No abstract available.
Humans ; Tuberous Sclerosis*

Despite the continually improving results of total knee arthroplasty, infection remains the most debilitating complication. The treatments of infected total knee arthroplasty were variable, but initially we removed infected implants and inserted antibiotic containing cemented spacer. Postoperatively, patients were mobilized in a 30 knee flexion state and treated with parenteral antibiotics. After control of infection was clinically and radiologically determined, we inserted PCL substitute total knee prosthesis. Five days postoperatively, patient began touch down standing exercise. We observed two cases in whom infected total knee arthroplasty had been salvaged successfully with two-stage implantation using cement spacers containing antibiotics.
Anti-Bacterial Agents* ; Arthroplasty* ; Humans ; Knee Prosthesis ; Knee* ; Replantation*

Although the distribution of locus ceruleus terminals has been demonstrated in the fundus striati[nucleus accumbens septi] by light microscopy[Jones & Moore, 1977 ; Mason & Fibiger, 1979 ; Streit or et al., 1979 ; Groenewegen et al., 1980], the synaptic organization of its terminals was not clarified. The purpose of the present investigation was to demonstrate the direct monosynaptic connection of the locus ceruleus terminals to the neuronal elements of the fundus stirati, and to clarify the synaptic structures of its terminals by electron microscopy two days after unilateral electric coagulation of the locus ceruleus. In the ipsilateral fundus striati, many axon terminals undergone dark degeneration were observed. These degenerating terminals containing small clear vesicles have asymmetric synaptic contacts with dendritic spines. Already two days after locus ceruleus lesion, distinct features of terminal degenerations appeared in the fundus striati ; enlarged axon terminals with altered synaptic vesicles, decrease of synaptic vesicles detached from the synaptic site, multiplication of dense bodies and infiltration of floccular material. At the same time, a regressive change occurred in which astrocytic processes encircled totally degenerated synapses spiraled around the synaptic remnants. These observations indicate that monosynaptic noradrenertic afferent connections to the fungus striati are confirmed, and the locus ceruleus terminals characterized by small round vesicles might be formed asymmetrical axo-spinous synapses with spiny neurons in the fundus striati.
Animals ; Cats* ; Dendritic Spines ; Fungi ; Locus Coeruleus* ; Microscopy, Electron ; Neurons ; Presynaptic Terminals ; Synapses ; Synaptic Vesicles

The present study was performed to investigate the role catecholamine in the genesis of reperfusion injury of ischemic heart. The possible involvement of catecholamine in the xanthine oxidase-linked production of oxygen free radicals was studied. langendorff preparations of rat hearts were made ischemic for 60 min followed by reperfusion. Upon reperfusion norepinephrine(NE) was significantly released into the coronary effluent regardless of oxygenation of the perfusion solution. Both the increased releases of creatine phosphokinase(CPK) and malondialdehyde(MDA) and the production of superoxide anion in the ischemic-reperfused hearts were significantly reduced by the treatment with either reserpine, a catecholamine depletor, or propranolol, a beta-adrenergic receptor blocker. In the reserpinized hearts, infusion of exogenous NE reversed the releases of CPK and MDA and the superoxide anion production to the original higher levels. The releases of CPK and MDA as well as the production of superoxide anion induced by NE in the reserpinized hearts were significantly depressed either by allopurinol, a specific competitive inhibior of xanthine oxidase(XOD), or by the calcium removal from the perfusion solution. Compared with the XOD activity of control ischemic hearts, that of the hearts treated with reserpine or propranolol showed lower activity in the oxygen radical producing 0-form and higher activity in D/0-form. In the reserpinized ischemic hearts, infusion of exogenous NE increased 0-form, but decreased D/0-form of XOD. The changes in XOD activities induced by exogenous NE was prevented by phenylmethylsulfonyl fluoride(a serine protease inhibitor) and pimoxide(a calmodulin inhibitor) as well as by calcium removal from the perfusion solution. It is suggested from the results that in the inchemic-reperfused heart of rat catecholamine participates in D/0 to 0-form conversion of XOD by promoting the calcium-calmodulin-dependent proteolysis and plays a contributing role in the production of oxygen free radical.
Allopurinol ; Animals ; Calcium ; Calmodulin ; Creatine ; Free Radicals ; Heart* ; Oxygen ; Perfusion ; Propranolol ; Proteolysis ; Rats* ; Reperfusion Injury* ; Reperfusion* ; Reserpine ; Serine Proteases ; Superoxides ; Xanthine Oxidase* ; Xanthine*

No abstract available in English.

PURPOSE: To determine the accuracy of automated computer aided volumetry for simulated small pulmonary nodules at computed tomography using various types of phantoms MATERIALS AND METHODS: Three sets of synthetic nodules (small, calcified and those adjacent to vessels) were studied. The volume of the nodules in each set was already known, and using multi-slice CT, volumetric data for each nodule was acquired from the three-dimensional reconstructed image. The volume was calculated by applying three different threshold values using Rapidia(R) software (3D-Med, Seoul, Korea). RESULTS: Relative errors in the measured volume of synthetic pulmonary nodules were 17.3, 2.9, and 11.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=0.96, p<0.001). For calcified nodules, relative errors in measured volume were 10.9, 5.3, and 16.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=1.03, p<0.001). In cases involving synthetic nodules adjacent to vessels, relative errors were 4.6, 16.3, and 31.2 % at -200, -400, and -600 HU, respectively. There was good correlation between true volume and measured volume at -200 HU (r=1.1, p<0.001). CONCLUSION: Using computer-aided volumetry, the measured volumes of synthetic nodules correlated closely with their true volume. Measured volumes were the same at each threshold level, regardless of window setting.
Cone-Beam Computed Tomography ; Seoul

