With the advent of faster scan time and new computer program, a scanning technique called “dynamic computedtomography” has become possible. Dynamic CT consists of performing multiple rappid sequence scans after injectionof contrast material. The authors have evaluated the clinical usefulness of CT and dynamic CT of 93 patients withbrain infarction and/or ischemia during the period of 17 months from April 1983 to Aug. 1983 to Aug. 1984 inDepartment of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The agedistribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59years(40.9%). 2. The sites of brain infarction were cerebral lobes(63 cases,68), basal ganglia(15 cases, 16.1%)and mlultiple sites(6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. Thecontrast enhancement of acute infarction was noted in 14 cases(17.5%) which occured commonly between 3 days and 2weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a .Depression of slow wash-in phase was 20 cases(59%). b. Lower peak concentration was 17 cases(50%), c. Lower anddelayed peak concentration was 7 cases(21%), d. No definite peak concentration was 6 cases(18%). First threepatterns of time-density curve were thought as relatively characteristic curve of brain infarction and/orischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings ashypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entityof dynamic CT scan were as follows: a. large artery thrombotic infarction were 23 cases (58%). b. lacunarinfarction were 6 cases (15%). c. ischemia were 5 cases (13%), d. normal were 5 cases(13%), In six cases oflacunar infarction which was doubtful hypodensity on pre-and postcontrast CT scan had a marked difference in CT#(HU) on absolute scale graph of dynamic CT, so diagnosis of lacunar infarction could be made easily. 7. Theclinical values of dynamic CT consist in not only diagnosis of lacunar infarction but also evaluation ofeffectiveness of medical or surgical treatment.
Arteries ; Brain Infarction ; Brain ; Depression ; Diagnosis ; Humans ; Infarction ; Ischemia ; Jeollabuk-do ; Middle Cerebral Artery ; Stroke, Lacunar ; Tomography, X-Ray Computed

Complete decompression is very important for the surgical treatment of the spinal stenosis. But it may produce the segmental instability or spondylolisthesis as postoperative complications. So rigid internal fixation is mandatory to reduce this problem. Authors treated 16 cases of spinal stenosis by complete decompression and pedicale screw fixation and posterolateral fusion, analyzed 11 cases which were followed more than 9 months. The results were as follows: 1. Among the 11 cases, the mean age was 49 years old and there were 5 males and 6 females. 2. The most common cause was degenerative type, 7 cases. The most frequent level of involvement was L4–L5, 10 cases and two level involvement was 3 cases. 3. Among the 11 cases, 6 cases were excellent and 4 cases were good, and 1 case was fair, in Hanley's criteria. 4. In spondylolisthetic stenosis, the average percentage of slippage was changed from 22% pre-operatively to 2.7% postoperatively and 3.8% after 9 months follow up. 5. The complications were relatively few(1 case of hematoma and 3 cases of pain on the bone graft donor site).
Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Male ; Pedicle Screws ; Postoperative Complications ; Spinal Stenosis ; Spondylolisthesis ; Tissue Donors ; Transplants

The talus is a bone with unique biomechanical features and vascular supply. Although fractures of the talus are not common, the complications of the displaced fractures or dislocation are frequent and resulting disabilities are so severe that the importance of proper management is emphasized. Authors analyzed 17 cases of fracture-dislocation of the talus, treated at Soon Chun Hyang University Hospital from January 1983 to December 1988. The results were as follows:l. Among the 17 cases, there were 15 males and 2 females and the average age was 28 years old, ranged from 21 years to 58 years. 2. The causes were fall from height in 10 cases, traffic accident in 6 and others in one. 3. According to Marti-Weber classification, 2 cases were type I, 5 in type II, 7 in type III and 3 type IV. 4. Among the 17 cases, 9 cases in type I and II were treated conservatively, and 8 cases in thpe III and IV were treated operatively. 5. Complications were avascular necrosis in 3 cases, degenerative arthritis in 4 and nonunion in 1. 6. Final results, evaluated by the criteria of Mindell et al., were as follows: excellent in 7 cases, good in 5, fair in 3 and poor in 2.
Accidents, Traffic ; Classification ; Clinical Study ; Dislocations ; Female ; Humans ; Male ; Necrosis ; Osteoarthritis ; Talus

