PURPOSE: The purpose of this study is to illustrate MR patterns of bone marrow of calvarium and vertebral body in normal subjects according the age distribution and to understand the course of the fatty replacement from red marrow. METHODS AND MATERIAL: We retrospectively evaluated MR examinations of the calvaria(n=71), cervical spine(n=71), thoracic spine(n=65), Imbar spine(n =68) in subjects without bone marrow abnormality whose age ranged 3 weeks to 74 years. Three distinctive patterns were categorized on Tl-weighted images of the skull. In pattern 1, uniformly low signal intensity with or without very small areas of high intensity in frontal and occipital bones is noted. In pattern 2, frontal and occipital bones have uniformly high signal intensity, and patchy area of high intensity appears in parietal bone. In pattern 3, the entire skull has uniformly high signal intensity. In the spine, four patterns were categorized on Tl-weighted MR images. In pattern 1, the vertebral body has uniformly low signal intensity except for linear areas of high intensity superior and inferior to basivertebral vein. In pattern 2, bandlike and triangular areas of high signal intensity are found in the periphery. Pattern 3 and 4 have diffusely distributed areas of high signal intensity; pattern 3 consist of numerous indistinct dots measuring a few millimeter or less, and pattern 4 consist of fairly well marginated areas ranging in size from 5 to 1.5cm. RESULT:In the calvaria, 73% of pattern 1 were younger than 20 years, pattern 2 were evenly distributed, and 86% of pattern 3 were older than 40 years. In the spine, 87% of pattern 1 were younger than 40 years, 72% of pattern 3 were in 40 to 50 years, and 87% of pattern 4 were older than 50 years. Pattern 2 were evenly distributed in the cervical and thoracic spine, but in the thoracic spine 62% were younger than 30 years. CONCLUSION:It is concluded that younger age group shows mainly pattern 1, whereas elderly group has pattern 3 or 4 in the calvarial and vertebral body marrow. This suggests that conversion to fatty marrow begin locally and progress diffusely with age.
Age Distribution* ; Aged ; Bone Marrow* ; Humans ; Occipital Bone ; Parietal Bone ; Retrospective Studies ; Skull* ; Spine ; Veins

BACKGROUND: Liver ischemia and reperfusion injury is associated with activation of several inflammatory pathways including cytokines, tumor necrosis factor (TNF) and cell-mediated tissue damage. tacrolimus causes a regulatory effect on some inflammatory pathways, such as cytokines, TNF, adhesion molecule and inflammatory cells. Prostaglandin E1 (PGE1) has shown vasodilatation by relaxing vascular smooth muscles and inhibits the effect of proinflammatory cytokines which could reduce leukocyte- sinusoidal and platelet-sinusoidal interactions. METHODS: Liver ischemia was induced in rats by occluding the vessels, the supplying median segment, and the left lateral segment with an aneurysmal clip for 60 minutes. The rats received tacrolimus (0.5 mg/kg, tacrolimus group) or PGE1 (100 ug/kg, PGE1 group) or normal saline (Control group) 30 and 5 minutes before ischemia and reperfusion of the liver, respectively. The serum ALT, nitric oxide, and TNF were determined at 1, 24, and 48 hours after reperfusion, and hepatic necrosis was determined at the same times by using HE staining and a microscopic grading system. RESULTS: 1) In the control group, the serum ALT and TNF levels had peak values at 1 hour and were gradually decreased, but the serum nitric-oxide level was gradually increased after the time of reperfusion (p<0.05). No necrosis existed at in one hour, but the tissue necrosis at 24 hours was higher than that at 48 hours (p<0.05). 2) At one hour, the tacrolimus group had significantly lower serum ALT and TNF levels and a higher serum nitric-oxide level in the liver compared with the control group, but the serum nitric-oxide level did not change significantly after reperfusion (p<0.05). The extent of hepatic necrosis was significantly inhibited in the tacrolimus group when compared with that in the control group and the PGE1 group (p<0.05). 3) The PGE1 group exhibited improved hepatic necrosis compared with the control group (p<0.05). The improved hepatic necrosis was reflected in reductions of the serum ALT and TNF and an increase in the serum nitric-oxide level. CONCLUSIONS: These result suggest that tacrolimus and PGE1 protect the liver against ischemia- reperfusion injury by reducing the serum TNF level and increasing the serum nitric-oxide level. The protective effect of tacrolimus is more beneficial than that of PGE1.
Alprostadil* ; Aneurysm ; Animals ; Cytokines ; Ischemia ; Liver* ; Muscle, Smooth, Vascular ; Necrosis ; Nitric Oxide ; Rats* ; Reperfusion ; Reperfusion Injury* ; Tacrolimus* ; Tumor Necrosis Factor-alpha ; Vasodilation

