PURPOSE: To assess how accurately computed tomography (CY) can demonstrate the abnormal findings which are believed to cause the clinical signs and symptoms of hearing loss (HL), vertigo and facial paralysis (FP) in patients with temporal bone trauma. MATERIALS AND METHODS: The authors studied CT scans of 39 ears in 35 patients with temporal bone trauma. CT scans were performed with 1-115 mm slice thickness and table incrementation. Both axial and coronal scans were obtained in 32 patients and in three patients only axial scans were obtained. We analyzed CT with special reference to the structural abnormalities of the external auditory canal, middle ear cavity, bony labyrinth, and facial nerve canal, and correlated these findings with the actual clinical signs and symptoms. As to hearing loss, we evaluated 32 ears in which pure tone audiometry or brainstem evoked response audiometry had been performed. RESULTS: With respect to the specific types of HL, CT accurately showed the abnormalities in 84% (16/19) in conductive HL, 100% (2/2) in sensorineural HL, and 25% (2/8) for mixed HL. When we categorized HL simply as conductive and sensorineural, assuming that mixed be the result of combined conductive and sensorineural HL, CT demonstrated the abnormalities in 89% (24/27) for conductive HL and 50% (5/10) for sensorineural HL. Concerning vertigo and FP, CT demonstrated abonormalities in 67%(4/6), and 29% (4/14), respectively. CONCLUSION: Except for conductive HL, CT seems to have a variable degree of limitation for the demonstration of the structural abnormalities resulting sensorineural HL, vertigo or facial paralysis. It is imperative to correlate the CT findings with the signs and symptoms in those clinical settings.
Audiometry ; Audiometry, Evoked Response ; Brain Stem ; Ear ; Ear Canal ; Ear, Inner ; Ear, Middle ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Humans ; Temporal Bone* ; Tomography, X-Ray Computed ; Vertigo

OBJECTIVES: Seoul-Activities of Daily Living(S-ADL) was developed to assess elderly person's basic activities of daily living. This study aims to develop standardized ADL assessment scale and confirm the reliability and validity of the S-ADL. METHODS: It was participated in 336 controls and 145 patients diagnosed Alzheimer's disease. RESULTS: In controls, it was statistically significant to age, but not sex, education, region and presence of spouse. Also, reliability and validity were statistically significant. Principal axis factoring analysis revealed three factors that accounted for 66.67% of the total variance(1.self-care/hygiene, 2.ambulation, 3.toileting). According to each CDR stage, there were significant difference, except for CDR 0.5 and CDR 1 suggesting early dementia. Particularly, it was remarkable for functional impairment in CDR 2 and CDR 3 suggesting moderate to severe dementia. The order of the loss of function was (1) self-care/hygiene, (2) toileting, and (3) ambulation. CONCLUSIONS: Our study showed that the S-ADL could be a very reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-ADL would be useful in assessing daily function of moderate to severe AD.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Education ; Humans ; Reproducibility of Results* ; Spouses ; Walking

The immunocompetence is important not only to kill the neoplastic cells but also to keep the neoplastic cells from growing further. T lymphocyte is plays the most important role in maintaining the tumor immunity efficiently. T lymphocyte has its specific functions depending in the subset of T lymphocytes. The author analyzed the T lymphocyte subsets in 31 brain tumor patients using anti-CD3, anti-CD4, anti-CD8 monoclonal antibodies and flow cytometry to determine the immunological status of brain tumor patients. All CD3, CD4 and CD8 subsets were reduced in both benign and malignant brain tumor patients but more signigicantly reduced in malignant tumor group. But in benign tumor group, the subtypes of T lymphocytes were not so different from those of normal healthy controls except the pituitary tumor patients, who showed the significant decrease in all the subtypes. In malignant tumor group, each subtype was signigicantly reduced and CD8 subtypes was markedly reduced in metastatic tumor patients, These analyses were considered to have the possibility to be contributable to planning the further immunotherapy and also the possibility to moniter the brain tumor patients clinically.
Antibodies, Monoclonal ; Brain Neoplasms* ; Brain* ; Flow Cytometry ; Humans ; Immunocompetence ; Immunotherapy ; Lymphocytes ; Pituitary Neoplasms ; T-Lymphocyte Subsets* ; T-Lymphocytes*

Intracerebral hemorrhage is the most serious complication of cerebral arteriovenous malformations (AVM). To identify angiographic characteristics of AVM which correlate with a history of hemorrhage, we retrospectively analyzed angiographic findings of 25 patients with AVM. Nine characteristics were evaluated; these include nidus size, location, arterial aneurysm, intranidal aneurysm, angiomatous change, venous drainage pattern, venous stenosis, delayed drainage and venous ectasia. These characteristics were correlated with hemorrhage, which was seen in 18 (72%) patients of CT or MR images. Venous stenosis (P<.05) and delaved venous drainage (P<.05) well correlated with a history of hemorrhage. Arterial aneurysm and intranidal aneurysm also had a tendency hemorrhage although they did not prove to be statistically significant. Detailed analysis of angiographic finding of AVM is important for recognition of characteristics which are related to hemorrhage and may contribute to establishing a prognosis and treatment planning.
Aneurysm ; Cerebral Hemorrhage ; Constriction, Pathologic ; Dilatation, Pathologic ; Drainage ; Hemorrhage* ; Humans ; Intracranial Arteriovenous Malformations* ; Prognosis ; Retrospective Studies

