Malignant hyperthermia is a genetically transmitted, catastrophic, hypermetabolic syndrome that is induced by potent volatile anesthetics and/or depolarizing muscle relaxants. It is now well established that the pathophysiology is related to a malfunction of the intracellular calcium homeostasis in skeletal muscle. Morbidity has been correlated to the duration of symptoms. Dantrolene decreased release of calcium from the sarcoplasmic reticulum. We recently encountered a fulminant case during halothane anesthesia. Anesthesia was induced with thiopental and succinylcholine without jaw tightness or stiffness. After induction, tachycardia, arrhythmias, increased end-tidal CO2, and high body temperature were noted. Arterial blood gas analysis showed a severe, mixed acidosis. Intensive treatment with body cooling was immediately initiated. But dantolene could not be available. The patient died of renal failure and disseminated intravascular coagulation 41 hours after induction of anesthesia.
Acidosis ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Arrhythmias, Cardiac ; Blood Gas Analysis ; Body Temperature ; Calcium ; Dantrolene ; Disseminated Intravascular Coagulation ; Halothane ; Homeostasis ; Humans ; Jaw ; Malignant Hyperthermia* ; Muscle, Skeletal ; Neuromuscular Depolarizing Agents ; Renal Insufficiency ; Sarcoplasmic Reticulum ; Succinylcholine ; Tachycardia ; Thiopental

No abstract available.
Epilepsy, Benign Neonatal*

PURPOSE: The purpose of this study was to evaluate the machining accuracy and consistency of implant/abutment/screw combination of internal connection type. MATERIAL AND METHODS: In this study, each two randomly selected internal implant fixtures from ITI, 3i, Avana, Bicon, Friadent, Astra, and Paragon system were used. Each abutment was connected to the implant with 32Ncm torque value using a digital torque controller or tapping. All samples were cross-sectioned with grinder-polisher unit (Omnilap 2000 SBT Inc) after embeded in liquid unsaturated polyester (Epovia, Cray Valley Inc). Then optical microscopic and scanning electron microscopic(SEM) valuations of the implant-abutment interfaces were conducted to assess quality of fit between the mating components. RESULTS: 1) Generally, the geometry of the internal connection system provided for a precision fit of the implant/abutment interface. 2) The most precision fit of the implant/abutment interface was provided in the case of Bicon System which has not screw. 3) The fit of the implant/abutment interface was usually good in the case of ITI, 3I and Avana system and the amount of fit of the implant/abutment interface was similar to each other. 4) The fit of the implant/abutment interface was usually good in the case of Friadent, Astra and Paragon system. The case of Astra system with the inclined contacting surface had the most intimate contact among them. 5) Amount of intimate contact in the abutment screw thread to the mating fixture was larger in assembly with two-piece type which is separated screw from abutment such as Friadent, Astra and Paragon system than in that with one-piece type which is not seperated screw from abutment such as ITI, 3I and Avana system. 6) Amount of contact in the screw and the screw seat of abutment was larger in assembly of Friadent system than in asembly of Astra system or Paragon system. CONCLUSION: Although a little variation in machining accuracy and consistency was noted in the samples, important features of all internal connection systems were the deep, internal implant - abutment connections which provides intimate contact with the implant walls to resist micromovement, resulting in a strong stable interface. From the results of this study, further research of the stress distribution according to the design of internal connection system will be required.
Polyesters ; Torque

No abstract available.
Giant Lymph Node Hyperplasia* ; Paraproteinemias*

PURPOSE: The aim of this study was to evaluate the effect of tamsulosin on expulsion of ureteral stones after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: Seventy-six patients(39 with upper ureteral stones and 37 with lower ureteral stones) treated with ESWL for stones <10mm were randomly divided into two groups. Tamsulosin(0.2mg orally once daily) was administered to group 1; group 2 received no medications. All patients were evaluated with respect to the number of episodes of ureteral colic, the expulsion rates of stones after ESWL, and the mean number of sessions of ESWL until complete expulsion of stones. RESULTS: The complete expulsion rates of upper and lower ureteral stones did not differ significantly between groups 1 and 2 during each session of ESWL; however, the mean session of ESWL was lower in group 1 than in group 2. For upper ureteral stones, 1.8 sessions were necessary per patient in group 1, while 2.3 sessions were required for the patients in group 2(p=0.039). For lower ureteral stones, 2.0 sessions were necessary per patient in group 1, while 2.9 sessions were required for the patients in group 2(p=0.032). There were significant decreases in the number of episodes of pain in group 1 with lower ureteral stones(p=0.014). There were no side effects associated with tamsulosin. CONCLUSIONS: The use of tamsulosin in the treatment of upper and lower ureteral stones after ESWL can decrease the mean number of sessions of ESWL and the number of episodes of pain, but cannot improve the expulsion rate. Further research regarding the cost-effectiveness of tamsulosin after ESWL is needed.
Calculi ; Humans ; Lithotripsy ; Renal Colic ; Shock ; Sulfonamides ; Ureter

We report a patient who developed pyoderma gangrenosum in the penis with invasion of the distal urethra. The patient was treated with prednisolone and thalidomide, followed by a reconstructive surgical repair using a scrotal island flap. We report this case with a brief review of the literature.
Anti-Inflammatory Agents/therapeutic use ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; *Penile Diseases/drug therapy/pathology/surgery ; Penis/*pathology ; Prednisolone/therapeutic use ; *Pyoderma Gangrenosum/drug therapy/pathology/surgery ; Thalidomide/therapeutic use ; Treatment Outcome

