No abstract available.
Korea*

Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are described. Case 1 was a 28-year-old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multiseptation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 revealed moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus. Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms. Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells. All two cases revealed neither nuclear atypism nor increased abnormal mitoses in both giant and stromal cells, suggesting no evidence of malignancy. Thereafter the lesions were treated with excision and curettage, and histologically confirmed as giant cell tumors of the bone.
Adult ; Biopsy, Fine-Needle ; Chromatin ; Curettage ; Cytoplasm ; Epiphyses ; Female ; Femur ; Forearm ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Glomerulonephritis* ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Mitosis ; Osteoclasts ; Radius ; Stromal Cells ; Thigh ; Young Adult

Torsades de pointes, a polymorphic ventricular tachycardia associated with prolonged QT interval, is a well-known life-threatening arrhythmia, which has been found to be induced by various causes such as drugs, electrolyte imbalances, and severe bradycardia. Cisapride is a gastrointestinal prokinetic drug, which is widely used to treat gastroesophageal reflux disease or other functional gastrointestinal disorders. Cisapride can cause torsades de pointes and cases of torsedes de pointes induced by cisapride have been reported in other countries. Cases of torsades de pointes associated with antihistamine drugs have been reported in Korea, however, cisapride-induced torsades de pointes case has not been reported. We report a case of 31 year-old female patient who experienced repeated loss of consciousness due to cisapride-induced torsades de pointes.
Adult ; Arrhythmias, Cardiac ; Bradycardia ; Cisapride* ; Female ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Humans ; Korea ; Tachycardia, Ventricular ; Torsades de Pointes* ; Unconsciousness

Incidence of non-contiguous multiple spine fracture was increased from 3.2%~4.5% at 1960th and 70th to 5.7% ~23.8% at 80th and 90th. But there is no reports in Korea which has high incidence of traffic and industrial accidents. In 345 consecutive patients with acute spine fracture, we found that 43 patients (12.5%) had multiple non-contiguous spine fractures. At the 43 patients studies 37 (87.4%) sustained fractures at 2 levels while 6 had more than 3 levels of injury, 26 were injured by fall from heights, 27 (62.8%) had 2.33 associated injuries on an average, and 12 (27.9%) had a neurologic deficit. There are five patterns account for 26 (50%) of the total number of patients. In 19 patients (44.2%), there was a mean 29.3 days delay (from 3 to 233 days) in diagnosis of the minor lesions. In 19 delay diagnosed minor lesions, it confirmed by bone scan in 12 patinets(63.6%). Two patients died within 24 hours after accident, and 41 patients (41 major and 50 minor fractures) were treated in our hospital. Among them, 21 (51.2%) needed modification of treatment by the presence of non-con- tiguous multiple spine fractures. According to above findings, the physician must be aware of the possible noncontiguous multiple spine fractures when examine and treat the patients with spine fracture.
Accidents, Occupational ; Diagnosis ; Humans ; Incidence ; Korea ; Neurologic Manifestations ; Spine

Sudden cardiac death accounts for approximately half of all cardiovascular mortality in the industrialized countries and ventricular tachyarrhythmia is the most common mechanism for this event. Implantable cardioverter-defibrillator (ICD) has been effectively used for prevention of sudden cardiac death in patients with life-threatening ventricular tachyarrhythmias since 1980. Clinical experience with ICD device now exceeds 100,000 implants worldwide and the number of implantation is increasing. In Korea, there is also increasing trend of ICD implantation. The authors report the initial experience of of ICD implantation in 6 patients who had high risk of sudden cardiac death.
Death, Sudden, Cardiac ; Defibrillators, Implantable* ; Developed Countries ; Humans ; Korea ; Mortality ; Tachycardia

This study aimed to investigate the mechanism of action of baclofen on the detrusor muscle isolated from rat. Rats (Sprague-Dawley) were sacrificed by decapitation and exsanguination. Horizontal muscle strips of 2 mm x 15mm were prepared for isometric myography in isolated muscle chamber bubbled with 95% / 5%-OZ / CO2 at 371C, and the pH was maintained at 7.4 Detrusor strips. contracted responding to the.. electrical field stimulation (EFS) by 2 Hz, 2U msec, monophasic square wave of 60 VDC. The initial peak of EFS-Induced contraction was tended to be suppresed by a,p-methylene-adenosine 5'-triphosphate (mATP), a partial agonist of purinergic receptor, and baclofen, a GABAB receptor agonist (statistically nonsignificant). The late sustained contraction by EFS was suppressed significantly (p < 0.05) by additions of atropione, a cholinergic muscarinic receptor antagonist and baclofen. The adenosine 5'-triphosphate-induced contraction was completely abolished by mA TP but not by baclofen. In the presence of atropine, the subsequent addition of acetylcholine could not contract the muscle strips: but the addition of acetylcholine in the presence of baclofen evoked a contraction to a remarkable extent.
Acetylcholine ; Adenosine ; Animals ; Atropine ; Baclofen* ; Decapitation ; Exsanguination ; Hydrogen-Ion Concentration ; Myography ; Rats* ; Receptors, Muscarinic

