A case of severe aseptic meningitis with communicating hydrocephalus following iotrolan myelography is presented. The patient's condition improved very quickly after corticosteroid therapy. Rapid improvement and absence of pathogenic organisms in the CSF culture strongly favor an aseptic meningitis. This is the first reported case of aseptic meningtis with the secondary development of hydrocephalus caused by iotrolan myelography.
Hydrocephalus* ; Meningitis, Aseptic* ; Myelography*

A case of severe aseptic meningitis with communicating hydrocephalus following iotrolan myelography is presented. The patient's condition improved very quickly after corticosteroid therapy. Rapid improvement and absence of pathogenic organisms in the CSF culture strongly favor an aseptic meningitis. This is the first reported case of aseptic meningtis with the secondary development of hydrocephalus caused by iotrolan myelography.
Hydrocephalus* ; Meningitis, Aseptic* ; Myelography*

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

We report magnetic resonance imaging findings of massive spinal subarachnoid hemorrhage (SAH) caused by repeated lumbar punctures during spinal anesthesia in a 36-year-old man. The signal intensities of spinal SAH were similar to those of the conus medullaris on both T1 and T2- weighted spin-echo images. Although spinal SAH is hardly recognized on MR, spinal SAH of sufficient amount may cause alteration of the cerebrospinal fluid signal.
Adult ; Anesthesia, Spinal ; Cerebrospinal Fluid ; Conus Snail ; Humans ; Magnetic Resonance Imaging* ; Spinal Puncture ; Subarachnoid Hemorrhage*

PURPOSE: Most of recent MR imagings of cerebral cortex activation have been performed by using high field magnet above 2-T or echo-planar imaging technique. We report our experience on imaging of cerebral cortex activation with a widely available standard 1.5-T MR. MATERIALS AND METHODS: Series of gradient-echo images (TR/TE/flip angle :80/60/40 degrees64 x 128 matrix) were acquired alternatively during the periods of rest and task in five normal volunteers. Finger movement (n=10 ;5 right, 5 left) and flashing photic stimulation (n=l) were used as a motor task and a visual task to activate the motor cortex and visual cortex, respectively. Activation images were obtained by subtracting sum of rest images from that of task images. Changes of signal intensity were analyzed over the periods of rest and task. RESULTS: Activation images were obtained in all cases. Changes of signal intensity between rest and task periods were 6.5-14.6%(mean, 10.5%) in the motor cortex and 4.2% in the visual cortex. CONCLUSION: Functional imaging of cerebral cortex activation could be performed with a widely available 1.5-T MR. Widespread applications of this technique to basic and clinical neuroscience are expected.
Cerebral Cortex* ; Echo-Planar Imaging ; Fingers ; Healthy Volunteers ; Motor Cortex ; Neurosciences ; Photic Stimulation ; Visual Cortex

BACKGROUND: Pityriasis rosea is an acute inflammatory dermatosis with an unproven etiology. The typical clinical feature consists of an initial, single herald patch followed by development of smaller, disseminated, papulosquamous, ovoid macules. However, an unusual papular type of pityriasis rosea is relatively common in children and it shows similar clinical characteristics to pityriasis lichenoides. OBJECTIVES: Our purpose was to observe the clinical and histologic features of pityriasis rosea and pityriasis lichenoides, and differentiate two diseases in children. METHODS: Sixteen children with pityriasis rosea and nineteen children with pityriasis lichenoides were investigated clinically and histologically. RESULTS: 1. Clinically, pityriasis rosea may be differentiated from pityriasis lichenoides by the existence of herald patch, short duration, the uniformity of size and shape, and residual pigmentation. 2. Focal parakeratosis, intraepidermal vesicle and papillary derma edema are more common in pityriasis rosea. In contrast, deep dermal infiltration, dyskeratosis, epidermal necrosis and confluent parakeratosis are more common in pityriasis lichenoides. 3. Comparing to the plaque type, a papular type of pityriasis rosea shows more involvement in the extremities with longer duration. Histologically, parakeratosis and papillary dermal edema are less and spongiosis is more commonly observed in papular type. CONCLUSIONS: Pityriasis rosea in children often shows papules especially on the extremities, similar to that of pityriasis lichenoides. However, from the results in this study, we believe that two diseases can be differentiated if both clinical and histologic findings are carefully studied.
Child* ; Edema ; Extremities ; Humans ; Necrosis ; Parakeratosis ; Pigmentation ; Pityriasis Lichenoides* ; Pityriasis Rosea* ; Pityriasis* ; Skin Diseases

