No abstract available.

No abstract available.
Malaria*

No abstract available.

Magnetic resonance imaging(MRI) appears to be the most sensitive modality for early diagnosis of avascular necrosis of the femoral head and has recently been recommanded as a means of strengthening individual treatment decisions, However, MR signal patterns in AVN has been described to vary widely. And the understanding of the anatomic and pathologic structures represented on the MRI thus appears desirable for improved tissue characterization, staging of disease, and therapeutic planning. The object of this study was to analyze the correlation of MRI, radiographic staging, radionuclide imaging, and histological findings in AVN of the femoral head. The authors analyzed retrospectively 30 patients(36 hips) of AVN of the femoral head who underwent bipolar hemiarthroplasty or total hip replacement arthroplasty at Korea University Hospital from Nov. 1990 to Oct. 1993. The radiographic stage was evaluated according to Ficat and Arlet classification, and MRI was evaluated according to Mitchell et al. classification. The histologic changes corresponding to MRI abnormalities were assessed in 10 fresh surgical specimens. The obtained results were as follows; 1. Nine cases (25%) were class A, 3 class B (8%), 6 class C (17%) and 18 class D(50%) by Michell et al. classification on MRI and typical double line sign was found in 20 cases(56%). 2. Most of the cases of Ficat and Arlet stage II in simple radiograph showed MR class A or B, and stage III and IV showed class C or D. 3. There cases(10%) showed false negative studies in radionuclide imaging. 4. The necrotic bone & marrow and amorphous cellular debris represented the low signal intensity on both T1WI and T2WI, and repairing tissue, thickened trabeculae with mesenchymal cell infiltration was low signal intensity in T1WI and intermediate signal intensity in T2WI, and fibrous tissue was low signal intensity on both T1WI and T2WI. 5. MR classification by Mitchell et al. was not correlated with histological finding in respect of progression. Above results suggest that MRI provide the information about accurate anatomical location and involved site of necrosis, while MR classification by Mitchell et al. was not useful for staging of pathogenic process of AVN of the femoral head. The therapeutic plan and modalities have to be estabilished by comprehensive analysis of MRI, simple radiograph and other diagnostic modalities.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Marrow ; Classification ; Early Diagnosis ; Head ; Hemiarthroplasty ; Korea ; Magnetic Resonance Imaging ; Necrosis ; Radionuclide Imaging ; Retrospective Studies

OBJECTIVE: The purpose of this study was to evaluate the validity and reliability of Korean version of Addiction Severity Index for the systematic diagnosis and evaluation of alcoholism. METHODS: The authors selected 65 alcoholic patients with the criteria of DSM-VI. RESULTS: The results were as follows: 1) The exception of the significant correlation between psychiatric and the family/social problem area, the 6 sections of ASI were mutually independent. 2) There was significant inter-rater reliability in all sections of ASI. 3) In medical, alcohol use, family/social and psychiatry section, the calculation of composite score showed reasonable level of item consistency. In all sections, there was significant correlation between composite scores and severity ratings of corresponding section. 4) The important items of each section were most highly correlated with their corresponding severity ratings except two sections. 5) In the multiple regression analysis, the amount of variance accounted far by the most important 4 items were 83% in medical section, 45% in employment/support,43% in alcohol use section, 55% in legal section,53% in family/social section and 84% in psychiatric section. 6) Severity rating of psychiatric section was significantly correlated with the scores of MMFI, MAST and SCL-90-R. CONCLUSION: The result suggests that Korean version of the ASI showed relatively reasonable reliability and validity and it can be used in treatment and study of alcoholic patients.
Alcoholics* ; Alcoholism ; Diagnosis ; Humans ; Reproducibility of Results*

PURPOSE: Colonic diverticulitis is an uncommon disease in Korea, but the incidence of the disease is increasing. The right colon is the more preferred site for diverticulitis in Korea, but the incidence of left diverticulitis is increasing. Therefore, comparing the clinical features and treatments for right diverticulitis with those for left diverticulitis may help us to treat the disease more properly. METHODS: This study was performed retrospectively by reviewing the medical records of 96 patients with colonic diverticulitis, in whom either conservative or operative treatments were performed. RESULTS: Eighty-six patients had right diverticulitis (RD), and 10 patients had left diverticulitis (LD). The mean age of the patients was older for LD. Sixteen patients (18.6%) with RD had complications, and 7 patients (8.1%) underwent operations. On the other hand, 4 patients (40%) with LD had complications, and 3 patients (30%) underwent operations. The rates of complications and operations among old-aged patients were higher. The operations for 7 patients with RD who underwent surgery were 6 ileocecectomies and 1 diverticulectomy. On the other hand, the operations for the 3 patients with LD who underwent surgery were 2 resections and anastomoses and 1 diverticulectomy. The reasons for the operations were abscess formation, recurrence, perforation, and development of generalized peritonitis without response to conservative treatment. CONCLUSION: The incidence of LD is lower than that of RD in Korea, but the rate of complications and operations seems higher in LD. Therefore, patients who complain of left lower abdominal pain need to be thoroughly examined for LD.
Abdominal Pain ; Abscess ; Colon ; Diverticulitis ; Diverticulitis, Colonic ; Hand ; Humans ; Incidence ; Korea ; Medical Records ; Peritonitis ; Recurrence ; Retrospective Studies

