There are many kinds of instrumentation systems for posterior operation in the treatment of scoliosis. Cotrel-Dubousset (C-D) system is most widly used for its excellent correction potential and stability. However there were some problems in C-D hook system such as hook dislodgement and correction loss. So, in order to reduce these problems we use transpedicular screw system and compare the results between two systems. We studied 44 cases of scoliosis ( hook 19 cases, screw 25 cases) who were operated with C-D instrumentation from February 1988 to August 1995. The average follow-up period was 54 months in hook group and 23 months in screw group. 1. Operation time was 241 minutes in hook group and 223 minutes in screw group. Average amount of transfusion was 5.0 pints in hook group and 4.6 pints in screw group. 2. Involved segments of main curvature were 7.0 in hook group and 6.6 in screw group. 3. Scoliotic curve was changed from 49degrees to 13degrees (73%) in hook group and from 47degrees to 12degrees (74%) in screw group. Loss of correction during follow up period was 7degrees in hook group and 3 in screw group. 4. Thoracic kyphosis was changed from 24degrees to 26degrees in hook group and from 27degrees to 30degrees in screw group. Lumbar lordosis was changed from 26degrees to 29degrees in hook group and from 26degrees to 31degrees in screw group. 5. Correction rate of rotation of apex vertebrae by Pedriolle method was 43% (from 20degrees to 12degrees) in hook group and 50% (from 22degrees to 11degrees) in screw group. 6. Complications were two cases of hook dislodgement, one delayed deep infection and four cases of progression of curvature in hook group and one case of malinsertion of screw and two cases of progression of curvature in screw group. In conclusion, these results suggested that screw system is more effective than hook system on rotational correction of apex vertebra and prevention of loss of correction.
Animals ; Follow-Up Studies ; Kyphosis ; Lordosis ; Scoliosis* ; Spine

No abstract available.
Transplants*

No abstract available.
Blepharoptosis* ; Orbit*

No abstract available.
Meconium* ; Peritonitis*

PURPOSE: The objective of this study was to evaluate fracture strength of collarless metal-ceramic FPDs according to their metal coping designs. MATERIALS AND METHODS: Four different facial margin design groups were investigated. Group A was a coping with a thin facial metal collar, group B was a collarless coping with its facial metal to the shoulder, group C was a collarless coping with its facial metal 1 mm short of the shoulder, and group D was a collarless coping with its facial metal 2 mm short of the shoulder. Fifteen 3-unit collarless metal-ceramic FPDs were fabricated in each group. Finished FPDs were cemented to PBT (Polybutylene terephthalate) dies with resin cement. The fracture strength test was carried out using universal testing machine (Instron 4465, Instron Co., Norwood MA, USA) at a cross head speed of 0.5 mm/min. Aluminum foil folded to about 1 mm of thickness was inserted between the plunger tip and the incisal edge of the pontic. Vertical load was applied until catastrophic porcelain fracture occurred. RESULTS: The greater the bulk of unsupported facial shoulder porcelain was, the lower the fracture strength became. However, there were no significant differences between experimental groups (P > .05). CONCLUSION: All groups of collarless metal-ceramic FPDs had higher fracture strength than maximum incisive biting force. Modified collarless metal-ceramic FPD can be an alternative to all-ceramic FPDs in clinical situations.
Aluminum ; Bites and Stings ; Collodion ; Dental Porcelain ; Denture, Partial, Fixed ; Head ; Resin Cements ; Shoulder

BACKGROUND: Nonrheumatic atrial fibrillation is common in elderly and associated with an increased risk for thromboembolism. Left atrial spontaneous echo contrast(SEC) and thrombus. which are easily detected by transesophageal echocardiography(TEE) in patients with rheumatic mitral valve disease and atrial fibrillation, have been known as markers of thromboembolism. However, most of the previous studies on left atrial SEC and thrombus were performed in rheumatic mitral valve disease or various conditions including rheumatic mitral valve disease. Therefore this study was underaken in order to investigatd 1) the prevalence of left atrial SEC and thrombus, and 2) clinical and echocardiographic variables related to left atrial SEC and thrombus in nonrheumatic atrial fibrillation. METHODS: In patients with estabished atrial fibrillation over 7 days, we examined the clinical gistory and performed transthoracic echocardiography(TTE) and TEE simultaneously. Enlisted patients were those without rheumatic mitral valve disease, prosthetic valves, previous thromboembolism, and recent anticoagulant therapy. RESULTS: 1) Left atrial SEC was detected in 32(62.7%) of 51 patients and left atrial thrombus in 10(19.6%). All thrombi were located in the left atrial appendage. 2) In univariate analysis, SEC positive group showed higher prevalence of congestive heart failure(CHF)(56.3% vs 0%, p<0.001), lower ejection fraction(42.2+/-14.1% vs 50.8+/-9.7%, p<0.05), lower left atrial appendage blood flow velocity(peak positive flow velocity ; 18.7+/-11.1cm/sec vs 32+/-12.4cm/sec, p<0.01, and peak negative flow velocity ; 21.4+/-12.4cm/sec vs 31.9+/-12.8cm/sec, p<0.01) than SEC negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial SEC(p=0.02, Odds ratio ; 2.38, 95% CI ; 1.18-4.82). 3) In univariate analysis. left atrial thrombus positive group showed higher prevalence of CHF(70% vs 26.8%, p<0.05), larger left atrial demension(34+/-3.4mm/m2 vs 30.6+/-4.6mm/m2, p<0.05) than thrombus negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial thrombus(p=0.04, Odds ratio ; 4.30, 95% CI ; 1.11-16.68). 4) Left atrial thrombus is more frequent in SEC positive group than in SEC negative group(28.1% vs 5.3%), however, there was no statistical significance(p=0.07). CONCLUSION: 1) Left atrial SEC is common in nonrheumatic atrial fibrillation and significantly related to CHF. 2) Left atrial thrombus is frequently detected in SEC positive patients, however, it is more realted to CHF than left atrial SEC itself.
Aged ; Atrial Appendage ; Atrial Fibrillation* ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Mitral Valve ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Thromboembolism ; Thrombosis*

Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.
Aged ; Anti-Bacterial Agents/therapeutic use ; Cystectomy/adverse effects ; Enterococcus/isolation & purification ; Escherichia coli/isolation & purification ; Female ; Humans ; Ileum/*surgery ; Incidence ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications ; Reconstructive Surgical Procedures ; Retrospective Studies ; Risk Factors ; Urinary Bladder Neoplasms/*surgery ; Urinary Tract Infections/drug therapy/*epidemiology/etiology/microbiology ; Urodynamics

PURPOSE: The incidence of urolithiasis has recently shown an increasing tendency in relation to improvements in living conditions in Korea. With the development of extracorporeal shock wave lithotriptor (ESWL), endourology and other new instruments, urolithiasis has become easier to treat, without surgical intervention. The incidence and treatment of urolithiasis, between the 1980 and 2000, were evaluated. MATERIALS AND METHODS: 328 and 1,142 patients with urolithiasis, either admitted between January 1981 and December 1984 or treated at the out-patient clinic between January 2001 and December 2004, respectively, were analyzed. RESULTS: In the early 1980s, 328 (27.3%) patients of the total 1,203 admitted to the urology department had urolithiasis. In the early 2000s, 1,142 patients were treated for urolithiasis. The total number and incidence constantly increased over the stated period. The ratio of males to females was 1.3:1 in the 1980s and 2.0:1 in the 2000s. The occurrence rate for those under 20 years decreased, but increased after the 6th decade. And the seasonal occurrence was highest during the summer of the early 1980s, but there was no seasonal difference during the early 2000s. The incidences of lower ureteral, bladder and urethral calculi were decreased, but those of renal and upper ureteral calculi increased. In the management of urolithiasis, open surgery and expectant therapy decreased during the 2000s. In the endourological management of urolithiasis, the success rates of ESWL, percutaneous nephrolithotomy (PNL) and ureteroscopic removal of stone (URS) were 94.5, 86.6 and 96.4%, respectively. CONCLUSIONS: The incidence and treatment modalities of urolithiasis have changed, especially since the late 1980s.
Calculi ; Female ; Humans ; Incidence* ; Korea ; Male ; Nephrostomy, Percutaneous ; Outpatients ; Seasons ; Shock ; Social Conditions ; Ureter ; Ureteral Calculi ; Urinary Bladder ; Urolithiasis* ; Urology

