Cartilage ; Cleft Lip ; Congenital Abnormalities ; Ear ; Humans ; Palate ; Rhinoplasty ; Transplants ; Young Adult

OBJECTIVE: Hysterectomy is one of the most common gynecological operations. The objective of this study is to compare the efficacy of suturing methods of vaginal cuff between laparoscopic and vaginal approach. METHODS: One hundred and sixty one cases of laparoscopic hysterectomy were devided into two groups. In group A(n=67), vaginal cuff was sutured by laparoscopic suture technique and in group B(n=94), vaginal cuff was repaired by vaginal approach. RESULTS: There were no significant differences in uterine weight, hospital stay, pre-and postoperative hemoglobin level and complications including febrile morbidity in two groups. Operation time was significantly shorter in group B(p=0.05). CONCLUSION: Transvaginal repair of vaginal cuff showed shorter duration of operation time than laparoscopic suture technique in total laparoscopichy sterectomy.
Hysterectomy* ; Laparoscopy ; Length of Stay ; Suture Techniques

No abstract available.

Subdural empyema is a rare form of intracranial sepsis associated with high morbidity and mortality. The most frequent cause is extension of paranasal sinusitis through emissary veins or of mastoiditis through the mucosa, bone, and dura mater. Development of subdural empyema after pyogenic meningitis is known to be very unusual in adults. We report a rare case of fatal subdural empyema, an unusual complication of pyogenic meningitis. Our bitter experience suggests that subdural empyema should be borne in mind in patient with pyogenic meningitis who exhibit neurological deterioration.
Adult ; Dura Mater ; Empyema, Subdural ; Humans ; Mastoid ; Mastoiditis ; Meningitis ; Mucous Membrane ; Sepsis ; Sinusitis ; Veins

No abstract available.
Adult* ; Humans ; Ophthalmic Artery*

The Dandy-Walker syndrome is a developmental disorders of the brain characterized by cystic deformity of the 4th ventricle and agensis of the cerebellar vermis. Other systemic anomalies and chromosomal abnormalities are associated with this syndrome. We are experienced a case in a 9 months old male infant who presented initially with frequent vomiting, low birth weight, On the physical examination, a prominent occiput, palpable mass below the right upper quadrant, pulmonary valve stenosis, congenital dislocation of the hips, ventral flexion of fingers, clubfoots and the rocker-bottom deformities of feet were present. On the chromosomal study, there were chromosomal polymorphisms in a thickened C-band of chromosome No. 1 by C-banding method. The brain CT revealed a large, thin-walled, low density mass of CSF without enhancement in the posterior fossa, showing upward displacement of cerebellar hemisphere with absent inferior vermis(or associated with dysplastic cerebellar hemisphere). A brief review of the related literatures were included in this report.
Brain ; Chromosome Aberrations* ; Clubfoot ; Congenital Abnormalities ; Dandy-Walker Syndrome* ; Dislocations ; Fingers ; Foot ; Hip ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Physical Examination ; Pulmonary Valve Stenosis ; Vomiting

With the advent of improyed external fixation device, femoral lengthening has gained renewed popularity in recent years in the treatment of unequal leg length. Wagner(1971) and De Bastiani et al(1987), among others, have made epochal contribution in this field. During the period from May 1984 to May 1987, 25 patients with leg length discrepancy underwent femoral lengthening using Wagner's or De Bastianis distractable external fixators at the Department of Orthopedic Surgery, Seoul National University Hospital. There were 6 patients below 16 years of age admitted to the Children's Hospital, and 19 patients were 16 years or older. The mean age was 18.2 years, ranging from 3 years to 36 years. The underlying etiology included residual poliomyelitis in 20 patients, epiphyseal injury in 2 patients, congenital short femur in 1 patient, septic hip residua in 1 patient, and cerebral palsy in 1 patient. The mean leg length discrepancy was 4.5cm, ranging from 1.3cm to 7.4cm. The mean length gained was 4.1cm, ranging from 1.8cm to 6.4cm. All except two patients had two stage procedures with iliac crest strut bone graft. The mean time required for radiological consolidation of bone graft was 4.8 months. The plate and screws used for osteosynthesis was removed after the medullary canal has been re-established. Six patients had removal of the plate and screws between 8 months and 25 months after the second stage osteosynthesis. Technical errors included 1 case of incomplete osteotomy which required manual clasis, and another case of faulty insertion of Schanz screws that required reinsertion. Five cases (33.3%) had the minor pin tract infection. Schanz screw breakage occurred in a case of one stage femoral lengthening. Loosening of plate and screws was seen in three cases. One case had delayed union requiring augmentation bone graft. Stiff knee with less than 90°of flexion was encountered in one case. One case sustained fracture of patella during physiotherapy. Despite of a long list of complication, the ultimate goal of leg length equalization was successfully achieved in all the cases.
Cerebral Palsy ; External Fixators ; Femur ; Hip ; Humans ; Knee ; Leg ; Orthopedics ; Osteotomy ; Patella ; Poliomyelitis ; Seoul ; Transplants

