The present study was performed to evaluate the effect of Tetracycline-HCl on the change of implant surface microstructure according to application time. Implant with hydroxyapatite surface was were utilized. Implant surface was rubbed with 50mg/ml Tetracycline-HCl solution and sterilized saline for 1/2min., 1min., 1 1/2min., 2min., 2 1/2min. and 3min. respectively in the test group. Then, specimens were processed for scanning electron microscopic observation and measured surface roughness by optical interferometer. The results of this study were as follows. 1. Hydroxyapatite surface showed that round particles were deposited irregularly. 2. The roughness of surfaces conditioned with Tetracycline-HCl and saline was lessened and the cracks were increased relative to the application time. In conclusion, the detoxification with 50mg/ml Tetracycline-HCl must be applied respectively with appropriate time according to hydroxyapatite implant surfaces.
Durapatite*

PURPOSE: Thallous-201 chloride produced at Korea Cancer Center Hospital(KCCH) is used in detecting cardiovascular disease and cancer. Thallium impurity can cause emesis, catharsis and nausea, so the presence of thallium and other metal impurities should be determined. According to USP and KP, their amounts must be less than 2 ppm in thallium and 5 ppm in total. In this study, the detection method of trace amounts of metal impurities in [201Tl]TlCl injection with polarography was optimized without environmental contamination. MATERALS AND METHODS: For the detection of metal impurities, Osteryoung Square Wave Stripping Voltammetry method was used in Bio-Analytical System (BAS) 50W polarograph. The voltammetry was composed of Dropping Mercury Electrode (DME) as a working electrode, Ag/AgCl as a reference electrode and Pt wire as a counter electrode. Square wave stripping method, which makes use of formation and deformation of amalgam, was adopted to determine the metal impurities, and pH 7 phosphate buffer was used as supporting electrolyte. RESULTS: T1, Cu and Pb in thallous-201 chloride solution were detected by scanning from 300 mV to -800 mV. Calibration curves were made by using TlNO3, CuSO4 and Pb(NO3)2 as standard solutions. Tl was confirmed at -450 mV peak potential and Cu at -50 mV. Less than 2 ppm of Tl and Cu was detected and Pb was not detected in KCCH-produced thallous-201 chloride injection. CONCLUSION: Detection limit of thallium and copper is approximately 50 ppb with this method. As a result of this experiment, thallium and other metal impurities in thallous-201 chloride injection, produced at Korea Cancer Center Hospital, are in the regulation of USP and KP. Polarograph could be applied for the determination of metal impurities in the quality control of radiopharmaceuticals conveniently without environmental contamination.
Calibration ; Cardiovascular Diseases ; Catharsis ; Copper ; Electrodes ; Hydrogen-Ion Concentration ; Korea ; Limit of Detection ; Metals, Heavy* ; Nausea ; Polarography* ; Quality Control ; Radiopharmaceuticals ; Thallium ; Vomiting

PURPOSE: If significantly influenced by chronic otomastoiditis(COM), mastoid pneumatization and the position of the sigmoid sinus affect the operative procedure and postoperative complications in middle ear surgery. We evaluated mastoid pneumatization and sigmoid sinus position, and their relationship in COM, especially its during onset. MATERIALS AND METHODS: Using temporal bone CT and referring to any relevant medical records, we retrospect+tively analyzed 107 cases of COM and 49 cases of normal ear. The total case load comprised an adult group, aged above 16 years [100 cases of COM (M:F=46:54, mean age = 45 years), and 42 cases of normal ear,(M:F=20:22, mean age = 44 years)], and a childhood group, aged less than 16 years [7 cases of COM (M:F=4:3, mean age = 8.4 years), and 7 cases of normal ear (M:F=4:3, mean age = 7 years)]. We determined the thickness of the mastoid bone by measuring the shortest distance between the outer cortex of this bone and the deepest border of the sigmoid sinus; the depth of the sigmoid sinus; and the degree of mastoid pneumatization and sclerosis. Fifty-three patients whose medical history clearly included the onset of otomas-toiditis were divided into a child-onset group and an adult-onset group, and the relationship between the onset of otomastoiditis and the thickness of the mastoid bone was compared between the two groups. RESULTS: The mean axial thickness of the mastoid bone was 9.672 <+/-2.745 mm in COM and 12.430 +/-3.027 mm in normal ear. The difference was statisfically significant (p < 0.0001). The mean depth of the sigmoid sinus was 7.557 +/-1.868 mm in COM and 7.591 +/-2.315 mm in normal ear, with no statistically significant difference. In the childhood group, the mean axial thickness of the mastoid bone was 8.672 +/-2.978 mm in COM and 11.778 +/-3.087 mm in normal ear. This difference was statistically significant (p < 0.05). In the adult group, the corresponding figures were 9.742 +/-2.731 mm in COM and 12.538 +/-3.041 mm in normal ear, a dif-ference which was also statistically significant (p < 0.0001). Among patients with an obvious history of COM, child-onset cases totalled 24 (mean axial thickness of the mastoid bone, 9.2.0 +/-2.158 mm), while there were 29 adult-onset cases (mean axial thickness, 10.08 +/-2.99 mm). This difference in thickness between child-onset and adult-onset COM was statistically significant (p < 0.05). CONCLUSION: In COM, the degree of mastoid pneumatization is proportional to the axial thickness of the mastoid bone, and inversely proportional to the degree of sclerosis, anterior location of the sigmoid sinus and the onset of COM. If the sigmoid sinus is properly located, COM may inhibit mastoid pneumatization.
Adult ; Colon, Sigmoid* ; Ear ; Ear, Middle ; Humans ; Mastoid* ; Medical Records ; Postoperative Complications ; Sclerosis ; Surgical Procedures, Operative ; Temporal Bone

