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

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

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

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: It is well known that hypotension and hypoxia are detrimental secondary brain insults and have deleterious effects on the outcome of patients with severe closed head injuries. We evaluated the effect of hypotension and hypoxia on aneurysmal subarachnoid hemorrhage(SAH). METHODS: We reviewed retrospectively 159 consecutive operated aneurysmal SAH cases. Hypotension and hypoxia were identified during the patients' operation and intensive care unit hospitalization. We analyzed them as four mutually exclusive categories: neither hypotension nor hypoxia(normal), hypotension only, hypoxia only, hypotension and hypoxia combined. The outcome following aneurysmal SAH was determined by the Glasgow outcome scale score and then analyzed. The incidence of occurrence of hydrocephalus and clinical vasospasm were also analyzed. RESULTS: 22 patients(13.8%) experienced hypotension and 16 patients(10.1%) experienced hypoxia and 8 patients(5.0%) experienced both hypotension and hypoxia. The incidence of hydrocephalus in combined category(75.0%) was significantly higher than normal category(14.3%). The incidence of clinical vasospasm in hypotension category(77.3%) and combined category(87.5%) were significantly higher than normal category(38.1%, p<0.05). The outcome of hypotension category and combined category were significantly unfavorable compared with normal category(p<0.05). Furthermore, the impact of hypotensive insult was much greater on good grade Hunt-Hess patients. CONCLUSION: The detrimental secondary brain insults as hypotension and hypoxia occurred not infrequently in aneurysmal SAH patients and had deleterious effects on the outcome of aneurysmal SAH patients. These data suggest that hypotension during critical period in aneurysmal SAH patients should be avoided to improve outcome.
Aneurysm* ; Anoxia* ; Brain ; Critical Period (Psychology) ; Glasgow Outcome Scale ; Head Injuries, Closed ; Hospitalization ; Humans ; Hydrocephalus ; Hypotension* ; Incidence ; Intensive Care Units ; Retrospective Studies ; Subarachnoid Hemorrhage*

OBJECTIVE: The authors present the clinical and radiologic outcomes of microsurgical anterior foraminotomy in 36 cases of cervival radiculopathy. METHODS: Thirty-six patients were treated with anterior cervical foraminotomy between January 1998 and June 2002. There were 13 men and 23 women(age range, 34-74 years). Twenty-nine had symptomatic soft disc herniation and 7 had uncovertebral osteophytes confirmed by magnetic resonance imaging and computed tomography. Thirty-one patients had single anterior cervical microforaminotomy and five had procedures at adjacent levels. RESULTS: Good or excellent result were obtained in 75% of the patients. On roentgenographic examination, the height of intervertebral space was maintained at twenty-one levels(51%) and was decreased at seventeen levels(42%). Two patients who underwent anterior cervical microforaminotomy developed kyphosis of the cervical spine and one patient developed instability of the cervical spine. CONCLUSION: Anterior cervical foraminotomy appears to be a good alternative procedure for carefully selected patients with unilateral cervical radiculopathy and avoids a fusion of the disc space.
Foraminotomy* ; Humans ; Kyphosis ; Magnetic Resonance Imaging ; Male ; Osteophyte ; Radiculopathy* ; Spine

OBJECTSIVE: This study investigated the frequency of metabolic syndrome, associated factors and its risk for cardiovascular morbidity in schizophrenic patients. METHODS: In this cross-sectional study, nineteen-six patients with schizophrenia defined by DSM-IV criteria were included. All subjects were assessed for the presence of metabolic syndrome by means of the criteria of the National Cholesterol Education Program-Adult Treatment Panel III. In addition, we compared clinical characteristics, laboratory variables and risk for cardiovascular morbidity between patients with and without metabolic syndrome. RESULTS: Of patients, 43% had metabolic syndrome. Metabolic syndrome was associated with illness chronicity and current status of antipsychotic agents use, total duration of atypical agents used, but not with daily chlorpromazine equivalent dose. Compared with the patients without metabolic syndrome, patients with metabolic syndrome had higher risk for cardiovascular morbidity. CONCLUSION: This study suggests that metabolic syndrome is common among patients with chronic schizophrenia. Clinicians should be cautious to aware the increased risk for the metabolic syndrome and intervene actively to prevent and treat metabolic morbidity among chronic patients with schizophrenia.
Antipsychotic Agents ; Chlorpromazine ; Cholesterol ; Cross-Sectional Studies ; Diabetes Mellitus ; Diagnostic and Statistical Manual of Mental Disorders ; Dyslipidemias ; Education ; Humans ; Hypertension ; Obesity ; Schizophrenia*

OBJECTIVE: Anterior cervical fusion is widely used with many kinds of plate systems. The purpose of this study is to evaluate the rate and influencing factor of instrument failure. METHODS: The authors reviewed 101 consecutive patients who underwent anterior interbody fusion used Caspar, PCB(Cervical Plate Cage System), Orion and Atlantis plate system during the period of January 1991 to December 2000. The cases of trauma were 49, tumor 2 and degenerative disorder 50. The average length of follow up was 12.2 months. RESULTS: There were 10 cases of instrument related complications and 18 cases of non-instrument related complications. Among 10 cases of instrument related complication, eight patients showed screw loosening and two patients showed bone graft displacement. The nine cases of hardware failure occurred within 3 months. The rate of instrument failure was higher in trauma, unlocking plate and multi-level than non-trauma, locking plate and one-level. There were no injuries to tracheoesophageal or neurovascular structures as a results of instrument failure. CONCLUSION: We conclude that anterior cervical plating can be carried out with acceptable complication rate. The incidence of prominent instrument failure that endangers tracheoesophageal structures is minimal.
Follow-Up Studies ; Humans ; Incidence ; Transplants