No abstract available.
Asthma, Occupational* ; Paint* ; Urethane*

Granuloma annulare is a benign, usually self-limited chronic dermatasia of unknown cause, charaeterized by akin colored papules that may be arranaged in an annular configuraticn. Histopathologically, it is charicterized by camplete or incomplete foeal degeneration of collagen of chronic infliammatory cells. The authors obaerved an atypical case of granuloma annulare in a 4-year-old girl. She showed multiple papules and nodule on hands and feet. On inital examination, her skin lesions suggested histiacytosis, xanthanulama, rheumatoid nodule, or benign skin tumor. But the skin biopey revealed typica1 findings of granuloma awulare. Focal degeneration of colagen was confirmed by toluictine blue stain. Her skin lesions were almoatly cleared by skin biopsy and intralesional injectian of corticosteroid.
Biopsy ; Child, Preschool ; Collagen ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Hand ; Humans ; Rheumatoid Nodule ; Skin

We decribe the CT findings in a case of mediastinal hemangioma. Precontrast enhanced CT demonstrated a homogeneous soft tissue mass with weveral nodular calcifications indicating phleboliths. Contrast enhanced CT revealed some areas of enhancement similar to that of adjacent vascular structures. Hemangiomas of the mediastinum, although rare, should be included in the differential diagnosis of enhancing mediastinal masses.
Diagnosis, Differential ; Hemangioma* ; Mediastinum

One of the common serious consequences of trauma to the temporal bone is facial nerve paralysis. Several attempts have been made to evaluate the relationship between the radiological findings and traumatic facial paralysis. These works have demonstrated the usefulness of high-resolution computed tomogrphy in assessment of facial nerve pathway. The authors tried to clarify the significant factors contributing to the facial nerve paralysis due to temporal petrous fractures clinically and radiologically including the high resolution CT findings. Fifty eight patients with 66 petrous fractures were reviewed in this context. Various clinical factors including hearing disturbance, CSF otorrhea demonstrating the objective traumatic evidences were reviewed. Plain X-ray findings and CT findings were reviewed as radiologic evidences. The radiologic factors were fracture evidence and wide fracture gap(more than 1mm) in plain film. Among CT findings, evidence for blood in middle ear, blood in mastoid air cells, ossicular disruption, fracture line compromising the facial nerve pathway from internal acoustic canal to mastoid portion and multiplicity of fracture lines were reviewed. These factors were analyzed statistically. In this study, it was found that traumatic bony involvement in facial nerve pathway did not necessarily mean facial paralysis. The most relavent factor contributing to the traumatic facial paralysis was multiple petrous fractures.
Acoustics ; Ear, Middle ; Facial Nerve ; Facial Paralysis* ; Hearing ; Humans ; Mastoid ; Paralysis ; Temporal Bone