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.
Anaphylaxis ; Autopsy ; Forensic Medicine ; Korea ; Mast Cells ; Tryptases

Chondroma is a benign bone tumor and rarely involves the spine ; even if this occurs however, neurological symptoms and signs rarely arise. We encountered one case of chondroma which developed in the posterior arch of the atlas. The patient complained of quadriparesis, hypesthesia, and urinary frequency. MR imaging showed that the tumor had compressed the cord dorsolaterally at the C1 level. It was completely removed, and the posterior arch of the atlas and surrounding ligamentum flavum disclosed hypertrophy. Postoperatively, the neurological status of the patient improved. On pathologic examination, hypocellularity and mature hyaline cartilage was seen, as well as chondrocytes residing in the lacunae ; all these findings were compatible with benign chondroma.
Chondrocytes ; Chondroma* ; Humans ; Hyaline Cartilage ; Hypertrophy ; Hypesthesia ; Ligamentum Flavum ; Magnetic Resonance Imaging ; Quadriplegia ; Spinal Cord Compression* ; Spinal Cord* ; Spine

PURPOSE: To evaluate 5-year survival rate, patterns of failure and complications of cervical cancer treatment, fifty nine patients treated by curative cancer were analyzed retrospectively. METHODS AND MATERIALS : From March 1986 to May 1990, fifty nine patients with histologically proven uterine cervical cancer were analyzed. According to FIGO stage, there were 2 patients (3.4%) in stage Ib, 2 patients (3.4%) in stage IIa, 31 patients (52.5%) in stage IIb, 15 patients (25.4%) in stage IIIb, 9 patients (15.3%) in stage IV, External RT was per formed by 6 MVLINAC with daily 1.8 Gy, 5 times per week and followed by ICR, A point dose of ICR was calculated to 30-43.66 Gy (median : 34.6Gy). These techniques delivered total A point dose of 80.4 to 109.8 Gy (median : 85Gy). Patients had been followed up from 2 to 110 months (median : 61 months) RESULTS: The overall 5-year survival rate & disease free survival rate were 55.9% and 55.0 % respectively. According to FIGO stage, the 5-year survival rate for less than Iia, IIb, IIIb, IV were 75.0%, 74.8%, 26.7%, 33.3%, respectively. In univariate analysis, the 5-year survival rate for stage IIb and below versus stage llla and above revealed 74.8%, 29.2% respectively (p<0.005). According to FIGO stage, the 5-year survival rate for less than lla, llb, lllb, IV were 75.0%, 74.8%, 26.7%, 33.3%, respectively. In univariate analysis, the 5-year survival rate for stage llb and below versus stage llla and aboce revealed 74.8%, 29.2% respectively (p<0.005). According to the hemoglobin level during RT, the 5-year survival rate of was 73.3% for patients with Hg 10 gm/dL or higher, in contrast to 0% for those with lower than 10 gm/dL (p<0.005). In 18 patients with nonbulky tumor (<5 cm), the 5-year survival rates were 71.8%. The 5-year survival rates for 18 patients with 5 cm or greater in tumor diameter were 22.2% (p<0.005). The 5-year survival rate for patient age of above 50 years and below were 65.3%, 34.2% respectively (p<0.05). ECOG performance status, pathologic finding, total dose, total treatment time were not statistically significant factors. The significant prognostic factors affecting overall 5-year survival rate by multicariate analysis showed the hemoglobin level during RT (p=0.0001), tumor size (p=0.0390), FIGO stage (p=0.0468) Total recurrence rate was 23.7%; local failure 15.2% (9/59), distant metastasis 6.8% (4/59), local and distant metastasis 1.7% (1/59). According to the RTOG/EORTC Soma Scales, the late complication rate was 23.8% (14/59). The late complication rate of colorectum and genitourinary tract were 15.3% (9/59), 8.5% (5/59), respectively : 10 patients(17.0%) were grade 2, 3 patients (5.1%) were grade 3 and one patient (1.7%) (1/59). According to the RTOG/EORTC Soma Scales, the late complication rate was 23.8% (14/59). The late complication rate of colorectum and genitourinary tract were 15.3% (9/59), 8.5% (5/59), respectively : 10 patients (17.0%) were grade 2,3 patients (5.1%) were grade 3 and one patient(1.7%) was grade 4. The late complications were radiation proctitis, rectal bleedint, radiation colitis, diarrhea and radiation cystitis in decreasing order. CONCLUSION: For improvement of therapeutic results, prospective randomized trials are recommended to discover new prognostic factors and more aggressive radiation therapeutic methods are needed for poor prognostic patients. The adjuvant chemotherapy or radiation-sensitizing agents must be considered to inhibit regional and distant metastasis.
Carisoprodol ; Chemotherapy, Adjuvant ; Colitis ; Cystitis ; Diarrhea ; Disease-Free Survival ; Humans ; Neoplasm Metastasis ; Proctitis ; Radiation-Sensitizing Agents ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms* ; Weights and Measures

