A finite element analysis has been utilized to analyze stress and strain fields and design a new configuration in orthopedics and implant dentistry. Load transfer and stress analysis at implant bone interface are important factors from treatment planning to long term success. Bone configuration and quality are different according to anatomy of expecting implantation site. The purpose of this study was to compare the stress distribution in maxilla and mandible according to implant length and bone engagement types. A three dimensional axi-symmetric implant model(Nobel Biocare, Gothenburg, Sweden) with surrounding cortical and cancellous bone were designed to analyzed the effects of bone engagement and implant length on stress distribution ANSYS 5.5 finite element program was utilized as an interpreting tool. Three cases of unicortical anchorage model with 7, 10, 13mm length and four cases of bicortical anchorage model with 5, 7, 10 and 13mm lenght were compared both maxillary and mandibular single implant situatiion. Within the limits of study, following conclusions were drawn. 1. There is difference in stress distribution according to cortical and cancellous bone thickness and shape. 2. Maximum stress was shown at the top of cortical bone area regardless of bone engagement types. 3. Bicortical engagement showed less stress accumulation when compared to unicortical case overall. 4. Longer the implant fixture length, less the stress on cortical bone area, however there is no difference in mandibular bicortical engagement case.
Dentistry ; Finite Element Analysis* ; Mandible ; Maxilla ; Orthopedics

Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.
Abdominal Pain ; Adolescent ; Capsules ; Emergency Service, Hospital ; Female ; Humans ; Inflammation ; Pelvic Inflammatory Disease ; Point-of-Care Systems ; Ultrasonography

Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.

The authers performed long coloaofiherscopy with barium enema study on 134 cases, of coloreatal diseasea, who had been admitted to the department of Internal Medicine, Kwangiu Christian Hospital from July 1984 to Aupist 1986, The results were following: 1) Among 134 cases of colonoacopy, abnormal findings were 70 cases (52.2%) and normal findings 64 cases (47.8%). 2) among 70 cases of colonoscopic abnormal findings, nonspecific inflammatory colitis were 27 cases, colon tuberculosis 15 cases, colon and rectal cancer 14 cases, colon polyps 8 cases, ulcerative colitis 3 cases, internal hemorrhoid 2 cases, sigmoid diverticular 1 case. 3) The cases in which the findings of barium contrast enema were compatible with those of colonoscopy were 84 cases (62.7%), not compatible 50 cases(37.3%). There were not compatible with findings in 4 cases of colon cancer (10 cases), 7 cases of colon tuberculosis (15 cases), 4 cases of colon polyps (8 cases), 1 case of ulcerative colitis (3 cases). 4) The insertion ratio to ileocecal valve was 79.1%. The rate of correct approach by a colonoscopy to the lesion site shown at barium contrast enema was 94.1%
Barium ; Colitis ; Colitis, Ulcerative ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonoscopes* ; Colonoscopy ; Enema ; Hemorrhoids ; Ileocecal Valve ; Internal Medicine ; Polyps ; Rectal Neoplasms ; Tuberculosis

Gastric neurofibroma is rare and its exact incidence is unknown. We experienced a case of solitary gastric neurofibroma. A 49-year-old woman was admitted because of hematemesis and melena. Neither cafe-au-lait spots in skin nor superficial tumor were found. Gastrofibroscopic examination and UGI series showed a 3 * 4 cm sized luminal protruding mass with adjacent bridging mucosal fold and cental ulceration on the anterior wall of lower body. Mass excision was performed. Grossly, the mass was 4.5 * 3.0 * 2.0 cm sized, well circumscribed submucosal tumor with homogenous cut surface, Microscopically, each of the tumor cells had oval shaped nucleus and spindle shaped cytoplasm. Nuclear atypism and frequent mitosis were not observed. We report a rare case of solitary gastric neurofibroma with review of the literatures.
Cafe-au-Lait Spots ; Cytoplasm ; Female ; Hematemesis* ; Humans ; Incidence ; Melena* ; Middle Aged ; Mitosis ; Neurofibroma* ; Phenobarbital ; Skin ; Stomach ; Ulcer

