No abstract available.
Frontal Bone* ; Humans

PURPOSE: To quantitatively evaluate by MRI brain atrophy and abnormal parenchymal signal intensity onT2-weighted spin echo image in alcoholics. MATERIALS AND METHODS: MRI of 24 alcoholic patients were retrospectively evaluated to measure brain atrophy (cerebral sulcal width, bifrontal horn distance, third ventricular width, fourth ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci) and abnormal high signal lesions of brain parenchyma onT2-weighted spin echo image, and were compared with age matched controls (n=29). The alcoholics and controls were divided into two age groups, younger (30 - 49 years) and older (50 - 72 years), and statistical analysis was then performed. Axial and sagittal T1- and T2-weighted spin echo images were obtained using a 0.5 Tesla superconductive system. RESULTS: Statistical significant parameters in the supratentorial region were cerebral sulcal width, distance between lateral ends of frontal horns of both lateral ventricles, and third ventricular width (p<0.05),and in the infratentorial region were fourth ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci (p<0.05). In the younger age group, statistical significant parameters were cerebral sulcal width, third ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci (p<0.05) and in the older group were cerebral sulcal width, bifrontal horn distance, third ventricular width, fourth ventricular width, number of cerebellar sulci, and number of vermian sulci (p<0.05). Abnormal high signal intensity onT2-weighted spin echo images were seen in 46% of alcoholics (11/24) and in 13% of controls (3/29). High signal lesions in the older group were statistically significant (p<0.05). CONCLUSION: Atrophic brain changes and periventricular high signal foci on T2-weighted spin echo image are significantly higher in chronic alcoholics than in age-matched normal controls.
Alcoholics* ; Alcoholism ; Animals ; Atrophy* ; Brain* ; Cerebellopontine Angle ; Horns ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging* ; Retrospective Studies

No abstract available.
Craniocerebral Trauma* ; Head* ; Hematoma*

Predicting factors of post-stroke depression were investigated. The subjects were 254 stroke patients who had been discharged and visited regularly the outpatient clinic for follow up care. The influencing factors were classified into five categories: demographic, disease-related, current state, social support, and illness intrusiveness. Sex, age, job, and educational level were defined as the demographic factor. The disease-related factors included stroke type, illness duration, attack frequency, and NIH score. ADL, cognitive function, and social activity were considered as the current state factors. The social support was measured as the perceived amount of social support. Illness intrusiveness means the perceived illness induced life style disruptions. Demographic, disease-related, current state, and social support were hypothesized to directly and indirectly affect post-stroke depression through illness intrusiveness. The illness intrusiveness was hypothesized to directly affect post-stroke depression. The hierarchial multiple regression was used to identify significant factors. The result showed that this model explained 43.3% of variance of post-stroke depression. And the prevalence of post-stroke depression was 38.8%. Among the demographic factors, job was identified as a main contributor to indirectly increase the post-stroke depression. Among the disease-related factors, stroke type, attack frequency, and NIH score were found to indirectly affect the post-stroke depression. Among the current state factors, ADL and social activity indirectly affected the post-stroke depression through illness intrusiveness. Social support and illness intrusiveness were identified to directly affect the post-stroke depression. This study has proved the factors likely to be implicated in the development of post-stroke depression. Based upon these results, it is recommended that the nurses who take care of post-stroke patients consider the risk factors such as social support, illness intrusiveness et al. Also programs which decrease the illness intrusiveness and increase the social support to reduce post-stoke depression recommended to be developed.
Activities of Daily Living ; Ambulatory Care Facilities ; Demography ; Depression* ; Follow-Up Studies ; Humans ; Life Style ; Prevalence ; Risk Factors ; Stroke

In this paper, we examined the depression of stroke patient's caregivers and analyzed influencing factors of the depression. The subjects were 215 caregivers who have takencare of stroke survivors in their home. The conceptual model of this study consisted of the caregiver's depression, perceived burden, illness intrusiveness, and patient's ADL. Modified Korean CES-D, modified subjective and objective Burden Scale, Illness intrusiveness(II), and Instrumental Activity of Daily Living(IADL) were used to measure concepts. Path analysis was used to test the model of this study. The results were as follows: 1. The mean depression score was 11.6 which was below the cut-off score of the CES-D. This score indicates that the subjects were higher than normal adults' mean score but not depressive. Eighty-six out of 215 caregivers(40%) were above the cut-off score. This finding was different from previous research results, and the reason might be the patients' capability of ADL. In a group of low capability patient's activities of daily living, caregiver's depression score was 15.5. 2. Caregiver's depression was positively related to caregiver's burden and illness intrusiveness, but negatively related to patient's activities of daily living. 3. The caregiver's perceived burden and illness intrusiveness directly influenced on their depression. Furthermore, the and caregiver's illness intrusiveness led to depression indirectly through their burden. A patient's activities of daily living didn't influence directly on depression but indirectly through caregiver's illness intrusiveness and burden.
Activities of Daily Living ; Caregivers* ; Depression* ; Humans ; Stroke* ; Survivors

