In eyes with media opacity and equivocal ultrasonographic findings, we can differenciate retinal detachment from vitreous membrane using color doppler imaging(CDI), which allows the display of blood flow characteristics on conventional ultrasonography. The authors performed high resolution Bscan ultrasonography and color doppler imaging simultaneously in 31 eyes with opacity of ocular media, and their intraoperative characteristics and post operative results were evaluated. In 30 eyes with retinal detachment or vitreous membrane, 7 eyes(23%) had equivocal ultrasonographic findings and needed color doppler imaging. Nine eyes(75%) had positive color signal in 12 eyes with retinal detachment, whereas 3 eyes negative. 17 eyes(94%) had negative color signal in 18 eyes with vitreous membrane, 1 eye with proliferative diabetic retinopathy had positive. In conclusion, color doppler imaging is a useful diagnostic method in differentiating retinal detachment from vitreous membrane.
Diabetic Retinopathy ; Membranes* ; Retinal Detachment* ; Retinaldehyde* ; Ultrasonography

Long term follow-up study was done on 38 cases of anterior fusion for spinal tuberculosis especially about effect of buttress graft. The average follow-up period was 16 months. 14 cases of effective buttress group were appeared' to achieve more rapid bony union and prevent further kyphosis or lateral wedging of the involved vertebral body than inadequate buttress group of 7 cases.
Follow-Up Studies ; Kyphosis ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

PURPOSE: The objective of this study was to evaluate fracture strength of collarless metal-ceramic FPDs according to their metal coping designs. MATERIALS AND METHODS: Four different facial margin design groups were investigated. Group A was a coping with a thin facial metal collar, group B was a collarless coping with its facial metal to the shoulder, group C was a collarless coping with its facial metal 1 mm short of the shoulder, and group D was a collarless coping with its facial metal 2 mm short of the shoulder. Fifteen 3-unit collarless metal-ceramic FPDs were fabricated in each group. Finished FPDs were cemented to PBT (Polybutylene terephthalate) dies with resin cement. The fracture strength test was carried out using universal testing machine (Instron 4465, Instron Co., Norwood MA, USA) at a cross head speed of 0.5 mm/min. Aluminum foil folded to about 1 mm of thickness was inserted between the plunger tip and the incisal edge of the pontic. Vertical load was applied until catastrophic porcelain fracture occurred. RESULTS: The greater the bulk of unsupported facial shoulder porcelain was, the lower the fracture strength became. However, there were no significant differences between experimental groups (P > .05). CONCLUSION: All groups of collarless metal-ceramic FPDs had higher fracture strength than maximum incisive biting force. Modified collarless metal-ceramic FPD can be an alternative to all-ceramic FPDs in clinical situations.
Aluminum ; Bites and Stings ; Collodion ; Dental Porcelain ; Denture, Partial, Fixed ; Head ; Resin Cements ; Shoulder

We studied two hundread cases of replantations-61 cases of major limb replantation and 139 cases of finger replantation. 53 of 179 patients had multiple amputation. The most common cause of amputation was cutting-machine injury and the next one was belt and roller injury. The patients were followed than 6 months, ranging 6 months to 5 years and 10 months, averaging 36 months. The success rate of replantation is 86.9%(53/61) in the amputated limbs and 80.6%(112/139) in the amputated digits. Main causes of failure were tissue crushing, vessel thrombosis, long ischemic time, and amputation wound infection. Common complications were infection (25 cases), delayed union(7 cases), nonunion(2 cases), bleeding tendency and hematoma formation due to systemic heparinization(5 cases). We used Seddon's classification to assess the recovery of the nerve function of the replanted limbs and digits. 84.6 % of success cases of limb replantation presented the excellent result in the motor fuction recovery and 89.1% also presented the excellent sensory recovery. 89.8% of the success cases of the digit replantation showed the excellent result in the sensory recovery. The factors influencing the functional recovery of the replantation surgery were mechanism of injury, ischemic time, surgical technique, numbers of anastomosed vessels, ratio between anastomosed artery and vein, and wound infection. This analysis demonstrated that strict selection of the indication or the replantation is the first step in the limb and digit replantation surgery.
Amputation ; Arteries ; Classification ; Extremities ; Fingers ; Hematoma ; Hemorrhage ; Humans ; Operative Time ; Replantation ; Thrombosis ; Veins ; Wound Infection

The authors made an attempt to classify the supracondylar extension-valgus fracture according to the direction and location of the fracture line based on the radiographic manifestation. This new classification helps to dictate the model of treatment, possible sequence of reduction and the causes of deformity of the elbow after treatment. During the last 12 years of this study, 200 supracondylar fractures of the humerus were treated in the Kyung Hee University Hospital. Of the cases 82 were extension-valgus fractures. The results were as follows: 1. The supracondylar extension-valgus fracture were classified into 5 types: Type I: fish-tail fracture (14 cases) Type II : obtuse fish-tail fracture (27 cases) Type III: oblique fracture (16 cases) Type IV: oblique fracture with comminution of lateral column (14 cases) Type V: Transverse fracture (11 cases) 2. The displacement of the distal fragment in the fish-tail fracture is severe but it can be reduced easily by manipulation. Once reduction has been obtained, the fracture is stable and maintained by a long arm cast with acute flexion of the elbow alone. There is no need of percutaneous pinning. Among 14 cases of type I fracture there was no cubitus varus deformity. 3. The line of the obtuse fish-tail fracture lies distal to fish-tail fracture. This is unstable so it is necessary to percutaneous pinning. 4. The oblique fracture is produced by the hyperextension of the elbow and degrees of the obliquity of the fracture line were 12 to 20 degrees (Av. 14 degrees). The valgus angles in opposit elbows were 9 to 25 degrees (Av. 16 degrees). The forearm must be pulled into valgus position during the reduction of the fracture. 5. Type IV fracture occures under 4 years old, and more commonly in girls. This is unstable, so it is necessary to percutaneous pinning.
Arm ; Child ; Classification ; Congenital Abnormalities ; Elbow ; Female ; Forearm ; Humans ; Humerus

