STATEMENT OF PROBLEM: The success of implants depends on intimate and direct contact of implant material on bone tissue and on functional relationship with soft tissue contact. Creation and maintenance of osseointegration depend on the understanding of the tissue's healing, repairing, and remodeling capacity and these capacities rely on cellular behavior. Altering the surface properties can modify cellular responses such as cell adhesion, cell motility, bone deposition. Therefore, various implant surface treatment methods are being developed for the improved bone cell responses. PURPOSE: The purpose of this study was to evaluate the responses of osteoblast-like cells to surface- modified titanium. MATERIALS AND METHODS: The experiment was composed of four groups. Group 1 represented the electropolished surface. Group 2 surfaces were machined surface. Group 3 and Group 4 were anodized surfaces. Group 3 had low roughness and Group 4 had high roughness. Physicochemical properties and microstructures of the d iscs were examined and the responses of osteoblast-like cells to the discs were investigated. The microtopography was observed by SEM. The roughness was measured by three-dimension roughness measuring system. The microstructure was analyzed by XRD, AES. To evaluate cell responses to modified titanium surfaces, osteoblasts isolated from calvaria of neonatal rat were cultured. Cell count, morphology, total protein measurement and alkaline phosphatase activities of the cultures were examined. RESULTS AND CONCLUSION: The results were as follows 1. The four groups showed specific microtopography respectively. Anodized group showed grain structure with micropores. 2. Surface roughness values were, from the lowest to the highest, electropolished group, machined group, low roughness anodized group, and high roughness anodized group. 3. Highly roughened anodized group was found to have increased surface oxide thickness and surface crystallinity. 4. The morphology of cells, flattened or spherical, were different from ach other. In the electropolished group and machined group, the cells were almost flattened. In two anodized groups, some cells were spherical and other cells were flattened. And the 14 day culture cells of all of the groups were nearly flattened due to confluency. 5. The number of attached cells was highest in low roughness anodized group. And the machined group had significantly lower cell count than any other groups(P<.05). 6. Total protein contents showed no difference among groups. 7. The level of alkaline phosphatase activities was higher in the anodized groups than electropolished and machined groups(P<.05).
Alkaline Phosphatase ; Animals ; Bone and Bones ; Cell Adhesion ; Cell Count ; Cell Movement ; Edible Grain ; Crystallins ; Osseointegration ; Osteoblasts ; Rats ; Skull ; Surface Properties ; Titanium*

Purpura fulminans is a potentially disabling and life-threatening disorder characterized by acute onset of progressive cutaneous hemorrhage and necrosis on distal extremities, and disseminated intravascular coagulopathy. We experienced a case of purpura fulminans due to Streptococcus pneumoniae. A 42-year-old women presented with skin petechiae, ecchymosis and gangrene on distal extremities with laboratory evidence of DIC. The latex agglutination test with CSF was positive at Streptococcus pneumoniae. To our knowledge, this is the first report of purpura fulminans caused by Streptococcus pneumoniae in Korea.
Adult ; Dacarbazine ; Ecchymosis ; Extremities ; Female ; Gangrene ; Hemorrhage ; Humans ; Korea ; Latex Fixation Tests ; Necrosis ; Purpura Fulminans* ; Purpura* ; Sepsis ; Skin ; Streptococcus pneumoniae* ; Streptococcus*

No abstract available.
Anemia* ; Erythropoietin* ; Humans*

PURPOSE: It is well known that a high proportion of patients with cerebral palsy have neurogenic bladder. However, cystometry performed to determine the presence and type of neurogenic bladder is an invasive procedure. We evaluated the validity of uroflowmetry and postvoid residual urine volume as a screening tool for neurogenic bladder in children with cerebral palsy. MATERIALS AND METHODS: 34 children with cerebral palsy (range 6-13 years) were randomly selected for this study. Uroflowmetry and residual urine volume were deter mined at least twice in 22 children. Uroflow curve pattern was classified into normal, tower, plateau and staccato type. All patients underwent cystometry with sphincter elec tromyography. We analyzed relationship between the results of uroflowmetry and cystometry. RESULTS: Of the 34 patients, 23 (67.6%) children displayed upper motor neuron lesion of bladder. 11 (32.4%) had uninhibited contraction, 9 (26.5%) small capacity and con comitant detrusor-external sphincter dyssnergia was found in 3 (8.8%). Of 22 children who performed uroflowmetry, 13 showed abnormality. Staccato, tower, and plateau type of pattern was seen 11 (84.6%), 1 (7.7%), and 1 (7.7%) patient, respectively. The re maining 9 (40.9%) children were normal. Eleven of the 13 children with abnormal uroflow curve on uroflowmetry showed upper motor neuron lesion of bladder. Among 13 children with abnormal cystometric results, 11 reveal abnormal uroflow curves. 2 children (22.2%) displayed upper motor neuron lesion of bladder among the 9 children with normal uroflow curve. So, uroflowmetry reveal sensitivity 84.6%, specificity 77.8% for neurogenic bladder in cerebral palsied children. CONCLUSIONS: These results show a high rate of neurogenic bladder in children with cerebral palsy as in previous reports. Abnormalities on uroflow curve correlated well with abnormal cystometry findings. We believe that uroflowmetry is a viable noninvasive screening tool for the detection of neurogenic bladder in children with cerebral palsy.
Cerebral Palsy* ; Child* ; Humans ; Mass Screening* ; Motor Neurons ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urodynamics

