Sterilization has received much attention in orthodontic practices over the past several years. The present study was undertaken to investigate the effects of sterilization on the physical properties of orthodontic pliers-AEZ, Unitek, and Dentronix ligature cutters. This study was designed to examine the tips of ligature cutters before and after 200 and 400 sterilization cycles using the Bowmar RHT-1000, the Dentronix DDS-5000, and the Eschmann SES-2000. The tip surface and the fracture surface were observed with a scanning electron microscope. The microstructure was observed with an optical microscope. The hardness test was carried out with the micro-Vickers hardness tester and the Rockwell C Scale hardness tester. The chemical composition was analyzed_ by energy dispersive X-ray spectrometer. The results of this study were as follows: 1. The number and the size of corrosion products on the tip surface and the proportion of cleavage planes in fractured specimen increased, but the hardness of the tip decreased in proportion to sterilization cycles. From these observations, it was considered that mechanical properities decreased in proportion to sterilization cycles. 2. The number and the size of chromium carbides increased in proportion to sterilization cycles. Coarse microstructure decreased mechanical properities. 3. The AEZ and Unitek ligature cutters were Fe-Cr stainless steels, but the Dentronix ligature cutter was Co-Cr alloy. There were many differences among manufactures, but the chemical composition was not changed after sterilization cycles. 4. The tip edge of ligature cutter used in a clinic revealed microcracks with the SEM observation. Clinical experience confirmed that ligature cutters were gradually degraded by sterilization.
Alloys ; Chromium ; Corrosion ; Hardness ; Hardness Tests ; Ligation ; Stainless Steel ; Sterilization*

This comparative study was undertaken to investigate the position of the hyoid bone in unilateral cleft lip and palate individuals. The materials for this study consisted of 35 subjects with surgically repaired unilateral cleft lip and palate (25 males, 10 females) and 40 subjects with normal facial morphology (20 males, 20 females). Cephalometric measurements of unilateral cleft and palate individuals were compared with those of non-cleft individuals. The conclusions of this study were obtained as follows: 1. To the anterior cranial base, the hyoid bone in unilateral cleft lip and palate individuals was located downward as compared with non-cleft individuals. 2. To the mandible, the hyoid bone in unilateral cleft lip and palate individuals was located backward as compared with non-cleft individuals. 3. The distance between the dorsum of the tongue and the inferior border of the hard palate in unilateral cleft lip and palate individuals was longer than that in non-cleft individuals. 4. Unilateral cleft lip and palate individuals showed no significant difference in the distance between the hyoid bone and the dorum of the tongue as compared with non-cleft individuals.
Cleft Lip* ; Humans ; Hyoid Bone* ; Male ; Mandible ; Palate* ; Palate, Hard ; Skull Base ; Tongue

OBJECTIVES: In previous studies, significant correlations between depression or somatization and the mode of anger expression were reported. However few studies were done in psychiatric patients, while some evidences were found that anger expression as well as anger suppression were related to development of somatization. This study aimed to investigate the relationship of the state-trait anger and the mode of anger expression to depression and somatization in psychiatiric patients. METHODS: The depression and somatization questionnaire of SCL-90-R and Korean Adaptation of the State-Trait Anger Expression Inventory were administered to 53 psychiatric patients and 59 normals. The relationship of anger to depression and somatization was analyzed by correlation and regression analyses. RESULTS: In comparison with the normal control group, the psychiatric patient group showed significant differences on trait anger temperament but no significant differences on other anger variables. In regression analysis, the anger-in score was related to depression and somatization. However, the degree of explanatory power was higher in depression than in somatization. In the case of analyzing the state-trait anger, anger-in was significant predictor variable for depression in psychiatric patient group. CONCLUSION: These results suggested that anger-in is the important factor in the onset of depression and somatization. Rather than the relationship of anger-in and somatization, the relationship of anger-in and depression is higher; therefore the caution is necessary in the interpretation of previous studies. The relationship of anger-in to depression and somatization may have important implications for psychotherapy.
Anger* ; Depression* ; Humans ; Psychotherapy ; Surveys and Questionnaires ; Temperament

No abstract available.
Glycogen Storage Disease*

In a jaundiced patient, it is important to ascertain as early as possible whether the bile duct is dilated. Ultrasonography, computed tomography & conventional cholangiography are widely accepted methods of determining the size of the extrahepatic bile ducts. But there is a considerable discrepancy among the size of the bile duct as measured from them. So the author analyzed and compared the respective diameters of the bile ducts in Korean normal adults as measured from cadaver, IV cholangiography, ultrasoud and computed tomography. The materials were 45 cases of cadaver, 38 cases of IV cholangiography, 100 cases of ultrasonography & 55 cases of computed tomography. The results were as follows ; 1. The diameters of the bile ducts were 7.58±2.26mm at CHD & 8.04±2.42mm at CBD from cadaver ; 5.38±1.90mm at CHD & 6.58±2.37mm at CBD from IV cholanglography ; 3.24±1.13mm at CHD & 4.71±1.48mm at CBD from ultrasonography ; and 4.56±1.51mm at CHD & 5.87±1.68mm at CBD from computed tomography. 2. The diameter of the bile duct was greatest in cadaver, and then reduced in IV cholangiography, computed tomography and ultrasonography in this orde.r 3. There were no size discrepancy between the diameter of the common hepatic duct and that of the common bile duct. 4. There were no discrepanry of the diameter of the bile duct by sex.
Adult* ; Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Cadaver ; Cholangiography ; Common Bile Duct ; Hepatic Duct, Common ; Humans ; Ultrasonography

