No abstract available.
Adult* ; Humans

Takayasu's arteritis(arteritis syndrome) is an inflammatory disease process affecting primarily the aorta and its main branches. It's etiology and pathogenesis are unknown. Controversy exists in treatment. Segmental stenoses, occlusions, and aneurysmal degeneration of the aorta and the proximal arterial tree are frequent findings. Clinical presentations may include cerebrovascular ischemia, limb ischemia, aortic valvular insufficiency, heart failure, renovascular hypertension, or renal failure. Recently, we experienced a case of Takayasu's arteritis in a 24 years old female with severe dizziness, claudication in right upper extremity. Patient was treated by angioplasty of left vertebral artery and concomitant left subclavian-to-right axillary artery bypass surgery followed by percutaneous transluminal angioplasty with stent therapy of right vertebral artery to prevent cerebrovascular ischemia during the operation. Postoperative result was excellent and dizziness and claudication of right arm were completely relieved.
Aneurysm ; Angioplasty ; Aorta ; Arm ; Axillary Artery ; Constriction, Pathologic ; Dizziness ; Extremities ; Female ; Heart Failure ; Humans ; Hypertension, Renovascular ; Ischemia ; Renal Insufficiency ; Stents ; Takayasu Arteritis* ; Upper Extremity ; Vertebral Artery* ; Young Adult

BACKGROUND: Chronic cutaneous lupus erythematosus(CCLE) is a well-known disease entity. But there has been no data about its clinical behavior and histopathologic features in Korea. OBJECTIVES: This study was conducted to elucidate the clinical, laboratory, and histopathologic features of CCLE, and the relationship between CCLE and SLE. MATERIALS AND METHODS: We investigated 48 cases of CCLE that visited the department of dermatology at the Seoul National University Hospital from January 1990 to June 1997. Medical records and biopsy slides were reviewed.
Biopsy ; Dermatology ; Korea ; Lupus Erythematosus, Cutaneous* ; Medical Records ; Seoul

PURPOSE: To obtain magnetization transfer ratio(MTR) of the annulus fibrosus and nucleus pulposus and to assess the feasibility of utilizing the changes of these MTRs as an early indicator of disk degeneration. MATERIALS AND METHODS: MR images of lumbar spine with magnetization transfer(MT) technique in 42 patients were obtained. spin echo techniques (600/14) with same TR/TE with 1KHz off-resonance saturation were employed in 1.0T MR system. MTRs were calculated in two regions, anterior annulus fibrosus and nucleus pulposus, and the results were compared between the normal and degenerative disks, from grade I to IV, on T2-weighted images. RESULTS: MTRs of the nucleus pulposus were 17.6% in the normal disks, and 26.7%, 28.4%, 29.1%, 29.7% in degenerative disks, from grade I to IV, respectively, with a significant difference(P<0.05). On the other hand, MTRs in the annulus fibrosus were 30.2% in the normal disks and 31.5%, 33.2%, 32.1% and 35.6% in degenerative disks, from grade I to IV, respectively, without significant difference. CONCLUSION: Since MTRs are significantly higher in degenerative nucleus pulposus than those of the normal disks, increased MTRs in the nucleus pulposus can be used as an early sign of the degeneration of the nucleus pulposus.
Hand ; Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging* ; Spine

PURPOSE: Magnetization transfer imaging(MTI) is a new imaging contrast technique. Our MT pulse sequence is designed as fixed time interval between echo and MT pulse. This study was peformed to evaluate the influence of variations in TR/TE on MTR in T1 weighted image of normal brain tissue on this kind of MT pulse sequence. MATERIALS AND METHODS: Seven healthy volunteers in twenties of age as the objectives, MRI was taken under various TR/TE(TR/TE ;700/14, 650/14, 750/14, 700/20 and 1500/20 msec). MTR was calculated from signal intensities measured at the same point in both pre and post MT images and statisticslly analyzed. The MR imager used in this study was 1.0T Magnetom 42SP(Siemens, Erlangen, Germany) and the parameters of additional MT pulse sequence were offset 1000Hz and bandwidth 250Hz, and posteriorly located to echo with 7.7 msec fixed interval. Offset of this MT pulse was variable. RESULT: In white matter of brain tissue from a normal person, MTR was 34-39%(average 37%) for TR and TE of 700/14 in T1WI and 33-36%(average 35%) for TR/TE of 650/14, and 34-38%(average 35%) for TR/TE of 750/14 which showed no statistical difference. However, in case of 1500/20 of TR/TE, MTR was 26-28%(average 26%) which is statistically significant. With TR/TE of 700/14 as the standrd value, the MTR of gray and white matter were 37% and 29% respectively, showing a definite difference of statistical means. Signal from CSF in ventricles is rarely influenced by MT pulse. CONCLUSION: Conclusively, a subtle variation in TR/TE in T1WI has little influence on MTR but wide range of variation in TR/TE as in proton density image induces significant difference in MTR on this kind of MT pulse sequence. Therefore, the exchangeable usage of MTR data would be possible in narrow range of TR/TE change but difficult in wide range of variation.
Brain* ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Protons ; Reference Values*

