To examine the usefulness of cardiac MRI in assessing patients (pt) with congenital heart diseases(CHD), informations obtained from MRI and echocardiogrphy (echo) were compared in 91 consecutive pt with CHD and was correlated with findigs at cardiac catheterization (53pt) and at surgery (71pt). Pt were studied with 1.5 Tesla MRI unit and multiplanar images of the heart and great vessels were obtained using ECG-gated multislice spin-echo technique. Age ranged from newborn to 22 years. We obtained the following results. MRI was vary useful in providing important diagnostic informations in 19pt, provided informations which was not crucial to the clinical decision in 28pt, and did not provide additional informations in 44pt. MRI was very useful in assessing complex lesions, particularly in identifying atrial situs, rudimentary ventricular chamber, criss-cross atrioventricular connection, total anomalous pulmonary venous connection, anatomy of ventricular septal defect in double outlet right ventricle, anomalous ventricular muscles, aortopulmonary collateral artery and distal pulmonary artery anatomy. En face view of the ventricular septum was very useful in clearly outlining the ventricular septal defect. MRI gave false information in 17pt. Diagnostic accuracy of MRI was poor for coarctation of the aorta in neonates and small infants, patent ductus arteriosus and pulmonary stenosis. Cardiac MRI is recommended for preoperative planning in selected pt with CHD, particularly with complex lesions.
Aortic Coarctation ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Double Outlet Right Ventricle ; Ductus Arteriosus, Patent ; Echocardiography* ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging* ; Muscles ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Ventricular Septum

The prevalence and related diseases of otitis media with effusion(OME) which is a very common disease in infants and young children were investigated in a group of 3 to 6 year old children. The study population includes 374 children with 185 boys and 189 girls enrolled in 7 kindergartens in Puchun city. The middle ear status was assessed by combination of findings of otomicroscope, pneumatic otoscope, impedence audiometry. The related diseases were evaluated by radiologic findings and questionnare with statistic analysis. Fifty-nine children were considered to have OME(prevalence: 15.8%) with peak at 3 years of age(30.6%). Of the 59 children with OME, fifty-four percent had bilateral involvement and all the remainder had unilateral involvement. The risk for otitis media with effusion increased in children with adenoid enlargement, tonsillar enlargement, and paranasal sinusitis, and this was confirmed to be statistically significant(p<0.01).
Adenoids ; Audiometry ; Child* ; Cross-Sectional Studies* ; Ear, Middle ; Female ; Gyeonggi-do* ; Humans ; Infant ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Otoscopes ; Prevalence* ; Sinusitis

PURPOSE: Our purpose was to assess the results of lunate excision and tendon ball implantation with temporary scaphocapitate fixation for Lichtman stage IIIB Kienbockos disease in middle-aged patients. METHODS: Ten patients with Lichtman stage IIIB Kienbock's disease who underwent lunate excision and tendon ball implantation and followed up at least 24 months were analyzed. There were 4 males and 6 females. The mean age at the time of surgery was 55.4 years (range, 48-67 years), and follow-up period ranged from 24 to 68 months (mean, 46 months). Radiocarpal joint pain, grip strength, return to daily living activity, range of motion were evaluated and radiologic findings of preoperative, postoperative and last follow-up were evaluated. RESULTS: All patients returned to daily living activity after 6 months of surgery. At the last follow up, 8 patients had no pain and 2 patients experienced mild pain occasionally. The mean improvement of extension arc was 14.5degrees, and the mean flexion arc improved 8.5degrees. The mean grip strength was 88% of unaffected side. The mean carpal height ratio was 0.49 preoperatively, 0.47 at final follow-up. No patients showed osteoarthritis change at the last follow-up. The mean Cooney's wrist function were 83, 4 patients had excellent, 4 had good, and 2 had fair. CONCLUSION: Lunate excision and tendon ball implantation with temporary scaphocapitate fixation for Lichtman stage IIIB Kienbock's disease in middle-aged patients showed satisfactory clinical, functional and radiological results. So this can be a reasonable treatment option.
Activities of Daily Living ; Arthralgia ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Osteoarthritis ; Osteonecrosis* ; Range of Motion, Articular ; Tendons* ; Wrist

