In the personalized medicine era, utilizing paraffin blocks in pathology archives for investigating human diseases has come into the limelight. This archived material with clinical data will reduce the research time and could prevent new patient recruitment to obtain tissue for research. However, the clause indicating the necessity of consent from human material providers in the Korean Bioethics and Safety Act has made the Institutional Review Board (IRB) deny permission to use paraffin blocks for research without consent, and alternatively to get the same before starting an experiment. Written consent may be waived off in studies using paraffin blocks with anonymous status or conditions not linked to personal information by applying the paragraph 3, article 16 of the current Bioethics and Safety Act. Also, the IRB should recommend researchers to preserve the blocks as medical records of patients in long-term archives.
Anonyms and Pseudonyms ; Bioethics ; Ethics Committees, Research ; Humans ; Medical Records ; Paraffin ; Pathology ; Patient Selection ; Precision Medicine

In the personalized medicine era, utilizing paraffin blocks in pathology archives for investigating human diseases has come into the limelight. This archived material with clinical data will reduce the research time and could prevent new patient recruitment to obtain tissue for research. However, the clause indicating the necessity of consent from human material providers in the Korean Bioethics and Safety Act has made the Institutional Review Board (IRB) deny permission to use paraffin blocks for research without consent, and alternatively to get the same before starting an experiment. Written consent may be waived off in studies using paraffin blocks with anonymous status or conditions not linked to personal information by applying the paragraph 3, article 16 of the current Bioethics and Safety Act. Also, the IRB should recommend researchers to preserve the blocks as medical records of patients in long-term archives.

Nonunion of comminuted distal humeral fracture is troublesome problem to orthopedic surgeon. We report a case of 59 years old woman, who suffered nonunion of comminuted distal humeral fracture previously treated by open reduction and internal fixation with plate and screws concomitantly autoiliac bone graft. We reconstructed humeral condyle with fibular inlay graft inside cortical shell of intercondylar bone fragment and obtained excellent result in radiological and functional outcome.
Female ; Fractures, Comminuted ; Humans ; Humeral Fractures ; Humerus ; Inlays ; Orthopedics ; Transplants

A 64-year-old woman with ischemic heart disease was admitted to our hospital because of both leg pain and difficulty to walk for 5 days. She had taken cerivastatin and gemfibrozil for atherosclerosis and ischemic heart disease. One year ago, she had been admitted to our hospital because of acute renal failure due to rhabdomyolysis of unknown origin and was improved after conservative therapy. Laboratory studies revealed serum creatinine 1.2 mg/dL, creatine kinase 23,700 IU/L, serum myoglobin >500 ng/mL, urine myoglobin >3,000 ng/mL. (99m)Tc-HDP whole body Bone scan showed multiple increased uptakes of the soft tissue, especially both calf. With supportive care, she was recovered and discharged with normal creatinine(0.8 mg/dL) and creatine kinase(260 IU/L).
Acute Kidney Injury ; Atherosclerosis ; Creatine ; Creatine Kinase ; Creatinine ; Female ; Gemfibrozil ; Humans ; Leg ; Middle Aged ; Myocardial Ischemia ; Myoglobin ; Rhabdomyolysis*