The author attempted to clarify the nature of alpha-adrenoceptors in relation to the pressor response to the increased intracranial pressure(ICP) in urethane-anesthetized rabbits, using the epidural balloon method. 1) The blood pressure increased in parallel with the raised ICP which was made by gradual inflation of the balloon. 2) B-HT 920, an alpha2-agonist, which elicited depressor and bradycardiac responses in normal rabbits inhibited markedly the pressor response to the raised ICP. 3) Piperoxan, an alpha2-antagonist, potentiated the pressor response to the raised ICP. 4) Piperoxan antagonized the depressor and bradycardiac responses by B-HT 920 as well as the inhibitory effect of B-HT 920 on the pressor response to the raised ICP. 5) The pressor response to the raised ICP were not affected at all by prazosin, an alpha1-antagonist. 6) Neither the depressor and bradycardiac responses by B-HT 920 itself nor the inhibitory effect of B-HT 920 on the pressor response to the raised ICP were significantly affected by prazosin. It is inferred from these observations that the central alpha-adrenoceptors play an important role in producing the pressor response to the raised ICP and that the receptors involved here seems to be of alpha2-type.
Blood Pressure ; Inflation, Economic ; Intracranial Pressure* ; Piperoxan ; Prazosin ; Rabbits

The author attempted to clarify the nature of alpha-adrenoceptors in relation to the pressor response to the increased intracranial pressure(ICP) in urethane-anesthetized rabbits, using the epidural balloon method. 1) The blood pressure increased in parallel with the raised ICP which was made by gradual inflation of the balloon. 2) B-HT 920, an alpha2-agonist, which elicited depressor and bradycardiac responses in normal rabbits inhibited markedly the pressor response to the raised ICP. 3) Piperoxan, an alpha2-antagonist, potentiated the pressor response to the raised ICP. 4) Piperoxan antagonized the depressor and bradycardiac responses by B-HT 920 as well as the inhibitory effect of B-HT 920 on the pressor response to the raised ICP. 5) The pressor response to the raised ICP were not affected at all by prazosin, an alpha1-antagonist. 6) Neither the depressor and bradycardiac responses by B-HT 920 itself nor the inhibitory effect of B-HT 920 on the pressor response to the raised ICP were significantly affected by prazosin. It is inferred from these observations that the central alpha-adrenoceptors play an important role in producing the pressor response to the raised ICP and that the receptors involved here seems to be of alpha2-type.
Blood Pressure ; Inflation, Economic ; Intracranial Pressure* ; Piperoxan ; Prazosin ; Rabbits

PURPOSE: We analyzed the therapeutic results of 703 cases of urinary calculi treated using an EDAP-Sonolith Praktis, an electroconductive lithotriptor (ECL). MATERIALS AND METHODS: Between January 2000 and June 2004, 703 patients meeting the study inclusion criteria were treated with an EDAP-Sonolith Praktis. The site and size of the stones, session, auxiliary procedure, success rate, causes of failure, complication, efficiency quotient (EQ) and retreatment were analyzed. RESULTS: The records of 703 patients, in whom urinary calculi were treated by extracorporeal shock wave lithotripsy, using an EDAP-Sonolith Praktis, were retrospectively reviewed. The success rates were 99.3, 92.5, 66.7 and 12.5% for stone sizes < or=9, 10-19, 20-29 and > or=30mm, respectively, with an overall success rate of 95.3%. The EQ, mean number of session and retreatment rate were 0.71, 1.7 and 30.6%, respectively. As auxiliary procedures, double-J stenting, ureteroscopic stone removal and open surgery were performed in 6, 15 and 1, respectively. The complications were gross hematuria, flank pain, steinstrasse, nausea and fever, which were successfully controlled by conservative treatment. CONCLUSIONS: EDAP-Sonolith Praktis, an ECL, is an efficient and safe outpatient procedure for initial urinary calculi treatment.
Fever ; Flank Pain ; Hematuria ; Humans ; Lithotripsy* ; Nausea ; Outpatients ; Retreatment ; Retrospective Studies ; Shock* ; Stents ; Urinary Calculi*

Reflex sympathetic dystrophy is an important clinical entity that is characterized by excessive or prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function, and trophic changes. This syndrome is among the most frequently encountered problems in clinical medicine, and proper diagnosis and therapy are critical. Accidental or surgical trauma or one of a variety of disease states may become a precipitating factor. Proper recognition and treatment result in rapid elimination of symptoms and complete recovery. A 56-years old male accidented total amputation of the proxomal part of the left index finger in May, 1996. Emergently, complete replantation procedure was successfully performed in the department of reconstructive surgery, medical center, Korea University. Afterward, he began to suffer from uncontrolled, prolonged pain in left index finger, proximally spreading pain to the left upper extremity and limited joint movement of the left shoulder. Although many treatments were used for this syndrom, not all of them were effective. Furthermore, the treatments which proved effective had detrimental side effects. However, thoracoscopic left thoracic sympathectomy was performed in our department. This therapy successfully relieved the pain and improved shoulder joint movement.
Amputation ; Clinical Medicine ; Diagnosis ; Fingers ; Humans ; Joints ; Korea ; Male ; Middle Aged ; Precipitating Factors ; Recovery of Function ; Reflex Sympathetic Dystrophy* ; Reflex* ; Replantation ; Shoulder ; Shoulder Joint ; Sympathectomy* ; Sympathetic Nervous System ; Thoracoscopy ; Upper Extremity