PURPOSE: We compared and analyzed the short term results of high flexion total knee arthroplasty (TKA) with mobile-bearing and fixed bearing designs. MATERIALS AND METHODS: We studied 32 patients that had undergone TKA with LPS-Flex Mobile and 34 patients with LPS-Flex Fixed using an electromagnetic navigation system between January 2010 and June 2010, and were followed up for at least 1 year. RESULTS: Knee Society Functional Score (KSFS) and Knee Society Knee Score (KSKS) of the mobile-bearing group were 94.5 and 93.8 points, respectively, and were 48.2 and 45.3 points preoperatively, whereas those of the fixed-bearing group were 95.1 and 94.2 points, respectively, and were 49.5 and 46.9 points preoperatively. Postoperative mechanical axis deviation and implant position of the femoral and tibial component both on the coronal and sigittal planes showed no significant differences between the two groups. Range of motion (ROM) and maximal flexion angle (MFA) of the knee joint also showed no significant differences between the two groups. The possibility of crossed-legged sitting and kneeling position also showed no significant differences between the two groups. CONCLUSIONS: Clinical and radiologic parameters, ROM and MFA of knee joints showed no significant differences in both the groups, but long term follow-up results may be necessary, including survival rate.
Arthroplasty ; Axis, Cervical Vertebra ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Magnets ; Range of Motion, Articular ; Survival Rate ; Ursidae

Patellectomized patients may have less satisfactory clinical outcomes following total knee arthroplasty (TKA) due to a decreased extensor mechanism efficiency and potential instability. Furthermore, the existing literature does not provide concrete guidance on the expected results of TKA or the type of implant that should be used in patellectomized patients. We present a case of a patient with an ankylosing knee who had undergone patellectomy due to gunshot injury 45 years ago and was treated with primary TKA using a posterior stabilized prosthesis at our institution. TKA using this prosthesis in the ankylosed knee with a previous history of patellectomy yielded good results in terms of postoperative clinical scores, range of motion and joint stability.
Ankylosis ; Arthroplasty ; Humans ; Joints ; Knee ; Prostheses and Implants ; Range of Motion, Articular

PURPOSE: The purpose of this study is to compare and analyze the precision of optical and electromagnetic navigation systems in total knee arthroplasty (TKA). MATERIALS AND METHODS: We retrospectively reviewed 60 patients who underwent TKA using an optical navigation system and 60 patients who underwent TKA using an electromagnetic navigation system from June 2010 to March 2012. The mechanical axis that was measured on preoperative radiographs and by the intraoperative navigation systems were compared between the groups. The postoperative positions of the femoral and tibial components in the sagittal and coronal plane were assessed. RESULTS: The difference of the mechanical axis measured on the preoperative radiograph and by the intraoperative navigation systems was 0.6 degrees more varus in the electromagnetic navigation system group than in the optical navigation system group, but showed no statistically significant difference between the two groups (p>0.05). The positions of the femoral and tibial components in the sagittal and coronal planes on the postoperative radiographs also showed no statistically significant difference between the two groups (p>0.05). CONCLUSIONS: In TKA, both optical and electromagnetic navigation systems showed high accuracy and reproducibility, and the measurements from the postoperative radiographs showed no significant difference between the two groups.
Arthroplasty ; Axis, Cervical Vertebra ; Humans ; Knee ; Magnets ; Retrospective Studies

Human seminal fiuid (HSP) hypersensitivity is rare, but possibly a life-threatening disease. The pathogenesis of seminal plasma hypersensitivity and the exact nature of the HSP allergens remains to be clarified. We report a case of 25-year-old female patient who complained of severe itching sensation, flushing and edema of external genitalia, facial edema and dyspnea after sexual intercourse. The diagnosis was established by skin pr ick test with her husbands diluted semen. Intravaginal desensitization was performed by modified Matloffs method. Dilutions was made with sterile human serum albumin(0.2%) and 0.4% pheno1-0.9% saline solution. Two ml each of progressively greater concentrations of semen dilutions(1: 100,000 v/v, 1: 10,000 v/ v, 1:1,000 v/v, 1:100 v/v, 1:10 v/v) were inserted intravaginally at 45-min intervals, followed by an undiluted specimen. The patient was successfully desensitized and could have unprotected intercourse without anaphylaxis.
Adult ; Allergens ; Anaphylaxis ; Coitus ; Diagnosis ; Dyspnea ; Edema ; Female ; Flushing ; Genitalia ; Humans ; Hypersensitivity* ; Pruritus ; Semen ; Sensation ; Skin ; Sodium Chloride ; Spouses