PURPOSE: Chronic granulomatous disease(CGD) is a group of genetic disorders characterized by recurrent pyogenic infections of the respiratory tract, skin,and soft tissue. The aim of this study is to describe the radiological findings of CGD. MATERIALS AND METHODS: We retrospectively analyzed radiological findings of 11 patients of CGD, which were diagnosed by nitroblue tetrazolium test. We analyzed the pattern of pneumonia on chest radiograph in all infants. Three cases of chest CT and one case of digital subtraction angiography were performed. According to infant's symptom, abdominal ultrasonography(n=8), abdominal CT(n=5), simple bone radiography(n=2), and brain CT(n=I) were performed. RESULTS: Repeated infiltration(100%), mass-like consolidation(73%), hilar or mediastinal lymph node enlargement(64%), scattered nodules(55%), cavity formation(27%), and pleural effusion(27%) were found on the chest radiographs(n=11) and CT(n=3). On the abdominal imagings(n=8), there were hepatosplenomegaly(n=6), calcifications in the liver(n=2) and kidney(n=1), hepatic granuloma(n=1) and renal abscess(n=1). Two patients had osteomyelitis. There were findings of meningitis on brain CT(n=1). CONCLUSION: We believe that the combinations of these radiological findings may suggest the diagnosis of CGD in patients with history of reccurent infection.
Angiography, Digital Subtraction ; Brain ; Diagnosis ; Granulomatous Disease, Chronic* ; Humans ; Infant ; Lymph Nodes ; Meningitis ; Nitroblue Tetrazolium ; Osteomyelitis ; Pneumonia ; Radiography, Thoracic ; Respiratory System ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

PURPOSE: We compared the safety and efficacy of ureteroscopy with intravenous propofol anesthesia with those with spinal anesthesia for the treatment of lower ureteral calculi. MATERIALS AND METHODS: Ureteroscopy with intravenous propofol anesthesia was performed in 38 patients with ureteral caluli, and spinal anesthesia was performed in 41. Ureteroscopy was performed with a 9.5Fr rigid ureteroscope. RESULTS: The overall success rate of stone removal was 99% (100% in IV propofol anesthesia cases and 98% in spinal anesthesia cases). Hospital stay times were significantly shorter for patients given propofol: 1.5 vs 3 days, respectively(p<0.05). CONCLUSIONS: Stone removal under intravenous propofol anesthesia does not increase the risk of complication or compromise the results of treatment and hospital stay times.
Anesthesia* ; Anesthesia, Intravenous ; Anesthesia, Spinal ; Endoscopy ; Humans ; Length of Stay ; Propofol* ; Ureter* ; Ureteral Calculi* ; Ureteroscopes ; Ureteroscopy*

Dysembryoplastic neuroepithelial tumor(DNET) is a recently described rare tumor that occurs most frequently in the temporal lobe of the brain and is characterized by long-standing, intractable complex partial seizures in children. The authors experienced one case of DNET occurring in a 13-year old boy, who had refractory complex partial seizure for 7 years. CT scan revealed nonenhancing low density mass in the left temporal lobe. MR images demonstrated a well-marginated cortical mass with very low signal intensity on TIWI and multinodular appearance of high signal intensity on T2WI. A few small enhancing foci within the mass were noted on contrast enhanced MR images. DNET, a rare tumor, should be considered in the differential diagnosis of neoplasm which causes seizure and is distinguished from other tumors because of its benign course. Differentiation between DN ETand other tumors by CT and MR findings is very difficult. But, our case showed the multinodular pattern on T2W image, which may be helpful feature in the differential diagnosis.
Adolescent ; Brain ; Child ; Diagnosis, Differential ; Humans ; Male ; Neoplasms, Neuroepithelial* ; Seizures ; Temporal Lobe ; Tomography, X-Ray Computed

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.
Early Ambulation ; Humans ; Immobilization ; Rehabilitation ; Spine ; Surgical Procedures, Operative

