The development of CT scanning has revolutionized the role of radiology in the management of the pediatric head trauma. The procedure is safe and can be repeated to reassess a changing neurologic picture, thereby correlation the clinical and pathologic changes. This study included evaluation of CT of 178 infants and children with head trauma during the period of 31 months from Feb. 1979 to Aug. 1981 in the department of radiology, College of Medicine, Hanyang University. 1. Age distribution of the total 178 pediatric patients was ranging from one month to 16 years. The pediatric patient population was comprised of 128 males and 50 females, and its male to female ratio was about 2.5:1. The incidence of age occurring in 3 to 6 years was 38.2% and 7 to 10 years was29.2%. Therefore the distribution of age between 3 to 6 years and 7 to 10 years was occurred in two-thirds of allpediatric patients. 2. Of all cases of injuries, traffic accidents were 60.1% and falls were 34.8%. 3. Skull fractures were roentgenographically detected in 61 (34.3%). However, the incidence of fractures in pretoddler group (0-2 years) was 61.1% and 7 to 10 years was 37.8%, 3 to 6 years was 36.8%. Most common site of skull fracture was occipital bone, next parietal bone. 4. 54.8% of pediatric head trauma due to a fall had a skull fracture, as did25.2% of those who were injured in traffic accident. 5. Cerebral CT of the total 178 pediatric patients were revealed as following study; Normal was 74.2%, epidural hematoma was 8.9%, subdural hematoma was 5.1%, Cerebral contusion was 4.5%, intracerebral hematoma was 2.2% etc. 6. Of 25 cases of the epidural and subdural hematoma, Supratentorial area was 15 cases, infratentorial area was 10 cases. 7. Most of the epidural hematoma was demonstrated a clear mental state. 8. However, intracerebral hematoma and cerebral contusion were occurred almost impairment of mental state.
Accidental Falls ; Accidents, Traffic ; Age Distribution ; Child ; Contusions ; Craniocerebral Trauma ; Female ; Head ; Hematoma ; Hematoma, Subdural ; Humans ; Incidence ; Infant ; Male ; Occipital Bone ; Parietal Bone ; Skull Fractures ; Tomography, X-Ray Computed

CT is a new non-invasive diagnostic imaging method, which has ability to differentiate D.S.F., hematoma, and even edematous brain from normal brain tissue. Prior to the introduction of the CT, the diagnosis of the intraventricular hemorrhage in living patients was difficult and was confirmed by surgery or autopsy. Intracranial hemorrhages are visible on the CT with density higher than brain tissue in acute phase. CT is an accurate method for detecting of intraventricular hemorrhage including detection of nature, location, amount, and associated changes. CT is also useful as a surgical guidance and in the evaluation of fate of the hematomas by easily performable follow up studies. The causes of the intraventricular hemorrhages are hypertension, rupture of aneurysm, arteriovenous malformation, head trauma, brain tumor, and others. This study included evaluation of CT of 69 patients who show the high density in cerebral ventricular system during the period of 31 months fromFeb.1979 to Aug. 1981 in the department of radiology, college of medicine, Hanyang University. The results were as follows. 1. Age distribution of the total 69 patients was broad ranging from 1 month to 80 years. 28% of patients were in the 6th decade. The male to female ratio was 2:1. 2. The consciousness of patients at CT study: Those were conscious in 11 cases, stuporous in 41 cases and unconscious in 17 cases. 3. The causes of intraventricular hemorrhages were hypertension in 28 cases, head trauma in 12 cases, aneurysm in 4 cases, tumor in 2 cases and others in 23 cases. 4. 9 cases showed intraventricular hematomas only, other 60 cases showed associated intracranial hematomas: Those were intracerebral hematomas in 53 cases including 30 cases of basal ganglial & thalamic hematomas, subarachnoid hemorrhages in 17 cases, epidural hematomas in 3 cases, and subdural hematomas in2 cases. 5. All cases of the intraventricular hematomas except one showed hematoma in the lateral ventricles, hematomas in the 3rd ventricle in 35 cases, and hematomas in the 4th ventricle in 29 cases. 6. 28 out of 69 cases showed dilatation of the lateral ventricles. 7. Only 8 out of 69 cases were improved remarkably, 11 cases were slightly improved, and 48 cases were expired. The overall mortality was 70%. 8. The consciousness of the patient at the CT study and possibly the associated intracerbral hematoma play an important role in mortality. The age of the patients, causes of hemorrhages, presence of ventricular dilatation, and methods of treatment did not affect the mortality.
Age Distribution ; Aneurysm ; Arteriovenous Fistula ; Autopsy ; Brain ; Brain Neoplasms ; Cerebral Ventricles ; Consciousness ; Craniocerebral Trauma ; Diagnosis ; Diagnostic Imaging ; Dilatation ; Female ; Follow-Up Studies ; Fourth Ventricle ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhages ; Lateral Ventricles ; Male ; Methods ; Mortality ; Rupture ; Stupor ; Subarachnoid Hemorrhage ; Third Ventricle

