PURPOSE: This is to evaluate the clinical results and radiologic changes of the mandibular condyle fractures following the open reduction and fixation using the Lag-screws introduced by Eckelt and Martin Co. MATERIALS & METHODS: Ten patients who had been treated by the Lag-screw fixation for the unilateral fracture of the mandibular condyle at the high level and followed up for over 6 months(ranged from 24 weeks to 33 weeks). The incisal opening by time elapsed, displacement of the fragments, bone resorption around the Lag-screws, operating time consumed, and untoward complications were evaluated. The data were tested by repeated measure ANOVA and paired t-test. RESULTS: The maximum mouth opening was increased by time as follows ; 20.2+/-2.8mm soon after reduction. 26.3+/-3.9 at the 2nd week, 37.7+/-4.2mm at the 4th week, 44.4+/-4.3mm in PO 2 months(P<0.05). The bone resorption at anterior to lag-screw nut was measured to 1.9+/-1.0mm, while the posterior resorption was 2.6+/-1.9mm on average(P<0.05). Reduction and fixation of the fragments by Lag-screw were done within 80 minutes including the skin closure. The clicking sound of the TMJ(40%), weakness of the marginal branch(60%) were complicated but transient for 4-8weeks. There were no signs of bony displacement, but loosening of screws were observed at the time of removal. CONCLUSION: Open reduction and fixation with condylar Lag-screw(Martin co., Germany) thru the ramus can be a good option to reduce the high level(Kruger's Level III & IV) fracture of the mandibular condyle with anterior or medial displacement. However, this procedure requires 2nd surgery to remove the devices and it may complicate improper reduction for delayed fractures and in case of 's' curved mandibular ramus.
Bone Resorption ; Humans ; Mandibular Condyle* ; Mouth ; Nuts ; Prognosis* ; Skin

No abstract available.
Appendicitis* ; Barium* ; Enema*

Vibrio parahaemolyticus is a gram-negative halophilic organism commonly associated with outbreaks of acute gastroenteritis which also sometimes causes serious wound infection. It is an uncommon cause of bacteremia. We have experienced a case of bacteremia due to Vibrio parahaemolyticus in a 59-year old man who initially presented with edema and dyspnea. He was diagnosed as liver cirrhosis, gastric cancer, and hepatoma. On hospital day 13, Vibrio parahaemolyticus was isolated from blood culture. The isolate showed typical cultural and biochemical characteristics such as salt tolerance and did not ferment lactose. The isolate was intermediate to ampicillin but susceptible to other agents.
Ampicillin ; Bacteremia* ; Carcinoma, Hepatocellular ; Disease Outbreaks ; Dyspnea ; Edema ; Gastroenteritis ; Humans ; Lactose ; Liver Cirrhosis ; Middle Aged ; Salt-Tolerance ; Stomach Neoplasms ; Vibrio parahaemolyticus* ; Vibrio* ; Wound Infection

No abstract available.
Animals ; Rats* ; Reperfusion*

BACKGROUND/AIMS: Although the mechanism of hepatocellular carcinogenesis still remains to be clarified, it has been suggested that persistent hepatic necrosis and resultant irregular regeneration might cause genetic mutations, such as activation of protooncogenes, inactivation of tumor suppressor genes and modulation of apoptosis-related genes, finally leading to hepatocellular carcinoma (HCC). To elucidate the role of cell proliferative activity and apoptosis, a major mechanism of cell death, in hepatocellular carcinogenesis, we analyzed expression of proliferation cell nuclear antigen (PCNA), p53 protein and apoptotic cells in HCC and surrounding nonneoplastic hepatic parenchyma. METHODS: We performed immunohistochemical staining to detect P CAN, p53 protein, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labelling (TUNEL) method for the detection of apoptosis in 52 hepatocellular carcinomas and their adjacent nonneoplastic liver. We scored the expression of PCNA and p53, and apoptotic index by a 5 point scale' 0, 0%,1, 1-25%', 2, 25-50%, 3, 50-75%', 4, >76%, and analyzed the results with other clinicopathologic characteristics. RESULTS: p53 protein was expressed in 42.3% of the HCC, but was not evident in nonneoplstic liver. P53 overexpression was correlated with the histologic grade of HCC (p<0.05). PCNA labelling indices (LI) of HCC were correlated with those of liver cell dysplasia and normal liver (p<0.05). Leading edges of HCCs showed higher proliferative activity than the central part of HCC. Four cases of HCCs with high TUNEL also showed high proliferative activity. There was no difference of the TUNEL between HCC and surrounding nonneoplastic liver. Expression of p53, PCNA LI and TUNEL had no relationship with clinicopathologic parameters including viral markers, aFP elevation, tumor size and underlying cirrhosis. CONCLUSION: p53 overexpression in HCC and absence of p53 mutation in nonneoplastic liver indicates the active participation of p53 in hepatocellular carcinogenesis. Invasiveness and metastatic potential appear to be related with the strong expression of PCNA, but apoptosis in HCC has no direct implication in hepatocellular carinogensis.
Apoptosis* ; Biomarkers ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Death ; Fibrosis ; Genes, Tumor Suppressor ; In Situ Nick-End Labeling ; Liver* ; Necrosis ; Proliferating Cell Nuclear Antigen ; Regeneration

