PURPOSE: Radionuclide cisternography may be helpful in understanding pathophysiology of postural headache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. MATERIALS AND METHODS: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 1/2 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. RESULTS: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30 min (6/10) and 2 hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30 min. Epidural blood patch was done in 11 patients and headache was improved in all cases. CONCLUSION: The characterstic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.
Absorption ; Blood Patch, Epidural ; Diagnosis ; Headache ; Humans ; Intracranial Hypotension* ; Pentetic Acid ; Radioactivity ; Spinal Puncture ; Subarachnoid Space ; Urinary Bladder

Conservative treatment alone may not give satisfactory results for medial collateral ligament injuries, so surgical treatment may be needed.In this case, the distal end of the medial collateral ligament was treated surgically because the distal end of the medial collateral ligament was caught between the sartorial fascia rupture. Through physical examination and magnetic resonance imaging, avulsion damage at the distal attachment part of the medial collateral ligament was confirmed, and the method of anchoring the distal end of the ligament to the crural fascia helped the ligament to heal with minimal tissue damage. Subsequently, satisfactory results are obtained and reported.

Thymoma occurs in about 20% of patients with myasthenia gravis (MG), but the recurrence of thymoma has rarely been reported. A 68-year-old man presented with ptosis and weakness of the neck muscles. He had undergone thymectomy for ocular MG with invasive thymoma 20 years previously. Chest computed tomography revealed recurrence of the thymoma. This 20-year period is, to our knowledge, the longest reported interval for recurrence of an MG-associated thymoma. The literature on the optimal follow-up duration after thymectomy is reviewed.
Aged ; Follow-Up Studies* ; Humans ; Myasthenia Gravis* ; Neck Muscles ; Recurrence* ; Thorax ; Thymectomy* ; Thymoma*

Although lipomas are among the most common benign tumors, their occurrences in the oral cavity has been reported infrequently, accounting for only 2.2% to 4.4% of all benign tumors in this site. Especially, lipomas of the tongue are rare tumors that are represented by less than 0.5% of all benign tumors in the oral cavity. There are two types of solitary lipomas, the cutaneous (superficial) type and the deep-seated (subfascial) type. The deep and soft tissue-infiltrating lipomas are classified into between-muscle groups (intermuscular lipoma) or within-muscle groups (intramuscular lipoma). Intramuscular lipoma is composed of mature adipose tissues that infiltrate into muscles in a diffuse manner, and the entrapped muscle fibers exhibited varying degrees of atrophic change. We experienced a case of bilateral multiple intramuscular lipomas of the tongue which was cured by surgery.
Lipoma* ; Mouth ; Muscles ; Tongue*

BACKGROUND AND OBJECTIVES: Although there are many different reasons for rhinoplasty, there has not been any been systematic research conducted about different motivations patients have. The motivation for the surgery, the preferred shape of nose, the concerns about surgery, the terms needed to make the decision were different and greatly depended on the circumstances. MATERIALS AND METHODS: Two hundred and seventeen persons who have been operated in the Inha Hospital from 1996 to 2000 have been consulted. The survey paper is constituted by fifty-one multiple-choice questions. RESULTS: For the question asking the main reason for wanting rhinoplasty, the majority answered it was to restore their injured nose. The next popular answer was the desire to have a better-shaped nose. For male patients, their deviated nose was caused by injury or accident, and thus desired to have the normal or the original shape of nose by operation. The survey revealed a different result for the opposite sex. The main reason for female patients' wanting rhinoplasty was to have a good-looking nose, and for that purpose they expressed their desire to heighten their nose. Interestingly, the concern about the side effects after the surgery was the greatest reason for avoiding rhinoplasty. CONCLUSION: Every surgery should be well-prepared with the exact analysis of the patient's nasal history and his special request.
Esthetics ; Female ; Humans ; Male ; Motivation ; Nasal Surgical Procedures* ; Nose ; Psychoanalysis* ; Rhinoplasty

BACKGROUND: Near-infrared light (NIR, 0.8-1.5 micrometer light) has been used in therapeutic devices for various injuries such as infected, ischemic and hypoxic wound. NIR-emitting technology has been developed recently in Korea. We hypothesized that NIR may have an anti-inflammatory effect and investigated the effect of NIR-irradiated media on cell culture. METHODS: Three kinds of cell lines, CAPE (vascular endothelial cell), NIH3T3 (fibroblast), and RD (smooth muscle cell) cells were cultured for 4 days in 10% FBS-containing media (1x10(4) cells/well), which were irradiated or not irradiated (control) by Eco-NFIR Drive (Model #0210, Ecowavetech, Korea). The cells were stimulated by 10 mcg/mL of bacterial lipopolysaccharide (LPS) or sodium nitroprusside (SNP). Cellular proliferation was measured by methylthiazol tetrazolium assay. Expression of interleukin (IL)-1 beta and nitric oxide was measured by ELISA. Expression of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) was measured by immunofluorescence staining. RESULTS: NIR-irradiated medium was favorable for CAPE cell proliferation (N=8, P=0.000). IL-1 beta secretion from LPS-stimulated NIH3T3 cells incubated in the NIR medium was below that of control medium (N=4, P=0.026). Nitrate production seemed to be low in NIR-irradiated medium although statistically insignificant (N=4, P=0.076). Expression of iNOS of the LPS-stimulated cells was decreased in NIR medium, however, Cox-2 expression was not different between the two media. CONCLUSIONS: NIR-irradiated medium supported vascular endothelial cell proliferation and showed an anti-inflammatory effect on fibroblast culture. These results can be used as basic data for future research on the clinical application of NIR.
Animals ; Anti-Inflammatory Agents/*chemistry ; Cattle ; Cell Line ; *Culture Media ; Cyclooxygenase 2/metabolism ; Humans ; *Infrared Rays ; Interleukin-1beta/metabolism ; Lipopolysaccharides/pharmacology ; Mice ; Nitric Oxide/metabolism ; Nitric Oxide Synthase Type II/metabolism