The purpose of this study was to evaluate the effect of EDTA irrigant according to application time and temperature. 31 human mature extracted teeth with a single canal were sectioned with microtome in 3mm thickness and gained 62 samples of root canals. They were distributed randomly into 6 groups of 10 specimens each and control group of 2 specimens. Each specimen was prepared with GT rotary file (Dentsply, Maillefer Co., Swiss) and irrigated with 3 ml sodium hypochlorite every minute. Then smear layer was removed with EDTA solution (PULPDENT(R), PULPDENT Co., USA.) except two control specimens. Specimens of each group were irrigated with 17% EDTA. All specimens were split longitudinally and prepared for examination by scanning electron microscopy. A set of reference micrographs was used to award a debris score as follows: 0 = no smear layer, all tubules clean and open; 1 = no superficial smear layer, tubule openings visible, but some contain debris plug or soft tissue remnants; 2 = moderate smear layer, some tubules open and others closed; 3 = heavy smear layer, most/all tubule openings obscured. Results were evaluated with Kruskal-Wallis test to determine whether there was statistically significant difference among six groups. Pairs of groups were analyzed using the Student-Newman-Keuls Method and Mann-Whitney test. The results were as follows: 1. Control specimens showed heavy smear layer at the canal walls. 2. Among the groups applied with EDTA for 2 minutes, group 1 showed the heaviest smear layer, and there was statistically significant difference between group 1 and the other groups(p<0.05). 3. Among the groups applied with EDTA for 5 minutes, group 4 and group 6 showed smear layer, but there was no significant difference between them. 4. Among the groups applied with EDTA for the same temperature, group 1 showed heavier smear layer than group 4, and there was statistically significant difference(p<0.05). 5. Among the groups applied with EDTA for the same temperature, group 2 showed heavier smear layer than group 5 and group 3 showed heavier smear layer than group 6. But there was no statistically significant difference among them. From the results above, it could be concluded, EDTA solution is effective in removing of smear layer when it is applied for 5 minutes. If EDTA is applied for 2 minutes, it should be applied above room temperature.
Awards and Prizes ; Calcium Hydroxide ; Dental Pulp Cavity ; Edetic Acid ; Humans ; Microscopy, Electron, Scanning ; Smear Layer ; Sodium Hypochlorite ; Tooth

The present study was designed to estimate the seroprevalence of NLVs among diarrheagenic children and in healthy adults in Seoul and its vicinity with the use of an EIA and an Western blot (WB) based on recombinant Norwalk virus capsid protein (rNV) and crude virus preparations as antigen. Seroconversion was observed in 34 (83%) of 41 tested using the EIA and in 21 (54%) of 39 using the WB, suggesting that the NLVs with epitopes common to rNV are prevalent in Seoul area. Diarrheal children who were known to have been infected with several other strains of the NLVs showed no significant antibody response to the rNV. Infection with rNV occurred earlier in life: primary infections with rNV were common before the age of 6 months and over 91% of children had evidence of infection by that age by the EIA. Since the amount of the NLV antigens available for seroepidemiologic surveys is limited, we tried to detect NLV antibody by using crude virus preparations as antigen. One crude virus preparation of a child whose stool yielded genetically distinct NLV revealed the presence of the plural number of bands upon SDS-PAGE, but precipitated only one band (62 kDa) after the WB with a serum (collected 10 days after the onset of symptoms) of another diarrheal child. The WB assay we present in this report revealed that the NLVs are prevalent among Korean population and that the sera contained antibody to a single major structural protein, with molecular sizes of 58 to 62 kDa, compatible with the sizes reported for the Norwalk virus and Snow Mountain agent proteins, respectively. When the results of the WB were compared with those obtained by the EIA, the EIA antibody assay was sensitive enough to detect an antibody rise of as much as 4096-fold but not as specific as the WB. The WB assay presented in this paper will provide a powerful tool to elucidate not only antigenic structures of the NLVs but also seroepidemiology of the NLV infection. The availability of an unlimited source of antigen will enable a large scale serologic studies that will greatly increase our understanding of the role of NLVs in human enteric illness.
Adult ; Antibody Formation ; Blotting, Western ; Capsid Proteins ; Capsid* ; Child ; Electrophoresis, Polyacrylamide Gel ; Epitopes ; Humans ; Norovirus* ; Norwalk virus* ; Seoul* ; Seroepidemiologic Studies* ; Snow

