Lesions of the skull vault are often incidentally encountered during in plain radiography, CT, and MR imaging of the brain and benign lesions are more common than primary malignancies. The usefulness of plain skull films is limited, but when combined with CT or MRI, there is a high probability of accurate diagnosis. The aim of this essay is to describe a wide range of cranial lesions and to illustrate their distinguishing features.
Brain ; Diagnosis ; Magnetic Resonance Imaging ; Radiography ; Skull*

No abstract available.
Appendicitis* ; Child* ; Humans

BACKGROUND/AIMS: We measured the brachial artery pulse wave velocity (BaPWV) and intima-media thickness (IMT) of the common carotid artery to evaluate atherosclerosis in young women with systemic lupus erythematosus (SLE) and healthy controls. METHODS: Twenty-one premenopausal female patients with SLE and 21 healthy controls were enrolled. The groups were matched for age, sex, ethnicity, and atherosclerosis risk factors. Smokers and those with the atherosclerosis risk factors hypertension and diabetes were excluded from this study. IMT was measured with high-resolution ultrasonography. BaPWV was measured with volume plethysmography. RESULTS: The mean age was 34.20 years in the SLE group and 36.87 years in the healthy controls. The IMT of the right and left common carotid arteries in the SLE group did not differ significantly from that in the healthy controls. The BaPWV was significantly higher in the right (1.40+/-0.26 vs. 1.17+/-0.09 cm/sec, mean+/-SD; p=0.003) and left (1.41+/-0.26 vs. 1.19+/-0.08 cm/sec, p=0.013) arms in the SLE group than in the healthy controls. There were no significant differences in the ankle-brachial pressure index (ABI), body mass index (BMI), C-reactive protein (CRP), total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, lipoprotein a, and homocysteine between the two groups. CONCLUSIONS: The IMT in premenopausal women with SLE was not significantly different from that in healthy controls, while the BaPWV, which reflects arterial stiffness, was significantly higher than in the healthy controls.
Arm ; Atherosclerosis ; Body Mass Index ; Brachial Artery ; C-Reactive Protein ; Carotid Artery, Common ; Cholesterol ; Female ; Homocysteine ; Humans ; Hypertension ; Lipoprotein(a) ; Lipoproteins ; Lupus Erythematosus, Systemic ; Pulse Wave Analysis ; Risk Factors ; Vascular Stiffness

The treatment of epidural hematoma is operative or conservative and sometimes, the choice of the method is somewhat controversial. Traditional operative method is craniotomy or craniectomy. 34 patients treated surgically with burr hole trephination and urokinase irrigation at Taegu Fatima hospital between Jan 1989 and Mar 1991 are reviewed in point of clinical features, brain computerized tomography findings and outcomes. And we found several advantages in this method compared to conservative or traditional operative method. Advantages of this method were as follows: 1) It was simple. 2) It enabled us to operate under local anesthesia. 3) It was possible to reduce the rate of delayed intracranial hematoma and rebleeding. 4) It was possible to prevent air embolism. 5) Possible seizure focus was removed. But, there were disadvantages as follows: 1) There was difficulty in early ambulation. 2) Much effort to irrigate the hematoma was required.
Anesthesia, Local ; Brain ; Craniotomy ; Daegu ; Early Ambulation ; Embolism, Air ; Hematoma* ; Humans ; Seizures ; Trephining ; Urokinase-Type Plasminogen Activator*

