To evaluate the characteristics of MR findings in osteomyelitis, retrospective MR image interpretations were made in 18 patients with osteomyelitis proved either either by surgery(n=17) or clinical course(n=1). Osteomyelitis was acute in five patients, subacute in five, chronic in seven, and healed in one. Area of active inflammation had low marrow marrow signal intensity on T1-weighted images, high signal intensity on T2-weighted images inhomogeneously. It has been said that morrphologic characteristics of osteomyelitis in MR improved the accuracy in diagnosis of osteomyelitis and that gadolinium enhanced MR image further assisted in the planning of surgery. Out study was performed to observe the signal intensity change or morphologic change of bone marrow, cortex, periosteal reaction, and soft tissue which are specific for osteomyelitis. Multiple inhomogensous round marrow lesions were noted with central high signal intensity and peripheral low signal intensity on T1-weighted images, and central low signal intensity and peripheral high signal intensity on T2 weighted images in two patients. Intra and extraosseous abscesses showed rim enhancement after gadopentetate dimeglumine injectron. The signal intensity of the relatively higher than the internal area of the abscess on T1-weighted images. Cortical bone destruction showed high signal intensities T2-weighted images with destruction patterns of fine radial, circumferential, vertical or wedge shaped. MR imaging, by displaying specific signal intensities and morphological changes of bone marrow, cortex, periosteal reaction and soft tissue, would be an aid in early diagnosis and in planning for appropriate conservative and operative therapeutic procedures for osteomyelitis.
Abscess ; Bone Marrow ; Diagnosis ; Early Diagnosis ; Extremities* ; Gadolinium ; Gadolinium DTPA ; Humans ; Inflammation ; Magnetic Resonance Imaging* ; Osteomyelitis* ; Retrospective Studies

We reviewed the post-reconstructive results and complications of arthroscopic anterior cruciate ligament reconsbuction using the patellar bone-tendon-bone autograft in 91 patients who underwent the index surgery at least one year ago. The changes of Lysholm knee score, limitation of motion, instability of the reconstructed ACL, musc)e strength, presence of anterior knee pain and other complications were evaluated at final fol- low-up(mean, 2.6 year). The results were as follows. 1. The mean Lysholm knee score was 65.5+-15.5 preoperatively and improved to 88.5+-7.4 postoperatively(p<0.05), 2. Of all, nine(9.9%) complained anterior knee pain. 3. Three patients(3.3%) showed limited range of motion. 4. Five(3.5%) showed instability of reconstructed ACL during the followup. Two were caused by trauma. Ln other three, no definite causes were found. 5. In 23 patients, cybex isokinetic thigh muscle strength test was perfornied preoperatively and at post-up. One year. The strength of quadriceps of the operated side at the angular velocity of 60 degrees per second showed mean 41.7% deficit of the normal side at postoperative one year. 6. Other complications were one case of chronic click sound in motion, and one case of the fracture which occurred at the autograft donor site of the proximal tibia.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Muscle Strength ; Postoperative Complications ; Range of Motion, Articular ; Thigh ; Tibia ; Tissue Donors

OBJECTIVE: We evaluate the effect of the copolymer-coated coils on immediate occlusion of the aneurysm, preventing rupture, and decreasing compaction or re-growth. METHODS: Thirty-five aneurysms treated between September 2003 and December 2004 using Matrix detachable coil were reviewed. Study population consisted of 12 men and 23 women ranging in age from 34 to 75 years(mean, 55.1 years). Twentytwo aneurysms were ruptured and 23 aneurysms were located in the anterior circulation. Follow-up angiography was obtained in 16 patients after 6 months from the procedure. RESULTS: Initial complete occlusion was achieved in 17 aneurysms(48.6%), and the others remained as a residual neck in 8 aneurysms(22.8%) and residual sac in 10 aneurysms(28.6%). Among these incompletely occluded aneurysms, 7 aneurysms were performed follow-up angiography. And 6 of them converted into complete occlusion. In the other hands, among 17 aneurysms achieved complete occlusion initially, 9 aneurysms were performed follow-up angiography. Recurrence due to coil compaction occurred in one aneurysm and the others maintained complete occlusion. There was one mortality case due to thromboembolic complication. CONCLUSION: In spite of difficulty in achieving complete occlusion with Matrix coil system, there is no rupture or re-rupture during follow-up period. Follow-up angiography shows many conversions of residual sac into complete occlusion. Embolization using Matrix coil system is safe and effective, but the effects of PGLA copolymer need further investigation.
Aneurysm ; Angiography ; Female ; Follow-Up Studies* ; Hand ; Humans ; Intracranial Aneurysm* ; Male ; Mortality ; Neck ; Recurrence ; Rupture

