PURPOSE: This paper is proposing an improved CT-free registration method which may provide us an accurate and reliable placement of acetabular cup without CT/MRI images. DESIGN AND METHODS: The proposed method employs a T-bar shaped gauge placed on the anatomical landmarks of the pelvis for the registration. The T-bar shaped gauge has its own LED markers and the position of the gauge is obtained through OPTOTRAK3020 system. These landmark points are the anterior superior iliac spines and the symphysis pubis defining anterior pelvic plane. Two subjects were tested to compare the landmark based registration and the proposed T-bar based registration. RESULTS: The measurement deviations of the pelvic obliquity in the frontal plane, tilt in the sagittal plane, and rotation in the transverse plane were 2.08, 1.41, and 2.51 degrees respectively in the point based registration. The T-bar based registration produced 40% smaller deviations(p<0.05): the pelvic obliquity in the frontal plane, tilt in the sagittal plane, and rotation in the transverse plane were 0.84, 0.81, and 1.17 degrees respectively in the T-bar based registration. There was no outlier exceeding 5 degrees in measurement deviation by the T-bar based registration while the outliers were found by the landmark based registration. CONCLUSIONS: We found that T-bar based CT free registration method is more reliable and accurate than the landmark based registration for the acetabular cup navigation. Also, the new method produced more precise registration(p<0.05). We are expecting some offset error of the new registration method due to the skin thickness existing between the T-bar frame and the bony pelvic frame, which may be compensated if we may accumulate sufficient database of the offset.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Pelvis ; Skin ; Spine

BACKGROUND: The previous reports have demonstrated that coronary artery flow profiles might change in patients with aortic valve disease. Our objective was to assess phasic coronary artery flow and velocity characteristics and coronary flow reserve in patients with severe aortic vale disease. METHOD: We studied six patients (4 men and 2 women, mean age 61.3+/-6.3 years) with aortic regurgitation and seven patients (3 men and 4 women, mean age 66.3+/-10.3 years) with aortic stenosis. Coronary flow velocity was measured at the proximal portion of left anterior descending artery with 0.014-inch Doppler tipped guide wire and intracoronary injection of adenosine. Nineteen patients (11 men and 8 women, mean age 52+/-9.8 years) with normal coronary artery were served as normal control. Result: The velocity-time integral of systolic coronary flow (SPVi) was significantly higher in patient with severe aortic regurgitation than control (21.1+/-5 vs 9.4+/-3.1, p<0.05, respectively) and ratio of diastlic to systolic the velocity-time integrals (DSiR) was significantly lower in patient with severe aortic regurgitation than control subject (1.5+/-0.5 vs 3.7+/- 0.8 p<0.05, respectively). Patients with severe aortic stenosis had significantly higher velocity-time integral of diastolic coronary flow (DPVi) than control subject (17+/-9.7 vs 8.8+/-3.0 p<0.05, respectively) and slighly higher DSiR than control subject (4.0+/- 2.5 vs 3.7+/-0.8 p<0.05, respectively). Coronary flow reserve was significantly decreased in patient with aortic valve disease compared with control subject (2.1+/-0.8 vs 3.2+/-0.4 p<0.05, respectively). CONCLUSION: Coronary flow reserve decreased significantly in patients with AR and with AS compared with normal control. Coronary blood flow profiles in patients with AR was characterized by systolic flow predominance and reduced diastolic flow whereas patients with AS was a tendency toward decreased systolic flow and increased diastolic flow.
Adenosine ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Aortic Valve* ; Arteries ; Coronary Vessels* ; Female ; Humans ; Male