The authors experienced 2 cases of bacterial intracranial aneurysm, the mortality of which has been reported to by very high and the management of which is controversial. Some authors have recommended observation with serial angiography during antimicrobial therapy and surgery for aneurysms that enlarge or remain patent. Others have argued for promt surgical removal. Bothof our patients had multiple aneurysms and were treated with appropriate, high-dose antibiotics, but intracerebral homorrhage(ICH) occurred during antibiotiecs treatment in both cases and they underwnet emergent operation, but both died.
Aneurysm ; Angiography ; Anti-Bacterial Agents ; Humans ; Intracranial Aneurysm* ; Mortality

PURPOSE: We evaluated the usefulness of quantitative spiral CT to predict postoperative lung function in patients undergoing pulmonary resection. MATERIALS AND METHODS: Fourteen patients in whom pneumonectomy or segmentectomy were performed underwent preoperative chest spiral CT and pulmonary function test(PFT). Six patients underwent postoperative follow-up PFT. Ten patients underwent preoperative radioisotope(RI) lung perfusion scan. Preoperative CT data were postprocessed with contiguous pixel method ranged from -9107HU to -500HU to quantify total functional lung volume(TFLV) and regional volume to be resected(RFLV). Postoperative lung function was predicted by following formula;Predicted postoperative PFT value=preoperative PFT x 1-RFLV/TFLV). CT predicted value was compared with postoperative measured PFT value and those value of RI perfusion scan. RESULTS: CT predicted values were very close to postoperative measured value and RI predicted value, and were correlated well with postoperative measured values (FVC: r=0.988, P<0.001 ;FEV1: r=0.994, P<0.001) and RI predicted values (FVC :r=0.976, P<0.001 ;FEVl: r=0.974, p<0.001). CONCLUSION: Quantitative spiral CT was useful to predict postoperative lung function and could be an effective alternative to RI perfusion scan.
Follow-Up Studies ; Humans ; Lung* ; Mastectomy, Segmental ; Perfusion ; Pneumonectomy ; Thorax ; Tomography, Spiral Computed*

PURPOSE: We applied spiral CT to evaluate the dynamic changes of regional ventilation of the lung in normal subjects and abnormal patients. MATERIALS AND METHODS: This study includes normal subjects (n:5) and patients with chronic obstructive pulmonary disease (n=4), small air-way disease (n=3), diffuse panbronchiolitis (n=4), and tracheobronchial tuberculosis (n=2). Time-continuous scan data at a fixed level during forced vital capacity maneuver (10--12 seconds) were obtained and images were reconstructed retrospectively by using 0.67 second scan data per image. The reconstructed images were displayed in a cine mode. Time-density curves were plotted and were correlated with clinical diagnosis. RESULTS: In normal subjects, mean attenuation difference between full inspiration and full expiration was 145. 8HU and mean time interval between 20% expiration and 80% expiration was 2.04 seconds. In chronic obstructive lung disease, mean attenuation difference between full inspiration and full expiration was 21.2HU and mean time interval between 20% expiration and 80% expiration was 3.63 seconds. In small air-way disease, mosaic-pattern hyperlucency and normal portion of lung showed mean attenuation differences between 20% expiration and 80% expiration to be 49.8HU and 167.0HU, respectively. In diffuse panbronchiolitis, centrilobular region and normal portion of lung showed mean attenuation differences between 20% expiration and 80% expiration to be 35.4HU and 79.3HU, respectively. CONCLUSION: Respiratory dynamic CT is an updated technique which enable imaging of the functional status of the lung parenchyma. It may be useful in differentiation and quantitation of variable obstructive lung diseases.
Diagnosis ; Humans ; Lung Diseases, Obstructive ; Lung* ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Tomography, Spiral Computed ; Tuberculosis ; Ventilation ; Vital Capacity

Intracerebral hemorrhage is the most serious complication of cerebral arteriovenous malformations (AVM). To identify angiographic characteristics of AVM which correlate with a history of hemorrhage, we retrospectively analyzed angiographic findings of 25 patients with AVM. Nine characteristics were evaluated; these include nidus size, location, arterial aneurysm, intranidal aneurysm, angiomatous change, venous drainage pattern, venous stenosis, delayed drainage and venous ectasia. These characteristics were correlated with hemorrhage, which was seen in 18 (72%) patients of CT or MR images. Venous stenosis (P<.05) and delaved venous drainage (P<.05) well correlated with a history of hemorrhage. Arterial aneurysm and intranidal aneurysm also had a tendency hemorrhage although they did not prove to be statistically significant. Detailed analysis of angiographic finding of AVM is important for recognition of characteristics which are related to hemorrhage and may contribute to establishing a prognosis and treatment planning.
Aneurysm ; Cerebral Hemorrhage ; Constriction, Pathologic ; Dilatation, Pathologic ; Drainage ; Hemorrhage* ; Humans ; Intracranial Arteriovenous Malformations* ; Prognosis ; Retrospective Studies