This study was designed for comparison of shear bond strengths and failure patterns of four experimental groups which combinated mesh-backed metal brackets and texture based ceramic brackets (Transcend series 2000((TM))) with chemically cured resin (Mono Lok2((TM))) and visible light cured resin (Transbond((TM))). Brackets were bonded on the extracted human bicuspids, after etching them by manufacturer's recommand, and the shear bond strengths were measured on the Instron machine after 24 hrs passed in the 37degrees C water bath. The results were as follows. 1. Ceramic brackets, transcend series 2000((TM)), bonded with MonoLok2((TM)) showed statistically higher shear bond strength than mesh-backed metal brackets bonded with MonoLok2((TM)). 2. There was no significant difference in shear bond strengths between metal and ceramic brackets bonded with Transbond((TM)). 3. Ceramic brackets bonded with both Transbond((TM)) and MonoLok2((TM)) showed primarily fractures bet?ween brackets adhesive interface. 4. Enamel crack was not found in anyone specimen.
Adhesives ; Baths ; Bicuspid ; Ceramics* ; Dental Enamel ; Humans ; Light ; Water

The author reviewed 148 cases of phalangeal and metacarpal fractures of the hand, excluding distal phalangeal and carpal bones, in 75 patients treated at the Department of Orthopaedic Surgery, Dong-Kang Hospital, from January, 1984 to December, 1987. We obtained the following results ; 1. Better results were obtained in younger patients, transveres or spiral fractures, and cases immobilized in MP joint flexion. 2. Factors that led to worse results included older age, comminuted fracture, wide displacement, intra articular fracture, associated tendon injury, intraarticular pin placement. 3.In case of K-wire fixation, dorsal placement of the wire revealed better result than volar one.
Carpal Bones ; Clinical Study ; Fractures, Comminuted ; Hand ; Humans ; Joints ; Tendon Injuries

To clarify the exact role of endomyocardial biopsy in the diagnosis and monitoring of adriamycin-induced cardiotoxicity and to observe the actual relationship between pathologic changes and cardiac dysfunction, a cross-sectional clinical study was conducted. Echocardiography was used to evaluate cardiac dysfunction in 18 patients who had received chemotherapy including adriamycin(mean dose : 410mg/m2 of B.S.A.) without clinical evidence of congestive heart failure, and in 19 normal controls. Six patients receiving adriamycin underwent 7 transfemoral endomyocardial biopsy procedures, and the specimens were evaluated by light and electron microscopy for evidence of drug-related cardiotoxicity. Indexes of cardiac systolic function obtained by M-mode echocardiography(left ventricular dimension, excursion of interventricular septum and left ventricular posterior wall, shortening fraction and ejection fracton) did not show any statistically significant difference between patients who received adriamycin and normal controls. In transmitral flow-velocity curves recorded by Doppler echocardiography with a 2.25MHz probe, the patients showed less E peak velocity and decreased E/A ratio compared with normal controls, which suggests left ventricular diastolic dysfunction in the patients who received adriamycin. All the specimens of the endomyocardial biopsy showed significant pathologic changes of adriamycin indnced cardiotoxicity which was characterized by myofibrillar loss and vacuolization of the cytoplasm. In 2 specimens, pathologic grade was II, while 5 specimens showed pathologic changes of grade III and further chemotherapy with adriamycine was not done in thse 5 cases. From these results it is suggested that pathologic changes precede the clinical onset of congestive cardiomyopathy in the patients receiving adriamycin and left ventricular diastolic dysfunction occurrs before ejection fraction falls to subnormal levels. We conclude that sequential endomyocardial biopsy is absolutely indicated for exact diagnosis and monitoring of adrinamycin-induced cardiotoxicity to prevent the development of irreversible and often fatal cardiomyopathy.
Biopsy ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cytoplasm ; Diagnosis ; Doxorubicin* ; Drug Therapy ; Echocardiography ; Echocardiography, Doppler ; Heart Failure ; Humans ; Microscopy, Electron

