number is small, but we think transurethral laser thermotherapy (Prostalase) to be a safe and less morbid alternative to transurethral resection of prostate.
Aged ; Anesthesia ; Ejaculation ; Hematuria ; Humans ; Hyperthermia, Induced* ; Male ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate ; Urinary Incontinence ; Urinary Retention ; Urinary Tract Infections

Since CT scanning was introduced in the diagnosis of calcaneal fracture, we became to understand more clearly the pathoanatomy of the injury. However we have to determine if we would or would not take CT scanning by simple radiography in the acute setting and most of the surgeons still use simple radiography in evaluating postoperative result. And also we have to determine the accuracy of reduction and position of screws by simple radiography intraoperatively. The purpose of this report is to determine the accuracy of simple radiography in assessing the pathological anatomy of the intraarticular calcaneal fracture by experimental and clinical studies. This is a combined experimental and clinical studies using four below knee amputation specimens and 15 patients with 19 displaced intraarticular calcaneal fractures treated at Hanil General Hospital between Jan. 1996 and May 1997. The lateral view of the foot was the best radiographic view for visualizing the degree of depression of the posterior facet. With regard to the location of a fracture line, findings of Broden views correlated well with findings on CT in 17 of 19 fractures. With regard to gapping between fragments, the axial view was not satisfactory in the majority of cases(15 of 19 cases). There was no case which showed more than 2 mm of discrepancy between the findings on Broden view and CT. We conclude that we may obtain most of the important informations about the pathological anatomy of the intraarticular calcaneal fracture by simple radiography.
Amputation ; Depression ; Diagnosis ; Foot ; Hospitals, General ; Humans ; Knee ; Radiography* ; Tomography, X-Ray Computed

Intraabdominal abscess usually causes distress with fever, leukocytosis, pain and toxicity. Diagnosis of intraabdominal abscess is occasionally difficult and it has high morbidity. However radiologic method, such as ultrasonography, CT scan, or RI scan are helpful to early detection of intraabdominal abscess. Among these methods, ultrasonography is a noninvasive technique and performed without discomfort to patient. And also differential diagnosis between cystic and solid lesion is very easy and sequential ultrasonography in same patient is valuable for the evaluation of treatment effect. We analyzed the ultrasonic features of 48 cases with intraabdominal abscesses and the results are as follows; 1. In total 48 cases, the intraabdominal abscesses were 30 cases, the retroperitoneal abscesses, 5 cases, and the visceral abscesses, 13 cases. 2. The causes of the intraabdominal abscesses were perforating appendicitis (25 cases), postoperative complications (5 cases), pyogenic and amebic hepatic abscesses (13 cases), and the other (5 cases). 3. Round or oval shaped lesions were 26 cases (54%), irregular shape, 18 cases (38%), and multiple abscess formation in 4 cases (8%). 4. The size of the lesions were between 5 and 10cm in diameter in 54% of total 48 cases, and the most frequent feature of the echo pattern of the lesions was cystic with or without internal echogenicity (69%).
Abdominal Abscess* ; Abscess ; Appendicitis ; Diagnosis ; Diagnosis, Differential ; Fever ; Humans ; Leukocytosis ; Liver Abscess ; Methods ; Postoperative Complications ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography

PURPOSE: To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). MATERIALS AND METHODS: 46 patients underwent PTBD in 52 occassions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general dondition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. RESULTS: Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. CONCLUSION: We PTBD using large neddie is a simple and safe procedure for prompt bile decompression.
Bile ; Decompression ; Drainage* ; Humans ; Needles*

A case of the tuberous sclerosis, 14-years old boy, was observed. In his father and sister, the cerebral tubers were noted by brain computerized tomography. This disease has been reported occasionally in dermatologic and psychiatric department because of adenoma sebaceum, mental retardation and epilepsy respectively, but it has not been reported at neurosurgical department in Korea. The histopathology of the brain lesion showed atypical cell(tuberous sclerosis cell), gliosis and nonspecific calcification which confirmed the diagnosis of tuberous sclerosis.
Adolescent ; Brain ; Diagnosis ; Epilepsy ; Fathers ; Gliosis ; Humans ; Intellectual Disability ; Korea ; Male ; Sclerosis ; Siblings ; Tuberous Sclerosis*

Bilateral nonfunctioning adrenal cortical carcinoma is an extremely rare disease with poor prognosis. We report a case of asynchronous bilateral nonfunctioning adrenal cotical carcinoma. The patient was a 55 year-old man who had complained of discomfort in the right upper quadrant and flank area. There was no endocrinological abnomaliries. Abdominal CT revealed about 9.5 x 7.0 cm sized right adrenal mass. Under the impression of nonfunctioning adrenal cortical carcinorna, right radical adrenalectomy was performed. After 1 year from operation, 5.0 x 7.0 x 6.0 cm sized new mass was detected in the left adrenal gland with metastasis to the peritoneum.
Adrenal Glands ; Adrenalectomy ; Adrenocortical Carcinoma* ; Humans ; Middle Aged ; Neoplasm Metastasis ; Peritoneum ; Prognosis ; Rare Diseases ; Tomography, X-Ray Computed