The purpose of this study was to investigate the characteristics of mesiodens among children in Korea. The study population consisted of 20 children whose ages ranged from 4 years to 26 years. The characteristics of mesiodens were obtained from radiographs and clinical examination results, and were confirmed by surgical intervention. Results showed that males were affected four times as frequently as female. Thirty-five percent of the patients had more than one supernumerary tooth. About 67% of the mesiodens were conical in shape and about 34% of the mesiodens were in the upward position. The age and sex distribution, number of mesiodens per patient, shape, direction, size, and effect on permanent upper incisors are also presented in this study.
Child ; Female ; Humans ; Incisor ; Korea ; Male ; Sex Distribution ; Tooth, Supernumerary

PURPOSE: To understand the normal endosonographic anatomy of the perianal spaces, and to evaluate the diagnostic efficacy and limitation of endorectal sonography(EUS), correlative study with MRI, cadaveric sectional image and cadaveric MRI were performed. MATERIALS AND METHODS: EUS images of the normal 6 perianal spaces (pelvirectal, ischiorectal, intersphincteric, subcutaneous, central, submucous space) which were bounded by internal and external anal sphincters, rectal wall and levator ani muscle were correlated with MRI in 10 normal persons, cadaveric sectional images and cadaveric MRI in 2 cadavers. RESULTS: Pelvirectal space located superior to levator ani muscle could be demonstrable only on anterior wall scan but could not be visualized on lateral or posterior wall scan on EUS. Five perianal spaces located inferior to levator ani muscle were well seen on anterior, lateral, and posterior wall EUS. MRI was superior to EUS in the evaluation of pelvirectal and ischiorectal spaces but equal or inferior to EUS in the evaluation of intersphincteric, subcutaneous, central and submucous spaces. CONCLUSION: EUS was valuable in the evaluation of perianal spaces inferior to levator ani muscle but was limited in the evaluation of perianal spaces superior to levator ani muscle.
Anal Canal ; Cadaver* ; Humans ; Magnetic Resonance Imaging*

PURPOSE: Chronic prostatitis frequently occurs in men of all ages. Recent studies suggest that fastidious microorganisms may play a role in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The aim of this study was to evaluate the usefulness and significance of multiplex polymerase chain reaction (PCR) in the diagnosis of CP/CPPS. MATERIALS AND METHODS: First voided urine (FVU) and/or expressed prostatic secretions (EPS) were collected from 92 patients. Multiplex PCR, using Dual Specificity Oligo (DSO(TM)) primers, was used to test for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Ureaplasma urealyticum (UU). RESULTS: Multiplex PCR can be easily analyzed via visual comparison. Nine (39.1%) of the 23 CP/CPPS IIIa and 12 (17.4%) of the 69 IIIb patients had positive multiplex PCR, with a total of 27 microorganisms isolated, including CT, MH, MG, UU, TV and NG in 9, 7, 4, 4, 2 and 1 case, respectively. Co-infections with 2 or 3 organisms occurred in 5 cases. For the samples collected from 32 patients for both FVU and EPS, 68.7% gave the same results. CONCLUSIONS: Multiplex PCR, using DSO(TM) primers, can be useful for the simple detection of fastidious microorganisms in CP/CPPS. To achieve reliable results with multiplex PCR, feasible guidelines and standardization are of major importance. Further studies will be required to define the usefulness of molecular tests for CP/CPPS in clinical practice.
Chlamydia trachomatis ; Coinfection ; Diagnosis ; Humans ; Male ; Multiplex Polymerase Chain Reaction* ; Mycoplasma genitalium ; Mycoplasma hominis ; Neisseria gonorrhoeae ; Pelvic Pain ; Polymerase Chain Reaction ; Prostatitis* ; Sensitivity and Specificity ; Trichomonas vaginalis ; Ureaplasma urealyticum

PURPOSE: Transobturator slings have become an alternative to retropubic slings for the surgical treatment of stress urinary incontinence (SUI). We aimed to compare the efficacy and outcome between transobturator and retropubic mid-urethral sling procedures. MATERIALS AND METHODS: We reviewed the chart of 186 consecutive women who had sling procedures with a follow-up of at least 1 year from 2001 to 2006. The retropubic sling procedure was perfomed on 76 women assigned to retropubic group. A total 110 women received transobturator slings assingned to transobturator group. The preoperative evaluations, the indices of voiding, and postoperative complications were analysed by Student's t-test and chi-square. RESULTS: Two groups were similar in their preoperative characteristics and the perioperative parameters except the period of hospitalization and operative time. There were significant difference between the 2 groups in terms of the postoperative obstructive and iatrogenic complications. Transobturator group had shorter hospitalization and operative time and lower complications than retropubic group. CONCLUSIONS: Because transobturator sling procedures showed better results and less complications than retropubic slings, it is a safe and efficient surgical treatment for female SUI.
Female* ; Follow-Up Studies ; Hospitalization ; Humans ; Operative Time ; Postoperative Complications ; Suburethral Slings* ; Surgical Mesh ; Urinary Incontinence*