1. Partial nephrectomy was done on 7 cases of various renal diseases including 5 cases of renal tuberculosis, 1 case of renal stone and l case of focal nephritis.Satisfactory results were noted in 5 cases of them. while in other 2 cases secondary nephrectomy was indicated because of severe postoperative shock and profuse hematuria. 2. Through the clinical experiences on the partial nephrectomy, it is believed that the method of choice in effective hemostasis during the operation should be included (a) the blunt division of renal parenchyma using scalpel han8e, (b) accurate ligation of the parenchymal vessels found during the division and (c) suture of the arcuate vessels at the corticomedullary junction under the aid of renal arterial clamping. On the other hand, tense and deep mattress suture to get indirect hemostasis is considered to be inadequate and unfavorable for the method having brought parenchymal necrosis and profuse delayed hemorrhage in a few instances. 3. Duration of renal arterial clamping using Bulldog clamp ranged about 30 minutes or so, and no definite renalinjury followed after the procedure.
Constriction ; Hand ; Hematuria ; Hemorrhage ; Hemostasis* ; Ligation ; Necrosis ; Nephrectomy* ; Shock ; Sutures ; Transcutaneous Electric Nerve Stimulation ; Tuberculosis, Renal

In an attempt to elucidate the morphologic changes of normal aging skin, the present study was undertaken in human facial and chest well skin of individuals aged from 4 months to 76 years old. Biopsied skin was studied with light microscope, scanning electron microscope, and transmission electron microscope, using both conventional and tannic acid staining. The morphologic changes in the skin were noted as follow: 1. Structurally, the aged epidermis gradually became somewhat thinner, with flattening of the dermoepidermal interface. The number of melanocytes also decreased. 2. Abnormalities of elastic fibers such as loss of oxytalan fibers were observed from age 30. It was the initial sign of the aging process of elastic fibers, followed by abnormal changes in elaunin and mature elastic fibers. The degree of facial skin abnormality was rather more severe than that of the chest wall skin. 3. In individuals more than 50 years old, the age related changes in mature elastic fibers were more severe. Transmission electron microscopically, the electron density in elastin was irregular. The elastic fibers also showed pores and irregular splitting with fragmentation. Fine granular materials were scattered near the elastin. 4. Scanning electron microscopically, the elastic fibers in young adult skin showd ribbon-like fibers aligned in the same direction. They were either cylindrical or elliptical, having smooth surface. In old skin, the elastic fibers ran in various directions, forming complicated networks. These were larger, more elliptical and more branched than those in young adult skin. In summary, histologic changes of aging are much more prominent in sun-exposed skin(facial skin) than in sun protected skin(chest wall skin). A completely different spectrum of elastic fiber abnormalities was found in individuals more than 30 years old. The result indicates that elastic fiber abnormalities are related to aging skin.
Adult ; Male ; Female ; Humans

One hundred eighty-eight patients with avascular necrosis of the femoral head in adults, who were admitted and treated in Department of Orthopedic Surgery, Seoul National University Hospital between January of 1965 and May of 1985 are investigated in terms of the history, clinical data and laboratory examinations. And, the following results were obtained. 1. The incidence was higher in the 5th decade and the sex ratio between male and female was 3.3:l. 2. 106 cases (56%) had the bilateral hip involvement. 3. The most frequent etiological factor was alcohol (72 cases, 38%), followed by trauma (35 cases, 19 %), and steroid (32 cases, 17%). 4. Underlying diseases in steroid-induced avascular necrosis of the femoral head were dermopathy (9 cases), nephropathy (4 cases), pain over other joints (5 cases), systemic lupus erythematosus (2 cases), etc. 5. The time intervals between etiological events and appearances of clinical symptoms were 2 years and 3 months in the steroid induced cases, 1 year and 1 month in trauma induced ones, 2 years and 1 month in femur neck fracture cases, 2 years and 2 months in Caissons disease, and 3 years in post-irradiation 6. Bone scan was valuable in the early diagnosis of avascular necrosis of the femoral head. 7. Selective femoral head angiography show narrowing of lateral femoral circumflex artery, narrowing or obstruction of medical femoral circumflex artery, and obstruction of superior retinacular artery. 8. It is suggested that minor trauma and osteoporosis could make micro-fracture, resulting avascular necrosis of the femoral head, and the vascular change is secondary to the avascular necrosis.
Adult ; Angiography ; Arteries ; Early Diagnosis ; Female ; Femoral Neck Fractures ; Femur ; Head ; Hip ; Humans ; Incidence ; Joints ; Lupus Erythematosus, Systemic ; Male ; Necrosis ; Orthopedics ; Osteoporosis ; Seoul ; Sex Ratio