The Marfan syndrome is a generalized connective tissue disease involving eye, musculoskeletal system, cardiovascular system, and inherited autosomal dominant with various expression type. The cardiovascular complications such as aortic aneurysm, aortic dissection, aortic regurgitation, mitral regurgitation and aortic dissection which usually occurs in previously normal sized aorta are poor prognostic factors. However, the aortic dissection which developed in patient with Marfan syndrome and aortic aneurysm was rare. We experienced one case of dissecting aneurysm in patient diagnosed as previous aortic aneurysm, aortic regurgitation, and Marfan syndrome, receiving successful operation.
Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm* ; Aortic Valve Insufficiency ; Cardiovascular System ; Connective Tissue Diseases ; Humans ; Marfan Syndrome* ; Mitral Valve Insufficiency ; Musculoskeletal System

PURPOSE: To report the treatment results of 7 cases of distal radius nonunion with a review of the relevant literature. MATERIALS AND METHODS: Seven patients treated with an autoiliac bone graft and rigid internal fixation for nonunion of the distal radius were analyzed retrospectively for the cause of injury, the factors affecting nonunion, radiological findings, treatment method and complications. The results were analyzed radiologically using Kreder's method and functionally using the Anderson' protocols. RESULTS: Union was achieved in all cases after a mean period of 19 weeks. The functional result of treatment at the last follow-up was excellent in 4 cases and satisfactory in 3 cases. The probable factors of nonunion were instability of the fracture site in three cases, type II or III open fracture in 2 cases, postoperative infection in one case and idiopathic in one case. CONCLUSION: Infection control using a stepwise operation, rigid internal fixation and autogenous iliac bone graft showed satisfactory results in distal radius nonunion, which had developed in those with severe open fractures, postoperative infection, instability on the fracture site and associated distal ulnar fracture.
Follow-Up Studies ; Fractures, Open ; Humans ; Infection Control ; Radius ; Retrospective Studies ; Transplants

PURPOSE: To give a help in the interpretation of cardiac cine-MR examination, the extent, shape, and timing of appearance of signal void regions near atrioventricular(A-V) valve prospectively evaluated in the healthy population. MATERIALS AND METHODS: Using an axial gradient-echo technique with small flip angle, repetition time(TR) of 36 msec and echo time(TE) of 22 msec, 20 volunteers without known valvular abnormalities undertook cardiac cine-MR imaging including atrioventricualr valve areas. RESULTS: Transient signal void was observed within the atrium near the tricuspid(13/20 = 65%) and mitral valves(9/20 = 45%), respectively, which is so called "physiologic atrioventricular valvular insufficiency". Eight subjects revealed the signal void areas near both tricuspid and mitral valves but, 5 subjects didnot show any evidences of physiologic insufficiency. This physiologic condition does not extend more than lcm proximal to A-V valve plane and is generally observed only during early systole. Its morphology is semilunar or triangular configuration with the base to the valve plane in most cases of normal tricuspid insufficiency and small globular appearance in most cases of normal mitral insufficiency. CONCLUSION: Awareness of normal signal void areas near the A-V valve and their characteristics is critical in the interpretation of cardiac cine MR examinations and maybe helpfal in the study of the normal cardiac physiology.
Magnetic Resonance Imaging* ; Mitral Valve ; Mitral Valve Insufficiency ; Physiology ; Prospective Studies ; Systole ; Volunteers

STATEMENT OF PROBLEM: There have been many studies about marginal discrepancy of single restorations made by various systems and materials. But most of statistical inferences are not definite because of sample size, measurement number, measuring instruments, etc. And there have been few studies about the marginal fit of Computer-aided Cercon crowns. PURPOSE: The purpose of this study was to compare the marginal fit of the anterior single restorations made using computer-aided milled Cercon crowns with metal-ceramic restorations and to obtain more accurate information by using a large enough sample size and by making sufficient measurements per specimen. Material and methods. The in vitro marginal discrepancies of computer-aided milled Cercon crowns and control groups (metal ceramic crowns) were evaluated and compared. The crowns were made from one extracted maxillary central incisor prepared by milling machine. 30 crowns per each system were fabricated. Measurements of a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Parametric statistical analysis was performed for the results. RESULTS: The means and standard deviations of the marginal fit were 85+/-22micrometer for the control group and 91+/-15micrometer for the Cercon crowns. The t-test of the marginal discrepancies between Cercon crowns and metal-ceramic crowns were performed. Significant differences were not found between groups (P=0.230>.05). Based on the criterion of 120micrometer as the limit of clinical acceptability, the mean marginal fits of Cercon crowns and metal-ceramic crowns were acceptable. Conclusion. Within the limitations of this in vitro study, the following conclusions were drawn: 1. Mean gap dimensions and standard deviations at the marginal opening for maxillary incisal crowns were 85+/-22micrometer for the control (metal-ceramic crowns), 91+/-15micrometer for Cercon crowns. 2. The Cercon crowns showed slightly larger marginal gap discrepancy than the control but marginal gap between Computer-aided milled Cercon crowns and metal ceramic crowns did not showed significant difference (P>.05). 3. The Cercon crowns and metal ceramic crowns showed clinically acceptable marginal discrepancy.
Ceramics ; Crowns* ; Incisor ; Sample Size