BACKGROUND: Vasoconstrictors have been used as an adjunct to local anesthetics to prolong the duration of spinal anesthesia. Recently, clonidine, an 2-receptor agonist has been shown to prolong the duration of spinal anesthesia following intrathecal administration. Bupivacaine has been used for spinal anesthesia and compared with tetracaine in recent studies. We have undertaken this study to further evaluate the effect of clonidine in hyperbaric 0.5% bupivacaine spinal anesthesia. METHODS: Thirty patients who were scheduled for lower limb or urologic operation were divided into 2 groups: Group A (hyperbaric bupivacaine 13 mg, 2.6 ml + N/S 1 ml), Group B (hyperbaric bupivacaine 13 mg, 2.6 ml + clonidine 150 g, 1 ml). We used standardized techniques and injected above drugs to group A and B intrathecally for spinal anesthesia. We investigated the onset and the duration of spinal anesthesia along with hemodynamic changes (blood pressure and heart rate) in patients. RESULTS: There were no significant differences in the onset of spinal anesthesia and hemodynamic changes between two groups. The time taken to recover from the nerve block was more prolonged in the group B (touch 225, pain 262, foot dorsiflexion 271, knee flexion 290 minutes) than group A (touch 154, pain 188, foot dorsiflexion 198, knee flexion 216 minutes). There were no significant differences in sedation, and in experiencing dry mouth and other side effects between two groups. CONCLUSION: Intrathecal clonidine 150 g has been proved to prolong the duration of hyperbaric 0.5% bupivacaine spinal anesthesia without neurotoxicity or dangerous hemodynamic depression. Therefore, clonidine can be used as an effective adjunct in hyperbaric bupivacaine spinal anesthesia.
Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine* ; Clonidine* ; Depression ; Foot ; Heart ; Hemodynamics ; Humans ; Knee ; Lower Extremity ; Mouth ; Nerve Block ; Tetracaine ; Vasoconstrictor Agents

PURPOSE : To compare the clinical, roentgenographic results and patient self assessment between posterior cruciate retaining TKA and posterior cruciate substituting TKA. MATERIALS AND METHODS : From January 1993 to May 1999, 68 patients (106 knees) were performed total knee arthroplasty using the PFC system. Seventy five PCL retaining and thirty one PCL substituting components were used. Retrospective analysis were done in two groups by the clinical and radiological evaluation system using American Knee Society Scale and patient self assessment using WOMAC score. RESULTS : There were no statistically significant differences in knee score and functional score, improvement of range of motion, and self assesment of the PCL retaining and substituting group. We also observed improvement of pain, knee scores, and functional scores according to flexion contracture in both groups but there were no significant differences statistically. Tibiofemoral angles were corrected in both groups. There was no case of complete radiolucency, osteolysis, and component loosening. CONCLUSION : Surgeons will achieve good result of operation, if they choose proper type of TKA systems according to state of posterior cruciate ligament, degree of deformity, and technique of surgery.
Arthroplasty* ; Congenital Abnormalities ; Contracture ; Equidae ; Humans ; Knee* ; Osteolysis ; Posterior Cruciate Ligament ; Range of Motion, Articular ; Retrospective Studies ; Self-Assessment

No abstract available.
Adult* ; Humans ; Neck*

PURPOSE: This study was performed to examine the effects of image filter on observer performance by counting the number of holes at each wedge step on a radiographic image. MATERIALS AND METHODS: An aluminum step wedge with 11 steps ranged in thickness from 1.5 mm to 16.5 mm in 1.5 mm increments was fabricated for this study. Each step had 10 notched holes with 1.0 mm diameter on the bottom of the step wedge which were ranged in depths from 0.1 mm to 1.0 mm in 0.1 mm increments. Digital radiographic raw images of the aluminum step wedge were acquired by using CCD intraoral sensor. The images were processed using several types of noise reduction filters and kernel sizes. Three observers counted the number of holes which could be discriminated on each step. The data were analyzed by ANOVA. RESULTS: The number of holes at each step was decreased as the thickness of step was increased. The number of holes at each step on the raw images was significantly higher than that on the processed images. The number of holes was different according to the types and kernel sizes of the image filters. CONCLUSION: The types and kernel sizes of image filters on observer performance were important, therefore, they should be standardized for commercial digital imaging systems.
Aluminum ; Noise ; Radiographic Image Enhancement ; Radiography, Dental ; Task Performance and Analysis

PURPOSE: The purpose of this study was to develop a system for the measurement and simulation of the TMJ movement and to analyze the mandibular movement quantitatively. MATERIALS AND METHODS: We devised patient-specific splints and a registration body for the TMJ movement tracking. The mandibular movements of the 12 subjects with facial deformity and 3 controls were obtained by using an optical tracking system and the patient-specific splints. The mandibular part was manually segmented from the CT volume data of a patient. Three-dimensional surface models of the maxilla and the mandible were constructed using the segmented data. The continuous movement of the mandible with respect to the maxilla could be simulated by applying the recorded positions sequentially. Trajectories of the selected reference points were calculated during simulation and analyzed. RESULTS: The selected points were the most superior point of bilateral condyle, lower incisor point, and pogonion. There were significant differences (P<0.05) between control group and pre-surgical group in the maximum displacement of left superior condyle, lower incisor, and pogonion in vertical direction. Differences in the maximum lengths of the right and the left condyle were 0.59+/-0.30 mm in pre-surgical group and 2.69+/-2.63 mm in control group, which showed a significant difference (P<0.005). The maximum of differences between lengths of the right and the left calculated during one cycle also showed a significant difference between two groups (P<0.05). CONCLUSION: Significant differences in mandibular movements between the groups implies that facial deformity have an effect on the movement asymmetry of the mandible.
Congenital Abnormalities ; Displacement (Psychology) ; Humans ; Incisor ; Mandible ; Maxilla ; Splints ; Temporomandibular Joint ; Track and Field

