The pulsed laser lithotripsy has been used in the treatment of urinary calculi. We treated 153 patients of stones, via the pulsed dye laser(Technomed Pulsolith) with 7.5 and 6.5 F. rigid ureteroscope between January 1992 and January 1995. Stones were in bladder(4 cases), upper ureter(17), mid ureter(31) and lower ureter(101). The laser lithotripsies were applied for impacted stones and relatively large stones(more than 6 mm) The success rates according to location were 47%(8/17) in upper ureter, 77%(24/31)in middle ureter, 95%(96/101)in lower ureter and 100%(4/4) in bladder and mean success rate was 86% (132/153). There were 21 failures due to upward migration(9 cases), poor visual field(7), laser resistant stone(3) and malfunction of laser(2). Complications were showed in 28 cases that were gross hematuria(16 cases), ureteral perforation(6), fever(4) and ileus(2), but most of them might be related to ureteroscopy rather than laser, and all of them were resolved with conservative management. So laser lithotripsy is safe and effective method of middle and lower ureteral calculi, and upward migration of stones, the major cause of failure may be resolved by use of extracorporeal shock wave lithotripsy and flexible ureteroscope.
Humans ; Lithotripsy ; Lithotripsy, Laser* ; Shock ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy ; Urinary Bladder ; Urinary Calculi

Congenital chylothorax is a rare disorder and can be diagnosed by prenatal ultrasonography recently. Most cases of congenital chylothorax were characterized by different clinical courses of respiratory distress. We describe two female cases with congenital chylothorax observed by ultra- sonography prenatally. In the first case, left-sided pleural effusion was noted by prenatal ultrasonography taken at 34 weeks of gestation, and then pleural fluid was extracted by intrauterine thoracentesis under sonography guidance. After birth, this patient was managed by TPN(total parentral nutrition) and intermittent thoracentesis without surgical treatment. But, pleural fluid was accumulated recurrently and respiratory distress was aggravated. At 15th hospital day, shock state was developed and patient died. In the second case, bilateral pleural effusion and ascites were noted by prenatal ultrasonography, and then patient was delivered immediately without intrauterine thoracentesis. After birth, the second case received conservative therapy including mechanical ventilation, TPN, intermittent thoracentesis and paracentesis. The patient was discharged with complete regression of chylothorax. We report the two cases with brief review of related literatures.
Ascites ; Chylothorax* ; Female ; Humans ; Paracentesis ; Parturition ; Pleural Effusion ; Pregnancy ; Respiration, Artificial ; Shock ; Ultrasonography, Prenatal*

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

No abstract available.
Posterior Cruciate Ligament* ; Tendons*

Lipiodol, lipid soluble contrast media, was applied to 59 patients, who was clinically suspected to havehepatic tumor, in the department of Diagnotic Radiology, Seoul National University Hospital. The results of theclinical use of Lipiodol were as follows: 1. The clinical diagnosis was hepatocellular carcinoma(HCC) in 50 cases,cavernous hemangioma in 4 cases, metastasis in one case and others in 4 cases. 2. After hepatic arteriography,Lipiodol only was injected in 28 cases, mixture of Lipiodol and Mitomycin was injected in 22 cases andtranscatheter arterial embolization was performed additionally after injection of Lipiodol and Mitomycin in 9cases. 3. Among the 50 cases of HCC, Lipiodol was accumulated in the lesion in 49 cases. However, similaraccumulation of Lipiodol occured in a metastatic cancer and cavernous hemangiomas. 4. Plain radiographic patternsof Lipiodol accumulation could be divided into fine granular type, nodular type and linear or branching type. Thelinear or branching pattern disappeared in follow-up radiography after one week. 5. As minor complication afterLipiodol Injection. GOY &GPT were transiently elevated in 30 cases and normalized in a week. Abdominal pain andfever developed but subsided in a week too. 6. When an appropriate lipid-soluble chemotherapeutic agent orradioisotope is applied to this phenomenon in which Lipiodol is selectively accumulated in hepatic tumor, thediagnostic and therapeutic values will be more enhanced.
Abdominal Pain ; Angiography ; Contrast Media ; Diagnosis ; Ethiodized Oil ; Follow-Up Studies ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Mitomycin ; Neoplasm Metastasis ; Radiography ; Seoul

During the period from July 1975 to June 1982 we performed 17 Putti-Platt operations on 16 males and one female, ranging from 19 to 39 years. The average follow-up period was 3.8 years in 13 cases of them. The results were as follows: 1. The ages in initial dislocation were ranged from 14 to 31 with an average of 18.5 years. 2. Right side was involved in 15 cases and. left in 2 cases. 3. On radiological finding Hill-Sachs lesion was found in 41%.0n pathological finding at operation of 15 cases, Bankart lesion was seen in 73%, Hill-Sachs lesion in 60%, glenoid erosion in 33%, capsular loosening in 33%, and capsular tear in 13%. 4. Limitation of external rotation compared with sound opposite side was measured in 12 to 40 with an average of 19.2 degrees. 5. The Putti-Platt operation is considered as sound, surgical procedure that gives excellent functional results.
Dislocations ; Female ; Follow-Up Studies ; Humans ; Male ; Shoulder ; Tears