This dealt with the 23 cases of giant cell tumor of femur and tibia who were treated with curettage and cementation of the lesion, over 14 year period. Cement by virtue of it's heat of polymerization may “sterilize” the wall upto 3-5mm in depth. Authors adoped cement treatment as an effective adjuvant after intra-lesional surgery(curettage). Curettage was indicated in all stage I lesions; most stage 2 and some stage 3 lesions, provided the residual bone stock were sufficient to make it oncologically and mechanically effective. The follow-up period ranged from 3 to 14 years(oaverage 8 years and 6 months). The sites of the lesions were proximal tibia in 8, dital femur in 13, proximal femur in one, and distal tibia in one. Among these cases, 3(13.0%) cases(two grade 1 and one grade 2) of stage II(To: active), and 2(8.7%) of stage III(grade 2) (Tl or T2: aggressive). Utmost attention was paid to nulify or to reduce the local seeding of the tumor cell during aggressive curettage, which was followed by electrical cautery of the cavitey wall, and lastly by the cavity obliteration with bone cement. None of the cases had lung metastasis. Only in a stage III GCT case(4.3%) of local recurrence after curettage and bone and artificial bone graft, recurettage and cementation brought the successful outcome. Through this study, it was reconfirmed that with correct indications the use of cement as a local adjuvant in conjuction with curettage was effective method in treating GCT without any side effects.
Cautery ; Cementation ; Curettage ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Hot Temperature ; Lung ; Methods ; Neoplasm Metastasis ; Polymerization ; Polymers ; Recurrence ; Tibia ; Transplants ; Virtues

The purpose of this study is to present a legal system in which information is actively collected and utilized to monitor the location and health of self-quarantined persons through IT, to identify loopholes in the law and regulatory system in view of data protection and utilization, and to propose a legislative solution for those loopholes. In Korea, the Infectious Disease Control and Prevention Act (“the Prevention Act”) regulates all matters related to the prevention and management of infectious diseases, including the use of information on self-quarantine apps. Article 42(2) of the Prevention Act states that local governments are authorized to collect the location and health information of a quarantined citizen; however, the law does not elaborate on how this information can be used and what other information can be used in combination with the collected information. Thus, the Personal Information Protection Act (“the Protection Act”), as a general privacy law, is applied supplementarily. However, since the Protection Act is very general and does not have accumulated cases, there is uncertainty about how governments can utilize the collected information. Therefore, it is necessary to consider a legislative solution that includes a direct and clear basis for the use of personal information collected under the Prevention Act in consideration of Korean privacy regulations.

BACKGROUND: Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period. METHODS: Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Post-treatment evaluations were performed 1 month after the fourth treatment session. RESULTS: All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves. CONCLUSIONS: This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.
Aluminum ; Cicatrix ; Cosmetics ; Humans ; Lacerations ; Laser Therapy ; Lasers, Solid-State ; Patient Satisfaction ; Quality of Life ; Skin ; Yttrium

BACKGROUND: Postoperative nausea and vomiting remain troublesome problems, especially in women receiving the opioid analgesics. This study was performed to assess the antiemetic efficacy of ondansetron in patients using an intravenous patient-controlled analgesia (IV-PCA) after gynecologic surgery. METHODS: In this randomized placebo-controlled study, forty healthy gynecologic surgical patients received ondansetron 4 mg or placebo at the end of surgery. Patients in the recovery room received fentanyl by PCA which provided a bolus dose of 20 microgram, a lockout time of 6 minutes, and a basal infusion of 20 microgram/hr. We assessed the occurrence of nausea, vomiting, and the need for rescue antiemetics during the first 24 hours after operation. RESULTS: During the first 24 hr after operation, 40% of patients experienced no nausea or vomiting in the ondansetron group compared to 30% of patients in the placebo group. There was no significant difference in the incidence of nausea between groups (70% in placebo group vs 60% in ondansetron group). However, ondansetron reduced the incidence of vomiting from 50% to 15%, and the need for rescue antiemetics significantly from 25% to 0% (P< 0.05). CONCLUSIONS: Ondansetron in a dose of 4 mg does not prevent postoperative nausea during the first 24 hours after operation when used with fetanyl PCA. However, ondansetron significantly reduces the chance of postoperative vomiting and rescue antiemetics.
Analgesia, Patient-Controlled* ; Analgesics, Opioid ; Antiemetics ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Nausea ; Ondansetron* ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Recovery Room ; Vomiting