No abstract available.
Decompression* ; Facial Nerve* ; Melkersson-Rosenthal Syndrome*

No abstract available.
Anemia*

No abstract available.
Cochlear Implants*

No abstract available.
Finger Injuries* ; Fingers*

PURPOSE: To determine the preferred method of drinking water before spiral CT scanning of a gastric lesion. MATERIALS AND METHODS: Spiral CT scans of 92 patients with gastric lesion were obtained and evaluated. Patients drank tap water as oral contrast material and were scanned in the prone position; they were divided into two groups according to the method by which water was ingested. Group 1 patients drank 500ml 60 minutes before scanning; 500mL, 30 minutes before scanning; and 500mL just before scanning, while those in group 2 drank 800-1000mL just before scanning. In all cases, precontrast images were obtained, and an additional 300mL of water was given if the stomach was not adequately distended. Postcontrast images were obtained at 35 seconds, 80 seconds and 3 minutes after the start of infusion of contrast material. For 35- and 80-second scans, spiral CT was performed with 5-mm collimation, 7mm/sec table feed, and 5-mm reconstruction interval; for precontrast and 3-minute scans, 10-mm collimation, 10mm/sec table feed, and 10-mm reconstruction interval were used. There were 40 patients in group 1, and 52 in group 2. The images of the two groups were evaluated according to three criteria: gastric distension, mucosal enhancement, and tumor distinction. For each criterion, the images were evaluated by grading; an 'excellent' image scored 3, 'good' 2, 'ordinary' 1, and 'poor' 0. The differences in imaging quality between the two groups were statistically evaluated. Images obtained at 35 and 80 seconds, and at 3 minutes after the start of infusion of contrast material were compared, and the detectability of 18 confirmed cases of early gastric cancer was evaluated. RESULTS: For gastric distension, the mean score was 1.65 in group 1, and 1.81 in group 2 (P=0.33); the corresponding figures for mucosal enhancement were 1.45 and 1.65 (P=0.11), and for tumor distinction, 1.30 and 1.52 (P=0.09). Between the two groups, there was therefore no statistical difference in image quality. With regard to postcontrast images, those obtained after a delay of 35 seconds were best; those obtained at 80 seconds were better than those obtained at 3 minutes. Fifteen of 18 case of early gastric cancer were detected on spiral CT, and the detection rate was 83.8%. CONCLUSION: No statistically significant difference was seen between the two groups, and a single drink of water-just before scanning- is thus preferable to several drinks. Two scans, with images delayed for 35 and 80 seconds after contrast enhancement, are adequate. The use of these methods may improve the image quality of gastric lesions and the detection rate of early gastric cancer.
Drinking Water ; Eating* ; Humans ; Prone Position ; Stomach ; Stomach Neoplasms ; Tomography, Spiral Computed* ; Water*

The spleen is the most common intraabdominal organ injured in blunt trauma, Although physical signs andsymptoms, coupled with abdominal paracentesis & peritoneal lavage confirm intraabdominal injury, but isolatedsplenic injury especially delayed rupture, the diagnosis and clinical course is variable. We are reevaluation ofplain roentgenologic findings for the light of early diagnosis of isolated splenic injury. 24 patiens of theautopsy and surgically proven isolated splenic injury at Chosun University Hospital in the period from 1980January to 1986 June were analyzed plain roentgenogram retrospectively. The results were as follows: 1. Malepatients predominate, constitution 87.5%. Incidence has been greatest in second to fourth decade. 2. Mode oftrauma causing isolated splenic injury is most common in motor vehicle accident and others are fall down, struckby fist, blow to object, uncertain blunt trauma. 3. Delayed rupture of spleen occured in 2 cases(8.3%). 4. Commonpatterns of splenic injury is simple laceration that involves both the capsule and the parenchyma and a lacerationthat involves the splenic pedicle. 5. Plain chest roentgenographic findings were abnormal in 4 cases (16.7%). Themost common plain abdominal roentgenographic findings was the evidence of intraabdominal fluid in 21 cases(87.5%).The others are included in order of frequency: gastric dilatation, prominent mucosal folds on greater curvature ofthe stomach, evidence of pelvic fluid, displacement of stomach to the right or downward, mass density in theregion of spleen. 6. No relationship can be shown between patterns of injury, time lapse after trauma and plainroentgenological findings. But the evidence of intraabdominal fluid is most important in the light of earlydiagnosis. 7. Diagnosis of splenic injury may be most helpul that in combination with clinical history, clinicalsymptoms & signs and plain film findings. In delayed rupture, diagnostic value of serial examination and surgicalobservation is emphasized.
Constitution and Bylaws ; Diagnosis ; Early Diagnosis ; Gastric Dilatation ; Incidence ; Lacerations ; Motor Vehicles ; Paracentesis ; Peritoneal Lavage ; Retrospective Studies ; Rupture ; Spleen ; Stomach ; Thorax

Alveolar soft part sarcoma is a clinically and morphologically distinct soft tissue tumor that was first defined and named by Christopherson et al in 1952. Since 1953, alveolar soft part sarcoma invading bone have been reported sporadically. We experienced a case of alveolar soft part sarcoma with metastasis to femoral shaft, which was treated by wide resection & vascularized fibular strut graft.
Neoplasm Metastasis ; Sarcoma, Alveolar Soft Part ; Transplants