Aconite is a common remedy of herb doctors and is widely used in the Far East. Clinical aspects of the visual disturbance produced by this drug have been described, but little is known about its pathology. Tinctura aconiti (0.6 mg of total alkaloid/kg 2x) was administered intraperitoneally in rabbits to evaluate its toxic effects on the visual system. The alteration in the visual evoked potential following aconite injection consisted of a delay in the onset and peak latency. Histopathologically, there were damages to the myelin sheath of the visual pathway, spinal cord and peripheral nerves. These findings suggest that aconite may cause primarily myelo-optic neuropathy.
Aconitum/administration & dosage/*toxicity ; Animals ; Evoked Potentials, Visual/*drug effects ; Injections, Intraperitoneal ; Myelin Sheath/*drug effects/ultrastructure ; Optic Nerve/*drug effects/ultrastructure ; Optic Nerve Diseases/*chemically induced/pathology ; Rabbits ; Spinal Cord/*drug effects/ultrastructure

Alveolar soft-part sarcoma is a rare malignant neoplasm. It occurs most commonly in the deep tissue of the extremity, particularly in the anterior aspect of the thigh. It usually presents as a slow-growing, painless mass with little functional impairment. Because of the relative lack of symptoms, it may be easily overlooked. The course of the disease tends to be long but unrelenting, and local recurrences are frequent. There were no lifetime cures in the reported cases. This tumor is relatively unknown to orthopaedic surgeons, and a wider knowledge of its characteristics may lead to its more frequent recognization, Recently, two cases of alveolar soft-part sarcoma were encountered on the orthopaedic department of Dong-kang Hospital, Ulsan. In case 1, the tumor was found in the vastus lateralis muscle; and in case 2, vastus intermedius muscle. The authors will present these cases in detail to provide a glance at this very rare but more frequently recognizable tumor, the alveolar soft-part sarcorna.
Extremities ; Quadriceps Muscle ; Recurrence ; Sarcoma ; Sarcoma, Alveolar Soft Part ; Surgeons ; Thigh ; Ulsan

PURPOSE: The purpose of this animal and clinical study was to compare intra-arterial(IA) scintigraphy withangiography in the localization of gastrointestinal (GI) bleeding. MATERIALS AND METHODS: After sedation withintramuscularly administered ketamine, lower GI bleeding was induced in ten rabbits. Using inguinal cut-down, anarterial femoral 3F catheter was placed in the proximal mesenteric artery. Following abdominal incision to exposethe bowel, lower GI bleeding was caused by incising the antimesenteric border of the small bowel wall. Initialangiography was performed, and this was followed by Tc-99m pertechnetate IA scintigarphy. Tc-99m RBC IAscintigraphy involved two patients who had undergone selective mesenteric arterial catheterization for theevaluation of acute lower GI bleeding. RESULTS: Ten rabbits, bleeding at a mean rate of 0.7g/min, were studied.IA scintigraphy was superior to angiography in four cases and equal in six. The sensitivity of angiography was40%(4/10), and IA scintigraphy 80%(8/10). In one patient, Tc-99m RBC was administered directly into the superiormesenteric artery and ulcer bleeding in the transverse colon was identified. Prior to conventional angiography,the bleeding had been occult. In a second patient, in whom angiography had revealed a hypervascular mass,selective injection of Tc-99m RBC into the superior mesenteric artery revealed tumor(leiomyoma) bleeding in thejejunum. CONCLUSION: Selective IA scintigraphy was valuable for detecting intestinal bleeding, occult duringconventional studies and may be useful for detecting acute bleeding at the time of negative angiography.
Angiography ; Animals ; Arteries ; Catheterization ; Catheters ; Colon, Transverse ; Hemorrhage* ; Humans ; Ketamine ; Mesenteric Arteries ; Mesenteric Artery, Superior ; Rabbits ; Radionuclide Angiography ; Radionuclide Imaging* ; Sodium Pertechnetate Tc 99m ; Ulcer