No abstract available.
Cartilage* ; Ear*

Seven cases of retroperitoneal laparoscopic lumbar sympathectomy were successfully performed in 10 patients with ischemic lesions of lower limbs or ischemic rest pain between June, 1996 and October, 1996. All patients had nonreconstructable distal vessels on femoral angiogram. Our techniques of retroperitoneal laparoscopic lumbar sympathectomy is described in detail. Procedure offers the advantage of minimally invasive surgery and can be performed more efficiently as the experience of the surgeon accumulates.
Humans ; Lower Extremity ; Surgical Procedures, Minimally Invasive ; Sympathectomy*

Cerebrovascular accident remains the second most common cause of death in Korea, following combined cancer mortality. It is one of the most common causes of disability, and atherothromboembolic ischemic infarction accounts for nearly half of stroke in Korea. Carotid endarterectomy is proven to be effective in preventing stroke from internal carotid artery stenosis. The authors report the results of prospective study of 63 carotid endarterectomies, performed from September, 1995 to November, 1997 at our institution, to clarify the persisting diversity of opinions as to ideal preoperative diagnostic tests, anesthetic management, intraoperative monitoring techniques for cerebral protection, type of arterial repair, and postoperative evaluation for cerebral function. We confirmed that preoperative diagnostic tests of duplex scanning and magnetic resonance angiogram can replace the invasive conventional cerebral angiography, and observation of consciousness under regional anesthesia is the most reliable and safe method for carotid endarterectomy utilizing selective shunting, if needed.
Anesthesia, Conduction ; Carotid Stenosis ; Cause of Death ; Cerebral Angiography ; Consciousness ; Diagnostic Tests, Routine ; Endarterectomy, Carotid* ; Infarction ; Korea ; Monitoring, Intraoperative ; Mortality ; Prospective Studies* ; Stroke

BACKGROUND: The infrarenal abdominal aorta and the iliac arteries are the most common sites of chronic atherosclerosis in patients with symptomatic occlusive disease of the lower extremities. Direct anatomic reconstruction is the standard surgical treatment for a patient with aortoiliac occlusive disease, but extraanatomic bypass is used in patients with high cardiac or other risks. The purpose of this study was to compare the operative results of direct anatomic reconstruction with those an extraanatomic bypass and to select the optimal surgical treatment according to the preoperative risk. METHOD: The cases of 40 patients who received vascular reconstruction for aortoiliac occlusive disease between January 1995 and October 1997 were reviewed. The patients were classified in two groups: a direct anatomic reconstruction group and an extraanatomic bypass group. Operative risks were analyzed by the scoring system recommended by the Subcommittee on Reporting Standards for Lower Extremity Ischemia of International Society for Cardiovascular Surgery (ISCVS). Graft patency, operative mortality, and morbidity were also analyzed for the two groups. RESULT: There was no significant difference in operative risk (p>0.05) between the two groups, but the result of graft patency was better and the postoperative morbidity was less in direct anatomic reconstruction group. There was no postoperative mortality in either group. CONCLUSION: According to this study, direct anatomical reconstruction was superior to extraanatomic bypass inspite of same operative risks.
Aorta, Abdominal ; Atherosclerosis ; Humans ; Iliac Artery ; Ischemia ; Lower Extremity ; Mortality ; Transplants

PURPOSE: Robot-assisted laparoscopic radical cystectomy (RLRC) is a new option for the treatment of muscle-invasive bladder cancer, and case series for RLRC have been increasing recently. We report our operative technique and initial experiences with RLRC with extracorporeal urinary diversion. MATERIALS AND METHODS: Between October 2008 and November 2009, 17 consecutive patients with muscle-invasive bladder cancer underwent RLRC, pelvic lymph node dissection, and extracorporeal urinary diversion. Urinary diversion included 13 ileal conduits and 4 orthotopic neobladders (Studer method). Data were collected prospectively on patient demographics, intraoperative parameters, pathologic staging, and postoperative outcomes. RESULTS: The mean patient age was 63.7 years. The mean body mass index was 22.6 kg/m2. No patients had a history of previous abdominal surgery. The mean operative time was 379.1 minutes, including 32.6 minutes for pelvic lymph node dissection, 185.2 minutes for RLRC, and 159.4 minutes for urinary diversion. The mean estimated blood loss was 210.5 ml. The mean hospital stay was 20.7 days and the mean time to oral intake and ambulation was 5.0 and 1.3 days, respectively. There were no major perioperative complications. The pathologic reports showed urothelial cell carcinomas in all cases. CONCLUSIONS: Our initial clinical experiences indicate that RLRC with pelvic lymph node dissection and extracorporeal urinary diversion is a safe and feasible procedure with minimal blood loss and rapid recovery. Long-term follow up in a larger patient population is needed to determine the true oncological and functional benefit of this procedure.
Body Mass Index ; Cystectomy ; Demography ; Humans ; Length of Stay ; Lymph Node Excision ; Operative Time ; Prospective Studies ; Robotics ; Urinary Bladder Neoplasms ; Urinary Diversion ; Walking