A retrospective comparative study of MRI and CT in 24 patients with diffuse axonal injury (DIA) was undertaken. Three-quaters of the lesions were non-hemorrhagic, and the sites of involvement were lobar white matter (96%), corpus callosum (70%), and rostral brainstem (42%), in descending order. MRI was singnificantly more sensitive than CT in detecting DAI lesions. The average number of DAI lesions was higher with increasing clinical stage of the injury. MRI is more valuable than CT for staging the full magnitude of the injury and in predicting the neurologic prognosis of DAI lesions.
Axons* ; Brain Stem ; Brain* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging* ; Prognosis ; Retrospective Studies ; White Matter

Celiac plexus block with neurolytic agents is widely recommended for the management of intraabdominal pain due to malignant disease as a simple, asafe and effective method. We performed neurolytic celia: plexus block with 60% ethanol in lidocaine in 8 patients: with gastric cancer(4), hepatoma(2), pancreatic cancer(1), and chronic pancreatitis(1). Good to excellent pain relief was obtained in the 2 hepatoma cases, 1 pancreatic cancer, and a gastric cancer patient. In one patient with gastirc cancer, analgesia lasted for about 3 months but the second block was entirely unsatisfactory. The result was uncertain in one patient with chronic pancreatitis because the pain was non-specific and responded even to saline solution(placebo). In the remaing 2 patients, the result was entirely negative and eventually, epidural morphine was given periodically through an indwelling catheter.
Analgesia ; Carcinoma, Hepatocellular ; Catheters, Indwelling ; Celiac Plexus* ; Ethanol ; Humans ; Lidocaine ; Morphine ; Pancreatic Neoplasms ; Pancreatitis, Chronic ; Stomach Neoplasms

PURPOSE: To measure the size of normal corpus callosum in each portion using objective and reproducible method with MRI and evaluation of morphological change of corpus callosum by grade of hydrocephalus. MATERIALS AND METHODS: Midsagittal Tl-weighted MR imaging of the corpus callosum was investigated in 41 volunteers of normal Korean adults and 19 patients with hydrocephalus. Corpus callosum was measured for the anteroposterior length(A), height(B), and the thickness of genu(C), body (D), splenium(E), and the narrowest portion of body(F). And the analysis of morphology and signal intensity of the corpus callosum were also evaluated. Hydrocephalus was graded as mild, moderate, and severe, and comparision of thickness with normal corpus callosum in each portion was done. RESULTS: The mean length and height were 72.3mm, 28.6mm in male, and 70.7ram, 28.9mm in female. And the mean dimention for C, D, E, and F were 13.1 ram, 8ram, 13.2mm, 5.2ram in male, and 12.8mm, 7.5ram, 12.3 ram, 5mm in female. The morphology of normal corpus callosum was "hook" shaped on midline sagittal Tl-weighted image. Narrowing at posterior third portion of body were present on 30 cases(73.2%) and even in thickness of the body in 11 cases(26.8%). The signal intensity of the corpus callosum on midsagittal Tl-weighted spin echo image of normal cases was homogeneous hyperintense as compared with cerebral gray matter. In hydrocephalus, A and B were increased and other portions were decreased in thickhess. Genu and the narrowest portion of body showed significant difference of thickness according to the grade of hydrocephalus. CONCLUSION: The mean dimention of all portion of corpus callosum were larger in male than female except for callosal height but not significant statistically with the exception of splenium. Hydrocephalus lead to morphological change of the corpus callosum. Among the portion of corpus callosum, genu and the narrowest portion of the body were thought to be the most sensitive indicators of degree in hydrocephalus.
Adult* ; Corpus Callosum* ; Female ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging* ; Male ; Volunteers

Twenty-two children(4 months to 17 years old)with a clincial diagnosis of complex partial seizure(CPS) were examined with a 0.5T MRI scanner using spin-echo sequences. Eleven patients showed abnormal brain MRI findings; two had focal lesions with corresponding seizure foci on the EEG, one arising from temporal lobe(Hippocampal Formation atrophy) and the other from the frontal lobe. Nine patients showed diffuse lesions with inconsistent seizure foci on EEG. The remaining 11 patients were normal on bran MRI; two of them had normal EEG findings and the others either focal or diffuse abnormalities on EEG.
Brain* ; Child* ; Diagnosis ; Electroencephalography ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Seizures*

