PURPOSE: This study was performed to evaluate MR signal intensity(SI) of calcification and to assess the capability of MRI in detection of various intracranial calcifications. MATERIALS AND METHODS: The MR findings and ROI value of experimental model of calcium carbonate suspension according to each concentration (20, 35, 50%) and diameter (1-10 mm) and hydroxyapatite suspension according to each concentration (10, 20, 30, 40, 50%) were analyzed. A specimen of calcification in cranio-pharyngioma was analyzed for its composition by XRD(X-ray diffractometer) and ICP(inductively coupled plasma) methods. MRI of 34 patients with intracranial calcifications were retrospectively analyzed for signal intensity of the calcification and its capability to detect calcifications according to size, location, and contrast with adjacent lesion. RESULTS: The calcium carbonate phantom with larger diameter and low concentration showed lower signal intensity on T2 than TlWl. Hydroxyapatite phantom showed high signal intensity in 10-30% concentration and low signal intensity in 40-50% concentration on T1 weighted image. The 5 cases of 34 intracranial calcifications showed high signal intensity on T1 weighted image. The capability of MRI in the detection of intracranial calcifications decreased in the circumstances such as small size(<2.5mm) and intraventricular location. Although the size of calcification was small, the detection was easy in the good contrast with adjacent lesion. However, the detection of the small sized calcification was easy if the contrast with adjacent lesion was good. CONCLUSION: lntracranial calcification shows generally low signal intensity on T1 and T2 weighted image with the exception of occasional high SI on TlWl. Detection of intracranial calcification in MRI is affected by its composition, size, location, and contrast with adjcent lesion.
Calcium Carbonate ; Durapatite ; Humans ; Magnetic Resonance Imaging* ; Models, Theoretical ; Retrospective Studies

BACKGROUND: It is known that dyslipidemia plays and important role in atherogenesis and progression for the disease. Recently it was reported that apolipoprotein levels are important in athcrogenesis. In Korean patients the study of the apolipoprotein levels as for the risk factor for atherogenesis is still needed. Subjects and METHODS: The 107 patients who underwent coronary angiography to differentiate chest pain syndrome were subjected to this study. Thirty-two patients who had no significant coronary artery disease served as a control group and 75 patients who had one or more coronary stenoses more than 50% narrowing by luminal diameter served as the coronary artery disease(CAD) group. Plasma levels of total cholesterol, triglycerides, high density lipoprotein cholestero(HDL-C), apolipoprotein A-1(Apo- A1) and apolipoprotein B(Apo B) were measured from venous blood after overnight fastion, and the results were compared between the groups. RESULTS: The male gender and smoking habits were more prevalent in the CAD group. Total cholesterol levels were significantly higher in the CAD group but the HDL-C level was not significantly different in two groups though the mean level of the HDL-C was some lower in the CAD group. The Apo A-1 level was lowere in the CAD group while the Apo B level was higher in teh CAD group compared to those of the control, Apo B / Apo A-1 ratio much more distinctly discriminated the two groups. CONCLUSION: Theses results suggest that the plasma Apo-A-1, Apo B levels and the ratio of Apo B / Apo A-1 can be used for risk statification of CAD.
Apolipoprotein A-I* ; Apolipoproteins B ; Apolipoproteins* ; Atherosclerosis ; Chest Pain ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Dyslipidemias ; Humans ; Lipoproteins ; Male ; Phenobarbital ; Plasma* ; Risk Factors ; Smoke ; Smoking ; Triglycerides

