No abstract available.
Hematuria*

The authors report the result of cryo-extraction of the lens in 50 eyes (44 cases) which were operated in B.N.D. Hospital from January 1978 to April 1980. The results are as follows: 1. The incidences of complication during operation were hyphema(8%), vitreous loss and rupture of the lens capsule(2%). Hyphema was the most common complication during operation. 2. The incidences of early postoperative complication were striate keratitis(26%), hyphema (2%), shallow anterior chamber(2%) and uveitis. 3. The incidences of late postoperative complication were vitreous prolapse into anterior chamber (6%), updrawn pupil(6%), macular edema(4%) and posterior synechia (2%), corneal degeneration with abnormal tissue growth into anterior chamber (2%), iris atrophy (2%) and vitreous opacity (2%). 4. The postoperative final visual acuity more than 0.5 were 37 eyes(74%) and less than 0.1 were 2 eyes(4%).
Anterior Chamber ; Atrophy ; Cataract* ; Hyphema ; Incidence ; Iris ; Postoperative Complications ; Prolapse ; Rupture ; Uveitis ; Visual Acuity

Crossed aphasia refers to a combination of aphasia and right hemiparesis in a left handed person or left hemiparesis and aphasia in a dextral. While crossed aphasia is not infrequent at all among left-handers, it remains an extremely rare event in dextrals. Its incidence is probably about 0.4% after right hemispheric lesions and prevalence is about 1% among right-handed aphasics. The neurobiological mechanisms of this phenomenon are unknown, and the neuropsychological correlations are only incompletely understood. We report a case of crossed aphasia in a 61-year-old right-handed woman who presented with sudden, severe global aphasia and left hemiplegia without any personal or family history of left-handedness. Brain MR image clearly showed a right hemispheric infarction in the territory of the right middle cerebral artery and brain SPECT also displayed reduction of regional cerebral blood flow in the right hemisphere sparing the left hemisphere. In this patient, cerebral dominance for speechseems to lay in the right hemisphere, while dominance for limb praxis seemsto lay in the left as the patient did not develop right limb apraxia. This case provides evidence that cerebral dominance for speech and handedness in dextrals can be dissociated. It also suggests that crossed aphasia in a dextral may be severe and persisting.
Aphasia* ; Apraxias ; Brain ; Dominance, Cerebral ; Extremities ; Female ; Functional Laterality ; Hand ; Hemiplegia ; Humans ; Incidence ; Infarction ; Middle Aged ; Middle Cerebral Artery ; Paresis ; Prevalence ; Tomography, Emission-Computed, Single-Photon

In 1968, Cairns introduced the trabeculectomy operation and reported it to be a highly succesful form of surgery for the reduction of intraocular pressure in primary open-angle glaucoma. At the present time trabeculectomy is the treatment of choice for patients with primary open-angle glaucoma requiring surgery. In the period January, 1975. to March, 1978, 72 eyes of chronic simple, chronic angle-closure, secondary, and developmental glaucoma were operated by trabeculectomy and/or trabeculotomy in Busan National University Hospital. Follow-up study was achieved in 28 eyes(chronic simple glaucoms 17, chronic angle-closure glaucoma 4, secondary glaucoma 3, and developmental 4) of 72 eyes, and the duration of follow-up ranged from 1 year to 2 and 1/2 years(average 18 months). Our operative procedure, which was different from others, was made with 1/3 thickness of scleral flap, and made 2 knots with 8-0 nylon placed in free edge of scleral flap and 1/3 of all cases was not placed scleral flap sutures. We achieved success in 23 eyes (82.1% )of 28 eyes of all types of glaucoma and 14 eyes (82.4%) of 17 eyes of openangle glaucoma. The control of intraocular pressure in interrelationship to formation of filtering bleb was statistically significance(x2(0.05, 1)=3.84>5.46), and to scleral flap suture was not significance(x2(0,05, 1)=3.84>0.39). The complications during and after operation were delayed formation of anterior chamber, hyphema, posterior synechia, vitreous prolapse, choroidal detachment, and lens and vitreous opacity in order.
Anterior Chamber ; Blister ; Busan ; Choroid ; Follow-Up Studies* ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Hyphema ; Intraocular Pressure ; Nylons ; Prolapse ; Surgical Procedures, Operative ; Sutures ; Trabeculectomy*

