Temporomandibular (TM) joint pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT. The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above three background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.
Arthralgia ; Decompression ; Humans ; Joints ; Mandibular Condyle ; Mass Screening ; Maxillary Sinus ; Occipital Bone ; Radiography ; Temporomandibular Joint* ; Tomography, Emission-Computed, Single-Photon*

Purpose: The purpose of this study was to develop a substantive theory that can understand the process of illness experience in brain tumor patients and explain their experiences. Methods: Data were analyzed by Corbin & Strauss's grounded theory method. Results: As a result of this study, the core category of brain tumor patients was the reintegration process to adapt to the changed me. This reintegration process has experience of illness through the stages of shock, ambivalent recognizer, relief, re-anxiety and readaptation. During the process of this illness experience, causal conditions were the testimony of the body, the threat of death, the contextual condition were the vulnerability of the woman, the search for the alternative, and the central phenomenon appeared to be the ambivalence toward escape versus acceptance. The interventional conditions were hopes of discovery, common patient wishes. The positive aspects of action/interaction were bright vision of the illness, prevention of recurrence, facing the illness, and the negative aspect was mental sequela. As a result, the paradoxical gift growth of the disease and recovery of normalization were derived. Conclusion The disease experience of these brain tumor patients was found to be through the stages of shock stage, ambivalent stage, relief stage, re-anxiety stage, re-adaptation stage. This reintegrated into the changed body and reality, and the transition of life was made by the illness event of brain tumor.

A 24 hour ECG monitoring was performed before hospital discharge in 19 patients who survived the hospital phase of acute myocardial infarction and follow-up 6 hour daytime ambulatory ECG monitoring was performed in 11 out of 19 patients 6 months after discharge. In predischarge ambulatory ECG monitoring, VPBs were detected in 78.9% with 26% of complex VPB s(bigeminy, multiform, salvos and R on T) and these rates were some-what decreased in follow-up study(63.6% and 19%). The mean number of VPBs was decreased in follow-up study(18.6+/-7.6/hour) than that of predischarge ECG monitoring(27.9+/-1/hour), but the premature index was similar in both studies. In patients with complex VPBs, the mean number of VPBs(93+/-17.1/hour) was greater than that of low grade VPBs(6.5+/-1.8/hour)(P<0.01) and the EPSS measured by echocardiography was greater in patient with VPBs than inpatients without VPBs(P<0.05). Inspite of using antiarrhythmic drugs such as beta-blocker and calcium channel blocker, only half of the patients improved and one-third of patients were aggravated. Sudden cardiac death was datected in one patient at 13th month after discharge who had multiple-site infarction and ventricular tachycardia.
Anti-Arrhythmia Agents ; Calcium Channels ; Cardiac Complexes, Premature* ; Death, Sudden, Cardiac ; Echocardiography ; Electrocardiography* ; Follow-Up Studies ; Humans ; Infarction ; Inpatients ; Myocardial Infarction* ; Tachycardia, Ventricular

Tuberculous meningitis, which commonly causes thick granulations over the base of the brain, is a frequent cause of post-meningitic hydrocephalus. Raised intracranial tension affects the cause of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a V-A(V-P) shunt significally alters the course of the disease. The results in 5 cases have been detailed and discussed. Operation could be performed even in an active stage of the disease without much fear of milliary dissemination.
Brain ; Hydrocephalus* ; Intracranial Pressure ; Tuberculosis, Meningeal*

Congenital long QT syndrome (LQTS) is an inherited disease characterized by prolonged QT intervals and polymorphic ventricular tachycardia. The clinical manifestations vary from sudden cardiac death by ventricular arrhythmia to asymptom throughout life. In 1957, Jervell and Lange-Nielsen reported a syndrome of congen-ital sensory deafness associated with a prolonged QT interval in four children. The affected children had multiple syncopal episodes, and three died suddenly. The mode of inheritance is autosomal recessive. Affected persons are susceptible to recurrent syncope, and they have a high incidence of sudden death and short life expectancy. We report a case and review the literature on long QT syndrome diagnosed in a 30-year-old female with a history of convulsion and loss of consciousness during delivery.
Adult ; Arrhythmias, Cardiac ; Child ; Deafness* ; Death, Sudden ; Death, Sudden, Cardiac ; Female ; Humans ; Incidence ; Jervell-Lange Nielsen Syndrome ; Life Expectancy ; Long QT Syndrome* ; Seizures ; Syncope* ; Tachycardia, Ventricular ; Unconsciousness ; Wills