The fractures of the both forearm bones are extremely common in children. Between the radius and ulna, there is normally through an arc of 180° rotation. To restore full rotation, rotational deformity and angulation after fracture must be corrected. The goal of treatment of the unstable forearm fracture is to increase the function of the forearm and hand as well as to get solid bone union. The general principle of treatment of forearm fracture in children is conservative due to remodeling and spontaneous correction ability. Thus, most fractures at any level need not and should not be treated by open reduction and internal fixation. But the operation will be perform frequently who shortly before maturity. We reviewed twenty-three children between 8-13 age, who had dsiplaced both forearm bones fracture, and who were treated with fixation using K-wire(14 cases) or plate(9 cases). Of the twenty-three fractures, sixteen were unsatisfactory reduction with more than 10° of angulation after initial closed reduction, two were loss of reduction in cast immobilization, and five were internally fixed primarily because of soft tissue interposition between fragment. The results were as follows. l. Operation time was 51.4 minutes in K-wire group and 86.7 minutes in plate group. 2. Bone union occured in all cases, at 7.3 weeks in K-wire fixation group and 8.9 weeks in plate fixation group. And immobilization period 7 weeks in K-wire fixation group and 4 weeks in plate fixation group. 3. Functional results were satisfactory all cases in both group. 4. The advantage of K-wire is a simple safe operation with minimal morbidity and small scar and compares with the extensive approach need for plate fixation which often giving a poor cosmetic result. Moreover, a second operation, with significant morbidity, is need to remove the plate after solid union. In Conclusion, this method is a favorable altenative to plate fixation of children forearm fractures. It allows rapid bone union with minimal morbidity, complication and scar.
Child ; Cicatrix ; Congenital Abnormalities ; Forearm ; Hand ; Humans ; Immobilization ; Methods ; Radius ; Ulna

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Audiometry ; Carpal Tunnel Syndrome* ; Condoms* ; Diagnosis ; Hand ; Mass Screening ; Median Nerve ; Neural Conduction ; Occupations ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Ulnar Nerve ; Vibration ; Wrist

Serum specimens from leprosy patients, their contacts and controls were examined for the presence of phenolic glycolipid I (PGL-I), a Mycobacterium leprae specific antigen, and antibodies to the antigen using enzyme-linked immunosorbent assays. Of 12 lepromatous patients with less than 2 years of therapy, 11(91.7%) were seropositive to PGL-l, thus indicating that new lepromatous cases can be identified by detecting anti-PGL-l antibodies. In contrast 88(56.4%) of 156 lepromatous patiens treated more than 2 years were positve. Moreover, only 69(40.8%) were seropositve among 169 lepromatous patients in the leprosy resettlement villages. The mean antibody level also declined significantly in proportion to the duration of chemotherapy. This may suggest the possibility of monitoring chemotherapy by detecting anti-PGL-l antibodies. The prevalence of anti-PGL-l antibodies among 200 controls from a high endemic area for leprosy was 5.5% and was significantly higher than that(1.5%) among 200 controls from a low endemic area. Of 103 household contacts in the resettlement villages, 10(9.7%) were seropositive, reflecting the frequent chance of exposure to M. leprae. However, PGL-l was not detected many in any of the sera from controls, contacts, and inactive lepromatous patients having the anti-PGL-l antibodies; on the other hand, 6(50%) of 12 lepromatous patients treated less than 2 years had detectable PGL-l in their sera. The results thus indicate that PGL-l detection may be more suitable for monitoring the effectiveness of chemotherapy and that it may be necessary to examine for the presence of PGL-l in sera from contacts and normal populations for confirming M. leprae infection.
Antibodies, Bacterial/*analysis ; Glycolipids/*blood ; Human ; Leprosy/*blood/diagnosis ; Serologic Tests ; Support, Non-U.S. Gov't