BACKGROUND: Total occlusion of the infrarenal abdominal aorta is a very rare disease in clinical practice. The clinical outcome may be poor unless management is attempted promptly. Surgical bypass has been recommended as the treatment of choice for these lesions. However, there was relatively high surgical mortality and morbidity associad with aorto-bifemoral bypass graft in patients with other systemic disease, especially coronary artery disease. As a result, the use of, thrombolysis with percutaneous transluminal angioplasty (PTA) has recently been extended to this disease as an alternative method to surgery. PTA is technically simpler with less morbidity and mortality than surgery.We report our experience with thrombolysis and balloon angioplasty of total aortic occlusion in 14 patients between March 1991 and December 1996. METHODS: Fourteen patients, whose mean age was 59+/-13 years (11 male, 3 female), serve as the study's patients. Aortography was introduced via transbrachial artery. The end hole multipurpose catheter with guidewire was introduced into the thrombotic portion of the total occlusion. Urokinase was infused into the thrombus through the catheter if there were no contraindications. in sysremic thrombolysis. Thrombolytic therapy was continued until the thrombi was resolved and flow was restored. Balloon dilatation was followed in residual stenotic lesions. Stents were implanted in case of suboptimal results after ballooning. RESULTS: Clinical findings were resting leg pain in 6 patients, gangrene in 5 patients, and claudication in 3 patients. The causes of aortic occlusion were thromboembolism in 4 patients and thrombosis of an atherosclerotic aorta in 10 patients. Location of obstruction was below the renal artery in all cases. The clinical outcome of interventional therapy was successful in all cases except one patients. Operative treatment was undertaken in 2 cases because they could not received thrombolytic therapy due to contraindication and complication of thrombolytic therapy (gastrointestinal bleeding). Near normal revascularization was achieved in 3 patients by thrombolytic therapy only. PTA was performed at the stenotic after thrombolytic therapy in 4 patients. Stenting were performed at the stenotic sites after balloon dilatation in another 4 patients. There was bleeding complication in one case. CONCLUSIONS: Interventional therapy such as thrombolytic therapy with PTA is an effective and safe treatment modality for abdominal aortic total occlusion in selected cases. These techniques were very useful in some high risk patients who received surgical bypass procedures.
Angioplasty ; Angioplasty, Balloon ; Aorta ; Aorta, Abdominal* ; Aortography ; Arteries ; Catheters ; Coronary Artery Disease ; Dilatation ; Gangrene ; Hemorrhage ; Humans ; Leg ; Male ; Mortality ; Rare Diseases ; Renal Artery ; Stents ; Thromboembolism ; Thrombolytic Therapy ; Thrombosis ; Transplants ; Urokinase-Type Plasminogen Activator

PURPOSE: We reported the CT and MR findings of 2 cases with Sturge-Weber syndrome which were not accompanied by facial nevi. MATERIALS AND METHODS: They were examined with both CT and MR in one case and with MR only in the other case. RESULTS: CT was better than MR in the demonstration of the characteristic cortical calcification. MR was superior to CT in the depiction of the abnormalities of the surrounding parenchyma and the intense enhancement of pial angiomatosis with Gd-DTPA enhancement. CONCLUSION: Gd-DTPA enhanced MR imaging could be useful in the demonstration of the presence and extent of pial angiomatosis in patients with suspected Sturge-Weber syndrome.
Angiomatosis ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Nevus* ; Sturge-Weber Syndrome*

OBJECTIVE: Whether the anterior approach is better than the posterior one for cervical disc disease still remains unsettled. However, anterior discectomy and fusion procedures for all types of discs have been more popular than the posterior one. Posterior approach should not be underestimated since it has many benefits. To study it's feasibility, the effectivenes and safety of the lamino-foraminotomy for cervical disc disease, we review 10 surgical cases with posterior approach. METHODS: Ten consecutive cervical lateral disc protrusion cases which underwent lamino-foraminotomy with or without discectomy were reviewed. Patient's age, sex, main symptom, EMG studies, surgical procedure were studied retrospectively. The outcome was rated with Prolo's scale. RESULTS: There were one female and nine male patients. Major preoperative symptoms were radicular pain radiating to upper extremity, numbness, axial neck pain and motor weakness. Electromyography was performed in eight cases with six correspondent results. Lamino-foraminotomy was performed in all cases and discectomy was done in nine patients. By modified Prolo's outcome scale, nine patients enjoyed good results and one was moderate, nine patients were able to carry on their original occupations. The mean hospital stay was 14.6 days. There was no postoperative instability. CONCLUSION: With posterior approach, critical complications of anterior approach could be averted. No bone graft is needed. No graft donor site pain is expected either. Hospital stay could be shortened. The posterior foraminotomy is an easy and effective procedure in the treatment of patients for laterally located soft disc herniations.
Diskectomy* ; Electromyography ; Female ; Foraminotomy ; Humans ; Hypesthesia ; Length of Stay ; Male ; Neck Pain ; Occupations ; Retrospective Studies ; Tissue Donors ; Transplants ; Upper Extremity

