PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty ; Arteries ; Cardiac Output ; Catheters ; Coronary Artery Disease ; Endarterectomy ; Femoral Artery* ; Follow-Up Studies ; Humans ; Popliteal Artery* ; Punctures ; Stethoscopes

The spleen is the most common intraabdominal organ injured in blunt trauma, Although physical signs andsymptoms, coupled with abdominal paracentesis & peritoneal lavage confirm intraabdominal injury, but isolatedsplenic injury especially delayed rupture, the diagnosis and clinical course is variable. We are reevaluation ofplain roentgenologic findings for the light of early diagnosis of isolated splenic injury. 24 patiens of theautopsy and surgically proven isolated splenic injury at Chosun University Hospital in the period from 1980January to 1986 June were analyzed plain roentgenogram retrospectively. The results were as follows: 1. Malepatients predominate, constitution 87.5%. Incidence has been greatest in second to fourth decade. 2. Mode oftrauma causing isolated splenic injury is most common in motor vehicle accident and others are fall down, struckby fist, blow to object, uncertain blunt trauma. 3. Delayed rupture of spleen occured in 2 cases(8.3%). 4. Commonpatterns of splenic injury is simple laceration that involves both the capsule and the parenchyma and a lacerationthat involves the splenic pedicle. 5. Plain chest roentgenographic findings were abnormal in 4 cases (16.7%). Themost common plain abdominal roentgenographic findings was the evidence of intraabdominal fluid in 21 cases(87.5%).The others are included in order of frequency: gastric dilatation, prominent mucosal folds on greater curvature ofthe stomach, evidence of pelvic fluid, displacement of stomach to the right or downward, mass density in theregion of spleen. 6. No relationship can be shown between patterns of injury, time lapse after trauma and plainroentgenological findings. But the evidence of intraabdominal fluid is most important in the light of earlydiagnosis. 7. Diagnosis of splenic injury may be most helpul that in combination with clinical history, clinicalsymptoms & signs and plain film findings. In delayed rupture, diagnostic value of serial examination and surgicalobservation is emphasized.
Constitution and Bylaws ; Diagnosis ; Early Diagnosis ; Gastric Dilatation ; Incidence ; Lacerations ; Motor Vehicles ; Paracentesis ; Peritoneal Lavage ; Retrospective Studies ; Rupture ; Spleen ; Stomach ; Thorax

PURPOSE: The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CT with multiplanar reformation in patients with extrahepatic biliary obstruction. MATERIALS AND METHODS: Helical CT was performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasive cholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). The cause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, three pancreatitis) and 18 malignant diseases(seven common bile duct carcinomas, seven pancreatic head carcinomas, three ampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bile duct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained with multiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level and the cause of the obstruction. We compared findings of the CT cholangiogram with that of operation or invasive cholangiography. RESULTS: In 100%(36/36) of cases, CT cholangiography could be obtained successfully. The accuracy of the CT cholangiography in determinating the level of the obstruction was 100%(11 cases of suprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and the accuracy in determinating the cause of the obstruction was 91.7%(all cases of 18 benign diseases, and 15 cases of 18 malignant diseases). CONCLUSION: In evaluating the obstruction of extrahepatic bile ducts, the CT cholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinating the level.and the cause of biliary obstruction and therefore could replace t~e invasive cholangiography.
Bile Ducts, Extrahepatic ; Cholangiography* ; Choledochal Cyst ; Common Bile Duct ; Head ; Humans ; Retrospective Studies ; Tomography, Spiral Computed*

Pulmonary Embolism, one of the causes of maternal death, is a life threatening disease that needs early and accurate diagnosis. We have exprerienced a case of a fatal pulmonary embolism which was diagnosed by lung perfusion scan on the postoperative 1 day after cesarean delivery and was managed with heparin therapy. We present this case with a brief review of literatures.
Diagnosis ; Heparin ; Lung ; Maternal Death ; Perfusion ; Pulmonary Embolism*