The embryology of the various parts of the human body, especially that of the eye, has its years-long history. But in recent years, the embryological study of the eye didn't attract much attention of the investigators. Lately the author had an opportunity to obtain the eyeballs (54) in the gestational age irom at least 3 months to 10 months. The specimens used were sectioned for tissue microscopy and stained when necessary. I studied the developmental process of the uveal tract, such as ciliary body, ciliary process and ciliary muscle the marginal sinus and its relationship between pupillary muscles and pigmentation of the iris epithelial vessels of choroid and pupillary membrane. The result obtained are as follows: 1. The ciliary body appeared at the 12th week of embryonic life and the ciliary processes were formed at the 16th week of embryonic life. At the 36th week of embryonic life, the ciliary body was divided into the pars plana and pars plicata. Condensation of the ciliary muscle cells appeared at the 12th week and continued its development until birth. 2. The marginal sinus appeared at the 12th week of embryonic life and reached the maximum in its size at the 16th week, it disappeared completely at the 28th week of embryonic life. 3. At the 16th week of embryonic life, pigmentation of the iris pigment epithelium began from the outer wall of the marginal sinus and fully developed pigmentation at the 28th week, at the same stage, the mesodermal tissues, vessels and fibroblasts, growing into the muscle stump. 4. At the 12th week of embryonic life, small vessels made their appearance in the choroid By the 20th week of embryonic life, large vessels developed and the choroid showed a fully matured vascular appearance. 5. The pupillary membrane remained until the 32nd week and completely disappeared at the 36th week of embryonic life. These findings suggested that the size of marginal sinus closely related to development of the pupillary muscles and pigmention of the iris pigment epithelium.
Choroid ; Ciliary Body ; Embryology ; Epithelium ; Fibroblasts ; Gestational Age ; Human Body ; Humans ; Iris ; Membranes ; Mesoderm ; Microscopy ; Muscle Cells ; Muscles ; Parturition ; Pigmentation ; Research Personnel

Heel cord advancement(HCA), which has been applied for the correction of equinus deformity in spastic cerebral palsy, has some theoretical advantages. However, HCA has also theoretical disadvantage that the procedure remove the tensile force exerting to the calcaneal apophysis. In order to evaluate the effect of HCA on the calcaneal growth, we compared the changes of calcaneal and foot lengths between the operated feet and non-operated feet after HCA. Among the 54 patients who had been treated with HCA at Seoul National University Childrens Hospital from March 1990 to August 1995, we excluded the cases who had been treated bilaterally, and also excluded hemiplegic patients in whom the ipsilateral feet were already shortened and the growth rates are different between the ipsilateral and contralateral foot. Seven patients who met the criterior of this study were included for the evaluation. There were 3 diplegics and 4 paraplegics, and average age at operation was 10 years and 6 months(range; 7 year 8 months-16 year 5 months). Average follow-up period was 3 years and 5 months(range; 2 years-4 years 9 mos). Total calcaneal lengths, anterior and posterior part of calcaneal lengths were measured on the standing lateral radiographs of the foot and ankle. Ratios of the operated limb over the non-operated limb were calculated for the three parameters. Ratios of posterior part of calcaneal lengths decreased significantly(P=0.031). Ratios of total calcaneal lengths decreased and ratios of anterior part of calcaneal lengths increased. However, the changes of two ratios were not significant. Ratios of posterior part calcaeal lengths over total calcaneal length decreases significantly(P=0.016). In conclusion, HCA can cause calcaneal growth retardation, especially posterior part of calcaneus, due to removal of physiologic tensile force of Achilles tendon.
Achilles Tendon ; Ankle ; Calcaneus ; Cerebral Palsy* ; Child ; Equinus Deformity ; Extremities ; Follow-Up Studies ; Foot ; Heel* ; Humans ; Muscle Spasticity* ; Seoul

