The presence of traumatic subarachnoid hemorrhage on the initial computerized tomographic scans has been known to be associated with worse results. By means of a simple and reliable computerized tomographic grade system proposed by Greene and his colleagues, prognostic factors of the traumatic subarachnoid hemorrhage was significantly related to clinical outcome at the time of discharge from acute hospitalization. Between February 1992 and August 1995, 3975 patients were admitted to our department of neurosurgery due to head injury. Clinical data were retrospectively reviewed to ascertain the relationship of the thickness of traumatic subarachnoid hemorrhage, its location, evidence of mass lesion(s), midline shift, obliteration of the basal cistern, and cortical sulcal effacement to outcome. Additionally, initial Glasgow coma scale score, arterial gas study, systemic blood pressure and prothrombin time were also analyzed for the same purpose. Among 3975 head-injured patients, 213 patients were identified to h ave traumatic subarachnoid hemorrhage on the initial computerized tomographic scan. Among 213 traumatic subarachnoid hemorrhage patients, the patients treated with calcium channal blocker(32 patients) and 3 patients lost to follow-up were excluded from this study for a total of 178. The computerized tomographic scan findings were divided into a 3 grade system;Grade 1 indicating only traumatic subarachnoid hemorrhage, Grade 2 indicating traumatic subarachnoid hemorrhage with mass lesion(s) , Grade 3 indicating traumatic subarachnoid hemorrhage with mass lesion(s) and midline shift. All these data were compared to Glasgow outcome scale on discharge, and arbitrarily these were divided into the good(good recovery and moderate disability) and the bad(severe disability, vegetative state and death). The authors conclude that the contributing factors to outcome at discharge were as follows:1. midline shift(p=0.002), PT< or =70%(p<0.001), obliteration of the basal cistern(p=0.001) and cortical sulcal effacement(p=0.001) were shown to the statistically significant. 2. initial computerized tomographic grade contributed to outcome at discharge.
Blood Pressure ; Calcium ; Craniocerebral Trauma ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hospitalization ; Humans ; Lost to Follow-Up ; Neurosurgery ; Persistent Vegetative State ; Prothrombin Time ; Retrospective Studies ; Subarachnoid Hemorrhage, Traumatic*

In the present study, we made an attempt to compare polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with PCR-direct sequence analysis for their accuracy and sensitivity in detecting resistance to rifampicin (RMP). A total of 32 clinical isolates of Mycobacterium tuberculosis including 22 resistant and 10 sensitive isolates, whose drug susceptibility have been tested by conventional proportion method, were analyzed by using PCR-SSCP and PCR-sequence analysis. Among 22 RMP resistant isolates, 16 isolates showed SSCP profiles different from that of a RMP sensitive control strain, M. tuberculosis H37Rv indicating the possible existence of a sequence alteration in this region of the rpoB gene, while 6 resistant isolates displayed SSCP profiles indistinguishable from the sensitive control strain. On the other hand, all of 10 RMP sensitive isolates showed SSCP profiles similar to that of the sensitive control strain. Therefore, overall agreement rste between conventional proportion method and PCR-SSCP reached 81%. Subsequently, all of 32 clinical isolates were subjected to sequence analysis. The results from the sequence analysis revealed that all of 22 resistant isolates indeed contain mutations in the stretch of 81 bp region of rpoB gene, while none of 10 sensitive isolates contain any sequence alterations. Therefore, this study suggests that PCR-sequence analysis works more efficiently and accurately than PCR-SSCP analysis for rapid screening of RMP-resistant M. tuberculosis clinical isolates.
Hand ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational ; Rifampin* ; Sequence Analysis* ; Tuberculosis

A case of aneurysmal bone cyst(ABC) secondary to eosinophilic granuloma of the skull is reported. In the skull, the presence of ABC secondary to eosinophilic granuloma is rare. We reviewed the clinicopathological- and radiological features of this type of eocinophilic granuloma at the cranium.
Aneurysm* ; Eosinophilic Granuloma* ; Eosinophils* ; Granuloma ; Skull*

OBJECTIVES: Accurate diagnosis of the mechanism and origin site of paroxysmal supraventricular tachycardia(PSVT) can be made using electrophysiologic study(EPS). Recently, radiofrequency catheter ablation technique has been introduced and widely used for the definitive treatment of various forms of PSVT, thereby precise determination of the mechanism of PSVT can be possible. It has been known that atrioventricular reentry tachycardia (AVRT) using concealed bypass tract is more frequent than atrioventricular nodal reentry tachycardia (AVNRT) in Korea. But it is not certain that those studies represent actual distribution of PSVT in Korea. This study was designed to determine the mechanism and clinical characteristics of PSVT in Korea. METHODS: We investigated 136patients in whom electrophysiolosic study was performed from October 1992 through October 1994 at the Chonnam National University Hospital, the only tertiary referral center of the Kwangju-Chonnam area of Korea. RESULTS: 1) The electrophysiologic mechanism of PSVT was AVNRT in 44patients(32.4%), WPW syndrome in 46(33.8%), AVRT using concealed bypass tract in 40(29.4%), sinoatrial nodal reentry tachycardia (SANRT) in 4(2.9%), and automatic atrial tachycardia(AAT) in 2(1.5%), ensuing that AVNRT is most common mechanism of PSVT with no preexcitation during sinus rhythm. 2) Male is more frequent than female in AVNRT, WPW syndrome, and AVRT, which was most prominent in WPW syndrome. 3) The first episode of symptom occured at the age of 34.9 +/- 17.3 years in AVNRT, 25.5 +/- 13.3 years in WPW and 26.3 +/- 15.0 years in AVRT(p<0.05). There was no significant difference in the duration of symptom. The tachycardia rate in WPW syndrome was 183.6 +/- 23.9 per minute and AVRT was 186.7 +/- 38.0 per minute, which were faster than that of AVNRT(161.7 +/- 28.6/min)(p<0.05). 4) There was no significant difference in the presenting symptoms and in the provocation factors between AVNRT and AVRT. CONCLUSION: AVNIlT is most common mechanism of PSVT with no preexcitation during sinus rhythm, developed at older age than WPW syndorme and AVRT, and had lower tachycardia rate than WPW syndrome and AVRT.
Catheter Ablation ; Diagnosis ; Female ; Humans ; Jeollanam-do ; Korea ; Male ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Sinoatrial Nodal Reentry ; Tachycardia, Supraventricular* ; Tertiary Care Centers ; Wolff-Parkinson-White Syndrome