The purpose of this study was to investigate the effect that three resin indexing materials had on the distortion of split cast in the procedures of solder indexing and block fabrication. The specimen had two cylinders and connecting bar. Two cylinders were a reference cylinder and a test cylinder that were machined precisely and placed on metal base. The total of specimens wee 30 and they were divided into 3 groups according to the resin indexing materials : Acrylic solder , G-C Pattern resin , Z-100 . The relative coordinates (X, Y, Z) of centroids of both cylinders were measured by using 3-D coor dinates measuring machine. The value of indexing distortion was obtained after application of indexing material, and the value of the block distortion was obtained after fabrication of soldering block, and the value of total distortion was a value sum of indexing distortion and block distortion. Intercentroidal linear distortion({{{{ SQRT {X'^2 + Y'^2 +Z'^2 }- SQRT {X^2 + Y^2 +Z^2} }} }}) and global distortion {{{{rm SQRT {(X'-X)^2 +(Y'-Y^)2 +(Z'-Z^)2} }} }} were calculated from data of coordinates of centroids at each mea s u r ing stages. The results of this study were as belows ; 1. The intercentroidal distance between the split casts was reduced by indexing distortion and increased by block distortion. 2. The indexing global distortion between the split casts was smaller than block global distortion. 3. The intercentoidal linear distortion and the global distortion were no significant difference between indexing materials.
Abstracting and Indexing as Topic

The current available treatment methods of spasticity are consisted of physical therapies, medications, surgeries, injections of phenol or botulinum, and electrical stimulations. The purposes of this study were to evaluate the effectiveness of surface electrical stimulation in reducing spasticity in the spinal cord injured patients, to find out carry-over effects of electrical stimulation and to find out the factors influencing the effects of the treatment. The subjects were 10 quadriplegics with the cervical cord injuries. The electrical stimulation was applied to the antagonists of major spastic muscles of the knee joints for 2 weeks. The evaluation of spasticity were done by using the modified Ashworth scale, beats of ankle clonus, patellar tendon reflex(latency and amplitude), and relaxation index of patellar knee by pendulum test before and after treatment sessions. The results of the study revealed no statistically significant changes in relaxation index, modified Ashworth scale, ankle clonus and the latency and amplitude of patellar tendon reflex(P<0.05), however there were tendencies of improvement in relaxation index and modified Ashworth scale after the stimulations. We could not find out statistically significant factors influencing the effects of the surface electrical stimulation. Further investigations to assess the mechanism of electrical stimulation and the adquate parameters of electrical stimulation in a larger population of subjects will be needed.
Ankle ; Electric Stimulation* ; Humans ; Knee ; Knee Joint ; Muscle Spasticity* ; Muscles ; Patellar Ligament ; Phenol ; Relaxation ; Spinal Cord Injuries ; Spinal Cord*

OBJECTIVE: To investigate the clinical usefulness of newly developed 3-dimensional virtual reality (VR) program to assess the unilateral neglect. METHOD: Sixteen unilateral neglect patients and forty healthy subjects were included in this study. Forty healthy subjects were classified into two groups (control group I, II) based on the previous computer experience. This VR program was composed of two sessions, the first session was to search the midpoint of the monitor and the second session was to scan the randomized target movement. Head-mounted display and 3-dimensional position sensor were used during VR program. The unilateral neglect patients performed the line bisection test and the letter cancellation test. The correlations of the clinical measurements and the parameters of the 3-dimensional VR program were analyzed. RESULTS: All parameters of the VR program in patient group were significantly different with those in control group I, II (p <0.05). Left directional parameters were significantly different with right directional parameters of the VR program in patient group (p <0.05), but not in control group I, II. The parameters of the VR program were significantly correlated with clinical measurements (p <0.05). CONCLUSION: The assessment of unilateral neglect using 3- dimensional virtual reality program may be clinically useful.
Humans ; Stroke

The diffuse form of supravalvar aortic stenosis represents a surgical challenge when the ascending aorta, aortic arch, proximal descending thoracic aorta and arch arteries are involved. It can be treated by a variety of surgical approaches. We report a case of severe diffuse supravalvar aortic stenosis combined with an aortic valve anomaly and occlusion of the right coronary artery ostium in a 14-year-old boy with Williams syndrome. We enlarged the aortic root (Nick's procedure), ascending aorta, aortic arch, proximal descending thoracic aorta, and innominate artery with patches and replaced aortic valve with 19 mm St. Jude valve. Deep hypothermic circulatory arrest and retrograde cerebral perfusion were used during repair of the arch and arch artery.
Adolescent ; Aorta ; Aorta, Thoracic ; Aortic Stenosis, Supravalvular* ; Aortic Valve* ; Arteries ; Brachiocephalic Trunk ; Circulatory Arrest, Deep Hypothermia Induced ; Coronary Vessels ; Humans ; Male ; Perfusion ; Williams Syndrome

OBJECTIVE: It is known that spinal cord injury (SCI) in adult men may result in sex hormonal changes. To investigate this change, we compared sex hormone levels of male SCI patients, uninjured normal, and infertile subjects. METHOD: Serum levels of follicular-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone were determined in 67 male SCI patients, 20 uninjured normal men and 39 idiopathic infertile men. One-way analysis of variance (ANOVA) procedures were performed with a significance level of 0.05. RESULTS: Compared with normal and infertile control groups, SCI patients had lower levels of testosterone and higher levels of prolactin. FSH levels of SCI patients were only lower than those of infertile controls. LH levels of SCI patients showed no significant difference. Compared with hormone levels of acute SCI patients, those of chronic SCI patients showed a tendency to increase in FSH, LH and testosterone, and a tendency to decrease in prolactin. Etiology of injury, completeness of injury and voiding method for neurogenic bladder did not influence the sex hormone levels in SCI patients. CONCLUSION: In our study, male SCI patients showed sex hormonal abnormalities of hypothalamo-pituitary type. And elevated serum prolactin level might influence hormonal changes and sexual dysfunction in male SCI patients.
Adult ; Humans ; Luteinizing Hormone ; Male ; Prolactin ; Spinal Cord Injuries ; Testosterone ; Urinary Bladder, Neurogenic

