To define the basic sequential events of the healing process in normal fracture and evaluate the role of growth regulatory molecules and extracellular matrix components, the expression of transforming growth factor β(TGF-β), platelet-derived growth factor(PDGF), type I and II collagen, and chemistry during the healing process of an experimental fracture of tibia in 41 adult rats for 7 weeks using ABC methods. The phases of inflammation, reparation, and remodeling followed each other in sequence. The inflammatory phase was characterized by hemorrhage, edema, and infiltration of inflammatory cells on the first day. During the reparative phase, the undifferentiated mesenchyme undergoes rapid chondrogenesis, followed by endochondral ossification and supplemented by appositional bone formation. At day 3, the expression of TGF-β and PDGF was noted in the undifferentiated mesenchymal cells and from day 5, these two growth factors were detected in the osteoblasts and extracellular matrix in areas of endochondral ossification and newly formed periosteal bone. From day 3, the expression of type I collagen and osteonectin was noted in the osteoblasts and extracellular matrix in both endochondral ossification and appositional bone growth as a marker of ossification. From day 3, type III collagen was mainly expressed in the plump mesenchymal cells showing chondroid differentiation and chondroid matrix as a marker of cartilaginous reparative phase. From day 14, these growth factors and extracellular matrix components were decreased in staining intensity and at the 5th week, the histology and immunostaining pattern were similar to the mature bone.
Adult ; Animals ; Bone Development ; Chemistry ; Chondrogenesis ; Collagen Type I ; Collagen Type III ; Collagen ; Edema ; Extracellular Matrix ; Fracture Healing ; Hemorrhage ; Humans ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Mesoderm ; Osteoblasts ; Osteogenesis ; Osteonectin ; Rats ; Tibia ; Transforming Growth Factors

OBJECTIVE: The aim of this study was to compare the success rates of the manual and motor-driven mini-screw insertion methods according to age, gender, length of mini-screws, and insertion sites. METHODS: We retrospectively reviewed 429 orthodontic mini-screw placements in 286 patients (102 in men and 327 in women) between 2005 and 2010 at private practice. Age, gender, mini-screw length, and insertion site were cross-tabulated against the insertion methods. The Cochran-Mantel-Haenszel test was performed to compare the success rates of the 2 insertion methods. RESULTS: The motor-driven method was used for 228 mini-screws and the manual method for the remaining 201 mini-screws. The success rates were similar in both men and women irrespective of the insertion method used. With respect to mini-screw length, no difference in success rates was found between motor and hand drivers for the 6-mm-long mini-screws (68.1% and 69.5% with the engine driver and hand driver, respectively). However, the 8-mm-long mini-screws exhibited significantly higher success rates (90.4%, p < 0.01) than did the 6-mm-long mini-screws when placed with the engine driver. The overall success rate was also significantly higher in the maxilla (p < 0.05) when the engine driver was used. Success rates were similar among all age groups regardless of the insertion method used. CONCLUSIONS: Taken together, the motor-driven insertion method can be helpful to get a higher success rate of orthodontic mini-screw placement.
Female ; Hand ; Humans ; Male ; Maxilla ; Private Practice ; Retrospective Studies

Purpose: To report a case of bilateral congenital cataract in a patient with triple X syndrome.Case summary: A 9-month-old female was referred to our clinic because of poor fixation and white pupils in both eyes. The patient underwent a performed chromosomal study in the pediatric department due to developmental delay and torticollis. As a result, she was diagnosed with triple X syndrome (47, XXX). Under general anesthesia, the patient underwent lens aspiration with intraocular lens insertion and anterior vitrectomy was performed followed by posterior capsulotomy with optic capture. Intraoperatively, remnant pupillary membrane, posterior embryotoxon, and anterior lenticonus with anterior capsular defect in both eyes were observed. But there was no specific finding on fundus examination. Conclusions We report the first case of bilateral congenital cataract in a patient with triple X syndrome. It is recommended that clinicians check for cataracts as soon as possible when this chromosome abnormality is confirmed.