BACKGROUND: The angiotensin coverting enzyme(ACE) gene(encoding kininase II, EC3.4.15.1) contains a polymorphism based on the presence(insertion [I]) or absence(deletion[D]) within an intron of a 287bp nonsense DNA domain, resulting in three genotypes(D/I) and I/I homozygotes, and I/D heterozygotes). Alu insertion is associated with lowerACE level than deletion allele(D) and it was observed that D/D individuals have twice theACE activity of I/I patients. Pregnancy induced hypertension(PIH) probably results fromdominating pressor systems owing to loss of antagonizing vasodilator autacoids. AngiotensinII is an extremely potent arteriolar vasoconstrictor. Overactivity or failure to supressresponsiveness to the increased activity of angiotensin II, which is generated by ACE,would seem to be a reasonable basis for the vasoconstriction of PIH. The aim of this studyis to evaluate the relationship between ACE genotype and PIH. METHODS: Blood sampling was taken from 39 patients with PIH. The hypertensivedisorders, confirmed at postpartum follow up, were classified as gestational hypertensionwithout proteinuria, preeclampsia(mild and severe) and eclampsia. The diagnosis ofpreeclampsia was made according to the American College of Obstetrics and Gynecology criteriaof hypertension and proteinuria(>300 mg/24 hr urine). Genomic DNA was extractedfrom blood sample. After PCR amplification of the respective fragments from intron 16 ofthe ACE gene, size fractionation and visualization by electrophoresis were performed. RESULTS: PIH group(including gestational hypertension, mild and severe preeclampsia: frequency of I allele 0.756 and D allele 0.244) had more I allele and less D allele whencompared with normal population(frequency of I allele 0.609 and D allele 0.391)(p < 0.05).And PIH group had more I/I homozygote individuals showing significant distortion fromHardy-Weinberg equilibrium of ACE genotype(p < 0.05). Moreover, severe preeclampsiagroup alon(frequency of I allele 0.759 and D allele 0.241) had more I allele and less Dallele when compared with normal population and had significantly more I/I homozygoteindividuals. CONCLUSION: As pregnancies with PIH had more ACE I allele and I/I homozygoteindividuals. PIH could be associated with I allele of the ACE gene. Considering the observedcodominant association between the D-I polymorphism and plasma ACE activity, our resultis in favor of the thesis that PIH primarily arises from defective synthsis of vasodilatingautacoids and renin-angiotensin system exerts secondary vasoconstrictive action. However,the relationship between ACE genotype and defective vasodilating mechanism during pregnancyis unknown at present.
Alleles ; Angiotensin II ; Angiotensins* ; Autacoids ; Diagnosis ; DNA ; Eclampsia ; Electrophoresis ; Female ; Follow-Up Studies ; Genotype ; Gynecology ; Homozygote ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Introns ; Obstetrics ; Peptidyl-Dipeptidase A ; Plasma ; Polymerase Chain Reaction ; Postpartum Period ; Pre-Eclampsia ; Pregnancy* ; Proteinuria ; Renin-Angiotensin System ; Vasoconstriction

PURPOSE: The optimal dose of oximes for use in the treatment of organophosphorus pesticide poisoning has not been conclusively established. In this retrospective study, we assessed the effectiveness of the use of high-dose pralidoxime infusion in treating organophosphorus pesticide poisoning. METHODS: From January 1998 to December 2009, 71 patients visited the hospital Emergency Department (ED) as a result of organophosphate pesticide intoxication. All of these patients received an initial bolus of 2 g of pralidoxime as the first step of treatment. Patients who then received continuous infusion of pralidoxime at a dose of 500 mg/hr were entered into study group 1 (low dose), and those treated by continuous infusion of pralidoxime at a dose of 1000 mg/hr were entered into study group 2 (high-dose). Plasma cholinesterase activities for each patient were evaluated at ED arrival and re-evaluated 24 hours after pralidoxime infusion. The effectiveness of the two treatment modalities was gauged by comparing the required duration of mechanical ventilation, time spent in the intensive care unit (ICU) and total time spent in the hospital. RESULTS: The mean duration of mechanical ventilation was 9.98+/-6.47 days for group 1 and 4.39+/-6.44 days for group 2. The respective mean duration of time spent in ICU and the total number of days in the hospital were 16.38+/-18.84 days and 21.87+/-20.16 days for group 1, and 7.83+/-9.99 days and 11.71+/-13.53 days for group 2. High-dose pralidoxime treatment was associated with shorter required durations for mechanical ventilation, ICU and hospital stay. In addition, plasma cholinesterase reactivation rates were higher for those patients receiving high-dose pralidoxime treatment. CONCLUSION: The results suggest that high-dose pralidoxime treatment has greater efficacy for patients suffering from organophosphorus pesticide poisoning.
Cholinesterases ; Emergencies ; Humans ; Intensive Care Units ; Length of Stay ; Organophosphates ; Oximes ; Plasma ; Pralidoxime Compounds ; Resin Cements ; Respiration, Artificial ; Retrospective Studies ; Stress, Psychological

