No abstract available.
Humans ; Spondylolisthesis*

No abstract available.
Hematoma* ; Orbit*

Intramedullary spinal cord metastasis is rare and the treatment remains controversial. The authors report a case of thoracic intramedullary spinal cord metastasis in a 74-years-old man. The patient was admitted to our hospital due to the weakness of both lower extremities and urinary difficulty. The thoracic magnetic resonance image revealed the enhanced intramedullary mass in T11-12 level. With the conservative management, the symptoms got worsen and he underwent the removal of thoracic mass. The pathologic finding was small cell cancer from the lung. After tumor removal, radiation therapy was done. We discuss the diagnosis, pathophysiology and treatment of the intramedullary spinal cord metastasis.
Diagnosis ; Humans ; Lower Extremity ; Lung ; Neoplasm Metastasis* ; Spinal Cord*

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.
Acetazolamide* ; Arteriovenous Malformations* ; Brain* ; Humans ; Perfusion* ; Prognosis* ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

Coarctation of aorta is a rare cause of secondary hypertension, and premature death will occur if no appropriate treatment is given. The only effective treatment was surgery before 1980, but restenosis was frequent. Several works on percutaneous transluminal angioplasty of the disease were reported. In patients with previously operated recoarctation, there is no doubt that balloon angioplasty is now the first choice of the therapy because of the surgical risks of reoperation. Nevertheless, there has still been some controversy regarding the application of this therapy to native coarctation, because of the potential risk of aortic disruption and the high incidence of restenosis. There have been some clinical reports of successful stent implantation for coarctation without major complications since 1991. We report on our experience with balloon-expandable stent implantation for native coarctation of the aorta in a 23-year-old man with congenital mitral stenosis. Aortogram showed a coarcted aortic segment of 3 mm in diameter and 25 mm long just distal to the left subclavian artery. The peak systolic pressure gradient across the coarctation before stent implantation was 100 mmHg. Stent implantation was performed with 14 X 40 mm balloon with Palmaz P308 stent. The peak systolic pressure gradient decreased to zero and the diameter of the coarctation of aorta increased to 14 mm after stent implantation immediately. The patient tolerated well and no significant complications were encountered during the procedure.
Angioplasty ; Angioplasty, Balloon ; Aortic Coarctation* ; Blood Pressure ; Humans ; Hypertension ; Incidence ; Mitral Valve Stenosis* ; Mortality, Premature ; Reoperation ; Stents* ; Subclavian Artery ; Young Adult

Coarctation of aorta is a rare cause of secondary hypertension, and premature death will occur if no appropriate treatment is given. The only effective treatment was surgery before 1980, but restenosis was frequent. Several works on percutaneous transluminal angioplasty of the disease were reported. In patients with previously operated recoarctation, there is no doubt that balloon angioplasty is now the first choice of the therapy because of the surgical risks of reoperation. Nevertheless, there has still been some controversy regarding the application of this therapy to native coarctation, because of the potential risk of aortic disruption and the high incidence of restenosis. There have been some clinical reports of successful stent implantation for coarctation without major complications since 1991. We report on our experience with balloon-expandable stent implantation for native coarctation of the aorta in a 23-year-old man with congenital mitral stenosis. Aortogram showed a coarcted aortic segment of 3 mm in diameter and 25 mm long just distal to the left subclavian artery. The peak systolic pressure gradient across the coarctation before stent implantation was 100 mmHg. Stent implantation was performed with 14 X 40 mm balloon with Palmaz P308 stent. The peak systolic pressure gradient decreased to zero and the diameter of the coarctation of aorta increased to 14 mm after stent implantation immediately. The patient tolerated well and no significant complications were encountered during the procedure.
Angioplasty ; Angioplasty, Balloon ; Aortic Coarctation* ; Blood Pressure ; Humans ; Hypertension ; Incidence ; Mitral Valve Stenosis* ; Mortality, Premature ; Reoperation ; Stents* ; Subclavian Artery ; Young Adult