PURPOSE: We compared the contrast enhancement patterns of hepatocellular carcinomas(HCC), hemangiomas, and metastasis on two phase imagings to determine the value of two phase dynamic CT in the differential diagnosis. MATERIALS AND METHODS: Two phases spiral volumetric CT scan were obtained 45 seconds and 6 minutes after bolus injection of contrast material in 106 patients. A bolus of 100 mL of nonionic contrast material was administered intravenously at a injection rate of 2 mL/sec. RESULT:In Hepatocollular carcinoma, 47% were totally hyperdense and 30% were totally hypodense in early phase, and 82% were totally hypodense in late phase. In hemangioma, 90% were peripherally hyperdense in early phase, 52% were isodense and 27% were totally hyperdense in late phase. In metastatic liver malignancies, 65% were hypodense and 32% were peripherally hyperdense in early phase, and 79% were hypodense in late phase. CONCLUSION: Two phases spiral volumetric CT scaning is considered to be heplful in the differential diagnosis of hepatic tumors.
Diagnosis, Differential* ; Hemangioma ; Humans ; Liver ; Neoplasm Metastasis ; Spiral Cone-Beam Computed Tomography ; Tomography, Spiral Computed*

BACKGROUND: Acute normovolemic hemodilution (ANH) is known as the easieat and most economical and the quality of autologous blood saved by it is the best of all methods of autotransfusion. To investigate the efficacy of ANH, we studied whether it could reduce the transfusion requirement in spinal surgery. METHODS: Forty patients were randomly divided into 2 groups. In the hemodilution group (n=20), 2 or 3 units of autologous blood were procured immediately before or after anesthetic induction while Ringer's lactate and pentastarch were infused to maintain normovolemia. All patients received deliberate hypotension induced by labetalol. Perioperative changes of hemoglobin, hematocrit and platelets, the transfusion requirement and the amount of postoperative drainage were compared between each group. RESULTS: Perioperative changes of hemoglobin, hematocrit and platelet showed no significant differences between each group. Less packed RBC were used in the hemodilution group (1.9 2.0 units) than in control group (5.9 6.8 units) (p<0.05). In the control group, 4 patients were transfused with fresh frozen plasma (mean 4.8 units), 3 patients with platelets (mean 13 units) and 1 patient with cryoprecipitate (10 units) while only one patient was transfused with 3 units of fresh frozen plasma in the hemodilution group. Postoperative drainage was significantly less in the hemodilution group (1,494 488 ml) than in the control group (2,476 1,730 ml). CONCLUSION: ANH seems to decrease the transfusion requirement in spinal surgery. Reduction of postoperative wound drainage appears to play an important role in that.
Blood Platelets ; Blood Transfusion, Autologous ; Drainage ; Hematocrit ; Hemodilution* ; Humans ; Hydroxyethyl Starch Derivatives ; Hypotension ; Labetalol ; Lactic Acid ; Plasma ; Wounds and Injuries

Megaureter is a relatively rare disease and its first description was done by Caulk in 1923. It is characterized by marked ureteral dilatation without obvious cause, and occurs in lower ureter especially. Authers report a case of primary obstructive megarureter with CT demonstration in 19 year-old female. To our knowledage,this is the first case report of primary obstructive megaureter in Korea.
Dilatation ; Female ; Humans ; Korea ; Rare Diseases ; Ureter

PURPOSE: To report three cases of Urrets-Zavalia syndrome after deep lamellar keratoplasty. CASE SUMMARY: A retrospective chart analysis of two men who underwent deep lamellar keraplasty after corneal chemical burns and one woman who was treated with deep lamellar keratoplasty due to lattice dystrophy was performed. To maintain the anterior chamber depth and prevent formation of a double anterior chamber after deep lamellar keratoplasty, air or gas (C3F8) was injected into the anterior chamber for all three cases. After injections of air or gas (C3F8) into the anterior chamber, pupillary blocks occurred and intraocular pressures increased. Afterwards, intraocular pressures were well-controlled, but the pupil remained irreversibly fixed and dilated despite the use of miotics. CONCLUSIONS: Urrets-Zavalia syndrome, a postoperative complication, was first reported in a patient who underwent penetrating keratoplasty for keratoconus. This syndrome can also occur after deep lamellar keratoplasty on rare occasions.
Anterior Chamber ; Burns, Chemical ; Corneal Transplantation ; Female ; Humans ; Intraocular Pressure ; Keratoconus ; Keratoplasty, Penetrating ; Male ; Miotics ; Postoperative Complications ; Pupil ; Retrospective Studies