No abstract available.
Dislocations*

Recent technological advances in ultrasound instrumentation have resulted in equipment that will image in "real-time" slices of the human brain similar in quality to computerized tomography(CT). Multiple authors have attested to its usefulness in locatin, characterizing, and facilitating in the biopsy or removal, or both, of intracerebral masses. In this study, the author has examined the efficacy of intraoperative neurosurgical ultrasound in 18 patients who were admitted to the Department of Neurosurgery, Kyung Hee University Hospital. The results were as follows : 1) It can provide critical assistance in precise localization of subcortical masses, since in many instances the overlying surface of brain provides no clue for localization. 2) This technique is very useful for the identificantion of deep lesions, provding infromation about their solid and cystic components and about the shortest route of access to tumor. 3) It provides precise information to help guide biopsy needles into deep lesions, and to confirm their presence within the lesion itself. 4) The system is highly accurate in visualizing ventricular catheters during and after their placement. 5) The system is inherently safe for the patient and the operating room personnel since there is no radiation exposure.
Biopsy ; Biopsy, Needle ; Brain ; Catheters ; Humans ; Needles ; Neurosurgery* ; Operating Rooms ; Ultrasonography*

This study was carried out to find out changes in regional cerebral blood flow(r-CBF) in relation to(i) clinical status of patients with subarachnoid hemorrhage due to ruptured intracranial aneurysms ; (ii) the degree of subarachnoid hemorrhage as indicated by brain CT scanning ; (iii) the severity of angiographic vasospasm, and (iv) other neuropathological condition. Measurement of r-CBF were performed, using 133Xe inhalation method, on 50 patients with ruptured intracranial aneurysms. Some of the major findings were as follows : 1) The degree of abnormalities of blood flow correlated well with the clinical severity of neurological deficits. 2) A marked reduction in r-CBF was found in patients with intracerebral hematoma, ischemic lesion and hydrocephalus. 3) In angiospasm area, r-CBF was found in patients with intracerebral hematoma, ischemic lesion and hydrocephalus. 3) In angiospasm area, r-CBF decreases below 30ml/100gm/min in almost all of the patients, and severity of vasospasm correlated with the decrease of CBF. 4) The measurement of CBF on patients with subarachnoid hemorrhage was thought to the useful for foreseeing the clinical outcome of the patients.
Brain ; Hematoma ; Humans ; Hydrocephalus ; Inhalation ; Intracranial Aneurysm* ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

We evaluated the feasibility and safety of this method by reviewing the early outcome of the patients who underwent coronary artery bypass grafting(CABG) utilizing parallel sequential anastomoses with saphenous vein grafts, comparing with the outcome of the patients revascularized with grafts having only single distal anastomosis. During the one-year period of 1995, a total of 79 patients underwent isolated CABG, among whom 39 patients with sequential vein grafts(sequential group) and 40 patients without sequential grafts(non-sequential group). There was no difference between the two groups in terms of preoperative status, except in the extent of the coronary disease; 87.2% of the sequential group and 45.0% of the non-sequential group had left main and/or triple vessel involvement. 318 distal coronary anastomoses were done; 198 for the sequential group(5.1/patient) and 120 for the non-sequential group(3.0/patient). In the sequential group, the mean durations of cardiopulmonary bypass and aortic clamp per one distal anastomosis were 33.5 and 21.1 minutes, respectively. In the non-sequential group, these were 41.8 and 22.7 minutes. There were two operative deaths, both in the non-sequential group. There was no difference in the incidence of postoperative complications including myocardial infarction. During the follow-up period(2 to 15 months), 8 patients(3 in the sequential and 5 in the non- sequential group) complained of residual or recurrent angina. Comparison of preoperative and postoperative 201Thallium myocardial perfusion scans in 30 patients showed improved or normal perfusion reserve in 83.3% of segments bypassed with sequential grafts and 82.5% of segments bypassed with non-sequential graft(s). These results show that, utilizing parallel sequential anastomoses with saphenous vein grafts, we could achieve satisfactory short-term clinical results in patients with extensive coronary stenoses. So, we conclude that this technique is a safe, technically feasible strategy for CABG, which can achieve the aim of complete myocardial revascularization with a limited length of graft. These results show that, utilizing parallel sequential anastomoses with saphenous vein grafts, we could achieve satisfactory short-term clinical results in patients with extensive coronary stenoses. So, we conclude that this technique is a safe, technically feasible strategy for CABG, which can achieve the aim of complete myocardial revascularization with a limited length of graft.
Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Disease ; Coronary Stenosis ; Follow-Up Studies ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Revascularization* ; Perfusion ; Postoperative Complications ; Saphenous Vein ; Transplants ; Veins

