No abstract available.
Chondromatosis, Synovial* ; Knee Joint* ; Knee* ; Osteoarthritis*

PURPOSE: This study compared the accuracy of an abutment-framework (A-F) taken with open tray impression technique combining cementon crown abutments, a metal framework and resin cement to closed tray and resin-splinted open tray impression techniques for the 3-implant definitive casts. The effect of angulation on the accuracy of these 3 techniques was also evaluated. MATERIAL AND METHODS: Three definitive casts, each with 3 linearly positioned implant analogs at relative angulations 0, 30, and 40 degrees, were fabricated with passively fitted corresponding reference frameworks. Ten impressions were made and poured, using each of the 3 techniques on each of the 3 definitive casts. To record the vertical gap between reference frameworks and analogs in duplicate casts, a light microscope with image processing was used. Data were analyzed by two-way analysis of variance and the Tukey test. RESULTS: The open tray techniques showed significantly smaller vertical gaps compare to closed tray technique (P < .05). The closed tray and the resin-splinted open tray technique showed significantly different vertical gaps according to the angulation of implant (P < .05), but the A-F impression technique did not (P > .05). CONCLUSION: The accuracy of the A-F impression technique was superior to that of conventional techniques, and was not affected by the angulation of the implants.
Crowns ; Light ; Resin Cements

PURPOSE: To evaluate the appropriate entry point of an intramedullary tibial cutting guide in total knee arthroplasty in Koreans by measuring the "intramedullary canal axis" of the proximal tibia in three dimensions. MATERIALS AND METHODS: Computed tomography was performed on 116 lower extremities from the hip to the ankle on 58 Korean cadavers. A three dimensional image of the tibia was reconstructed using the program, Bionix version 3.3. The location of intramedullary canal axis of proximal tibia passing through tibial plateau, canal axis center 1 (CAC 1), was measured. The beta' angle was defined as the angle between the tibial anatomical axis and a line perpendicular to the knee joint line. The correlations between the beta' angle and the CAC 1 mediolateral coordinates were analyzed. RESULTS: The CAC 1 is located on 56.3% from the medial cortex and 27.8% from the anterior cortex on the average. On average, the CAC 1 was located 1.2 mm medially and 15.9 mm anteriorly from the lateral tibial spine 1. The beta' angles and medial-lateral coordinates of the CAC 1 showed a significant positive correlation (r=0.418, p=0.000). CONCLUSION: When using an intramedullary guide for tibial cutting in total knee arthroplasty in Koreans, the entry point at the lateral and anterior positions from the surface center of the tibial plateau is appropriate. The lateralization of the entry point of intramedullary tibial cutting guide becomes necessary as the varus of the tibia becomes more severe. Because of the marked variability in the CAC 1, a preoperative evaluation of the CAC 1 needs to be carried out in order to properly locate the appropriate entry point of the intramedullary tibial cutting guide in total knee arthroplasty.
Ankle ; Arthroplasty* ; Axis, Cervical Vertebra* ; Cadaver ; Hip ; Imaging, Three-Dimensional ; Knee Joint ; Knee* ; Lower Extremity ; Spine ; Tibia*

PURPOSE: The aim of this study was to determine whether liver resection treated by using laparoscopy is equally safe for patients who have benign liver mass, hepatolithiasis, hepatocellular carcinoma (HCC), or metastatic liver cancer. METHODS: We performed our study in 32 patients with the following conditions: 17 patients with IHD stones, 7 with HCC, 1 with cholangiocarcinoma, and 7 patients who had colon cancer with liver metastasis. On a retrospective bases, these patients were investigated for clinical history, type of operation, time for the operation, hospital stay, and post operative complications. RESULTS: The target age range was from 37 to 80 years and the mean age was 61.2 years old. The percentage of patients over 60 years old was 68.7%. According to their past history, 8 patients had experienced an upper abdominal operation. In our study there were 9 cases of left hepatectomy (28.1%), 9 cases of left lateral segmentectomy (28.1%), 2 cases of sectionectomy, and 12 cases of wedgeresection. The average operation time was 364+/-148 mins, the average bleeding amount was 417 cc, and the average hospital stay was 13.2 days. There were 8 cases (25%) of postoperative complications developed (2 bile leak, 1 intrabdominal abscess, 1 acute renal failure, 2 wound infection). All cases were improved with conservative management. And there was one case of remnant IHD stone, which had surgical treat and one patient had peritoneal carcinomatosis, who had laparoscopic liver resection for HCC. CONCLUSION: Our study showed that laparoscopic liver resection has advantages; it is less painful, causes a small operative scar, a the short period of hospital stay and has cosmetic benefits. In the future, laparoscopic liver resection could be an important option for the treatment of hepatolithiasis and HCC through improved surgical instrument and skill of operation.
Abscess ; Acute Kidney Injury ; Bile ; Carcinoma ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cicatrix ; Colonic Neoplasms ; Cosmetics ; Hemorrhage ; Hepatectomy ; Humans ; Laparoscopy ; Length of Stay ; Liver ; Mastectomy, Segmental ; Neoplasm Metastasis ; Postoperative Complications ; Retrospective Studies ; Surgical Instruments