PURPOSE: Small caliber catheter drainage is proposed and attempted as a alternative modality due to the invasiveness of a closed thoracostomy. The purpose of this study is to examine the effectiveness of a small caliber catheter (7.0 Fr), which is less invasive and relatively easy to use compared to a closed thoracostomy in the treatment of a spontaneous pneumothorax. METHODS: This study included 90 spontaneous pneumothorax patients who visited the Emergency Department of Kyungpook National University Hospital and who were treated with a small caliber catheter from January to December 2003. We investigated the success rate, the existence of underlying pulmonary disease, the total number of incidences at the time of visit, the size of the pneumothorax, the number of days to re-expansion, the days of hospitalization, and the rates of recurrence by reviewing the medical records retrospectively. RESULTS: The mean age was 30.4+/-15.6 years old, and there were 79(87.8%) males and 11(12.2%) females with an average hospitalization of 3.25+/-3.16 days. The treatment succeeded in 61 patients (67.8%) and failed in the remaining 29. A conventional large caliber chest tube was inserted in 16 of the 29 failures, but it was successful in only 5. The success rate was 76.7%(23/30), 78.6%(33/42), and 27.8%(5/18) when the size of the pneumothorax was 20~39%, 40~79%, and greater than 80% of the volume of the pleural cavity, respectively (p=0.000). The other factors did not influence the outcome. CONCLUSION: Small caliber catheter drainage can be considered as the initial treatment of choice for a spontaneous pneumothorax, especially for a pneumothorax with a size smaller than 80% of the volume of the pleural cavity.
Catheterization ; Catheters* ; Chest Tubes ; Drainage* ; Emergency Service, Hospital ; Female ; Gyeongsangbuk-do ; Hospitalization ; Humans ; Incidence ; Lung Diseases ; Male ; Medical Records ; Pleural Cavity ; Pneumothorax* ; Recurrence ; Retrospective Studies ; Thoracostomy

PURPOSE: Chronic pelvic pain syndrome (CPPS) is treated by use of various protocols. We compared tamsulosin monotherapy with tamsulosin in combination with antibiotics or anti-inflammatory agents and evaluated the efficacy of these treatments in patients with CPPS. METHODS: Patients (n=107) who were younger than 55 years and diagnosed with CPPS were randomly assigned to treatment with tamsulosin at 0.2 mg (group A), tamsulosin at 0.2 mg plus anti-inflammatory drugs (group B) or tamsulosin at 0.2 mg plus antibiotics (group C) daily. We applied the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS) to evaluate 100 patients who were treated for 12 weeks (7 withdrew). Scores of the three groups were compared by analysis of variance and we also evaluated subscores, which included pain, voiding and quality of life (QoL). RESULTS: All three groups showed statistically significant decreases in NIH-CPSI score, IPSS and subscore scores (P<0.05). There were no statistically significant differences between the groups except for the QoL domain of the IPSS (group A vs. C; P<0.01). CONCLUSIONS: Tamsulosin monotherapy for 12 weeks was effective for treating patients with CPPS, compared with combination therapy with antibiotics or anti-inflammatory drugs.
Academies and Institutes ; Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Humans ; Pelvic Pain ; Prostate ; Prostatitis ; Quality of Life ; Sulfonamides

PURPOSE: The genetic alteration of the janus kinases (JAKs), non-receptor tyrosine kinase, is related to the development of human cancers. However, little is known about how the sequence variation of JAK3 contributes to the development of lung cancer. This study investigated whether polymorphisms at the promoter region of the JAK3 gene are associated with the risk of lung cancer in the Korean population. MATERIALS AND METHODS: A total of 819 subjects, including 409 lung cancer patients and 410 healthy controls were recruited. The SNaPshot assay and polymerase chain reaction-restriction fragment length polymorphism analysis were used, and logistic regression analyses were performed to characterize the association between polymorphisms of JAK3 and lung cancer risk. RESULTS: Three polymorphisms (-672 G>A, +64 A>G and +227 G>A) of JAK3 were analyzed for large-scale genotyping (n=819). Statistical analyses revealed that polymorphisms and haplotypes in the JAK3 gene were not significantly associated with lung cancer. CONCLUSION: JAK3 gene was not significantly associated with the risk of lung cancer in the Korean population.
Haplotypes ; Humans ; Janus Kinase 3 ; Janus Kinases ; Korea ; Logistic Models ; Lung ; Lung Neoplasms ; Promoter Regions, Genetic ; Protein-Tyrosine Kinases