A young male patient diagnosed with Klinefelter syndrome was admitted to our hospital via the emergency room with chief complaints of acute chest pain and dyspnea. Pulmonary thromboembolism was diagnosed from his chest CT images. His symptoms improved after he underwent thrombolysis and anticoagulation treatment. Klinefelter syndrome has a tendency towards hypercoagulability due to hormonal imbalance and one or more inherited thromophilic factors. Thus, Klinefelter syndrome patients with a past medical history of venous thromboembolism require continuous oral anticoagulation therapy for a period of at least six months.
Chest Pain ; Dyspnea ; Emergencies ; Humans ; Klinefelter Syndrome ; Male ; Pulmonary Embolism ; Thorax ; Thrombophilia ; Venous Thromboembolism ; Venous Thrombosis

Prolonged administration of steroid in children with steroid-dependent nephrotic syndrome can cause serious complications including growth failure, and various alternative treatments have been used for these children to alleviate steroid-induced complications and to achieve long-lasting remission. Present study was undertaken to compare the therapeutic efficacy of cytotoxic agents (cyclophosphamide and chlorambucil), cyclosporine and levamisole in 88 children with steroid-dependent mininal-change nephrotic syndrome, who have been followed-up in Pediatric Department, Kyungpook National University Hospital from 1985 to 1995. Cyclophosphamide and chlorambucil were given for 8 weeks (cyclophosphamide in 36 and chlorambucil in 13 cases) or 12 weeks (cyclophosphamide in 34 and chlorambucil in 12 cases), and cyclosporine (3-5mg/kg/day) and levamisole (2-2.5mg/kg alternate day) were given for 6-12 months. And the results were as follows ; Results of cytotoxic therapy ; At the end of the 1st year, remission rate with 12 wks course of cyclophosphamide(53%) was better than with 12 wks course of chlorambucil(33%) or 8 wks course of either drugs. However, at the end of the 2nd year, no difference was noted in remission rate between 12 wk course of cyclophosphamide(19%) and chlorambucil(17%). Results of cyclosporine therapy ; Out of 44 cases, 28(64%) showed sustain-ed remission, 8(18%) relapse with decreased frequency and steroid-sparing effect, and 8 no therapeutic effects. During treatment period, BUN, creatinine and blood pressure were remained in normal ranges. Remission rates with cyclosporine alone therapy without steroid in cyclosporine-responsive children were 83%, 83%, 57% and 43% at 2, 4, 6 and 8 months, respectively. Results of levamisole therapy ; Out of 16 cases, 8 (50%) showed sustained remission, 5(31%) relapse with decreased frequency and steroid-sparing effect, and 3 no therapeutic effects. In one case, transient neutropenia was observed without serious sequelae. Remission rate with levamisole alone therapy without steroid in levamisole-responsive children were 88%, 85%, 67% and 44% at 2, 4, 6 and 8 months, respectively. In conclusion, present study indicates that 12 weeks course of cyclohospha-mide or chlorambucil seems to be the most effective therapy for inducing long-lasting remission in steroid-dependent nephrotic children. And long-term use of cyclosporine or levamisole can also be used quite effectively in achieving prolonged remission and steroid-sparing effects without serious side effects.
Blood Pressure ; Child* ; Chlorambucil ; Creatinine ; Cyclophosphamide ; Cyclosporine* ; Cytotoxins* ; Gyeongsangbuk-do ; Humans ; Levamisole* ; Nephrotic Syndrome* ; Neutropenia ; Recurrence ; Reference Values

