Obstruction of the inferior vena cava(IVC) is an uncommon condition, and the collateral pathway variesaccording to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in itshepatic portion might be one of the principal cause among Korean, though not reported till now. Analytical studywas perfomred in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relativelyeven distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. Themain cause of upper caval obstruction was membranous obstruction . 3. As a whole, the main collateral pathway wasthe central route(22 case:85%). 4. Characteristic collateral pathway unique to upper caval obstruction wastranshepatic vanous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5.Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chestX-ray finding in IVC obstruction.
Collateral Circulation ; Vena Cava, Inferior

CT is the most accurate and reliable method for the diagnosis of intracerebral and intraventricularhemorrhage. The precise anatomic extent of the hematoma, associated cerebral edema, ventricular deformity anddisplacement, and hydrocephalus are all readily assessed. Aside from head trauma, the principal cause ofintracerbral hematoma is hypertensive vascular disease. Although hematomas from various causes may present similarCT appearances frequetnly the correct etiology may be suggested by considereation of patient's age, clinicalhistory, and the location of the hematoma. The analytical study was performed in 180 cases of intracerebralhamorrhages by CT from Oct. 1981 to Jan. 1983. The results were as follows; 1. The most prevalent age group was6th decade(37.2%) Male was prevalent to female at the ration of 1.6 to 1. 2. The most common symptom and sign wasmental distrubance (48.7%), motor weakness(23%), headache(10.6%), nausea and vomiting (9.8%). 3. The causes ofhemorrhage were hypertension (53.9%), head trauma (30.6%), aneurysm(6.1%) and A-V malformation (7.2%). 4. Thefrequent locations of hemorrhage were basal ganglia and thalamus(40.4%), lobes(35%), ventricles(21.8%). 5. Thedistribution of hemorrhage was intracerebral hemorrhage(65.6%), intracerebral and intraventricularhemorrhage(30.3%), intraventricular hemorrhage(4.4%).
Basal Ganglia ; Brain Edema ; Cerebral Hemorrhage ; Congenital Abnormalities ; Craniocerebral Trauma ; Diagnosis ; Female ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Male ; Methods ; Nausea ; Vascular Diseases ; Vomiting

Transcatheter arterial embolization was applied in 7 cases of hepatic disease including hemobilia of various causes and malignant tumors at Department of Radiology, Seoul National University Hospital during recent several years. The embolic materials were autologous blood clot and Gelfoam particle. Successful control of bleeding or devascularization of tumor vessel was made in 6 of the 7 patients. There was no serious complications; however, post embolization syndrome was found including pain, fever, nausea and vomiting in all cases and subsided after a few days. Transcatheter hepatic arterial embolization is suggested to be a safe and effective treatment in control of hemobilia and devascularization of malignant hepatic tumors.
Fever ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemorrhage ; Humans ; Nausea ; Seoul ; Vomiting

In 31 cases of abdominal vascular lesions including aorta, inferior vena cava and portal vein, ultrasonographyand angiography were done at departement of radiology, Seoul National University Hospital, for recent 3 years forcomparative analysis of those findings. The results are ad follows: 1. There are 11 cases of abdominal aorticlesion such as atherosclerotic aneurysms and dissecting aneurysms, 12 cases of inferior vena cava lesion such asmembraneous obstruction and 5 cases of portal vein invasion due to hepatoma. 2. Ultrasonography revealed enlargedlumen and extent of the lesions in all cases of aortic aneurysm and showed intraluminal thrombus more accuratelythan aortography. 3. Intimal flap was detected in all case of dissecting aneurysm, however, ultrasonography couldnot show proximal extent and involvement of major branches. 4. In the cases of inferior vena cava obstructionultrasonography revealed obstruction site and extent of the leisons accurately but vena cavography depictedcollateral circulation better. 5. In 5 cases of angiographic portal vein invasion due to hepatoma, portal veinthrombus was detected in 4 cases by ultrasonography. And ultrasonography could not reveal collaterals,arteriovenous shunt and thread and streaks sign.
Abdomen ; Aneurysm ; Aneurysm, Dissecting ; Angiography ; Aorta ; Aortic Aneurysm ; Aortography ; Carcinoma, Hepatocellular ; Portal Vein ; Seoul ; Thrombosis ; Ultrasonography ; Vena Cava, Inferior

BACKGROUND: Combining blepharoptosis correction with double eyelid blepharoplasty is common in East Asian countries where larger eyes are viewed as attractive. This trend has made understanding the relationship between brow position and height of the palpebral fissure all the more important in understanding post-operative results. In this study, authors attempt to quantify this relationship in order to assess whether the expected postoperative brow descent should be taken into consideration when determining the amount of ptosis to correct. METHODS: Photographs of ten healthy female study participants were taken with brow at rest, with light elevation and with forceful elevation. These photographs were then viewed at 2 x magnification on a computer monitor and caliper was used to measure the amount of pull on the eyebrow in relation to the actual increase in vertical fissure of the eye. RESULTS: There was a positive, linear correlation between amount of eyebrow elevation and height of the palpebral fissure, which was statistically significant. Brow elevation increased vertical fissure, and thereby aperture of the eye, by 18%. CONCLUSIONS: Although the eye-opening strength as well as height of the palpebral fissure is improved with ptosis repair, the true effectiveness of ptosis surgery is diminished by the associated descent of the brow from relief of the involuntary frontalis muscle action and this should be taken into account prior to surgical intervention. Regardless, the combination of frontalis muscle relaxation and the increased eye-opening strength from ptosis repair gives the eye and the periorbital region a more natural look.
Asian Continental Ancestry Group ; Blepharoplasty ; Blepharoptosis* ; Eyebrows* ; Eyelids ; Female ; Humans ; Muscle Relaxation ; Muscles