PURPOSE: The purpose of this research was to analyze drinking on the day of injury, usual drinking pattern, factors associated with the injury and socioeconomic factors for patients who visited the emergency room (ER) for injuries. METHODS: From among all the trauma patients who visited ER, this research included 474 patients who were over 18 years of age and who visited the ER within 48 hours of their injury. Questionnaire surveys, telephone surveys, and serologic tests were conducted for all the patients. RESULTS: The drinking rate before injury was 51.9% among the 337 drinkers. The rate of drinkers was 72.2% (male 85%, female 42.6%), and the rate of habitual drinkers was 22.4% among the 466 subjects. The rates of habitual drinkers and nonhabitual drinkers were 31.5% and 68.5%, retrospectively, among the 337 drinkers. Such groups as assaulted patients, patients operated on under local anesthesia, patients injured indoor or outdoor except on roads, patients diagnosed as laceration, and patients injured between midnight and 8 a.m., and between 4p.m. and midnight had significantly higher incidents of drinking on the day of the injury (p=0.00~0.02). Such groups as males, older people, married people, people with low levels of education, people with high incomes and assaulted patients had significantly higher numbers of habitual drinkers (p= 0.00 ~ 0.04 ). CONCLUSION: This study suggests that alcohol use is an important factor for patients who visit the ER for injuries and alcohol drinking. But it can not be concluded that there is a causal relation between alcohol use and injury. Such groups who visit the ER for injuries as males, older people, married people, people with low levels of education, people with high incomes and assaulted patients need to be screened for alcohol misuse.
Alcohol Drinking ; Anesthesia, Local ; Drinking* ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Lacerations ; Male ; Surveys and Questionnaires ; Retrospective Studies ; Serologic Tests ; Socioeconomic Factors ; Telephone

No abstract available.
Encephalitis, Herpes Simplex ; Herpes Simplex ; Methylmethacrylates ; Neurosyphilis ; Polystyrenes

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in both nosocomial and community settings, and screening for a carrier is an important infection control practice in many hospitals. We evaluated the sensitivity and specificity of the ChromID MRSA assay (bioM?rieux, Marcy I'Etoile, France). METHODS: A total of 190 clinical samples were collected from the anterior nares of premature infants in a newborn intensive care unit (N-ICU). Equal volumes (100microliter) of the samples were inoculated on mannitol salt agar with oxacillin 6 mg/L (MSAO) and ChromID MRSA after emulsifying the screening swab in brain-heart Infusion broth with oxacillin 6 mg/L (BE). The specimens in BE were subcultured on ChromID MRSA after an overnight incubation. RESULTS: Twenty-one of 190 samples (11%) was positive for MRSA by BE. After a 24 h incubation, the sensitivity/specificity of MSAO was 52%/98% and that of ChromID MRSA was 62%/100%, and at 48 h, the sensitivity/specificity of MSAO was 62%/92% and that of ChromID MRSA was 81%/99%. CONCLUSION: ChromID MRSA is a useful selective medium for the rapid isolation and identification of MRSA.
Agar ; Humans ; Infant, Newborn ; Infant, Premature ; Infection Control ; Intensive Care Units ; Mannitol ; Mass Screening ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxacillin ; Sensitivity and Specificity

This report was designed to investigate a rare case that brachialis tear and hematoma caused by acute elbow posterior dislocation. We studied a 20-year-old male patient with right elbow joint pain after outstretched injury. Physical examination showed instability of hright elbow joint and simple radiography indicated a posterolateral dislocation of right elbow joint. Computed tomography taken after closed reduction using Parvin technique revealed a few small bone fragment located on posterior humerus capitulum. Magnetic resonance imaging showed complete tear of brachialis and anterior articular capsule with hematoma. The patient was managed with long arm splint and hinge brace for an elbow dislocation with brachialis rupture and hematoma. The elbow joint range of motion was recovered to be in a normal range, and pain was diminished. There are few reported cases of acute elbow posterior dislocation combined with brachialis rupture and hematoma. The patient showed good clinical outcome after conservative treatment.
Arm ; Braces ; Dislocations* ; Elbow Joint ; Elbow* ; Hematoma* ; Humans ; Humerus ; Joint Capsule ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Radiography ; Range of Motion, Articular ; Reference Values ; Rupture ; Splints ; Young Adult