No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Retinopathy of Prematurity* ; Risk Factors*

Spinal epidural hematoma is a rare complication of epidural anesthesia and most commonly associated with intraoperative or postoperative anticoagulant administration. We describe the case of an acute thoracolumbar epidural hematoma at the T12-L4 level complicated by cauda equina syndrome, which occurred after placement of spinal epidural catheter for anesthesia and anticoagulant therapy for acute myocardial infarction developed postoperatively. In our experience, the spinal epidural catheterization and anticoagulant therapy may potentially increase the risk of epidural hematoma formation.
Anesthesia ; Anesthesia, Epidural* ; Catheterization ; Catheters ; Cauda Equina* ; Hematoma* ; Hematoma, Epidural, Spinal ; Heparin* ; Myocardial Infarction ; Polyradiculopathy*

A total of 132 cases of structural scoliosis have been followed since Jan. 1963 up to Dec. 1976 at the Hanyang University Hospital. The present paper classified scoliosis according to the etiology and analyzed curve patterns and spinal deformties such as rotation and wedging. Various kinds of treatment were done and these included Milwaukee brace, posterior spinal fusion with or without Harrington instrumentation. The end results of these treatment were also analyzed. The results concluded from the present studies were as follows: 1. Poliomyelitis was the most common cause of structural scoliosis. Of 132 cases of scoliosis, paralytic scoliosis was 48.5% while idiopathic scoliosis was 31.1% and congenital scoliosis 9.8%. 2. In paralytic scoliosis lumbar curves were the most common pattern and thoracic and thoracolumbar curves were the next. 3. In idiopathic scoliosis, the most common pattern was the right thoracic. 4. Very severe curves over 80° were more frequent in paralytic than in idiopathic scoliosis, showing the percentage of 20.3% in paralytic scoliosis and 10.3% in idiopathic scoliosis respectively. 5. The number of vertebrae involved in primary curve was approximately the same in both paralytic and idiopathic scoliosis. 6. In paralytic scoliosis, as the curves progressed, rotation of vertebrae became more marked in lumbar curve than in thoracic curve, while wedging deformity was more severe in thoracic curve than in Jumbar curve. 7. The tendency of the rotation and wedging in thoracic and lumbar curve was the same in both idiopathic scoliosis and paralytic scoliosis. When the degree of curves was the same, rotation and wedging were slightly more severe in idiopathic than in paralytic scoliosis. 8. In congenital scoliosis hemivertebrae were the most common anomaly and the majority of congenital anomalies were located at lumbar region. 9. Treated with Milwaukee brace, 22.1% of original curve angle was corrected in idiopathic coliosis, 9.8% in paralytic scoliosis, and 7.3% in congenital scoliosis, respectively. The Milwaukee brace was effective in thoracic and thoracolumbar curves but not in lumbar curves. 10. In paralytic scoliosis treated with posterior spinal fusion without Harrington instrumentation, the final degree was 43.2 and the correction loss was 12.6% but with both posterior fusion and Harrington instrumentation, the final degree was 50.2 and the correction loss was 6.8%. 11. There were 2 cases of complication after posterior spinal fusion without Harrington instrumentation. One was pseudarthrosis and the other was bending of graft with some loss of correction. One case of complication occured after posterior spinal fusion with Harrington instrumentation. It was a case of displacement of distraction hook on the rod.
Braces ; Clinical Study ; Congenital Abnormalities ; Lumbosacral Region ; Poliomyelitis ; Pseudarthrosis ; Scoliosis ; Spinal Fusion ; Spine ; Transplants

