No abstract available.
Kidney* ; Radionuclide Imaging*

No abstract available.
Kidney* ; Radionuclide Imaging*

The type-specific PCR and the sequence analysis of 56 kDa gene of Orientia tsutsugamushi infected in field rodents specimens have shown intratypic genetic heterogeneity in genotype Karp. In sequence comparison, this genetic heterogeneity was mainly due to insertion or deletion of a repeated unit in variable domain I (VDI) region. These results suggested that genetic duplication or deletion of the specific sequence rnight be involved in intratypic genetic heterogeneity of Orientia tsutsugamushi.
Genetic Heterogeneity* ; Genotype* ; Orientia tsutsugamushi* ; Polymerase Chain Reaction ; Rodentia ; Sequence Analysis

No abstract available.
Trophoblasts*

We report two patients with Hallervorden-Spatz disease, who were diagnosed by same MR findings of marked low signal intensity in the globus and substantia nigra. They presented with ataxic and spastic gait, intention tremor, delayed mental development, and dysarthria. They were 7 year-old male and 8 yea r-old female siblings, who were healthy until 3 years of age when they suffered from progressive symptoms. T2-weighted images showed marked low signal intensity in the globus pallidus and substantia nigra indicating an increased irondeposition, and it might suggest Hallervorden-Spatz disease.
Child ; Dysarthria ; Female ; Gait Disorders, Neurologic ; Globus Pallidus ; Humans ; Male ; Pantothenate Kinase-Associated Neurodegeneration* ; Siblings* ; Substantia Nigra ; Tremor

No abstract available.
Brain Injuries* ; Brain* ; Disability Evaluation* ; Humans ; Perfusion* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: Pediatric sedation is an important factor for obtaining the images of good quality. We performed this study to analyze the efficacy of our sedation protocol using chloral hydrate. MATERIALS AND METHODS: We collected prospectively 151 sedation records of children(1 day-15 years old), who were sedated with chloral hydrate for MR(n=112) or CT(n=39) studies. We initially administered 50mg/Kg orally(n=94) or rectally(n=57) 30 minutes before the scheduled examinations, and then administered additionali dose (second dose :25-35mg/Kg, third dose:10-15mg/Kg) to patients whom initial dose failed to sedate. RESULTS: Satisfactory sedation was achieved by initial administration in 109 patients(72%) without si difference between oral(per oral: P.O.) and rectal(per rectal: P.R.) administration. Second dose was required in 28% and third dose in 5%. MR and CT examinations required second dose in 36(32%) and 6 patients(15%), respectively. P.O. -patients vomited in 5%. P.R. -patients defecated in 22% after initial administration. There were no other serious complications. Time interval from the drug administration to the start of examinations was 33 minutes in initial-dose-group and 64 minutes in additional-dose-group. Two patients could not complete MR examination due to early arousal. Prolonged sedation, requiring more than 30 minutes for alertness after MR and CT examinations, was encountered in twenty(18%) and two patients(5%), respectively. CONCLUSION: Our protocol using chloral hydrate(P.O. or P.R.) is thought to be an effective and safe method for pediatric sedation for MR or CT imaging.
Arousal ; Child* ; Chloral Hydrate* ; Humans ; Prospective Studies

Spinal epidural abscesses were evaluated using Gadolinium-enhanced magnetic resonance imaging (MRI) in 19 surgically and clinically confirmed cases, including 13 with tuberculous spondylitis and 6 with pyogenic spondylitis. We observed rim enhancement patterns in 10 patients and diffuse enhancement patterns in 9 patients. The spread patterns were localized to ventral or dorsal epidural space and encircled entire epidural space. We conclude that rim enhancement indicates abscess and diffuse enhancement indicates granulation tissue and fibrosis. Tuberculous epidural abscess spreads to ventral epidural space and pyogenic epidural abscess encircles entire epidural space.
Abscess ; Epidural Abscess* ; Epidural Space ; Fibrosis ; Granulation Tissue ; Humans ; Magnetic Resonance Imaging* ; Spondylitis

