The pulsed dye laser, emitting at wavelengths of 504nm. for 1 micro sec. at a frequency of 10 Hz. transmitted via a 200 micron in-diameter silicon-coated fiber, was send for fragmentation of urinary stones. The mechanism of stone fragmentation by laser is 'shock wave' formation by laser light ( photoacoustic effect). From Nov. 1988 to Apr. 1990, we performed 89 procedures in 86 patients for the removal of stones (80 procedures in 77 ureteral stones, 3 procedures in bladder stones and 6 procedures in urethral stones). Of the calculi 80 were fragmented to spontaneously passable or easily extractable fragments. There was no significant complications attributable to laser lithotripsy. And there was no significant differences in the fragmentation of stones according to the component. So, we think that laser lithotripsy is a safe and effective modality in management of the urinary stones including renal and upper ureter stones with some exceptions if deflecting ureterorenoscope is available.
Calculi ; Humans ; Lasers, Dye* ; Lithotripsy, Laser ; Ureter ; Urinary Bladder Calculi ; Urinary Calculi*

No abstract available.
Animals ; Embryonic Development* ; Embryonic Structures* ; Female ; Mice* ; Pregnancy

No abstract available.
Diabetes Mellitus*

PURPOSE: To determine the usefulness of the fat-suppressed (FS) conventional spin-echo (CSE) sequence for the diagnosis of meniscal tears. MATERIALS AND METHODS: We retrospectively reviewed 323 MR images of the knee, the standard of reference being the findings of arthroscopy. In all knees, fast SE proton density-weighted and T2-weighted sagittal and coronal images and double-echo in steady state (DESS) sagittal images were obtained, and during 202 MR Procedures, FS-CSE T1-weighted sagittal images were also obtained. The results of MR imaging were then correlated with those of arthroscopy, the accuracy with which meniscal tears were diagnosed being compared between two groups: group I (202 knees for which FS-CSE T1-weighted sagittal images were obtained), and group II (121 knees for which these images were not obtained). For statistical analysis the chi-square test was used. RESULTS: In group 1, sensitivity, specificity and accuracy were 94.7%, 92.4% and 93.5%, respectively, for the medial meniscus, and 83.3%, 95.7% and 90.5% for the lateral meniscus. In group II, the corresponding findings were 92.5%, 94% and 93.3%; and 87.3%, 98.2% and 92.5%. The differences between the groups were not statistically significant (p>0.05) CONCLUSION: For meniscal tears of the knee, the addition of FS-CSE T1-weighted MR imaging to the fast SE proton density-weighted, T2-weighted and DESS sequences does not enhance diagnostic accuracy.
Arthroscopy ; Diagnosis ; Knee* ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Protons ; Retrospective Studies ; Sensitivity and Specificity

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.
Dental Pulp Necrosis ; Diagnosis ; Incisor* ; Membranes ; Periodontal Diseases ; Tooth ; Transplants

PURPOSE: Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. MATERIALS AND METHODS: We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. RESULTS: ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%). In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p<0.05), but differences in the prevalence and location of meniscal tears were not (p>0.05). CONCLUSION: Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no signifficant difference in meniscal tears with or without kissing contusion.
Animals ; Arthroscopy ; Collateral Ligaments ; Contusions* ; Diagnosis ; Horns ; Knee ; Lateral Ligament, Ankle ; Ligaments* ; Menisci, Tibial ; Posterior Cruciate Ligament ; Prevalence ; Retrospective Studies