Many calcifications due to fat encrosis in the buttocks detected on the pelvis roentgenogram suggest that themajorityof injections intended to be intramuscular actually are delivered into fat. We measured thickness of adultgluteal fat to decide whether the injection using needle of usual length is done into fat or muscle. We measuredthe vertical thickeness of the subcutaneous fat at a point of 2-3cm above the femoral head cut slice with randomlycollected 116 cases of adults in the departement of Radiology, St.Mary's Hospital, Catholic Medical College. Wefound that 32% female cases might actually receive on intraadipose injection when a needle of maximum 3.8cm lengthis inserted into the buttock. If deposition into muscle is desirable, we need to choose needle whose length isappropriate for the site of injection and patient's deposits of fat.
Adult ; Buttocks ; Female ; Head ; Humans ; Needles ; Pelvis ; Subcutaneous Fat

PURPOSE: To describe the radiographic and MR characteristics of subacute diaphyseal osteomyelitis of the long bone. MATERIALS AND METHODS: We retrospectively analyzed plain radiographs and MR images in nine children and two young adults with surgically-proven diaphyseal osteomyelitis of the long bones. MR imaging was carried out before and after Gd-DPTA administration. Patients charts were reviewed for clinical and laboratory data and histologic correlation was available in all cases. RESULTS: All patients had a history of a minimum of 2 weeks' duration. All presented with an insidious onset of mild pain; they showed apyrexia and normal erythrocyte sedimentation rate. In all patients, plain radiographs showed single or multiple linear periosteal reaction with cortical irregularity. Medullary abnormality was not found except in one case which showed an abscess cavity. MR images revealed thickening or irregularity of the cortex, periosteal reaction, bone marrow signal alteration, and perilesional edema. CONCLUSION: Subacute diaphyseal osteomyelitis of the long bone is broadly based on the cortex, and elicits more sclerosis and periosteal reaction. Familarity with plain radiographs and MR features may be useful in the diagnosis of subacute diaphyseal osteomyelitis.
Abscess ; Blood Sedimentation ; Bone Marrow ; Child ; Diagnosis ; Edema ; Humans ; Magnetic Resonance Imaging* ; Osteomyelitis* ; Periostitis ; Retrospective Studies ; Sclerosis ; Young Adult

BACKGROUND: Radiofrequency catheter ablation therapy of idiopathic ventricular tachycardia in patients without obvious structural heart disease has been assessed in a few studies, but the clinical feasibility and efficacy are not certain. This study reports our results of catheter ablation with radiofrequency energy in thirteen patients. METHODS: Thirteen consecutive patients with idiopathic ventricular tachycardia underwent electrophysiologic study, pharmacological interventions and radiofrequency catheter ablation therapy. RESULTS: There were 7 men and 6 women with a mean age of 34+/-11years(13-55 years). The QRS configuration during tachycardia were left bundle branch block and inferior axis in 5 patients, right axis in 1 patient and right bundle branch block configuration with superior axis in 4 patients, right axis in 2 patients, left axis in 1 patients. Mean tachycardia cycle length was 361 +/-20 milliseconds. The focus of ventricular tachycardia were located in the right ventricular outflow tract(six patients) and the left ventricular inferior wall(four patients), posterobasal wall(one patients), anterolateral wall(one patients). Ventricular tachycardias were electrically induced in 9/13 patients. Mapping and radiofrequent catheter ablation was done with standard technique and ventricular tachycardia or VPCs were successfully eliminated in nine patients(69.2%). One patients complicated with transient pleural effusion. During mean follow-up period of 12+/-3months, one patients had a recurrence of symptomatic ventricular tachycardia. CONCLUSION: Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease is effective and safe and may be considered as primary choice of therapy in the patients.
Axis, Cervical Vertebra ; Bundle-Branch Block ; Catheter Ablation* ; Female ; Follow-Up Studies ; Heart Diseases* ; Heart* ; Humans ; Male ; Pleural Effusion ; Recurrence ; Tachycardia ; Tachycardia, Ventricular*