MRI has proved to be very reliable in evaluating the menisci and cruciate ligaments. On MRI, several diagnostic criteria of ruptured ACL were reported. Boeree and Ackyroyd reported that when the ACL is ruptured the PCL may appear to be curled up or sigmoid. But these morphologic changes may be shown in the normal ACL, so the quantitative analysis of these morphologic changes in considered as a way to increase the diagnostic sensitivity. We have used 1.0 tesla MRI scanner(SIMENS W. Germany) with a surface coil. We compared two groups of patients; a ruptured ACL group(16 patients) in which had indicated and arthroscopy confirmed rupture of the ACL and control group(46 patients), in which had shown the ACL to be entirely normal. At first, we made a line(basal line) between the femoral attachment and tibial attachment of the PCL and decided the point(apex) which was located far distant from the line. And we made a line(A line) between the femoral attachment and apex of the PCL, another line(B line) between the tibial attachment and apex of the PCL. We divided the basal line into the four areas. We measured the each angle between basal line and A line(angle a), between basal line and B line(angle b). And we measured the entire length of basal line, each height of the PCL previously divided point of the basal line(H1, H2, H3) and the apex of the PCL on the basal line. We compared the control group and ruptured ACL group by t-test from the measured factors angle a, angle b, H1, H2, H3, H4, and length of basal line. We studied factors which were able to decide whether the ACL was ruptured or not in MRI finding by logistic regression. 1. H1, the distance from the basal line to the PCL at 1/4 point on the basal line, were 5.7±1.6 mm in ruptured ACL group, 4.7±1.3 mm in control group, so there was statistically significant increase in ruptured ACL group. 2. The angle a were 56.0±14.4° in ruptured ACL group, 39.7±10.1° in control group, so there was statistically significant increase in ruptured ACL group. 3. From the measured factors angle a was able to decide whether the ACL was ruptured or not in MRI and the slope of angle a in logistic regression was 0.1. In conclusion, when the apex of the PCL is located at proximal 1/4 of the PCL and PCL and greater curve, above signs will be considered to be a sign of ruptured ACL in MRI.
Arthroscopy ; Colon, Sigmoid ; Humans ; Ligaments ; Logistic Models ; Magnetic Resonance Imaging ; Rupture ; Tears

Stomach carcinoma is more common disease in korea than western contries. The reported ultrasonographicfindings of gastric carcinoma were thickening of gastric wall and “pseudokidney” sign. The auther analizedultrasonographic findings of 101 cases with gastric carcinoma who were performed ultrasonography and gastroscopyat Kyung Hee Universtiy Hospital from Oct. 1982 to Oct. 1985. The results were as followings; 1. Types of gastriccarcinoma were consisted with infiltrative type 68 cases, infiltrative type with ulceration 16 cases, polypoidtype with ulceration 1 cases, infiltrative and polypoid type 4 cases, linities plastica type 3 cases, lcerativetype 1 case and polypoid type 1 case. 2. Extent of the lesions were in body and antrum 45 cases, entire stomach 18cases, antrum 18 cases, body 12 cases, body and fundus 6 cases. 3. Ultrasonography was useful in demonstrating theextent of the tumor and the presence of materials elsewhere in abdoment.
Korea ; Stomach ; Ulcer ; Ultrasonography

No abstract available.
Humans ; Infant, Newborn*

PURPOSE: The purpose of this study is to assess the usefulness of dynamic MR imaging after contrast enhancement with Gd-DTPA in the differential diagnosis of hepatic focal lesions. MATERIALS AND METHODS: The population consists of 22 cases of hepatocellular carcinoma, 44 cases of hemangioma, and five cases of metastasis. Diagnosis of hepatocellular carcinoma was made by surgery, fine needle biopsy, ultrasonography, CT and conventional angiography. Hemangioma was diagnosed on the basis of ultrasonography, CT, conventional spin-echo MRI and clinical data. Diagnosis of metastasis was done by fine needle aspiration biopsy. Dynamic and delayed images were obtained using 1.5T superconductive magnetom after Gd-DTPA(0.1mmol/kg) intravenous injection. Quantitative and qualitative evaluation was done for each lesion. RESULTS: Early contrast enhancement with rapid or gradual washout was noted in 15 lesions of hepatocellular carcinoma(68.2%) ;on the delayed images, no contrast enhancement was noted in 18 lesions(81. 8%). Peripheral contrast enhancement pattern was predominantly(86.4%) observed in hemangiomas during dynamic phase. On the delayed images, homogeneous and persistent contrast enhancement of masses were noted in all hemangiomas. Characteristic centripetal fill-in pattern was observed in 32 lesions of hemangioma (72.7%). Contrast inversion of masses during contrast enhancement study was noted in all hemangiomas, while continuous negative contrast was noted in hepatocellular carcinomas and metastases. CONCLUSION: Dynamic MR imaging after contrast enhancement with Gd-DTPA is an useful method in the differential diagnosis of hepatic focal lesions.
Angiography ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential* ; Evaluation Studies as Topic ; Gadolinium DTPA ; Hemangioma* ; Injections, Intravenous ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Ultrasonography

