No abstract available.
Chorea* ; Humans

The authors experience 3 cases of angiographically occult vascular malformation(AVOM) of the brain during the last 3 months in 1990. All cases were diagnosis of either operative or pathological finding and were associated with intracerebral hemorrhage. The authors recommend that surgery should be considered even to those angiographically negative intracerebral hemorrhage cases, once clinical features are highly suggestive of AOVM. Surgery can be an effective and define therapy for these entities, which are prone to cause recurrent hemorrhage and persistent neural deficits.
Brain* ; Cerebral Hemorrhage ; Diagnosis ; Hemorrhage ; Magnetic Resonance Imaging ; Vascular Malformations*

Primary tumors of the heart are uncommon lesions that can mimic almost any type of cardiac disease. Over 90 per cent of myxoma which are the most common cardiac tumor occur in the atria, with 3 to 4 times as many occuring on the left as on the right. The development of nonivasive echocardiographic technique has made it possible to screen large numbers of patients with atrial myxoma with ease and safe. A 28 year old housewife was admitted because of dyspnea for 5 months. Clinical diagnosis of right atrial myxoma was made by echocardiography and right atrial angiocardiogram. Surgical resection was performed successfully. We presented a case of right atrial myxoma with a review of literatures.
Adult ; Diagnosis ; Dyspnea ; Echocardiography ; Heart ; Heart Diseases ; Heart Neoplasms ; Humans ; Myxoma*

PURPOSE: This study was conducted to construct traffic-accident-related injury pyramid based on the New Injury Severity Score (NISS). METHODS: We constructed injury episodes to use the Traffic Accident Insurance database (1997~2001) and calculated the NISS by Abbreviated Injury Scale (AIS). All episodes were classified into three groups by using the NISS: minor group (1~10), moderate group (11~25), and severe group (25~75). Seventy-five points were assigned to all death episodes. We constructed a traffic-accident-related injury pyramid by using an NISS criterion. We compared frequencies and percentiles of episodes in the NISS-based injury pyramid. RESULTS: The number of episodes was 2,012,135. Of these, 1,331,599 episodes involved males, and the other 680,536 episodes involved females. The number of death episodes was 2,091 in 1997, 1,971 in 1998, 2,430 in 1999, 2,546 in 2000 and 141 in 2002. The mean NISS was 6.89+/-6.31, and the percents for the minor group, the moderate group, and the severe group were 85.58%, 13.39%, and 1.03%, respectively. The percent of males in the severe group was higher than that of females by 2.43 times. The percent of older persons (>46 yrs) in the severe and moderate groups was higher than that of young adults (16-45 yrs) The percents of belt-unattached episodes, pedestrian episodes, and separated-car accident episodes in the severe group were higher than those of bet-attached episodes, passenger or driver episodes, and car-to-car accident episodes. The mean out-patient-department follow-up period and the mean loss rate of labor ability increased from the minor group through the moderate group to the severe group. CONCLUSION: We confirmed the characteristics of the traffic-accident-related injury pyramid.
Abbreviated Injury Scale ; Accidents, Traffic* ; Female ; Follow-Up Studies ; Humans ; Injury Severity Score* ; Insurance ; Male ; Young Adult

The recent advances in interventional radiology have made balloon catheter dilation the alternative treatment modality for ureteral stricture. However, it has not been widely accepted despite proven success in some case reports. Herein we analyzed the effect of antegrade balloon dilation on the 19 patients with various ureteral strictures. Twelve iatrogenic, 4 tuberculosis, 1 retroperitoneal fibrosis, 1 primary UPJ obstruction and 1 patient with unknown cause were included. The mean follow up period was 18.5 months. Symptomatic and radiologic success rate, factors influencing the outcome such as etiology. duration, length and site of stricture were evaluated. The overall success rates were 68% symptomatically and 63% radiologically. The success rate was not different between iatrogenic and non-iatrogenic strictures significantly. Most favorable results were obtained in the patients with tuberculosis and postsurgical strictures of less than 6 months in duration. Significant complications were not observed in all patients. Conclusively, balloon catheter dilation seems to be effective alternatives in the treatment of ureteral strictures of various etiology without severe complication. To improve the success rate, more experiences, development of equipment and method, and establishment of indications should be necessary.
Catheters ; Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Humans ; Radiology, Interventional ; Retroperitoneal Fibrosis ; Tuberculosis ; Ureter*

The recent advances in interventional radiology have made balloon catheter dilation the alternative treatment modality for ureteral stricture. However, it has not been widely accepted despite proven success in some case reports. Herein we analyzed the effect of antegrade balloon dilation on the 19 patients with various ureteral strictures. Twelve iatrogenic, 4 tuberculosis, 1 retroperitoneal fibrosis, 1 primary UPJ obstruction and 1 patient with unknown cause were included. The mean follow up period was 18.5 months. Symptomatic and radiologic success rate, factors influencing the outcome such as etiology. duration, length and site of stricture were evaluated. The overall success rates were 68% symptomatically and 63% radiologically. The success rate was not different between iatrogenic and non-iatrogenic strictures significantly. Most favorable results were obtained in the patients with tuberculosis and postsurgical strictures of less than 6 months in duration. Significant complications were not observed in all patients. Conclusively, balloon catheter dilation seems to be effective alternatives in the treatment of ureteral strictures of various etiology without severe complication. To improve the success rate, more experiences, development of equipment and method, and establishment of indications should be necessary.
Catheters ; Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Humans ; Radiology, Interventional ; Retroperitoneal Fibrosis ; Tuberculosis ; Ureter*

