PURPOSE: The aim of our study was to evaluate the usefulness of MR imaging in cases of traumatic brachial plexus injury. MATERIALS AND METHODS: We evaluated 25 patients with traumatic brachial plexus injury as seen on MR images prior to surgical exploration and repair. MR images were retrospectively evaluated for nerve root avulsion and pseudomeningocele, and postganglionic lesions. Results were correlated with final diagnosis after surgical exploration . RESULTS: One hundred and four of 125 root levels (83%) were adequately imaged. Neve root avulsion was shown at 28 levels(54%). Avulsion with or without pseudomeningocele was seen at 37 levels(71%)(80% sensitivity, 91% specificity). The presence of ten of 12 postganglionic lesions (83%) was revealed by MR imaging. CONCLUSION: MR imaging is valuable for revealing preganglionic nerve root avulsion in patients with traumatic brachial plexus injury or postganglionic lesions.
Brachial Plexus* ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

PURPOSE: The aim of our study was to evaluate the usefulness of MR imaging in cases of traumatic brachial plexus injury. MATERIALS AND METHODS: We evaluated 25 patients with traumatic brachial plexus injury as seen on MR images prior to surgical exploration and repair. MR images were retrospectively evaluated for nerve root avulsion and pseudomeningocele, and postganglionic lesions. Results were correlated with final diagnosis after surgical exploration . RESULTS: One hundred and four of 125 root levels (83%) were adequately imaged. Neve root avulsion was shown at 28 levels(54%). Avulsion with or without pseudomeningocele was seen at 37 levels(71%)(80% sensitivity, 91% specificity). The presence of ten of 12 postganglionic lesions (83%) was revealed by MR imaging. CONCLUSION: MR imaging is valuable for revealing preganglionic nerve root avulsion in patients with traumatic brachial plexus injury or postganglionic lesions.
Brachial Plexus* ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

Functional voiding disorder is characterized by symptoms referable to the genitourinary organs without organic obstruction or neurovesical dysfunction. In an attempt to understand possible mechanisms of symptoms of functional voiding disorder in young male adult, we retrospectively reviewed the urodynamic findings of 51 men with functional voiding disorder between the ages of 19 and 51 (mean 40.7 years). Presenting symptoms are divided into three groups: 1) Sx. of irritation(irritation group) in 17 patients; 2) Sx. of bladder outlet obstruction(BOO group) in 25 patients; 3) Sx. of bladder outlet obstruction with episodes of overdistention (overdistention group) in 9 patients. On filling cystometry, time of first filling sense and urge sense was delayed significantly in overdistention group and involuntary contraction was found in 5 patients with BOO(20%), in 3 patients with irritation(18%), and in 1 patients with episodes of overdistention. In overdistention group, maximal voiding detrusor pressure was significantly lower and amount of postvoiding residual urine was significantly larger than other two group on pressure/flow study. Total voiding time and time to maximal uroflow rate were delayed significantly in BOO and overdistention group. Pseudo detrusor-sphincter-dyssynergia was found in 3 patients among 25 patients with BOO. Therefore, we were able to find correlations between specific symptomatic group and urodynamic parameters by this result. Results of urodynamic assessment were divided into 5 categories: Impaired detrusor contractility(IDC), detrusor instability(DI), obstruction, sensory urge syndrome, and equivocal studies. DI was found in 20% of patients with irritation or BOO. IDC was found in 80% of patients with episodes of overdistention and in 24% of patients with BOO. Thorough care is necessary in determining the treatment modality, and in follow up evaluation for patients showing IDC, DI or obstruction on urodynamic study. Conclusively, urodynamic study is thought to afford the opportunity in identifying these specific voiding disorder.
Adult ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urodynamics* ; Young Adult*