BACKGROUND: Horner's syndrome, including ptosis and miosis, is a sign of success following stellate ganglion block (SGB). However, it is not sufficient to ensure adequate sympathetic block to the upper extremity. There are numerous recommended local anesthetic volumes for SGB. The aim of this study was to evaluate the effects of differing volumes used in SGB on the elevation of skin temperature of ipsilateral upper extremity, and to find the volume required to elevate skin temperature most frequently. METHODS: Patients with sensory neural hearing loss underwent SGB, repeated daily in the paratracheal approach using different volumes (6, 8, 10, 12 and 16 ml) of 0.2% bupivacaine. Skin temperatures were checked in the hypothenar area before SGB, and 1, 2, 3, 4, 5, 10 and 15 minutes following SGB. Time intervals required for the elevation of skin temperature 1oC above the preblock level, and for the appearance of Horner's syndrome were recorded. RESULTS: Twenty-three patients repeatedly received SGB over 4 times at different volumes. The total SGB was 100 times, and all displayed Horner's syndrome. The total incidence of skin temperature elevation was 48%. Horner's syndrome appeared prior to the elevation of skin temperature (2.0 2.1 vs 5.3 3.8 min). There were significant differences in the incidence of skin temperature elevation, depending on the volume of the local anesthetics; 6 ml (17.6%), 8 ml (34.8%), 10 ml (52.2%), 12 ml (73.9%) and 16 ml (57.1%); greater volumes resulted in high incidences (pearson chi-square test, P = 0.005). The volume of twelve ml resulted in the highest incidence. Each patient needed different minimal volume to lead to the skin temperature elevation; 6 ml (13.1%), 8 ml (21.7%), 10 ml (17.4%), 12 ml (26.1%) and 16 ml (4.4%), and several patients (17.4%) did not have elevated skin temperature at any volumes. CONCLUSIONS: This study reveals that a large volume of local anesthetic (e.g. 12 ml) is needed in SGB for adequate sympathetic blockade to the upper extremity, and that each patient needs a different minimal volume for the skin temperature elevation to occur.
Anesthetics, Local ; Bupivacaine ; Hearing Loss ; Horner Syndrome ; Humans ; Incidence ; Miosis ; Skin Temperature* ; Skin* ; Stellate Ganglion* ; Upper Extremity*

BACKGROUND: Horner's syndrome, including ptosis and miosis, is a sign of success following stellate ganglion block (SGB). However, it is not sufficient to ensure adequate sympathetic block to the upper extremity. There are numerous recommended local anesthetic volumes for SGB. The aim of this study was to evaluate the effects of differing volumes used in SGB on the elevation of skin temperature of ipsilateral upper extremity, and to find the volume required to elevate skin temperature most frequently. METHODS: Patients with sensory neural hearing loss underwent SGB, repeated daily in the paratracheal approach using different volumes (6, 8, 10, 12 and 16 ml) of 0.2% bupivacaine. Skin temperatures were checked in the hypothenar area before SGB, and 1, 2, 3, 4, 5, 10 and 15 minutes following SGB. Time intervals required for the elevation of skin temperature 1oC above the preblock level, and for the appearance of Horner's syndrome were recorded. RESULTS: Twenty-three patients repeatedly received SGB over 4 times at different volumes. The total SGB was 100 times, and all displayed Horner's syndrome. The total incidence of skin temperature elevation was 48%. Horner's syndrome appeared prior to the elevation of skin temperature (2.0 2.1 vs 5.3 3.8 min). There were significant differences in the incidence of skin temperature elevation, depending on the volume of the local anesthetics; 6 ml (17.6%), 8 ml (34.8%), 10 ml (52.2%), 12 ml (73.9%) and 16 ml (57.1%); greater volumes resulted in high incidences (pearson chi-square test, P = 0.005). The volume of twelve ml resulted in the highest incidence. Each patient needed different minimal volume to lead to the skin temperature elevation; 6 ml (13.1%), 8 ml (21.7%), 10 ml (17.4%), 12 ml (26.1%) and 16 ml (4.4%), and several patients (17.4%) did not have elevated skin temperature at any volumes. CONCLUSIONS: This study reveals that a large volume of local anesthetic (e.g. 12 ml) is needed in SGB for adequate sympathetic blockade to the upper extremity, and that each patient needs a different minimal volume for the skin temperature elevation to occur.
Anesthetics, Local ; Bupivacaine ; Hearing Loss ; Horner Syndrome ; Humans ; Incidence ; Miosis ; Skin Temperature* ; Skin* ; Stellate Ganglion* ; Upper Extremity*