BACKGROUND: The goal of antihypertensive therapy will be to extended the life expectancy of hypertensive patients to that of subjects without high blood pressure. Hypertension treatment in the 1990s will focus on the mechanisms by which blood pressure is lowered by various antihypertensive agents, as will as individualization of drug therapy. In recognition of their lack of adverse lipid effects and their tolerability, first line therapy with alpha blocker, angiotensin converting enzyme inhibitors and calcium antagonists will become increasingly commom. We studied a new dihydropyridine calcium antagonist barnidipine to evaluate the efficacy and safety in patients with essential hypertension. METHODS: The rabit aortic rings were cut and mounted on the force transducer to record an isometric tension on polygraph. To elucidate the mechanism of saponin effect on vascular smooth muscle, the contractility of the vascular smooth muscle were measured under vatying experimental condition. RESULTS: 1) The baseline sitting systolic and diastolic blood pressure after 4 weeks washout period were 154.+/-15.9mmHg and 1.0+/-8.2mmHg. At the end of 8 weeks of therapy sitting systolic and diastolic blood pressure were 126+/-9.5mmHg and 84.5+/-4.6mmHg which declined statistically significant(p<0.05). 2) The pulse rates did not change significantly during treatment period(70.0+/-6.6 beats / min at baseline, 70.9+/-7.2 beats / min at 2 weeks, 71.2+/-5.0 beats / min at 4 weeks, 72.8+/-8.5 beats / min at 6 weeks, and 71.9+/-6.8 beats / min). 3) The adverse reactions due to branidipine were reported in 2 patients(6.5%) with headache, 2 patients(6.5%) with facial flushing, 1 patient(3.4%) with dizziness and 1 patients(3.4%) with nausea and vomiting). 4) The abnormal laboratory findings due to barnidipine were reported in 1 patient with increased total bilirubin and GPT, 1 patient with increased transaminase and 1 patient with CK but another findings were normal. CONCLUSION: These results indicate that barnidipine is effective and safe antihypertensive agent in the treatment of essential hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Antihypertensive Agents ; Bilirubin ; Blood Pressure ; Calcium ; Dizziness ; Drug Therapy ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Life Expectancy ; Muscle, Smooth, Vascular ; Nausea ; Saponins ; Transducers

BACKGROUND: Calcium antagonists are highly effective agents for lowering high blood pressure and play a very important role in the treatment of Patient with ischemic heart disease and various other cardiovascular disorder. Manidipine, a dihydropyridine-type ccalcium channel blocker, is a potent relaxant of the arteriolar smooth muscle. We studied ths new calcium channel blocker to evaluated the efficacy and safety in patients with essectial hypertension. METHODS: Twenty patients(ten women and ten men;range of age, 30-66 years old)with mild-to-moderate essential hypertension were enrolled in this study. After a placebo run-in phase of two weeks duration, 5mg-20mg manidipine once daily orally was administered for eight weeks. RESULTS: 1) At the end of 8 weeks of manidipine therapy, systolic and diastolic blood pressure were significantly reduced from 160.1+/-11.8/105.5+/-5.1mmHG in sitting, 160.1+/-12.1/104.5+/-5.4mmHG in supine, 157.1+/-17.0/104.1+/-5.3mmHg in standing to 128.4+/-10.1/85.2+/-5.7mmHg in sitting, 129.1+/-10.2/84.2+/-5.9mmHg in supine, 128.1+/-12.8/86.7+/-5.9mmHg in standing(p<0.01). 2) The pulse rate did dnot change significantly. 3) The reduction of mean systolic and diastolic blood pressur at the end of 8 weeks were 31.5+/-14.5/20.3+/-7.4mmHg in sitting. 4) There was no serious side effect except mild symptom, mild headache(6 casem 30%) and facial flushing(1 case, 5%). CONCLUSION: These results indicate that manidipine is an effective and safe antihypertensive agent in the treatment of mild and moderate essential hypertension.
Blood Pressure ; Calcium ; Calcium Channels ; Female ; Heart Rate ; Humans ; Hypertension* ; Muscle, Smooth ; Myocardial Ischemia