PURPOSE: The purpose of this study is to describe the anglographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid arteries and to evaluate the extent of anglographic assessmant needed before embolization. MATERIALS AND METHODS: We retrospectively reviewed 10 cervicofacial vascular lesions with previously ligated carotid artery, which were 6 cases of arteriovenous malformation, 2 cases of carotid cavernous fistula, 1 case of hemangioma and 1 case of arteriovenous realformation with carotid cavernous fistula. The previously ligated arteries are proximal external carotid artery (n=5), branches of external carotid artery (n=2) and common carotid artery (n=3). Common carotid artery or internal carotid artery (n=9), vertebral artery (n=5), ipsilateral external carotid artery (n=4), contralateral external carotid artery (n=5), costocervical trunk (n=2), thyrocervical trunk (n=2) were assessed by conventional angiography. Angiography of both carotid and vertebral arteries was performed in 5 cases. RESULTS: The collateral vascular channels were inferolateral trunk of internal carotid artery (n=8), vertebral artery (n=5), contralateral external carotid artery (n=5), ipsilateral external carotid artery (n=4), deep cervical artery (n=2) and ascending cervical artery (n=l). Embolizations were performed in 9 cases with operative cannulation(n=4), embolization via collateral branches of ipsilateral external carotid artery (n=l), embolization via collateral branches of contralateral external carotid artery (n=3) and balloon occulusion via direct puncture (n=l). CONCLUSION: The collateral channels in cervicofacial vascular lesions with previouly ligated carotid artery were inferolateral trunk of internal carotid artery, contralateral or ipsilateral external carotid artery, vertebral artery, deep cervical artery and ascending cervical artery on angiography. Complete anglographic assessment of possible collateral channels is mandatory for the effective and safe embolization.
Angiography ; Arteries ; Arteriovenous Malformations ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal ; Fistula ; Hemangioma ; Punctures ; Retrospective Studies ; Vertebral Artery

PURPOSE: To evaluate the degree of contrast enhancement of intracranial tumors on delayed (6-8min.) MR imaging after administration of Gd-DTPA. MATERIALS AND METHODS: Both immediate and delayed post-contrast MR imagings were studied prospectively in 35 patients. with brain tumors (11 gliomas, 6 meningiomas, 4 neurinomas, 5 parencymal metastases, 5 hemangioblastoma, 4 others) at either 0.5 T or 2.0 T unit. After precontrast TI-, proton-density, and T2-weighted spin echo images were obtained, each patient underwent Tl-weighted imaging immediately following infusion of 0.1 mmol/Kg of Gd-DTPA. Subsequently, the second postcontrast Tl-weighted images were obtained with no additional injection of the contrast media. Time-interval between the postcontrast immediate and the delayed images was approximately 6-8 minutes. Degree of contrast enhancement of the lesions was assessed both visually and quantitatively. For quantitative study, contrast enhancement ratio(CER) of tumors was calculated in both immediate and delayed post-contrast images. RESULTS: There was stronger visual enhancement in 7 of 11 cases with gliomas and 3 of 5 cases with parenchymal metastasis on delayed images when compared with immediate images, whereas all 10 cases of extraaxial tumors(meningiomas and neurinomas) showed decreased enhancement on delayed images. Quantitatively, mean CERs of gliomas and metastases were higher on delayed study than on immediate study by 20. 5% and 49.2%, respectively. Extraaxial tumors showed decrease of CER on delayed study by 19.7% as compared with that of immediate study. Hemangioblastomas showed visually poor enhancement on delayed image in 4 cases and equal enhancement on both immediate and delayed images in remaining one case, and quantitatively demonstrated decrease of CER on delayed study by 15.4%. CONCLUSION: Since there was more conspicuous contrast enhancement in many intraaxial tumors such as gliomas and metastases on 6-8 minutes delayed post-contrast MR study, the delayed post-contrast study may be needed in some intraaxial tumors for their characterization, and may also be helpful for the differential diagnosis between intraaxial and extraaxial tumors.
Brain Neoplasms* ; Brain* ; Contrast Media ; Diagnosis, Differential ; Gadolinium DTPA ; Glioma ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging* ; Meningioma ; Neoplasm Metastasis ; Neurilemmoma ; Prospective Studies