Posterior cerebral artery (PCA) aneurysm is a rare disease, and has some distinctive features compared with aneurysms located elsewhere. This study is to investigate results of the management and characteristics of posterior cerebral artery aneurysm. Between 1996 and 2005, we treated 8 patients (4 male, 4 female) via endovascular or surgical approach. Six patients underwent endovascular treatment and two were treated with open surgery. The Glasgow Outcome Scale (GOS) was used for estimating the results. Five patients had ruptured PCA aneurysms and three had unruptured aneurysms. The locations were one case of P1 branch, two cases of P1-P2 junction, four cases of P2-P3 junction and one case of distal P4 branch. Among 8 patients, five had good recovery, two had a moderate disability and another one was expired due to rebleeding. Optimal treatment of PCA aneurysms is able to perform via surgical or endovascular approach. Endovascular treatment is effective and an alternative method for PCA aneurysm because of the difficulty and several complications of surgical approach.
Aneurysm ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm* ; Male ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery* ; Rare Diseases

Although it's been about 100 years since the vascular malformation was first discovered, it is very recent situation that the natural history of cavernous malformations is being clarified. Once it was considered to be very rare, but the introduction of MRI made it possible to diagnose more asymptomatic patients than ever. With this sophiscated tool, it become easy to diagnose and follow up this vascular disease. As more and more asymptomatic or minimally symptomatic patient are being discovered, it become very difficult part for a neurosurgical surgeon to choose the method of treatment in each clinical case. A great deal of recent controversy has been generated concerning the best surgical approach to treat benign lesions that are associated with epilepsy. Since the definition of the bleeding and the clinically significant symptom are different from author to author, one should be careful to recognize the statistical numbers of the from articles. We reviewed dozens of articles to figure out the right indication, approach and microsurgical technique. The surgical risk should be carefully weighed against the morbidity from the natural history of the disease.
Epilepsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Natural History ; Vascular Diseases ; Vascular Malformations

To elucidate the funcion of arachidonic acid as a secondary brain edema facotr, the infusion edema model was constucted using adult cats with studies of somatosensory evoked potentials, regional cerebral blood flow of white matters, brain water contents, magentic resonance images and histological findings. Among 50 cats, 6 cats were used as sham poerated group without infustion and in 45 cats solutions of various concentrations of arachidonic acid and physiologic saline were infused into the left and right frontal white maters respectively. According to the different concentrations of arachidonic acid, three groups were named as group A(0.1mg/ml), group B(1mg/ml), group C(10mg/ml). During 4 hours of slow infusion of the infusates(average 0.5ml in each side totally) central conduction time(CCT) was measured every an hour with contralateral median nerve stimulation bilaterally and cerebral blood flow(CBF) of white matter was measured by hydrogen clearance method every 2 hours. Finally the cats were sacrificed and specimens of edematous white matter obtained bilaterally at the coresponding points. Water contents were measured with vacuum freeze drying method. T2-weighted magnectic resonance images(MRI) and light microscopic studies were performed in a cat of each groups. The results were as followed ; 1) MRI and histologic findings showed that the infusion brain edema technique was efective in inducing interstitial edema, but the differences in the degree of edema formation between the right and the left sides were not siginificant in all groups. 2) There were no statistically significant difference between the water contents of the right and that of left in all groups. 3) Either infusion of arachidonic acid or physiologic saline in the white matter did not change regional white matter CBF in all groups. 4) The I-N1 interpeak latency was labelled as central conduction time(CT), and the baseline CCT was 5.83+/-0.52msec. 5) The differences of CCT between infusion group and noninfusion group were statistically significant in group C at 2, 3, 4hours(p>0.01) and the differerences of cct between arachidonic acid and physiologic saline infustion sites were statistically significant in group B at 4 hors, group C at 1 hour(p>0.05) and group C at 2, 3, 4hours(p>0.01) after eginning of infusion and the differences increased with time in group C(p>0.01). The results indicate that arachidonic acid does not have edemogenic properties during 4 hours infusion but may induce neurologic dysfunction as to increase the CCT in somatosensory evoked potential studies if it exists in the edema fluid of brain white matter.
Adult ; Animals ; Arachidonic Acid* ; Brain Edema ; Brain* ; Cats ; Edema ; Evoked Potentials, Somatosensory* ; Freeze Drying ; Humans ; Hydrogen ; Magnetic Resonance Imaging ; Median Nerve ; Neurologic Manifestations ; Vacuum