The authors experienced a case of anterior uneitis associated with secondary glaucoma caused by a cycitsercosis cellulosae in the anterior chamber of the left eye of a 39-year-old Korean male. The cyst appeared from the posterior surface of the iris through the pupillary margin of 10-o'clock position and grew larger and larger with automatic active movements, filling finally the nasal upper one third of the anterior chamber, but the cyst did not change the position to the 6-o'clock chamber angle. The cysticercus grown for almost four months was extracted successfully with a teethless, serrated, curved forceps with some resistance after opening the anterior chamber from 7~11-o'clock position without iris prolapse and any damage to the anterior lens capsule. The extracted cyst with the size of 8 mm X 6 mm X 3 mm was confirmed as a cysticercus cellulosae by parasitological examinations (Fig. 2,3). After the extraction of the cysticercus the uveitis and the increased intraocular tension subsided completely, remaining some brownish fine keratic precipitates, pigment masses on the anterior surface of the lens and irregularly somewhat dilated pupil due to partial posterior synechia. The naked vision O.S., however, was 20/25 using pin hole, and the eye has been still quiet during last 3 and half years following surgical extraction. In addition the authors have recently seen three cases of subconjunctival cystiticercosis cellulosae. In the first case the cysticercus with the size of 8 mm X 7 mm X 4 mm appeared at the nasal superior part of the bulbar conjunctiva O.D. of a three-year-old Korean male. In the second case the cyst with the size of 7 mm X 5 mm X 3 mm was seen at the nasal inferior part of the bulbar conjunctiva O.S. of a 12-year old Korean female. In the last case the cyst with the size of 10 mm X 8 mm X 5 mm was located beneath the plica semilunaris of 3-o'clock position O.D. of a 58-year-old Korean female. All the cysts were extracted successfully without any rupture, and they were confirmed as the cysticercus cellulosae histologically.
Adult ; Anterior Chamber* ; Child ; Conjunctiva ; Cysticercosis* ; Cysticercus* ; Female ; Glaucoma ; Humans ; Iris ; Male ; Middle Aged ; Prolapse ; Pupil ; Rupture ; Surgical Instruments ; Uveitis

Forty three cases of the Tetralogy of Fallot for whom palliative surgical treatment was performed at the Department of Thoracic Surgery from January 1962 to October 1971 were reviewed in this study. 1. Sex ratio of the observed patients was 1.9:1, showing relating relatively high incidence on the male patients. 2. The age distribution in the series ranged from 2 to 24 years of age. and 31 patients were under 10 years of age. 3. On the electrocardiogram right ventricular hypertrophy pattern was observed in all of the patients and right axis deviation patern was observed in all except two cases which had dextrocardia and situs inversus visceralis. 4. The so-called "Pentalogy of Fallot" associated with atrial septal defect was observable in 7 cases and one of the pentalogy case had persistent left superior vena cava. Dextrocardia with situs inversus visceralis was observed in two cases. 5. Procedures employed in this series were as follows; Glenn operation in 13 cases, Bakulev operation in 1 cases, Blalock operation in 16 cases, Brock operation in 3 cases, Waterston's operation in 10 cases. 6. The operative mortality was 18.6% (8 cases).;i.e., 2 cases after Glenn operation, 2 cases after Brock operation, 1 case after Blalock operation, and 3 cases during or following Waterston's operation.
Age Distribution ; Axis, Cervical Vertebra ; Dextrocardia ; Electrocardiography ; Heart Septal Defects, Atrial ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Mortality ; Palliative Care* ; Sex Ratio ; Situs Inversus ; Tetralogy of Fallot* ; Thoracic Surgery ; Vena Cava, Superior

Spontaneous Intracranial Hypotension(SIH) is a rare syndrome of spontaneous postural cephalalgia associated with low CSF pressure and usually without evidence of CSF leakage from meningeal defect due to dural puncture. The postural headache may appear suddenly or gradually and disappear within several weeks spontaneously. MRI findings maybe include diffuse symmetric pachymeningeal gadolinium-enhancement, also subdural effusion and downward brain displacement. We report two cases of SIH in which MRI of the brain reveals diffuse symmetric pachyme-ningeal enhancement.
Brain ; Headache ; Intracranial Hypotension* ; Magnetic Resonance Imaging* ; Punctures ; Subdural Effusion