BACKGROUND: Terminology is a good index of reflections in conceptional imaginations, trends and technological advances in the field of their own. The goal of this study was to compare the similarity and difference of terms in anesthesiology to evaluate the communicability between South and North Korea. These results may be particularly helpful during the next step of making glossary, academic communication and the searching of social unity at the time of reunion. METHODS: Several books and indexes written in South and North Korea and data from seminars were obtained. Multiple terms were then drawn from these data. These terms were used to make a comparison between South and North side. RESULTS: Both side does not use a Chinese character in their books and indexes, even though many terms stem from a Chinese character. North side had more terms of native language than South side. There were some different terms because of each others rules of grammar. Several terms were confusedly used in both side. In some of combined terms, words were reversed in their orders. CONCLUSIONS: We conclude that terminology using in South and North Korea in the field of anesthesiology is not so far way and both side can be capable of communication without any difficulty. But both have many areas to be filled with terms of native language to have identity.
Anesthesiology* ; Asian Continental Ancestry Group ; Democratic People's Republic of Korea* ; Humans ; Imagination ; Reunion

PURPOSE: To compare the CT findings of peritoneal tuberculosis (PT) and peritoneal carcinomatosis (PC) based on the morphologic features of the peritoneum and assess the relationship between the degree of peritoneal thickness and the severity of omental infiltration in PT and PC. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 15 patients with PT and 14 with PC. We checked the morphologic changes of the peritoneum as seen on CT, for the following points: 1) the presence of peritoneal change: 2) the pattern of any change-diffuse thickening, plaque or nodularity, combined thickening (diffuse and plaque, or nodularity); 3) the degree of thickness on the whole peritoneum - mild (grossly definite, but not more than 3 mm), moderate (more than 3mm); 4) the presence of irregularity on the peritoneal surface. We also evaluated the significance of the relationship between peritoneal thickness and omental infiltration in both disease entities. The degree of omental infiltration was described as follows : grade I (no change or focal smudge pattern); grade II ( diffuse smudge), grade III (omental cake regardless extent). RESULTS: Peritoneal change was seen in 12 of 15 PT patients and in 7 of 14 PC patients. In all 12 PT patients, the pattern of change was diffuse thickening, and among the seven PC patients, there was diffuse thickening in one, plaque or nodular thickening in four, and combined thickening in two. In PT patients, the degree of thickness on the whole peritoneum was mild in six and moderate in six, and in PC patients it was mild in two and moderate in one. An irregular peritoneum surface was seen in one patient with PT and in two with PC. The degree of omental infiltration in PT was grade I in four patients, grade II in six andgrade III in five. In PC, it was grade I in six patients, grade II in two and grade III in six. Smooth diffuse thickening of the peritoneum was seen in 11 of 15 PT cases and in one of 14 PC (P<0.01). Accompanying plaque or nodularity was seen only in PC, in six of 14 patients (P<0.001). The relationship between the degree of peritoneal thickness and severity of omental infiltration was significantly proportional in PT (r=0.900, P<0.001), but not in PC (r=0.068, P>0.5). CONCLUSION: In PT and PC different CT findings based on peritoneal morphologic changes might be useful in differentiating these two entities. In addition, careful observation of relationship between the peritoneal change and the severity of omental infiltration is necessary.
Carcinoma* ; Humans ; Peritoneum ; Peritonitis, Tuberculous* ; Retrospective Studies ; Tuberculosis

The common arterial trunk is a congenital cardiovascular malformation in which one arterial trunk gives origin to the aortic arch, pulmonary and coronary arteries. Other cardiovascular malformations are often associated, such as ventricular septal defect, aortic arch interruption, patent arterial duct and so on. During the early period of life, the persistence of the increased pulmonary arteriolar resistance results in cyanosis. As the pulmonary vascular resistance decreases, the cyanosis disappears but signs of congestive heart failure become the main problems. We report five cases of common arterial trunk that was confirmed by autopsy at Chungnam National University Hospital, Seoul National University Hospital, and Yonsei University Severance Hospital between 1983 and 1995. The ages of these patients at autopsy were 8-28 days and four of them were male. Pulmonary arteries arose as a pulmonary trunk in two cases but three cases showed two arteries arising separately from the posterior wall of the common trunk. The type of ventricular septal defect was juxtatruncal in every case. All five cases had three leaflet truncal valves but three cases showed dysplasia of the leaflets. Interruption of aortic arch was associated in two cases. The cause of death was renal failure in two cases, cardiac failure after corrective surgery in two cases, and pulmonary edema and failure in one case.