PURPOSE: To classify the cavernous sinus lesions, to describe their radiological findings, and to assess the usefulness of MR compared to CT. METHODS AND MATERIALS: Fourty-five patients with lesions involving the cavernous sinus proved by histological and/or clinical and imaging methods were studied retrospectively and classified into neoplastic, vascular, and inflammatory lesions. CT and MR findings were compared in 21 patients evaluated by both modalities simultaneously according to these 4 categories. RESULTS: Pitiutary macroadenoma was the most common cavernous sinus lesion(42%). Diffuse convex bulging of the lateral wall of cavernous sinus was the most frequent radiological finding(84%), and the others were encasement of the cavernous carotid artery(49%), remodelling of the surrounding bones(44%), and complete obliteration of Meckel's cave(38%), in descending order of frequency. Bulging of the lateral wall of cavernous sinus was equally well demonstrated on both modalities, but encasement or displacement of the cavernous carotid artery and complete or partial obliteration of Meckel's cave were much better delineated on MR than on CT with the ratio of 3.8:1 and 4.6: 1, respectively. Only bone changes were much better demonstrated on CTthan on MR with the ratio of 3.8: 1. CONCLUSION: MR issuperior to CTin demonstrating thecavernouscarotid artery encasement and obliteration of Meckel's cave, but CT is much better than MR in demonstrating bone changes.
Arteries ; Carotid Arteries ; Cavernous Sinus* ; Humans ; Retrospective Studies

No abstract available.
Curriculum* ; Forensic Medicine* ; Korea* ; Schools, Medical*

PURPOSE: To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. MATERIALS AND METHOD: A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. RESULTS: Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. CONCLUSION: MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage.
Brain ; Cerebral Palsy* ; Gestational Age ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

This case involved a pulmonary thromboembolism, which originated from the lower extremity. A 68-year-old female, with a femur neck fracture, underwent spinal anesthesia with 0.5% heavy bupivacaine 11 mg for total hip arthroplasty. Ten minutes after the induction of spinal anesthesia, dyspnea, tachycardia and hypotension appeared. Under the impression of a pulmonary embolism, intubation was done and dopamine and epinephrine were infused. The operation stopped and she was sent to the intensive care unit. On the spiral CT chest angiogram, a pulmonary embolism was found. Deep venous thrombosis was detected in the left lower extremity on the venogram. Heparin therapy was started at a rate of 800 U/hour with a bolus of 5000 U. A consultative operation for the removal of deep vein thrombosis was performed by a chest surgeon, and total hip arthroplasty was performed successfully under spinal anesthesia.
Aged ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Bupivacaine ; Dopamine ; Dyspnea ; Epinephrine ; Female ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Heparin ; Humans ; Hypotension ; Intensive Care Units ; Intubation ; Lower Extremity ; Pulmonary Embolism* ; Tachycardia ; Thorax ; Tomography, Spiral Computed ; Venous Thrombosis

As times go by, the objects and subjects of researches have changed. Forensic medicine and science can not be escaped. To overview the international changes and trend of forensic medicine and science, we gathered abstracts of 3,354 articles from 5 outstanding international journals, those are (1) Forensic Science International, (2) Journal of Forensic Science, (3) American Journal of Forensic Medicine and Pathology, (4) Medicine, Science and the Law, (5) International Journal of Legal Medicine. There were 1,226 articles (36.6%) on forensic pathology, followed by forensic genetics (902 articles, 26.9%), toxicology (549 articles, 16.4%), forensic sciences (445 articles, 13.3%) and medical law & criminal psychology (232 articles, 6.9%). Corresponding authors from 4 countries (USA, Great Britain, Germany and Japan) took more than half of total corresponding authors. And there were 27 articles (0.8%) from Korea. This article will introduce us an overview of international trend of forensic researches.
Criminal Psychology ; Forensic Genetics ; Forensic Medicine ; Forensic Pathology ; Forensic Sciences ; Germany ; Great Britain ; Jurisprudence ; Korea ; Pathology ; Toxicology ; United Nations

PURPOSE: The traditional management of a periappendiceal abscess or a perforated appendicitis has been initial conservative treatment, followed by an interval appendectomy (IA). However, the necessity of the interval appendectomy has been questioned by an increasing number of studies recently. The purpose of this study was to clarify the role of conservative treatment, instead of IA, in managing a perforated appendicitis or a periappendiceal abscess after successful initial conservative treatment. METHODS: We prospectively studied 26 out of 80 patients who had been admitted for a perforated appendicitis or a periappendiceal abscess to Chonbuk National University Hospital from March 2005 to December 2007. These 26 patients were initially treated by using conservative treatment instead of surgery. We analyzed these 26 patients' progression and prognosis after treatment. The IAs were conducted at intervals of 6 to 12 wk after colonoscopy when the patient wanted an operation. RESULTS: Twenty-three out of 26 (88.5%, 23/26) patients were improved after initial conservative treatment. Only 3 patients who were not improved were managed surgically. Four out of 23 patients who were relieved by conservative treatment underwent an IA voluntarily at intervals of 6 to 12 wk. Of the remaining 19 patients without IA, 1 patient (5%, 1/19) suffered a recurrence after 6 mo, and an appendectomy was performed. Eighteen (78%, 18/23) patients without an IA have shown no recurrence for 15 mo, and they are still being followed up. CONCLUSION: We conclude that a routine IA after successful initial conservative treatment for a perforated appendicitis or a periappendiceal abscess seems unnecessary. Those patients should undergo colonoscopy to detect any underlying diseases and to rule out coexistent colorectal cancer.
Abscess ; Appendectomy ; Appendicitis ; Colonoscopy ; Colorectal Neoplasms ; Humans ; Prognosis ; Prospective Studies ; Recurrence