BACKGROUND: The insulin resistance is common in the patients with essential hypertension, even in the absence of non-insulin-dependent diabetes mellitus(NIDDM) or hyperlipidemia. It is well known that the offspring of patients with NIDDM have shown less insulin sensitivity compared with that of normal parents. But it is not yet known whether the insulin resistance is common in the offspring of patients with essential hypertension in Korea, who have no hypertension, NIDDM and hyperlipidemia. The aims of this study were to find out whether the insulin resistance exist in the middle aged normal offspring of the patients with essential hypertension and whether the insulin resistance is dependent on the metabolic abnormalities such as the body mass index(BMI), obesity and hyperlipidemia. METHODS: The serum lipid profiles and oral glucose tolerance test were performed. The anthropometrical measurement was done. The abdominal CT scan at umbilicus level and thigh CT was performed in the 11 offspring of parents with essential hypertension(group I;male : 7, female : 4)and 24 offspring of parents without essential hypertension, NIDDM, ischemic heart disease and hyperlipidemia(group II; male : 9, female : 15). RESULTS: The average age of group I was 44.1+/-6.9 years, and that of the group II was 47.5+/-9.5 years. There were no significant differences in the blood pressure, weight, BMI, waist to hip ratio, waist to thigh ratio. And there were no significant differences in the serum cholesterol, triglyceride, HDL-cholesterol, serum Na, and plasma renin activities between both groups. Fasting plasma insulin and 2 hour insulin after 75gm glucose ingestion were significantly higher in group I than in group II(8.5+/-3.0mU/mL versus 5.0+/-1.8mU/mL, 61.6+/-31.7mU/mL versus 33.3+/-16.8mU/mL, p<0.05). The insulin sensitivity index was significantly lower in group I than in group II(355.1+/-92.6 versus 451.8+/-88.1, p<0.05). The visceral fat area was wider in group I than in group II(102.0+/-30.7cm2 versus 64.5+/-28.5cm2, p<0.05). The multiple regression analysis with the fasting plasma insulin and insulin sensitivity index as the dependent variables and family history of essential hypertension, visceral fat area and BMI as the predictor variables revealed that only the family history was associated with the fasting plasma insulin and insulin sensitivity index. CONCLUSIONS: The offspring of the parents with essential hypertension showed the insulin resistance with increased visceral fat area in comparison with the offspring of the parents without essential hypertension.
Blood Pressure ; Cholesterol ; Diabetes Mellitus, Type 2 ; Eating ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperlipidemias ; Hypertension ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat ; Korea* ; Male ; Middle Aged* ; Myocardial Ischemia ; Obesity ; Parents* ; Plasma ; Renin ; Thigh ; Tomography, X-Ray Computed ; Triglycerides ; Umbilicus ; Waist-Hip Ratio

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origins of the coronary arteries. It may be localized or diffuse, and includes a wide spectrum of pathologic changes. A 16 years old school boy was admitted because of exertional dyspnea for 6 years. Clinical diagnosis of supravalvular and valvular aortic stenosis with bicuspid aortic valves and myocardial hypertrophy was made by echocardiography and angiocardiography. Surgical correction was performed successfully. We presented a case of supravalvular and valvular aortic stenosis with a review of literatures.
Adolescent ; Angiocardiography ; Aorta ; Aortic Stenosis, Supravalvular ; Aortic Valve ; Aortic Valve Stenosis* ; Bicuspid ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Hypertrophy ; Male

The paint gun is an industrial instrument which ejects paint through a small opening with pressure of l,500 to 3,000 Ib/inch. In case of the paint-gun injury, the paint penetrates through a tiny wound of skin and spreads widely along the fascial plane or tendon sheath. It destroys the tissues rapidly. Moreover, the toxicity of the paint material evokes acute inflammatory reaction which is accompanied by localized swelling, erythema, heat and sometimes generalized symptoms (i.e fever). Local toxic reaction leads to swelling, circulatory disturhance and foIlowed hy gangrene of the tissue. Sometimes tissue condition is too desperate to survive and bring about amputation unfortunately. Authors treated eleven patients of the paint gun injury f'rom March 1988 to April 1995. The paint materials were removed thoroughly via large skin incision as immediately as possible after the injury. Usually the wound is left to be open for seven to ten days and is followed by delayed primary wound closure. In our experience of three cases of delayed removal( two, five and seven days after injury), the outcomes were poor with problems of pain, sensory disturhance, limitation of finger motio, and two cases of digit amputation. On doing paint gun injection, right hand was used to hold the paint-gun and left hand was used to hold the cable. Our study showed right hands were injured mainly(nine cases). It means the paint gun injury is caused by inattention of work partner.
Amputation ; Erythema ; Fingers ; Gangrene ; Hand ; Hot Temperature ; Humans ; Paint* ; Skin ; Tendons ; Wounds and Injuries