BACKGROUND: From a pharmacokinetic standpoint, middle ear effusion (MEE) acts as a sequestered compartment since diffusion of antibiotics from serum and to this compartment is limited. The effectiveness of an antibiotic to eradicate infection within an anatomic compartment is related to both its ability to penetrate and the susceptibility of the causative pathogen. OBJECTIVE: The goal of this study was to determine the steady state plasma and MEE concentrations of cefprozil in pediatric chronic otitis media with effusion (COME). MATERIALS AND METHODS: Twenty-five children with COME were enrolled, and MEE was collected using a ventilation tube insertion after 0.5, 2, 3, 5, and 6 hours of single oral administration of 15 mg Cefprozil/kg body weight. Blood samples were also collected as soon as the MEE was collected, and analyzed in order to measure the concentration of Cefprozil using the validated high performance liquid chromatography (HPLC) method. RESULTS: The mean concentrations of cefprozil in MEE ranged from 0.4 to 4.4 ug/ml. The penetration of cefprozil into the MEE was rapid and effectively. Cefprozil in the MEE was maintained at a greater level than MIC90 in Streptococcus pneumoniae for at least 6 hours after administration of 15mg/kg. CONCLUSION: Cefprozil penetrates well into MEE in patients with pediatric COME.
Administration, Oral ; Anti-Bacterial Agents ; Body Weight ; Child ; Chromatography, Liquid ; Diffusion ; Ear, Middle* ; Humans ; Otitis Media with Effusion* ; Otitis* ; Plasma ; Streptococcus pneumoniae ; Ventilation

Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%–24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%–24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

The Truncus arteriosus is a congenital malformation in which only one great artery arises from the base of the heart and gives origin to the systemic, pulmonary and coronary arteries proximal to the aortic arch. Pulmonary blood flow is governed by the size of the pulmonary arteries and the pulmonary vascular resistance. In infancy, pulmonary blood flow is usually excessive because pulmonary vascular resistance is not greatly increased. Thus, despite an obligatory admixture of systemic and pulmonary venous blood in the common trunk, only minimal cyanosis is present. Rarely pulmonary blood blood flow is restricted by hypoplastic or stenotic pulmonary arteries arising from the truncus. The prognosis in persistent truncus arteriosus is very poor. the median age of survival of the 94 patients with the disease reported up to 1962 was only five weeks. The longest survival reported is the case of the man described by Carr et al who lived to the age of 36 years and 2 months. We report the case of a man with persistent truncus arteriosus who lives to the age of 29 years.
Aorta, Thoracic ; Arteries ; Coronary Vessels ; Cyanosis ; Heart ; Humans ; Prognosis ; Pulmonary Artery ; Truncus Arteriosus ; Truncus Arteriosus, Persistent* ; Vascular Resistance

BACKGROUND: The distinction between secretors and nonsecretors of ABH and Lewis substances is made by inhibiting an antiserum agglutinin reaction with saliva, but many variables such as ethnic group, Lewis and ABO genotype, saliva collection method and antiserum influence the detection of salivary substances. Human secretor (1,2) fucosyltransferase (FUT II) gene determines the ABH secretor status and influences the Lewis phenotype of an individual. The aim of this study is to comparison between the genotype of the secretory (FUT II) gene and the secretory phenotype of the saliva and evaluate the usefulness of genotyping secretory gene. METHOD: In order to explore the secretory genotypes, the 79 specimens were analyzed by the PCR-RFLP method designed for the detection of the A385T, the C357T and the G428A mutations of FUT II gene. Also, we performed secretory phenotyping of the saliva by hemagglutination inhibition test and compared between the genotype of FUT II gene and secretory phenotype of the saliva. RESULT: The frequencies of Se1, Se2 and sej among 158 alleles examined in a random sample were 11.1%, 40.5% and 48.4%. The frequencies of Se1/Se1, Se1/Se2, Se2/Se2, Se1/sej, Se2/sej and sej/sej among 158 genotypes were 3.2%, 3.2%, 20.3%, 12.7%, 37.3% and 23.4%. The frequencies of Secretor and nonsecretor phenotypes were 76.6% and 23.4%. There were 3 mismatch individuals between phenotype and genotype, all three cases were nonsecretor in phenotype but secretor (Se1/Se1, Se1/Se2, Se2/sej) in genotype. CONCLUSION: PCR-RFLP method can be effectively used for the genotyping of the FUT II gene and offer an attractive alternative to the phenotype of secretor state using saliva.
Alleles ; Ethnic Groups ; Genotype* ; Hemagglutination Inhibition Tests ; Humans ; Phenotype* ; Saliva*

Pimecrolimus cream 1% has shown to be effective in patients with a variety of inflammatory cutaneous disorders. And it might be a useful modality in the treatment of seborrheic dermatitis. This prospective study was aimed at assessing the efficacy and tolerability of pimecrolimus cream 1% in the treatment of facial seborrheic dermatitis. Twenty patients were instructed to apply pimecrolimus cream 1% for 4 consecutive weeks. Assessment of the disease severity was performed at baseline and at week 1, 2, and 4. Clinical assessments of erythema, scaling, and pruritus were measured using a 4-point scale (0-3). Global assessments of the disease severity by patients and investigators were performed at each visit. Mean clinical scores of erythema, scaling, and pruritus significantly improved by 87.4%, 91.9%, and 91.5% respectively at week 4 (p<0.001). Improvements in the global assessment of disease severity determined by patients and investigators also showed excellent results. No specific adverse events other than transient burning and tingling sensations were noted. The relapse of facial seborrheic dermatitis was mostly observed between 3 to 8 weeks after the discontinuation of pimecrolimus. We suggest that the topical application of pimecrolimus cream 1% can be an effective and safe alternative for treatment of facial seborrheic dermatitis.
Adult ; Aged ; Dermatitis, Seborrheic/*drug therapy ; Erythema/drug therapy ; Face ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Middle Aged ; Severity of Illness Index ; Tacrolimus/*analogs & derivatives/therapeutic use ; Time Factors ; Treatment Outcome