Over the past four decades after Korean War, a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of cardiovascular diseases. Among many institutes, Seoul National University Hospital Including Children's Hospital has played a leading role up to date. Clinical data following the first open heart surgery on August 7,1959 up to December 1993 revealed that the total number of open heart surgery was cises in Seoul National University Hospital and overall mortality was 6.8%. Since 1977, the cases of open heart surgery has rapidly increased due to two main reasons : Accumulation of untreated cardiac patients and widening coverage by national medical insurance. The number of cases exceeded 100 in 1978, 400 in 1980, 600 in 1982 and 700 in 1986. In the second half of 1980's and 1990's the number of cases were over 700 per year. The ratio of congenital to acquired heat disease was 1.5:1 , and that of acyanotic to cyanotic congenital cardiac anomaly was 2.0: 1. The order of frequency of acyanotic group was Ventricular Septal Defect(56.4%), Atrial Septal Defect(28.6%), Endocardial Cushion Defect(4.6%), Pulmonary Stenosis(2.9%) and Patent Ductus Arteriosus(1.0%). Whereas the incidence of cyanotic group was Tetralogy of Fallot(57.5%), Transpotion of Great Arteries(9.5%),Double Outlet Right Ventricle(8.7%) and Pulmonary Atresia(5.7%). The overall mortality of acyanotic congenital heart disease was 2.9% and that of cyanotic congenital heart disease was 16.7%. Transposition of Great Arteries, Pulmonary Atresia and Truncus Arteriosus especially resulted in very high mortality,25-30%. The causes of high mortality in these group were inadequate patient selection for operation, inexperienced perioperative neonatal care and unskiled operative technique, but the figure was remarkebly improved since 1990, and now operative mortality reached under 10%. In 2019 cased of valvular heart disease, single mitral valve disease was most common (1139 cases) and double valvular disease was 534 cases and triple valvular disease was 41 cases. According to the order of frequency in redo valvular disease was 6,0%. The frequency of ischemic heart disease and aortic disease were not so frequency previously but these figures rapidly increase in recent days. The first CABG was performed at this hospital in 1981 and 240 cases have been performed by 1993.Overall mortality was 7.1%. The number of cases in 1993 was increased two times compared to 1992, but the mortality was decreased to 2.4%. Acute aortic dissection (57 cases) was most common among 127 cases of aortic disease which was operative mortality was 26.3% which was very high. Mortality gradually decreased recently down to zero because of appropriate brain protection technique including deep hypothemia, circulatory arrest and selective cerebral perfusion. In Korea, brain death is not accepted by law as well as traditional concept. However in 1993 and up to now, five cases of heart transplantation were performed by voluntary consent of familly of the donor and recipient.
Academies and Institutes ; Aortic Diseases ; Brain ; Brain Death ; Cardiovascular Diseases ; Diagnosis ; Endocardial Cushions ; Heart Defects, Congenital ; Heart Transplantation ; Heart Valve Diseases ; Heart* ; Hot Temperature ; Humans ; Incidence ; Insurance ; Jurisprudence ; Korea ; Korean War ; Mitral Valve ; Mortality ; Myocardial Ischemia ; Patient Selection ; Perfusion ; Pulmonary Atresia ; Seoul ; Thoracic Surgery* ; Tissue Donors ; Transposition of Great Vessels ; Truncus Arteriosus