STATEMENT OF PROBLEM: Loosening or fracture of the abutment screw is one of the common problems related to the dental implant. Generally, in order to make the screw joint stable, the preload generated by tightening torque needs to be increased within the elastic limit of the screw. However, additional tensile forces can produce the plastic deformation of abutment screw when functional loads are superimposed on preload stresses, and they can elicit loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum tightening torque that maximizes a fatigue life and simultaneously offer a reasonable degree of protection against loosening. PURPOSE: The purpose of this study was to present the influence of tightening torque on the implant-abutment screw joint stability with the 3 dimensional finite element analysis. MATERIAL AND METHODS: In this study, the finite element model of the implant system with external butt joint connection was designed and verified by comparison with additional theoretical and experimental results. Four different amount of tightening torques (10, 20, 30 and 40 Ncm) and the external loading (250 N, 30degrees C) were applied to the model, and the equivalent stress distributions and the gap distances were calculated according to each tightening torque and the result was analyzed. RESULTS: Within the limitation of this study, the following results were drawn; 1) There was the proportional relation between the tightening torque and the preload. 2) In case of applying only the tightening torque, the maximum stress was found at the screw neck. 3) The maximum stress was also shown at the screw neck under the external loading condition. However in case of applying 10 Ncm tightening torque, it was found at the undersurface of the screw head. 4) The joint opening was observed under the external loading in case of applying 10 Ncm and 20 Ncm of tightening torque. 5) When the tightening torque was applied at 40 Ncm, under the external loading the maximum stress exceeded the allowable stress value of the titanium alloy. CONCLUSION: Implant abutment screw must have a proper tightening torque that will be able to maintain joint stability of fixture and abutment.
Alloys ; Dental Implants ; Fatigue ; Finite Element Analysis ; Head ; Joints ; Neck ; Plastics ; Titanium ; Torque

The clinical trial was carried out with carteolol in 30 patients with essential hypertension. The results were as follows : 1) Before medication and after 2,4,6 and 8 weeks of medications, the overall average systolic and diastolic blood pressure were 175+/-17.7/105+/-9.3, 144+/-8.9/92+/-6.9, 143+/-11.2/90+/-6.6, 141+/-8.4/88+/-6.9, and 142+/-9.0/88+/-7.1 mmHg. As a result, blood pressure significantly fell with carteolol treatment. 2) In 80+/- of all cases, marked or moderate degree of hypotnesive effect was observed within 2 weeks of treatment. 3) Before medication and after 2, 4, 6 and 8 weeks of medication, the overall average heart rates were 75+/-11.8, 73+/-9.0, 71+/-8.7, 71+/-8.2 and 71+/-8.6 beats/minute. There was no significant changes in heart rates before and after treatment. 4) Dizziness or fatigability were complained in 4 patients (13+/-) each while receiving carteolol. These side effects were mild in 3 patients, but one patient discontinued treatment due to dizziness. On the basis of these results, carteolol was evaluated to be promising hypotensive drug.
Blood Pressure ; Carteolol* ; Dizziness ; Heart Rate ; Humans ; Hypertension

Borrmann type 4 gastric is a malignant disease that shows enlarged gastric folds, and this is easily mistaken as a mucosal flare or as inflammation because a third of these patients show normal mucosa without mucosal defects and the lesion diffusively infiltrates into the submucosal area. Endoscopic ultrasonography is an effective tool for making the differential diagnosis of gastric subepithelial lesion and hypertrophic gastric fold when endoscopy is not suitable to use. Eosinophilic gastritis is a benign lesion with enlarged gastric folds and it shows pathologic eosinophil infiltration in the walls of the stomach. We report here on a case that was suspected to be Borrmann type 4 advanced gastric cancer according to the endoscopic ultrasonography and this was confirmed by abdominal operation. Otherwise, this condition would have been mistaken for eosinophilic gastritis.
Diagnosis, Differential ; Endoscopy ; Endosonography ; Enteritis ; Eosinophilia ; Eosinophils ; Gastritis ; Humans ; Inflammation ; Mucous Membrane ; Stomach ; Stomach Neoplasms