PURPOSE : To investigate the incidence and prevalence of C-shaped root canal using computed tomographic images of head and neck in Korean population. MATERIALS AND METHODS : Regardless of each examination purpose, randomly selected 268 examples which have serial axial computed tomographic images with 8 normal molars in maxilla and mandible were selected and investigated. Defined C-shaped root canal and we could get 82 proper image examples in view of this definition. These were detected and investigated of incidence and prevalence of C-shaped root canal. RESULTS : C-shaped root canals were found in 82 examples among 268 (30.6%) and 147 teeth. They were only found on molar area, and the highest incidence was 37.41% of left mandibular second molars, and the lowest was 2.04% of right maxillary second molars. On prevalence of tooth position, mandibular second molar was the highest, 65% of C-shaped root canal teeth and maxillary second molar was 6% the lowest. CONCLUSION : 31% of randomly selected CT images no considering check-up reason have C-shaped root canals. The C-shaped root canals of mandibular second molar are found most frequently and they are also detectable on maxilla. On Korean population, C-shaped root canals are one of conditions that have to concern with dental treatment for it appears at a high prevalence relatively.
Dental Pulp Cavity ; Head ; Incidence ; Mandible ; Maxilla ; Molar ; Neck ; Prevalence ; Tooth

Primitive neuroectodermal tumor (PNET), which belongs to the Ewing's sarcoma (ES) family of tumors, is mainly seen in children and young adults. PNETs are extremely rare in the maxilla. Here, we report a case of PNET of the left maxillary sinus in an elderly male. Magnetic resonance imaging (MRI) revealed a slightly enhanced solid mass occupying the left maxillary sinus and infiltrating into the retroantral space. A partial maxillectomy was performed. Despite postoperative chemotherapy, follow-up computed tomography (CT) and MRI revealed a nodal metastasis in the submandibular space. Neck dissection was performed. However, the patient died 10 months after the second surgery because of distant metastasis to the liver. MRI and CT were particularly useful in detecting the extent of the tumor, recurrence, and metastasis. Further, a literature review of the previously reported PNET cases of the maxilla was carried out. In this paper, we also discuss the current approach for the diagnosis and management of these tumors.
Aged* ; Child ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Liver ; Magnetic Resonance Imaging ; Male ; Maxilla ; Maxillary Sinus* ; Neck Dissection ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive* ; Recurrence ; Sarcoma, Ewing ; Young Adult

Ovarian fibroma is one of the sex cord-stromal tumor, and accounts for about 5 percent of all ovarian tumors surgically removed. This tumor is almost always unilateral and appears to affect the left ovary more often (75%) than the right. Calcification is one of the secondary changes that can take place in a fibroma of ovary. The occurrence of ossification in these calcified fibromas is rare. We experienced a case of an ovarian calcified fibroma with ossification occurring in a 19 year old, unmarried woman with a brief review of literature.
Female ; Fibroma* ; Humans ; Osteoma* ; Ovary ; Sex Cord-Gonadal Stromal Tumors ; Single Person ; Young Adult

Modern capacity for high-resolution brain imaging has facilitated studying the clinicoanatomic correlations of small lesions in subcortical nuclear structures. Several recent reports have convincingly demonstrated that there were particular clinical syndromes associated with specific distributions of thalamic lesions. Thalamic dysfunction due to diveres casues, particularily in the left side has been associated with memory impairment, speech disturbance, cognitive deficits, and behavioural changes. Simplified bedside behavioral examinations were performed in six patients with the left tuberothalamic infarcts. We found severe neuropsychological deficits considered as dementia meeting the DSM III criteria, leaving few focal motor and sensory deficits. The disturbance of attention, speech, cognition and behavior after the left tuberothalamic infarcts are probably related not only to intrinsic thalamic dysfunction itself, but also to the disruption of the regular function of motor, sensory, and integrative cortical stuctures connecting with the thalamus.
Cognition ; Dementia* ; Humans ; Memory ; Neuroimaging ; Thalamus

We evaluated the therapeutic effects and complications of 118 patients with idiopathic parkisonism who were receiving levodopa therapy for more than 1 year. Response to therapy and complications of drug were correlated with duration of the disease and with duration of the treatment. Patients with motor fluctuation were likely to have been treated for 3 years or longer. Patients treated with levodopa for 5 years or longer were significantly more impaired with parkinsonism than patients treated for 1 to 3 years. Our findings suggest that the deterioration of responsiveness after several years of levododpa therapy may be due to the therapy itself, and utilization of levodopa therapy should be delayed until a patient becomes significantly impaired in occupational or social situations.
Humans ; Levodopa* ; Parkinson Disease* ; Parkinsonian Disorders