Prosthetic replacement was performed in 31 patients (32 cases) with femoral neck fractures at National Medical Center from 1968 to 1981. We reviewed the records of 28 patients having Austin-Moore prosthetic arthroplasty in 29 cases, and of 3 patients having Thompson prosthetic arthroplasty; then obtained following results. l. Of the 31 patients, 23 were female and 8 were male. The left hip was involved in 20 patients, right in 10, and the both sides in one. 2. The age range was between 35 and 84 years, with the average age of 61.2 years. 74.2% of patients were older than 51 years of age. 3. The most common cause of fracture was slipping or fall (65.6%), and the fracture sites were subcapital in 11 (34.4%), transcervical in 12 (37.4%), and basilar in 3 (9.4%). 4. Three cases (9.4%) were operated within a week, and 21 cases (65.6%) more than 3 weeks after injury. Good results were obtained in fresh fracture which was operated within a week. 5. In comparing the blood loss in Moores and modified Gibson's surgical approaches, the average total loss by the former was 1,290 ml and 1,720 ml by the latter. 6. In complications, one case of fracture of the posterior rim of acetabulum with subsequent subluxation and two cases of fracture of the greater trochanter were notable as operative complicatiens. 7. In a follow-up study averaging 13.1 months, good to excellent results were obtained in 8 cases, fair in 6, poor or bad in 5, respectively.
Acetabulum ; Arthroplasty ; Female ; Femoral Neck Fractures ; Femur ; Femur Head ; Follow-Up Studies ; Hip ; Humans ; Male

No abstract available.
Fluconazole* ; Humans

To examine the usefulness of cardiac MRI in assessing patients (pt) with congenital heart diseases(CHD), informations obtained from MRI and echocardiogrphy (echo) were compared in 91 consecutive pt with CHD and was correlated with findigs at cardiac catheterization (53pt) and at surgery (71pt). Pt were studied with 1.5 Tesla MRI unit and multiplanar images of the heart and great vessels were obtained using ECG-gated multislice spin-echo technique. Age ranged from newborn to 22 years. We obtained the following results. MRI was vary useful in providing important diagnostic informations in 19pt, provided informations which was not crucial to the clinical decision in 28pt, and did not provide additional informations in 44pt. MRI was very useful in assessing complex lesions, particularly in identifying atrial situs, rudimentary ventricular chamber, criss-cross atrioventricular connection, total anomalous pulmonary venous connection, anatomy of ventricular septal defect in double outlet right ventricle, anomalous ventricular muscles, aortopulmonary collateral artery and distal pulmonary artery anatomy. En face view of the ventricular septum was very useful in clearly outlining the ventricular septal defect. MRI gave false information in 17pt. Diagnostic accuracy of MRI was poor for coarctation of the aorta in neonates and small infants, patent ductus arteriosus and pulmonary stenosis. Cardiac MRI is recommended for preoperative planning in selected pt with CHD, particularly with complex lesions.
Aortic Coarctation ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Double Outlet Right Ventricle ; Ductus Arteriosus, Patent ; Echocardiography* ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging* ; Muscles ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Ventricular Septum

The cases of twenty-eight patients with spinal stenosis treated by microscopic decompressive surgery from January 1991 to September 1995, were analysed in an attempt to define is clinical feature, and to evaluate the results of our modified operation technique of preventing postoperative spinal instability. The main age group of the patients were in the fifties and sixties. On plain X-ray, most lumbar spine of the patients showed degenerative change. Pain in lower back and legs were the most common symptom, and intermittent neurogenic claudication was presented in three quarters of the patients. Radiologically, the diagnosis was confirmed by either myelography, CT, and MRI or by their combination. The major etiologic factors were thickening of ligamentum flavum, hypertrophy of laminae or facet joints and associated herniated nucleus pulposus. Since a significant rate of postdecompressive instability had been reported by other authors, therefore we have decided to performed less extensive decompressive total laminectomy procedure. The outcome of our decompressive laminectomy was favorable. In patients with no preoperative instability, newly developed instability following the less extensive decompressive total laminectomy was none.
Decompression* ; Diagnosis ; Humans ; Hypertrophy ; Laminectomy ; Leg ; Ligamentum Flavum ; Magnetic Resonance Imaging ; Myelography ; Spinal Stenosis* ; Spine ; Zygapophyseal Joint

No abstract available.
Glioblastoma*

No abstract available.
Aneurysm* ; Arteries*

Among the four-hundred patients with cerebral aneurysms confirmed by cerebral angiography, we divided them into two age groups, one with ages 39 years or younger(young-aged group: 51 patients, 12.8%), and another with ages 65 years or older(old aged group: 45 patients, 11.3%). A comparison was undertaken in regard to clinical characteristics and overall outcome in two groups. In young-aged group, the female-to-male ratio was 2.2: 1 whereas, women was predominant by five times more in old aged group. Anterior communicating artery aneurysm was the most common site(43.1%) in young-aged group, unlike to old aged group where posterior communicating artery was the most common site(33.3%). The most common symptom was headache in both groups, and the hypertension was more frequent in young-aged group(45.5%) than old-aged group(33.3%). Surgery was performed in 43 patients(84%) in younger group, and 37 patients(82.2%) in elderly group. Young-aged group showed more favorable outcome(91%) than old-aged group(70%).
Aged ; Arteries ; Cerebral Angiography ; Female ; Headache ; Humans ; Hypertension ; Intracranial Aneurysm* ; Prognosis