BACKGROUND: This study was conducted to investigate whether the preoperative nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) was a risk factor for surgical site infections and nosocomial infections in open heart surgery patients. METHODS: From June 10, 2002 to October 30, 2002, data were collected by prospective surveillance carried out by infection control nurses. Nasal swabs were taken from patients (N= 106) on the day before surgery. The swabs were incubated in staphylococcal broth for 24 hours, and then it was incubated on mannitol salt agar for 24 hours. Muller-Hinton agar supplemented with oxacillin (6 microgram/mL) was used to identify MRSA. RESULTS: Among the study patients (N=106), four(4/106, 3.8%) were identified as MRSA carriers and nine (9/103 , 8.7%) developed nosocomial infections, including three patients (3/103 , 2.9%) who had postoperative mediastinitis Preoperative nasal carriage of MRSA was not associated with nosocomial infections nor surgical site infections (P>0.05). However, the length of hospital stay prior to nasal swab or surgery was found to be associated with MRSA carriage (OR=1.108, 95%CI: 1.026-1.197) or nosocomial infections (OR=1.087, 95%CI: 1.017-1.161). Additionally, the patients with nosocomial infections were more likely than those without to stay in the hospital for a longer period after surgery (P<0.00l). CONCLUSION: Preoperative nasal carriage of MRSA by the patient was not identified as a risk factor for surgical site infection and nosocomial infections in open heart surgery.
Agar ; Cross Infection* ; Humans ; Infection Control ; Length of Stay ; Mannitol ; Mediastinitis ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Prospective Studies ; Risk Factors ; Thoracic Surgery*

OBJECTIVE: We report a retrospective investigation of the prognostic value of bcl-2 and bax expression, and Ki-67 proliferative index in 42 astrocytic tumors. METHODS: We classified the astrocytic tumors and reviewed the clinical information and survival time. The sections were taken from surgically resected paraffin-embedded tissue and performed immunohistochemical stains for bcl-2, bax and Ki-67. RESULTS: The immunohistochemical stain for bcl-2 revealed a positivity in only two(4.76%) among forty-two cases. The immunostain for bax was positive in 35 cases(83.3%). However, the correlation between bcl-2 & bax expression and age, sex, tumor location, size, and histologic grade was not found. By Kaplan-Meier analysis, bcl-2 & bax expression and survival time in astrocytic tumors was no significance in log rank test(p>0.05). There were prognostic values between Ki-67 LI and histologic grade and between Ki-67 LI and survival time, respectively(p<0.05). CONCLUSION: Bcl-2 and bax are not significant, whereas Ki-67 LI is suggested as a significant prognostic factor, associated with histologic grade and survival time of astrocytic tumors.
Coloring Agents ; Kaplan-Meier Estimate ; Prognosis* ; Retrospective Studies

Traumatic pseudoaneurysms of the cavernous portion of the internal carotid artery(ICA) presenting with epistaxis are uncommon and potentially lethal complication of head injury. Because the onset of delayed bleeding from the time of injury is variable, prompt diagnosis and treatment of cavernous ICA pseudoaneurysm is important. A patient with a giant traumatic pseudoaneurysm of the left ICA presented with massive epistaxis 5 months after a head trauma. This patient was treated with occlusion of the opening of pseudoaneurysm and ICA by a detachable balloon and fibered coils.
Aneurysm, False* ; Balloon Occlusion ; Carotid Artery, Internal* ; Craniocerebral Trauma ; Diagnosis ; Epistaxis ; Hemorrhage ; Humans

Traumatic pseudoaneurysms of the cavernous portion of the internal carotid artery(ICA) presenting with epistaxis are uncommon and potentially lethal complication of head injury. Because the onset of delayed bleeding from the time of injury is variable, prompt diagnosis and treatment of cavernous ICA pseudoaneurysm is important. A patient with a giant traumatic pseudoaneurysm of the left ICA presented with massive epistaxis 5 months after a head trauma. This patient was treated with occlusion of the opening of pseudoaneurysm and ICA by a detachable balloon and fibered coils.
Aneurysm, False* ; Balloon Occlusion ; Carotid Artery, Internal* ; Craniocerebral Trauma ; Diagnosis ; Epistaxis ; Hemorrhage ; Humans

OBJECTIVE: The purpose of this study is to evaluate the findings of magnetic resonance(MR) perfusion study and relation with the prognosis in patients of head trauma. METHODS: Forty-two consecutive patients with head trauma were evaluated and the findings of brain computed tomography(CT) and MR image were compared with MR perfusion study. We classified perfusion MR findings into 5 categories and correlated with the prognosis. RESULTS: In all 42 patients with head trauma, 38 cases(90.5%) showed new lesions of abnormal perfusion pattern in MR perfusion study compared to CT and conventional MR image. Causes of the trauma were motor vehicle accident(73.8%) falling(16.7%), and blows to the head(7.1%) in order of frequency. The cumulative prevalent sites of focal abnormalities were frontal lobe in 11 cases(39.3%), basal ganglia and thalamus 9 cases(32.1%), temporal lobe 3 cases(10.7%) and parietal lobe 3 cases(10.7%) and occipital lobe 1 case(3.6%) and cerebellum 1 case(3.6%). The pattern of abnormalities in MR perfusion study were focal type in 18 cases(42.8%), diffuse type 18 cases(42.8%), mixed type 4 cases(9.5%). MR perfusion findings showed statistically significant correlation with initial Glasgow Coma Scale score and Glasgow Outcome Scale score(p<0.05). CONCLUSION: The patterns of perfusion MR abnormality show significant correlation with the prognosis. Further study is mandatory to define the meaning of perfusion defect area and clinical significance.
Basal Ganglia ; Brain* ; Cerebellum ; Craniocerebral Trauma* ; Frontal Lobe ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head* ; Humans ; Motor Vehicles ; Occipital Lobe ; Parietal Lobe ; Perfusion* ; Prognosis ; Temporal Lobe ; Thalamus