No abstract available.
Ultrasonography*

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

OBJECTIVES: This study was performed to consider the clinical experience of an ultrasound-guided vacuum-assisted resection (Mammotome) for benign breast lesions through a core needle biopsy. METHODS: The authors carried out a core needle biopsy and Mammotome for 347 patients and investigated the pathologic results. RESULTS: The significant difference of core needle biopsy and Mammotome results was demonstrated, Spearman correlation coefficient is 0.413 in a correlation analysis. CONCLUSION: This experience suggest Mammotome is a useful procedure for providing more correct pathologic findings through complete resection of benign breast lesions.
Biopsy, Large-Core Needle ; Breast ; Breast Diseases ; Breast Neoplasms ; Humans ; Mammography ; Needles

Lower eyelid retraction is usually managed by recession of the lower lid retractors and interposition of a spacer graft including ear cartilage, nasal septal cartilage, donor sclera or autogenous tarsoconjunctiva.We have used hard palate mucosa as a spacer in 10 patients (11 eyelids)with lower lid retraction.Average age at operation was 36 years with the range of 10 years to 59 years.Causes of the lower lid retraction were thyroid ophthal-mopathy (4 eyelids), strabismus surgery (2 eyelids), entropion repair (2 eye-lids), eyelid infection (2 eyelids), and trauma (1 eyelid).Of 11 eyelids, 7 eye-lids were combined with entropion due to the shortage of posterior lamella. The follow-up period ranged from 3 to 45 months (mean 17 months).Surgi-cal results in all 11 eyelids were satisfactory.There was no complication in donor site.Hard palate closely approximates lower lid tarsus in terms of contour, thickness, and stiffness, provides a mucosal surface and shows only minimal shrinkage. We suggest hard palate mucosal grafts as one of the best available spacer material for the treatment of lower lid retraction.
Ankle ; Cartilage ; Ear Cartilage ; Entropion ; Eyelids ; Follow-Up Studies ; Humans ; Mucous Membrane* ; Palate ; Palate, Hard* ; Sclera ; Strabismus ; Thyroid Gland ; Tissue Donors ; Transplants*

Syphilitic aortitis, passing out of our mind, is the most common systemic manifestation of late syphilis and is more typically manifestated 10 to 30 years afterward. This diagnosis has been made less frequently in recent decades than in the past, because of public awareness of syphilis and screening program. Treponema pallidum lodge within vasa vasorum, especially ascending aorta cause the histologic changes, which are responsible for the three major forms of symptomatic cardiovascular syphilis, including aortic insufficiency, coronary ostial stenosis, and aortic aneurysm. We experienced a case of syphilitic aortitis with aortic insufficiency and aortic aneurysm in a 48-year-old man presented with progressive dyspnea. Echocardiography, chest CT, and later surgical correction were performed and surgical specimen revealed the histologic finding consistent with syphilitic aortitis. We report this case with a review of the literature.
Aorta ; Aortic Aneurysm* ; Aortitis ; Constriction, Pathologic ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Mass Screening ; Middle Aged ; Syphilis ; Syphilis, Cardiovascular* ; Tomography, X-Ray Computed ; Treponema pallidum ; Vasa Vasorum

The purpose of this study was to compare the normal and two times of application time of six self-etching primers applied to enamel using microshear bond strength (uSBS) test and the finding of scanning electronic microscope (SEM). Crown of sixty human molars were bisected mesiodistally and buccal and lingual enamel of crowns were partially exposed and polished with 600 grit SiC papers. They were divided into one of two equal groups subdivided into one of six equal groups (n = 10) by self-etching primer adhesives. After the same manufacture's adhesive resin and composites were bonded on the enamel surface of each group, the bonded specimens were subjected to uSBS testing and also observed under SEM. In conclusion, generally two times of primer application time increased the enamel uSBS, especially with the statistical increase of bond strength in adhesives involving high-pH primers.
Adhesives ; Crowns ; Dental Enamel ; Electronics ; Electrons ; Humans ; Molar