The pathologic spectrums of the tennis elbow are varies as lateral epicondylitis, degenerative partial tear of extensor tendon origin, annular ligament lesion, synovial fringe between radio-capitellar joint, bursitis and posterior interosseous nerve pathology. So it is difficult to perform separate treatments for each different pathologic conditions. Conservative treatments for the tennis elbow are consisted of rest, immobilization, non-steroidal anti-inflammatory drugs (NSAID), and local injection of the steroid. Usual success rates of the conservative treatment have been reported approximately more than 90%. Several methods of surgical treatm nt of the resistant tennis elbow have been reported. Authors performed surgical treatment for twelve cases of the resistant tennis elbow from Jan. 1989 to Jan. 1994. Authors modified the Nirschl's technique; flap retraction of the extensor carpi radilais brevis (ECRB) and common extensor tendon to expose the radio-capitellar joint and no reattachment of detached tendons to the lateral epicondyle and side-to-side suture with maximal stretching of the ECRB tendon. Identified pathologic conditions were the degenerative partial tear and friable granulation tissues at the ECRB origin, sclerosis of the lateral epicondyle (ten cases), synovial fringe bewteen the radio-capitellar joint (two cases). In one case, authors couldn't find any abnormal pathologic conditions. Microscopic examinations (two cases) showed angioblastic proliferation, fibrosis, degeneration of the collagen fiber. Among these patients, eleven patients were industrial worker (eight painter, two welder and one carpenter). They have something in common with using hammer mainly. The hammering might be a possible cause of the tennis elbow. After the surgery, the functional recoveries were satisfactory. The final results were four excellent (33.3%) and good (66.6%) by Nirsh & ettrone grading system. The time required to return to the original job were varied from one month to eight months (average 4.3 months).
Bursitis ; Collagen ; Elbow ; Fibrosis ; Granulation Tissue ; Humans ; Immobilization ; Joints ; Ligaments ; Pathology ; Sclerosis ; Sutures ; Tendons ; Tennis Elbow* ; Tennis*

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, which is an obligate intracelluar pathogen. It presents broad spectrum of clinical manifestations depending on the host's specific cell-mediated immune response to M. leprae. Especially, type I Th cells and macrophages are important in defense mechanism to M. leprae, and the immune response is regulated by cytokines secreted by immune cells. Recent investigations showed nitric oxide(NO) was the key molecule in the killing activity of macrophages, which was enhanced by IFN-gamma but suppressed by TGF-beta1 and IL-10. Since cytokine is secreted by activated immune cells with antigenic stimulation, decreased antigens by treatment modulates the expression of cytokines in leprosy. In this study, we observed the dynamics of cytokines expression using RT-PCR, such as TGF-beta1 and IL-10, which suppress the activity of macrophages, IFN-gamma, which activates macrophages, and iNOS, which represents the killing activity of macrophages, in the lesions taken from fifteen borderline lepromatous leprosy patients before and after multiple drug therapy for 4 weeks. The results are summarized as follows: 1. Before treatment, cytokines were expressed in order of IL-10, iNOS, TGF-beta1 and IFN-gamma(p>0.05). 2. After 4 weeks treatment, cytokines were expressed in order of iNOS, IL-10, TGF-beta1 and IFN-gamma(p<0.05). 3. Fifty-four percent of patients showed a non-polarized Th 0 pattern, 33% a polarized Th 1 pattern, and 20% Th-negative. Th 2 pattern was not observed. 4. The changes of cytokines expression after 4 weeks treatment were not significant, although mRNA of IL-10, TGF-beta1 and IFN-gamma were somewhat decreased. 5. There was negative correlation between TGF-beta1 and iNOS(gamma(2)=0.499, p<0.05, before treatment), positive correlation between TGF-beta1 and IFN-gamma(gamma(2)= 0.622, p<0.05, before treatment), and positive correlation between IFN-gamma and IL-10(gamma(2)= 0.935, p<0.05, before treatment; gamma(2)= 0.937, p<0.05, after treatment). In conclusion, these results suggest that TGF-beta1 and IL-10 may contribute to immune suppression in multibacterial leprosy patients, and that TGF-beta1 suppresses iNOS expression in macrophages. With 4 weeks treatment, the significant changes in cytokines expression were not observed. Interestingly, the majority of BL patients showed Th 0 pattern of cytokine, and none of Th 2 pattern.
Cytokines ; Drug Therapy ; Granulomatous Disease, Chronic ; Homicide ; Humans ; Interleukin-10* ; Leprosy* ; Leprosy, Multibacillary* ; Macrophages ; Mycobacterium leprae ; RNA, Messenger* ; Transforming Growth Factor beta1*

No abstract available.