BACKGROUND: Dizziness is a common complaint in patients presenting to the emergency room and that has various pathologic causes. This study investigate the clinical differences in dizziness between the central origin and the peripheral origin and to provides the clues far diagnosis and proper treatment. METHODS: We analysed 290 patients with dizziness during 12 months period prospectively, who visited in ED, Inha University Hospital from Jan. 1997 to Dec. 1997. We analysized sex ratio, characteristics of the dizziness, associated past illness, associated symptoms, severity, results of the special radiologic study, nystagmus type, and causes of central origin and peripheral origin dizziness. RESULTS: Male to female ratio was 1:1.4 in central origin(n=165) and 1:2.0 in peripheral origin(n=125). Most common age group was 11th decade in both groups. According to the characteristics of the dizziness, rotation sense was the main complaint of the peripheral origin dizziness. Most common past illness was hypertension in both groups. MRI has diagnostic priority than CT scan in central origin dizziness. Types of nystagmus has some significant differences between two groups. CONCLUSION: Dizziness may represented as a sign of significant pathological neurologic status especially in central origin. So we must precisely evaluate the patient history, neurologic examination of the inner ear and CNS, and special radiologic study incliding MRI.
Diagnosis ; Dizziness* ; Ear, Inner ; Emergency Service, Hospital ; Female ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Prospective Studies ; Sex Ratio ; Tomography, X-Ray Computed

PURPOSE: To analyze the variable MRI features and clinical significance of intracranial cavernous realformation. MATERIALS AND METHODS: Forty patients(mean age 35.4) with cavernous malformation were evaluated by MRI. Eleven patients were surgically confirmed. Cavernous malformations were divided into four categories on the basis of the MR imaging characteristics, especially on T2-weighted image. Type I lesion was defined as an extralesional subacute hemorrhage outside the low signal rim, type II as an intralesional hemorrhage surrounded by low signal rim, type III lesion as an intralesional thrombosis with variegated central core surrounded by low signal rim, and type IV lesion as a focal old hemorrhagic core with small low signal intensity. Type IV was further divided into IVa and IVb, whether the lesion has small iso- or hypersignal central core (IVa) or not (IVb). Follow-up MRI was evaluated in 12 patients who were managed conservatively. Follow-up intervals ranged from 2 weeks to 29 months (mean 6months). RESULTS: Total 80 lesions were detected in 40 patients. Multiple lesions were noted in 10 patients. The topography of the cavernous malformations was supratentorial in 75% and infratentorial in 23%. There were 10 lesions in type I, 15 in type 11, 21 in type III, 14 in type IVa, and 20 in type IVb. Type I lesions mainly showed mass effect and edema. Type III lesions showed minimal contrast enhancements in 7 lesions on delayed images. Type II lesions showed the characteristics of both type I and type III lesions. On follow up images, decrease in size in 5, change of type in 7, rebleeding in 2 and no change in 12 lesions were demonstrated. Hemorrhage, edema and mass effect were combined in the cases of rebleeding. On follow-up study, the estimated risk of bleeding was 32.3%/person-year and 13.7%/lesion-year. CONCLUSION: Cavernous realformations show as variable appearance, on MR imaging suggesting variable stages of evolution. The MR morphologic classification and evaluation of secondary findings are helpful to predict natural course and possibility of rebleeding of the lesion.
Classification ; Edema ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Thrombosis

No abstract available.
Meningitis, Cryptococcal*

A 43-year-old male patient showed well defined, irregular, dark eythematous, thick plaque and tumor with ulceration on the right chest, right axilla, pubis and scrotum, Histopathological findings rervealed atypical lymphocytes showing epidermotrophism and heavy infiltrations in the deep dermis and subcutaneous tissue. The infiltrative cells were positively stained with leukocyte common antigen and T-cell UCHL-1 antigen, but not with L26 antigen. This clinicohisto-pathological features were consstent with dermblade type of mycosis fungoides. The authors report clinicopathological findings of the case with its thrapeutic responses to systemic chemotherapy and radiation treatment.
Adult ; Antigens, CD45 ; Axilla ; Dermis ; Drug Therapy ; Humans ; Lymphocytes ; Male ; Mycosis Fungoides ; Scrotum ; Subcutaneous Tissue ; T-Lymphocytes ; Thorax ; Ulcer

No abstract available.