Various kinds of spinal instruments have been developed for the treatment of lumbar spinal disordors. Recently, the Graf instrument as soft stabilizer has been introduced in treating lumbar spinal disordors associated with instability. To determine the reliability of Graf instrument providung spinal stability we have analysed 19 cases of unstable lumbar degenerative disease treated with adequate decompression and Graf instrumentation between May 1991 and March 1992. There were 15 females and 4 males. Average age at operation was 50.8 years (Range, 35 to 70). Minimum follow up was 14 months. The main surgical indication was serious limitation of daily activity caused by intractable symptoms and signs with spinal instability. Clinical assesment based on authors modified criteria revealed satisfactory (Exellent/Good) in 16 cases (84.2%). The Graf instrument has many advantages over rigid implant such as enough stability without arthrodesis after extensive surgical decompression, rapid rehabilitation, less operative risk and preservation of spinal motion. These results suggests Graf instrument instead of rigid implant is highly recommendable in managing unstable lumbar disordors.
Arthrodesis ; Decompression ; Decompression, Surgical ; Equidae ; Female ; Follow-Up Studies ; Humans ; Male ; Rehabilitation

A 9-year-old Korean boy with lissencephaly was found dead at home. He had previously been diagnosed with lissencephaly that presented with infantile spasm on the basis of magnetic resonance imaging and electroencephalogram results. Antemortem chromosomal banding revealed a normal karyotype. A legal autopsy was requested to eliminate the possibility of neglect or abuse by his parents. The autopsy findings revealed type I lissencephaly with the associated microcephaly. No external wounds or decubitus ulcers were noted. Postmortem fluorescence in situ hybridization for the LIS1 locus and nucleotide sequence analysis of the whole coding regions of the LIS1 gene did not reveal any deletions. The antemortem and postmortem findings revealed that lissencephaly syndrome was associated with isolated lissencephaly sequence. External causes of death were excluded by the full autopsy and toxicology test results. Because patients with mental retardation are frequently victimized and suffer neglect or abuse, thorough external and internal examinations should be conducted at the time of autopsy.
Autopsy ; Base Sequence ; Cause of Death ; Child ; Child Abuse ; Classical Lissencephalies and Subcortical Band Heterotopias ; Clinical Coding ; Electroencephalography ; Fluorescence ; Forensic Pathology ; Humans ; In Situ Hybridization ; Infant ; Infant, Newborn ; Intellectual Disability ; Karyotype ; Lissencephaly ; Magnetic Resonance Imaging ; Microcephaly ; Parents ; Pressure Ulcer ; Spasms, Infantile ; Toxicology

BACKGROUND: The recent experimental observations suggested that location of M. leprae in the Schwann cells was mediated by epineurial and endoneurial endothelial cells, giving M. leprae access to the inner compartment of nerves and thus to Schwann cells. CD1 is a family of nonpolymorphic beta2-microglobulin-associated transmembrane glycoproteins that is structurally related to classical MHC Ag-presenting molecules, but is encoded by a separate genetic locus. Recent reports have described that human T cells specifically recognize foreign lipid and glycolipid antigens presented by CD1 proteins. Thus, it appeared likely that CD1 represents the key component of a MHC - independent pathway for antigen presentation to T cells. OBJECTIVE: we observed expression of antigen presenting molecules, such as MHC class I, II and CD1, in the vascular endothelial cells and inflammatory cells of leprosy skin lesion. METHODS: MHC class I, II and CD1 expression were studied using immunohistochemical stains. RESULTS: 1. In immunohistochemical stain of HLA-A, B, C, the level of expression in vascular endothelial cells of the borderline tuberculoid leprosy is higher than that of borderline lepromatous leprosy, but lower than that of normal skin tissue. 2. In HLA-A,B,C expression of the inflammatory cells, the level of borderline tuberculoid leprosy is higher than that of borderline lepromatous leprosy and of normal skin tissue(p>0.05). 3. Expression levels of HLA-DP, DQ, DR on endothelial cells decrease significantly in order of normal tissue, borderline tuberculoid leprosy, borderline lepromatous leprosy, lepromatous leprosy(p<0.05). 4. Expression levels of HLA-DP, DQ, DR on inflammatory cells decrease in order of lepromatous leprosy, borderline lepromatous leprosy, borderline tuberculoid leprosy, normal tissue, but statistical significance did not exist. 5. In immunohistochemical stains of CD1b, 3 sections of all 4 normal skin sections and 1 section of 3 borderline tuberculoid leprosy sections showed focal positivity on the dermal inflammtory cells, but borderline lepromatous leprosy sections did not show any positive inflammatory cells. 6. Epidermal Langerhans cells showed positivity on immunohistochemical stains of CD1a and CD1b. CONCLUSION: These results suggest that expression of MHC class I and II on the vascular endothelial cells and expression of CD1b on the inflammatory cells decrease in order of immunity of lepromatous skin lesion and that vascular enothelial cells play an important role in the pathogenesis of leprosy.
Antigen Presentation ; Coloring Agents ; Endothelial Cells* ; Genetic Loci ; Glycoproteins ; HLA-A Antigens ; HLA-DP Antigens ; Humans ; Langerhans Cells ; Leprosy* ; Leprosy, Borderline ; Leprosy, Lepromatous ; Leprosy, Multibacillary ; Leprosy, Paucibacillary ; Leprosy, Tuberculoid ; Schwann Cells ; Skin* ; T-Lymphocytes