BACKGROUND: Bacteriokiller system(BKS) produces disinfectant which is generated by the mixture of active oxygen and hypochlorous acid with tap water. Previous studies showed that BKS disinfectant is highly bacteridal against clinical isolates in in vitro testings and more effective than general soap and water for the disinfecttion of contaminated handa. This study was performed to evaluate ling-trem effects of BKS as a handwasing agent in clinical settings. METHODS: Five BKS were installed for the 9-month period from June 1995 to February 1996 in 16-bed Neurosurgery Intensive Care Unit. Handwashing was frequency was observed after 1, 6, and 8 month of BKS use. Six-month incidences of nosocomial infecrion before and after BKS installation were compared to evaluate the possible effect of handwashings on nosocomial infection rates. A self-administered questionaire was used to collect data on handwashing frequency and their opinions of the BKS disinfectant at 2 and 8 months after the installation. RESULTS: Handwashing frequency of healthcare workers(HCWs) before and after patient contacts was increased from 34.1%(137/402) to 50.3%(193/384) (p<0.00001). At the same time, the 6-month nosocomial infection rate was down to 10.5%(43/411) from the pre-BKS rate of 13.0%( 51/431) and the patient-day rate was also decreased from 18.3(56/3068) to 15.1(43/2,844). Most (80.5%) of HCWs thought that BKS promote handwashing and "convenience" was the main reason for more frequent handwashing. Ninety three percent of HCWs would recommend the replacement of tne existing sinks and handwashing disinfectants with BKS. NO adverse skin reaction were reported after 8 months. Conclusions: BKS appears to promote handwashing because it is easy to use with no skin irritation and may contribute toward the prevention of nosocomial infections.
Cross Infection ; Delivery of Health Care ; Disinfectants ; Hand Disinfection ; Humans ; Hypochlorous Acid ; Incidence ; Intensive Care Units ; Neurosurgery ; Reactive Oxygen Species ; Skin ; Soaps

The administration of local anesthetics or steroids via the lumbar approach to the epidural space is one of the most common procedures performed in contemporary pain management by the pain specialist. This technique is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back syndrome, spinal stenosis, and vertebral compression fractures. Given the increased number of epidural nerve blocks being performed, some have reported unexpected complications of a transient or permanent nature and of varying degrees of severity. However, no case report has been issued that includes objective magnetic resonance imaging data showing a transient asymptomatic intraspinal cyst-like lesion after epidural nerve block. We experienced a case of a transient asymptomatic intraspinal cyst-like lesion after administering an epidural steroid and local anesthetic injection to a 59 year old female patient suffering from a back pain with multiple old vertebral compression fractures and herniated intervertebral discs. The intraspinal cyst-like lesion was found incidentally by magnetic resonance imaging after an epidural nerve block. We report upon this case and provide subjective data.
Anesthetics, Local ; Back Pain ; Epidural Space ; Female ; Fractures, Compression ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Middle Aged ; Nerve Block* ; Pain Management ; Radiculopathy ; Specialization ; Spinal Stenosis ; Steroids

The purpose of this study was to provide a basic resource for establishment of hygienic management standards for meal delivery from the central kitchen to schools. Flow diagrams for delivery of food were analyzed, and time-temperature conditions of the food and environment were measured. Four different foods samples including Mexican salad, radish salad, stir-fried pork and vegetables, and stir-fried chicken and vegetables were collected after production and before service. Microbiological analysis was performed for aerobic plate counts (APC), Enterobacteriaceae, coliforms, E. coli, Salmonella spp., S. aureus, B. cereus, C. perfringens, and L. monocytogenes. After completion of production of cooked foods 2~3 hours were taken for the cooked foods to reach the temperature danger zone. Food temperatures at the meal service did not meet the recommended temperatures (10/57degrees C) for conventional school food service systems. The highest APC counts were observed in radish salad (5.70 log CFU/g), followed by Mexican salad (5.18 log CFU/g). Enterobacteriaceae and coliform counts were within acceptable levels of those recommended by the UK Public Health Laboratory Service. No E. coli or pathogens were found. These results provide useful information for determination of microbiological hazards in school food service systems, and suggest that time-temperature control during delivery is necessary for the safety of cooked foods.
Chickens ; Enterobacteriaceae ; Food Services ; Humans ; Meals ; Public Health ; Raphanus ; Salmonella ; Vegetables

This author tried to find if the size of the frontal sinus can be used as a diagnostic aid to predict the mandibular growth pattern in growing patients-in lateral cephalogram utilizing the fact the the frontal sinus completes its growth in earlier stage but the mandible continues to grow until later. At this study, the 228 samples were divided into 3 groups as skeletal Class I , II, III malocclusions and three indicies(ANB, APDI, Wits) were measured which hidicate the mandibular body length and the antero-posterior relationship of maxilla and mandible to evaluate their relations with frontal sinus. And results were obtained as followings. 1. The size of frontal sinus is highly related to ANB, APDI, Wits and mandilar body length(p<0.001) 2. the size of the frontal sinus of the Cl III malocclusion group was on the lateral cephalogram larger than Cl I and C1 II group.
Frontal Sinus* ; Malocclusion ; Mandible ; Maxilla