The authors analyzed ultrasonographically the total 45 cases of thyroid disease verified by historicaldiagnosis, functional diagnosis, and morphological diagnosis at the Departement of Radiology, Busan NationalUniversity hospital from June to Sept. 1982. The resuls obtained were as follows; 1. In the sex distributionfemale was 38 cases (84.4%), and male 7 cases (15.6%). 2. Among the total 4 cases thyroid adenoma was 24 cases(53.3%), nodular hyperplasia 8 cases (17.7%), thyroid carcinoma 7 cases (15.6%), diffuse hyperplasia 3 cases(6.7%), Hanshimoto's thyroiditis 1 cases (2.2%), subacute thyroiditis 1 cases(2.2%), tuberculous thyroiditis 1cases(2.2%) in orders. 3. On ultrasonogram, total 24 cases of thyroid adenoma showed a single nodule in 24 cases(100.0%), smooth outer margin in 23 cases (95.8%), capsular echo in 23 cases (95.8%), pure cystic nodule in 4cases (16.7%), and increased echogenicity in 17 cases (85.0%) among the 20 cases excluded the pure cystic nodules.4. Total 7 cases of thyroid carcinoma showed no capsular echo in 4 cases (57.1%), irregular outer margine in 4cases(57.1%), no pure cytic nodule in all cases, and enlargement of metastatic lymphnode in 4 cases (57.1%). 5.Total 8 cases of nodular hyperplasia showed enlargement of thyroid gland and multiple nodule in 8 cases (100.0%),and increased echogenicity in 7 cases (87.5%). 6. Total 3 cases of diffuse hyperplasia showed enlargement ofthyroid gland and increased echogenicity in 3 cases (100.0%). 7. Total 3 cases of thyroiditis showed decreasedechogenicity in 3 cases (100.0%) and enlargement of thyroid gland in 2 cases (66.7%). 8. The cold area visualizedon radionuclide scan could be differentiated from a solid mass and cystic one by utrasonogram.
Busan ; Diagnosis ; Humans ; Hyperplasia ; Male ; Thyroid Diseases ; Thyroid Gland ; Thyroid Neoplasms ; Thyroiditis ; Thyroiditis, Subacute ; Ultrasonography

Cerebrotendinous xanthomatosis-is a very rare, automsomal recessive disorder which characterized by xanthomatous deposits in multiorgan system. The main clinical features include pyramidal, cerebellar and brain stem dysfunction, juvenile cataracts, dementia and xanthomas, especially on Achilles tendon and other tissues. We experienced a patient, 43 year old male who showed cataract, mild cerebellar dysfunction and multiple xanthomas as well as recently developed right hemiparesis. The tendinous xanthomatosis was confirmed pathologically and the brain CT scan showed cortical atrophy, demyelination and multifocal cerebromalacia, which correlated with neurologic manifestation of this patient and with neuropathologic findings of cerebrotendinous xanthomatosis. The EEG showed generalized slowing of background activities.
Achilles Tendon ; Adult ; Atrophy ; Brain ; Brain Stem ; Cataract ; Cerebellar Diseases ; Cerebral Infarction* ; Dementia ; Demyelinating Diseases ; Electroencephalography ; Encephalomalacia ; Humans ; Male ; Neurologic Manifestations ; Paresis ; Tomography, X-Ray Computed ; Xanthomatosis ; Xanthomatosis, Cerebrotendinous*

Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty and lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Adult ; Brain Stem ; Brain* ; Cerebellum ; Emergency Service, Hospital ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Seizures ; Skull ; Spine ; Tuberculoma* ; Tuberculosis, Pulmonary*

No abstract available.
Cystectomy*

No abstract available.
Talus*

Hyponatremia is frequently seen in intracranial hemorrhagic patients and has been often attributed to inappropriate secretion of antidiuretic hormone. But in recent years, a number of studies have shown that hyponatremia in many patients with intracranial disease may actually be caused by cerebral salt wasting (CSW) syndrome and circulating Atrial natriuretic peptide (ANP) and Brain natriuretic peptide (BNP) are probably involved. This report describes a patient who developed bacterial meningites caused by pseudomonas aeruginosa and CSW syndrome after removal of pituitary adenoma. CSW syndrome resolved by fluid and salt replacement after 4 months.
Humans ; Hyponatremia ; Meningitis* ; Meningitis, Bacterial ; Natriuretic Peptide, Brain ; Pituitary Neoplasms* ; Pseudomonas aeruginosa ; Pseudomonas* ; Wasting Syndrome*