Gastric dilatation is a rare life-threatening condition and consists of massive distention of the stomach by gas and fluid. Its etiology is unclear but predisposing factors include recent surgery, diabetic gastroparesis, fundoplication and gastric outlet obstruction. As the distended stomach grows larger, it hangs down across the duodenum, producing a mechanical gastric outlet obstruction, venous obstruction of the mucosa, ischemic necrosis and perforation. The distended stomach pushes the diaphragm upward, causing collapse of the left lung, rotation of the heart, and obstruction of the inferior vena cava. Hypochloremia, hypokalemia, and alkalosis may result from fluid and electrolyte losses and may precipitate cardiac arrhythmias. If acute gastric dilatation is not treated promptly, cardiovascular and pulmonary compromise may compound an increasing intravascular volume deficit leading to hypotension, which may be a cause of death.
Alkalosis ; Arrhythmias, Cardiac ; Causality ; Cause of Death ; Diaphragm ; Duodenum ; Fundoplication ; Gastric Dilatation* ; Gastric Outlet Obstruction ; Gastroparesis ; Heart ; Hypokalemia ; Hypotension ; Lung ; Mucous Membrane ; Necrosis ; Stomach ; Vena Cava, Inferior

Gastric dilatation is a rare life-threatening condition and consists of massive distention of the stomach by gas and fluid. Its etiology is unclear but predisposing factors include recent surgery, diabetic gastroparesis, fundoplication and gastric outlet obstruction. As the distended stomach grows larger, it hangs down across the duodenum, producing a mechanical gastric outlet obstruction, venous obstruction of the mucosa, ischemic necrosis and perforation. The distended stomach pushes the diaphragm upward, causing collapse of the left lung, rotation of the heart, and obstruction of the inferior vena cava. Hypochloremia, hypokalemia, and alkalosis may result from fluid and electrolyte losses and may precipitate cardiac arrhythmias. If acute gastric dilatation is not treated promptly, cardiovascular and pulmonary compromise may compound an increasing intravascular volume deficit leading to hypotension, which may be a cause of death.
Alkalosis ; Arrhythmias, Cardiac ; Causality ; Cause of Death ; Diaphragm ; Duodenum ; Fundoplication ; Gastric Dilatation* ; Gastric Outlet Obstruction ; Gastroparesis ; Heart ; Hypokalemia ; Hypotension ; Lung ; Mucous Membrane ; Necrosis ; Stomach ; Vena Cava, Inferior

BACKGROUND: We evaluated the effects of endurance exercise and a high-fat diet on insulin resistance and ceramide contents of skeletal muscle in Sprague-Dawley rats. METHODS: We randomly divided 32 rats into four groups: control (CON, n = 8), high fat diet (HF, n = 8), exercise (Ex, 24 m/min for 2 hours, 5 days/wk, n = 8), HF/Ex (n = 8). After 4-week treatments, plasma lipid profiles, glucose and insulin concentrations were measured. The triglycerides (TG), ceramide, and glucose transporter 4 (GLUT-4) contents were measured in the skeletal muscle. The rate of glucose transport was determined under submaximal insulin concentration during the muscle incubation. RESULTS: Free fatty acid levels were significantly higher in CON and HF than Ex (P = 0.032). Plasma glucose levels in HF were significantly higher than the two Ex groups (P = 0.002), and insulin levels were significantly higher in HF than in other three groups (P = 0.021). Muscular TG concentrations were significantly higher in HF than CON and Ex and also in HF/Ex than Ex, respectively (P = 0.005). Hepatic TG concentrations were significantly higher in HF than other three groups but Ex was significantly lower than HF/Ex (P = 0.000). Muscular ceramide content in HF was significantly greater than that in either Ex or HF/Ex (P = 0.031). GLUT-4 levels in CON and HF were significantly lower than those in Ex and HF/Ex (P = 0.009, P = 0.003). The glucose transport rate in submaximal insulin concentration was lower in CON than in either Ex or HF/Ex (P = 0.043), but not different from HF. CONCLUSION: This study suggests that high fat diet for 4 weeks selectively impairs insulin resistance, but not glucose transport rate, GLUT-4 and ceramide content in skeletal muscle per se. However, endurance exercise markedly affects the content of ceramide and insulin resistance in muscle.
Animals ; Ceramides ; Diet, High-Fat ; Glucose ; Glucose Transport Proteins, Facilitative ; Glucose Transporter Type 4 ; Insulin ; Insulin Resistance ; Muscle, Skeletal ; Muscles ; Plasma ; Rats ; Rats, Sprague-Dawley ; Triglycerides