OBJECTIVES: For the relapse prevention in alcohol dependence, a lot of studies suggested that combined administration of two or more drugs which have different mechanism of action is more effective than each drug alone. In order to investigate the effectiveness of combined administration of naltrexone and acamprosate in comparison with naltrexone alone, this study was carried out by comparing the amount of alcohol intake in C57BL/6 mice co-administered with naltrexone and acamprosate with that in C57BL/6 mice with naltrexone alone. METHODS: In 42 C57BL/6 mice in the state of alcohol dependence, naltrexone 0.025mg/kg or 1.0mg/kg alone or with acamprosate 50mg/kg or 200mg/kg were administrated for ten days. The amounts of alcohol consumption for 2 hour, water consumption for 22 hours, and food intake for 24 hours were measured. RESULTS: 1) A significant reduction of alcohol intake for 2 hours was observed when the mice were treated with naltrexone 0.025mg/kg or 1.0mg/kg and acamprosate 50mg/kg or 200mg/kg simultaneously compared with naltrexone 0.025mg/kg or 1.0mg/kg alone. This effect was significant on the eighth and tenth days of drug administration. 2) Naltrexone administration of 1.0mg/kg was significantly more effective than that of 0.025 mg/kg in reducing alcohol intake from the second day of drug administration up to the tenth day. 3) No significant difference was revealed between the effect of naltrexone alone and that of naltrexone with acamprosate on 22 hour water consumption and 24 hour food intake. CONCLUSION: From these results, it is suggested that the effect of combined treatment with naltrexone and acamprosate is superior to that of naltrexone alone in prevention of relapse in alcohol dependence.
Alcohol Drinking ; Alcoholism ; Animals ; Drinking ; Eating ; Mice* ; Naltrexone* ; Recurrence

PURPOSE: To analyze the factors associated with the zebra pattern in CT during arterial portography(CTAP). MATERIALS AND METHODS: In 275 CTAP procedures, the factors associated with the zebra pattern, such as laminar flow in the portal vein, the presence of liver cirrhosis, the artery selected for CTAP, location of the catheter tip in the superior mesenteric artery(SMA), splenic volume, and the existence of an aberrant right hepatic artery(RHA) emerging from the SMA were analyzed. RESULTS: In 106 of 275 procedures (38.5%), a zebra pattern was apparent. Portal venous laminal flow was seen in 92 % of procedures in the group with this pattern and in 63 % in the group without it. Eighty-three of 235 procedures (35.3 %) in which the SMA was injected and 23 of 40(57.5 %) involving splenic artery injection showed the zebra pattern. In 22 of 35(62.8 %) in which the catheter tip was located in the distal SMA and 61 of 200 ( 30.5 %) in which this was at a proximal site, the zebra pattern was evident. Mean splenic volume was less in the group with the zebra pattern. The effect on the zebra pattern of liver cirrhosis and an aberrant RHA emerging from the SMA was not statistically significant. CONCLUSION: In CTAP, the incidence of the zebra pattern was 38.6%, and was related to laminal flow in the portal vein. The pattern is frequently seen in CTAP involving contrast injection via the splenic artery, distal location of a catheter tip in the SMA, and small splenic volume.
Arteries ; Catheters ; Equidae* ; Incidence ; Liver Cirrhosis ; Portal Vein ; Portography* ; Splenic Artery

PURPOSE: To determine the rate of congruence and to standardize assessment of US (ultrasound) phantom images with the use of an ATS-539 multipurpose phantom for US equipment currently utilized in Korea MATERIALS AND METHODS: US phantom images were scanned with a 3.0-5.0 MHz convex transducer and were digitized by use of an analogue-digital converter. Members of a committee with consent evaluated the US phantom images from 108 types of ultrasound equipment. The dead zone, vertical and horizontal measurement, axial/lateral resolution, focal zone, sensitivity, functional resolution and gray scale/dynamic range were evaluated. Congruence or incongruence of ultrasound equipment was determined based on the results of dead zone, axial/lateral resolution and gray scale/dynamic range measurements. Other factors were evaluated for the possibility as criteria with the use of the Mann-Whitney U test and receiver operator characteristic (ROC) curve analysis. RESULTS: The dead zone, axial/lateral resolution and gray scale/dynamic range were 91.7%, 94.4% and 76.9%, respectively, for suitable US equipment. Considering all three factors, 78 types of ultrasound equipment were passed. The congruence rate of focal zone and functional resolution were 62.4% and 69.3% of the US equipment, respectively. CONCLUSION: Of the US equipment, 72.2% of the equipment was acceptable based on the dead zone, axial/lateral resolution, and gray scale/dynamic range measurements as determined with the use of an ATS-539 phantom. Focal zone and 8 mm-functional resolution can be useful as a standard in the assessment of a US phantom image.
Korea ; Quality Control ; Transducers