BACKGROUND: Restenosis is a major limitation of balloon angioplasty. Recently, new angioplasty devices have been used in an attempt to reduce the restenosis compared with coronary balloon angioplasty. Directional coronary atherectomy effectively dilated the lesion by removal of the atherosclerotic plaque. Therefore, we tried to evaluate immediate and late clinical outcomes after directional coronary atherectomy in the 57 patients with coronary artery disease. METHODS: From October 1991 to March 1997, fifty seven consecutive patients with 69 lesions were treated with directional coronary atherectomy. The patients underwent coronary angiography at pre-intervention, immediately after intervention and at 6 months post-intervention. Restenosis was assessed clinically and by computer-assissted quantitative measurements of luminal dimensions. Patients were requested to undergo coronary angiography at 6 months after directional coronary atherectomy. Angiographic restenosis was defined as more than 50% diameter stenosis by quantitative coronary angiographic analysis. RESULTS: Successful results were achieved in 61 of the 69 lesions(88%) and mean stenosis was reduced from 78.0+/-13.0% to 10.0+/-5.0%. Atherectomy resulted in an increase in minimal lumen diameter from 0.8+/-0.3mm to 3.0+/-0.6mm. Six months follow-up angiogram was obtained in 68% of 50 eligible lesions. The overall angiographic restenosis rate was 32%. Six month clinical follow-up was obtained in 94% of the eligible lesions. The clinical recurrence occured in 38% of the patients. The target lesion revascularization rate was 17%. CONCLUSIONS: Removal of coronary artery plaque with directional atherectomy led to large luminal diameter and six months follow-up angiography shows an overall restenosis rate of 32% However, further clinical study is warranted to evaluate the efficacy of atherectomy with larger numbers of patients.
Angiography ; Angioplasty ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary ; Atherectomy ; Atherectomy, Coronary* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Follow-Up Studies ; Humans ; Phenobarbital ; Plaque, Atherosclerotic ; Recurrence

BACKGROUND: The intracoronary stent implantation is regarded as an effective treatment modality to reduce restenosis. However, subacute stent thrombosis and subsequent anticoagulation therapy have been major problems after stenting. The high-pressure inflation stenting reduced the incidence of stent thrombosis and resulted in less need of anticoagulation therapy. We intended to analyze the high-pressure inflation stenting with intravascular ultrasound(IVUS) and to evaluate different IVUS criteria of optimal stenting. METHOD: One hundred and forty eight patients with 160 lesions were treated with 175 stents of various types. IVUS images were obtained after angiographic optimization (<10% of residual stenosis) with high-pressure inflation stenting. The quantitative and qualitative off-line measurements of IVUS parameters were performed. RESULTS: More high-pressure or larger-sized balloon inflation was needed in 32 lesions (20%) after IVUS. The incomplete stent apposition was observed in 5 lesions (3%). The edge dissection occurred distally or proximally to stented site in 19 lesions (12%). The plaque prolapse was observed within the stent in 24 lesions (15%). In single stent implantation for discrete lesions, optimal stent expansion defined by IVUS was achieved in 69% with minimal stent lumen area of 90% of distal reference lumen area and in 75% with minimal stent lumen area of 80% of average reference lumen area. The IVUS criteria of minimal stent lumen area 9mm2 and 7-9mm2 was met in 29% and 29%, respectively. In stents implantation for diffuse lesions including long stent,multiple overlapping stents and hybrid stents implantation, optimal stent expansion defined by IVUS was achieved in 69% with minimal stent lumen area of 90% of distal reference lumen area and in 67% with minimal stent lumen area of 80% of average reference lumen area. The IVUS criteria of minimal stent lumen area 9mm2 and 7-9mm2 was met in 17% and 23%, respectively. CONCLUSION: IVUS provided a valuable informations leading to additional intervention in 20% of the lesions after angiographic optimization with high-pressure balloon inflation. Even though additional interventions were performed with IVUS-guidance, the optimal stent expansion by IVUS criteria was achieved in about 70%. Therefore, we suggest that IVUS might be used more generally to improve the acute results after coronary stenting.
Humans ; Incidence ; Inflation, Economic* ; Prolapse ; Stents* ; Thrombosis ; Ultrasonography*