BACKGROUND AND OBJECTIVES: Fibroblasts interact with eosinophils and play a key role in the pathogenesis of airway diseases. The aims of this study were to investigate whether Th1 or Th2 type cytokines can induce mRNA and protein expression of eotaxin and RANTES in human nasal fibroblast (HNF) and to verify the correlation between the stimulation of different cytokines and chemokines in HNF. Materials and Methods: Cultured HNF were stimulated by IL-13, TNF-alpha, IFN-gamma, IL-13 with TNF-alpha, IL-13 with IFN-gamma, TNF-alpha with IFN-gamma for 6, 24 and 48 hours. In addition, HNF were stimulated by different concentration of IL-13 (0.2, 2, 20, 200 ng/ml). MRNA expression of eotaxin and RANTES were revealed by RT-PCR and protein of eotaxin and RANTES were revealed by ELISA. RESULTS: TNF-alpha and IFN-gammar induced mRNA and protein expression of RANTES in HNF and they synergistically induced protein expression of RANTES. RANTES expression increased in a time dependent manner. IL-13 induced mRNA and protein expression of eotaxin in HNF and it synergistically reacted with TNF-alpha or IFN-gamma. The effects of IL-13 on mRNA and protein expression of eotaxin increased in a concentration dependent manner. CONCLUSION: Th1 or Th2 type cytokines induce mRNA and protein expression of eotaxin and RANTES in human nasal fibroblasts. TNF-alpha or IFN-gamma induce more RANTES than eotaxin but IL-13 induces more eotaxin than RANTES. There may be some synergic effects of cytokines for mRNA and protein expression of chemokines.
Chemokine CCL5* ; Chemokines ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Fibroblasts* ; Humans* ; Interleukin-13 ; RNA, Messenger* ; Tumor Necrosis Factor-alpha

STUDY DESIGN: A retrospective study. OBJECTIVE: To analyze the clinical features and prognosis of intraoperative incidental durotomy during posterior surgery for degenerative lumbar disease. In addition, we tried to evaluate clinical outcome and safety of skillful neglect of pin point dural tear. SUMMARY OF LITERATURE REVIEW : Incidental durotomy is one of the most common complications during the operation of degenerative lumbar disease. It may cause signs and symptoms of cerebrospinal fluid leakage and complications such as meningitis, wound infection, pseudomeningocele and fistula. From the literature review, primary repair is mandatory even in the case of pin point dural tear. MATERIALS AND METHODS: Seven hundred fifty-five patients with degenerative lumbar disease, who were operated posteriorly from Jan. 1990 to Feb. 2002, were reviewed retrospectively. Primary operations were 378 cases of laminectomy without instrumentation and 377 cases of decompression and instrumented fusion. Of these patients, 44 (6 percent) sustained an incidental dural tear. We analyzed the mechanisms of dural tear, intraoperative treatment, postoperative management and clinical outcome. RESULTS: Eight cases (2.1%) of dural tears occurred during discectomy, 36 (9.5%) during instrumentation and fusion, and 12 (20%) during revision surgery. Dural tears were treated intraoperatively by primary repair in 20 cases, by fascial graft in 2 and without repair (skillful neglect) in 22. There were no cases of persistent cerebrospinal fluid leakage or fistula formation, and the symptoms of cerebrospinal fluid leakage were transient. Of 36 patients followed for more than one year, 82% had good or excellent result. CONCLUSION: Incidental durotomy occurred in 5.8 percent of lower back surgery patients, and more frequently in revision surgery. Very small dural tears did not have significant influence on the clinical outcome, whether they were repaired or not. Skillful neglect of pin point dural tear may be a reasonable treatment option.
Cerebrospinal Fluid ; Decompression ; Diskectomy ; Fistula ; Humans ; Laminectomy ; Meningitis ; Prognosis ; Retrospective Studies ; Transplants ; Wound Infection

