The authors have experienced a case of histiocytosis-X. A 7-year-old male patient had three tender masses, one on the right parietal region, another on the left parietal region, the other on the left occipital region and revealed exophthalmus on his left side. Plain skull films showed multiple punched out skull defects and on lumbar spine films, collapse of body of second lumbar vertebra was detected. Among the masses, the largest right parietal one was excised totally. The final diagnosis revealed histiocytosis-X on pathologic basis and he was given subsequent chemotheraphy.
Child ; Diagnosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Male ; Rabeprazole ; Skull ; Spine

The authors report a rare case of right distal posterior inferior cerebellar artery(PICA) aneurysm arising from just distal to its vermian brance. A 36-year-old female patient presented with a sudden onset of headache, nausea, dizziness and ataxia without any other neurologic deficit. On brain computerized tomographic(CT) scan and magnetic resonance imaging(MRI), a well-defined round mass was detected just behind the fourth ventricle. On transfemoral vertebral angiogram(TFVAG), it was confirmed as a saccular aneurysm arising from the vermian brance of the right PICA. The aneurysm was initially directly clipped through bilateral suboccipital approach. Postoperative follow up angiogram after two weeks revealed a more enlarged aneurysm and an incompletely clipped neck. After making sufficient exposure of the aneurysm, the neck was reclipped and the sac removed. Postoperative results were uneventful.
Adult ; Aneurysm* ; Arteries* ; Ataxia ; Brain ; Dizziness ; Female ; Follow-Up Studies ; Fourth Ventricle ; Headache ; Humans ; Nausea ; Neck ; Neurologic Manifestations ; Pica

Spontaneous cervical epidural hematoma is an infrequent entity that usually requires emergency decompression on account of impending neurologic deficit. We present a case of a 36-year-old man who visited our emergency room complainng of severe neck pain with progressive weakness of both upper extrmities. On cervical MRI, fusiform epidural hematoma was found extending from the fifth to the seventh cervical vertebrae. Emergency surgical evacuation was performed. The patient was fully recovered and discharged uneventfully.
Adult ; Cervical Vertebrae ; Decompression ; Emergencies ; Emergency Service, Hospital ; Female ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Neck Pain ; Neurologic Manifestations

The authors retrospectively analized the radiographs and medical records of 135 consecutive patients who underwent minimaly invasive spinal surgery from January, 1990 to December, 1994 at our institution. Among these, 72 patients have had chemonucleolysis and others percutaneous automated lumbar discectomy(PALD). The success rate was similar in both groups, ie, 75% in chemonucleolysis and 74.6% in PALD by Macnab's criteria. The higher success rate could be obtained in 1) younger age below 30, 2) predominant sciatica than lower back pain, 3) eccentric bulged disc with minimal degeneration, 4) abscent or minimal neurologic deficits. In conclusion, provided patients are carefully screened, minimal invasive spinal surgery is more preferable over conventional surgery, providing a safe and effective therapeutic alternative to many patients suffering from herniated lumbar disc.
Diskectomy* ; Humans ; Intervertebral Disc Chemolysis* ; Low Back Pain ; Medical Records ; Neurologic Manifestations ; Retrospective Studies ; Sciatica

PURPOSE: We analyzed the frequency and characteristics of atherosclerotic plaques in the patients without coronary artery calcification (CAC) by the use of multidetector row CT (MDCT). In addition, we analyzed patients with negative CAC to guarantee the absence of coronary artery disease (CAD). MATERIALS AND METHODS: One hundred-ten patients with a suspicion of CAD and no CAC as detected on 16-slice and 64-slice MDCT were enrolled in this retrospective study. We analyzed the frequency of atherosclerotic plaques. For characterizing the atherosclerotic plaques, location, attenuation, volume, the degree of stenosis, and the remodeling index (RI) were analyzed. RESULTS: Atherosclerotic plaques were detected in 8 patients (7.3%). The plaques were located in the right coronary artery (n=3), left anterior descending artery (n=3), and left main coronary artery (n=2). Attenuation, volume, stenosis and RI were 41.4+/-16.6 HU (range, 20.2 - 69.9 HU), 55+/-55 mm3 (range, 15-179 mm3), 40.7+/-16.3% (range,16.0-68.0%) and 1.35+/-0.13 (range, 1.16-1.50). Lipid rich plaque and significant stenosis were detected in 6 patients and in 2 patients, respectively. CONCLUSION: Despite negative CAC as detected on MDCT, atherosclerotic plaque might have significant stenosis or lipid rich plaque. Therefore, negative CAC does not seem to guarantee the absence of CAD. Coronary CT angiography was recommended for patients with negative CAC.
Angiography ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Plaque, Atherosclerotic ; Retrospective Studies