PURPOSE: To evaluate the effect of Bog Bilberry (Vaccinium uliginosum) extract in eyes with early age-related macular degeneration (AMD). METHODS: Forty-four eyes of forty four patients with early AMD were included in this randomized, double-blinded, and placebo-controlled study. All participants were randomly assigned to either the placebo group (n = 24), or the bog bilberry extract group (n = 20). Before drug administration, an ophthalmic examination which included slit lamp microscopy, best corrected visual acuity, and intraocular pressure was performed, and repeated 1and 3 months after treatment. Objective scatter index, glare and tear film break-up time were checked by Optical Quality Analysis System (OQAS, Visiometrics, Spain) and drusen volume, central macular thickness, and RPE and IS/OS junction thickness were investigated with spectral-domain optical coherence tomography (Spectralis, Heidelberg, Germany). RESULTS: In the bog bilberry extract group, RPE and IS/OS junction thickness was significantly increased compared to the placebo group after 3 months of drug administration. CONCLUSIONS: Bog Bilberry extract may play a favorable role in preventing the atrophic change of RPE and IS/OS junction layer and the progression of early macular degeneration.
Eye ; Glare ; Humans ; Intraocular Pressure ; Macular Degeneration ; Microscopy ; Tears ; Tomography, Optical Coherence ; Vaccinium ; Vaccinium myrtillus ; Visual Acuity ; Wetlands

Enalapril, a new angiotensin converting enzyme inhibitor,was administered in 30 hypertensive patients for 12 weeks or longer in order to evaluate the antihypertensive effects and side effects (in some cases combination with hydrochlorthiazide). The doses were from 10mg to 40mg once a day. The results were as follows : 1) Before medication and 2, 4, 6, 8, 10 and 12weeks of medication, the average systolic and diastolic pressure were 176.7+/-16.0/108.6+/-7.6, 146.0+/-12.5/91.7+/-6.9, 138.3+/-16.1/87.3+/-10.6, 140.7+/-13.9/87.3+/-9.6, 137.3+/-13.5/87.7+/-9.1, 137.3+/-14.8/87.0+/-8.5, 138.7+/-15.4/87.3+/-9.1mmHg respectively. After 12 weeks of medication, marked or moderate degree of anti-hypertensive effect was observed in 90% of all cases (p<0.005), and the further significant decease of systolic blood pressure after 4 weeks compared with 2 weeks (p<0.025) was observed. 2) There was no significant change in pulse rate before and after medication. 3) There was no significant change in the laboratory findings such as fasting blood sugar, serum BUN, creatinine, cholesterol, GOT, GPT, blood WBC, hemoglobin, hematocrit, and urine protein before and after treatment. 4) The side effects of enalapril were observed in 2 cases of 30 cases (6.6%), mild dizziness and mild fatigue, which were not required discontinuing the medication or decreasing the dose.
Blood Glucose ; Blood Pressure ; Cholesterol ; Creatinine ; Dizziness ; Enalapril* ; Fasting ; Fatigue ; Heart Rate ; Hematocrit ; Humans ; Peptidyl-Dipeptidase A

Presented below are the author's report of the result of surgical treatment of 53 intramedullary gliomas. In the analysis of survival data, twenty patients with low grade glioma(except the ependymoma) were followed for a period of mean 54 months, from 1 to 103 months. Five of these patients had died from progression of the disease and the 5 year survival rate was 75%. Nine patients from the above group received postoperative radiation therapy, 6 with no apparent benefit in terms of survival rate. The median survival of thirteen patients with high grade glioma patients were 11 months and there were significant increase of median survival time in patients receiving radiation therapy, from 4 to 17 months(P=0.04). The histological grade is the important factor in determining the survival of glioma patients(P=0.01). In sixteen, out of 20 ependymoma patients, 'radical removal(>95%)' was achieved and the patients showed no signs of recurrence until the mean follow-up period of 42 months. Two of the 4 ependymoma patie nts, whose tumors were partially removed, suffered recurrence and had to be re-operated. We concluded that the 'radical removal' in ependymomas is a significant factor in determining recurrence(P=0.009). The effect of radical removal on survival is not verified statistically. Total removal is more frequently performed in ependymomas than in gliomas(p=0.03). As to functional outcome, better outcome is expected in radical removal on long-term follow-up(p=0.00506), more so in ependymoma than in glioma. Intramedullary gliomas are extremely rare. Therefore sufficient data is unavailable for the determination of efficient treatment plan. However, recently aggressive surgical treatment with the aid of microsurgical techniques has become a trial option.
Ependymoma ; Follow-Up Studies ; Glioma ; Humans ; Recurrence ; Survival Rate