PURPOSE: To evaluate the NT in the first trimester associated with fetal chromosomal abnormality, fetal structural abnormality and adverse pregnancy outcome. METHODS: From Mar. 1993 to Dec. 1997, 133 cases of increased NT were reviewed retrospectively. All these fetues were taken a karyotyping and/or a high resolution ultrasonography for associated anomaly. The NT was measured by transvaginal ultrasonography(TVS) and transabdominal ultrasonography(TAS) if difficulty was encountered with TVS in the period of the 10th-14th week of gestation. The increased NT is approved when it is over 3mm. RESULTS: Of these 133 cases, 102 cases(76.7%) revealed normal outcomes and 31 cases(23.3%) revealed abnormal outcomes such as chromosomal abnormality, structural abnormality and adverse pregnancy outcome, The mean value of NT was 3.44+/-0.68mm in the normal group and 4.93+/-2.70mm in the abnormal group, respectively. The chromosomal abnormalities were found in 16 of the 31 cases: nine Down SD, two Patau syndrome, one Tuner synrome, one triploidy, one 46, XX,i(18q), one 47,iso(Xp)/46,XX one confined placental mosaicism. In 12 cases of the 31 cases, the structural anomalies were detected. Of these 12 cases, 3 cases were eventually developed to cytsic hygroma, 3 cases were cardiac anomaly, 3 cases were renal anomaly, 1 case was congenital diaphragmatic hernia, 1 case was skeletal dysplasia and 1 case was suspected syndrome. The adverse pregnancy outcome such as intrauterine growth restriction, intrauterine fetal death and preterm labor was revealed in 3 cases. In the cases of NT over 7mm, the result was 100% abnormal outcome. CONCLUSION: Increased NT in the first trimester could be a highly efficient the predictor for detection of chromosomal abnormality, structural anomaly and adverse pregnancy outcome.
Chromosome Aberrations ; Female ; Fetal Death ; Hernia, Diaphragmatic ; Humans ; Karyotyping ; Lymphangioma, Cystic ; Mosaicism ; Nuchal Translucency Measurement ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, First ; Pregnancy* ; Retrospective Studies ; Triploidy ; Ultrasonography

BACKGROUND: Ebstein's anomaly is characterized by various degrees of apical displacement of the proximal attachment of the tricuspid valve. The disease has an extremely variable course in presenting itself. Therefore, we examined the morphologic and clinical features of Ebstein's anomaly as presented in the fetus to define the factors that determine its outcome. METHODS: We reviewed the history and echocardiographic studies of 10 fetuses (mean gestational age 28.0 weeks) diagnosed in utero with Ebstein's anomaly. The reason for referral was cardiomegaly on routine obstetric scanning in 5 cases, fetal arrhythmia in 3 cases, small main pulmonary artery in 3 cases, vessel view in 1, and twin pregnancy complicated by polyhydramniosis in 1. RESULTS: Of the 10 cases, pregnancy was terminated after diagnosis in 5, 2 cases were carried to term, and 1 case was at 34 weeks of gestation. We were unable to follow-up 2 cases. There were no intrauterine deaths and no misdiagnoses. Massive cardiomegaly and severe tricuspid regurgitation were detected in 7 cases; mild cases were detected in two, and one was nearly normal. Associated cardiac lesions included pulmonary artresia in 4 cases, pulmonary stenosis in 3, and pulmonary hypoplasia in 1. The cases with right ventricular outflow tract (RVOT) obstruction showed a tendency to develop more cardiomegaly and tricuspid regurgitation than with normal RVOT. There was no abnormality in other organ systems and karyotyping. CONCLUSION: Although increased cardiothoracic ratio and associated lesions of the right ventricular outflow tract contribute to the poor outcome in the prenatally detected cases, the absence of these features does not always indicate a good prognosis because progression of the disease can occur with advancing gestational age. No absolute measurement or single echocardiographic feature emerged as a consistent predictive factor for prognosis.
Arrhythmias, Cardiac ; Cardiomegaly ; Diagnosis ; Diagnostic Errors ; Ebstein Anomaly* ; Echocardiography* ; Fetus* ; Follow-Up Studies ; Gestational Age ; Karyotyping ; Pregnancy ; Pregnancy, Twin ; Prognosis ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Referral and Consultation ; Tricuspid Valve ; Tricuspid Valve Insufficiency

The authors report a case of falx meningioma which was first diagnosed with apopletic symptom due to intratumoral hemorrhage. A 72-year-old man was admitted to our hospital with a sudden deterioration of his level of consciousnesss down to a deep drowsiness, generalized seizure, and right hemiparesis. Radiological examinations, including brain CT(Computed Tomographic) scan and MRI(Magnetic Resonance Image) revealed a giant falx meningioma with intratumoral hemorrhage. During the operation the authors found a massive hemorrhage inside the tumor. Histologically, the tumor was meningotheliomatous meningioma and showed a hemorrhagic area with diffuse hemosiderin deposition. The authors also review the relevant literature and discuss the possible mechanism of hemorrhage in the meningioma.
Aged ; Brain ; Brain Neoplasms ; Hemorrhage* ; Hemosiderin ; Humans ; Meningioma* ; Paresis ; Seizures ; Sleep Stages