Since the introduction of MRI, the arachnoiditis could easily haute been diagnosed by confirming the abnormal distribution of the roots in the dural sac. But the arachnoiditis-like pattern of nerve root distribution in a degenerative disc disease has been regarded as a an incorrect diagnosis of arachnoiditis. The arachnoiditis has been one of the most serious complication in the failed back surgery syndrome. MR images of 32 patients with acute or chronic radicular pain syndrome were investigated by a radiologist and a orthopedc surgeon. 17 patients had lumbar disc herniation; 13 patients, pure spinal stenosis; 2 patients, spondylolisthesis. The discriminant analysis was used to calculate the cutting point of clumping for the abnormal nerve root distribution and to assess the relationship between the arachnoiditis-like pattern of nerve root distribution and other factors According to the result of calculation, the cutting point of clumping In spinal stenosis was 9mm and that in a disc herniation was 6mm. Central clumping of nerve roots in the durn is considered as a characteristic finding at the constricted level of the lumbar degenerative disease. However, the appearance is not a differentiating factor between the adhesive arachnoiditis and constriction in the lumbar degenerative disease. Clinically, the adhesive arachnoiditis should be suspected in the lumbar degenerative disease with the nerve root clumping at multiple level, not associated with remarkable constriction of spinal canal. In the disc herniation with their sagittal diameter over 6mm, the clumping seems to imply the possibility of association with adhesive arachnoiditis.
Adhesives ; Arachnoid ; Arachnoiditis ; Constriction ; Diagnosis ; Failed Back Surgery Syndrome ; Humans ; Magnetic Resonance Imaging ; Spinal Canal ; Spinal Stenosis ; Spondylolisthesis

No abstract available.
Arm* ; Glomus Tumor*

Arachnoid cyst of the velum interpositum is unusual and causes symptoms similar to those seen with a third ventricular mass. This report describes a case in which the arachnoid cyst occupied the cistern of the velum interpositum and was coincident with multiple cranial neuropathies. The patient was treated by endoscopic fenestration of the cyst. The surgery resulted in decreased in the size of the cyst but aggravation of cranial neuropathies. The patient underwent methylprednisolone pulse therapy and intravenous immunoglobulin administration under the impression of the multiple cranial neuropathies and recovered completely 3 months later. The authors conclude that combined neurological disease that needs medical treatment should be differentiated and priority of the treatment should be determined carefully if arachnoid cyst is associated with unrelated or ambiguous neurological symptoms and signs. Careful considerations of cause and effect may avoid an unnecessary surgical manipulation
Arachnoid* ; Cranial Nerve Diseases* ; Humans ; Immunoglobulins ; Methylprednisolone

No abstract available.
Hand*

The trachea is a cartilagenous and membranous tubular midline structure with parallel walls. Tracheal deviation may be caused either by traction toward the diseased hemithorax or by compression toward the normal side. Unless an obvious mass is observed radiographically, occasionally it can be difficult to decide whether the trachea has been pushed or pulled from its normal position in the mediastinum. We studied the differences between tracheal deviation patterns in 23 patients with fibroatelectatic pulmonary tuberculosis and 35 patients with elongated and dilated aortas. In cases of retraction of the trachea by fibroatelectatic pulmonary tuberculosis, the diameter of the deviated segment was greater than that of the normal segment and deviation of the wall adjacent to the fibroatelectasis from its normal position was greater than that of the opposite wall. In cases of compression of the trachea by the elongated and dilated aorta, the diameter of the diviated segment was smaller than that of the normal segment and deviation of the wall adjacent to the aortic arch from its normal position was greater than that of the opposite wall. We conclude that these differences between tracheal deviation patterns are useful signs for discriminating retraction from compression. Thus when the trachea is retracted, the deviation of the juxtalesional wall is greater than that of the lesion-free wall, and vice versa.
Aorta ; Aorta, Thoracic ; Diagnosis, Differential* ; Humans ; Mediastinum ; Trachea* ; Traction* ; Tuberculosis, Pulmonary

