No abstract available.
Parotid Gland*

No abstract available.
Congenital Hypothyroidism*

Percutaneous nephrostomy has been effectively performed 107 times in 72 patients for relief of obstruction,drainage of urinary fistula and renal or extrarenal fluid collection, and functional preservation of urinarysystem, and follow-up check has been made for recent 3 years at department of Radiology in Seoul NatinalUniversity Hospital. All procedures were successful and bilateral nephrostomy was done in 1 case of bilateral congenital UPJ obstruction. Percutaneous nephrostomy was done in left kidney in 38 cases(52.8%), permanent drainagewas done in 55 cases(76.4%) and external drainage was done in 65 cases (90.3%), and the duration of follow-up wasup to 8 months. Underlying disease were supravesical obstruction in 63 cases(87.5%), urinary fistula in 3 casses,inflammatory disease in 5 cases and infravesical obstruction in 1 case. Satisfactory outcomes were made in 68patients, whose BUN and serum creatinine levels have decreased near to upper normal range in at least 3 weeks. Major complications have occurred in 7 cases; symptomatic urinary infection in 3 cases, fracture of the catheterin 2 cases, pneumothorax in 1 case and sepsis in 1 case. Minor complications have occurred in 76 cases; catheterdislodgement or obstruction in 42 cases, fever in 10 cases, perirenal extravasation in 2 cases and periureteralleakage in 2 cases, etc. These complications can be prevented by adequate method duing Seldinger technique undnerultrasonography, CT or fluoroscopy, prophylactic and post-nephrostomy antibiotics, use of disposable catheterkits, frequent irrigation of the catheter and dressing of catheter fixation site when contaminated, prevention ofextraction of the catheter due to patient's carelessness, adequate fixation of the catheter to skin, and continuous follow-up of patients, It is expected that the territory of this iterventional procedure will beextended by instrument insertion and drug instillation through the nephrostomy tract.
Anti-Bacterial Agents ; Bandages ; Catheters ; Creatinine ; Drainage ; Fever ; Fluoroscopy ; Follow-Up Studies ; Humans ; Instillation, Drug ; Kidney ; Methods ; Nephrostomy, Percutaneous ; Pneumothorax ; Reference Values ; Seoul ; Sepsis ; Skin ; Urinary Fistula

This is a long term follow-up study to clarify whether arthroscopic synovectomy would be able to prevent further destruction of the articular cartilage in rheumatoid joints. Three hundred and eighteen rheumatoid joints of 94 patients who had surgery in the multiple joints(average 3.4 joints per person) and was followed for an average 39.9 months (range, 24-126 months) were selected. Diagnosis of rheumatoid arthritis was made according to the 1987 revised criteria of the American College of Rheumatology. The preoperative roentgenographic narrowing of cartilage space (modified classification of ARA) and the arthroscopic findings (grading of Outerbridge) were recorded. The points of investigation were 1) further destruction of articular cartilage on X-ray, postoperatively, and 2) reaccumulation of effusion. The results were as follows; 1) Knee Joint: Among 103 knee joints there were 92 (89.3%) Stage I, G-0 knees, 8 Stage II (G-2: 1, G-3: 3, G-4: 4 joints), and 3 Stage IIIB, G-4, preoperatively. The 3 Stage IIIB, G-4 knees showed progression of narrowing of joint space and were replaced by artificial joints two years after the synovectomy. 2) Wrist joint: Fifteen joints (28.3%) out of 53 joints were Stage II, G-4, and 2 joints joints (3.8%) were Stage I, G-3, preoperatively. They were progressed to Stage IIIB at final follow-up. 3) Other Joints: There was no further narrowing of the joint space following surgery in 22 fingers, 2 toes, 34 elbows, 34 shoulders and 70 ankles. 4) Prognosis seemed to depend upon postoperative medication. From these results it would be suggested that the rate and severity of recurrence of synovitis and further destruction of articular cartilage can be decreased with early synovectomy so long as proper anti-rheumatic medication is followed, although the surgery can not halt the disease process.
Ankle ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Classification ; Diagnosis ; Elbow ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Prognosis ; Recurrence ; Rheumatology ; Shoulder ; Synovitis ; Toes ; Wrist Joint

Glanzmann's thrombasthenia is a rare autosomal recessive hemorrhagic disorder characterized by prolonged bleeding time, ad deficient or absent clot retraction in the presence of normal platelet count. The major underlying abnormality in this disease is grossly defective first-phase aggregation of platelet, which are unresponsive to ADP or other platelet agonists such as epinephrine, collagen, thrombin in any concentration. This disability is caused by a decrease or absence of the platelet membrans glycoprotein IIb-IIIa complex, a member of the integrin family of adhesive receptors involved in cell-cell and cell-matrix fibronectin, and vitronectin On the development of surface labeling technique, a variety of biochemical techniques such as radioimmunoassay, crossed immunoelectrophoresis and SDS-PAGE have been used to study the structure and the function of platelet membrane glycoproteins, and to detect the platelet functional defect. But all of these techniques demand a relatively large amount of homogeneous paletelet population that requires manipulation through isolation and washing procedures before analysis. In order to eliminaste such an intricate procedure, we have applied method for analyzing platelet surface components in whole blood using monoclonal antibody and flow cytometry to recognize the absence of severe reduction of platelet membrane glycoprotien llb-llla complex. Platelet analysis by flow cytometry is a successful alternative rapid diagnostic technique for Glanzmann's thrombasthenia patients as well as well as for carriers of this disease. Fow cytometry technique provides a sensitive tool for investigating platelet functional defects caused by altered expression or deficiency of platelet surface proteins.
Adenosine Diphosphate ; Adhesives ; Bleeding Time ; Blood Platelets* ; Clot Retraction ; Collagen ; Electrophoresis, Polyacrylamide Gel ; Epinephrine ; Fibronectins ; Flow Cytometry* ; Glycoproteins ; Hemorrhagic Disorders ; Humans ; Immunoelectrophoresis, Two-Dimensional ; Membrane Glycoproteins* ; Membrane Proteins ; Membranes* ; Platelet Count ; Platelet Membrane Glycoproteins ; Radioimmunoassay ; Thrombasthenia* ; Thrombin ; Vitronectin

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

No abstract available.

No abstract available.
Dental Enamel* ; Lasers, Solid-State*

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

Since Thomas et al reported the first instance of successful removal of a broken intravascular guidewire without surgical intervention by using a bronchoscopic forceps in 1964, there have been a number of nonsurgical removal of intravascular or intracardiac foreign bodies using the bronchoscopic forceps, loop snare or basket stone catchers. We experienced a successful retrieval of accidentally broken subclavian puncture catheter from right atrium in 76 year old male patient with cerebral infarction admitted to this hospital on May, 1989. By percutaneous catheterization via right basilic vein, using a loop snare which is modified manually by guidewire for PTCA(USIC(R) Teflon coated PTCA Guide wire : ".014"), we removed successfully foreign body from right atrium. Therefore, we report a case of nonsurgical retrieval of foreign body from right atrium with the review of the literature.
Aged ; Catheterization ; Catheters ; Cerebral Infarction ; Foreign Bodies* ; Heart Atria ; Humans ; Male ; Ocimum basilicum ; Polytetrafluoroethylene ; Punctures ; SNARE Proteins ; Surgical Instruments ; Veins