No abstract available.
Plasminogen Activators* ; Plasminogen* ; Pulmonary Embolism*

BACKGROUND: Respiratory depression with high dose of propofol during induction is one of the major complications. We studied the effects of midazolam as premedicant on frequency and duration of apnea and frequency of loss of consciousness in relation to single dose of propofol. METHODS: We selected 194 adult patients who had clear consciousness and no depression of respiration. We allocated patients randomly to control group and midazolam group. In midazolam group, we injected 0.06mg/kg of midazolam intravenously 10min before induction, and in control group, we did nothing. Under mask oxygenation with 100% oxygen, we administered a bolus of propofol (1, 1.5, 2 mg/kg to subgroup 1, 2, 3 respectively) intravenously. The change of respiration and loss of consciousness were observed. RESULTS: The frequency and duration of apnea increased with the dose of propofol in both control and midazolam group. But there were no difference between groups except frequency of apnea with 1.5 mg/kg of propofol. In control group, frequency of loss of consciousness increased with the increasing dose of propofol. But in midazolam group, nearly all the patients was slept without difference by the dose. CONCLUSIONS: Premedication with midazolam reduce the sleeping dose of propofol to induce anesthesia, so the frequency and duration of apnea which is caused by high dose of propofol can be decreased.
Adult ; Anesthesia ; Apnea* ; Consciousness ; Depression ; Humans ; Masks ; Midazolam* ; Oxygen ; Premedication ; Propofol* ; Respiration ; Respiratory Insufficiency ; Unconsciousness*

This study consisted of 66 peritrochanteric fractures which were treated by the modified Gamma nail (Asian Pacific nail) from August 1993 to October 1995. Sixty-one intertrochanteric fractures and five subtrochanteric fractures were treated in our institution. Average length of follow-up was 15.0 months. Four patients died during follow-up. The results were as follows; Lag screws were ideally introduced in 55 (83%) cases. The mean length in lag screw sliding was 4.3 mm in stable trochanteric fractures and 5.7 mm in unstable ones. Fifty-one out of 62 patients (82%) were returned to their previous ambulatory status. Intraoperative complications were as follows; distal crack (3 cases); rotation of femoral head (2 cases); entry point crack (I case); medialization of proximal fragment (7 cases); and missing of the interlocking screw (1 case). All of these complications did not affect the outcome. All medial cortical gaps were closed after sliding of lag screws. Three distal cracks did not propagate to the shaft. Postoperative complications were a case of superior cut-out, and two second fractures after falls. Callus formed more early in the stable trochanteric fractures (5+/-2.1 weeks) than unstable fractures (7.3+/-2.1 weeks). It was statistically significant. Union time between stable and unstable trochanteric fractures was not statistically significant. In conclusion, the Asian Pacific (AP) nail could appropriately fix the osteoporotic peritrochanteric fractures in elderly patient. It could offer early rehabilitation to these patients and decrease the mortality and morbidity.
Aged ; Asian Continental Ancestry Group ; Bony Callus ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Head ; Hip Fractures ; Humans ; Intraoperative Complications ; Mortality ; Postoperative Complications ; Rehabilitation

Myositis ossificans progressiva is a rare disease characterized by the formation of areas of calcification in the interstitial connective tissue of muscles, tendons, ligaments, fascia, and aponeuroses. There may be exacerbations and remissions of the disease, but the general course is an insidious loss of body motion, affecting especially the neck, spine and upper extremities and, rarely, the hips and lower extremities. It is commonly associated with various congenital anomalies. The cause is unknown and there is no known effective treatment. Myositis ossificans progressiva associated with brachydactyly of both great toes, in a 34 year old femaIe, is presented with a review of the literature. Chief complaints were ankylosis of the left knee and hip of 9 years duration. We performed biopsy of tubular bone which is placed antero-lateral side of the left knee.
Ankylosis ; Biopsy ; Brachydactyly ; Connective Tissue ; Fascia ; Hip ; Knee ; Ligaments ; Lower Extremity ; Muscles ; Myositis Ossificans ; Myositis ; Neck ; Rare Diseases ; Spine ; Tendons ; Toes ; Upper Extremity

No abstract available.
Interferon-alpha* ; Interleukin-2* ; Killer Cells, Lymphokine-Activated*