PURPOSE: To determine the magnetic resonance (MR) imaging findings of tuberculous arthritis, and the frequency-in such cases-with which tuberculoma occurs. MATERIALS AND METHODS: MR images of 26 patients (M:F, 14:12; mean age, 46.2 years) with pathologically proven tuberculous arthritis were retrospectively reviewed. The presence of joint effusion, subchondral erosion, synovial proliferation and soft tissue abscess, and whether the inner wall of this abscess was smooth, were assessed. In particular, we determined whether a nodular lesion which showed low SI on T1WI, central low SI with peripheral high SI on T2WI, and rim enhancement on contrast study, was a tuberculoma. RESULTS: The joints involved were those of the knee (n=7), hip (n=7), shoulder (n=4), sacroiliac region (n=3), elbow (n=3), and ankle (n=2). Joint effusion was noted in 15 cases (58%), and subchondral erosion in 24(92%). synovial proliferation was found in 23 cases (88%), and soft tissue abscess in 24 (92%). The inner wall of this abscess was irregular in 17 cases (71%). A tuberculoma was present in intra- or extra-articular soft tissue in 18 cases (69%). CONCLUSION: The MR findings of tuberculous arthritis were subchondral erosion, synovial proliferation, and soft tissue abscess. The presence of a tuberculoma in intra- or extra-articular soft tissue, a specific finding in tuberculous arthritis, was noted in 69% of our cases.
Abscess ; Ankle ; Arthritis* ; Elbow ; Hip ; Humans ; Joints ; Knee ; Retrospective Studies ; Shoulder ; Tuberculoma*

BACKGROUND: The inhalational anesthesia is performed by the administration of inhalational agents and fresh gases. Low and high flows have their own advantages and disadvantages. In Korea, many anesthesiologists use more than 2 L/min of fresh gas flow (FGF). This study was performed to analyze the practice and knowledge of FGF use by Korean Anesthesiologists. METHODS: A questionaire was sent to 122 anesthesiologists (15 university hospitals and 16 general hospitals) who attended the 47th Annual Autumn Meeting of the Korean Society of Anesthesiology in 2002. The questionaire covered topics dealing with inhalational agents, FGF, and safety systems for inhalational anesthesia practice. RESULTS: The most preferred inhalational anesthetic was sevoflurane (65.6%). 88.5% of respondents used more than 2 L/min of FGF. The majority of the respondents, however, did not consider the reasons for using certain levels of FGF. Only 27% of hospitals had pulse oximetry, capnogram or muti-gas analysis, fail-safe device, and a scavenging system. CONCLUSIONS: Many anesthesiologists, especially trainees, failed to consider the use of FGF during inhalational anesthesia. Therefore, special consideration should be given to the training and education of trainees about the proper of FGF.
Anesthesia ; Anesthesiology ; Surveys and Questionnaires ; Education ; Gases ; Hospitals, University ; Korea ; Oximetry

PURPOSE: To evaluate the difference between the predicted postoperative refraction and the actual postoperative refraction after simultaneous vitrectomy and cataract surgery with sulcus fixation of an intraocular lens (IOL). METHODS: The records of patients with simultaneous vitrectomy and cataract surgery with sulcus IOL implantation (group 1) and with in-the-bag IOL implantation (group 2) were reviewed. We compared the spread between the predicted and actual refractive errors in the two groups. RESULTS: Group 1 consisted of 19 eyes in 19 patients and group 2 consisted of 23 eyes in 20 patients. The spread between the predicted and actual refraction (spread = actual-predicted) was -0.71 +/- 1.02 D in group 1 (p = 0.012) and -0.07 +/- 0.74 D in the group 2 (p = 0.86). The actual refractive errors in group 1 shifted toward myopia from the predicted in-the-bag refraction when compared with group 2. CONCLUSIONS: For the implantation of an IOL in the sulcus after simultaneous vitrectomy and cataract surgery, the IOL power should be approximately 1.0 D less than the power for in-the-bag fixation.
Cataract ; Humans ; Lenses, Intraocular* ; Myopia ; Refractive Errors* ; Vitrectomy