Over the past four decades after Korean War, a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of cardiovascular diseases. Among many institutes, Seoul National University Hospital Including Children's Hospital has played a leading role up to date. Clinical data following the first open heart surgery on August 7,1959 up to December 1993 revealed that the total number of open heart surgery was cises in Seoul National University Hospital and overall mortality was 6.8%. Since 1977, the cases of open heart surgery has rapidly increased due to two main reasons : Accumulation of untreated cardiac patients and widening coverage by national medical insurance. The number of cases exceeded 100 in 1978, 400 in 1980, 600 in 1982 and 700 in 1986. In the second half of 1980's and 1990's the number of cases were over 700 per year. The ratio of congenital to acquired heat disease was 1.5:1 , and that of acyanotic to cyanotic congenital cardiac anomaly was 2.0: 1. The order of frequency of acyanotic group was Ventricular Septal Defect(56.4%), Atrial Septal Defect(28.6%), Endocardial Cushion Defect(4.6%), Pulmonary Stenosis(2.9%) and Patent Ductus Arteriosus(1.0%). Whereas the incidence of cyanotic group was Tetralogy of Fallot(57.5%), Transpotion of Great Arteries(9.5%),Double Outlet Right Ventricle(8.7%) and Pulmonary Atresia(5.7%). The overall mortality of acyanotic congenital heart disease was 2.9% and that of cyanotic congenital heart disease was 16.7%. Transposition of Great Arteries, Pulmonary Atresia and Truncus Arteriosus especially resulted in very high mortality,25-30%. The causes of high mortality in these group were inadequate patient selection for operation, inexperienced perioperative neonatal care and unskiled operative technique, but the figure was remarkebly improved since 1990, and now operative mortality reached under 10%. In 2019 cased of valvular heart disease, single mitral valve disease was most common (1139 cases) and double valvular disease was 534 cases and triple valvular disease was 41 cases. According to the order of frequency in redo valvular disease was 6,0%. The frequency of ischemic heart disease and aortic disease were not so frequency previously but these figures rapidly increase in recent days. The first CABG was performed at this hospital in 1981 and 240 cases have been performed by 1993.Overall mortality was 7.1%. The number of cases in 1993 was increased two times compared to 1992, but the mortality was decreased to 2.4%. Acute aortic dissection (57 cases) was most common among 127 cases of aortic disease which was operative mortality was 26.3% which was very high. Mortality gradually decreased recently down to zero because of appropriate brain protection technique including deep hypothemia, circulatory arrest and selective cerebral perfusion. In Korea, brain death is not accepted by law as well as traditional concept. However in 1993 and up to now, five cases of heart transplantation were performed by voluntary consent of familly of the donor and recipient.
Academies and Institutes ; Aortic Diseases ; Brain ; Brain Death ; Cardiovascular Diseases ; Diagnosis ; Endocardial Cushions ; Heart Defects, Congenital ; Heart Transplantation ; Heart Valve Diseases ; Heart* ; Hot Temperature ; Humans ; Incidence ; Insurance ; Jurisprudence ; Korea ; Korean War ; Mitral Valve ; Mortality ; Myocardial Ischemia ; Patient Selection ; Perfusion ; Pulmonary Atresia ; Seoul ; Thoracic Surgery* ; Tissue Donors ; Transposition of Great Vessels ; Truncus Arteriosus

Surgical reconstruction of the anterior cruciate ligament is undergoing constant evolution. The variable success of these procedures can be attributed to many factors including graft selection, graft placement, graft tensioning, graft remodelling and rehabilitation program. Rigid fixation is probably the most important factor in the success of these procedures during the initial stages of healing. Arthroscopically assisted reconstruction of the ACL-deficient knee using a bone-patellar tendon-bone graft(two-incision technique) is a reliable and evolving technique. Rosenberg et al, described a one-incision technique that allows endosteal fixation of bone plugs within their femoral tunnels intraarticularly via the intercondylar notch. These two techniques are different from their femoral tunnel direction and bone plug placement. The present study was designed to develop a swine model for in vitro biomechanical testing of the bone-patellar tendon-bone ACL autograft to compare the pull-out strength of Outside-In technique and Inside-Out technique. The result were as follows: 1. Normal ACL(N=10 knees) pull-out tensile strength tests showed a maximum tensile strength of 1295.34(N), a stiffness of 120.95(N/mm), and a linear load of 1104.26(N). The failure sites were all tibial attachments. 2. Femoral and Tibial interference fit pull-out tensile strength tests(N=10 knees) showed a maximum tensile strength of 463.23±42.27(N), a stiffness of 33.62±3.18(N/mm), and a linear load of 392.51±95.42(N). The failure sites were all in the tibial tunnel area(N=9 knees), except for one which femoral tunnel area. 3. Inside-Out technique(N=15 knees) showed a maximum tensile strength of 1250.64±75.67(N), a stiffness of 94.31±26.44(N/mm), and a linear load of 1046.92±367.55(N), but the Outside-In tech-nique(N=15 knees) showed a maximum tensile strength of 805.35±54.61(N), a stiffness of 83.33±10.98(N/mm), and a linear load of 685.99±86.32(N)(p < 0.0001). The failure sites were all in the femoral tunnel area. 4. Tensile testing demonstrated that the Inside-Out technique was significantlly stronger than Outside-In technique for maximum tensile strength, stiffness and a linear load.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Autografts ; In Vitro Techniques ; Knee ; Rehabilitation ; Swine ; Tensile Strength ; Transplants

