Vertical and marginal fractures of the patella are uncommon injuries compared with other types of patellar fracture. It's possible that they are more common than supposed, but often remain undiagnosed as acute injuries. Vertical and marginal fractures often results in less acute disability than stellate or transverse fracture and the routine radiographs are often unhelpful. Failure to diagnose acute vertical and marginal fractures of the patella, especially when the fragments are displaced, may result in prolonged disability of the knee and possible development of degenarative changes in the patello-femoral joint later. Twelve patients of the vertical and the marginal patellar fractures treated at St. Mary's Hospital from Feb. 1982 to Dec. 1987 were analyzed in clinical and radiological aspect. The results obtained from this study were as followings. 1. Vertical and marginal fractures had 15.4% of injury rate in all patellar fractures. 2. The fracture and its displacement were always present on the tangential view of the patella. 3. The mechanism of the fracture was s direct blow to the patella in which the affected knee was flexed. 4. The location of the fracture line was related to the degree of the flexed knee at the time of fracture. 5. Large separated fragments of the patella should be accurately reduced with rigid fixation in the rationale of the intraarticular fracture.
Clinical Study ; Humans ; Intra-Articular Fractures ; Joints ; Knee ; Patella

Recently, various implant cylinders were supplied, especially received gold cylinders, cast cylinders produced from premade gold and plastic cylinders and plastic cylinders. This study measured and compared precise fit produced when using conventional gold and plastic cylinders. The comparative fit of lapped and non-lapped castings made from plastic pattern was examined. The implant/abutment interface fit was evaluated by scanning electron microscopy(SEM) for each of four cylinders. The following results were obtained: 1. The case of plastic cylinder showed 9.67+/-1.50micrometer gap Steri-Oss fixture was connected. 2. The case oflapped casting made from plastic cylinder showed 3.01+/-2.81micrometer gap when Steri-Oss fixture was connected. 3. The case of gold/plastic cylinder showed 9.80+/-1.68micrometer gap when Steri-Oss fixture was connected. 4. The case of gold cylinder showed 5.47+/-2.43micrometer gap when Steri-Oss fixture was connected. 5. In case of each cylinder which was connected with Steri-Oss fixture, the size of gap was showed less in the order of the case of gold/plastic cylinder, the case of plastic cylinder, the case of gold cylinder and the case of lapped casting made from plastic cylinder. As results of this study, the use of premade gold cylinder offers an advantage over plastic patterns in precise fit. When plastic patterns are used, polishing of implant cylinder components should provide precise fit.
Plastics* ; Prostheses and Implants*

PURPOSE:The natural course of Hashimoto' thyroiditis (HT) is so dynamic that the disease progresses to overt hypothyroid or spontaneous recovery. The authors reviewed the clinical course of this disease and analysed the possible predicting factors regarding remission. METHODS:Thirty nine patients with HT (38 girls and 1 boy) were studied retrospectively. Of these patients, 30 were followed for more than 2 years. The possible remission factors were analyzed at initial diagnosis and during follow-up period. RESULTS:The mean age at the diagnosis was 11.8+/-.1 years. Initial thyroid function was euthyroid in 38.5%, compensated hypothyroid in 35.9%, overt hypothyroid in 23.1%, and hyperthyroid in 2.6% of patients. Antithyroglobulin antibody (ATA) was positive in 94.7%, and antimicrosomal antibody (AMA) was positive in 74.4%. The overall remission rate was 53.3% during the follow-up period (51+/-7 months). Initial goiter size, thyroid function status, and autoantibody titer had no relation to the remission rate statistically. Follow-up autoantibody titers in remission group were marginally lower than those in nonremission group (P<0.1), and follow-up AMA titer was significantly higher than initial titers in nonremission group (P<0.05). CONCLUSION: We could not find any predictable remission factors from the initial clinical and autoantibody status. But, during follow-up period, patients with lower autoantibody titers showed slight higher remission, and those with increasing AMA titer showed less remission. Above results suggest that we should monitor antithyroid antibody titer as well as thyroid function regularly.
Adolescent* ; Child* ; Diagnosis ; Female ; Follow-Up Studies ; Goiter ; Humans ; Retrospective Studies ; Thyroid Gland* ; Thyroiditis*