BACKGROUND: Coagulase negative staphylococcus (CNS) spp. is a major pathogenic organism of nosocomial and community-acquired urianry tract infections, and causes infrctions in the immunocompromised host, and in particular, bloodstream infetions in patent with indwelling devices. High prevalance of methicillin resistance has been noticed in CNS which also have been recongnized as an important multidrug resistant pathogen. The optimal phenotypic method for detecting methicillin resistance still remains controversial, and new guidelines for detecting methicillin resistance of CNS was proposed by NCCLS in January 1999. We evaluated the relationship between mecA gene by PCR method and antimicrobial susceptibility tests according to the new NCCLS guidelines. METHODS: A total of 82 CNS isolates were examined for MICs and penicillin MICs by disk diffusion and agar dilution method according to NCCLS guidelines, and detections, and detection of mecA gene by PCR. RESULT: In disk diffusion method, 66 strains (80.5%) and 63 strains (76.8%) showed resistance to penicillin and oxacillin, respectively, and in agar dilution method, 71 strains(86.6%) and 53 strains (64.6%), respectively. In PCR method, mecA genes were detected in 49 strains(59.8%). Comparing with mecA gene detection by PCR method, the sensitivity of disk diffusion and agar dilution method was 95.8% and 89.8%, repectively. However, the sensitivity of disk diffusion and agar dilution method was 65.3% and 75.5%, respectively using previous NCCLS criteria. CONCLUSION: The new criteria of NCCLS detects the methicillin resistance induced by mecA gene more sensitively than previous one.
Agar ; Coagulase* ; Diffusion ; Immunocompromised Host ; Methicillin Resistance ; Oxacillin ; Penicillins ; Polymerase Chain Reaction ; Staphylococcus*

PURPOSE: We performed this study to compare T1-201 and Tc-99m MIBI scans for the differentiation of malignant from benign breast mass. MATERIALS AND METHODS: Thirty-eight female patients underwent T1-201 breast scan and thirty-two of them also underwent Tc-99m MIBI scan of the breast. After intravenous injection of 74-111 MBq of T1-201, early (10 minutes) and delayed (3 hours) images were obtained. Then, 555-740 MBq of Tc-99m MIBI was injected and images after 30 minutes were obtained. We compared T1-201 and Tc-99m MIBI scans with pathologic RESULTS. RESULTS: Twenty-three patients were confirmed to have infiltrating duct carcinoma and fifteen patients to have benign breast mass by excisonal biopsy. The sensitivity of early and delayed T1-201 scan and Tc-99m MIBI scan in the detection of malignant breast lesion were 100% (23/23), 82% (18/22), and 90% (18/20), respectively. The specificity of early T1-201 scan was significantly higher than that of delayed T1-201 scan (p<0.05). The specificity of early and delayed T1-201 scan and Tc-99m MIBI scan were 73% (11/15), 73% (11/15) and 83% (10/12), respectively (p:not significant). Three patients out of nine with fibroadenoma and one patient with atypical duct hyperplasia were false positive in both early and delayed T1-201 scans. The size of fibroadenoma with false positvie in early and delayed T1-201 scan (4 cases) was larger than that of 11 fibradenoma with true negative scan (p<0.01). Metastatic axillary lymph node involvement was present in fifteen patients. The sensitive to detect metastatic nodes was 38% (5/13) for early T1-201 images, 15% (2/13) for delayed T1-201 images, 58% (7/12) for Tc-99m MIBI planar images and 67% (4/6) for Tc-99m MIBI SPECT. The sensitive of Tc-99m MIBI planar or SPECT was significantly higher than that of delayed T1-201 images (p<0.05). CONCLUSION: Early T1-201 and Tc-99m MIBI scan are useful noninvasive methods to differentiate malignant form benign mass of breast. Tc-99m MIBI scan was sensitive in detecting axillary lymph node metastasis in patients with brease cancer.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis, Differential* ; Female ; Fibroadenoma ; Humans ; Hyperplasia ; Injections, Intravenous ; Lymph Nodes ; Neoplasm Metastasis ; Radionuclide Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon