No abstract available.
Anemia, Aplastic* ; Hepatitis*

Load transfer of implant overdenture varies depending on anchorage systems that are the design of the superstructure and substructure and the choice of attachment. Overload by using improper anchorage system not only will cause fracture of the framework or screw but also may cause failure of osseointegration. Choosing anchorage system in making prosthesis, therefore, can be considered to be one of the most important factors that affect long-term success of implant treatment. In this study, in order to determine the effect of anchorage systems on load transfer in mandibular implant overdenture in which 4 implants were placed in the interforaminal region, patterns of stress distribution in implant supporting bone in case of unilateral vertical loading on mandibular left first molar were compared each other according to various types of anchorage system using three-dimensional photoelastic stress analysis. The five photoelastic overdenture models utilizing Hader bar without cantilever using clips(type 1), cantilevered Hader bar using clips(type 2), cantilevered Hader bar with milled surface using clips(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4), and Hader bar using clip and ERA attachments(type 5), and one cantilevered fixed-detachable prosthesis(type 6) model as control were fabricated. The following conclusions were drawn within the limitations of this study. 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. Maximum fringe orders on ipsilateral distal implant supporting bone in a ascending order is as follows; type 5, type 1, type 4, type 2 and type 3, and type 6. 3. Regardless of anchorage systems, more or less stresses were generated on the residual ridge under distal extension base of all overdenture models. To summarize the above mentioned results, in case of the patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant and unfavorable antero-posterior spread,selecting resilient type attachment or minimizing distal cantilever bar is considered to be appropriate methods to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.
Denture, Overlay* ; Friction ; Humans ; Models, Theoretical ; Molar ; Osseointegration ; Prostheses and Implants

No abstract available.
Hypertension, Renovascular* ; Pheochromocytoma*

OBJECTIVE: A subdural drain using urokinase after a burr hole hematoma evacuation was performed for subacute subdural hematoma (SASDH), and its effectiveness and safety in elderly patients were evaluated. METHODS: Between January 2013 and May 2015, subdural drains using urokinase after burr hole hematoma evacuation were performed in 19 elderly patients. The inclusion criteria were as follows: 1) a subdural hematoma occurring between 4 and 20 days after injury; 2) worsening neurological symptoms, from mild to moderate or severe, due to injury during the subacute stage; 3) a mix of solid clots (high-density lighter shadow) and fluid hematoma (low-density darker shadow) on the computed tomography (CT) scan; 4) a score of ≥9 on the Glasgow Coma Scale (GCS) assessed immediately before surgery; and 5) an age of ≥65 years. When the majority of the hematoma was evacuated on the CT, we removed the catheter. RESULTS: Under local anesthesia, a catheter was inserted into the hematoma through a burr hole. The mean age of the patients was 73.7 years (range, 65-87 years). The mean preoperative GCS score was 11.2 (range, 10-13), and the mean Glasgow Outcome Scale score for all patients was 5 at discharge. No recurrences of hematomas or surgical complications were observed. CONCLUSION: A subdural drain using urokinase after burr hole hematoma evacuation under local anesthesia is thought to be an effective and safe method of blood clot removal with low morbidity. This surgical method is less invasive for treating elderly patients with SASDH.
Aged* ; Anesthesia, Local ; Catheters ; Drainage ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hematoma ; Hematoma, Subdural* ; Humans ; Methods ; Recurrence ; Urokinase-Type Plasminogen Activator*