PURPOSE: Bilateral high signal intensity in basal ganglia on Tl-weighted images is unusual. the purpose of this study is to describe the pattern of high signal intensity and underlying disease. METHODS AND MATERIALS: During the last three years, 8 patients showed bilateral high signal intensity in basal ganglia on Tl-weighted image, as compared with cerebral white matter. Authors analized the images and underlying causes retrospectively. Of 8 patients, 5 were male and 3 were female. The age ranged from 15 days to 79 years. All patient were examined by a 0.5T superconductive MRI. Images were obtained by spin echo multislice technique. RESULTS: Underlying causes were 4 cases of hepatopathy, 2 cases of calcium metabolism disorder, and one case each of neurofibromatosis and hypoxic brain injury. These process were bilateral in all cases and usually symmetric. In all cases the hyperintense areas were generally homogenous without mass effect or edema, although somewhat nodular appearence was seen in neurofibromatosis. Lesions were located in the globus pallidus and internal capsule in hepatopathy and neurofibromatosis, head of the caudate nucleus in disorder of calcum metabolism, and the globus pallidus in hypoxic brain injury. CONCLUSION: Although this study is limited by its patient population, bilateral hyperintense basal ganglia is associated with various disease entities. On analysis of hyperintense basal ganglia lesion, the knowledge of clinical information improved diagnostic accuracy.
Basal Ganglia* ; Brain ; Brain Injuries ; Calcium Metabolism Disorders ; Caudate Nucleus ; Edema ; Female ; Ganglia ; Globus Pallidus ; Head ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Male ; Metabolism ; Neurofibromatoses ; Retrospective Studies

No abstract available.
Humans ; Hyperbilirubinemia* ; Infant, Newborn*

Respiratory distress syndrome (RDS) of preterm infants remains a significant cause of morbidity and mortality despite improvements in neonatal intensive care and artificial ventilatory techniques. After identification of the deficiency of pulmonary surfactant is major pathophysiologic basis in RDS, artificial surfactant replacement therapy in RDS was first successfully tested by Fujiwara and co-workers in 1980. therefore, exogenous surfactant replacement produced exellent results in improved clinical and repiratory status during the acute period and decreased incidence of late complications and mortality. According to comparison of administration timing between early (within 6 hours after birth) and late (after 6 hours)group, early replacement therapy is more effective in improving of clinical course and prognosis. Because of that, early, just after birth, recognition and detection of RDS is also important procedure. There are many investigations and methods for the detection of RDS in prenatal or postnatal period. Among then, stable microbubble rating (SMR) test was a simple method and SMR test has a higher diagnostic accuracy. To determine the relation of the SMR and purified natural surfactant (PNS) concentration in vitro, the author conducted each 5 times test of SMR method according to 5 groups of PNS concentration by using modified Pattle's method. The results were as follows: 1) The mean and standard deviation of SMR according to 5 groups of PNS concentration were 119.4 (15.0in 20mug PL (phospholipid)/ml, 452.2 (160.2 in 40mug PL/ml, 879.0 (93.4 in 60mug PL/ml, 1311.8 (274.8in80mug PL/ml, 1710.6(272.3 in 100mug PL/ml. 2) The regression curve of SMR and PNS concentration showed statistically significant relation(p<0.005). In conclusion, the SMR test was a good method in estimation of surfactant concentration in vitro and also in diagnosis of RDS recognized as a surfactant deficiency. In the future, we expected that prophylactic surfactant replacement therapy. immediate after birth, will be more popular in the field of neonatal care of RDS. So, we recommended the use of this method for early detection and serving optimal care of RDS.
Diagnosis ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Microbubbles* ; Mortality ; Parturition ; Prognosis ; Pulmonary Surfactants*

OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans

It is well known that the medullary carcinoma of the breast is one of the special types of breast carcinoma with a good prognosis. At present, the medullary carcinoma of the breast is subclassified into 3 types: typical medullary, atypical medullary and nonmedullary carcinoma. Among them, the former has the best prognosis. We reviewed the film mammographic and ultrasonomammographic findings of 13 patients according to the reevaluated histopathologic diagnosis. Typical medullary carcinoma shows a well circumscribed mass with surrounding halo on film mammogram, and well defined mass with central intermediate echogenicity and peripheral low echogenicity and posterior acoustic enhancement on ultrasonomammogram. Atypical medullary carcinoma shows relatively well circumscribed mass with partial marginal obliteration on film mammogram, and irregular bordered mass with inhomogeneous echogenicity due to focal necrosis in the mass and associated findings of thick boundary, asymetrical lateral shadowing on ultrasonomammogram. Nonmedullary carcinoma shows lobulated mass with surrounding parenchymal distortion and skin thickening on film mammogram, and relatively well defined lobulating mass with surrounding parenchymal distortion and marked heterogeneous internal echogenicity on ultrasonomammogram. Therefore, differentiation between typical medullary carcinoma with good prognosis and atypical medulary or nonmedullary carcinoma with poor prognosis, may be possible by various diagnostic imaging modalities preoperatively. But further collective study shall be needed in near future.
Acoustics ; Breast Neoplasms ; Breast* ; Carcinoma, Medullary* ; Classification* ; Diagnosis ; Diagnostic Imaging ; Humans ; Necrosis ; Prognosis ; Shadowing (Histology) ; Skin