No abstract available.
Truncus Arteriosus*

BACKGROUND: Lung carcinogenesis is a multistage process involving alterations in multiple genes and diverse pathway. Mutational activation of oncogenes and inactivation of tumor suppressor genes, and subsequent increased genetic instability are the major genetic events. The p53 gene and FHIT gene as tumor suppressor genes contribute to the pathogenesis of lung cancer, evidenced by mutation, microsatellite instability(MI) and loss of heterozygosity(LOH). METHODS: We analysed genetic mutations of p53 and FHIT gene in 29 surgical specimens of nonsmall cell lung cancer using PCR-single strand conformation polymorphism, DNA sequencing and RT-PCR. MI and LOH were analyzed in loci of D3S1285, D9S171, and TP53. RESULTS: In 2 cases, point mutation of p53 gene was observed on exon 5. MI of 3 times and LOH of 14 times were observed in at least one locus. In terms of the location on microsatellite, D3S1285 as a marker of FHIT was observed in 5 cases out of 26 specimens;D9S171 as a marker of p16 in 5 out of 17;and TP53 as a marker of p53 in 7 out of 27. In view of histologic type, squamous cell carcinoma presented higher frequency of microsatellite alteration, compared to others. Mutation of FHIT gene was observed in 11 cases and 6 cases of those were point mutation as a silent substitution on exon 8. FHIT mRNA expression exhibited deletion on exon 6 to 9 in 4 cases among 15 specimens, presenting beta-actin normally. CONCLUSION: Our results show comparable frequency of genetic alteration in nonsmall cell lung cancer to previous studies of Western countries. Microsatellite analysis might have a role as a tumor marker especially in squamous cell carcinoma. Understanding molecular abnormalities involved in the pathogenesis could potentially lead to prevention, earlier diagnosis and the development of novel investigational approaches to the treatment of lung cancer.
Actins ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Diagnosis ; Exons ; Genes, p53 ; Genes, Tumor Suppressor* ; Loss of Heterozygosity ; Lung ; Lung Neoplasms ; Microsatellite Instability ; Microsatellite Repeats* ; Oncogenes ; Point Mutation ; RNA, Messenger ; Sequence Analysis, DNA

From Nov. 1986 to May 1988, we experienced 5 patients of bilateral recurrent patellar dislocation and obtained the following results:1. The age at operation raaged from 17 to 25 years. Among 5 patients, four were female and one, male. 2. The age at the onset of symptom ranged from 7 to 16 years. 3. The common presenting symptoms were pain(5 knees), giving way(4), grating(4), swelling (3), and weakness(2). 4. The roentgenographic findings were lateral patella tilt(9 knees), lateral femoral condyle hypoplasia(6), patella alta(2), patella dysplasia(2), and accessory ossification center(2). 5. All knees were treated by Hughston technique:One patient(2 knees) was treated with proximal realignment only, and the others(7 knees) were with proximal and distal realignments. 6. Follow up period ranged from 1 to 2 years. And the excellent to good result was obtained from the patients treated with proximal and distal realignments(excellent in 4 knees, good in 2 knees), the fair result from the patient treated with proximal realignment only(2 knees), and the poor result from the patient slipped down at 6 weeks postoperatively(1 knee).
Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Patella ; Patellar Dislocation

