PURPOSE: The purpose of this study is to analyze the change in re-osseointegration over time and bone reaction at the interface between implant fixture and the surface of the bone, after destroying re-osseointegration by distorting the bone-implant interface artificially. MATERIAL AND METHODS: Experimental implant fixtures (cp titanium, small ef, Cyrillic3.75 mm x 4 mm) which didn't have surface treatment were produced. Two or three fixtures were implanted on both tibias of twelve female rabbits (New Zealand white, more than 3.5 kg). Then after six weeks, removal torque (RT) was measured and the results were recorded as the first measurement values. The fixtures were submerged again to get reosseointegration between the bone and fixture. To identify the change in re-osseointegration of submerged fixtures over time, six groups had the healing time for four days (group I), one week (group II), two weeks (group III), three weeks (group IV), four weeks (group V) and five weeks (group VI), and then the secondary removal torque was measured for each group. To identify the bone formation under fluorescent light, tetracycline (15 mg/kg, IM) were treated on the rabbits of each group. After the second measurement, the rabbits were sacrificed, and 16 slides were made, two or three for each group. The slides were observed under the fluorescent light with light microscope. To find out the change in the secondary removal torque over the primary removal torque in progress of time, the averages of the increase rate of the primary and secondary torque removal force were calculated. Then, to find out if there were any critical differences between the primary removal torque and the secondary removal torque in each group and among the groups, the results were analyzed statistically by paired t-test, one-way ANOVA, and Duncan's Multiple Range Test. RESULTS: In group I and II, secondary removal torque decreased, especially in group I. In group III, IV, V, and VI, secondary removal torque increased critically. Comparing the differences among the groups, the critical difference was shown between group I, II and group III, IV, V, VI. Mineralization at the interface between the bone and implant fixture was identified from the first week, and bone formation was shown more clearly from the second week. CONCLUSION: If the implant fixture remains unforced for a certain period of time after the fixture has had iatrogenic mobility, re-osseointegration occurs at the surface of the fixture, and for tibias of rabbits, higher re-osseointegration was obtained within two weeks.
Female ; Humans ; Implants, Experimental ; Light ; Osseointegration ; Osteogenesis ; Rabbits ; Tetracycline ; Tibia ; Titanium ; Torque

Operators of hospital sterilizers who use ethylene oxide (EtO) were studied to determine the exposure of EtO level and the frequency of sister chromatid exchanges (SCEs) from June 12 to July 20, 1997. To evaluate SCEs in the peripheral blood cells, we selected 22 workers at the central supply room of 4 university hospitals and 22 unexposed workers at the same hospitals according to match sex, age, and smoking habit and also did questionnaires. The mean air concentrations (8-hr TWA) of EtO at 4 university hospitals were less than 1 ppm. The SCE frequencies in exposed workers to EtO and controls were normally distributed. The SCE frequencies in exposed workers to EtO and controls were 6.42+/-.63, 5.86+/-.69, respectively and their differences were statistically significant (p=0.0093). But there were no statistically significant differences in smoking, alcohol intake, coffee drinking. Especially smokers who exposed to EtO were increased SCE statistically significant than the exposed group who did not smoke.
Blood Cells ; Coffee ; Drinking ; Ethylene Oxide* ; Hospitals, University ; Humans ; Occupations* ; Questionnaires ; Siblings* ; Sister Chromatid Exchange* ; Smoke ; Smoking