Intimal hyperplasia is the universal response to endothelial denudation and occur after a variety of vascular procedures. In a proportion of cases the smooth muscle cell proliferation may lead to stenosis of the blood vessels. The precise pathophysiologic pathways leading to the development of intimal hyperplasia have not been characterized. Once the surface has been denuded of endothelium, a stereotyped sequence of events ensues and leads to intimal thickening. The denuded regions are immediately covered by a carpet of platelets. SMC in the media begin to proliferate. They then migrate into the intima and continue to proliferate as well as to synthesize and secrete large amounts of extracellular matrix. This study was undertaken to examine the effect of drugs on the development of proliferative intimal lesion after experimental arterial injury in a rat model. Aortic denudation was performed by balloon catheter in 30 rats. The rats were divided into five group: control group, normal feeding; heparin group, heparin 1200 U/kg/day subcutaneously; steroid group, dexamethasone 0.1 mg/kg/day; CsA group, CsA 3 mg/kg/day subcutaneously; ACE inhibitor, ramipril 10 mg/kg/day subcutaneously. The rat were sacrified and aortas were perfused and fixed at 21 days after denudation. Microscopic findings were observed and cross sectional intima-to-media ratio were calculated. The results were as follows: 1) Normal aorta with intima to media ratio was 0.38+/-0.06 2) Marked intimal thickening with a mean I-M ratio of 1.35+/-0.45 in the control group. 3) In contrast, the I-M ratio in the heparin group was 0.54+/-0.23, steroid group was 0.48+/-0.21, CsA group was 0.64+/-0.12, ramipril group was 0.71+/-0.27(P<0.05). In summary, this study shows that repair in even the simplest model of vascular injury is an exceedingly complex process and further studies are required.
Animals ; Aorta ; Blood Vessels ; Catheters ; Constriction, Pathologic ; Dexamethasone ; Endothelium ; Extracellular Matrix ; Floors and Floorcoverings ; Heparin ; Hyperplasia ; Models, Animal ; Myocytes, Smooth Muscle ; Ramipril ; Rats ; Vascular System Injuries

Bronchial foreign body aspirations are uncommon in adults and usually have various underlying conditions, otherwise accidentally occurred in dental procedure, medical, surgical procedure. The most commonly aspirated objects were food materials, with peanuts leading the list. When bronchial foreign body was aspirated, no definite respiratory symptoms or foreign body is may not seen, then diagnosis is delayed. Therefore late complications was developed. The tendency to use fiberoptic bronchoscope for removal of foreign bodies in adults is increased. We report a rare case of bronchial pneumonia due to occult aspiration of a twig before 1 year with a review of the literatures.
Adult ; Arachis ; Aspirations (Psychology) ; Bronchopneumonia ; Bronchoscopes ; Diagnosis ; Foreign Bodies ; Humans ; Pneumonia*

PURPOSE: To elucidate a potential association between Helicobacter pylori (HP) infection and iron-deficiency anemia (IDA) in infants and children in terms of the other factors related to iron utilization and storage although the association of ferritin was previously studied. METHODS: We evaluated 135 infants (aged 6-24 months) admitted at Gyeongsang National University Hospital from 2000 to 2006. Western blot assays using the HP CagA antigen (120 kD) were conducted to identify infections. The concentrations of six parameters were measured: hemoglobin (Hb), serum ferritin, soluble serum transferrin receptors, interleukin-6, prohepcidin, and C-reactive protein. In addition, the infants were classified into IDA, anemia from inflammation (AI), unclassified anemia (UCA), and normal groups on the basis of Hb and ferritin concentrations. RESULTS: In the IDA group (n=20), seven infants were infected with HP, with the other infants showing no evidence of infection. The mean Hb levels in the IDA group were significantly lower in HP-infected infants than those uninfected (7.1 vs. 8.2 g/dL, respectively); the mean ferritin levels were also significantly lower in the infected infants (3.2 vs. 6.8 microgram/L). The other four parameters did not differ significantly among the IDA infants. No correlations were found between the six parameters and HP infection status in the other groups. CONCLUSION: There were no significant differences in the HP infection rates among the study groups. However, in the IDA group, the HP-infected infants had significantly lower serum ferritin and Hb levels than the HP-negative infants (P<0.05).
Anemia ; Anemia, Iron-Deficiency ; Antimicrobial Cationic Peptides ; Blotting, Western ; C-Reactive Protein ; Child ; Ferritins ; Helicobacter ; Helicobacter pylori ; Hemoglobins ; Humans ; Infant ; Inflammation ; Interleukin-6 ; Iron ; Protein Precursors ; Receptors, Transferrin