Purpose: To validate the value of Duplex Color Doppler Ultrasonography (DDU) for the incidence and location of postoperative deep vein thrombosis (DVT) that developed after hip surgery Materials and Methods: 260 consecutive patients who did not undergo any preventive treatment for DVT and underwent hip surgery (osteosynthesis for femoral neck and intertrochanteric fracture, acetabular fracture, and hip joint arthroplasty) from July, 2003 to May, 2005 were evaluated for the incidence of DVT. DDU was carried out on 7th postoperative day in all cases. Results: DVT was detected in 16 cases (6.2%) with 7 being in the femoral vein and 3 in the calf vein. Only two cases showed clinical symptoms such as pain and edema but no pulmonary embolism developed. Conclusion: The incidence of DVT obtained from DDU after hip surgery was 6.2 %, and no serious complications developed due to the early diagnosis. DDU is valuable as a screening test for postoperative DVT as well as for the prevention of serious complications such as pulmonary embolism.
Acetabulum ; Early Diagnosis ; Edema ; Femoral Vein ; Femur Neck ; Hip Joint ; Hip* ; Humans ; Incidence ; Mass Screening ; Pulmonary Embolism ; Ultrasonography, Doppler, Color ; Veins ; Venous Thrombosis*

In order to study the relationship between clinical group of cervical spondylosis and electrical activity, we traced somatosensory evoked potential(SSEP) by stimulating the median nerve(MN) from the upper extremities, and the posterior tibial nerve(PTN) from the lower extremities simultaneously. The purpose of this study was to test the clinical diagnostic utility of the method, whether any consistent relationship exists between the severity and type of neurological symptoms and the results of the SSEP responses, and between neurological improved patients after operation and improved SSEP results. In this study patients were clinically divided into three groups : combined myelopathy and radiculopathy, myelopathy alone, radiculopathy alone. Over a 3-year period from 1987 to 1989, SSEP were performed on 112 patients of Korean adults and summary of the results obtained are as follows : 1) Among patients with cervical spondylosis, those with cervical myelopathy showed more abnormal SSEP than those cervical radiculopathy. 2) In the group with myelopathy, MN-cervical latensy, Ep-C2 interpeak latency. PTN-P1 latency, and N1 latency were prolonged more than MN-C2 latency, Ep-C2 interpeak latency, PTN-P1 latency, and N1 latency of the group with radiculopathy. 3) The longer the duration of the symptoms, the more abnormal were the SSEP in patients with cervical spondylosis. 4) In patient with cervical myelopathy, the latency of SSEP was prolonged not only in those with sensory deficit, but also with motor deficit. 5) Half of clinically improved patients after operation showed improved SSEP in follow-up examinations. 6) Improvement in SSEP after operation was much affected by posterior approach.
Adult ; Evoked Potentials, Somatosensory* ; Follow-Up Studies ; Humans ; Lower Extremity ; Radiculopathy ; Spinal Cord Diseases ; Spondylosis* ; Upper Extremity

The authors analyzed 60 cases of ruptured internal carotid artery(ICA) aneurysms admitted and operated at Department of Neurosurgery in Kyung Hee University Hospital during the period from July 1983 to June 1988. The results of analysis were summarized as follows; 1) Mean age of patients was 51 years. ICA aneurysms occurred more frequently in female(47) than male(13). 2) Distribution of ICA aneurysms were ophthalmic aneurysm 8 cases(13.3%), posterior communicating aneurysm 40 cases(66.6%), anterior choroidal aneurysm 7 cases(11.6%), bifurcation aneurysm 5 cases(8.3%). 3) Most common direction of aneurysmal dome in ophthalmic, anterior choroidal and posterior communicating aneurysm was posterior-inferior-lateral and in bifurcation aneurysm was posterior-superior. 4) Multiple aneurysm was 23 cases(38%). 5) Incidence of clinical vasospasm was 48.3% and that of rebleeding was 20%. 6) Clipping was done in all cases, 2 cases combined with wrapping and 2 cases with trapping. 7) Mortality rate was 21.6%.
Aneurysm* ; Carotid Artery, Internal* ; Choroid ; Humans ; Incidence ; Mortality ; Neurosurgery