This study was started to find out if plasma malondialdehyde(MDA), alpha-tocopherol and erythrocyte superoxide dismutase(SOD) activity could be markers of biological activity resulting from exposed to lead in workers. Blood samples were randomly obtained from lead -exposed workers(n=29), CO2 welders(n=60) and office workers(n=60). We used whole blood to analyse blood lead with atomic absorption spectrophotometer. Superoxide dismutase activity in erythrocyte was measured with spetrophotometer. MDA and alpha-tocopherol in plasma were measured with high performance liquid chromatography. Lead-exposed workers was significantly high in blood lead concentration(29.37 ng/dl) compared with welders(6.42 ng/dl) and office workers(5.01 ng/dl). The level of plasma MDA was significantly higher in the lead-exposed workers(1.87 nmol/g cholesterol) than the welders(1.41 nmol/g cholesterol) and office workers(1.41 nmol/g cholesterol). Erythrocyte SOD activity in lead-exposed workers(56.80 U/g Hb) was significantly increased than those of welders(37.63 U/g Hb) and office workers(20.47 U/g Hb). The plasma alpha-tocopherol level of lead-exposed workers(4.93 ng/g cholesterol) was statistically different from welders(4.25 ng/g cholesterol) and office workers(4.28 ng/g cholesterol). Neither age nor smoking was related to SOD or MDA level. Blood lead was significantly correlated with erythrocyte SOD activity(r=0.405), plasma MDA(r=0.296) and alpha-tocopherol(r=0.207). Plasma MDA was also significantly correlated with SOD (r=0.217). In multiple regression analysis, the change of MDA and SOD activity level related to the blood lead concentration. These results suggested that the increase of plasma MDA and erythrocyte SOD activity in lead-exposed workers had a close relationship with the oxidative stress induced by lead.
Absorption ; alpha-Tocopherol ; Antioxidants* ; Chromatography, Liquid ; Erythrocytes ; Lipid Peroxidation* ; Oxidative Stress ; Plasma ; Smoke ; Smoking ; Superoxide Dismutase ; Superoxides

BACKGROUND: The emergency physician(EP)'s interpretation of the electrocardiogram(ECG) is important in determining the disposition of patients evaluated in an emergency department(ED) for chest pain o other cardiac complaints. This particularly important in life-threatening ECG findings. When the cardiologist's final interpretation was defined as the correct one, the concordance compared with the EP was reported to be 50-60%, while the missed diagnosis of acute myocardial infarction(AMI) was reported as 0.6-8.0%, which could be deleterious to the patient. METHOD AND MATERIAL : One hundred and twenty eight ECGs were interpreted by two residents from each year residency. ED records of the study patients were reviewed, and the EP's and cardiologist's ECG interpretations were compared. The ECGs were classified by severity according to the following system: class I, normal or minor abnormalities only; class II, abnormalities with potential to alter case management; and class III, potentially life-threatening abnormalities. RESULTS: The overall concordance between EP's and cardiologist's ECG interpretations was 59.3% and the concordance comparing each year residency showed no statistical significant difference (p value less than 0.05). The underdiagnosed rate was 48.4%, 32.0%, 23.4%, 22.7% for first, second, third and fourth year residency respectively, and 2.3%, 5.5%, 10.9%, 5.5% respectively for the overdiagnosed rate. CONCLUSION: Although the overall concordance showed a relatively high result in our study, the concordance of class III ECG resulted a much lower rate. Therefore, additional studies are needed to identify variables that contribute to ED ECG misinterpretation and to develop methods to resolve these difficulties. Assessment of department ECG misinterpretation would be useful in focusing on resident and staff education.
Case Management ; Chest Pain ; Diagnosis ; Education ; Electrocardiography* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Internship and Residency

Stellate ganglion block (SGB) is a procedure that is widely used for many diseases associated with sympathetically-maintained pain in the head, neck, and upper extremities. Various hemodynamic changes may occur after SGB. Among them, we experienced two patients who developed highly increased blood pressure after SGB. We suspect that the spread of local anesthetics produced parasympathetic blockade of the vagus nerve, an imbalance between the sympathetic and parasympathetic activities and deafferentiation of the glossopharyngeal and vagus nerve, which both innervated the carotid sinus, as the mechanism of this increased blood pressure.
Anesthetics, Local ; Blood Pressure ; Carotid Sinus ; Head ; Hemodynamics ; Humans ; Neck ; Stellate Ganglion ; Upper Extremity ; Vagus Nerve

Implantation of a pregnancy within the scar of previous cesarean section is the rarest form of ectopic pregnancy. If diagnosed early, treatment options are capable of preserving the uterus and subsequent fertility. However, delayed diagnosis and treatment can lead to uterine rupture, hemorrhage and maternal morbidity. We present two cases of ectopic pregnancy developing in the previous cesarean section scar in which successfully treated with dilatation and evacuation after vaginal misoprostol.
Cesarean Section* ; Cicatrix* ; Delayed Diagnosis ; Dilatation* ; Female ; Fertility ; Hemorrhage ; Misoprostol* ; Pregnancy ; Pregnancy, Ectopic* ; Uterine Rupture ; Uterus