No abstract available.
Thorax*

Mitral stenosis is characterized by chronic pulmonary arterial hypertension. Although it is well recognized that right ventricle can be affected by pressure-overload in patients with mitral stenosis, the study for effects on right ventricular function after relief of pressure overload was difficult after open heart surgery due to paradoxical septal motion and scarring change of pericardium. Recently, percutaneous mitral valvuloplasty(PMV) has been used in patients with mitral stenosis as an alternative to surgical mitral commissurotomy. The present study was designed to demonstrate the difference of right ventricle between normal subjects and patients with mitral stenosis, as well as to investigate the changes of right ventricle before and after PMV with Doppler- echocardiography and isovolumic indices. The results were summarized as follows : 1) Right ventricular emptying fraction which was assumed to be proportional to right ventricular ejection fraction was depressed significantly in patients with mitral stenosis than those of normal subjects. However, there were no sighificant differences in Vpm between the two groups. 2) Right atrial and ventricular areas of patients with mitral stenosis were enlarged significantly than those of normal subjects. Right ventricular diastolic function measured by transtricuspid pulsed Doppler showed relaxation abnormality pattern in patients with mitral stenosis. 3) Enlarged right atrium and ventricular area were decreased significantly after PMV. Depressed right ventricular sytolic and diastolic function were recovered after relief of pressure-overload by PMV. However, there were no significant changes in Vpm after PMV. 4) Right ventricular emptying fraction was inversely correlated with mean pulmonary artery pressure and right ventricular end-diastolic area. Discriminant factor between group with right ventricular diastolic dysfunction and group without diastolic dysfunction was pulmonary vascular resistance. In conclusion, there were right ventricular systolic and diastolic dysfunction without abnormal right ventricular contractility in patients with mitral stenosis, moderate pulmonary hypertension and normal sinus rhythm, and these functional abnormalities were largery reversible after relief of pressure-overload on the right ventricle by PMV.
Cicatrix ; Echocardiography ; Heart Atria ; Heart Ventricles ; Humans ; Hypertension ; Hypertension, Pulmonary ; Mitral Valve Stenosis* ; Pericardium ; Pulmonary Artery ; Relaxation ; Stroke Volume ; Thoracic Surgery ; Vascular Resistance ; Ventricular Function, Right*

Purpose: To compare the degree of meibomian gland drop-out associated with Demodex infestation using non-contact meibography. Methods: We performed noncontact meibography using an infrared digital camera on 24 adult subjects infested by Demodex and 40 without infestation. The right upper and lower lids were scored based on the loss of meibomian glands, and the scores of the upper and lower eyelids were summed to obtain the total meiboscore for each subject. Meiboscores were evaluated according to Demodex infestation and gender in each group. Results: Sixty-four eyes of 64 people were enrolled in this study. The study subjects had an average age of 67.9 years (range, 40-79 years; men, 65.2 years; women, 69.1 years). There was a significant association between Demodex infestation and total meiboscore and upper and lower eyelid meiboscores (p = 0.000, p = 0.002, p = 0.004, respectively). There was no significant difference in the meiboscores between men and women. Age and meiboscore suggested a weak positive correlation; however, the R2 value was low, due to the concentrated age distribution of the study population. Conclusions Based on noncontact meibography, the authors concluded that the prevalence of changes in the meibomian glands was significantly related to Demodex infestation; however, there was no significant difference between men and women.

Mediastinal tuberculous lymphadenitis is rare in adults, and it is even rarer for dysphagia to be the presenting symptom of mediastinal tuberculous lymphadenitis. Mediastinal tuberculous lymphadenitis with esophageal symptoms has been presented as esophageal ulceration, mucosal or submucosal mass with ulceration, fistula or sinus formation, extrinsic compression, or displacement of the esophagus. An exaggerated form of extrinsic compression may be presented as a submucosal tumor, radiologically or endoscopically. A barium esophagography of a 34 year-old woman with painful dysphagia revealed a large submucosal tumor-like mass on the mid-esophagus. The symptom was spontaneously improved over a 3-week period together with reduction of the mass size. A computed tomography of the chest disclosed an enlarged subcarinal lymph node and histologic examination of the specimen obtained by thoracoscopic biopsy brought about a diagnosis of tuberculosis. We herein report a case of mediastinal tuberculosis with unusual manifestations.
Adult ; Case Report ; Deglutition Disorders/*etiology ; Diagnosis, Differential ; Esophageal Neoplasms/*diagnosis ; Esophagoscopy ; Esophagus/pathology/radiography ; Female ; Human ; Mediastinal Diseases/*complications/*diagnosis ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node/*complications/*diagnosis