OBJECTIVES: To obtain basic data on blood lead level and urinary level of arsenic and cadmium of children living near a petrochemical estate and a suburban area in Ulsan, Korea and to observe the trend of the changes in the level of these metals in these children. METHODS: The study subjects comprised 626 children living near a petrochemical estate and 299 children living in a suburban area of Ulsan. We analyzed the level of lead, arsenic and cadmium using atomic absorption spectrometer. RESULTS: The mean levels of blood lead in children living near the petrochemical estate were 5.25 microgram/dl, 5.24 microgram/dl, and 7.24 microgram/dl in the years 1997, 1999, and 2000, respectively, whereas those of children living in the suburban area were 3.81 microgram/dl, 4.75 microgram/dl, and 7.19 microgram/dl respectively. The mean levels of urinary arsenic in children living near the petrochemical estate were 4.57 microgram/g creatinine, 4.78 microgram/g creatinine, and 6.02 microgram /g creatinine in the year 1997, 1999, and 2000 respectively, whereas those of children living in suburban area were 2.35 microgram/g creatinine, 4.75 microgram/g creatinine, and 7.07 microgram/g creatinine, respectively. The mean levels of urinary cadmium in children living near the petrochemical estate were 1.15 microgram/g creatinine, 1.05 microgram/g creatinine, and 1.71 microgram/g creatinine in the year 1997, 1999, and 2000, respectively, whereas those of the children living in the suburban area were 0.74 microgram/g creatinine, 1.29 microgram/g creatinine, and 1.48 microgram/g creatinine, respectively. There were increasing trends in the level of blood lead, urinary arsenic and cadmium of children in Ulsan, and the differences in the level of these metals were disappearing between the children living in other areas year by year. CONCLUSIONS: These results suggest that the amount of exposure to lead, arsenic, and cadmium is increasing from year to year, and there is a need for periodic biological and atmospheric monitoring of these metals in Ulsan.
Absorption ; Arsenic* ; Cadmium* ; Child* ; Creatinine ; Follow-Up Studies* ; Humans ; Korea ; Metals ; Ulsan*

STUDY DESIGN: A case of brain infarction due to occlusion of vertebral artery after cervical spine fracture is reported. OBJECTIVES: Documentation of possibility and clinical significances of brain infarction as one of grave complications after cervical spine injury. SUMMARY OF LITERATURE REVIEW: Occlusion of vertebral artery and consequent brain infarction can be associated with cervical spine injuries because vertebral arteries course through the transverse foramina from sixth to second corvical vertebrae. Infarction of vertebrobasilar system may cause impairment of cerebral, cerebellar, or brain stem function and can occasionally bring grave functional loss, even death. MATERIALS AND METHODS: A case of occlusion of vertebral artery and consequent cerebral infarction after cervical spine fracture in a 66 year-old man. Brain CT and angiogram were performed. He was managed with anticoagulants. RESULTS: Neurologic deficits from brain infarction disappeared after 2 weeks. CONCLUSIONS: Attention to the possibility of these complications and awareness of their clinical features seem to be mandatory in managing cervical spine injury patients.
Aged ; Anticoagulants ; Brain ; Brain Infarction ; Brain Stem ; Cerebral Infarction* ; Humans ; Infarction ; Neurologic Manifestations ; Spine* ; Vertebral Artery*

OBJECTIVES: This study was to evaluate the impacts of simultaneous exposure to noise and mixed solvents on workers'hearing threshold level (HTL) over five-year period. METHODS: The study was conducted by interview and annual audiometric test on workers in ship building industry from 1994 to 1998. The cases(workers who exposed to noise and mixed solvent simultaneously) were 43 male workers and controls (workers who exposed to nolle) were selected by matching method with regard to age, sex, carrier, and noise exposure level. To assess the impacts of solvent exposure on hearing threshold level, with considering other factors, general liner model was used. RESULTS: 1. The audiogram of all subjects showed typical sensorineural hearing loss pattern. The mean HTLe were increased at high frequency (4000HB and 8000Hz) for study period. 2. The HTLs of cases were more increased than those of controls at high frequencies (4000Hz and 8000Hz), but there was not statlstical significance. 3. The impact of age on the HTL was statistically significant at 250Hz and 500Hz (p(0.05), and the impact of noise on the HTL was statistically significant at 250Hz, 2000Hz and 4000Hz (p(0.05), but the impact solvent exposure on the HTL was not significant. 4. The changes in HTLs of cases were higher than those of controls at high frequency, there were not statistical significance at 4000Hz, but only at 8000Hz (p=0.087). 5. Statistical analysis of the general linear model implicated that the changes in HTL was impacted by noise exposure bevel significantly (p=0.031) and Impacted by solvent exposure weakly (p=0.087) at 8000Hz. CONCLUSIONS: The results of this study suggest that workers who simultaneously exposed to noise and mixed solvent were at risk for more affected HTL than those exposed to noise exposure only, but we could not find definitive evidence. Further detailed studies must be made in large number of workers.
Construction Industry ; Hearing Loss* ; Hearing Loss, Sensorineural ; Hearing* ; Humans ; Linear Models ; Male ; Noise ; Ships ; Solvents

