No abstract available.

A study on branching patterns of middle hepatic artery was performed in 109 patients with A-P and oblique view hepatic angiogram, which refered to size and location of quadrate lobe in CT and SMA portography We could analyze the branching patterns of middle hepatic artery (MHA) in 100 among the 109 patients. MHA arising as a first branch of left hepatic artery was the most common pattern (50%), and MHA arising from proper hepatic artery separately one from left hepatic artery was the next common pattern (35%). MHA originating from left gastric artery, or from anterior or posterior of the right hepatic artery was seen. MHA WAS not found as an accessory or replaced artery except as replaced common hepatic artery.
Angiography* ; Arteries ; Hepatic Artery* ; Humans ; Portography

Congenital agenesis of the right lobe of liver is a rare anomaly and only 33 cases have been reported. CT showed absence of the right lobe of liver and compensatory hypertrophy of the other lobe. We report the CT findings of a new case of this anomaly with a review of the literatures.
Hypertrophy ; Liver*

Subcutaneous angiolymphoid hyperplasia is an uncommon disease characterized by eosinophilia, proliferation of the capillary vessels and lymphoid tissue and infiltration of the inflammatory cell, especially eosinophils. The etiology of the disease are obscure, but probably trauma, lower grade infection, nervous factor & hormonal status etc. The predilection sites are face, ears, scalf & neck, but rarely reported in the extremities. We experienced a case of subcutaneous angiolymphoid hyperplasia of the inguinal region and anteromedial side of the proximal thigh in a 10 year-old man who complained pain and tenderness on the above region. The patient was treated by excision with satisfactory result.
Capillaries ; Ear ; Eosinophilia ; Eosinophils ; Extremities ; Humans ; Hyperplasia ; Lymphoid Tissue ; Neck ; Thigh

No abstract available.
Endolymphatic Hydrops*

More than 10 years have passed since lumbar total disc replacement (LTDR) was introduced for the first time to the world market for the surgical management of lumbar degenerative disc disease (DDD). It seems like the right time to sum up the relevant results in order to understand where LTDR stands on now, and is heading forward to. The pathogenesis of DDD has been currently settled, but diagnosis and managements are still controversial. Fusion is recognized as golden standard of surgical managements but has various kinds of shortcomings. Lately, LTDR has been expected to replace fusion surgery. A great deal of LTDR reports has come out. Among them, more than 5-year follow-up prospective randomized controlled studies including USA IDE trials were expected to elucidate whether for LTDR to have therapeutic benefit compared to fusion. The results of these studies revealed that LTDR was not inferior to fusion. Most of clinical studies dealing with LTDR revealed that there was no strong evidence for preventive effect of LTDR against symptomatic degenerative changes of adjacent segment disease. LTDR does not have shortcomings associated with fusion. However, it has a potentiality of the new complications to occur, which surgeons have never experienced in fusion surgeries. Consequently, longer follow-up should be necessary as yet to confirm the maintenance of improved surgical outcome and to observe any very late complications. LTDR still may get a chance to establish itself as a substitute of fusion both nominally and virtually if it eases the concerns listed above.
Diagnosis ; Dichlorodiphenyldichloroethane ; Follow-Up Studies ; Head ; Prospective Studies ; Total Disc Replacement*

The management for herniated lumbar disc has been improved steadily since the standard discectomy was introduced at the early stage of this century. The therapeutic use of standard discetomy has been critisized by some investigators because of its incasiveness and potential postoperative sequele. Recently various non-invasive mean were developed, however there are still some disadvantages with them such as high cost and thire limitation of disc removal. In the present study fifty-nine cases managed with microsurgical discetomy were presented, all performed by one surgeon and analysed by the other. The operative results, assessed 6 months postoperatively, showed that the microdiscecetomy was of good quality, comparable to the results of the standard discectomy reported by others. Patients have discharged early(less than 10 days) and returned to their usual activities quickly(less than 3 weeks). The advantage of this technique is its capacity to preserve better integrity of normal tissue and to impose less trauma on the body. Furthermore it may be more cost-effective than any other surgical managements available. It can be concluded that microsurgical discectomy represents one of the best refinements of standard discectomy even if it has also some negative points.
Diskectomy ; Humans ; Microsurgery* ; Research Personnel