We reviewed 46 hips of the 36 patients treated with free vascularized fibular graft for avascular necrosis of femoral head with a mean follow-up of 39.9 months (ranging from 2 years to 6 years 4 months). There were thirty-four men and two women. The mean age of patients at the time of operation was 36.6 years (ranging from seventeen to fifty-seven years). The procedure was performed on both hips in ten patients. Of the 46 hips, twenty-nine were idiopathic, ten alcoholic, six steroid induced, and one traumatic. According to Ficats stage, there were eighteen in Stage 2A, fifteen in Stage 2B and thirteen in Stage 3. According to Ohzonos classification, there were four in Type 1B, forty in Type 1C and one in Type 3B. Clinical assessments according to the cause and severity of the disease were evaluated using Harris hip scoring system. Thirty-two hips(69.6%) were excellent, 9 hips(19.6%) were good, 2 hips(4.3%) were fair, and 3 hips(6.5%) were poor. Therefore clinically satisfactory results, including excellent and good, were obtained in 41 hips(89.2%). Radiographic assessments according to healing of avascular necrosis lesion and collapsing the femoral head postoperatively were performed. Thirty hips(65.2%) were excellent, 9 hips(19.6%) were good, 4 hips(8.7%) were fair, and 3 hips(6.5%) were poor. Therefore radiographic satisfactory results were obtained in 39 hips(84.8%). Clinical and radiographic assessments according to Ohzonos classification were also evaluated. Clinically satisfactory result were obtained in 6 hips(100%) of Type 1A and 3B in 33 hips(82.5%) of Type 1C. The etiological factors didn t affect the results. There were two cases of peroneal nerve palsy in which one was irreversible and one case of clawing of great toe as complications. In conclusion, free vascularized fibular graft appears to be a very effective method for Ficats stage 2A, 2B, and early stage 3 of symptomatic avascular necrosis of femoral head, in Ohzonos Type 1C which have a high incidence of collapse.
Alcoholics ; Animals ; Classification ; Female ; Follow-Up Studies ; Head* ; Hip ; Hoof and Claw ; Humans ; Incidence ; Male ; Necrosis* ; Paralysis ; Peroneal Nerve ; Toes ; Transplants*

Plate fixation is being regarded as one of the reliahle fixation method in the management of tibial fractures. But this technique may leave many complications including infection. However, delayed local infection which developed several weeks after open reduction on the tibia has been rarely described as a complication in the literatures. The purpose of this study is to evaluate the contributing factors to the delayed locaI infection in tibial fracture treated with plate fixation. Authors reviewed and analyzed the 60 cases of tihial fracture that were treated with plate and screws from 1989 to 1996. Analyses dealt with fracture classification, laboratory and radiographic findings and the site of plate application. We defined a delayed local infection as a condition in which patient has infection signs on Jaboratory and physical examination at or over 8 week post-operation without any evidence of osteomyelitis on plain radiographs. We found 7 cases of delayed local infection out of 60 tibial fractures from 8 to 21 weeks postoperatively with an average of 14.1 weeks. All the 7 cases that had been treated with plate on medial aspect of tibia were treated by administration of antibiotics without surgery such as debridement or removal of hardwares. Authors concluded that the medial plating was the most important factor of the development of delayed local infection(Z=1.78).
Anti-Bacterial Agents ; Classification ; Debridement ; Humans ; Osteomyelitis ; Physical Examination ; Tibia ; Tibial Fractures*

The purpose of this study is to determine the effect of diabetes education program on Glucose Metabolism(blood sugar. HbAlc) and Lipid Metabolism(total cholesterol. triglyceride. low density lipoprotein. high density lipoprotein). Self-efficacy in non-insulin independent diabetes mellitus. The study design was a non equivalent control group pre-test post-test design. Data for the study were collected from March 12 to June 19, 2001. Sixty-two research subjects were assigned to experimental (36) and control (26) groups. The collected data was analyzed using the Chi-Square test. t-test by spsswin program The results are as follows: 1. Experimental group had higher level of glucose metabolism than control group(FBS: t=-3.317. p=.002. HbAlc: t=-4.956. p=.000). 2. Level of lipid metabolism were partly a significant different between experimental group and control group(Triglyceride: t=-2.108. p=.039). 3. Experimental group had higher efficacy score than control group(t=4.651. p=.000). In conclusion. the study supported the effects of diabetes education program to increase metabolism and self-efficacy. Further study with a longitudinal design is suggested to verify the effect of diabetes education program in NIDDM and standardized diabetes education program.
Cholesterol ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Education* ; Glucose* ; Humans ; Lipid Metabolism* ; Lipoproteins ; Metabolism* ; Research Subjects ; Triglycerides

The purpose of this study was to evaluate the effects of a sealant resin on enamel demineralization in orthodontic bracket bonding. The forty eight extracted sound bovine teeth were subdivided into four groups and treated with Phase II(R) (Reliance, Itasca, Ill) on the surface. Group 1 was not treated. Group 2 was acid etched with 37% phosphoric acid for 30 seconds. Group 3 was applied with sealant after acid etching. Group 4 was applied with resin paste after acid etching and sealant application. Each group was demineralized in artificial caries solution. Demineralized enamel depth was measured by confocal laser scanning microscopy. The results were as follows: the mean demineralized enamel depth was 47.4 micrometer (Group 1), 61.8 micrometer (Group 2), 13.9 micrometer (Group 3), 8.2 micrometer (Group 4); the demineralized enamel depth was increased in Group 2 than in Group 1 (p < 0.05); the demineralized enamel depth was reduced in Group 3 than in Group1 and Group 2 with statistically significant differences (p < 0.05); and demineralization in Group 4 was very little. The results of the present study indicate that sealant application is useful for reducing enamel demineralization in orthodontic bracket bonding.
Dental Enamel* ; Microscopy, Confocal ; Orthodontic Brackets* ; Tooth