Purpose: Laparoscopic hepatectomy has been widely performed by hepatobiliary surgeons for malignancy of liver and gained wide acceptance for various liver tumors, thanks to advances in surgical techniques and devices. But, there are some challenges for right side tumor in patients of cirrhotic liver. Especially, tumor located in right upper area is difficult for wedge resection in patients with marginal liver function, because trans-abdominal approach requires normal parenchymal dissection. Radiofrequency wave ablation is also difficult for such a lesion. So, we demonstrate unique technique of video-assisted transthoracic liver resection (VTLR) for overcome right upper side tumor abutting diaphragm. Methods: Four patients underwent VTLR. Four ports in right chest wall were created by a chest surgeon and diaphragm was open. Then traction of the diaphragm was done by suture. After exposure of liver surface, tumor localization was done by ultrasound. The mass excision was done by ultrasonic shear. Results: Four patients were discharged without complications within 11.3 days (range, 6–15 days). On average, patients started to consume a normal diet on an average of 2.4 days (range, 1–4 days). Conclusion VTLR is could be performed by an experienced surgeon and chest surgeon for right upper liver malignancy abutting diaphragm in patient of marginal liver function.

BACKGROUND: The p53 and retinoblastoma(Rb) tumor suppressor genes are associated with the pathogenesis of several types of human cancer. Substantial. proportion of the primary lung cancers or cell lines have been reported to have the p53 and/or the Rb gene mutations. But so far there is no report on the analysis of the Rb gene polymorphism as one of the genetic susceptibility marker. This study was undertaken to establish the gene frequencies of the polymorphic genotypes of the p53 and Rb genes in Koreans to evaluate the possible involvement of these genotypes as a risk factor of lung cancer. METHODS: In this study 145 controls without previous and present tumor history and 128 lung cancer patients were subjected to analysis The two intragenic polymorphisms of the p53 gene(exon 4/AccII, intron 6/MspI) and one intron 17/XbaI polymorphism of the Rb gene were analysed by the method of polymersae chain react lion-restriction fragment length polymorphisms(PCR-RFLPS). The genotype of the intron 3/16 bp repeat polymorphism of p53 was determined by PCR and direct gel electrophoresis. RESULTS: There were no significant differences in the genotype distributions of the p53 gene between lung cart cert patients and controls. But heterozygotes(Arg/Pro) of the exon 4/AcclII polymorphisms were slightly over-represented than controls, especially in the Kreyberg type I cancer, which was known 13 be associated with smoking. The intron 3/16 bp duplication and the intron 6/MspI polymorphisms were in complete linkage disequilibrium. About 95% of the individuals were homozygotes of the common alleles both in the 16 duplication and MspI polymorphisms, and no differences were deteced in the genotype distributions between lung cancer patients and controls. Overall genotype distributions of the Rb gene polymorphisms between lung cancer patients and controls were not significantly different However, the genotype distributions in the Kreyberg type I cancer were significantly different from those of controls(p=0.0297) or adenocarcinomas(p=0.0008). It was noticeable that 73.4% of the patients with adenocarcinomas were heterozygotes(r1/r2) whereas 39.2% of the Kreyberg type I cancer were heterozygous at this polymorphisms. In the lung cancer patients, significant differences were a]so noted between the high dose smokers and low dose smokers including non-smokers(p=0.0258). The relative risk to Kreyberg type I cancer was significantly reduced in the individuals with the genotype of r1/r2(odds ratio=0.46, 95%C.I.=0.25-0.86, p=0.0124). The combined genotype distribution of the exon 4/AccII of the p53 and the intron 17 Rb gene polymorphisms in Kreyberg type I cancers were significantly different from dose of controls or adenocarcinomas. The highest odds ratio were observed in the individuals with the genotypes of Arg/pro and r2/r2(odds ratio=1.97, 95%C.I.=0.84-4.59) and lowest one was in the patients with Arg/Arg, r1/r2 genotype(odds ratio=0.54, 95%C.I.=0.25-1.14). CONCLUSION: The p53 and the Rb gene polymorphisms modulate the risk of smoking induced lung cancer development in Koreans. However, the exact mechanism of risk modulation by these polymorphism remains to be determined. For more discrete clarification of associations between specific genotypes and lung cancer risk, the evaluations of these polymorphisms in other ethnics and more number of patients will be needed.
Adenocarcinoma ; Alleles ; Cell Line ; Electrophoresis ; Exons ; Gene Frequency ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Genetic Predisposition to Disease ; Genotype ; Homozygote ; Humans ; Introns ; Linkage Disequilibrium ; Lung Neoplasms* ; Lung* ; Odds Ratio ; Polymerase Chain Reaction ; Risk Factors ; Smoke ; Smoking