Tissue tear hemorrhages(TTHs) have been thought to be visible manifestation of more severe forms of diffuse axonal injury and thus portend a poor prognsis. Computed tomographic scans and magnetic resonance images from 1076 patients with closed head injuries were reviewed;30(3.5%) cases were found to have TTHs. The authors investigated the clinical spectrum of TTHs. No direct relationship could e established between presence of TTHs and the severity and/or outcome from the head injury in this group. Magnetic resonance imaging provided more sensitive information than computed tomography in evaluating TTHs.
Brain* ; Craniocerebral Trauma ; Diffuse Axonal Injury ; Head Injuries, Closed ; Humans ; Magnetic Resonance Imaging

Spinal subarachnoid hemorrhage (SAH) due to solitary spinal aneurysm is extremely rare. A 45-year-old female patient visited the emergency department with severe headache and back pain. Imaging studies showed cerebral SAH in parietal lobe and spinal SAH in thoracolumbar level. Spinal angiography revealed a small pearl and string-like aneurysm of the Adamkiewicz artery at the T12 level. One month after onset, her back pain aggravated, and follow-up imaging study showed arachnoiditis. Two months after onset, her symptoms improved, and follow-up imaging study showed resolution of SAH. The present case of spinal SAH due to rupture of dissecting aneurysm of the Adamkiewicz artery underwent subsequent spontaneous resolution, indicating that the wait-and-see strategy may provide adequate treatment option.
Aneurysm ; Aneurysm, Dissecting ; Aneurysm, Ruptured ; Angiography ; Arachnoid ; Arachnoiditis ; Arteries ; Back Pain ; Emergencies ; Female ; Follow-Up Studies ; Headache ; Humans ; Middle Aged ; Parietal Lobe ; Spine ; Subarachnoid Hemorrhage

The Currarino triad is a unique complex of congenital caudal anormalies including anorectal malformation, sacral bony abnormality, and presacral mass. Histologically the presacral mass has been identified as a meningocele, teratoma, enteric duplication or a combination of this. A Case of female infant with this triad was presented and was successfully treated by surgery. The presacral mass was a lipomyelomeningocele. The clinical features, unique radiologic findings, and importance of a correct diagnosis of currarino triad were reviewed.
Diagnosis ; Female ; Humans ; Infant ; Meningocele ; Teratoma

We propose the various Telemedicine applications on the DooRae (Distributed Object Oriented Multimedia Application Crafting Environment for Collaboration) framework(or platform). DooRae-Telemedicine supports the application development of the collaborative multimedia environment connected with the network(LAN, MAN, WAN) in the CBM(Computer based Multimedia) based. Also, it is not restrict on space between a doctor(s) and a patient(s) into cyberspace made by network. The kinds of Telemedicine in this paper have different distinction, and the development of these application system is possible on DooRae environment. DooRae-Telemedicine has a interaction, various communication type, a question and an answer, multi-session, application sharing and whiteboard which resembles chalkboard. Also, various supplementary functions such as video conference and voice conference for DooRae-telemedicine are what makes face-to-face medicine effective. Also it supports real or non-real type. The operating system developed on windows 95 and windows NT This research has been done creating multimedia-based telemedicine system for home PCs in network environment. Most of telemedicine used hardware and exclusive line of high cost as CATV broadcasting technique. But DooRae-telemedicine will contribute to change the Home-PC for better use of collaborations among doctor and patients through various modes o interactions in cyberspace.
Cooperative Behavior ; Humans ; Multimedia* ; Telemedicine* ; Voice