The protection afforded against CO2 and KTP(potassium titanium phosphate) laser-induced combustion by six different types of tracheal tubes was evaluated. Some of them were wrapped with aluminum foil. They were compared before and after the application of human blood to their external surfaces. The difference of protective efficacy against laser between normal saline filled and air filled cuff was evaluated, too. The tracheal tubes tested were laser-resistant tubes such as Bivona Fome-Cuf (Group 1), Xomed Laser-shield 11 (Group 2) and Mallincrodt Laser Flex (Group 3) tubes. Aluminum foil wrapped Rusch red rubber (RR) (Group 4) and Mallincrodt reinforced Polyvinylchloride (PVC) (Group 5) tubes and unwrapped Baxter plain PVC (Group 6) tubes were also tested. CO2 loser set to 38W in continuous mode and KTP laser set to 15W were directed at the shaft of the tracheal tube under study, which had 5L/min. of oxygen flowing through it. The laser was actuated for 90 seconds or until combustion or melting occurred. Bivona tubes (Group 1) resulted in combustion in 5 tubes before and after blood application with CO2 laser, but unaffected before blood and resulted in combustion in 4 of 5 after blood application with KTP laser. Laser-shield 11 tubes (Group 2) offered good protection form both laser before and after application of blood except 1 case. At one case in Group 2, combustion occurred after blood application with CO2 laser. A combustion occured in 1 of 5 prior to application of blood and 5 of 5 after blood in Laser Flex tubes (Group 3) with CO2 laser, but occurred no tube with KTP laser. Wrapped RR (Group 4) and reinforced PVC tubes (Group 5) were unaffected by both laser, but application of blood to the foil wrapped tube shaft resulted in melting in 4 of 5 tubes. Unwrapped PVC tube (Group 6) resulted in immediate combustion in all tubes tested with both laser. Saline inflated cuffs were not perforated only in Group 2 and 3 in KTP laser and perforated immediately in other groups, but there was no combustion with saline in all groups. Air filled cuffs were all perforated in both laser, and combustion occurred. The presence of blood on the surface of metallic foil wrapped or special laser-resistant tracheal tubes may make laser-induced combustion more likely during airway surgery. However, the Laser-shield 11 and aluminum foil wrapped tracheal tube provided good protection from even when covered with blood. In addition, Mallincrodt stainless steel Laser-Flex tube provided good protection from KTP laser only. The saline filling cuffs served as a heat sink that will absorb the lasers energy, thus preventing combustion of cuffs.
Aluminum ; Freezing ; Hot Temperature ; Humans ; Lasers, Gas ; Lasers, Solid-State ; Oxygen ; Rubber ; Stainless Steel ; Titanium

Recently with the development of magnetic resonance imaging(MRI) techniques, many reports of radiologic findings in spontaneous intracranial hypotension(SIH) have been reported. However in our review, the pachymeningeal changes within spinal canal secondary to SIH are not reported. In SIH, same mechanisms of it might act in the intraspinal space, which cause pachymeningeal changes of spinal dura and clinical features of spinal involvement. We reports four cases of SIH, in which MRI of the brain and spine reveals diffuse symmetric pachymeningeal enhancement. This is the first report of the spinal images in SIH.
Brain ; Intracranial Hypotension* ; Magnetic Resonance Imaging* ; Spinal Canal ; Spine

BACKGROUND: Good documentation of electrical injuries at the time of presentation is very important to emergency management, so this study was designed to investigate the clinical characteristics and the outcomes of patients with electrical injury. METHODS: A review of 75 cases of electrical injuries admitted to our hospital via the emergency department over a 4 year period from 1996 to 1999 was conducted. RESULTS: There were 49 patients with high-voltage injuries and 19 patients with low-voltage injuries. All but 4 patients were males, with a mean age of 29.5 years. The most common type of injury was 14.5% TBSA in the high-voltage group and 2.5% in the low-voltage group. Forty-nine(72.1%) of the injuries were work related. The number of patient with compartment syndrome was 19, and fasciotomies were performed in all but one patient. Myoglobinuria was noted in 22 patients, but no patient developed acute renal failure due to myoglobinuria. In the high-voltage group, 10 limb amputations were performed. Complication were observed in 12 patients. The most common complication was neurological injury. The average length of hospital stay was 50.7 days in the high-voltage group and 13.8 days in the low-voltage group. The overall mortality rate was 4.3%. CONCLUSION: Prevention of electrical injuries is very important. Education and compliance with safety measures, as well as basic knowledge and precaution in dealing with electricity, are essential to avoid these injuries.
Acute Kidney Injury ; Amputation ; Burns* ; Compartment Syndromes ; Compliance ; Education ; Electricity ; Emergencies ; Emergency Service, Hospital ; Extremities ; Humans ; Length of Stay ; Male ; Mortality ; Myoglobinuria

Background: It is important to make the accurate diagnosis of leptomeningeal metastasis(LM) because the institution of appropriate therapy may produce symptomatic improvement, prevent neurologic deterioration, and prolong survival. To evaluate the appropriate diagnostic methods of LM, we conducted the comparison of diagnostic yield in each diagnostic method and analyzed factors influencing the diagnostic results. METHODS: We analyzed 62 patients of LM with following inclusion criteria: positive CSF cytology, or abnormal neuroimaging, or elevated CSF biochemical marker, or characteristic clinical symptom and abnormal routine CSF examination. RESULTS: Primary cancer of LM was following; lung cancer 21, lymphoma 15, stomach cancer 13, breast cancer 9, rhabdomyosarcoma 2, bladder cancer 1, and colon cancer 1. The positive yield in the diagnosis of LM was 54.5% in CSF cytology, 55.9% in neuroimaging, 62.5% in CSF biochemical marker. As each diagnostic method was combined, the positive yield was increased to 86.4-88.5% with the highest in combination of CSF cytology with neuroimaging. The relationship between CSF cytology and neuroimaging is complementary in the diagnosis of LM (p=0.01). In positive group of CSF cytology, the count of CSF WBC was higher than in negative group (p=0.026), and clinical feature revealed a tendency of combined cerebral and cranial symptom than isolated symptom. The interval from the diagnosis of primary cancer to diagnosis of LM was most prolonged in breast cancer with a mean of 38.2 month. CONCLUSIONS: Combination of each diagnostic method increases the diagnostic yield, and CSF cytology and neuroimaging must be performed with each other.
Biomarkers* ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Lung Neoplasms ; Lymphoma ; Neoplasm Metastasis* ; Neuroimaging* ; Rhabdomyosarcoma, Alveolar ; Stomach Neoplasms ; Urinary Bladder Neoplasms