Objective: The purpose of the present study was to screen the prevalence of aneurysms in migraineurs; to differentiate presenting features in migraineurs with and without aneurysm; and also to correlate the locations of aneurysm to the clinical features of migraine. Methods: A total of 4,416 subjects were interviewed and completed self-reported questionnaires on headache. Of these, 1,773 subjects diagnosed to have migraines based on the International Classification of Headache Disorders II (ICHD-II) criteria were screened for aneurysm by magnetic resonance angiography (MRA). When aneurysm was suspected, further investigation with trans femoral cerebral angiography (TFCA) or three dimensional computerized tomography (CT) angiography was performed. Based upon MRA findings, subjects were grouped into unruptured aneurysm migraine patients (UAMP) and no aneurysm migraine patients (NAMP). Results: The prevalence of aneurysm was 3.6% (63 of 1,773) with the mean age of 56.0 years, which were not different from those of general population. There was no difference in migraine subtypes between UAMP and NAMP. Aggravation of headache by estrogen replacement therapy during menopause (p=.039), history of migraine in young age (p= .021), diplopia (p=.026), and retroauricular pain (p=.025) were significantly associated with presence of aneurysm. Although aneurysms were detected more in anterior circulation, there was no correlation between aneurysm site and headache location. The average size of aneurysm was 3.5 ± 2.1 mm and none were ruptured. Interventional therapy of aneurysm did not alter the feature of migraine. Conclusions: The incidence of aneurysm was not different in migraine patients as compared to the general population. Some features which significantly differentiate whether migrainuers have aneurysm or not warrant further study to have a predictive and localizing value.

Post-traumatic tricuspid insufficiency is a rare condition and may be clinically silent and imprecise. The diagnosis may be difficult when it progreses slowly and other acute lesions exist concomittantly. Two-dimenstional Doppler echocardiography appears to be an essential procedure in diagnosting the rupture of chordae tendineae or papillary muscle following traumatic injury. We report a case of tricuspid insufficiency of which symptom developed 8 years later following a blunt chest trauma. The patient was operated by tricuspid vlave repair with chordal replacement and ring annuloplasty successfully. We would like to emphasize that patients sustaining major thoracic trauma should be carefully examine for possible blunt chest trauma including cardiac valve rupture or tear.
Chordae Tendineae ; Diagnosis ; Echocardiography, Doppler ; Heart Valves ; Humans ; Papillary Muscles ; Rupture ; Thorax*

A case of recurrent fibrosarcoma arising from the distal portion of the left spermatic cord in a twenty-two-year-old male is presented, and is discussed on its incidence, differential diagnosis, treatment and prognosis with brief literature review.
Diagnosis, Differential ; Fibrosarcoma* ; Humans ; Incidence ; Male ; Prognosis ; Spermatic Cord*

An autopsy case of spontaneous rupture of urinary bladder followed by longstanding chronic and acute hemorrhagic cystitis associated with anomalous course of the right ureter and pyo-hydronephrosis, and acutely disseminated tuberculous pneumonia in a twenty-two-year-old Korean Army soldier is presented. Pathogenesis of spontaneous rupture of urinary bladder is briefly discussed.
Autopsy ; Cystitis* ; Humans ; Military Personnel ; Pneumonia ; Rupture, Spontaneous* ; Ureter* ; Urinary Bladder*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

No abstract available.
Humans ; Male*

Congenital diverticulum of the left ventricle is a very rare disease. Ventricular diverticulum is usually associated with other anomalies including intracardiac and midline thoracoabdominal defect. We describe a case with congenital left ventricular diverticulum presenting as an isolated lesion. A 37-year-old man presented with 4-year history of chest pain. Diverticulum was diagnosed by echocardiography and left ventriculogram.
Adult* ; Chest Pain ; Diverticulum* ; Echocardiography ; Heart Ventricles ; Humans ; Rare Diseases

Fractures, Comminuted ; Humans ; Immobilization ; Incidence ; Mandibular Fractures ; Wounds and Injuries

BACKGROUND: Propofol has a high incidence of pain with intravenous injection, and different methods have been used to minimize the incidence and severity of this pain. In this study, we have compared the effect of lidocaine pretreatment with that of metoclopramide pretreatment on propofol injection pain. METHODS: Ninety healthy female patients scheduled for general anesthesia were randomly divided into three groups; saline group (n = 30), lidocaine group (n = 30) and metoclopramide groups (n = 30). Each patient received 2 ml of pretreatment solution (normal saline, 1% lidocaine, 0.5% metoclopramide) via 18 G angiocatheter inserted in the antecabital fossa after applying an arm tourniquet inflated to 50 mmHg. The tourniquet was released 1 minute later, followed by intravenous injection of 2.5 mg/kg of propofol. The assesement of pain was made at the induction of anesthesia and in the recovery room and the severity of pain was classified as none, mild, moderate, severe by one observer. RESULTS: The severity and incidence of pain diminished significantly in the lidocaine group and the metoclopramide group compared with the saline group at the induction of anesthesia (P < 0.05) and there was no significant difference between the lidocaine group and metoclopramide group. We had similar results in the recovery room and one patient from the saline group and the metoclopramide group had no recall regarding injection pain. CONCLUSIONS: Intravenous metoclopramide pretreatment is as effective as intravenous lidocaine pretreatment in alleviating the propofol injection pain.
Anesthesia ; Anesthesia, General ; Anesthetics ; Arm ; Equidae ; Female ; Humans ; Incidence ; Injections, Intravenous ; Lidocaine* ; Metoclopramide* ; Propofol* ; Recovery Room ; Tourniquets

PURPOSE: This study using the finite element analysis (FEA) focused on evaluating the biomechanical stability of the LC-DCP in accordance with existing of the fracture gap at the facture site after bone fracture augmentation. MATERIALS AND METHODS: For FEM analysis, total eleven types with different fracture models considering clinical fracture cases were constructed according to the fracture gap sizes (0, 1, 4 mm)/widths (0, 25, 50, 75, 100%). Limited contact dynamic compression plate (LC-DCP) fixation system was used in this FEM analysis, and three types of load were applied to the bone-plate fixation system: compressive, torsional, bending load. RESULTS: The results in FEM analysis showed that the 1, 4 mm fracture gap sizes and 75% or more fracture gap widths increased considerably the peak von Mises stress (PVMS) both the plate and the screw under all loading conditions. PVMS were concentrated on the center of the LC-DCP bone-plate, and around the necks of screws. CONCLUSION: Based on the our findings, we recommend at least 50% contact of the fracture faces in a fracture surgery using the compression bone-plate system. Moreover, if x-ray observation after surgery finds 100% fracture gap or 50% or more fracture gap width, supplementary measures to improve biomechanical stability must be taken, such as restriction of walking of the patient or plastering.
Finite Element Analysis ; Fractures, Bone ; Humans ; Neck ; Walking