Bronchogenic cyst is a congenital anomaly of the embryolgic foregut. A bronchogenic cyst is thought to arise from developing lung bud structure in the 7th week of gestation. Subcutaneous bronchogenic cyst is developed from isolated lung parenchyme during cell migration. Sometimes the fistula is formed between cyst and epidermis. Histologically, fistula tract is lined with sebaceous gland, which is the evidence of embryologic anomaly of cyst. The most common extrapulmonary location of bronchogenic cyst is mediastinum. Subcutaneous location is uncommon. Subcutaneous bronchogenic cyst is commonly located in suprasternal notch followed by the presternal area, neck and scapula. Subcutaneous bronchogenic cyst is predominantly found in male and the ratio is four to one. Clinically the cutaneous presentation vary from nodular swelling, sinus tract ostium to papillomatous lesion. The differential diagnosis of bronchogenic cyst include branchial cleft cyst, thyroglossal duct cyst, cutaneous ciliated cyst and mature cystic teratoma. The diagnosis of subcutanoeus cyst is entirely dependent on the histologic feature. Bronchogenic cyst is lined with ciliated pseudostratified columar epithelium of respiratory origin. Underlying wall is surrounded by the smooth muscle, cartilage and seromucinous gland. This report is on a subcutaneous bronchogenic cyst in a 5-years-old male without fistula tract. The cyst is 5 x 4 x 3 cm in size and histolgically shows the typical feature of bronchogenic cyst.
Branchioma ; Bronchogenic Cyst* ; Cartilage ; Cell Movement ; Diagnosis ; Diagnosis, Differential ; Epidermis ; Epithelium ; Fistula ; Humans ; Lung ; Male ; Mediastinum ; Muscle, Smooth ; Neck ; Pregnancy ; Scapula ; Sebaceous Glands ; Teratoma ; Thyroglossal Cyst

Cerebral dural sinus thro-bosis(DST) has been described as a rare and severe disease, clinically characterized by headache, papiliedema, seizures, focal deficits,progressive coma and even to death With the, advances ih diagnostic tools particularly MRI, DST is more commonly detected and index of suspicion is being increased. In order to characterize clinical features of DST that has been rarely reported in this country, we investigate a series of 14 patients with radiologically cerebral dural sinus thrombosis. It showed a highly variable mode of onset, diverse causes and unpredictable clinical courses. DST consists of heterogenous disease entities, with more broad spectrum of clinical presentation. Outcome was felt to be rather favorable than previously thought. Therefore, early consideration of the possibility, proper neuroimaging diagnosis and appropriate therapeutic trial on individual basis is recommended in the management of DST.
Coma ; Diagnosis ; Headache ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Seizures ; Sinus Thrombosis, Intracranial*

A clinical analysis was carried out in 38 patients with cryptococcal meningitis who were admitted at Severance hospital from January 1983 to June 1993. Age of patients ranged from 3 to 72 years (mean 37.5). The number of patients with underlying disease were 19(50%), which are equal to the number of patients without associated disease. The major presenting symptoms were headache in 36 patients (95%), fever in 26 patients(68%), nausea and vomiting in 20 patients(53%) in that order. The brain imaging findings were abnormal in 21 patients(57%). The antifungal therapy was done; amphotericin B only in 3 patients; amphotericin B and flucytocine in 23 patients; fluconazole only in 5 patients. The therapeutic responses were good in 19 patients(50%). The patients with favorable outcome were younger less having focal deficit, seizure, or associated disease.
Amphotericin B ; Diagnosis* ; Fever ; Fluconazole ; Headache ; Humans ; Meningitis, Cryptococcal* ; Nausea ; Neuroimaging ; Seizures ; Vomiting

No abstract available.