No abstract available.
Ataxia* ; Brain Stem Neoplasms* ; Mesencephalon*

PURPOSE: To evaluate the diagnostic value of MRI of the shoulder. MATERIALS AND METHODS: Between January andJune 1997, shoulder MRI and arthroscopy were performed in a total of 48 patients with shoulder pain (n=30) orshoulder instability (n=18). Forty-five were males and three were females; their ages ranged from 16 to 67 (mean32.5) years. The period between shoulder MRI and arthroscopy was between one and 390 (mean, 42.2) days. Twenty-sixpatents underwent MR arthrography (AMR), and 22 conventional MRI(CMR). Each image was analyzed for rotator cuffinjury, glenoid labral injury, SLAP lesion, and biceps tendon injury. RESULTS: On arthroscopy, one disease wasfound in 34 patients, two were found in six, three diseases were found in seven, and one patient had fourdiseases. Arthroscopic diagnosis was as follows: rotator cuff injury, 29 ; SLAP lesion, 12 ; glenoid labralinjury, 10 ; biceps tendon injury, 4 ; subacromial bursitis, 2 ; chronic synovitis, 1 ; adhesive capsulitis, 1 ;superior glenohumeral ligament injury, 1 ; normal, 1. For rotator cuff injury, the sensitivity of MRI was 65.5%and specificity was 93.0% (AMR : 66.7%, 95.8%, CMR : 65.2%, 86.4%). For SLAP lesion, sensitivity was 58.3% andspecificity was 97.2% (AMR : 66.7%, 100%, CMR : 50%, 93.8%) ; for glenoid labral injury, sensitivity was 80.0% andspecificity was 89.5% (AMR : 85.7%, 84.2%, CMR : 66.7%, 94.7%), and for biceps tendon injury, the false negativerate was 100%. CONCLUSION: In cases involving glenoid labral injury, the diagnostic accuracy of shoulder MRI wasrelatively high ; in rotator cuff injury and SLAP lesion, however, diagnosis was limited, and in biceps tendoninjury was difficult. We suggest, however, that MR arthrography has certain diagnostic advantages overconventional MRI.
Arthrography ; Arthroscopy ; Bursitis ; Diagnosis ; Female ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Male ; Rotator Cuff ; Sensitivity and Specificity ; Shoulder Joint* ; Shoulder Pain ; Shoulder* ; Synovitis ; Tendon Injuries

OBJECTIVE: The IDET(Intradiscal electrothermal therapy) appears as a new therapeutic modality for intractable discogenic back pain. We carried out a prospective study to analyze and evaluate the therapeutic effects of IDET. METHODS AND RESULTS: During a six month period, we performed IDET in 39 patients with chronic low back pain using RITA Model 30 Electrosurgical device. The patients included 21 men and 18 women. The mean patient age was 50.2 years(range 21-73 years). All patients underwent preoperative plain radiography and MRI for excluding non-discogenic back pain. We conducted discography-CT to reveal painful discs in all patients. During the study, we measured intradiscal pressure subjectively. The area of annular tear, which identified with post-discography CT scan, was coagulated in 90degreesC of temperature for 15 minutes. Of the 17 patients who were followed up more than three months after surgery, the 10 patients(58.8%) experienced clinical improvement. Three patients had high intradiscal pressure on discography, other three patients had loss of disc height more than 30% of normal on plain radiography, and one patient suffered from postoperative epidural abscess. All of these patients were included in the remaining no improvement group(41.2%). CONCLUSION: The IDET procedure could be an alternative modality for discogenic back pain. It appears that a patient who has low intradiscal pressure on discography and intact disc height on plain radiography is considered a good candidate for IDET.
Back Pain ; Epidural Abscess ; Female ; Humans ; Low Back Pain* ; Magnetic Resonance Imaging ; Male ; Prospective Studies ; Radiography ; Tomography, X-Ray Computed

No abstract available.
Adult* ; Humans ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

No abstract available.
Sparganosis*

OBJECTIVES: This study was undertaken to evaluate associated underlying disease and follow-up changes of multiple cortical defects(MCD) in recurrent acute pyelonephritis(APN) patients with MCD on DMSA scan. METHODS: DMSA scan was performed in 128patients who visited Asan Medical Center with recurrent APN and 80patients showed MCD. Intravenous pyelography(IVP), ultrasound of the kidney(US), voiding cystourethrography(VCUG) were performed to search associated underlying diseases and changes of MCD were studied with follow-up DMSA scan at least 6 months after initial DMSA scan. RESULTS: 1) Underlying diseases were detected in 34patients, including vesicoureteral reflux in 21, renal stone in 4, renal tuberculosis in 3, ureteral stenosis in 3, renal infarction in 1, megaureter in 1, neurogenic bladder in 1, 2) Follow up DMSA scan revealed no changes in 14patients, improvement in 2. CONCLUSION: The patients with multiple defects on DMSa scan have underlying abnormalities in 42%, so they need more radiologic studies such as VCUG, IVP, US. Multiple defects indicate irreversible damage in most patients.
Chungcheongnam-do ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Infarction ; Pyelonephritis* ; Succimer* ; Tuberculosis, Renal ; Ultrasonography ; Ureter ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux

