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.
Central Venous Catheters* ; Fibrin*

No abstract available.

No abstract available.
Child* ; Humans ; Infant, Newborn*

STUDY DESIGN: This study analyzed the efficacy of the reduction and its maintenance using the posterior pedicular screw system in adult patients undergoing surgical treatment for symptomatic, isthmic spondylolisthesis. OBJECTIVE: To evaluate the effect of the reduction for lumbar isthmic spondylolisthesis in adult. SUMMARY OF LITERATURE REVIEW: If the increase of the shear force is approved as a main biomechanical feature of spondylolisthesis, reduction of the shear forces to the physiologic level must be regarded as the goal of surgical treatment. MATERIALS AND METHODS: 11 cases were treated with posterior monosegmental two point f;cation and posterolateral fusion (Group 1), 8 cases with a combined surgery of posterior monosegmental two point fixation, posterolateral fusion and anterior interbody fusion (Group 2), and 20 cases with posterior two segmental three point fixation and posterolateral fusion (Group 3). We assessed the clinical results and the radiologic objective parameters. RESULTS: The patients were followed up for more than 2 years (mean : 64 months). The satisfactory clinical results were 9 cases (81.8%) in Group 1 ,7 cases (87.5%) in Group 2 and 17 cases (85%) in Group 3. Radiologically, the efficacy of reduction and its maintenance were satisfactory results in Group 2, and the changes of the slip angle and the disc height showed that the loss of correction was greater than postoperative correction, although there were no statistical significant differences in the three groups. CONCLUSION: According to the our results, there was no significant relationship between the clinical result and the rdiological one. However, we think that the correcton of the deformity using the posterior pedicular screw system have some biomechanical advantages and seem to be recommendable for the treatment of isthmic spondylolisthesis in adults.
Adult* ; Congenital Abnormalities ; Humans ; Spondylolisthesis*

No abstract available.
Leukemia*

Spinal dysraphism, first described by Lichtenstein in 1940, is a congenital anom- aly due to incomplete fusion or malformation of the midline dorsal embryonic structures including the ectoderm, mesoderm, and neuroectoderm. Spina bifida occulta is a spinal dystraphism and a manifestation of a midline defect of osseous spine and related structures without cyst formation. Spinal dysraphism may be associated with hypertrichosis, lipoma, dimpling, pigmentation, hemangioma, congenital scar, sinus, cyst, or skin defect in the midline dorsal area. We observed a 23-year-old female patient with spina bifida occulta who had a blue scar surrounded by circumscribed hair growth of the lumbosacral area since 1-montb-old age. Histopathologic finding of the blue scar revealed common blue nevus showing intradermal melanocytes and melanophages. Spine X-ray showed hemivertebra of L5 and spina bifida occulta of Sl. There were no abnormal neurologic signs.
Cicatrix ; Ectoderm ; Embryonic Structures ; Female ; Hair ; Hemangioma ; Humans ; Hypertrichosis* ; Lipoma ; Melanocytes ; Mesoderm ; Neural Plate ; Neurologic Manifestations ; Nevus, Blue* ; Pigmentation ; Skin ; Spina Bifida Occulta* ; Spinal Dysraphism* ; Spine ; Young Adult

Systemic lupus erythematosus is an autoimmune disease characterized by multisystem involvement and various laboratory findings. A retrospective study was made of the medical records of 59 patients with SLE at Severance hospital, Yonsei University College of Medicine, for the analysis of clinical and laboratory findings during the years 1970 through 198I. The results were compared with those of previous serial studies in Korea and western countries. The results obtained are as follows: l. In 59 patients with SLE, 7 patients were men and 52 patients were women (M: F=l: 7.4). Their age at onset of the dsiease ranged mainly in the 3rd and 4th decades. 2. The major clinical manifestations were skin eruptions (81%), fever(73%), renal involvements(66%), pulrnonary(66%) and cardiac(61%) abnomalities. 3. The variety of skin and mucus membrane manifestations seen included butterfly rash of face(53%), maculopapular eruption (34%), purpura(22%), and mucosal ulcer (19%) in that order. 4. Mucosal ulcers and alopecia were correlated closely with exacerbations of disease activity. Patients with Raynauds phenomenon were not likely to have severe organ involvement. 5. Compared with Western series, renal manifestation, anemia and thrombocytopenia were more frequent, and lymphadenopathy, Raynauds phenomenon and alopecia were less frequent. 6. The ANA test showed a, high sensitivity(96%) and a high titer. Compared with the patients showing a speckled pattern(30%), those showing a homogenous pattern(60%) had more severe organ involvement and poorer prognosis. 7. The anti-nDNA antibody test had a high sensitivity(81%), and indicated. severe renal involvement and poorer prognosis. Also, the titer correlated well with disease activity. 8. The disease was associated with autoimmune hemolytic anemia, Buergers disease, thyroid diseases, myelofibrcsis and chilblain. 9. A bimodal rnortality pattern was seen with infection being the major cause of early death, and renal failure and cardiopulmonary abnormalities in late death.
Alopecia ; Anemia ; Anemia, Hemolytic, Autoimmune ; Autoimmune Diseases ; Butterflies ; Chilblains ; Exanthema ; Female ; Humans ; Korea ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Male ; Medical Records ; Membranes ; Mucus ; Prognosis ; Renal Insufficiency ; Retrospective Studies ; Skin ; Thromboangiitis Obliterans ; Thrombocytopenia ; Thyroid Diseases ; Ulcer

BACKGROUND: To compare the diagnostic usefulness of dobutamine stress echocardiography(DSE) and 99mTc-methoxyisobutyl isonitrile SPECT (MIBI SPECT), two studies were performed simultaneously. METHOD: Fifty-six consecutive patients undergoing coronary angiogram and MIBI SPECT for clinical indications without clincal evidence of myocardial infarction were studied prospectively. During the DSE, MIBI was injected at peak stress, and post-stress images of MIBI SPECT were required on hour later. Both echocardiographic and MIBI SPECT images were visually analysed in a blind fashion. RESULTS: On the basis of coronary angiographic findings, the sensitivites of the DSE and MIBI SPECT (n=36) were 89% and 86%, respectively. The specificities of those (n=20) were 90% and 85%, respectively. Among 33 patients without resting perfusion defect on MIBI SPECT, resting regional wall motion abnormalities on DSE were found in only one patient, whereas, resting perfusion defect on MIBI SPECT were found in 9 patients among 41 patients without resting regional wall motion abnormalities on DSE. Among 17 patients who had resting perfusion defects with partial reversibility on MIBI SPECT, resting wall motion abnormalities were present in 11 patients and five of them showed improvement in the regional wall motion during low dose dobutamine infusion. CONCLUSION: Both dobutamine stress echocardiography and MIBI SPECT are useful methods in the detection of the coronary artery disease, however, MIBI SPECT seems to overestimate the regional ischemic myocardium with contractile reserve that can hardly be evaluated with MIBI SPECT.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Humans ; Myocardial Infarction ; Myocardium* ; Perfusion ; Prospective Studies ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Biopsy* ; Child* ; Humans