PURPOSE: Orbital bone is one of the most complex bones in the human body. When the patient has a fracture of the orbital bone, it is difficult for the surgeon to restore the fractured orbital bone to normal anatomic curvature because the orbital bone has complex curvature. We developed a rapid prototyping model based on a mirror image of the patient's 3D-CT (3 dimensional computed tomography) for accurate reduction of the fractured orbital wall. METHODS: A total of 7 cases of large orbital wall fracture recieved absorbable plate prefabrication using rapid prototyping model during surgery and had the manufactured plate inserted in the fracture site. RESULTS: There was no significant postoperative complication. One patient had persistent diplopia, but it was resolved completely after 5 weeks. Enophthalmos was improved in all patients. CONCLUSION: With long term follow-up, this new method of orbital wall reduction proved to be accurate, efficient and cost-effective, and we recommend this method for difficult large orbital wall fracture operations.
Absorbable Implants ; Computer Simulation ; Computer-Aided Design ; Diplopia ; Enophthalmos ; Floors and Floorcoverings ; Follow-Up Studies ; Human Body ; Humans ; Orbit ; Orbital Fractures ; Postoperative Complications

We describe an unusual case of extragastrointestinal stromal tumor (EGIST) presenting as a scrotal mass. A 71-year-old man presented with a gradually enlarging scrotal mass with a 20-year duration. Physical examination revealed a huge (as large as volleyball), round, nontender mass occupying the whole scrotum, which was resected completely. Clinical and radiological findings did not comply with any other primary site disease. Under histological examination, the tumor showed a spindle cell pattern with low cellularity, absence of necrotic and mitotic features. immunohistochemical analysis revealed the tumor reactive for CD117 and CD34, while negative for smooth muscle actin, desmin and S-100 protein. To our knowledge, this is the first reported case of an EGIST involving the scrotum.
Aged ; Antigens, CD34 ; analysis ; Gastrointestinal Stromal Tumors ; diagnosis ; Humans ; Immunohistochemistry ; Male ; Proto-Oncogene Proteins c-kit ; analysis ; Scrotum ; pathology ; Sex Cord-Gonadal Stromal Tumors ; chemistry ; pathology

An extratesticular scrotal epidermal cyst is a very rare condition and few cases of extratesticular scrotal epidermal cyst with radiologic findings have been reported. Therefore, we report here on a rare case with ultrasonographic and MRI findings. A 70-year-old male patient was admitted with a palpable mass in the left scrotum. A well-defined heterogeneous hypoechoic mass with scattered echogenic reflectors in the scrotum was identified on ultrasonography. The cystic mass showed high signal intensity on T2-weighted images, low signal intensity on T1-weighted images, and diffusion restriction on diffusion weighted images.
Diffusion ; Epidermal Cyst ; Humans ; Male ; Scrotum

Background/Aims: Ascertaining the prevalence of isolated nocturnal hypertension (INHT) in the general population and identifying the characteristics of patients with INHT may be important to determine patients who should receive 24- hour ambulatory blood pressure (BP) measurements. This study aimed to evaluate the prevalence and characteristics of INHT in the general population. Methods: Of 1,128 participants (aged 20 to 70 years), we analyzed 823 who had valid 24-hour ambulatory BP measurements and were not on antihypertensive drug treatment. Results: The prevalence of INHT in the study was 22.8%. Individuals with INHT had a higher office, 24-hour, and daytime and nighttime ambulatory systolic and diastolic BPs compared to individuals with sustained day-night normotension. INHT was more prevalent in individuals with masked hypertension (MH) than in those with sustained hypertension (59.8% vs. 15.6%, p < 0.001). Among individuals with INHT, 92.6% had MH. Among individuals with office BP-based prehypertension, 34.5% had both INHT and MH. The prevalence of INHT was highest in individuals with office BP-based prehypertension. INHT was an independent determinant of MH after adjustment for age, sex, body mass index, diabetes, low-density-lipoprotein cholesterol, 24-hour systolic and diastolic BP, systolic and diastolic BP dipping, and systolic and diastolic BP non-dipping. Conclusions The present study showed that INHT is not uncommon and is a major determinant of MH. Our findings strongly suggest the use of 24-hour ambulatory BP measurement for individuals within the prehypertension range of office BP owing to the high prevalence of INHT and MH in this population.