A statistical observation was performed on 13,317 cases of neonates who had been delivered at Taegu Catholic Hospital during the past 3 years from Jan, 1st 1988 to Dec. 31st 1990. The results obtained were as follows: 1) Among 13,317 neonates, the male was 7,234 and the female 6,083, with the sex ratio of male to female being 1.19:1 2) Percentage distribution by birth weight was 5.6% for 2.500gm or less, 3.3% for 4,001gm or more. The mortality rate was 8.4 per 1,000 live births and 61.1% for very low birth weight infants. 57.1% of neonatal death occured within 24 hours after birth and the most common cause of death was prematurity (53.6%). 3) The mean growth data at birth were as following: Weight: 3,253+/-484gm in male, 3,160+/-456gm in female; Height: 50.11+/-2.59cm in male, 49.57+/-2.50cm in female; Head circumference: 33.60+/-1.74cm in male, 33.12+/-1.64cm in female; Chest circumference: 32.83+/-1.83cm in male, 32.41+/-1.75cm in female. 4) Among 13,317 noenates, 352 (2.6%) were under 37 wks and 555 (4.2%) above 42 wks and 92.6% very low birth weight infants under 37 wks. 5) 44.2% of 13,317 neonates, was the highest-density distribution which was between 47.5~52.4cm by length and 3,001~3,500gm by weighing. 6) The admission rate was 13.7% and the causes of admission in order of frequency were neonatal infection (47.9%), premature or low birth weight infant (12.9%), neonatal jaundice (11.3%), asphyxia neonatorum (6.9%), respiratory disress syndrome (5.4%), etc. 7) Among all neonates, 2.2% had neonatal asphyxia (a 1-minute Apgar score of 6 or less). The highest incidence was 19.7% in the breech delivery group by delivery mode and 33.6% in the prematurity by gestational age. 8) The types of delivery in order of frequency were spontaneous vaginal delivery (72.5%), Cesarean section (21.9%), vacuum delivery (5.0%), breech delivery (0.5%) and forceps delivery (0.1%). 9) The incidence of twin babies was 182 (91 pairs), 1.37% of all neonates, 1 pair per 145 neonates. Of all twins, 50.5% were below 2,500gm of birth weight and 20.9% premature. 10) The incidence of neonatal jaundice was 63.0%. Of icteric neonates, 8.2% had pathologic jaundice treated by phototherapy or exchange transfusion. 11) Among all neonates, there were 7,705 cases (57.9%) with high risk factors; the order of frequency was Cesarean section (37.8), meconium stained (13.3%), premature rupture of membranes over 24 hours (12.7%), birth weight 2,500gm or less (9.6%), etc.
Apgar Score ; Asphyxia ; Asphyxia Neonatorum ; Birth Weight ; Cause of Death ; Cesarean Section ; Daegu ; Female ; Gestational Age ; Head ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn* ; Infant, Very Low Birth Weight ; Jaundice ; Jaundice, Neonatal ; Live Birth ; Male ; Meconium ; Membranes ; Mortality ; Parturition ; Phototherapy ; Pregnancy ; Risk Factors ; Rupture ; Sex Ratio ; Surgical Instruments ; Thorax ; Twins ; Vacuum

The authors reviewed 1134 pediatric patients in the ebergency room in this hospital during 5 years period from Jan. 1979. to Dec. 1979. The results were obtained as follows: 1) Among the patients visiting the emergency room, the patients under 15 years of age were 6.1%(1134) of total emergency patients(18447). 2) The male to female ratio was 1.5:1. 3) The highest age group was in the 3-5 years, and the patients in this age group were occupied 23.8%. The age distribution showed that 57.7% was under the 5 years of age. 4) Seasonal distribution of patients showed high incidence in summer(June, July, and Aug.). 5) The most popular time of visiting the emergency room was between 8:00 P.M. to 12:00 P.M. at which time about 32.8% of patients were seen. 6) Distribution of cases as follows: Respiratory disease 35.7%, accident 177% and gastrointestinal disease 14.8%, in turn, kusted reseoectuvely in decresing order of frequency. URI was the most frequency, 25.1% of the total cases, The next diseases were diarrhea(9.5%), Bronchitis(6.6%) and febrile convulsion(6.3%) in turn decreasing order. 7) The most frequent case in various age groups was Respiratory disease. 8) Admission rate of total pediatric patients visiting ER was 7.4% by recommendation. Rate against recommendation of admission was 3.2% of total pediatric patients visiting ER. 9) We think the number of pediatric emergent patient is increasing due to understanding of community inhabitant.
Age Distribution ; Emergencies* ; Emergency Service, Hospital* ; Female ; Gastrointestinal Diseases ; Humans ; Incidence ; Male ; Seasons ; Statistics as Topic*

