Local steroid injection is applied for the various problems in orthopaedic fields. Its not well known whether local steroid injection can induce or aggrevate the tuberculous lesion of the injection site. Tuberculous lesion of the shoulder and posterior compartment of the lumbar spine is rare, but rather commonly noted in the steroid injection group. Fifteen patients of tuberculous lesion(8 in shoulder and 7 in posterior compartment of the lumbar spine) after local steroid injection were treated surgically at the Department of the Orthopaedic Surgery, College of Medicine, Seoul National University, from Jan. 1980 to Agu. 1986, and following results were obtained; 1. The highest incidence was in the 6th decade and male to female ratio was 2: 13. 2. The average number of the injection was 16 times and the average duration was 6 months. 3. The duration from the last steroid injection to the first sign of the tuberculous lesion was from 2 weeks to 3 months and average 2.4 months. 4. Of the 15 cases, active tuberculous lesion at other sites were associated in 6 patients. 5. All cases were treated by complete curettage. It took 5.2 months for the primary wound healing. 6. Local steroid injection could induce or aggrevate the local tuberculous lesion. Radical extirpation of the lesion is the treatment of choice, but with high recurrence rate.
Curettage ; Female ; Humans ; Incidence ; Male ; Recurrence ; Seoul ; Shoulder ; Spine ; Tuberculosis ; Wound Healing

Due to an increasing interest in esthetics and concerns about toxic and allergic reactions to certain alloys, patients and dentists have been looking for metal-free tooth-colored restorations. Recent improvement in technology of new all-ceramic materials and composite materials has broadened the options for esthetic single crown restorations. The aim of this investigation was to study the fracture strength of the metal-free posterior single crowns fabricated using two recently introduced systems, Empress 2 ceramic and Targis-Vectris. Forty premolar-shaped stainless steel dies with the 1mm-wide circumferential shoulder were prepared. Ten cylindrical crowns having a diameter of 8.0mm and total height of 7.5mm were fabricated for each crown system respectively (PFM, Empress staining technique, Empress 2 layering technique, and Targis-Vectris). The crowns were filled with cement and placed on the stainless steel dies with firm finger pressure. The crowns were then stored in distilled water at room temperature for 24 hours before testing. The crowns were tested for fracture strength in an Instron universal testing machine (Instron 6022). With a crosshead speed of 1mm/min the center of the occlusal surface of the crown was loaded using a 4mm-diameter stainless steel ball until fracture occurred. The fracture surfaces of the crowns were gold coated and examined using scanning electron microscopy (Jeol JSM-840 Joel Ltd., Akishima, Tokyo, Japan). Within the parameters of this study the following conclusions were drawn: 1. The mean fracture strength for PFM crowns was 5829(+/-906)N; for Empress staining technique the fracture strength was 1697(+/-604)N; for Empress 2 Layering technique the fracture strength was 1781N(+/-400)N, and the fracture strength for Targis-Vectris was 3093(+/-475)N. 2. The fracture strength of the PFM crowns was significantly higher than that of the Empress 2 and the Targis-Vectris crowns (P<0.05). 3. The fracture strength of the Targis-Vectris crowns was significantly higher than that of the Empress 2 crowns (P<0.05). 4. No statistical difference was found when Empress staining technique was compared with Empress 2 layering technique. 5. The SEM image of fracture surface of Empress 2 crown showed a very dense microstructure of the lithium disilicate crystals and the SEM image of fracture surface of Targis-Vectris crown showed indentations of Vectris and some fibers torn off from Vectris.
Alloys ; Ceramics* ; Crowns* ; Dentists ; Esthetics ; Fingers ; Humans ; Hypersensitivity ; Lithium ; Microscopy, Electron, Scanning ; Shoulder ; Stainless Steel ; Water

As a result of increased education and communication, the field of orthodontic has recently been expanded to include a greater number of adult treatment procedures. With this increased demand for adult orthodontic treatment, a problem that frequently arises is the placement of appliances of teeth restored with porcelain. But conventional acid-etching is ineffective in the preparation of porcelain surface for mechanical retention of orthodontic attachments. Also, it is possible to damage on porcelain. The purpose of this study was to evaluate the effect of composite bonding materials and the porcelain surface treatment methods on shear bond strength, and to observe the porcelain fracture rates. To accomplish this purpose, this study was carried out with feldsphatic porcelain, Ceram II. porcelain surface treatment methods were divided into intact glazed porcelain which had not treatment and surface roughening. Surface roughening by etching with Hydroluoric acid(HF), sandblasting with Microetcher II and compound treatment with etching and sandblasting. Bonding materials were Ortho-two and Transbond. All porcelain specimens were applicated with porcelain primer. 1. In comparision according to porcelain surface treatment, surface roughening groups by HF etching and sandblasting had higher shear bond than intact group. No significant difference was found in Transbond group. 2. Ortho-two group had thd higher shear bond strength than that of Transbond group in HF etching and sandblasting. 3. E(Transbond + Intact) group had the lowest shear bond strength in all experimental group. The bond strength was higher than clinically successful bond strength. 4. Non-treated group had very higher porcelain rates than treated group. 5. This study indicates that porcelain surface-roughening may not be necessary to attachment of orthodontic brackets to porcelain surfaces.
Adult ; Dental Porcelain ; Education ; Humans ; Orthodontic Brackets* ; Polymers* ; Tooth