BACKGROUND: We evaluated the antihypertensive effect, safety and effect on serum lipids of terazosin, second generation alpha1-blocker. METHODS: Terazosin 1-4mg was adminstered once daily in 20 patients for 12 weeks with dose titration every 2 weeks. RESULTS: 1) The systolic and diastolic blood pressure were decreased from 170.0+/-13.0/104.0+/-6.0mmHg to 144.0+/-13.3/88.0+/-5.6mmHg(p<0.01), but the heart rate and body weight were independant of terazosin administration. 2) Total cholesterol was decreased significantly from 209.9+/-33.5mg/dL to 194.6+/-30.1mg/dL after 12 weeks treatment(p<0.05), triglyceride was decreased significantly from 185.4+/-37.0mg/dL to 168.9+/-35.0mg/dL(p<0.05). and LDL-cholesterol was decreased significantly from 134.5+/-31.9mg/dL to 122.7+/-29.9mg/dL(p<0.05), but HDL-cholesterol was increased significantly from 37.8+/-5.6mg/dL to 40.6+/-5.5mg/dL(p<0.05). 3) The adverse effects of terazosin were dizziness in 2, headache in 2, asthenia in 1, peripheral edema in 1 and skin rash in 1 patient, but were not troublesome enough to stop medication. CONCLUSIONS: Terazosin 1-4mg once daily regimen was effective and safe as an antihypertensive agent, and moreover terazosin has favorable effects on serum lipids.
Asthenia ; Blood Pressure* ; Body Weight ; Cholesterol ; Dizziness ; Edema ; Exanthema ; Headache ; Heart Rate ; Humans ; Hypertension* ; Triglycerides

PURPOSE: Chronic pulmonary disease may be caused by aspiration of gastric contents secondary to gastroesophageal reflux. At present, there is no gold standard for documenting pulmonary aspiration. The purpose of this study was to investigate the usefulness of radionuclide scintigraphy in the detection of gastroesophageal reflux and pulmonary aspiration. METHODS: Thirty-five patients with suspected aspiration pneumonia, and five normal control subjects, were included in the study. All subjects underwent gastroesophageal reflux scintigraphy after the ingestion of a (99m)Tc-tin colloid mixture. Dynamic images to detect gastroesophageal reflux were obtained for 1 hour. Additional static images of the chest, to detect lung aspiration, were obtained at 6 and 24 hours after oral ingestion of the tin colloid. In addition to visual analysis, pulmonary aspiration was quantitated by counting the number of pixels labeled with radioactive isotope in the region of interest (ROI) of both lung fields. Aspiration index (AI) was obtained by subtracting the pixel counts of the background from the pixel counts of the ROI. RESULTS: Among 35 patients with suspected aspiration pneumonia, 23 proved to have gastroesophageal reflux by scintigraphy. One patient showed definite pulmonary accumulation of activity by visual analysis of the 6-hour image. Thirty of 35 (85.7%) patients showed higher AI beyond the upper limit of AI in the healthy controls. When we compared the reflux group with the non-reflux group, there was a significantly higher AI at 6 hours in the reflux group (p<0.05). CONCLUSION: The results suggest that radionuclide scintigraphy is useful in detecting small pulmonary aspiration in patients with suspected aspiration pneumonia secondary to reflux.
Colloids ; Eating ; Gastroesophageal Reflux ; Humans ; Lung ; Lung Diseases ; Pneumonia, Aspiration ; Thorax ; Tin

The purpose of this study was to evaluate the effect of additional etching procedure prior to Maxcem resin cement application in indirect restoration cementation using push-out bonding strength. One hundred and two extracted human molars were used to make indirect resin restorations of gold inlay and Synfony. These restorations were cemented using Maxcem and Variolink II. Additional etching procedures were done for one group with Maxcem. Three groups have 17 specimens in both restoration types. Push-out bond strength was measured using multi-purpose tester and calculated for bonding strength per sqaure-millimeter area. The mean bonding strength values were compared using SPSS 12.0K program for one-way ANOVA and Scheffe's Test with 95% significance. Under the condition of this study, the additional etching procedure prior to usage of Maxcem resulted in reduced bond strength for both of restoration types.
Cementation ; Humans ; Inlays ; Molar ; Resin Cements