No abstract available.
Child* ; Fatty Liver ; Humans ; Hypercholesterolemia ; Incidence* ; Obesity

PURPOSE: To correlate MR findings with histologic findings in avascular necrosis(AVN) of the femoral head. MATERIALS AND METHODS: MR imaging was performed with 8 femoral head specimens using T1- and proton density weighted coronal SE sequences, and compared with contact radiography and histologic sections. RESULTS: In each specimen, necrotic zone in the superior portion of femoral head, repair zone located inferior to the necrotic zone, and rim adjacent to normal bone marrow could be defined. Necrotic zone showed high signal intensity on both T1- and proton density- weighted images in 3 cases which were composed of necrotic bone and marrow, and low signal intensity on both sequences in 2 cases which were composed of necrotic bone marrow with amorphous cellular debris. Mixed high and low signal intensities were seen in 3 cases. The repair zone showed low signal intensity on Tl-weighted image and high signal intenisty on proton density weighted image in 5 cases which were composed of thickened trabecular bone and meSenchymal tissue and also showed intermediate signal intensity on T1 weighted image and high signal intensity on proton density weighted image in 3 cases which were composed of osteoid, chondroid and undifferentiated mesenchymal cells. Rim shown as the low signal intensity on T1 weighted image in all cases was corresponded to viable thickened trabecular bone. CONCLUSION: MR imaging would be the best modality in the diagnosis of avascular necrosis of fernoral head and when used in conjuction with degree and location of signal intensity, the prediction of histologic finding may be possible.
Bone Marrow ; Diagnosis ; Head* ; Magnetic Resonance Imaging* ; Necrosis* ; Protons ; Radiography

No abstract available.
Antistreptolysin* ; Child* ; Humans ; Reference Values* ; Seoul*

The most common fractures of the spine are associated with the thoracolumbar junction. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. However, it is still debatable about the treatment methods. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment. The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. It is still controversial for the use of these treatments because there have not been verified evidences yet. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity.
Early Ambulation ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Physical Examination ; Rehabilitation ; Soft Tissue Injuries ; Spine ; Surgical Procedures, Minimally Invasive

PURPOSE: The accuracy of bacteriologic diagnosis of beta-hemolytic streptococcal pharyngoton sillitis depends on the degree of carrier rate in that area. It is the purpose of this study to obtain the carrier rate from seven different areas and to find results and epidemiologic factors. METHODS: Throat swab was obtained from the tonsillar fossa of normal school children during March through May 1996. It was then plated on a 5% sheep blood agar plate and incubated overnight at 37 degrees C before examination for the presence of beta-hemolytic colonies. RESULTS: The carrier rate of beta-hemolytic streptococci and group A streptococci were 27.6%, 20.0% at Uljin; 16.3%, 6.3% at Checheon; 16.4%, 2.7% at Seoul; 12.8%, 3.4% at Masan; 33.0%, 26.0% at Osan; 20.0%, 12.3% at Kunsan; and 17.7%, 11.4% at Chongju, respectively. Among 2,159 normal school children from 7 different areas, we obtained 450 plates of beta-hemolytic streptococci. Osan had the highest carrier rate (33.3%) and Masan had the lowest rate (12.8%) of beta-hemolytic streptococci. Among 450 plates of beta-hemolytic streptococci, we obtained 265 strains of group A streptococci. Osan had the highest carrier rate (26.0%) and the Seoul had the lowest rate (2.7%) of group A streptococci. CONCLUSION: Higher carrier rates were found in Uljin and Osan, where there is a lower population density. We supposed that low carrier rates might be related to antibiotic abuse or some epidemiologic factor should be investigated.
Agar ; Child* ; Diagnosis ; Epidemiologic Factors ; Epidemiology ; Gyeonggi-do ; Humans ; Jeollabuk-do ; Korea* ; Pharynx ; Population Density ; Seoul ; Sheep

BACKGROUND: We studied the hemodynamic changes associated with steep Trendelenburg position and prolonged pneumoperitoneum during robot-assisted laparoscopic prostatectomy in elderly patients with cardiac diseases. METHODS: Hemodynamic variables were measured at baseline supine position, at 30 min, 1, 2, 3 and 4 h during CO2 insufflation in post-Trendelenburg position, and after deflation in the supine position. RESULTS: In comparison with normal subjects, the cardiac index and systemic vascular resistance index of patients with cardiac diseases were significantly affected by the Trendelenburg position and pneumoperitoneum (P < 0.001). However, other variables of heart rate, mean arterial pressure and central venous pressure were not differed between the groups. CONCLUSIONS: We conclude that attention should be paid to maintain adequate hemodynamic status during prolonged pneumoperitoneum in the Trendelenburg position, and which is unfeasible in patients with severe heart failure and unstable angina.
Aged ; Angina, Unstable ; Arterial Pressure ; Central Venous Pressure ; Head-Down Tilt ; Heart Diseases ; Heart Failure ; Heart Rate ; Hemodynamics ; Humans ; Insufflation ; Pneumoperitoneum ; Prostatectomy ; Supine Position ; Vascular Resistance