Penicillamine is a component of the penicillin molecule which was identified in the urine of patients with chronic liver disease who were receiving penicillin for the treament of intercurrent infections. Walshe demostrated its effectiveness as copper chelating agent and introduced it into the treatment of Wilson's disease. In addition, it has been shown to be effective in treatment of cystinuria, heavy metal poisoning, and rheumatoid arthritis. Levamisole is a three-ringed molecule which has been used as broad-spectrum antihelminthic drug. Levamisole is capable of T cell immune enhancer and has variable effects on antibody production, Since immune enhancer may affect multiple cell types, either directly or indirectly, and may operate on the adenylcyclase-cAMP-prostaglandin system, the results of treatment may be complex. Levamisole has been shown to be effective in rheumatoid arthritis by several study. We analysed the 29 rheumatoid arthritis patients who were treated at Deartment of Orthopedic Surgery, Chung Ang University Hospital from June, 1978 to June, 1982; among them 17 recieving penicillamine and 12 recieving levamisole. The results were as follows: 1. There were statistically significant improvement in ESR. But there were decrease in mean WBC and platelet counts in patients recieving penicillamine or levamisole. Hemoglobin was not affected. 2. Side effects led to withdrawal of treatment in 8(47%) patients in the penicillamine group and 5(42%) in the levamisole group. 3. In 17 patients having penicillamine treatment, one patient had complete remission(8%).
Antibody Formation ; Arthritis ; Arthritis, Rheumatoid ; Copper ; Cystinuria ; Hepatolenticular Degeneration ; Humans ; Levamisole ; Liver Diseases ; Orthopedics ; Penicillamine ; Penicillins ; Platelet Count ; Poisoning

PURPOSE: Lymphoma originated from MALT is common in stomach but infrequently found in bronchus, salivary gland, thyroid gland and orbit. We report a case of multifocal MALToma in bilateral main lacriamal gland, hard palate without systemic metastasis. METHODS: A 45-year-old male without known systemic disease visited with movable mass in left upper eyelid for 5 months. RESULTS: We found the mass which was hot uptaked by whole body SPECT in left main lacrimal gland and hard palate. By excisional biopsy, the mass was diagnosed as MALToma. After 1 year it recurred in contralateral main lacrimal gland. It was diagnosed as the same MALToma by excisional biopsy. Relapse and other metastasis have not been observed yet up to now(November, 2002) , since we treated radiation therapy.
Biopsy ; Bronchi ; Eyelids ; Humans ; Lacrimal Apparatus* ; Lymphoma ; Male ; Middle Aged ; Neoplasm Metastasis ; Orbit ; Palate, Hard* ; Recurrence ; Salivary Glands ; Stomach ; Thyroid Gland ; Tomography, Emission-Computed, Single-Photon

STATEMENT OF PROBLEM: Screw loosening has been a common complication and still reported frequently. PURPOSE: The purpose of this study was to evaluate abrasion of the implant fixture and TiN coated abutment screw after repeated delivery and removal with universal measuring microscope. MATERIAL AND METHODS: Implant systems used for this study were Osstem and 3i. Seven pairs of implant fixtures, abutments and abutment screws for each system were selected and all the fixtures were perpendicularly mounted in liquid unsaturated polyesther with dental surveyor. After 20 times of repeated closing and opening test, the evaluation for the change of inner surface of implant and TiN-coated abutment screw, and weight loss were measured. Mann-Whitney test with SPSS statistical software for Window was applied to analyze the measurement of weight loss. RESULTS: TiN-coated abutment screws of Osstem and 3i showed lesser loss of weight than non-coated those of Osstem and 3i (P < .05, Mann-Whitney test). CONCLUSION: Conclusively, TiN coating of abutment screw showed better resistance to abrasion than titanium abutment screw. It was concluded that TiN coating of abutment screw would reduce the loss of preload with good abrasion resistance and low coefficient of friction, and help to maintain screw joint stability.
Collodion ; Friction ; Joints ; Tin ; Titanium ; Weight Loss