OBJECTIVE: To study the clinical characteristics of pregnancy induced hypertension(PIH). METHODS: Five hundred seventy-five cases of PIH and 7,702 cases of normotensive pregnancies who were delivered their infants at Wonkwang University Hospital from January, 1994 to December, 1998 were selected for the study. The data were collected by review of the hospital record and the statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence of PIH was 7.1% of total deliveries. Among the PIH, the incidence of mild preedampsia was found in 59%, severe preeclampsia in 36%, and edampsia in 5%. The most prevalent gestational period was 38-42wks gestation in mild PIH and 33-37wks gestation in severe PIH & eclampsia. The incidence of cesarean section was significantly higher in severe PIH & eclampsia(72.2%) than in mild PIH(48.7%) and normotensive pregnancies(39.7%). The incidence of hypoalbuminemia, preterm labor, placental abruption, disseminated intravascular coagulation, and pulmonary edema were significantly higher in severe PIH & edampsia than in mild PIH and normotensive pregnancies. Compared with normotensive pregnancies or mild PIH, severe PIH & eclampsia had significantly elevated risks for low birth weight, intrauterine growth retardation, fetal distress, low apgar score, meconium stained, and neonatal deaths. CONCLUSION: The incidence of PIH is not decreasing and it still an important role in the cause of maternal and perinatal mortality and morbidity in Korea. So, further studies are necessary to prepare a guide for the treatment of PIH.
Abruptio Placentae ; Apgar Score ; Cesarean Section ; Disseminated Intravascular Coagulation ; Eclampsia ; Female ; Fetal Distress ; Fetal Growth Retardation ; Hospital Records ; Humans ; Hypertension, Pregnancy-Induced* ; Hypoalbuminemia ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Meconium ; Obstetric Labor, Premature ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy* ; Pulmonary Edema

OBJECTIVE: This study is performed in order to compare T2* weighted magnetic resonance(T2*W MR) image to computerized tomography(CT) and conventional magnetic resonance(MR) image for the detection of minute traumatic intracerebral hemorrhage. METHODS: A series of 40 patients with head trauma underwent CT and MR image including T2*W MR sequnence. The authors compared T2*W MR image to CT and conventional MR image in the diagnosis of traumatic intracerebral hemorrhage. RESULTS: Thirty five of 40 patients(88%) were revealed the hemorrhagic foci in the T2*W MR image, whereas 30 patients(75%) were revealed in the conventional MR image, 18 patients(45%) in the CT. Therefore it is concluded that T2*W MR image is more sensitive than CT or conventional MR image in the diagnosis of minute traumatic intracerebral hemorrhage in patients with head trauma. CONCLUSION: If headache is persisted in the head trauma patients with negative CT and MR image finding, We recommend T2*W MR image.
Cerebral Hemorrhage, Traumatic* ; Craniocerebral Trauma ; Diagnosis* ; Headache ; Hemorrhage ; Humans

PURPOSE: In order to avoid functional disability that may be caused by radical excision or amputation in extremity soft tissue sarcomas, authors employed limb-conserving surgery together with extemal radiation therapy plus interstitial brachytherapy. MATERIALS AND METHODS: From June 1995 to Febrary 1997, 10 extremity soft tissue sarcoma patients were treated with limb-conserving surgery and external radiation therapy plus interstitial brachytherapy. In six patients, whose histologic diagnoses were made at the time of surgery, wide or marginal excision and interstitial brachytherapy was done 4 weeks before postoperative external radiation therapy. In four patients whose histologic confinnations were done before definitive treatment, preoperative external radiation therapy was given 4 weeks before surgery and interstitial brachytherapy. The types of surgery were wide excision in five patients, and marginal excision in five patients. Gross or microscopic residual was left at the surgical resection margins in four patients. The brachytherapy dose ranged from 17.5 Gy to 24 Gy and external beam radiation did from 40 Gy to 45 Gy. RESULTS: With the median follow-up duration of 21.5 months(range: 13 to 29 months); one local recurrence, and three new distant metastases were observed. There were three patients with wound complications attributable to the current treatment regimen. CONCLUSION: Satisfactory local tumor control may be achievable with limb-conserving surgery and external radiation therapy plus brachytherapy in patients with extremity soft tissue sarcomas, while more caution should be used to avoid wound problems.
Amputation ; Brachytherapy* ; Diagnosis ; Extremities* ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Sarcoma* ; Wounds and Injuries

There have been reports of abnormalities in the lumbosacral region involving a lower-than-normal termination of the dural sac, which is caused by disease or anatomical variation. Inadvertent dural puncture or other unexpected complications can occur during caudal epidural block or adhesiolysis in patients with these variations, but only a small number of case reports have described this issue. We report a case of dural puncture by the introducer needle before attempting caudal epidural adhesiolysis, which occurred even though the needle was not advanced upward after penetrating the sacrococcygeal ligament. Dural puncture was caused by a morphological abnormality in the lumbosacral region, with no pathological condition; the dural sac terminal was located more distally than normal. However, dural puncture could have been prevented if we had checked for such an abnormality in the magnetic resonance imaging (MRI) taken before the procedure.
Humans ; Ligaments ; Lumbosacral Region ; Magnetic Resonance Imaging ; Needles ; Punctures