PURPOSE: The aim of this in vitro study was to examine the curing efficiency of various resin-based materials polymerized through ceramic restorations with 3 different thicknesses. Curing efficiency was evaluated by determining the surface microhardness (VHN) of the resin specimens. MATERIALS AND METHODS: Four kinds of resin materials were used. Z350 (3M ESPE Filtek(TM) Z350: A2 Shade), Z250 (3M ESPE Filtek(TM) Z250: A2 Shade) and Variolink(R) II (VL: Ivoclar vivadent, base: transparent) either with or without a self-curing catalyst (VLC: Ivoclar vivadent, catalyst: low viscosity/transparent) were filled into the silicone mold (10 mm diameter, 1 mm thick). They were cured through ceramic discs (IPS e.max Press MO-0 ingot ivoclar vivadent, 10 mm diameter, 0.5, 1 and 2 mm thicknesses) by LED light-curing units for 20 and 40 seconds. Vicker's microhardness numbers (VHNs) were measured on the bottom surfaces by a microhardness tester. Data were analyzed using a 3- way analysis of variance (ANOVA) at a significance level of 0.05. RESULTS: The thickness of ceramic disc increased, the VHNs of all four resin types were decreased (P<.05). The mean VHN values of the resins light cured for 40 seconds were significantly higher than that of LED for 20 seconds in all four resin materials (P<.05). VLC showed significantly higher VHN values than VL regardless of other conditions (P<.05). Z350 and Z250 showed higher values than VL or VLC (P<.01). CONCLUSION: Thinner ceramic disc with increased curing time resulted higher VHN values of all resin materials. The use of a catalyst produced a greater hardness with all polymerization methods. Restorative resin materials (Z350, Z250) showed higher VHN values than resin cement materials (VL, VLC).
Acrylic Resins ; Ceramics ; Composite Resins ; Fungi ; Hardness ; Light ; Polymerization ; Polymers ; Polyurethanes ; Resin Cements ; Silicones ; Waxes

Two cases of teratoma on sacrococcygeal region in newborn are reported with pathological findings, and a brief review of related literature is included in this report.
Humans ; Infant, Newborn* ; Sacrococcygeal Region* ; Teratoma*

PURPOSE: To evaluate the extrahepatic spread of peripheral cholangiocarcinoma with CT. MATERIALS AND METHODS: We retrospectively reviewed CT findings of extrahepatic spread in thirty-six patients with peripheral cholangiocarcinoma confirmed adenocarcinoma at surgery(n=5) or percutaneous biopsy(n--31) without primary leion in other organs, and analysed the frequency and distribution of enlarged lymph nodes, direct invasion of adjacent solid organs, and thrombosis of major vessels. RESULTS: Among the 36 cases, enlarged metastatic lymph node was noted in twenty-four(66.7%), direct invasion into adjacent organs in six(16.7%), portal and inferior vena caval thrombosis in five(13.9%). Enlarged lymph nodes were seen in hepatic nodes(n=16, 44.4%), portocaval nodes(n=15, 41.7%), interaortocaval nodes (n=10, 27.8) and celiac nodes in two(5.6%). Direct invasion was detected in the greater omentum(n=6), gallbladder(n:3) and stomach(n=2). Portal vein thrombosis(n:5) and thrombosis of inferior vena cava(n=2) were noted. CONCLUSION: Lymph node metastasis was seen in 67% in patients with peripheral cholangiocarcinoma. Direct invasion to adjacent organs and thrombosis in portal vein or inferior vena cava were occasionally associated.
Adenocarcinoma ; Cholangiocarcinoma* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Portal Vein ; Retrospective Studies ; Thrombosis ; Vena Cava, Inferior