Talc pleurodesis is a safe and effective treatment for a recurrent malignant pleural effusion. However, acute hypoxemia, pulmonary edema or acute respiratory failure can develop in a small number of patients. We report 2 patients who developed fatal hypoxemia after talc pleurodesis which was necessary the control recurrent pleural effusion. The first case was an 18-year old male diagnosed with Ewing's sarcoma with bilateral lung metastases and pleural effusion. The performance status was ECOG (Eastern Cooperative Foncology Group) grade 3. Fever along with hypoxemia and leukocytosis developed 10 hours after the second talc pleurodesis on the right side for an uncontrolled pleural effusion, The patient died from respiratory failure after 13 days. The second case was a 66-year old female diagnosed with non-small cell lung cancer with a bone metastasis. Two weeks after systemic chemotherapy, she complained of dyspnea, and a pleural effusion was observed on the right side. Her performance status was ECOG grade 3. Talc pleurodesis was performed for recurrent pleural effusion, but hypoxemia developed 6 days after pleurodesis and she died from respiratory failure 10 days after pleurodesis. In conclusion, talc pleurodesis should be performed very carefully in patients with a poor performance status, in cases with repeated pleurodesis, bilateral pleural effusion, recent chemotherapy, radiotherapy and when there are parenchymal metastatic lesions present.
Adolescent ; Aged ; Anoxia* ; Carcinoma, Non-Small-Cell Lung ; Drug Therapy ; Dyspnea ; Female ; Fever ; Humans ; Leukocytosis ; Lung ; Male ; Neoplasm Metastasis ; Pleural Effusion ; Pleural Effusion, Malignant* ; Pleurodesis* ; Pulmonary Edema ; Radiotherapy ; Respiratory Insufficiency ; Sarcoma, Ewing ; Talc*

BACKGROUND: It has been hypothesized that early atherosclerosis may be related to the pathogenesis of coronary vasospasm. This study was designed to investigate the relationship between early atherosclersosis and coronary vasospasm or vasoconstriction in response to axetylcholine utilizing intravascular ultrasonography. METHOD: Total 43 segments were analyzed from subjects who were composed of 10 patients with and 7 patients without coronary vasospasm in response to intra coronary acetylcholine infusion. Spasm segment(Sp) was defined as total or subtotal occlusion, constriction segment(C) as diameter decrease>/=10%, and normal segment(N) as diameter decrease<10% compared to baseline coronary angiogram. Atherosclerotic plaque thickness was defined as the sum of thickness of intimal leading edge and sonolucent zone. Atherosclerosis was defined as atherosclerotic plaque thickness > 0.5mm. RESULTS: The atherosclerotic plaques of spasm segments were significantly thicker than those of normal and constriction segments(spasm segments : 1.19+/-0.21mm, constrict segments : 0.58+/-0.11mm, normal segment : 0.37+/-0.11, p<0.05). Atherosclerosis was present in 90% of spasm segments. Among normal of constriction segments, atherosclerotic plaque thickness of patients with vasospasm was thicker than that of patients without vasospasm, although it was statistically insignificant(patients with vasospasm : 0.65+/-0.51mm, patients without vasospasm 0.36+/-0.39mm, p=0.07). Frequency of atherosclerosis in normal or constriction segments was significantly higher in patients with vasospasm than patients without vasospasm(patients with vasospasm 47%, patients without vasospasm : 11%, p<0.05). CONCLUSION: Atherosclerosis is present at segments of vasospasm in response to intracoronary acetylcholine. Even among normal or constriction segments, the artherosclerotic plaque thickness of patients with vasospasm was thicker than that of patients without vasospasm which may indicates that coronary vasospasm is a diffuse early atherosclerotic disease.
Acetylcholine ; Atherosclerosis ; Constriction ; Coronary Vasospasm* ; Humans ; Plaque, Atherosclerotic ; Spasm ; Ultrasonography* ; Ultrasonography, Interventional ; Vasoconstriction*