Pulmonary atresia with major aorto-pulmonart collateral arteries(abbreviated as MAPCA in the following)as a route for pulmonary blood flow presents many problem in diagnosis and management and recently new approach to surgical management (unifocalization)was suggested and few reported it's application. Nineteen cases who had pulmonary with MAPCA, diagnosed at Seoul National University Children's Hospital from October 1987 to May 1989, were studied to lool at the relationship between MAPCA, central pulmonary artery and segmental pulmonary arteries. Also was observed the clinical course and operative management. The average number of MACPA in each patient was 4, two toward right lung and the other two toward left lung. MACPA arose most frequently from descending aorta and innominate artery contralateral to the side of aortic arch. Central pulmonary artery was identified in 86.7%. The number of bronchopulmonary segment connected to central pulmonary artery directly or indrectly was very variable so was the number of bronchopulmonary segment connected to MAPCA only. Three had a total correction and 14 had a various kinds of palliative operation once or twice. Seven had a called "unifocalization"(connection of MAPCA to central pulmonary artery) to correct arborization abnormality but the result was not satisfactory for technical reason.
Aorta, Thoracic ; Arteries* ; Brachiocephalic Trunk ; Diagnosis* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Seoul

No abstract available.
Humans ; Infant, Newborn ; Meningitis, Bacterial*

Optic nerve sheath meningioma arises from the arachnoid cap cell of optic nerve sheath and comprises most of primary orbital meningioma. We experienced a rare case of optic nerve sheath meningioma originating in the left orbit. A 44-year-old woman had suffered from visual disturbance in the left eye for 3 years and had only light perceptibility for the recent 6 months. The right eye was normal. Brain CT scan and MRI revealed a 2x0.8 cm sized fusiform solid mass in the left retrobulbar area. Under the impression of optic nerve tumor. excision of the mass including a small segment of the optic nerve was performed. The tumor was a yellowish firm, relatively well demarcated mass that encircled the optic nerve without infiltrating it. Microscopically it was a typical meningioma, meningothelial type. The recovery of visual acuity was impossible due to resection of optic nerve but there was no evidence of recurrence for u months.
Female ; Humans ; Meningioma

No abstract available.
Rupture* ; Thorax*

No abstract available.
Heterotaxy Syndrome*

BACKGROUND: To get the information about the clinical characteristics of the paroxysmal junctional tachycardia in children and to get the general principle in managing these children. METHOD: Analysis of the medical records of the 43 patients(male 30, female 13) with paroxysmal junctional tachycardia(JT) who had been followed-up in this hospital for a mean of 4.6 years(range 1 month up to 12 years) was done. RESULT: In 19 patients, JT started before 1 years of age : in 2, during gestational period, in 15, within 4 months of age, in 2, after 4 months of age. The next peak was 7 in the age of 5 years. The associated cardiac abnormalities were complex congenital defects in 2, tumor in 1, dilated and hypertrophic cardiomyopathy in 1 each. The significant hemodynamic disturbances during JT were noticed in 25. Among those whose surface electrocardiogram during JT were available, mean heart rate during JT was 232rpm(range 160-310) ; narrow QRS complex in 33 and wide in 1 ; P` wave in ST segment or T wave in 22. The delta waves were noticed after stopping JT and during followe up in 20. The types of delta waves were A in 7, B in 9, and indeterminate in 4. The different forms of delta waves unrelated to the degree of fusion were noticed in 6 ; disappearance or intermittent form of delta wave in 4. The efficacy of stopping JT was as follows : ATP 84.4%(38/45), diving reflex 50%(7/14), other vagal stimulation 71.4%(5/7), digoxin 72.7%(8/11), verapamil 54.5%(12/22), D/C cardioversion 62.5%(5/8), neosynephrine 100%(2/2). There were 2 deaths due to associated cardiac defects and 2 elective catheter ablations during the followe up period. The preventive medication with digoxin, beta blocker, and/or verapamil was succesful in 14, partially succesful in 11, failed in 14. The 7 persistent JT were treated with amiodarone in 3, with amiodarone and beta blocker in 1, with flecainide and digoxin in 1. In 1, surgical ablation of accessory pathway was done due to persistent JT. At present, JT do not recur or occur transiently without drugs in 29 ; with drugs, JT become controlled without recurrence in 4, with transient episodes in 4 and with intermittent episodes in 1. CONCLUSION: Althouh the JT in children is benign in most cases spite of the severity during the early period, JT is persistent in cases and needs potent drugs to control JT. Ablation of the foci may be necessary in these cases. Even in patients whose long-term results are benign, it is necessary to choose the optimal drugs to terminate and prevent the JT during the intervening period.
Adenosine Triphosphate ; Amiodarone ; Cardiomyopathy, Hypertrophic ; Catheters ; Child* ; Congenital Abnormalities ; Digoxin ; Diving ; Electric Countershock ; Electrocardiography ; Female ; Flecainide ; Heart Rate ; Hemodynamics ; Humans ; Medical Records ; Phenylephrine ; Recurrence ; Reflex ; Tachycardia* ; Verapamil

No abstract available.
Hernia*

No abstract available.
Angiography* ; Heart Septal Defects, Ventricular* ; Pulmonary Artery* ; Pulmonary Atresia*

Between May 1982 and October 1983, arthroscopic meniscectomy had been performed in 54 knees between ages of 11 and 70 years. There were 32 male patients and 22 female patients in this series. The mean follow-up was 20 months, ranging from 15 months to 33 months. Postoperative complications developed were retropatellar tenderness and effusion. No infection, thrombophlebitis or instability occurred postoperatively. The aim of this study was to evaluate the effect of the various possible prognostic factors upon the developtnent of the above mentioned complications. The factors included were 1) shape of tear, 2) ligamentous injury, 3) degenerative arthritia, 4) discoid lateral meniscus, 5) quadriceps atrophy, 6) sites of meniscus(medial or lateral) & extent of excision, 7) preoperative retropatellar tenderness and 8) method of rehabilitation. The findings were statistically analyzed by the Chi-square test (df-1) & Fisher's direct probability method. The results obtained were as follows; 1. The rate of development of postoperative effusion was significantly high in cases of quadriceps atrophy (P<0.01) and preoperative retropatellar tenderness(P<0.01). 2. The rate of deveopment of postoperative retropatellar tenderness was significantly high in case of discoid lateral meniscus (P <0.01). 3. There was no significant correlation between complications and other factors including shape of tear, preoperative degerative arthritis, site of meniscus & extent of excision and methods of rehabilitation.
Arthritis ; Atrophy ; Female ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Male ; Menisci, Tibial ; Methods ; Postoperative Complications ; Prognosis ; Rehabilitation ; Tears ; Thrombophlebitis

No abstract available.
Interferon-alpha* ; Interleukin-2* ; Killer Cells, Lymphokine-Activated*