Lemierre syndrome is characterized by anaerobic bacterial infection in the head and neck and clinical or radiological evidence of internal jugular vein thrombophlebitis. The most common pathogens are Fusobacterium species, particularly Fusobacterium necrophorum. Septic emboli resulting from infected thrombophlebitis of the internal jugular vein leads to metastatic infections involving lung, liver, kidney, bone and central nervous system. The accurate diagnosis and treatment is important because it may be associated with a high mortality rate if untreated. We present a case of 28-year-old man with an atypical history for the diagnosis of Lemierre syndrome, which showed no definite evidence of internal jugular thrombophlebitis.
Adult ; Bacterial Infections ; Central Nervous System ; Diagnosis ; Empyema ; Fusobacterium ; Fusobacterium necrophorum ; Head ; Humans ; Jugular Veins ; Kidney ; Lemierre Syndrome* ; Liver ; Lung ; Mortality ; Neck ; Thrombophlebitis

PURPOSE: We undertook this study to evaluate the effects and the appropriateness of CPR training for elementary school children. METHODS: The Kangwon National University developed a "Human Body Explorer Program", where local fifth and sixth grade students would learn about the human body. The 72 students who participated in this program were used in this study. The subjects were evaluated by comparing CPR data collected from nurses working at Kangwon National University Hospital. The education sessions consisted of a 30 minute video tape and slides; then, under the supervision of their teacher, the subjects were asked to practice what they had seen. Ten criteria were used to evaluate the subject's CPR proficiency. The CPR skill sessions used Laerdal's HeartSim(R) 4000, and the data stored from the HeartSim(R) 4000 were collected for further analysis. A statistical analysis was done using the SPSS statistical software package. A pvalue< 0.05 was considered to statistically significant. RESULTS: A total of 72 subjects were evaluated. Their average age was 13.2+/-0.5 years. The subjects had very little experience with CPR education(0.17) prior to this study. The data gathered were compared to the evaluation table and yielded an average score of 20.53. The criteria used in the study had the following results: The assessing responsiveness(2.0/2.0), activating the EMS (calling for help) (1.99/2.0), checking for breathing(3.47/4.0), and compression to ventilation ratio of 15:2(1.6/2.0) showed to be at the 80 percentile. However the follow criteria showed a less than 80 percentile: opening the airway(1.54/2.0), mouth-to-mouth breathing(2.04/4.0), checking the carotid pulse(2.0/4.0), chest compression(1.88/4.0), chest compression velocity(1.02/4.0), and reassessment(1.44/2.0). The data from the manikin was extrapolated, and upon examination, we found the following: Correct ventilation was 25+/-31%, insufficient ventilation was 67+/-38% and excessive ventilation was 3+/-10%. Correct chest compression was 9+/-23% and insufficient compression was 91+/-23%, and excessive compression was absent. We compared these scores to the score from nurses of Kangwon University Hospital and found that elementary school children scored higher in all variables except in rate of chest compression. The scores were statistically significant (p<0.05) in total score, check for breathing, and reassessment. The skills evaluation showed that the adults scored higher than the elementary school children. All variables were significant (p<0.05). CONCLUSION: We found that elementary school children were superior to adult counterparts in understanding the CPR scheme. An expansion of CPR training to elementary school children is needed.
Adult ; Cardiopulmonary Resuscitation* ; Child* ; Education ; Gangwon-do ; Human Body ; Humans ; Manikins ; Organization and Administration ; Respiration ; Thorax ; Ventilation