Aneurysms of the superior mesenteric artery are rare, accounting for 8% of visceral artery aneurysms. About 60% of all superior mesenteric artery aneurysms have a mycotic origin. The only helpful clinical manifestations are episodes of previous abdominal pain and a history of valvular heart disease. In this case, a 66-year-old female patient with mitral regurgitation and aortic regurgitation presented with pain in the upper abdominal area. A superior mesenteric artery aneurysm was diagnosed at the time of impending rupture. Since excellent collateral circulation was present, an aneurysmectomy without revascularization was performed, and no ischemic symptom occurred. The patient presented no major complications during the postoperative course.
Abdominal Pain ; Aged ; Aneurysm ; Aneurysm, Infected* ; Aortic Valve Insufficiency ; Arteries ; Collateral Circulation ; Endocarditis* ; Female ; Heart Valve Diseases ; Humans ; Mesenteric Artery, Superior* ; Mitral Valve Insufficiency ; Rupture

PURPOSE: Recently, time interval between onset of transmitral early inflow (E) and onset of early diastolic (Ea) velocity of the mitral annulus (TE-Ea) has been used to identify diastolic dysfunction in adults, but to date, no studies have been done in infants. The purpose of our study was to evaluate the normal values of TE-Ea in infants under 1 year of age, and to assess the influence of age, heart rate and cardiac growth on this index. METHODS: Thirty healthy children (mean+/-SD, age; 5.4+/-2.3 months) underwent echocardiography. Mitral and tricuspid inflow and tissue Doppler velocities were obtained from the leaflet tips and lateral site of the annulus, respectively, in the apical four-chamber view. The time intervals between the peak of R wave and onset of mitral and tricuspid E velocity (T(E)) and between peak of R wave and onset of Ea velocity (T(Ea)) were measured. The differences between these time intervals were calculated as T(E-Ea), which were compared with demographic and echocardiographic variables. RESULTS: Mean heart rate was 125.27+/-10.78 (bpm). Mitral T(E-Ea) was shorter than tricuspid T(E-Ea) (mean+/-SD, 24.89+/-10.33 msec versus 32.43+/-12.72 msec, P=0.016). Both mitral and tricuspid T(Ea) were significantly greater than T(E) (both: P<0.01). Age and heart rate did not show correlation with T(Ea-E). When correlated with echocardiographic variables, mitral T(E-Ea) tended to decrease as mitral ring area increased. CONCLUSION: In normal infants, T(E-Ea) values differ between both ventricles, which suggest differences in ventricular adaptation in the first year of life.
Adult ; Child ; Diastole ; Echocardiography ; Echocardiography, Doppler ; Heart Rate ; Humans ; Infant* ; Reference Values

Kawasaki disease is an acute vasculitis of infancy and early childhood characterized by high fever, rash, mucositis, lymphadenopathy and coronary artery damage. The failure to indentify a causative organism using convetional culture and serological techniques, and the lack of response to antibiotics indicate that the disorder is probably not due to any known bacterial or viral pathogens. During the acute phase of the disease, the alterations of T and B cell functions, changes of cytokine and immunoglobulin levels have been reported. This study was performed to investigate the changes of immunoglobulins levels in patients with Kawasaki disease. IgG, IgA, IgM and IgG subclasses were measured using immunoprecipitation and EIA in the sera of patients with Kawasaki disease. The results were as follows: 1) Acute phase reactants such as CRP and ESR were significantly increased in Kawasaki patients compared to those in control patients(p<0.01). 2) Serum IgG levels in Kawasaki disease were markedly increased than those in control patients, while serum IgA and IgM levels showed no significant changes (P: No Significance). 3) IgG1 and IgG4 were predominantly increased increased in the sera of Kawasaki patients, while IgG2 and IgG3 were not significantly increased (P: No Significance). With these results, unidentified infectious organism with abnormal immune response could be suggested as an etiologic factor of Kawasaki disease.
Acute-Phase Proteins ; Anti-Bacterial Agents ; Child* ; Coronary Vessels ; Exanthema ; Fever ; Humans ; Immunoglobulin A ; Immunoglobulin G* ; Immunoglobulin M ; Immunoglobulins ; Immunoprecipitation ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome* ; Mucositis ; Vasculitis