Since 1983, the transtrochanteric rotational osteotomy has been performed in 38 hips of 36 patients for the nontraumatic avascular necrosis of the femoral head at the department of orthopaedic surgery of Seoul National University Hospital. Out of them, 26 hips(18 cases of Sugioka grade I and 8 cases of Sugioka grade II ) were followed up for more than 1 year. The average period of follow-up was 3 years and 5 months(range, 1 year and 2 months to 7 years). These cases include 3 cases of failure before 2 years after operation. Overall, the result was satisfactory in 20 cases(77%)out of a total of 26 cases(success in 18 cases(69%)and good in 2 cases(8%)). The results of the grade I lesions(14 cases of success and 1 case of good result out of 18 cases) were better than those of the grade I lesions(4 cases of success and 1 case of good result out of 8 cases). Complications occurred in 5 cases. These include an ectopic ossification, a stress fracture of the neck, a nonunion of the osteotomy site, a nonunion of the greater trochanter and a delayed union of the greater trochanter. There were 6 cases of failure. For the 4 cases of them, hip replacement arthroplasy was performed. The MRI images axial to the longitudinal axis of the femoral neck gave excellent information for the operation.
Femur ; Femur Neck ; Follow-Up Studies ; Fractures, Stress ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Neck ; Necrosis ; Ossification, Heterotopic ; Osteotomy ; Seoul

No abstract available.
Bone Density*

Pharmacologic therapy is still the primary management for epilpsy; however, surgical treatment is a reasonable therapeutic option for patients suffering from medically intractable seizures, especially temporal lobe epilepsy having a documented unilateral epileptogenic area. Thirty nine patients with pharmaco-resistant complex partial seizures underwent anterior temporal lobectomy and hippocampectomy in 38 cases and frontal cortisectomy in one case. On pathological examination, hippocampal sclerosis was a predominent pathologic finding and was identified in 18 cases. Other non-neoplastic lesions consisted of 5 cases of vascular lesions(2 cavernous angiomas, 2 arteriovenous malformations and 1 angiomatosis), 3 cases of fibrous nodule, 2 cases of cicatrical changes of cerebral cortex, and 1 case of parasitic infection. Neoplasms including two cases of oligodendroglioma and one case of anaplastic astrocytoma were also noted. In seven cases, there was no detectable lesion on gross and microscopic examination. On post-operative follow-up, seizures were completely terminated in most cases(31 cases, 79%). The rest of the patients also displayed marked alleviation of symptoms. The seizures tended to recur more aften among the patients with neoplasm or no pathologically detectable lesion. In order to detect any minute pathological lesion, thorough gross and microcsopic examinations are considered to be essential.

Menetrier's disease is a rare cause of thickened gastric wall. The differential diagnosis of diffuse gastricwall thickening such as lymphoma and adenocarcinoma should be expanded to include Menetrier's disease. The authorsexperienced a case of Menetrier's disease accompanied deep vein thrombosis, which was proved by operation andpathology. We carried out double cntrast upper G-I series and computed tomography , and report with review ofliteratures.
Adenocarcinoma ; Diagnosis, Differential ; Gastritis, Hypertrophic ; Iliac Vein ; Lymphoma ; Thrombosis ; Venous Thrombosis

PURPOSE: To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. MATERIALS AND METHODS: Sixteen patients with avascular necrosis of femoral head were examined with MRI. Tl-weighted and T2-weighted images and contrast-enhanced Tl-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. RESULTS: Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on Tl-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the portions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. CONCLUSION: Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease.
Head* ; Humans ; Joints ; Magnetic Resonance Imaging* ; Necrosis* ; Synovial Membrane

No abstract available.
Durapatite* ; Dust* ; Rabbits* ; Transplants*

PURPOSE: Algorithms to get cross-sectional bone density pattern(transverse histogram) to predict the loosening of hip prosthesis using DXA(Dual X-ray Absorptiometry) have been developed. We performed this study to analyze the correlation between radiologic findings and densitometric pattern of the THRA(Total Hip Replacement Arthroplasty) patients. MATERIALS AND METHODS: Thirty-six hips of 32 THRA patients were evaluated. The duration between THRA and DXA was from 1 year 7 months to 15 years. On transverse histogram, the periprosthetic bone density patterns were classified as 3 types;type I, rigid fixation in 17, type II, definite loosening in 8, and type III, partial loosening in 11 cases. Surgical findings, plain X-ray findnings and transverse histogram using DXA were correlated. RESULTS: Among 14 cases performing revision for acetabular prosthesis loosening, 5 cases revealed loosening of fernoral stems while 9 cases revealed rigid fixation of femoral stems. Sensitivity was 100% for either plain X-ray or DXA. Specificity was 88%, 77% for plain X-ray and DXA respectively. CONCLUSION: This preliminary study reveals that periprosthetic bone density pattern on transverse histogram on DXA may be useful in the evaluation of the loosening. However, further study will be needed for clinical application.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Bone Density ; Hip ; Hip Prosthesis ; Humans ; Prosthesis Failure ; Sensitivity and Specificity