OBJECTIVE: Patients treated with surgical clipping for anterior communicating artery (A-com) aneurysm often complain of anosmia, which can markedly impede their quality of life. We introduce a simple and useful technique to reduce postoperative olfactory dysfunction in A-com aneurysm surgery. METHODS: We retrospectively reviewed the medical records of patients who underwent surgical clipping for unruptured aneurysm from 2011-2013 by the same senior attending physician. Since March 2012, olfactory protection using gelfoam and fibrin glue was applied in A-com aneurysm surgery. Therefore we categorized patients in two groups from this time-protected group and unprotected group. RESULTS: Of the 63 enrolled patients, 16 patients showed postoperative olfactory dysfunction-including 8 anosmia patients (protected group : unprotected group=1 : 7) and 8 hyposmia patients (protected group : unprotected group=2 : 6). Thirty five patients who received olfactory protection during surgery showed a lower rate of anosmia (p=0.037, OR 10.516, 95% CI 1.159-95.449) and olfactory dysfunction (p=0.003, OR 8.693, 95% CI 2.138-35.356). Superior direction of the aneurysm was also associated with a risk of olfactory dysfunction (p=0.015, OR 5.535, 95% CI 1.390-22.039). CONCLUSION: Superior direction of aneurysm appears associated with postoperative olfactory dysfunction. Olfactory protection using gelfoam and fibrin glue could be a simple, safe, and useful method to preserve olfactory function during A-com aneurysm surgery.
Aneurysm ; Arteries ; Fibrin Tissue Adhesive* ; Fibrin* ; Gelatin Sponge, Absorbable* ; Humans ; Intracranial Aneurysm* ; Medical Records ; Olfaction Disorders ; Quality of Life ; Retrospective Studies ; Surgical Instruments

PURPOSE: Soft-tissue augmentation using hyaluronic acid (HA) gels is widely used in dermatology and plastic surgery. We performed this study to determine the feasibility of using HA gel to augment the glans penis. MATERIALS AND METHODS: In experiment I, 0.2 cc of HA gel was injected into the dermis of the glans penis of 25 New Zealand White rabbits via a 27-gauge needle. At 3, 7, 14, 30, and 90 days after injection, the histologic changes in the penis and systemic adverse effects were evaluated. In experiment II, 0.5 cc of HA gel was injected into the dermis of the glans penis of 14 Beagle dogs. Two weeks later, an additional 0.2 cc was injected in 7 of the dogs. For 6 months, the changes in the injected area were grossly evaluated using a 10-point visual scale, and at the end of the study, histologic changes were also evaluated. At autopsy, lung, liver, and spleen were studied for systemic adverse reactions. RESULTS: In the dogs receiving double injections, 85% to 90% of the initial volume was maintained at 6 months, with HA being identified in the lamina propria of the glans penis. Encapsulated material was confirmed to be HA by alcian blue stain and hyaluronidase immunohistochemical stain. No systemic adverse reaction was noticed in any animal. CONCLUSIONS: Hyaluronic acid gel is safe and effective for augmentation of the glans penis. Booster injection enhances the injected volume and facilitates injection of HA.
Alcian Blue ; Animals ; Autopsy ; Dermatology ; Dermis ; Dogs ; Gels ; Hyaluronic Acid* ; Hyaluronoglucosaminidase ; Liver ; Lung ; Male ; Mucous Membrane ; Needles ; Penis* ; Rabbits ; Spleen ; Surgery, Plastic

STUDY DESIGN: This is a retrospective study comparing the radiologic results of sacral fixation using anteromedially directedsingle screw and triangulated double sacral screws. OBJECTIVES: To know whether the single screw fixation is enough for short level lumbosacral fusion. SUMMARY OF LITERATURE REVIEW: Method of sacral fixation is one of a hot issue in spinal instrumentation because of high complication rate. So, many kinds of sacral fixation methods were developed for long level spinal instrumentation. But, it is unclear whether we should use the special sacral fixation techniques instead of simple single screw fixation for the short level lumbosacral fusion. MATERIALS AND METHODS: Inclusion criteria of this study were fixation down to sacrum or sacralized L5, less than three segments fixation and minimum radiologic follow-up for one year. Of those patients treated with lumbosacral fixation using pedicle screw instrumentation from March 1989 to June 1998, forty-four patients met these criteria. They were divided into two groups according to the method of sacral fixation, Group I for single screw fixation and Group II for double screw fixation. Number of patients were 37 in Group I and 7 in Group II. The mean follow-up was 36.5 and 66.6 months, respectively. The radiologic results were evaluated by metal failure, change of lumbar lordosis, change of lumbosacral angle and change of L5-S1 disc space height. RESULTS: metal failure were identified in five patients(13.5%), all in sacral screws of Group I. There were 4 screw breakages and 1 screwrod dissociation. The change of lumbar lordosis was averaged 2.3 degrees(-17~38) in Group I and -4.0 degrees(-25~17) in Group II(p=0.194). The change of lumbosacral angle was averaged 2.3 degrees(-7~12) and 3.7 degrees(-1~12), respectively(p=0.596). The change of disc height was 5.6%(-13~33) and 8.8%(-5~16), respectively(p=0.381). CONCLUSIONS: Group I has much higher rate of instrumentation failure than Group II and all the instrumentation failures were occured at sacral screws. Other radiologic measurements were not statistically significant between the two groups. Stable fixation of the sacrum is necessary to prevent instrumentation failure at the sacrum even though the fusion is less than three levels.
Animals ; Follow-Up Studies ; Humans ; Lordosis ; Retrospective Studies ; Sacrum