Postoperative visual loss (POVL) after non-ophthalmic surgery is rare, with a reported incidence ranging from 0.013 to 0.2%. Most perioperative visual loss is associated with spine operations and cardiac bypass procedures. The most common cause of POVL is ischemic optic neuropathy. However, there are no previous reports of postoperative visual loss after laparoscopic appendectomy. A 43-year-old female with no underlying disease underwent laparoscopic appendectomy; the operation was completed in one hour and her blood pressure was stable during the perioperative period. In the post-anesthetic care unit, the patient complained of nausea and headache, but she did not complain of any unusual visual symptoms. Approximately one hour after arriving at the ward, the patient complained of visual disturbance. Neurologic examination revealed left homonymous hemianopsia, and subarachnoid hemorrhage and intracerebral hemorrhage were found in the occipital area on brain MRI.
Adult ; Appendectomy* ; Blood Pressure ; Brain ; Cerebral Hemorrhage* ; Female ; Headache ; Hemianopsia ; Humans ; Incidence ; Magnetic Resonance Imaging ; Nausea ; Neurologic Examination ; Optic Neuropathy, Ischemic ; Perioperative Period ; Spine ; Subarachnoid Hemorrhage

BACKGROUND: The aim of this randomized, double-blind, placebo-controlled study was to evaluate dose effects of ephedrine pretreatment on the onset time and intubating conditions after cisatracurium administration. METHODS: A total of 140 adult patients were randomized into 4 groups to receive either 30 microg/kg ephedrine (Group 30, n = 35), 70 microg/kg ephedrine (Group 70, n = 35), 110 microg/kg ephedrine (Group 110, n = 35), 3 ml normal saline (Group C, n = 35) as pretreatment given 30 s before anesthetic induction. Neuromuscular block was achieved with 0.15 mg/kg cisatracurium, evaluated accelomyographically with train-of-four stimulation. An anesthesiologist blinded to patient grouping assessed the intubating conditions 1.5 min after cisatracurium administration. RESULTS: An onset time of 70 s was obtained in the ephedrine groups (Group 30: 155.4 +/- 44.7 s, Group 70: 152.6 +/- 40.3 s, Group 110: 151.2 +/- 51.6 s) compared to Group C (224.6 +/- 56.9 s) after 0.15 mg/kg of cisatracurium (P < 0.001). Ephedrine doses of either 70 or 110 microg/kg for pretreatment significantly improved intubating conditions (P < 0.05). Systolic and diastolic blood pressure and heart rate at 1 min after tracheal intubation were significantly increased than other times in all groups (P < 0.001), with no differences among the groups. However, 5 patients in Group 110 experienced marked hypertension (systolic/diastolic blood pressure: > 200/100 mmHg) 1 min after tracheal intubation with no patients in other groups. CONCLUSIONS: We conclude that pre-treatment with ephedrine 70 microg/kg improved intubating conditions 1.5 min after cisatracurium administration and facilitated the onset of neuromuscular block (70 s) without adverse hemodynamic effects.
Adult ; Blood Pressure ; Ephedrine* ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Intubation ; Neuromuscular Blockade

OBJECTIVE: This study compared the bone thickness of the palate between lateral cephalogram and 3D model measurements. METHODS: The subjects consisted of 30 adults (15 men,15 women) with a normal skeletal pattern and occlusion. The CT images were transformed to a 3D model, and were compared with the cephalometric image. Descriptive statistics for each variable were calculated. RESULTS: In the 3D CT model, the mid-palatal area was the thickest part. It became thinner as the palate tapered laterally. In the male group, the thinnest portion was positioned 6 mm away from the mid-palate, while in the female group the thinnest portion was 8mm away from the mid-palate. Correlation analysis between the lateral cephalometric and 3D CT model revealed a significant correlation except in the mid palatal area and the area 2 mm lateral to the mid-palate in men, whereas there was a significant relationship in every area in the women. In both men and women, the highest correlation appeared in the area 8 mm lateral to the mid palate. CONCLUSIONS: Using regression analysis, an actual prediction of the bone thickness between the measured bone thickness of the lateral cephalometric radiograph and 3D model was made. This will provide useful information for mini-implant length selection when inserting into the palate.
Adult ; Female ; Humans ; Male ; Palate

OBJECTIVE: Orthodontically induced root resorption (OIRR) involves partial loss of cementum and dentin of teeth caused by routine orthodontic treatment. It decreases root length and influences the function of affected teeth. In this study, the treatment and patient factors causing apical root resorption in Koreans were determined. The observed factors were extraction, gender, age, displacement of root apex, total treatment period, total teeth length, and shape of the root. METHODS: The records of 137 patients treated with full, fixed edgewise appliances were obtained from the Department of Orthodontics, Dankook University Dental Hospital, from November 2007 to December 2008. Periapical radiographs of the maxillary central incisors and cephalometric radiographs of each patient were used to assess apical root resorption and type of tooth movement. RESULTS: The mean amount of resorption was 1.62 +/- 1.58 mm. The amount of resorption in the extraction and non-extraction groups was 2.10 +/- 1.64 mm and 1.18 +/- 1.39 mm, respectively. The amount of root resorption increased with the total tooth length. Severe root resorption (> 4 mm) was related to abnormal root shape (blunt, pointed, or eroded). CONCLUSIONS: The variables significantly related to OIRR were extraction, initial tooth length, and root shape.
Dental Cementum ; Dentin ; Displacement (Psychology) ; Humans ; Incisor ; Orthodontics ; Root Resorption ; Tooth