Boerhaave's syndrome is difficult to diagnosis because of the esophageal rupture, which is caused by nausea and vomiting, and Boerhaave's syndrome is known to have a high mortality rate. The mortality increases with a delayed diagnosis; therefore, an early diagnosis and surgical treatment are critical for a good prognosis. Yet some recent cases have shown that non-surgical treatments are successful in some classified patient groups. These groups should be considered according to their symptoms and their laboratory and radiological findings. Sepsis and multi-organ failure should be continuously checked for to see if they occurred and/or progressed. We report here on a 51 year old woman who had Boerhaave's syndrome, and this was caused by heavy drinking, nausea and vomiting, and she improved with just non-surgical treatment such as fasting, antibiotics and endoscopic clipping.
Anti-Bacterial Agents ; Drinking ; Early Diagnosis ; Esophageal Perforation ; Fasting ; Female ; Humans ; Mediastinal Diseases ; Nausea ; Prognosis ; Rupture ; Sepsis ; Vomiting

BACKGROUND/AIMS: Complications related to foreign body ingestion are uncommon, and especially a food bolus, but some ingested foreign bodies are associated with severe and life threatening morbidity. The aim of this study is determine the predictive risk factors for complications resulting from foreign body ingestion in patients who are without gastrointestinal tract obstruction. METHODS: We retrospectively analyzed the data of 147 patients who were diagnosed with a foreign body in the GI tract without obstruction between Jan. 2000 to Aug. 2008. RESULTS: Animal bone fragment and coin were the most common type of foreign bodies in adults and children, respectively. Multivariate analysis showed age (p=0.019), the duration of impaction (p=0.013) and the location of the impacted foreign body (p=0.011) were significant independent risk factors associated with the development of complications. Especially, the most important risk factor for children was the location of the impacted foreign body and for adults it was the duration of impaction. CONCLUSIONS: Old age, a longer duration of impaction and impaction at the upper esophageal sphincter or upper esophagus are important predictive factors of complication after foreign body ingestion in patients without gastrointestinal tract obstruction. For cases with these factors, more intensive awareness by the physician should be adapted.
Adult ; Animals ; Child ; Eating ; Esophageal Sphincter, Upper ; Esophagus ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Multivariate Analysis ; Numismatics ; Retrospective Studies ; Risk Factors

BACKGROUND: Pyogenic liver abscess is an acute infectious disease caused by bacteria and can become severe and potentially life-threatening, with a mortality rate of 6-18%. The purpose of this study is to provide the basic informations for the management of liver abscess and the choice of the most effective and economic antibiotics. MATERIALS AND METHODS: We investigated clinical, laboratory, radiologic findings and the results of bacteriological studies retrospectively by reviewing the medical records of 141 cases of pyogenic liver abscess patients, admitted to Catholic University St Vincent's Hospital from January 1998 to December 2007. RESULTS: Patients demographics revealed a mean age of 57.1, (age: 18 to 87), and 71 of the 141 patients were male (50.4%). Cure was achieved in 51 (98.1%) of the 52 patients who were treated with the combination of percutaneous drainage and antibiotics, and in 80 (90.0%) of 89 patients who were treated only with antibiotics. However, there were no significant differences in mortality (P=0.092) and the time to defervescence between both groups. The mean duration of percutaneous drainage was 15.8+/-9.7 days. Sixty-four of 141 patients showed positive culture results, and K. pneumoniae (70.3%) was the most common organism. Among 45 K. pneumoniae, the rates of resistance were 73.3% to ampicillin, 66.7% to piperacillin, 8.9% to cefazolin, 2.2% to cefuroxime, 0% to ceftriaxone, and 0% to ciprofloxacin. CONCLUSIONS: Combination treatment of intravenous antibiotics and percutaneous drainage was effective for the treatment of pyogenic liver abscess. Initial broad spectrum antibiotic coverage and then switch to first or second cephalosporin according to the susceptibility results, could be recommended especially in patients with monomicrobial K. pneumoniae liver abscess.
Ampicillin ; Anti-Bacterial Agents ; Bacteria ; Cefazolin ; Ceftriaxone ; Cefuroxime ; Ciprofloxacin ; Communicable Diseases ; Demography ; Drainage ; Humans ; Liver Abscess ; Liver Abscess, Pyogenic ; Male ; Medical Records ; Piperacillin ; Pneumonia ; Retrospective Studies