Acute hepatitis E is an endemic disease, commonly reported in Indian subcontinent, China, Africa, Central America, and so forth. It is a self-limiting disease like other acute hepatitis except in pregnant patient. Although sporadic hepatitis E is noted all over the world, most of them are associated with travel history to HEV-endemic area. In Korea, Hepatitis E is rarely reported. Moreover, sporadic acute hepatitis E without travel history to HEV-endemic area is very rare. We experienced three sporadic cases of acute hepatitis E, without travel history. All of them presented acute hepatitis symptoms, elevated aminotransferase, and positive IgM HEV Ab. Symptoms and aminotransferase levels were normalized during hospitalization and IgM HEV Ab converted negative after 4-8 months. We report three sporadic cases of onset-acute hepatitis E without travel history to HEV-endemic area.
Acute Disease ; Adult ; Alanine Transaminase/analysis ; Aspartate Aminotransferases/analysis ; Female ; Hepatitis E/*diagnosis ; Humans ; Male

The purpose of this study was to determine whether the application of chlorhexidine varnish affects the shear bond strength and failure pattern of orthodontic brackets or not. The experimental group consisted of 22 human premolars which extracted after chlorhexidine varnish application (4 times for 1 week interval) in vivo, and the control group consisted of 22 human premolars which extracted without any pre-treatment. After all teeth wee etched with 37% phosphoric acid gel, metal orthodontic brackets (Q-3002, RMO, USA) were bonded to each tooth using auto-polymerizing orthodontic resin (Ortho-One, Bisco, USA) with the same bonding procedure. The shear bond strength was measured with Instron universal testing machine (model 4466, Instron Ltd., England), and the failure pattern of each bracket was examined with Scanning Electron Microscope (SM 840A, JEOL, Japan). The data were analysed statistically with t-test. The results were as follows: 1. Application of chlorhexidine varnish had no significant effect on the shear bond strength of the orthodontic bracket. 2. There was no significant difference in the failure pattern of orthodontic bracket between the experimental group and the control group.
Bicuspid ; Chlorhexidine* ; Humans ; Orthodontic Brackets* ; Paint* ; Tooth

PURPOSE: This study retrospectively reviewed the results of a closed reduction and internal fixation with cannulated screws for a displaced femoral neck fracture. MATERIALS AND METHODS: Among 631 patients between January 1991 and December 2000, 27 patients classified as Garden stage III or IV were treated with a closed reduction and internal fixation with cannulated screws. The mean follow-up duration was 4.5 years. The mean age of the patients was 56.5 years. RESULTS: Union and the restoration of function was observed in 15 cases (55.6%), and failure occurred in 12 cases (44.4%). The cause of failure was early stage reduction loss due to a failure to obtain anatomical reduction on the surgical field in 4 cases, reduction loss and displacement during the follow up period after an appropriate reduction at surgery in 4 cases and avascular necrosis in 4 cases. Seven cases were converted to a total hip arthroplasty, 4 cases were converted to bipolar hemiarthroplasty and 1 case is currently being followed up. CONCLUSION: A closed reduction and internal fixation for displaced femoral neck fracture showed a high failure rate. Therefore, an accurate anatomical reduction, firm internal fixation and efforts to prevent further unnecessary vascular injury will be needed to reduce the high failure rate and complications.
Arthroplasty, Replacement, Hip ; Femoral Neck Fractures* ; Femur Neck* ; Follow-Up Studies ; Hemiarthroplasty ; Humans ; Necrosis ; Retrospective Studies ; Vascular System Injuries