STUDY DESIGN: A prospective radiological assessment was conducted. OBJECTIVES: To analyze the changes in the height of the intervertebral disc, the slippage, slip angle, lumbar lordotic angle and sacral inclination after anterior lumbar interbody fusion and posterior pedicle screw fixation in a lumbar spondylolisthesis. SUMMARY OF LITERATURE REVIEW: The anterior lumbar interbody fusion causes changes in the lumbar sagittal alignment. METHODS: The mini-open anterior lumbar interbody fusion and pedicle screw fixation was undertaken in 33 cases from April 1995 to November 2003. MRI was done before and 6 months after surgery. The measuring factors were the heights of the intervertebral disc, slippage, slip angle, lumbar lordotic angle and sacral inclination. The measuring factors were independently assessed three times by three different orthopedic surgeons. The postoperative changes in measuring the factors were analyzed by a paired t-test statistically. RESULTS: The height of the intervertebral disc was increased by a mean of 14.0%, slippage was reduced by a mean of 2.8%, the slip angle was reduced by a mean of 16.0%, the lumbar lordotic angle was increased by a mean of 15.6% and the scaral inclination was increased by a mean of 3.0%. There was significance in the increase in the disc height, the reduction of slippage and the slip angle, and the increase in lumbar lordotic angle, but there were no significance regarding the changes in sacral inclina-tion. CONCLUSIONS: The anterior lumbar interbody fusion and the pedicle screw fixation significantly improved the height of the intervertebral disc, slippage, slip angle, and lumbar lordotic angle, except sacral inclination.
Intervertebral Disc ; Magnetic Resonance Imaging ; Orthopedics ; Prospective Studies ; Spine* ; Spondylolisthesis*

Primary bone lymphoma is a rare tumor accounting for only 5% of all primary osseous malignancies, defined as lymphoma which arises in the medullary cavity and there is no concurrent regional lymph node or visceral involvement. We experienced a case of primary bone lymphoma presented with multifocal bone involvemnt in a 30-year-old woman. She was admitted with 2-month-history of pain on the lower back and the right hip. On laboratory examination, pancytopenia was demonstrated. Radiologic studies showed multiple soft tissue masses that had destroyed the involved bones. The tissue section from bone marrow biopsy was positive for leukocyte common antigen and pan T-cell marker (UCHL-1) in the large malignant cells. The diagnosis of malignant lymphoma, diffuse large cell (T-cell phenotype) was made. On physical examination, pheripheral lymph nodes could not be palpable. Involvement of either regional lymph nodes or visceral organs could not be detected by radiological examinations including CT and Ga-67 scan. After the patient recieved 2 cycles of combination chemotheraphy with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) regimen, complete remission was achieved. Eight cycles of the chemotherapy were successfully completed.
Adult ; Antigens, CD45 ; Biopsy ; Bone Marrow ; Diagnosis ; Doxorubicin ; Drug Therapy ; Female ; Hip ; Humans ; Lymph Nodes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Pancytopenia ; Physical Examination ; T-Lymphocytes ; Vincristine

Although most ingested foreign bodies pass through the gastrointestinal tract spontaneously, those that are sharp, pointed, or large require removal to avoid serious complications. Here we report an interesting case of a 60-year-old man who swallowed a clamshell that passed through the pylorus and was caught in the duodenum. Radiologic findings made it look like a biliary stone. Endoscopic retrieval of the clamshell with a Dormia Basket was performed safely and the patient was discharged uneventfully on the day of the procedure.
Diagnostic Errors ; Duodenum/*pathology ; Endoscopy ; Endoscopy, Gastrointestinal ; Foreign Bodies/*diagnosis/surgery ; Foreign-Body Migration/*diagnosis/surgery ; Gallstones/*diagnosis/pathology ; Humans ; Male ; Middle Aged ; Seafood/*adverse effects

Disseminated intravascular coagulation (DIC) is the result of a severe underlying disorder that initiates massive activation of the coagulation system. We report an unusual case of 79-year-old man who developed DIC after tooth extraction in abdominal aortic aneurysm. He was referred to our hospital because of persistent bleeding after tooth extraction. Physical examination indicated a pulsating mass in abdomen. Abdominal computerized tomography (CT) scan revealed 70 mm diameter aneurysm of the abdominal aorta, extending from the renal infrahilar level to the common iliac artery, and his coagulation profile showed the features of DIC by revealing thrombocytopenia, hypofibrinogenemia, and increased level of fibrinogen degradation product (FDP). After he had received blood component therapy including fresh frozen plasma and continuous intravenous heparin infusion (4,800 U/day), the bleeding diathesis and coagulopathy improved. He refused to have definitive surgery for the aneurysm.
Abdomen ; Aged ; Aneurysm ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Dacarbazine ; Disease Susceptibility ; Disseminated Intravascular Coagulation* ; Fibrinogen ; Hemorrhage ; Heparin ; Humans ; Iliac Artery ; Physical Examination ; Plasma ; Thrombocytopenia ; Tooth Extraction* ; Tooth*