BACKGROUND: There has been increasing interest in facial contouring procedures throughout Asian countries. As such, botulinum toxin A injections for masseteric hypertrophy have become a common procedure provided to patients who desire non-surgical correction of a square-angled mandible. We published a retrospective review of our initial results and our technique and treatment protocol in 2005. We also completed a long-term follow-up of the results (average follow-up period of 4.28 years) and the efficacy of repeated injections in 2010. The purpose of the current study is to systematically evaluate the changes to the masseter muscle at weekly intervals to determine the physiologic effects of botulinum toxin A injection. METHODS: Eight patients were prospectively followed on a weekly basis after botulinum toxin A injection for masseteric hypertrophy. Eight patients were followed for 15 weeks and four patients were followed for 25 weeks. Changes in the thickness of the muscle were recorded and analyzed. RESULTS: A reduction in the muscle thickness was found during the clenching phase of the muscle in the first week followed by a reduction in thickness during the resting phase in the second week. The reduction in muscle thickness continued until the eleventh week after which there was a gradual, but incomplete, return of muscle thickness over the study period. CONCLUSIONS: There is a predictable, phasic reduction in muscle thickness after botulinum toxin A injection for masseteric hypertrophy. This reduction first occurs during the clenching phase followed by a concomitant reduction during the resting phase. Maximal size reduction occurs at 11 weeks followed by gradual muscle size recovery.
Asian Continental Ancestry Group ; Botulinum Toxins* ; Botulinum Toxins, Type A* ; Clinical Protocols ; Follow-Up Studies ; G0 Phase ; Humans ; Hypertrophy* ; Mandible ; Masseter Muscle* ; Nerve Block ; Prospective Studies ; Retrospective Studies

PURPOSE: The in vitro dissolution of intrahepatic stones was evaluated using the various solvent mixtures. MATERIALS AND METHODS: Sixty four intrahepatic stones from 16 patients were used. Four kinds of solvent mixtures(No. 1 = basic buffer + EDTA, No. 2=1 + Sulfobetain-12, No. 3=2 + N-acetylcysteine, No. 4=3 + urea) were used. Dissolution rates were determined by measuring the weight loss of stones after 6, 12, 24, 48 hours incubation periods, respectively. RESULTS: The highest dissolution rates in dissolving intrahepatic stones were achieved with No. 4 solvent mixture(1% W/V EDTA/80mM, Sulfobetain-12/1 M, urea, pH 9.5). CONCLUSION: lntrahepatic stones could be largely dissolved up to about 70% of their initial weight after 48 hours incubation period in vitro.
Acetylcysteine ; Edetic Acid ; Humans ; Hydrogen-Ion Concentration ; Urea ; Weight Loss

PURPOSE:The purpose of this study is to evaluate the change of pancreatic size after gastric resection in patients with gastric malignancy. MATERIALS AND METHODS: We compared the pancreatic sizes on pre- and post-operative abdominal CT scans in 50 patients whose stomach had been resected due to malignancy. The mean interval was 20.3 months (range, 5-81 months). The types of the operation were total gastrectomy with esophagojejunostomy and jejunojejunostomy (n=7), and subtotal gastrectomy with gastrojejunostomy (Billroth II) (n=43). Pancreatic thickness was measured perpendicular to the pancreatic long axis at head, body and tail. RESULT: There was a significant reduction of pancreatic size on postoperative CT scan. The reduction rate was 5.9% in the head (p<0.001), 7.1% in the body (p<0.001) and 14.4% in the tail (p<0.001). CONCLUSION:Significant reduction of pancreatic size was observed after gastric resection due to gastric rnalignancy, especially in tail.
Axis, Cervical Vertebra ; Gastrectomy ; Gastric Bypass ; Head ; Humans ; Stomach ; Tomography, X-Ray Computed

Zinner's syndrome is a rare congenital abnormality of the mesonephric duct. Unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction are the triad of maldevelopment of the mesonephric duct which comprises Zinner's syndrome. It is an extremely rare case, in that approximately 100 cases only have been reported worldwide. We discovered a rare developmental anomaly with other mesonephric duct-associated abnormalities, Zinner's syndrome with a presumed ectopic prostate and triorchidism and do report here.

Autologous fat injection had not gained an attention in aesthetic plastic surgery, because of high reabsorption. Recently, fatty tissue was obtained by the low-power technique and centrifuged, results of autologous fat injection was improved. The authors performed autologous microfat injections on 277 patients from March 1997 through December 2002 to correct soft tissue facial contour such as aging, depressed facial contour, thin and long faces as well as postoperative complications and scars. The fatty tissues remaining from the first injection were kept at -20 degrees C up to twelve months, and were used for repeated injections in the overly- absorbed or inadequate areas. Of those 277 patients, 59% received an injection once, 35% received an injection twice, 5% received an injection three times and 1% received an injection up to four times. Follow-ups and postoperative photo confirmations were possible only in 119 out of 277 cases. 81.5% showed satisfied results, and development of complications were insignificant occurring at 6.2%. Owing to advances in tissue engineering and frozen storage method, autologous microfat used for injection will be developed as a better filler, which may substitute soft tissues.
Adipose Tissue ; Aging ; Cicatrix ; Follow-Up Studies ; Humans ; Postoperative Complications ; Surgery, Plastic ; Tissue Engineering