Doxylamine is common over-the-counter sleep preparations & frequently involved in overdoses. The clinical course is dominated by the anticholinergic effects, including central nervous system & autonomic effects. We report 4 cases of suicide attempts in adults where ingestion of the doxylamines were complicated by rhabdomyolysis. They ingested doxylamines variable amount & were carried to emergency department. They complained gastrointestinal or central nervous system symptoms. Gastric lavages & administrations of activated charcoal were done. Creatine phosphok inase levels were normal or markedly elevated on arrival, but peaked several days later. Serum creatinine levels were normal. 99mTc-MDP bone scans were showed increased muscle labelling at the regions of muscle injury. They were treated with hydration, urine alkalinization, & supportive measures in hospital. On considering cause of rhabdomyolysis, our patients did not show any evidence of viral illness or coingestion of other potential myopathic toxins to support a secondary cause of rhabdomyolysis. The mechanism of rhabdomyolysis in cases of doxylamine overdose seems to be a direct toxic effect of the drug on striated muscle, but the exact mechanism is not clear. In all cases where such overdoses are suspected, consideration should be given to obtaining a urinalysis & a creatine phosphokinase level on arrival & creatine phosphokinase levels are carefully followed. Primary detoxication included gastric lavage & administration of activated charcoal. The patient's urine output & renal function should be closely monitored.
Adult ; Autonomic Agents ; Central Nervous System ; Charcoal ; Creatine ; Creatine Kinase ; Creatinine ; Doxylamine* ; Eating ; Emergency Service, Hospital ; Gastric Lavage ; Humans ; Muscle, Striated ; Rhabdomyolysis* ; Suicide ; Technetium Tc 99m Medronate ; Urinalysis

Recently, self-contained underwater breathing apparatus (SCUBA) diving's popularity has been increasing tremendously. Most diving injuries are related to the behavior of the gas and to pressure changes during descent and ascent. A scuba diver at depths greater than 7 m may accumulate a tissue partial presure of nitrogen large enough that, on ascent to the surface, nitrogen exist the tissues rapidly, forming bubbles in the blood and other organs, which is known as decompression sickness (DCS). Although both of these bubble disorders can, in theory, cause injury to skeletal muscles (rhabdomyolysis), the case are report here demonstrates the potential for massive muscle necrosis after scuba diving. We report a case of rhabdomyolysis presented with general weakness after scuba diving.
Acute Kidney Injury ; Decompression Sickness ; Diving* ; Muscle, Skeletal ; Necrosis ; Nitrogen ; Respiration ; Rhabdomyolysis*

PURPOSE: Dynamic changes in the dimensions of the left ventricle (LV) during cardiac arrest might influence the efficacy of CPR. However, the relationship between change in LV dimensions during cardiac arrest and CPR hemodynamics and outcomes have not yet been addressed. In the present study, we investigated changes in left ventricular volume and area during prolonged, untreated ventricular fibrillation (VF); we related those change to coronary perfusion pressure (CPP) during CPR and resuscitation outcomes. METHODS: In 12 domestic male pigs weighing 40+/-3 kg, VF was electrically induced and left untreated for 15 min. CPR was performed for 5 min prior to defibrillation. CPR was continued until the return of spontaneous circulation (ROSC) or for a maximum of 15 minutes. Mean aortic pressure and right atrial pressures were measured and CPP was calculated. LV dimensions were continuously assessed by echocardiographic measurement during the 15 minutes of interval VF. RESULTS: Six animals were successfully resuscitated. During the 15 minute interval of VF, LV area and volume were reduced in all animals. In animals that were not resuscitated, LV dimensions were significantly lower than those in resuscitated animals (p<0.01). These differences were observed after 10 minutes of VF. The animals with greater reduction in LV dimension during VF achieved significantly lower CPP during CPR in contrast to animals with larger LVs during VF. CONCLUSION: Greater decreases in LV volume and area during cardiac arrest are associated with low CPP during CPR and poor resuscitation outcomes. LV dimensions prior to starting CPR might therefore modulate the effectiveness of resuscitation interventions.
Animals ; Arterial Pressure ; Atrial Pressure ; Cardiopulmonary Resuscitation ; Heart Arrest ; Heart Ventricles ; Hemodynamics ; Humans ; Male ; Perfusion ; Piperazines ; Resuscitation ; Swine ; Ventricular Fibrillation