PURPOSE: To determine the diagnostic performance of contrast-enhanced multidetector CT (MDCT) and the Alvarado score for acute appendicitis. MATERIALS AND METHODS: MDCT and determination of the Alvarado score were prospectively performed in 282 patients with 146 pathologically proven cases of acute appendicitis and 136 pathologically proven or clinically diagnosed cases of non-acute appendicitis. To compare the diagnostic performance of MDCT and the Alvarado score, the patients were subdivided according to age and sex, and receiver operating characteristics (ROC) analysis and Spearman rank correlation were performed. RESULTS: ROC analysis revealed that the optimal cut off value of the CT appendicitis grades was 2 in all patients, resulting in a sensitivity of 96.6% and a specificity of 94.9%. The optimal cut off values of the Alvarado score was different according to age and sex, resulting in a sensitivity of 85.6% and a specificity of 48.5%. There was a significant correlation between the CT appendicitis grades and the surgical-pathological grades (r=0.496, p<.0001). However, no significant correlation was observed between the Alvarado score and the surgical-pathological grades. CONCLUSION: Contrast-enhanced MDCT has a higher diagnostic accuracy and significant correlation with pathological findings than those of the Alvarado score in patients with acute appendicitis.
Acute Disease ; Appendicitis* ; Humans ; Prospective Studies* ; ROC Curve ; Sensitivity and Specificity

Pure word deafness is characterized by an impairment of auditory comprehension and repetition of speech while a preservation of reading, writing, spontaneous speech and ability to comprehend non-verbal sounds. It is caused by trauma, infection, tumor or infarction in the temporal lobe of brain. In most cases, the lesions are bilateral, in the middle third of superior temporal gyri, but in a few cases unilateral lesions of dominant temporal lobe are localized. We experienced a case of 45 year-old right handed woman with systemic lupus erythematosus (SLE) who presented pure word deafness after left temporal lobe infarction including primary auditory center. Her auditory comprehension was impaired, while reading and visual comprehension were normal. Audiometric tests and auditory evoked potentials disclosed no hearing defect. Brain MRI showed a left temporal lobe infarction without abnormal vascular finding in MRA. She was diagnosed as pure word deafness due to SLE vasculitis and managed with high dose steroid and cyclophosphamide therapies.
Brain ; Cerebral Infarction ; Comprehension ; Cyclophosphamide ; Deafness* ; Evoked Potentials, Auditory ; Female ; Hand ; Hearing ; Humans ; Infarction ; Lupus Erythematosus, Systemic* ; Magnetic Resonance Imaging ; Middle Aged ; Temporal Lobe ; Vasculitis ; Writing

In vivo 31P NMR spectra were obtained in eight infant brain at 4.7T. Each phosphorus metabolite and its ratio were analyzed to evaluate the brain damage and maturity, and compared with the reported data obtained at the lower field strength. Measurement of T1 relaxation time at 4.7T was done in an infant and a cat brain in vivo. PCr/Pi and PCr/β-ATP ratio were used as a marker of brain damage. PME/PDE revealed higher values than those of the reported data obtained at the lower field strength and the difference was partly attributed to the long T1 relaxation time of PME rather than the brain immaturity. Although the resolution of the spectrum was improved at 4.7T, a long repetition time is recommended to minimize T1difference of phosphorus metabolites of brain at 4.7T.
Animals ; Brain* ; Cats ; Humans ; Infant ; Magnetic Resonance Spectroscopy* ; Phosphorus ; Relaxation