The cerebroprotective effects of mild to moderate hypothermia(about 32degreesC) in brain ischemia have been well established. Taking into consideration of potential deleterious systemic effects of total body cooling, selective brain cooling(SBC) can be considered as an alternative mean, and recently the protective effects of SBC in focal cerebral ischemia have been reported. However, there has been no attempt to draw a comparison of antiischemic and systemic effects between systemic hypothermia(SH) and SBC. The present study investigates the effects of SH and SBC on the physiological variables, neurological outcome, and the volume of brain infarction and edema, and compares each other. In thirty adult male Sprague-Dawley rats weighing 300-400g, permanent middle cerebral artery(MCA) occlusions were performed. Five groups of animals were studied; group 1, normothermic control(n=6); group 2, systemic hypothermia for 30min(n=6); group 3, selective brain cooling for 30min(n=6); group 4, systemic hypothermia for 60min(n=6); and group 5, selective brain cooling for 60min(n=6). In the hypothermia groups, active cooling was performed 15min following MCA occlusion. During the experimental procedures, the physiological variables such as mean arterial blood pressure and blood gases were continuously monitored. Twenty-four hours following MCA occlusion, the rats were sacrificed. Eight predefined coronal sections were stained with hematoxylin-eosin and the volume of ischemic damage and edema was computed. The results are as follows: 1) There were no differences in the physiological variables between SH and SBC groups. 2) In the hypothermia groups, neurological outcome was much better(p<0.05) than that in the control. 3) The volume of ischemic damage was significantly reduced to 49.2%(p<0.05) in group 4 and 26.7%(p<0.05) in group 5, compared to group 1. 4) Ischemic brain edema was significantly attenuated in group 4(23.6%; p<0.05) and group 5(7.8%; p<0.05), compared to group 1. These results reveal that systemic hypothermia may exert more beneficial effects upon focal cerebral infarction without significant systemic complication than selective brain cooling.
Adult ; Animals ; Arterial Pressure ; Brain Edema ; Brain Infarction ; Brain Ischemia ; Brain* ; Cerebral Infarction* ; Edema ; Gases ; Humans ; Hypothermia* ; Male ; Rats ; Rats, Sprague-Dawley

The theoretical advantages of spondlylolisthesis reduction-fixation are substantial, but some questions such as excessive risk and morbidity relative to in situ fusion remain unresolved yet. This study included 10 consecutive patients(2 male, 8 female) who underwent posterior lumbar interbody fusion(PLIF) with transpedicular instrumentation(AKITA pedicular screw system) over the past six menths from July to December 1993. All patients were isthmic type, adult(between 30 and 57) and between grades I and II. Claudication was the most common symptom. All patients were operated upon by one surgeon(C.K.P.) and follow-up was conducted through patient interviews and examinations, both clinically and rediologically. The patients were followed postoperatively from 6 to 12 months. There were no neurologic complication related to the procedures. The clinical outcomes assessed more than 6 months postoperatively were as follows:improvement, 9/10;stationary 1/10. Radiologically, the mean reduction rate of slippage(preoperative percentage slip-postoperrative one/preoperative one x100) was 4.3% and all patients developed solid fusion. In conclusion, patients who underwent PLIF supplemented with transpedicular fixation had good overall clinical and radiological outcomes without significant neurological complications related to PLIF or screw placement.
Follow-Up Studies ; Humans ; Male ; Spondylolisthesis*

OBJECTIVE: To evaluate the diagnostic value of computed tomography-myelography (CTM) compared to that of magnetic resonance imaging (MRI) in patients with lumbar radiculopathy. METHODS: The study included 91 patients presenting with radicular leg pain caused by herniated nucleus pulposus or lateral recess stenosis in the lumbar spine. The degree of nerve root compression on MRI and CTM was classified into four grades. The results of each imaging modality as assessed by two different observers were compared. Visual analog scale score for pain and electromyography result were the clinical parameters used to evaluate the relationships between clinical features and nerve root compression grades on both MRI and CTM. These relationships were quantified by calculating the receiver-operating characteristic curves, and the degree of relationship was compared between MRI and CTM. RESULTS: McNemar's test revealed that the two diagnostic modalities did not show diagnostic concurrence (p<0.0001). Electromyography results did not correlate with grades on either MRI or CTM. The visual analog pain scale score results were correlated better with changes of the grades on CTM than those on MRI (p=0.0007). CONCLUSION: The present study demonstrates that CTM could better define the pathology of degenerative lumbar spine diseases with radiculopathy than MRI. CTM can be considered as a useful confirmative diagnostic tool when the exact cause of radicular pain in a patient with lumbar radiculopathy cannot be identified by using MRI. However, the invasiveness and potential complications of CTM are still considered to be pending questions to settle.
Constriction, Pathologic ; Electromyography ; Humans ; Leg ; Magnetic Resonance Imaging* ; Myelography ; Pain Measurement ; Pathology ; Radiculopathy* ; Spine ; Visual Analog Scale