BACKGROUND: Previous studies indicated that a recently approved synthetic HMG-CoA reductase inhibitor, atorvastatin, reduces LDL cholesterol and triglyceride. To assess the efficacy on the level of serum LDL cholesterol and other lipoprotein fractions and its safety, we investigated 59 patients for lipid and side effect profile. METHOD: In patients with hypercholesterolemia, who showed 12-hours fasting serum LDL cholesterol>145 mg/dl and <250 mg/dl and triglyceride levels<400 mg/dl were enrolled to diet therapy for 4 weeks. After 4 weeks of diet therapy, serum lipid profile were reevaluated and patients with LDL cholesterol > or =130 mg/dl were assigned to receive 10 mg dose of atorvastatin once daily for 4weeks. After 4 weeks of drug therapy, serum lipid profile were rechecked, if showed LDL cholesterol level> or =130 mg/dl, assigned to receive 20 mg dose of atorvastatin once daily until 8 weeks. RESULTS: Of the 59 patients were assigned to receive atorvastatin therapy, 52 patients completed the study. Among lipid profiles, total cholesterol, triglyceride, LDL-cholesterol and apolipoprotein B levels showed significant reduction with mean reduction rate of 28%, 13%, 38%, 32% respectively after 4 weeks and 31%, 13%, 41% and 34% respectively after 8 weeks. HDL-Cholesterol and lipoprotein (a) level did not show significant change after 8 weeks of therapy. Nine patients had mild adverse events, such as elevated ALT, epigastric pain, insomnia, thumb pain. postural hypotension, palpitation and constipation. Only three patients of fifty-nine withdrew from the study due to adverse events related to drug treatment. CONCLUSION: The atorvastatin was highly effective and generally well tolerated with an acceptable safety profile in patients with primary hypercholestelemia.
Apolipoproteins ; Cholesterol ; Cholesterol, LDL ; Constipation ; Diet Therapy ; Drug Therapy ; Fasting ; Humans ; Hypercholesterolemia* ; Hypotension, Orthostatic ; Lipoprotein(a) ; Lipoproteins ; Oxidoreductases ; Sleep Initiation and Maintenance Disorders ; Thumb ; Triglycerides ; Atorvastatin Calcium

No abstract available.
Gastrointestinal Tract* ; Leiomyosarcoma*

Basal cell nevus syndrome (BCNS) is principally characterized by cutaneous basal cell carcinomas, multiple odontogenic keratocysts and skeletal abnormalities. Our patient represented several characteristics of BCNS, such as, multiple odontogenic keratocysts, facial nevus, calcification of falx cerebri, parietal bossing and mental retardation. The cyst on posterior mandible showed recurrent and newly developing tendency.
Basal Cell Nevus Syndrome* ; Carcinoma, Basal Cell ; Humans ; Intellectual Disability ; Mandible ; Nevus ; Odontogenic Cysts* ; Rabeprazole

No abstract available.
Transplantation* ; Tuberculosis*

No abstract available.
Transplantation* ; Tuberculosis*

BACKGROUND: The intimal thickening of coronary artery was understood as an early process in the beginning of atherosclerosis. However, the implication of intimal thickening as a morphologic change of coronary artery disease, on the coronary vascular hemodynamics has not been explored. METHODS: To evaluate the effect of intimal thickening on the coronary vascular hemodynamics, we studied the extent of intimal thickening on intravascular ultrasound(IVUS) and the coronary vascular flow and resistance by using Doppler wire in left anterior descending coronary arteries after successful intervention in 40 patients(29 males, mean age 55+/-9 years) with coronary artery disease. Mean intimal index and mean lumen cross sectional area were determined by IVUS and coronary flow average peak velocity was obtained by using Doppler wire before and after intracoronary adenosine in distal artery to the stenosis. Coronary flow velocity reserve(CFR), volumetric coronary blood flow(CBF) and coronary vascular resistance index(CVRI) were calculated. Hyperemic pressure-to-flow ratio(hyperemic mean aortic pressure/hyperemic volumetric coronary blood flow), ie, an index of minimal coronary vascular resistance(mCVR), was further derived. RESULTS: Intimal index(mean 20.0+/-8.3%) was significantly correlated with CVRI(mean 0.33+/-0.14, r=.37, p=.02) and mCVR(mean 0.81+/-0.40mmHg/ml/min, r=.36, p=.02). However, there was no correlation with CBF and CFR. CONCLUSION: The CVRI and mCVR(hyperemic pressure to flow ratio), the indices coronary microvascular resistance, were significantly related to the degree of intimal thickness of coronary artery. The extent of intimal thickness of coronary artery on IVUS study may be related to microvascular integrity.
Adenosine ; Arteries ; Atherosclerosis ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Hemodynamics ; Humans ; Male ; Vascular Resistance*