BACKGROUND: This study was designed to investigate the correlation between pain and non-pain sensation of the cutaneous nociceptors in healthy adults use 250 Hz and 5 Hz evoking neuroselective sinusoidal current to A delta and C-fiber separately. METHODS: Fifty healthy adult volunteers who have no history of neurological illness were examined. Twenty-five of them were male, and twenty-five were female. Their ages ranged from 20 to 46 years, with a mean equal to 29.5 years old. The thresholds for both current perception and nociceptive perception were measured bilaterally in volar aspect of wrist using a Neurometer CPT/C (Quantitative Sensory Nerve Testing Device). The manual mode for current perception threshold and the staircase method for nociceptive current perception threshold was performed individually. RESULTS: The mean values of the threshold for perception evoked by 250 Hz were 0.30 mA in left and 0.31 mA in right, 0.17 mA in left and 0.14 mA in right at 5 Hz respectively. The mean values of the nociception threshold were 0.52 mA in both site at 250 Hz and from 0.35 mA to 0.32 mA at 5 Hz (Table 1). There were no differences between left and right wrist (Fig. 1). Also a significant positive correlation between current perception and nociception thresholds was found (p<0.05) (Fig. 2, 3). There appeared to be different between genders in perception threshold evoked by 250 Hz and nociception threshold evoked by 5 Hz in left (p<0.05) (Table 2). CONCLUSIONS: There exists a meaningful correlation between both sensations of non-pain and pain perception thresholds obtained from all subjects. The measurement of the current perception threshold is considered to be a unique and valuable resource in evaluation of patient with neurologic condition, as well as in serial evaluation of patient to assess the outcome of therapeutic intervention.
Adult* ; Female ; Humans ; Male ; Nociception* ; Nociceptors ; Pain Perception ; Sensation ; Volunteers ; Wrist

A 29-year-old woman in her 8th week of pregnancy was referred to our hospital for swelling in the lower extremities, rapid onset of dyspnea (1 hr) and pre-syncope. Severe right ventricular dysfunction and moderate pulmonary hypertension were detected using 2-dimentional Doppler echocardiography. In addition, left calf vein and proximal thromboses were detected by venous compression ultrasound imaging. After successful thrombolytic treatment, the patient quickly recovered and was discharged from hospital on subcutaneous low-molecular-weight heparin. She delivered a normal, healthy infant at full-term (40 weeks).
Adult ; Dyspnea ; Echocardiography, Doppler ; Female ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary ; Infant ; Lower Extremity ; Pregnancy* ; Pulmonary Embolism* ; Thrombolytic Therapy ; Thrombosis ; Ultrasonography ; Veins ; Venous Thrombosis* ; Ventricular Dysfunction, Right

No abstract available.
Humans ; Pregnancy*

OBJECTIVE: The purpose of this study was to examine smoking status and the relates factors in the rural elderly. METHODS: This study was conducted with 2,421 elderly people(male 1,273 and female 1,148) residing in the selected 25 villages, and face-to-face interviews with the subjects were made from January 1 through March 30, 2002. RESULTS: The average age of the male subjects was 72.7 and that of the female subjects 72.8. The investigation of smoking states showed that for male subjects, smokers accounted for 49.4%, nonsmokers 26.9%, and abstainers from smoking 23.7% and that for female subjects, smokers accounted for 18.3%, nonsmokers 75.4%, and abstainers from smoking 6.3%. The level of 'low ADL' was significantly higher in abstainers. In men, smoking rate had higher in alone, non-job, queerstreet, 'high ADL'. In women, smoking rate had higher in younger age, queerstreet, unhealthy, 'high ADL'. CONCLUSIONS: The smoking rate of the elderly was relatively high, especially at abstainers. The smoking status of elderly was correlated with age, family type, job, economic status by self-assessment, Self-recognition of health status, ADL level.
Activities of Daily Living ; Aged ; Female ; Humans ; Male ; Self-Assessment ; Smoke ; Smoking