Ten opening-wedge callotasis through the proximal tibia just below the tuberosity were performed using the Ilizarov apparatus in ten patients who had premature asymmetrical closure of the proximal tibial physis and subsequent genu recurvatum. In 4 knees, the genu recurvatum was due entirely to osseous deformity. In the remaining 6 knees, it was due to a combination of ossseous and soft-tissue (ligament and capsule) deformity. In the 6 knees that had combined deformity, the osseous deformity was predominant in all knees. The average age of the patients at surgery was 16.3 years (range, 11.0-20.5 years). Before operation, the average angle of recurvatum was 19.6 degree (range, 15-26 degree) with an average of 76.6 degrees of abnormal tilt of the tibial plateau. The average shortening of the ipsilateral limb in ten patients was 2.7 cm (range, 0.5-8.7 cm). The average duration of correction was 49 days (23-85 days), and the average fixation time was 150 days for management of genu recurvatum and associated limb-length discrepancy. In 3 patients, there were complications including patella infera, pin track infection and transient peroneal nerve palsy. After a mean follow-up of 4.2 years (range, 1.1-5.9 years), most patients had an excellent or good radiographic and functional results without any recurrence. We have found the Ilizarov method to be valid in the management of genu recurvatum with or without concomitant shortening, with relatively few complications, but full understanding of the basic principles and strict adherence to the details of the method must be carefully followed.
Congenital Abnormalities* ; Extremities ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Knee ; Osteogenesis, Distraction ; Paralysis ; Patella ; Peroneal Nerve ; Recurrence ; Tibia

No abstract available.
Leiomyosarcoma*

STUDY DESIGN: A prospective study. OBJECTIVES: To evaluate the effectiveness of ultrasound guidance in caudal epidural block and sonographic feature of sacral hiatus. SUMMARY OF LITERATURE REVIEW: High success rate of ultrasound-guided regional nerve block has been reported and recently, ultrasound-guided nerve block in spinal field has been introduced. MATERIALS AND METHODS: Ultrasound-guided caudal epidural block was performed in 48 patients with radiating pain to leg. Patient was placed in the prone position and sonographic image of sacral hiatus was obtained using linear probe. After measuring the intercornual distance, thickness of sacrococcygeal membrane and depth of sacral canal in transverse view, then the probe was rotated 90degrees to obtain the longitudinal view of the sacral hiatus. Under ultrasound guidance, a 21-gauge needle was inserted into the sacral hiatus in parallel with sacrum base. After contrast dye injection, needle placement was checked by the fluoroscopy and then medication was injected into the caudal epidural space. We investigated the change of radiating pain after caudal epidural block using visual analogue scale(VAS). RESULTS: The intercornual distance was mean 16.4+/-2.3mm, thickness of sacrococcygeal membrane was mean 2.8+/-0.9mm and depth of sacral hiatus was mean 2.6+/-0.9mm. There was 97.9% success rate of the caudal epidural block under ultrasound guidance. The mean VAS for radiating pain was improved from 7.5+/-0.7 before the block to 2.8+/-1.5 after the block. CONCLUSIONS: Ultrasound-guided caudal epidural block seems to provide good anatomical landmark of sacral hiatus and an effective tool with high success.
Epidural Space ; Fluoroscopy ; Humans ; Leg ; Membranes ; Needles ; Nerve Block ; Prone Position ; Prospective Studies ; Sacrum ; Ultrasonography*