PURPOSE: The purpose of this study was to investigate the quantitative evaluation of the corticospinal tract (CST) at the multiple levels by using functional MRI (fMRI) co-registered to diffusion tensor tractography (DTT). MATERIALS AND METHODS: Ten normal subjects without any history of neurological disorder participated in this study. fMRI was performed at 1.5 T MR scanner using hand grasp-release movement paradigm. DTT was performed by using DtiStudio on the basis of fiber assignment continuous tracking algorithm (FACT). The seed region of interest (ROI) was drawn in the area of maximum fMRI activation during the motor task of hand grasp-release movement on a 2-D fractional anisotropy (FA) color map, and the target ROI was drawn in the cortiocospinal portion of anterior lower pons. We have drawn five ROIs for the measurement of FA and apparent diffusion coefficient (ADC) along the corona radiata (CR) down to the medulla. RESULTS: The contralateral primary sensorimotor cortex (SM1) was mainly found to be activated in all subjects. DTT showed that tracts originated from SM1 and ran to the medulla along the known pathway of the CST. In all subjects, FA values of the CST were higher at the level of the midbrain and posterior limb of internal capsule (PLIC) than the level of others. CONCLUSION: Our study showed that co-registered fMRI and DTT has elucidated the state of CST on 3-D and analyzed the quantitative values of FA and ADC at the multiple levels. We conclude that co-registered fMRI and DTT may be applied as a useful tool for clarifying and investigating the state of CST in the patients with brain injury.
Anisotropy ; Brain Injuries ; Diffusion ; Evaluation Studies as Topic ; Extremities ; Hand ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Mesencephalon ; Nervous System Diseases ; Pons ; Pyramidal Tracts ; Seeds ; Track and Field

In order to evaluate whether Wisconsin Card Sorting Test(WCST) could be used to detect the vulnerability markers of schizophrenia, three groups such as offsprings of schizophrenic patients(n=28), offsprings of alcoholic patients(n=18), and offsprings of psychiatrically normal persons(n=41) were examined for their concept formation and abstract thinking by means of WCST.The results were as follows; 1) No significant differences were noted in all variables of the WCST such as number of totol administered trials, total correct response %,total error response $,perseverative response %,perseverative error response %,nonperseverative error response %,conceptual level response %,number of completed category,number of trials to complete 1st category,number of failure to maintain a set,and learning to learn among three groups. 2) There was no difference in the number of cases with extreme low WCST total correct % of lower 10% of the normal controls among three groups. These results suggest that Wcst could be an ineffective instrument for using to detect the vulnerability markers of schizophrenia.
Alcoholics ; Concept Formation ; Humans ; Learning ; Schizophrenia ; Thinking ; Wisconsin*

PURPOSE: To analyze early postoperative complications of calcaneal fractures operated by a lateral extensile approach and to identify risk factors for wound complications. MATERIALS AND METHODS: From July 1990 to February 2003, 116 calcaneal fractures in 104 patients were treated by open reduction and internal fixation through a lateral extensile approach. The patient's records were reviewed for early postoperative complications. Statistical analysis was performed to determine significant relationships between predicted variables and the development of wound complications. RESULTS: Fourteen fractures (12.0%) developed infection. Ten of them were superficial infection and four were deep infection that required surgical treatment. Eight fractures (6.9%) developed skin necrosis. Six of them were marginal skin necrosis and two were flap necrosis that required surgical treatment. Seven fractures (6.0%) developed sural nerve injury, but their symptoms were improved without additional treatment. Open fracture (p=0.003) and prolonged operating time (p=0.049) increased significantly the rate of wound complications. CONCLUSION: The rate of early postoperative complications of calcaneal fractures operated by a lateral extensile approach is high. These complications can be reduced by meticulous treatment of an open wound, reduced operating time within 90 minutes through preoperative planning and skillful technique, and correct incision to avoid damage of the sural nerve.
Fractures, Open ; Humans ; Necrosis ; Postoperative Complications* ; Risk Factors ; Skin ; Sural Nerve ; Wounds and Injuries

BACKGROUND: It has been known that a patient head in sniffing position for lightwand facilitated tracheal intubation is not an anatomically appropriate method. However, there is no evidence nor study whether it is true or not. In this study, we compared success rates of lightwand facilitated tracheal intubation in neutral position versus sniffing position. METHODS: With informed consent, sixty adult patients of ASA physical status I or II were randomly allocated into two groups: neutral position (N) or sniffing position (S) group. A lightwand and tube were bent at approximately a 90degrees degree angle for N group and a 60 degree angle for S group on the basis of mouth axis and pharyngeal axis. The time to intubation, success rates of 1st trial of intubation, overall intubation success rates, hemodynamic changes and complications during the procedure were recorded. RESULTS: There was no significant difference in the time to intubation, success rates of 1st trial of intubation, overall intubation success rates, hemodynamic changes and complications between neutral position and sniffing position groups. CONCLUSIONS: Success rates of lightwand facilitated tracheal intubation in neutral position versus sniffing position showed no significant difference. Therefore, both positions are suitable for lightwand assisted intubation.
Adult ; Axis, Cervical Vertebra ; Head* ; Hemodynamics ; Humans ; Informed Consent ; Intubation* ; Mouth