PURPOSE: The chest radiograph is useful and reliable in assessing the severity and progression of neonatal respiratory distress syndrome. To evaluate the effect of exogenous surfactant r eplacement therapy, we performed sequential observation of chest radiogratphic findings in neonates with respiratory distress syndrome. METHODS: Two groups of infant with RDS in mechanical ventilation therapy were studied. Surfactant(S-Tx) group(n=36) was treated with Surfactant-TA and control group(n=19) was without use of surfactant. Observation of gestational age, birth weight, clinical severity by ventilatory index, sequential change of radiographic findings and radiological complications in RDS patients were performed. RESULTS: In RDS patients, there was correlation in the radiologic grading and clinical severity. In surfactant treated infants, change of chest radiographic finding was significantly improved than control group. Incidence of pneumothorax and or pulmonary interstial emphysema in S-Tx group was less than that of control group. CONCLUSIONS: Exogenous pulmonary surfactant replacement therapy may contribute the improvement of the clinical and radiological severity and reduction of the incidence of clinical complications. We suggest that surfactant replacement therapy is effective and important useful therapeutic method in neonates with respiratory distress syndrome.
Birth Weight ; Emphysema ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Pneumothorax ; Pulmonary Surfactants ; Radiography, Thoracic* ; Respiration, Artificial ; Respiratory Distress Syndrome, Newborn ; Thorax*

We report a rare case of the idiopathic membranous glomerulonephritis (IMGN) in association with the thin glomerular basement membrane nephropathy (TGBMN) in a 63-year-old female with hematuria. This is the first case reported in Korea. In renal biopsy of this case, direct immunofluorescence demonstrated anti-IgG Ab along the glomerular capillary wall with granular pattern. The basement membrane was thin, about 170-220 nm and small epimembranous electron dense deposits were observed by electron microscopy. As this case, the combination of TGBMN and IMGN is very uncommon because the IMGN is characterized morphologically by diffuse global thickening of the glomerular capillary wall, while the TGBMN is defined as an extreme thinning of the glomerular basement membrane, less than 200 nm. Our case showed no renal function deterioration and benign prognosis as other reports showed.
Basement Membrane ; Biopsy ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerular Basement Membrane* ; Glomerulonephritis, Membranous* ; Hematuria ; Humans ; Korea ; Microscopy, Electron ; Middle Aged ; Prognosis

BACKGROUND AND OBJECTIVES: Dobutamine stress echocardiography (DSE) with 2D echocardiography (2DE) is one of the time-consuming procedures in the diagnosis of coronary artery disease (CAD). Moreover, the accuracy of DSE with 2DE depends on the operator's skill or bias during the image acquisition. This study was conducted to determine the feasibility and accuracy of DSE with real-time 3D echocardiography (RT3DE) for the diagnosis of CAD. SUBJECT AND METHODS: 62 patients (RT3DE: 36, 2DE: 26), suspected of angina pectoris and post-revascularization ischemia, underwent DSE and coronary angiography (CAG). Image acquisition was performed at the baseline, and at 4 times during the dobutamine infusion and recovery stages. The procedure time (from the baseline to the end of the peak dose stage) was recorded. Off-line analyses of the volumetric images acquired with RT3DE were performed using 3D computer software (TomTec, Co.). Digitized quad-screen images acquired with 2DE were analyzed using the 2DE review system (ProSolv 4.0). >50% luminal diameter stenosis of any coronary artery on CAG was defined as significant coronary artery stenosis. RESULTS: The procedure time of DSE with RT3DE was significantly shorter than that of DSE with 2DE (25+/-4 vs. 37+/-4 mins, p<0.001). There was no significant difference in the sensitivity (p>0.05) or specificity (p>0.05) between the two procedures. CONCLUSION: DSE with RT3DE seems to be a feasible and less time consuming diagnostic procedure, probably providing comparable sensitivity and specificity for the detection of coronary artery stenosis, than DSE with 2DE.
Angina Pectoris ; Bias (Epidemiology) ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Dobutamine* ; Echocardiography* ; Echocardiography, Stress* ; Echocardiography, Three-Dimensional* ; Humans ; Ischemia ; Phenobarbital ; Sensitivity and Specificity