OBJECTIVE: Minocycline, a second-generation tetracycline-class antibiotic, has been well established to exert a neuroprotective effect in animal models and neurodegenerative disease through the inhibition of microglia. Here, we investigated the effects of minocycline on motor recovery and neuropathic pain in a rat model of spinal cord injury. METHODS: To simulate spinal cord injury, the rats' spinal cords were hemisected at the 10th thoracic level (T10). Minocycline was injected intraperitoneally, and was administered 30 minutes prior surgery and every second postoperative day until sacrifice 28 days after surgery. Motor recovery was assessed via the Basso-Beattie-Bresnahan test. Mechanical hyperalgesia was measured throughout the 28-day post-operative course via the von Frey test. Microglial and astrocyte activation was assessed by immunohistochemical staining for ionized calcium binding adaptor molecule 1 (Iba1) and glial fibrillary acidic protein (GFAP) at two sites: at the level of hemisection and at the 5th lumbar level (L5). RESULTS: In rats, spinal cord hemisection reduced locomotor function and induced a mechanical hyperalgesia of the ipsilateral hind limb. The expression of Iba1 and GFAP was also increased in the dorsal and ventral horns of the spinal cord at the site of hemisection and at the L5 level. Intraperitoneal injection of minocycline facilitated overall motor recovery and attenuated mechanical hyperalgesia. The expression of Iba1 and GFAP in the spinal cord was also reduced in rats treated with minocycline. CONCLUSION: By inhibiting microglia and astrocyte activation, minocycline may facilitate motor recovery and attenuate mechanical hyperalgesia in individuals with spinal cord injuries.
Animals ; Astrocytes ; Calcium ; Extremities ; Glial Fibrillary Acidic Protein ; Horns ; Hyperalgesia ; Injections, Intraperitoneal ; Microglia ; Minocycline ; Models, Animal ; Motor Neurons ; Neuralgia ; Neurodegenerative Diseases ; Neuroprotective Agents ; Rats ; Spinal Cord ; Spinal Cord Injuries

Biliary adenofibromas are rare biliary epithelial tumors that are classified as benign. Nevertheless, some cases have been reported to show malignant transformations. The radiologic findings of biliary adenofibromas and their malignant transformation are not well-established because of their rarity. We present a case of a cholangiocarcinoma arising from a biliary adenofibroma assessed using ultrasonography, CT, and MRI. The differential diagnoses include other hepatic tumors.

Biliary adenofibromas are rare biliary epithelial tumors that are classified as benign. Nevertheless, some cases have been reported to show malignant transformations. The radiologic findings of biliary adenofibromas and their malignant transformation are not well-established because of their rarity. We present a case of a cholangiocarcinoma arising from a biliary adenofibroma assessed using ultrasonography, CT, and MRI. The differential diagnoses include other hepatic tumors.

PURPOSE: To prevent surgical site complications, many plastic surgeons use the so-called “conventional protocol,” which immobilizes the shoulder and upper arm for 1 month after reconstruction. In an effort to improve the shoulder mobility of patients who received immediate breast reconstruction with tissue expander insertion (TEI), we introduced an early rehabilitation protocol with a short-term immobilization period of 2 weeks. This study aims to compare this early rehabilitation exercise program with the conventional protocol and to determine factors affecting shoulder mobility and quality of life of patients after immediate breast reconstruction. METHODS: A total of 115 patients with breast cancer who underwent reconstructive surgery were retrospectively reviewed. For patients who underwent reconstruction before January 2017, the conventional protocol was followed with immobilization of their shoulder for over 4 weeks. Patients who underwent reconstruction after January 2017 were educated to undergo a self-exercise program after a short-term immobilization period of 2 weeks. We compared shoulder mobility, pain, quality of life, and complications at postoperative 1 and 2 months between the groups. RESULTS: Patients who received early rehabilitation showed greater shoulder flexion and abduction range at postoperative 1 month than those who received the conventional protocol. This increased shoulder abduction range continued until postoperative 2 months. There were no significant surgical site problems in both groups during the 2 months of follow-up. CONCLUSION: To enhance the recovery of shoulder mobility, early rehabilitation with a shorter immobilization period should be recommended to patients with breast cancer undergoing reconstruction surgery with TEI. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03541161
Arm ; Breast Neoplasms ; Breast ; Case-Control Studies ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Mammaplasty ; Mastectomy, Simple ; Plastics ; Quality of Life ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; Rehabilitation ; Retrospective Studies ; Shoulder ; Surgeons ; Tissue Expansion Devices