A key factor in successful application of PBL is creation of good problems. Unfortunately, published collections of problems do not exist for many subjects. Consequently, instructors usually write their own problems and case studies if they want to use problem-based instruction. In this study we proposed principles for creation of PBL problems and presented its example. If effective problems suitable to educational goals are engaged, PBL can be introduced to the first grade medical students who do not have any knowlege about medicine. However, additional factors such as number of faculties and students, budget, availability of learning materials also affect successful implementation of PBL.
Budgets ; Humans ; Learning ; Students, Medical

Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.
Bowen's Disease* ; Follow-Up Studies ; Hematoporphyrin Derivative ; Humans ; Lasers, Gas ; Light ; Middle Aged ; Oxygen ; Palliative Care ; Photochemotherapy* ; Skin

OBJECTIVES: The pathophysiology of restless legs syndrome (RLS) is not obvious, but many promising theories involve dopaminergic deficiency and genetic causes. The RLS is presumed to occur more frequently among schizophrenic patients who take antipsychotics, most of which blocks the dopamine receptors. This study aimed to investigate whether dopamine transporter gene (DAT1) 40 base pair (bp) variable number of tandem repeat (VNTR) polymorphism is associated with the antipsychotic-induced RLS in schizophrenia. METHODS: We determined the diagnosis of RLS among the 190 Korean schizophrenic patients by the diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG). Genotyping was performed for the 40bp VNTR in DAT1 gene using polymerase chain reaction. RESULTS: We separated the schizophrenic patients into 44 patients with RLS and 146 patients without RLS. The genotype and allele frequencies did not differ significantly between two groups. CONCLUSIONS: These results suggest that DAT1 gene 40bp VNTR is not associated with the antipsychotic-induced RLS in schizophrenia. To confirm these results, larger-scale association study is needed in the future.
Antipsychotic Agents ; Base Pairing ; Dopamine ; Dopamine Plasma Membrane Transport Proteins ; Gene Frequency ; Genotype ; Humans ; Receptors, Dopamine ; Restless Legs Syndrome ; Schizophrenia ; Tandem Repeat Sequences

PURPOSE: To clarify the chracteristic sonographic features of benign soft tissue tumors and to evaluate the usefulness of sonographic imaging. MATERIALS AND METHODS: We retrospectively reviewed ultrasonographic images of 70 cases in 68 patients with histologically proved benign soft tissue tumors. RESULTS: The tumors included 33 lipomas, 11 hemangiomas. 11 lymphangiomas, 7 neurilemmomas, 4 epidermold cysts, 2 fibromas, 1 mesenchymoma, and 1 myxoma. The SOhographic appearances of the lesions were mainly solid in 53 cases(33 lipomas, 8 hemangiomas, 2 lymphangiomas, 7 neurilemmomas, 2 fibromas and 1 mesenchymoma), mainly cystic in 14 cases(1 hemangioma, 8 lymphangiomas, 4 epidermoid cysts, and 1 myxoma), and mixed in 3 cases(2 hemangiomas and 1 lymphangioma). Although an accurate histologic prediction could not be made in most cases, certain patterns appeared to be characteristic of specific tumor types. 26 cases(78%) of lipoma were seen as lentiform, iso- or hyperechoic, solid mass. Hemangioma had variable appearance and chacteristic calcifications were seen in 3 cases. Unicameral or multiseptated cystic mass with variable thickness of echogenic septa and solid portion was the characteristic finding of lymphangioma. Neurilemmoma showed Iobulated, oval to round, relatively hypoechoic mass with or without internal cystic portion. CONCLUSION: Sonographic evaluation of benign soft tissue tumros is useful in demonstrating the location, size, extent, and internal characteristics of the mass. A relatively confident diagnosis can be made when the characteristic features of the benign soft tissue tumor are present on sonographic imaging.
Diagnosis ; Epidermal Cyst ; Fibroma ; Hemangioma ; Humans ; Lipoma ; Lymphangioma ; Mesenchymoma ; Myxoma ; Neurilemmoma ; Retrospective Studies ; Ultrasonography