Cranial mononeuropathies, manifesting particulary as opthalmoplegia or facial palsy, are common entities in the dia-betic population. However, sequential multiple cranial neuropathies due to diabetes are much less common. It is often associated with other conditions such as a brain tumor or head trauma. A 61-year-old diabetic man presented with ptosis, opthalmoplegia, and facial palsy which were manifestations of multiple cranial neuropathies involving the left 3rd, 4th, 6th, and 7th cranial nerves throughout five weeks. The pupils were not involved. The neurologic evaluation included a CSF study and a brain MRI with MRA. None of them produced any significant results. Blink reflexes revealed evidence of a left facial nerve lesion. The blood glucose was strictly controlled and steroid therapy was administered. The ptosis of the patientanjx left eyelid improved during treatment and he was discharged after 13 days. In a follow-up examination 3 months after onset, focal neurological deficits including opthalmoplegia and facial palsy on the left side were greatly improved and barely noticeable.
Blinking ; Blood Glucose ; Brain ; Brain Neoplasms ; Cranial Nerve Diseases* ; Cranial Nerves ; Craniocerebral Trauma ; Diabetes Mellitus* ; Eyelids ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mononeuropathies ; Pupil

Purpose: This study aims to prospectively analyze the effects of anticholinergic therapy using imidafenacin on detrusor overactivity occurring after robot-assisted radical prostatectomy (RARP). Materials and Methods: Patients were followed-up at outpatient visits 2–4 weeks post-surgery (visit 2) to confirm the presence of urinary incontinence. Those confirmed with urinary incontinence were randomly assigned in a 1:1 ratio to the anticholinergic medication group (imidafenacin 0.1 mg twice daily) or the control group. Patients were followed-up at 1, 3, and 6 months post-surgery for observational assessments, including the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS). Results: A total of 49 patients (25 in the treatment group and 24 in the control group) were randomized for the study. There were no differences observed between the groups in terms of age, comorbidities, prostate size, or pathological staging. According to the IPSS questionnaire results, there was no statistically significant difference between the medication and control groups (p=0.161).However, when comparing storage and voiding symptoms separately, there was a statistically significant improvement in storage symptom scores (p=0.012). OABSS also revealed statistically significant improvement in symptoms from 3 months post-surgery (p=0.005), which persisted until 6 months post-surgery (IPSS storage: p=0.023, OABSS: p=0.013). Conclusions In the case of urinary incontinence that occurs after RARP, even if the function of the intrinsic sphincter is sufficiently preserved, if urinary incontinence persists due to changes in the bladder, pharmacological therapy using imidafenacin can be beneficial in managing urinary incontinence.

Purpose: This study aims to prospectively analyze the effects of anticholinergic therapy using imidafenacin on detrusor overactivity occurring after robot-assisted radical prostatectomy (RARP). Materials and Methods: Patients were followed-up at outpatient visits 2–4 weeks post-surgery (visit 2) to confirm the presence of urinary incontinence. Those confirmed with urinary incontinence were randomly assigned in a 1:1 ratio to the anticholinergic medication group (imidafenacin 0.1 mg twice daily) or the control group. Patients were followed-up at 1, 3, and 6 months post-surgery for observational assessments, including the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS). Results: A total of 49 patients (25 in the treatment group and 24 in the control group) were randomized for the study. There were no differences observed between the groups in terms of age, comorbidities, prostate size, or pathological staging. According to the IPSS questionnaire results, there was no statistically significant difference between the medication and control groups (p=0.161).However, when comparing storage and voiding symptoms separately, there was a statistically significant improvement in storage symptom scores (p=0.012). OABSS also revealed statistically significant improvement in symptoms from 3 months post-surgery (p=0.005), which persisted until 6 months post-surgery (IPSS storage: p=0.023, OABSS: p=0.013). Conclusions In the case of urinary incontinence that occurs after RARP, even if the function of the intrinsic sphincter is sufficiently preserved, if urinary incontinence persists due to changes in the bladder, pharmacological therapy using imidafenacin can be beneficial in managing urinary incontinence.