A 67-year-old male patient was admitted with an abrupt sudden cardiac death. He represented with an extreme electrical storm of 30 times of ventricular fibrillation (VF) episodes on one day. External shocks were performed to terminate VF. Transient J-wave in the inferior-lateral leads and Brugada electrocardiography pattern on the right precordial leads appeared during the electrical storm. And J-wave disappeared after the termination of electrical storm. We report a case of the appearance of J-wave during electrical storm in a patient with Brugada syndrome.
Brugada Syndrome ; Death, Sudden, Cardiac ; Electrocardiography ; Humans ; Male ; Shock ; Ventricular Fibrillation

BACKGROUND/AIMS: A recent clinical trial demonstrated that triple anti platelet therapy resulted in significantly larger minimal luminal diameter and lower restenosis rate compared with conventional therapy after bare metal stent (BMS) implantation. However, it is uncertain that this result will be repeated after drug eluting stent (DES) implantation, especially with low dose cilostazol therapy. Thus, we performed a prospective, randomized study to evaluate the effectiveness of long term triple therapy with low dose cilostazol after DES implantation. METHODS: We analyzed 109 patients (132 lesion) prospectively, who underwent successful coronary DES implantation. The patients were divided into two groups according to combined anti platelet regimen: triple combination of aspirin, clopidogrel, and low dose cilostazol (50 mg/bid) (Group I, n=56) or dual combination of aspirin and clopidogrel (Group II, n=53) for 6 months. The minimal luminal diameter and binary restenosis rate were compared at 6 month follow up by coronary angiogram. The rates of stent thrombosis, major adverse cardiac events (MACE), and bleeding complication were also analyzed. RESULTS: The baseline clinical and angiographic characteristics were not different between the two groups. Angiographic follow-up was performed in 80 patients (109 lesions, 74%). The minimal luminal diameter at 6 month was 2.25+/-0.63 mm in group I and 2.30+/-0.56 mm in group II (p=0.742). Restenosis occurred in 4 patients (7.2%) in group I and 3 patients (5.6%) in group II (p=0.611). There were no differences in the rates of stent thrombosis, MACE, or bleeding complications between the two groups. CONCLUSIONS: Long term triple anti platelet therapy with low dose cilostazol after DES implantation was not effective in obtaining larger minimal luminal diameter or reducing restenosis rate, but it was used safely without increasing bleeding complication.
Aspirin ; Blood Platelets ; Drug-Eluting Stents ; Follow-Up Studies ; Hemorrhage ; Humans ; Phenobarbital ; Prospective Studies ; Stents ; Tetrazoles ; Thrombosis ; Ticlopidine

Coronary air embolism remains a serious complication of coronary catheterization despite performing careful procedure to prevent this. We report here on a case of massive coronary air embolism that was complicated by cardiogenic shock in a 52-year-old male patient with angina pectoris. The patient had a stenosis in the middle left anterior descending artery (LAD) and percutaneous coronary intervention (PCI) was planned for the LAD lesion. During PCI, inadvertent manipulation of a pressure line induced massive air embolism in both proximal left coronary arteries, and this manifested as cardiogenic shock. The patient recovered after supportive measures and successive intracoronary injections of nitroglycerin and then he eventually underwent successful PCI.
Angina Pectoris ; Angioplasty ; Arteries ; Catheterization ; Catheters ; Constriction, Pathologic ; Coronary Vessels* ; Embolism ; Embolism, Air* ; Humans ; Male ; Middle Aged ; Nitroglycerin ; Percutaneous Coronary Intervention ; Shock ; Shock, Cardiogenic*

The appearance of a tumor in the chest wall is rare compared to that in any other part of the body. It can be classified into benign and malignant types and can be located in the rib, clavicle, sternum, cartilage and soft tissues. Tumors that are metastatic are commonly located in the lung, breast, bone and pleura. But, the soft tissue mass of anterior chest wall is rarely metastasized from a distant organ that is not confined to the thoracic cavity. This and thus has rarely been described. A 68-year-old man was admitted to our hospital with a chief complaint of resting dyspnea. A huge non-tender mass of about 10*15 cm in size was visible on his left lower anterior chest wall. We pathologically confirmed that the mass was a metastatic renal cell carcinoma of clear cell type by incision biopsy. Through an incision biopsy, the mass was pathologically confirmed as a metastatic renal cell carcinoma of the clear cell type.
Aged ; Biopsy ; Breast ; Carcinoma, Renal Cell* ; Cartilage ; Clavicle ; Dyspnea ; Humans ; Lung ; Neoplasm Metastasis* ; Pleura ; Ribs ; Sternum ; Thoracic Cavity ; Thoracic Wall* ; Thorax*