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

OBJECTIVE: It is well-known that antipsychotics are widely used in the treatment of bipolar disorder. So, the aim of this study was to examine the subjective response to antipsychotics in acute manic patients. METHODS: Data were gathered through the study for feasibility testing of Korean Medication Algorithm for Bipolar Disorder (KAMP-BP), which 17 nationwide clinical centers were entered into the study. A total 126 bipolar patients were enrolled and then 92 were treated according to the treatment algorithm. The data of 58 patients were completely recorded from baseline to 2 weeks of treatment and were entered into analysis. Drug Attitude Inventory-10 (DAI-10) was used for evaluating patient's subjective response to antipsychotics and patients were grouped as subjective non-dysphoric and dysphoric as the total score of DAI-10. For assessing the clinical status, Young Mania Rating Scale (YMRS), Clinical Global Impression- Severity scale (CGI-S), Hamilton Rating Scale for Depression (HAM-D), Global Assessment of Functioning (GAF) and Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) were used. RESULTS: Dysphoric group was younger and has more females in sex distribution than non-dysphoric group. YMRS and CGI-S were severer in dysphoric group. The prescription patterns were not different between two groups: Combinations of mood stabilizers and antipsychotics were administered to all patients and atypical antipsychotics were prescribed over 90% of the patients. At 2 weeks of treatment, more patients were turned into remission in non-dysphoric group. Dysphoric patients showed more changes of positive subjective response in DAI-10 from baseline and more patients turned toward the non-dysphoric group. CONCLUSION: Although the subjective response to antipsychotics using DAI-10 was not typically characterized in acute manic patients, it seems that atypical antipsychotics may have a role in determining the subjective feelings of the acute bipolar manic patients.
Antipsychotic Agents* ; Bipolar Disorder ; Depression ; Female ; Humans ; Prescriptions ; Sex Distribution

OBJECTIVE: Treating patients with acute manic episode has many problems such as recurrence, breakthroughs, treatment resistance, switching and worsening of its course. Recent developments of medication, including atypical antipsychotics and new mood stabilizers, make it difficult to choose the appropriate pharmacological options. The Korean Society of Psychopharmacology and Korean Academy of Schizophrenia have started to develop a Korean algorithm project to treat major mental disorders including manic patients with the better pharmacological treatments. METHODS: The first survey was performed with a questionnaire used in `The Expert Consensus Guideline Series-Medication Treatment of Bipolar Disorder 2000' (translated in Korean). Forty-eight members of the review committee completed the survey. However, there were some instances of non-consensus and gaps between research data and clinical usage in some steps. Hence we carried out a second survey to clarify these aspects and other minor problems. RESULTS: The first-line pharmacological treatment for acute manic episode is the initiation of either lithium plus an atypical antipsychotic, or divalproex plus an atypical antipsychotic. In the case of euphoric mania, monotherapy with lithium or divalproex can be first-line treatment, as well as in combination with an atypical antipsychotic. In the case of psychotic mania, we decided to recommend typical and atypical antipsychotics with a mood stabilizer as first-line treatment. For mixed and dysphoric episodes, according to the result of the second survey, carbamazepine also can be used as a first-line mood stabilizer. Alternative mood stabilizers include new anticonvulsants such as lamotrigine and topiramate. Clozapine can be used for refractory cases and electroconvulsive therapy (ECT) can be used at any time, if needed, on the clinician's discretion. CONCLUSION: Based on the results of two surveys, discussion in executive committee and review of journals about pharmacological treatment of acute mania, we developed the algorithm presented here for manic episode. As this algorithm may retain problems and shortcomings, we will continue to revise these issues.
Advisory Committees ; Anticonvulsants ; Antipsychotic Agents ; Bipolar Disorder ; Carbamazepine ; Clozapine ; Consensus ; Drug Therapy ; Electroconvulsive Therapy ; Humans ; Lithium ; Mental Disorders ; Psychopharmacology ; Surveys and Questionnaires ; Recurrence ; Schizophrenia ; Valproic Acid

OBJECTIVE: Treating depressive episode of bipolar disorder has many clinical problems such as recurrence, treatment resistance, switching and worsening of its course. Recent developments of medications including atypical antipsychotics and new antidepressants make it difficult to choose appropriate pharmacological options. The Korean Society of Psychopharmacology and the Korean Academy of Schizophrenia developed the Korean algorithm project for bipolar disorder including depressive episode of bipolar disorder to aid clinical decisions. METHODS: The first survey was performed with the questionnaire based on `The Expert Consensus Guideline Series-Medication Treatment of Bipolar Disorder 2000'. Because of inconsistency among experts in some aspects, we carried out the second survey and discussed with related literature about bipolar depression to make a proper algorithm. RESULTS: A mood stabilizer, such as lithium or divalproex, is recommended for treating mild bipolar depression. For moderate and nonpsychotic severe bipolar depression, the first-line treatment option is a combination of antidepressant and mood stabilizer, with which a high potency antipsychotic or atypical antipsychotic drug is combined for bipolar depression with psychotic features. In the case of poor or no response to the initial treatment, to add or change antidepressant is a next step of treatment strategy. In refractory bipolar depression, thyroid hormone, atypical antipsychotics, or other mood stabilizers are recommended. Electroconvulsive therapy (ECT) can be used at any point, if needed, by the decision of clinicians. CONCLUSION: With the results of two surveys and discussion in the executive committee, we developed the algorithm for depressive episode of bipolar disorder.
Antidepressive Agents ; Antipsychotic Agents ; Bipolar Disorder ; Consensus ; Drug Therapy ; Electroconvulsive Therapy ; Lithium ; Psychopharmacology ; Surveys and Questionnaires ; Recurrence ; Schizophrenia ; Thyroid Gland ; Valproic Acid