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: 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

No abstract available.
Meningioma* ; Radiosurgery*

OBJECTIVE: Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy in the upper extremities. For the surgical treatment of CTS, endoscopic carpal tunnel release(ECTR) has been developed as a minimally invasive method, alternative to the open procedure over the past decade. The authors present clinical experience and surgical outcome of ECTR. METHODS: One hundred cases(34 right, 30 left and 19 bilateral hands) in 81 consecutive patients(mean age: 51.8 years, range: 33-77 years) with electrodiagnostically-proven CTS underwent a single-portal ECTR from January 2001 to December 2002. Preoperative clinical findings and results of electrodiagnostic studies were compared with surgical outcome respectively after 3-month-follow-up period. RESULTS: Among 100 cases 94(94%) were satisfied with complete or significant relief of symptoms and 6(6%) were dissatisfied with partial or no relief of symptoms. Major complications in 2 cases(one with ulnar nerve injury and the other one with ulnar artery laceration), developed in early experience of ECTR and recurrence in 1 case occured. Severity of electrodiagnostic abnormalities were correlated with surgical outcome but there's no statistical significance between them. Severity of clinical findings, age at onset and symptom duration were not correlated with surgical outcome respectively. CONCLUSION: ECTR is effective in relieving symptoms of CTS with a low complication rate after the learning curve period. Thus, ECTR can be the first procedure, alternative to the open surgery as an efficient, minimally invasive surgical technique for CTS.
Carpal Tunnel Syndrome ; Learning Curve ; Recurrence ; Surgical Procedures, Minimally Invasive ; Ulnar Artery ; Ulnar Nerve ; Upper Extremity

PURPOSE: This study was performed in order to compare unenhanced CT with diffusion-weighted, T2-weight-ed,and fast FLAIR MR imaging in the detection of hyperacute cerebral ischema induced in a dog and to deter-mine whichmodality first detected cerebral ischemia. MATERIALS AND METHODS: Experimental cerebral infarction was induced bythe occlusion of intracerebral arter-ies using embolic materials (polyvinyl-alcohol, 300 -6 00 micro) introducedthrough a microcatheter into the internal carotid artery of five dogs weighing 12 -20 kg. Serial CT and MR imageswere obtained at one hour intervals from one to five hours after occlusion, and were analyzed independently by tworadiologists. We assessed changes in attenuation, as seen on unenhanced CT and the signal intensity of the lesionon each MR image, and measured the contrast-to-noise ratio (CNR) of the lesions. RESULTS: Ischemic lesions weredetected on unenhanced CT 1 -3 hours after occlusion of cerebral arteries. In all dogs, the lesions were detectedearliest on diffusion-weighted images obtained at 1 hour. They were detect-ed on T2-weighted images at 3 -5 hoursand on fast FLAIR images of 2 -5 hours. The CNR of ischemic lesions increased gradually during the 5-hour period.It was highest on diffusion-weighted images, while on unen-hanced CT, T2-weighted, and fast FLAIR images it wassimilar. CONCLUSION: Hyperacute ischemic lesions were detected earliest on diffusion-weighted images, and earlieron unenhanced CT than on fast FLAIR or T2-weighted MR image.
Animals ; Brain Ischemia ; Carotid Artery, Internal ; Cerebral Arteries ; Cerebral Infarction* ; Dogs* ; Magnetic Resonance Imaging*