No abstract available.
Classification* ; Humans ; Leukemia* ; Survival Rate*

BACKGROUND: Since prognosis of pontine hemorrhage (PH) is dependent on the initial consciousness level, prediction of outcome is not difficult in patients presenting deeply comatose mentality or mild neurologic deficits without altered consciousness. The outcome of PH accompanied by some degree of altered mentality is, however, so various and cannot be easily predicted. The aim of this study was to analyze the radiologic factors determining the prognosis in this subgroup of PH. We also tried to describe the common clinical and radiologic features in patients with benign clinical course, which have rarely been studied systematically. METHODS: Chiefly based on the initial level of consciousness, 42 patients were classified into benign (BH, n=14), non-benign (NBH, n=19), and fatal (FH, n=9) PH. We retrospectively reviewed their medical records and radiologic data. The modified Rankin score was used for evaluating long-term prognosis. In NBH group, transverse and vertical extension index of hematoma, hemorrhage volume, and presence of extrapontine extension were investigated on CT images. RESULTS: Hemiparesis with or without ocular disturbance was the most common manifestation in BH group (64%) and two patients showed neurologic signs identical to lacunar syndrome. The most common location of hemorrhage was unilateral tegmentum (64%). In NBH group, transverse extension index was significantly greater in the patients with worse prognosis, though vertical extension index and extrapontine extension did not seem to be important in predicting the prognosis. CONCLUSIONS: The clinical features simulating lacunar syndrome are frequently found in BH. The degree of transverse extension in the pons is important in predicting the prognosis of NBH subgroup.
Coma ; Consciousness ; Hematoma ; Hemorrhage* ; Humans ; Hydrogen-Ion Concentration ; Medical Records ; Neurologic Manifestations ; Paresis ; Pons ; Prognosis ; Retrospective Studies ; Stroke, Lacunar

Specular microscope has been used to examine the corneal endothelium of humans as a function of age. 82 normal eyes of 42 korean, 8 to 65 years of age, were examined with the contact-type specular microscope, and photographs of the central endothelium were obtained. The endothelial photographs were analyzed to determine mean endothelial cell density and the frequency distribution of cell density for each subject. The mean endothelial cell density was 2686 cell/mm2. The correlation coefficient between age and cell count showed that endothelial cell density decreased significantly with increasing age(p<0.01). No appreciable difference in cell density was found between the right and left eyes of the subjects nor between male and female subjects of similar age.
Cell Count ; Cornea* ; Endothelial Cells* ; Endothelium ; Endothelium, Corneal ; Female ; Humans ; Male

OBJECTIVE: A number of studies to improve in vitro culture conditions have been tried over past ten years by using co-culture system with helper somatic cells. However, the mechanism of coculture is poorly understood. This study was designed to understand the mechanism for the mode of actual action of co-culture system of ICR strain's 1-cell embryos with human oviduct epithelial cells by examining the effect of conditioned medium and contactless coculture using a cell culture insert on the embryo development and by measuring the level of superoxide anion from conditioned medium after co-culture. METHODS: ICR strain's zygote embryos were cultured in medium alone (control), coculture, conditioned medium, or contactless coculture system for 6 days. Conditioned media (CM) were prepared as following 5 groups. All CM were collected after culturing oviduct cells for 2 days. CM-1 was stored at -20degrees C until use, and CM-2 was prepared just before use as a culture medium. CM-3 was cocultured with embryos and retrieved just before use. CM-4 and CM-5 were derives from the microfilteration of CM-2 and CM-3, respectively, using Microcon-10 (10 kDa molecular weight cut-off). The percentage of the embryos developed to hatched blastocyst stage and the level of superoxide anion in supernatant from medium alone culture (control), coculture, and contactless coculture were measured. RESULTS: The rates of embryo development to the hatched blastocyst stage were significantly higher in coculture (43%) than in control (0%) (p<0.05). The CM-1 group had no embryo development since 2-cell embryonic stage, whereas the CM-2, CM-3, CM-4 and CM-5 groups had the improved development to 4 or 8 cell embryo stage, but the similar rate of development to hatched blastocyst compared to control. The effect of coculture on embryo develpment was disappeared in the contactless coculture group. The level of superoxide anion was significantly reduced in coculture group compared to control. CONCLUSION: It is concluded that the present coculture system overcomes the 2-cell block in vitro and improves the embryo development. This beneficial effect may be due to the direct cell-cell contact between embryo and helper cells or the removal of deleterious components from medium rather than the embryotrophic factors.
Animals ; Blastocyst ; Cell Culture Techniques ; Coculture Techniques* ; Culture Media, Conditioned ; Embryonic Development ; Embryonic Structures ; Epithelial Cells ; Female ; Humans ; Molecular Weight ; Oviducts ; Pregnancy ; Superoxides ; T-Lymphocytes, Helper-Inducer ; Zygote