To define the risk factors affecting the early major morbidity and mortality after multiple-valve operations, the preoperative, intraoperative and postoperative informations were retrospectively collected on 124 consecutive patients undergoing a multiple-valve operation between October 1985 and July 1996 at the department of Thoracic and Cardiovascular Surgery of Pusan Paik Hospital. The study population consists of 53 men and 71 women whose mean age was 37.9+/-11.5 (mean+/-SD) years. Using the New York Heart Association (NYHA) classification, 41 patients (33.1%) were in functional class II, 60 (48.4%) in class III, and 20 (16.1%) in class IV preoperatively. Seven patients (5.6%) had undergone previous cardiac operations. Atrial fibrillations were present in 76 patients (61.3%), a history of cerebral embolism in 5 (4.0%), and left atrial thrombus in 13 (10.5%). The overall early mortality rate and postoperative morbidity was 8.1% and 21.8% respectively. Among the 124 cases of multiple-valve operation, there were 57 (46.0%) of combined mitral valve replacement (MVR) and aortic valve replacement (AVR), 48 (38.7%) of combined MVR and tricuspid annuloplasty (TVA), 12 (9.7%) of combined MVR, AVR and TVA, 3 (2.4%) of combined MVR and aortic valvuloplasty, 2 (1.6%) of combined MVR and tricuspid valve replacement, and others. The patients were classified according to the postoperative outcomes; Group A (27 cases) included the patients who had early death or major morbidity such as low cardiac output syndrome, mediastinitis, cardiac rupture, ventricular arrhythmia, sepsis, and others; Group B (97 cases) included the patients who had the good postoperative outcomes. The patients were also classified into group of early death and survivor. In comparison of group A and group B, there were significant differences in aortic cross-clamping time (ACT, group A:153.4+/-42.4 minutes, group B:134.0+/-43.7 minutes, p=0.042), total bypass time (TBT, group A:187.4+/-65.5 minutes, group B:158.1+/-50.6 minutes, p=0.038), and NYHA functional class (I:33.3%, II:9.7%, III:20%, IV:50%, p=0.004). In comparison of early death (n=10) and survivor (n=114), there were significant differences in age (early death:45.2+/-8.7 years, survivor:37.2+/-11.6 years, p=0.036), sex (female:12.7%, male:1.9%, p=0.043), ACT (early death:167.1+/-38.4 minutes, survivor:135.7+/-43.7 minutes, p=0.030), and NYHA functional class (I:0%, II:4.9%, III:1.7%, IV:35%, p=0.001). In conclusion, the early major morbidity and mortality were influenced by the preoperative clinical status and therefore the earlier surgical intervention should be recommended whenever possible. Also, improved methods of myocardial protection and operative techniques may reduce the risk in patients with multiple-valve operation.
Aortic Valve ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Busan ; Cardiac Output, Low ; Classification ; Female ; Heart ; Heart Rupture ; Humans ; Intracranial Embolism ; Male ; Mediastinitis ; Mitral Valve ; Mortality* ; Retrospective Studies ; Risk Factors* ; Sepsis ; Survivors ; Thrombosis ; Tricuspid Valve