OBJECTIVE: To reveal the usefulness of abdominal computerized tomography (CT) for the detection of complicated and uncomplicated upper urinary tract infection (UTI)s in patients with spinal cord injury (SCI). METHOD: Twenty-two patients with SCI were included in this study. They had UTIs with persistent high fever despite conservative treatments. In all patients, abdominal CT was performed. RESULTS: Acute pyelonephritis (APN) with or without complications was detected in 13 patients (59.1%). Four patients were accompanied with complications, 1 perirenal abscess, 1 renal and perirenal abscess with staghorn stone, 1 urosepsis with renal abscess and 1 urosepsis. Simple nephrectomy was performed in a patient with perirenal and renal abscesses with a staghorn stone. Percutaneous abscess drainage was performed in one patient with perirenal abscess. They all recovered without further complications. CONCLUSION: Abdominal CT should be considered to detect uncomplicated and complicated upper UTIs in SCI patients who present persistent UTI symptoms despite conservative treatments.
Abscess ; Diagnosis* ; Drainage ; Fever ; Humans ; Nephrectomy ; Pyelonephritis ; Spinal Cord Injuries ; Spinal Cord* ; Tomography, X-Ray Computed ; Urinary Tract Infections* ; Urinary Tract*

To date, there is no standardization of the endoscopi c retrograde cholangiopancreatography (ERCP) room setting regarding with the size, equipment or space arrangement. Therefore, the authors visited 11 tertiary hospitals that recently remodeled or newly designed the ERCP room to analyze and identify their advantages and disadvantages. The ERCP room should have enough space for equipments including fluoroscopy, endoscopy, electrosurgical unit, preparation table and for patient movement. The EUS room does not require an independent space unless it is a very large scale hospital, and the ERCP room can be shared. Considering the pros and cons of each equipment, adequate fluoroscopic device should be selected depending on the hospital circumstance. Expensive equipment for X-ray fluoroscopy system is not necessarily good, and it is necessary to install equipment suitable for each hospital situation by understanding the advantages and disadvantages of fluoroscopy. For prevention of ERCP-related radiation hazard, both endoscopist and assistants should wear radiation-blocking apron, thyroid protectors, and lead glasses. Furthermore, a shield that can block radiation between the endoscopist and the patient should be installed to protect high-energy scattered waves. One-way direction should be designed to prevent cross infection when moving the endoscopic equipment from the ERCP to the cleaning room. If possible, it is recommended to keep a cardiopulmonary resuscitation cart in the ERCP room.

To date, there is no standardization of the endoscopi c retrograde cholangiopancreatography (ERCP) room setting regarding with the size, equipment or space arrangement. Therefore, the authors visited 11 tertiary hospitals that recently remodeled or newly designed the ERCP room to analyze and identify their advantages and disadvantages. The ERCP room should have enough space for equipments including fluoroscopy, endoscopy, electrosurgical unit, preparation table and for patient movement. The EUS room does not require an independent space unless it is a very large scale hospital, and the ERCP room can be shared. Considering the pros and cons of each equipment, adequate fluoroscopic device should be selected depending on the hospital circumstance. Expensive equipment for X-ray fluoroscopy system is not necessarily good, and it is necessary to install equipment suitable for each hospital situation by understanding the advantages and disadvantages of fluoroscopy. For prevention of ERCP-related radiation hazard, both endoscopist and assistants should wear radiation-blocking apron, thyroid protectors, and lead glasses. Furthermore, a shield that can block radiation between the endoscopist and the patient should be installed to protect high-energy scattered waves. One-way direction should be designed to prevent cross infection when moving the endoscopic equipment from the ERCP to the cleaning room. If possible, it is recommended to keep a cardiopulmonary resuscitation cart in the ERCP room.

Background/Aims: The study aimed to investigate the current practice patterns in the management of pancreatic cystic neoplasms in Korea. Methods: An electronic survey was systematically distributed by email to members of the Korean Pancreatobiliary Association from December 2019 to February 2020. Results: In total, 115 (110 gastroenterologists, five surgeons) completed the survey, 72.2% of whom worked in a tertiary/academic medical center. Most (65.2%) followed the 2012/2017 International Association of Pancreatology guidelines for the management of pancreatic cystic neoplasms. A gadolinium-enhanced magnetic resonance imaging/magnetic resonance cholangiopancreatography was the most common first-line diagnostic modality (42.1%), but a contrast-enhanced computed tomography scan was preferred as a subsequent surveillance tool (58.3%). Seventy- four percent of respondents routinely performed endoscopic ultrasound-guided fine needle aspiration for pancreatic cystic neoplasms with suspicious mural nodules. Endoscopic ultrasound-guided fine needle aspiration cytology (94.8%) and cystic fluid carcinoembryonic antigen (95.7%) were used for cystic fluid analysis. Most (94%) typically recommended surgery in patients with high-risk stigmata, but 18.3% also considered proceeding with surgery in patients with worrisome features. Most (96.5%) would continue surveillance of pancreatic cystic neoplasms for more than 5 years. Conclusions According to this survey, there was variability in the management of pancreatic cystic neoplasms among the respondents. These results suggest that the development of evidence-based guidelines for pancreatic cystic neoplasms that fit the Korean practice is needed to create an optimal approach to the management of pancreatic cystic neoplasms.