Several studies have reported the associations between airborne particles and/or ozone and respiratory diseases. This study examined whether such an association could be seen in Seoul, one of the greatest city in Korea. We compiled daily records of hospital visits in Seoul from November 1, 1995 to October 31, 1996. The daily averages of ozone and particle matter whose diameter is 10 micrometer or less(PM10) from all monitoring stations were computed. Daily respiratory hospital visits were regressed on temperature, humidity, day of weak indicators, seasonal variation indicators, and air pollution. Each pollutant was first examined individually and then two pollutant models were fitted. RESULTS : Both PM10 and Ozone were associated with increased risk of respiratory hospital visits. The relative risk of respiratory hospital visits for 50 microgram/m3 increase in PM10(lagged 2 days) was 1.11(95% confidence interval: 1.05-1.18). The PM10 associations was insensitive to alternative methods of control for weather, including exclusion of extreme temperature days and control for temperature on another day. The ozone results were more sensitive to the approach for weather control. The relative risk of respiratory hospital visits for 0.01 ppm increase in O3 was 1.08(95% confidence interval 1.00-1.17). The magnitude of the PM10 effect in Seoul, where SO2 was essential present, was similar to that reported in the Europe and United states. In conclusion, The consistency of investigations of the health effects of air pollution suggest that attention should be paid to the control of air pollution.
Air Pollution* ; Europe ; Humidity ; Korea ; Ozone ; Seasons ; Seoul* ; United States ; Weather

Caudal epidural anesthesia has become widely accepted as a means of providing postoperative pain relief and mtraoperative supplementation to general anesthesia for children. Caudal anesthesia was given to 63 infants and children under 15 years of age, who received lower abdominal surgery. After thiopental sodium 4-5 mg/kg IV and 1-2Vo1% halothane inhalation, caudal block was performed in the lateral position. Halothane was stopped immediately after caudal block and only 50% NO in oxygen was inhaled through the mask during operation. The patients were randomly divided into four groups: Group 1; 0.33% bupivacaine 0.7 ml/kg, Group 11; 0.33% bupivacaine 1.0 ml/kg, Group III; fentanyl 1 ug/kg combined with 0.33% bupivacaine 1.0 ml/kg, Group IV; 1.5% lidocaine 1.0 ml/kg. The time of onset, duration of analgesia, side effects during and after operation, intial voiding time, and use of analgesics in the ward were observed. The results were as follows: 1) Caudal block was successful at the 1st attempt in most cases. 2) During operation, supplementation of other inhalational anesthesies were need. 3) In all groups, surgical anesthesia could be obtained within 10 minutes. 4) Intraoperative adverse effects were not detected except for minimal movements on skin incision and spermatic cord traction in 12 cases and vomiting in 2 cases. 5) Postoperative analgetic effects were good in all groups, especially in fentanyl group. 6) In most cases, patients ean void within 6 hours without urinary catheterization. 7) Postoperative analgesics were not needed and patients parent's were highly satisfied with caudal anesthesia in all cases. From the above results, it was suggested that caudal anesthesia with 0.33% bupivacaine or 1.5% lidocaine without potent inhalational anesthetics was satisfactory for lawer abdominal surgery and l ug/kg of fentanyl had some benefits in postoperative analgesia in children.
Analgesia ; Analgesics ; Anesthesia ; Anesthesia, Caudal* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthetics ; Bupivacaine ; Child ; Fentanyl ; Halothane ; Humans ; Infant ; Inhalation ; Lidocaine ; Masks ; Oxygen ; Pain, Postoperative ; Skin ; Spermatic Cord ; Thiopental ; Traction ; Urinary Catheterization ; Urinary Catheters ; Vomiting

An extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) is the most frequent type of non-Hodgkin's lymphoma that primarily involves the lung. The radiographical discovery of a pulmonary lesion in an asymptomatic patient is the most common clinical presentation. In general, the prognosis of a localized extranodal pulmonary marginal zone B-cell lymphoma of MALT type is excellent. We report a case of a 61-year-old man who sought evaluation of an incidentally discovered mass in the lung.
Humans ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Prognosis