PURPOSE: Few studies are available on the role of female urethral length (UL) and anterior vaginal wall thickness (AVWT) in stress urinary incontinence (SUI). The aim of this study was to evaluate the usefulness of characterization of female UL and AVWT associated with SUI. MATERIALS AND METHODS: Between May 2006 and October 2006, a total of 53 women with or without SUI were included in this study. Twenty-three women with SUI and 30 healthy volunteers serving as controls underwent transvaginal ultrasound with use of a 7.5MHz transrectal probe. Measurement comprised UL and three portions of AVWT classified as proximal, middle, and distal according to the location against the urethra. RESULTS: The women's median age was 51.1 (range: 30-73) years. The UL (mm, mean+/-SD) was significantly shorter in women with SUI than in women without SUI (28.7+/-2.8 vs 31.2+/-4.5, respectively, p=0.02). The AVWT of women with SUI (mm, mean+/-SD) was 16.2+/-2.8 in the proximal, 10.7+/-1.9 in the middle, and 9.3+/-2.0 in the distal portion, and those of women without SUI were 16.8+/-3.2, 10.1+/-1.8, and 6.9+/-1.3, respectively. Distal AVWT was significantly thicker in women with SUI than in women without SUI (p=0.01). There were no significant differences in AVWT or UL between pre- and postmenopausal women. A significant positive correlation was found between advancing in age and decrease in UL (p=0.03). Body mass index and parity showed no correlation with UL or any AVWT (p>0.05). CONCLUSIONS: These results suggest that women with shorter UL and thicker distal AVWT are likely to have SUI. Furthermore, UL was shorter in older women.
Body Mass Index ; Female ; Humans ; Parity ; Urethra ; Urinary Incontinence

PURPOSE: The majority of upper and lower ureteral stones are primarily treated by extracorporeal shock wave lithotripsy(ESWL), but the optimal treatment for ureteral stones overlying the pelvic bone(middle third of the ureter) remains unclear and controversial. MATERIALS AND METHODS: From April 1999 to March 2003, out of 70 patients with stones in the middle third of the ureter, 62 who were followed up continuously were included in this study. Shock waves to the stones were delivered from the back because their pelvic bones were barriers for shock waves. We used third generation ESWL, Modulith SLX(R)(Storz, Germany). Patients who were treated primarily with ureterolithotomy or ureteroscopic stone removal were excluded from the study. The success and complication rates were analyzed. RESULTS: The overall stone free rates were 88.7% with ESWL. Out of 62 stones, 33 were removed at the middle third of the ureter, 25 migrated to the distal ureter, and 4 that remained at the same site were removed by ureterolithotomy. Out of the 25 stones which migrated to the distal ureter, 22 were removed by repeated ESWL, but 3 required ureteroscopy for removal. Complications were shown in 6 patients: gross hematuria persisting more than 48 hours in 3, abdominal and flank pain in 1, UTI with fever in 1, and steinstrasse in 1. CONCLUSIONS: In our study, ESWL provided satisfactory success rates even in the mid-ureteral stones. It is a noninvasive, simple and safe option for the management of stones in the middle third of the ureter.
Fever ; Flank Pain ; Hematuria ; Humans ; Lithotripsy ; Pelvic Bones ; Shock* ; Ureter ; Ureteroscopy ; Urolithiasis