PURPOSE: We performed this study to evaluate the usefulness and the limitation of magnetic resonance angiography in imaging portal vein and hepatic vein. MATERIALS AND METHODS: Magnetic resonance portography was performed in five normal subjects and seven patients with hepatomas, two patients with Budd-Chiari syndromes, one patient with liver cirrhosis and one patient with hepatic metastasis from stomach cancer. Magnetic resonance angiography was done with a 1.5-T Scanner. Breath-hold two-dimensional time-of flight images with spoiled gradient echo technique were acquired. Scan parameters were 34/8/40degrees(TR ms/TE ms/flip angle). The portal vein and the hepatic vein were selectively imaged by applying two presaturation bands. These images were then postprocessed by a maximum intensity projection algorithm. MRA findings were compared with ultrasonography in all cases of the hepatic disease, and conventional angiography (SMA portography) in four cases. RESULTS: In normal subjects, the splenic vein, intrahepatic and extrahepatic portions of the portal vein, and the hepatic veins were well visualized. In the patients with hepatic diseases, the varices (4 cases), the splenorenal shunts (2 cases), and the recanalized umbilical vein (1 case) were demonstrated. There were portal vein thrombosis in the cases of hepatomas and hepatic metastasis. In the cases of Budd-Chiari syndrome, the hepatic veins were not visualized and there were inferior vena cava obstructions with multiple collateral vessels. CONCLUSION: Compared with ultrasonography, MRP may be useful in evaluation of varices, splenorenal shunts, and other collaterals, though less accurate than conventional angiography. MRP can be useful as a noninvasive screening alternative in the evaluation of portal vein and hepatic veins.
Angiography ; Budd-Chiari Syndrome ; Carcinoma, Hepatocellular ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Magnetic Resonance Angiography ; Mass Screening ; Neoplasm Metastasis ; Portal Vein ; Portography* ; Splenic Vein ; Splenorenal Shunt, Surgical ; Stomach Neoplasms ; Ultrasonography ; Umbilical Veins ; Varicose Veins ; Vena Cava, Inferior ; Venous Thrombosis

With the recent increase of coronary artery disease in Korea, coronary arteriography israpidly gaining importance as a diagnostic procedure in the management of ischemic heart disease in this country. In order to delineate normal angiographic anatomy of the coronary arteries in Korean adults, the author reviewed 63 normal or near normal coronary angiograms out of 113 consecutive cases done at the cardiac laboratory of Yonsei University Severance Hospital from February, 1976 through September, 1982 and obtained the following results. 1) The diameter of the main stems of the left and the right coronary arteries measured 2.7-6.3mm(mean, 4.0mm) and 2.1-6.0mm(mean, 3.6mm) respectively, and the length of the left main stem measured 0-23mm(mean, 9.3mm). 2) The conus branch was visualized to originate from the proximal right coronary artery in 50 cases(79.4%), and in the other 13(20.6%) in whom the conus branch was not visualized, it was assumed to have a separate ostium directly from the aortic root. 3) The sinus node artery originated from the right coronary artery in 35 cases(55.5%) and from the left circumflex 20(31.7%). The remaining 8 cases(12.7%) appeared to have dual blood supply. 4) The artery to the A-V node arose from the proximal part of the posterior descending artery as a branch of the right coronary artery in 59 cases(93.7%) and of the left circumflex in only 4(6.3%), and the pattern of the A-V node blood supply coincided with the dominancy(crossing the crux of the heart and giving rise to the posterior descending artery) of the right or the left circumflex arteries. 5) In 33 cases(52.4%), both of the arteries to the SA and the AV nodes arose from the right coronary, and in 19(30.2%), the SA node artery came from the right, whereas the AV node artery originated from the left circumflex. 6) The number of ramifications(furcation) of the main left coronary artery was two in 53 cases(83.1%), three in 9(14.3%), and four in 1(1.6%). 7) The number of diagnoal branches of the left anterior descending artery was one in 34 cases(54%), two in 28(44.4%) and 3 in 1(1.6%).
Adult* ; Angiography ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels* ; Heart ; Humans ; Korea ; Myocardial Ischemia