BACKGROUND: To evaluate the left heart function, left atrial pressure(LAP) has been monitored directly via LA catheter and indirectly via Swan-Ganz catheter. But indirect pressure monitor cannot often reflect the LAP precisely. We compared the LAP via LA catheter with central venous pressure(CVP), diastolic pulmonary artery pressure(DPAP) and pulmonary capillary wedge pressure(PCWP) by Swan-Ganz catheter. METHODS: Eleven cardiac-surgical patients whose LAP measurements were needed for clinical management were the subjects of this study. The CVP, DPAP and PCWP by Swan-Ganz catheter, and LAP were measured just after cardiopulmonary bypass, just after sternal closure, after 6 hours and 18 hours from the end of operation. And we divided them into two groups which consisted below 35 mmHg(group I) and over 35 mmHg(group II) of systolic pulmonary artery pressure(SPAP), and compared two groups. RESULTS: In group I, the LAP, CVP, DPAP and PCWP was 11.7+/-3.9 mmHg, 10.5+/-3.9 mmHg, 12.5+/-5.1 mmHg and 12.5+/-4.4 mmHg respectively, and correlation coefficiency of LAP with CVP, DPAP and PCWP was 0.7478, 0.7128 and 0.9002 respectively(p<0.05). In the group II, the LAP, CVP, DPAP and PCWP was 16.5+/-3.2 mmHg, 12.8+/-2.9 mmHg, 23.4+/-3.8 mmHg and 20.8+/-4.7 mmHg respectively and there was no correlation between LAP, CVP, DPAP and PCWP. CONCLUSIONS: The Swan-Ganz catheterization for the estimation of LAP is useful in the patients without pulmonary hypertension, but in the patient with pulmonary hypertension, CVP, DPAP and PCWP do not reflect the LAP.
Atrial Function, Left ; Atrial Pressure* ; Capillaries ; Cardiopulmonary Bypass ; Catheterization, Swan-Ganz ; Catheters ; Central Venous Pressure* ; Heart ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Pulmonary Wedge Pressure*

BACKGROUND: To evaluate the left heart function, left atrial pressure(LAP) has been monitored directly via LA catheter and indirectly via Swan-Ganz catheter. But indirect pressure monitor cannot often reflect the LAP precisely. We compared the LAP via LA catheter with central venous pressure(CVP), diastolic pulmonary artery pressure(DPAP) and pulmonary capillary wedge pressure(PCWP) by Swan-Ganz catheter. METHODS: Eleven cardiac-surgical patients whose LAP measurements were needed for clinical management were the subjects of this study. The CVP, DPAP and PCWP by Swan-Ganz catheter, and LAP were measured just after cardiopulmonary bypass, just after sternal closure, after 6 hours and 18 hours from the end of operation. And we divided them into two groups which consisted below 35 mmHg(group I) and over 35 mmHg(group II) of systolic pulmonary artery pressure(SPAP), and compared two groups. RESULTS: In group I, the LAP, CVP, DPAP and PCWP was 11.7+/-3.9 mmHg, 10.5+/-3.9 mmHg, 12.5+/-5.1 mmHg and 12.5+/-4.4 mmHg respectively, and correlation coefficiency of LAP with CVP, DPAP and PCWP was 0.7478, 0.7128 and 0.9002 respectively(p<0.05). In the group II, the LAP, CVP, DPAP and PCWP was 16.5+/-3.2 mmHg, 12.8+/-2.9 mmHg, 23.4+/-3.8 mmHg and 20.8+/-4.7 mmHg respectively and there was no correlation between LAP, CVP, DPAP and PCWP. CONCLUSIONS: The Swan-Ganz catheterization for the estimation of LAP is useful in the patients without pulmonary hypertension, but in the patient with pulmonary hypertension, CVP, DPAP and PCWP do not reflect the LAP.
Atrial Function, Left ; Atrial Pressure* ; Capillaries ; Cardiopulmonary Bypass ; Catheterization, Swan-Ganz ; Catheters ; Central Venous Pressure* ; Heart ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Pulmonary Wedge Pressure*

Dysphagia is a relatively rare symptom of neurovascular compression of the lower cranial nerve (CN). Many case reviews of neurovascular compression required surgical treatment to improve the neurological symptoms. This report presents a 75-year-old female patient who complained of dysphagia due to neurovascular compression of CNs IX-XI at the left side after the onset period. The symptom was improved by treating with balloon swallowing rehabilitation (BSR). In a video fluoroscopic swallowing study (VFSS), no significant manifestations were observed in the oral phase. On the other hand, profuse post-swallow residue decreased pharyngeal propulsion were observed without aspiration or penetration during the semisolid portion of the swallowing test. To reduce the pharyngeal remnant and improve pharyngeal propulsion, the BSR protocol was performed and the patient recovered quickly.Follow-up VFSS showed improvement in the post-swallow residue from 42.6 to 7.3%. After discharge, the patient could resume a normal diet without complications. Based on this observed result, it is advantageous to consider the option of a prescribed rehabilitation program over surgical treatment.