To evaluate the nutritional status according to the degree of metabolic acidosis(MA) and determine that MA is a risk factor for malnutrition, we screened the laboratory data of 37 hemodialysis(HD) patients who were clinically stable for more than 6 months and taken bioelectrical impedence analysis(BIA) twice 6 months apart to check lean body mass (LBM). Mean age of patients was 49.1+/-15.0 years and sex ratio 1:2.4. Mean serum albumin level was 3.97+/-0.36g/dl and weekly Kt/V and normalized protein catabolic rate(nPCR) were 3.04+/-0.85 and 0.99+/-0.21g/kg/day. According to mean total CO2 content during the periods between BIA, the patients were divided to three groups[group 1(n=16):&18mEq/L, group 2(n=9):18< or =tCO2&21mEq/L, group 3(n=12):> or =21mEq/L). Group 1 had significantly higher body weight gain than group 2 and 3(1.82+/-1.62 vs. 0.77+/-3.13 and 1.35+/-3.85kg, P<0.05), and higher LBM gain(1.99+/-4.38 vs. 3.35+/-7.99kg, P<0.05), nPCR(1.05+/-0.20 vs. 0.91+/-0.13g/kg/day, P<0.05), intact parathyroid hormone(88.4+/-78.7 vs. 32.0+/-26.5pg/ml, P< 0.05), and phosphate(5.4+/-1.3 vs. 3.9+/-1.3mg/dl, P< 0.05) than group 3. There were no differences in age, serum albumin, BUN, creatinine and weekly Kt/V among three groups. Mean total CO2 level was inversely correlated with body weight gain and LBM gain. In conclusion, metabolic acidosis in stable HD patients may be the result of high protein intake and not related to decrease of body weight by protein catabolism.
Acidosis* ; Body Weight ; Creatinine ; Humans ; Malnutrition ; Metabolism ; Nutritional Status ; Renal Dialysis* ; Risk Factors ; Serum Albumin ; Sex Ratio

PURPOSE: The main factor limiting endovascular treatment of intracranial aneurysms is the shape of the a-neurysmal sac, especially the width of the neck. We describe an early experience and technical aspects of treating wide-necked cerebral aneurysm using a Guglielmi detachable coil (GDC) and simultaneous application of a temporary balloon. MATERIALS AND METHODS: Four cases of unruptured wide-necked cerebral aneurysm were treated with GDC, with simultaneous application of a temporary balloon. Patients were aged between 29 and 49 years. On admission, clinical presentation was subarachnoid hemorrhage (SAH) in all cases. Hunt and Hess grade was II in two cases, III in one case, and traumatic SAH in one case. In all patients angiography revealed an asymptomatic a-neurysm after rupture of another aneurysm or traumatic SAH. The aneurysms were occluded with GDC-10, and a Cirrus balloon occlusion system was used simultaneously. All procedures were performed under endo-tracheal general anesthesia and systemic heparinization. RESULTS: All cases were treated successfully, without parent artery compromise. The occlusion rate at the end of the procedure was total in three cases and subtotal in one. In one case a heparin-related hematoma occurred during post-procedural treatment and the patient eventually expired. One patient underwent follow-up angiography after 6 months, and the coil was not changed. CONCLUSION: An aneurysm may not be completely occluded, but with regard to coil compaction and parent artery preservation, the technique is an attractive alternative.
Anesthesia, General ; Aneurysm ; Angiography ; Arteries ; Balloon Occlusion ; Follow-Up Studies ; Hematoma ; Heparin ; Humans ; Intracranial Aneurysm* ; Neck ; Parents ; Rupture ; Subarachnoid Hemorrhage

PURPOSE: To find out the proper compression ratios without degrading image quality and affecting lesion detectability on diagnostic images used in dentistry compressed with JPEG 2000 algorithm. MATERIALS AND METHODS: Sixty Digora periapical images, sixty panoramic computed radiographic (CR) images, sixty computed tomographic (CT) images, and sixty magnetic resonance (MR) images were compressed into JPEG 2000 with ratios of 10 levels from 5 : 1 to 50 : 1. To evaluate the lesion detectability, the images were graded with 5 levels (1: definitely absent; 2: probably absent; 3: equivocal; 4: probably present; 5: definitely present), and then receiver operating characteristic analysis was performed using the original image as a gold standard. Also to evaluate subjectively the image quality, the images were graded with 5 levels (1: definitely unacceptable; 2: probably unacceptable; 3: equivocal; 4: probably acceptable; 5: definitely acceptable), and then paired t-test was performed. RESULTS: In Digora, CR panoramic and CT images, compressed images up to ratios of 15 : 1 showed nearly the same lesion detectability as original images, and in MR images, compressed images did up to ratios of 25 : 1. In Digora and CR panoramic images, compressed images up to ratios of 5 : 1 showed little difference between the original and reconstructed images in subjective assessment of image quality. In CT images, compressed images did up to ratios of 10 : 1 and in MR images up to ratios of 15 : 1. CONCLUSION: We considered compression ratios up to 5 : 1 in Digora and CR panoramic images, up to 10 : 1 in CT images, up to 15 : 1 in MR images as clinically applicable compression ratios.
Data Compression ; Dentistry* ; Radiography, Dental, Digital ; ROC Curve ; Tomography, X-Ray Computed