BACKGROUND: The Nuss procedure is a recently developed technique for minimally invasive repair of pectus excavatum using a metal bar. Although its technical simplicity and cosmetic advantages are remarkable, applications have been limited to children with standard pectus excavatum. We report a single center experience of the technique that has been evolving in order to correct asymmetric pectus configurations and adult patients. MATERIAL AND METHOD: Between August 1999 and June 2002, 322 consecutive patients underwent repair by the Nuss technique and its modifications. Among them, 71 (22%) were adults. For the precise correction, morphology of the pectus was classified as symmetric and asymmetric types. Asymmetric type was subdivided into eccentric and unbalanced types. In repair, differently shaped bars were applied to individual types of pectus to achieve symmetric correction. RESULT: Symmetric type was 57.5% (185/322) and asymmetric type was 42.5% (137/322). Eccentric, unbalanced, and combined types were 71, 47 and 19, respectively. Major modifications were bar shaping and fixation. In asymmetric group, different shapes of asymmetric bars were applied (n=125, 38.8%). For adult patients, double bar or compound bar technique was used (n=51, 15.8%). To prevent bar rotation, multipoint wire fixations to ribs were used. Major postoperative complications were pneumothorax (n=24, 7.5%) and bar displacement (n=11, 3.4%). 42 patient had bar removal 2 years after the initial procedure. CONCLUSION: The Nuss procedure is safe and effective.Modifications of the techniques in accordance with precise morphological classification enabled the correction of all variety of pectus excavatum including asymmetric types and adult patients.
Adult ; Child ; Classification ; Funnel Chest* ; Humans ; Pneumothorax ; Postoperative Complications ; Ribs

PURPOSE: To evaluate the involvement of apoptosis in N-methyl-D-aspartate (NMDA)-induced excitotoxicity in the rabbit retina. METHODS: After intravitreal injection of 680 and 2,000 nmoles of NMDA in rabbit eyes, the eyes were enucleated at 2, 16, and 60 hours and 1 and 2 weeks. The apoptotic cell death was determined with TdT-mediated biotin-dUTP nick end labeling (TUNEL) stain, and immunohistochemical stains of Bcl-2, Bax, and caspase-3 were performed. RESULTS: TUNEL showed increased labeling scattered in the ganglion cell layer and inner nuclear layer from 16 to 60 hours. The number of TUNEL-positive nuclei decreased at 60 hours, and none was observed at 2 hours, 1 week, and 2 weeks. More TUNEL-positive nuclei were seen with injection of 2,000 nmoles compared to 680 nmoles. Bcl-2, Bax, and caspase-3 were seen histologically as early as 2 hours in the ganglion cell layer and inner nuclear layer; there was no stained nuclei with the TUNEL stain. At 2 hours after intravitreal NMDA injection, Bcl-2, Bax, and caspase-3 were also stained in Muller cells. CONCLUSIONS: This study showed that apoptosis is involved in NMDA-induced excitotoxicity in the rabbit retina. Bcl-2, Bax, and caspase-3 may play important roles in modulating the apoptosis in NMDA-induced excitotoxicity, and Muller cells are involved in the apoptotic pathway.
Apoptosis ; Caspase 3 ; Cell Death ; Cinnarizine ; Coloring Agents ; Eye ; Ganglion Cysts ; In Situ Nick-End Labeling ; Intravitreal Injections ; N-Methylaspartate ; Retina