BACKGROUND: Risk for injuries resulting from overinflated or underinflated endotracheal tube cuff warrants adequate cuff inflation technique. Thus, this study was designed to measure the actual intracuff pressures obtained by new estimation techniques. METHODS: 95 adult surgical patients requiring tracheal intubation were randomized to two groups with respect to the endotracheal tube model: Portex(R) (n = 55) and Euromedical(R) (n = 40). After induction of anesthesia, the cuff was inflated using new estimation techniques with two different syringes: PR10 or PR20 (passive release technique using a 10-ml or 20-ml syringe, respectively). Subsequently, an aneroid manometer was used to measure the actual intracuff pressures. These inflation techniques were repeated two times. A direct cuff measurement range of 25 to 40 cmH2O was used as a reference for optimal intracuff pressure. Size 7.0 mm internal diameter (ID) tubes were used for women and size 7.5 mm ID for men. RESULTS: 88 eligible patients were studied: Portex group (n = 50) and Euromedical group (n = 38). With respect to the rate of optimal cuff inflation, PR10 was significantly higher than PR20 in both groups (56% vs. 10% in Portex group; 63.2% vs. 0% in Euromedical group, respectively) (P < 0.05). CONCLUSIONS: When direct intracuff measurement is not available, a new method, named "passive release technique" using a 10-ml syringe, is a useful alternative cuff inflation method.
Adult ; Anesthesia ; Female ; Humans ; Inflation, Economic ; Intubation ; Intubation, Intratracheal ; Male ; Statistics as Topic ; Syringes

PURPOSE: Comparing with suture and staple, skin graft fixation with Histoacryl (N-butyl-cyanoacrylate, B.Braun, Germany) has two advantages. Fixation is simple, painless and removal process is unnecessary. There are few reports that compare histoacryl with conventional methods for skin graft fixation in FTSG. However, there are no comparative studies in STSG. The purpose of this study is to show our experience of skin graft fixation with histoacryl in STSG of burn patients. METHODS: This study included those who was burned less than 10% of TBSA and needed STSG. The patients who had underlying disease (DM, hypertension, liver disease, lung disease) were excluded. 29 patients who visited Bestian burn center from January to July 2009 was enrolled in the study. In STSG, skin graft was fixed with histoacryl and authors marked the fixed points with pen. Fixation rate was checked in 7 days after STSG and take rate was checked in 14 days after STSG. RESULTS: The patient group consisted of 7 males and 22 females. The mean extent of burn area was 2.3%. The type of injury consisted of 18 contact, 8 scald, 1 flame, 2 friction. 31 STSG of 29 patients was done. STSG was done at 24th day after burn, the mean area of wound for STSG was 51 cm2. Mean numbers of fixation point with histoacryl per patients were 14.1. 430 of 436 fixation were stable and fixation rate was 98.6%. There was no infection case. Take rate was 99.1% in 14 days after STSG and it took 21 days for wound opening. CONCLUSION: Until now, suture and staple are common methods in skin graft fixation. However, it is disadvantageous that suture and staples should be removed. Histoacryl does not need those process. This study showed that take rate was 99.1% and fixation rate was 98.6% in fixation with histoacryl. In STSG, Skin graft fixation with histoacryl could be alternative methods for suture and staple.
Burn Units ; Burns ; Enbucrilate ; Female ; Friction ; Humans ; Hypertension ; Liver Diseases ; Lung ; Male ; Skin ; Sutures ; Tissue Adhesives ; Transplants