Cervical spine injury, because of its increasing frequency and catastrophic neurological complication, has attracted many attention of every orthopedic surgeons. Moreover, the indications of surgical treatment and the indications of anterior or posterior fusion have been argued till now. Forty-one patients with cervical spine injury had been treated operatively at Department of Orthopedic Surgery, Seoul National University Hospital from January, 1980 to April, 1987. The surgically treated patients were followed up from 1 year to 7 years with average duration of 2.5years. We performed this study to define the advantages of the surgical treatment, the indications of the anterior and posterior fusion, the postoperative neurological changes, the importance of early reduction, and the result of surgical treatment in late instability cases and obtained the following results. 1. Flexion-rotation injury, in twenty three patients(56.0%), was the most frequent mechanism of injury. 2. Anterior decompression and fusion was performed in 8 patients(19.5%) when there were neural compression by fractured bone fragment or ruptured intervertebral disc material and rupture of anterior longitudinal ligament with hyperextension injury, without poterior ligament complex injury, and posterior fusion and wiring in 33 patients(80.5%) when there were upper cervical spine(C1, C2) injuries and posterior ligament complex injury. 3. Neurological involvements were observed in 35 patients(85.4%) on arrival, and partial and complete neurological recoveries were obtained in 20 patients(57.1%) out of 35 patients postoperatively. 4. Neurological recovery was obtained in 80% when the closed reduction was performed within 12 hours after the injury and only 40% after 12 hours. 5. Neck pain and/or neurology was improved in all 9 patients with late instability postoperatively. 6. Postoperative complication rate was totally 43.9%, but direct surgical complications were 2 cases(4.9%) out of 18 cases.
Decompression ; Humans ; Intervertebral Disc ; Ligaments ; Longitudinal Ligaments ; Neck Pain ; Neurology ; Orthopedics ; Postoperative Complications ; Rupture ; Seoul ; Spine ; Surgeons

No abstract available.
Gonadotropin-Releasing Hormone* ; Humans ; Hypogonadism* ; Male*

PURPOSE: Using rest T1-201/dipyridamole stress Tc-99m-MIBI/24 hour T1-201 SPECT, we investigated the predictive values of the markers of the stress-rest reversibility (Rev), T1-201 rest perfusion (Rest), T1-201 24 hour redistribution (Del) and Tc-99m-MIBI gated systolic thickening (Thk) for wall motion improvement after coronary artery bypass surgery. MATERIALS AND METHODS: In 39 patients (M:F=34:5, age 58+/-8), preoperative and postoperative (3 months) SPECT were compared. 24 hour delayed SPECT was done in 16 patients having perfusion defects at rest. Perfusion or wall motion was scored from 0 to 3 (0:normal to 3:defect or dyskinesia). Wall motion was abnormal in 142 segments among 585 segments of 99 artery territories which were surgically revascularized. RESULTS: After bypass surgery, ejection fraction increased from 37.8+/-9.0% to 45.5+/-12.3% in 22 patients who had decreased ejection fraction preoperatively. Wall motion improved in 103 (72.5%) segments among 142 dysfunctional segments. Positive predictive values (PPV) of Rev, Rest, Del, and Thk were 83%, 76%, 43%, and 69% respectively. Negative predictive values (NPV) of Rev, Rest, Del, and Thk were 48%, 44%, 58%, and 21%, respectively. Rest/gated stress/delay SPECT had PPV of 74% and NPV of 46%. Though univariate logistic regression analysis revealed Rev (p=0.0008) and Rest (p=0.024) as significant predictors, stepwise multivariate test found Rev as the only good predictor (p=0.0008). CONCLUSION: Among independent predictors obtained by rest T1-201/stress gated Tc-99m-MIBI/delayed T1-201 myocardial SPECT for wall motion improvement after bypass surgery, stress-rest reversibility was the single most useful predictor.
Arteries ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Logistic Models ; Perfusion ; Tomography, Emission-Computed, Single-Photon*