The purpose of this study was to prove that the medial edge epithelial cells covering the secondary palatal shelves were removed by apoptosis during palatal fusion. 12 mature female rats (Suprague-Dawley) were mated overnight with male rats and sacrificed on days 16.0, 16.5, 16.75, 17.0 of pregnancy. The embryos were removed from the uterus and the heads were embedded in paraffin. The paraffin blocks were sectioned and the sections were undergone H-E staining for general histologic feature and TdT staining for detection of apoptotic cells. The obtained results were as follows. 1. In the section of 16.0 and 16.5 day embryos, the palatal shelves were prior to contact and no apoptotic cells wereobserved in the medial edge epithelium. At the initial contact of palatal shelves, there was a few apoptotic cells in the fusing epithelium. 2. In the 16.75 day embryos, the samples that epithelial seams did not lost there continuity, apoptotic cells were rarely seen at the midline epithelial seam. In contrast, a lot of apoptotic cells were observed at epithelial triangles and the junction between palatal shelves and nasal septum. 3. In the 16,75 day embryos, the samples that epithelial seams lost their continuity and disrupted to epithelial islands, large number, of apoptotic cells were observed at epithelial islands and epithelial triangles. Some apoptotic cells were also observed at the oral, nasal epithelium near the midline. 4. In the 17.0 day embryos, most of epithelial islands were disappeared and mesenchymal confluence was achieved. Apoptotic cells were rarely observed in the mesenchymal tissue which replaced epithelial islands, but there were some apoptotic cells at the epithelial triangles, oral and nasal epithelium. From the results of the study, it was revealed that medial edge epithelial cells of fusing palate were removed by apoptosis. Apoptotic cells were found mainly in the disappearing midline epithelial seam and the oral and nasal epithelial triangles at some late stages of palatal fusion.
Animals ; Apoptosis* ; Embryonic Structures ; Epithelial Cells* ; Epithelium ; Female ; Head ; Humans ; Islands ; Male ; Nasal Mucosa ; Nasal Septum ; Palate* ; Paraffin ; Pregnancy ; Rats* ; Uterus

PURPOSE: This study investigated the effects of abutment screw lengths on screw loosening and removal torque in external connection implants after oblique cyclic loading. MATERIALS AND METHODS: External connection implants were secured with abutment screws to straight abutments. The abutment-implant assemblies were classified into seven groups based on the abutment screw length, with each group consisting of five assemblies. A cyclic load of 300 N was applied at a 30° angle to the loading axis until one million cycles were achieved. Removal torque values (RTVs) before and after loading, and RTV differences were evaluated. The measured values were analyzed using repeated measures of analysis of variance with the Student-Newman-Keuls multiple comparisons. RESULTS: All assemblies survived the oblique cyclic loading test without screw loosening. There was a significant decrease in the RTVs throughout the observed abutment screw lengths when the abutment-implant assemblies were loaded repeatedly (P < .001). However, the abutment screw length did not show significant difference on the RTVs before and after the experiment when the abutment screw length ranged from 1.4 to 3.8 mm (P=.647). CONCLUSION: Within the limit of this experiment, our results indicate that the abutment screw length did not significantly affect RTV differences after oblique cyclic loading when a minimum length of 1.4 mm (3.5 threads) was engaged. These findings suggest that short abutment screws may yield stable clinical outcomes comparable to long screws in terms of load resistance.
Dental Implants ; Torque

PURPOSE: The purpose of this study is to describe characteristic contrast enhanced MR mammographic findings of ductal carcinoma in situ (DCIS) and also DCIS with microinvasion. MATERIALS AND METHODS: From January 2000 to July 2005, 32 women with 33 lesions affected by DCIS or DCIS with microinvasion underwent contrast enhanced MRI, and they were then retrospectively evaluated. All the patients had previously undergone mammography and ultrasonography. All the findings of mammography, ultrasonography (US), and MRI were analyzed by using an ACR BI-RADS lexicon. RESULTS: All 33 cases were enhanced on the enhanced MR images. A smooth margined homogeneous enhanced mass was seen in the two (2/33) cases, and nonmass enhancement was seen in 31 (31/33) cases. Among the non-mass enhancement, focal enhancement (7/31), ductal enhancement (5/31), segmental enhancement (9/31), and regional enhancement (10/31) were observed. On the kinetic study, a wash-out pattern (10/33), a plateau pattern (20/33), and a persistent pattern (3/33) were demonstrated. No significant differences were noted between the pure and microinvasive DCIS. CONCLUSION: There is no significant difference between pure and microinvasive DCIS. However, contrast enhanced MR images can demonstrate occult foci, multifocal lesion and the tumor extent of DCIS on mammogram or ultrasonogram.
Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Female ; Humans ; Magnetic Resonance Imaging* ; Mammography ; Retrospective Studies ; Ultrasonography

ICD (implantable cardioverter-defibrillator) has been recently accepted as the most effective treatment for patients with medically refractory or life threatening ventricular tachycardia or ventricular fibrillation. Determination of the DFT (defibrillation threshold) is important in the implantation of ICD. DFT is the lowest shock energy that successfully terminates ventricular fibrillation. Preoperative amiodarone use, increased body size, and left ventricular dilatation are associated with high DFT. Recently, we experienced a 66 year-old male patient presenting with syncope due to idiopathic ventricular fibrillation in whom DFT was high and unstable, probably due to preoperative use of amiodarone.
Aged ; Amiodarone ; Body Size ; Dilatation ; Humans ; Male ; Shock ; Syncope ; Tachycardia, Ventricular ; Ventricular Fibrillation*