The authors present a case of central neurocytoma in right lateral ventricle. Central neurocytoma is a rare clinicopathological entity that has been recently recognized and is characterized by 1) intraventricular location, 2) predominant occurance in young adults, 3) oligodendroglioma-like histology, 4) benign course, 5) immunohistochemical and ultrastructual evidence of neuronal differentiation. Twenty one year old female patient was admitted to the Department of neurosurgery of Chung Ang Gil hospital because of diplopia and headache which developed and progressed gradually 2 months prior to admission. The neurological examination showed paresis of right lateral rectus muscle, bilateral optic papilledema, nystagmus and mild left hemiparesis. MRI scan showd an intraventricular tumor of lateral ventricle that had isosignal and high signal intensity with cortex on T1-and T2-weighted and proton density images, respectively. Serpiginous flow voids representing blood vessels in the tumor were seen an all pulse sequences.
Blood Vessels ; Diplopia ; Female ; Headache ; Humans ; Lateral Ventricles* ; Magnetic Resonance Imaging ; Microscopy, Electron ; Neurocytoma* ; Neurologic Examination ; Neurons ; Neurosurgery ; Papilledema ; Paresis ; Protons ; Young Adult

The cerebral vasospasm after clipping surgery of unruptured aneurysm is uncommon. A 44-year-old man with unruptured left middle cerebral artery(MCA) aneurysm had clipping surgery. From the third postoperative day, he presented with drowsy mentality, dysphasia and right hemiparesis. Computed tomographic scans showed low density area in frontotemporal lobe and midline shift. Transfemoral cerebral angiography revealed severe vasospasm in supraclinoid internal carotid artery, anterior cerebral artery, and MCA on the operative side. We performed left frontotemporoparietal craniectomy and hypertensive-hypervolemic therapy. He recovered without neurological deficits but for dysphasia. Neurosurgeon should be alert to the possibility of vasospasm after clipping surgery even in case of unruptured cerebral aneurysm.
Adult ; Aneurysm ; Anterior Cerebral Artery ; Aphasia ; Carotid Artery, Internal ; Cerebral Angiography ; Humans ; Intracranial Aneurysm* ; Paresis ; Vasospasm, Intracranial

BACKGROUND: Carotid artery intima-media thickness (IMT) is an early structural marker of the atherosclerotic process and an elevated total homocysteine level is an early biochemical marker of atherosclerosis. But there are few reports about serum homocysteine level and carotid IMT between ischemic stroke, hypertensive intracerebral hemorrhage (HICH) and control group. METHOD: We studied about 173 patients with ischemic stroke, HICH and control group. Carotid IMT was defined as the mean of IMT measured by B-mode ultrasonography. Serum homocysteine level was measured by fluorescence polarization immunoassay method in fasting state. We compared serum homocysteine level and carotid IMT between ischemic stroke, HICH and control group. In statistics, One-Way ANOVA was used. RESULTS: A significant increase in carotid IMT was noted in ischemic stroke and HICH compared with that in the control group (p<0.05), whereas there was no significant differences in carotid IMT between ischemic stroke and HICH. The serum homocysteine level of ischemic stroke was significantly higher than that of control group (p<0.05). But there were no significant differences between HICH and control group, HICH and ischemic stroke. CONCLUSIONS: In our study, we thought a carotid IMT of ischemic stroke, HICH and serum homocysteine level in ischemic stroke can be used as early diagnostic marker. Therefore, our results address the need of further prospective clinical studies in patients with ischemic stroke and HICH in order to evaluate a possible diagnostic ability of carotid IMT and serum homocysteine level.
Atherosclerosis ; Biomarkers ; Carotid Arteries ; Carotid Intima-Media Thickness* ; Cerebral Hemorrhage ; Fasting ; Fluorescence Polarization Immunoassay ; Homocysteine* ; Humans ; Intracranial Hemorrhage, Hypertensive* ; Stroke* ; Ultrasonography