OBJECTIVE: Percutaneous kyphoplasty using a balloon-catheter is an widely accepted method which achieves the restoration of vertebral height and the correction of kyphotic deformity with little complication in osteoporotic vertebral compression fractures. The authors assess the results of 59 patients who underwent kyphoplasty, and analyze the factors that could affect the prognosis. METHODS: From December 2001 to May 2003, fifty-nine patients underwent kyphoplasty. The patients included 49 women and 10 men aged 52-85 years. Average t-score on bone marrow density was -3.58. About 7cc of polymethylmethacrylate(PMMA) was injected into the fractured vertebral body using Kyphon(R) under local anesthesia. The vertical height of all fractured vertebrae was measured both before and after surgery. Outcome data were obtained by comparing pre- and post-operative VAS score and by assessing postoperative satisfaction, drug dependency and activity. Various clinical factors were analyzed to assess the relationship with the outcome. RESULTS: The VAS score improved significantly, and the mean percentage of restored vertebral height was 53%. The mean improvement in kyphosis was 3.6degrees. Eighty-nine percent of the patients gained excellent or good results. Any of the clinical factors including the interval between fracture and operation, the degree of height loss, the degree of the vertebral height restoration or the correction rate of kyphosis did not affect the clinical results. CONCLUSION: Kyphoplasty is associated with a statistically significant improvement in pain and function with little complication. The clinical results are not affected by any clinical parameters. Further follow-up study is needed to determine whether the restoration affects the long-term clinical results.
Anesthesia, Local ; Bone Marrow ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphoplasty* ; Kyphosis ; Male ; Osteoporosis ; Prognosis ; Spine

This study was to determine which of two routes of administration of 5-fluorouracil (5-FU) is more effective, by measuring the radioactvity in the body tissues of gastric cancer patients after the administration of 5-FU-l4C via the systemic intravenous and the regional intra-arterial routes. After the drug was administered intravenously in one group of patients, and intra-arterially in another; samples of portal venous blood, the liver, the lymph nodes, and the normal and the cancerous tissues of the stomach were obtained. The radioactivities of the samples were measured, and it was found that those of the regional lymph nodes, the liver, and the normal and the cancerous tissues of the stomach were much higher in the latter group. The regional intra-arterial routes is the more effective way to administer 5-FU in patients with stomach cancer.
Carbon Radioisotopes/diagnostic use ; Comparative Study ; Fluorouracil/administration & dosage ; Fluorouracil/metabolism* ; Human ; Injections, Intra-Arterial ; Injections, Intravenous ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/metabolism

OBJECTIVE: The authors report an analysis of clinical data including incidence, clinical manifestations, diagnostic tools and surgical treatment of neoplasms of scalp and calvarium in adults. METHODS: The clinical, radiological, and pathological records of 67 patients who underwent mass excision in scalp or skull at our department during recent five years were reviewed. RESULTS: The mean age was 43 years(range 16 to 85 years) and male to female ratio was 42 : 25. There were 62 scalp and five calvarial masses. Among scalp masses, there were 52 tumors, three vascular lesions, three inflammatory lesions and four miscellaneous lesions. The scalp tumors were composed of 44 benign lesions and nine malignant lesions. The most common type of scalp tumor was lipoma, followed by epidermoid and dermoid. The calvarial masses consisted of four osteomas and one eosinophilic granuloma. Surgical excision was carried out in all cases. CONCLUSION: Most scalp and calvarial masses are benign lesions, however, surgical excision seemed to be indicated in most cases for diagnosis and treatment.
Adult ; Dermoid Cyst ; Diagnosis ; Eosinophilic Granuloma ; Female ; Humans ; Incidence ; Lipoma ; Male ; Osteoma ; Scalp* ; Skull ; Skull Neoplasms

BACKGROUND: Preemptive analgesia may prevent nociceptive input generated during surgery from sensitizing central neurons and, therefore, may reduce postoperative pain. The purpose of this study is to examine the effect of epidural fentanyl between preincisional (preemptive) and postincisional groups on postoperative morphine requirements. METHODS: Sixty patients (ASA physical status 1 or 2) scheduled for elective total abdominal hysterectomy under general anesthesia were allocated randomly to one of two groups and prospectively studied in a double-blind manner. Group 1 received epidural fentanyl(2 g/kg in 15 ml normal saline) before surgical incision followed by epidural normal saline (15 ml) 15 minutes after skin incision. Group 2 received epidural normal saline(15 ml) before surgical incision followed by epidural fentanyl(2 g/kg in 15 ml normal saline) 15 minutes after skin incision. No additional analgesics were used before or during the operation. Postoperative visual analogue pain scores, PCA morphine requirements and side effects were assessed. RESULTS: Postoperative PCA morphine requirements in preincisional group were significantly less (p<0.05) than those in postincisional group between 6 and 24 hours postoperatively. VAPS was also significantly less (p<0.05) in preemptive group than in postincisional group 12 hours after surgery. CONCLUSIONS: Preemptive analgesia with epidural fentanyl is more effective in reducing the postoperative morphine requirements and VAPS than analgesia with postincisional epidural fentanyl in patients with total abdominal hysterectomy.
Analgesia ; Analgesics ; Anesthesia, General ; Fentanyl* ; Humans ; Hysterectomy ; Morphine ; Neurons ; Pain, Postoperative* ; Passive Cutaneous Anaphylaxis ; Prospective Studies ; Skin