PURPOSE: To elucidate a potential association between Helicobacter pylori (HP) infection and iron-deficiency anemia (IDA) in infants and children in terms of the other factors related to iron utilization and storage although the association of ferritin was previously studied. METHODS: We evaluated 135 infants (aged 6-24 months) admitted at Gyeongsang National University Hospital from 2000 to 2006. Western blot assays using the HP CagA antigen (120 kD) were conducted to identify infections. The concentrations of six parameters were measured: hemoglobin (Hb), serum ferritin, soluble serum transferrin receptors, interleukin-6, prohepcidin, and C-reactive protein. In addition, the infants were classified into IDA, anemia from inflammation (AI), unclassified anemia (UCA), and normal groups on the basis of Hb and ferritin concentrations. RESULTS: In the IDA group (n=20), seven infants were infected with HP, with the other infants showing no evidence of infection. The mean Hb levels in the IDA group were significantly lower in HP-infected infants than those uninfected (7.1 vs. 8.2 g/dL, respectively); the mean ferritin levels were also significantly lower in the infected infants (3.2 vs. 6.8 microgram/L). The other four parameters did not differ significantly among the IDA infants. No correlations were found between the six parameters and HP infection status in the other groups. CONCLUSION: There were no significant differences in the HP infection rates among the study groups. However, in the IDA group, the HP-infected infants had significantly lower serum ferritin and Hb levels than the HP-negative infants (P<0.05).
Anemia ; Anemia, Iron-Deficiency ; Antimicrobial Cationic Peptides ; Blotting, Western ; C-Reactive Protein ; Child ; Ferritins ; Helicobacter ; Helicobacter pylori ; Hemoglobins ; Humans ; Infant ; Inflammation ; Interleukin-6 ; Iron ; Protein Precursors ; Receptors, Transferrin

PURPOSE: We aimed to compare the frequency of positive repeat urine cultures 48 hours after antimicrobial treatment between anatomically normal and abnormal urinary tract Infection (UTI) groups to determine the potential clinical usefulness of the tests. METHODS: We reviewed medical records of 930 patients under age 14, who had been admitted for UTI at Gyeongsang National University Hospital from January 1, 1998 to August 1, 2008. The eligible patients were divided into two groups the anatomically normal UTI group and the anatomically abnormal UTI group. Statistical analyses were performed with variables consisting of the sex ratio, age distribution and the frequency of positive repeat urine cultures of each group. RESULTS: The sex ratio of the anatomically normal UTI group was M:F=1.9:1, whereas that of the anatomically abnormal UTI group was M:F=3.5:1 (P=0.019). For age distribution, it was found that the mean age of the anatomically normal UTI group was 0.82+/-1.83 years, whereas that of the anatomically abnormal UTI group was 1.18+/-2.57 years (P=0.113). The frequency of positive repeat urine cultures in the anatomically normal UTI group was 3/279 (1.1%), whereas that of the anatomically abnormal UTI group was 1/90 (1.1%) (P=0.675). CONCLUSION: We conclude that performing a repeat urine culture is not justified in terms of clinical usefulness, and it is unreasonable to use the results as an index of therapeutic success. A follow-up urine culture is unnecessary in patients with both the anatomically normal and abnormal UTI group.
Age Distribution ; Follow-Up Studies ; Humans ; Hydronephrosis ; Medical Records ; Sex Ratio ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

Megacolon is an uncommon condition in which the bowel is persistently of increased diameter and it is always associated with long-standing constipation. Two main groups are recognized according to whether or not ganglia are present in the intermuscular plane of the rectal wall. Their complete absence, even along a short segment of rectum, denotes Hirschspurung's disease. If ganglia are present, the dilated bowel may be secondary to some predisposing factor such as a stricture, a congenital anorectal abnormality, a cauda equina lesion etc. In other instances, however, there may be no apparent organic reason as to why the bowel should be so dilated. This latter condition is termed "idiopathic megacolon". We report the case of one female patient with idiopathic megacolon. During medical treatment, she was complicated with a sigmoid volvulus, we performed subtotal colectomy and cecorectal anastomosis and she improved without any complication.
Cauda Equina ; Causality ; Colectomy ; Colon, Sigmoid* ; Constipation ; Constriction, Pathologic ; Female ; Ganglia ; Humans ; Intestinal Volvulus* ; Megacolon* ; Rectum

BACKGROUND: High risks of fire alway exist for buildings in urban areas, especially those in downtown. Crowds, as well as more complex and larger structures, may cause more victims in the event of fire; therefore, emergency medical service plans must be established for such disastrous events. METHODS: On the evening of October 30, 1999, a fire broke out in downtown, Dong-Incheon Live-Hof restaurant; 56 people were killed and 76 were injured. Most of them were teenagers. We retrospectively reviewed the medical records of the victims. RESULTS: 1) Among the 56 dead, 54 died from smoke inhalation, one from extensive burns, and one from sepsis during treatment. 2) Among the 76 injured, 70 patients suffered from smoke inhalation, 53 from burns, and 9 from several types of trauma (sprains, contusions, lacerations, abrasions, fractures, etc.). 3) Later complications were laryngeal edema, pulmonary edema, scar contracture, and hypoxic brain damage, and so forth. 4) Post traumatic stress syndrome was unexpectedly more prevalent in mildly to moderately injured survivors and witnesses than in seriously injured survivors. CONCLUSION: Many complications exist after a fire. Some may be resolved in time, but others may result in permanent sequelae. Early rescue, early triage, and early management during transport by emergency medical service (EMS) personnel can result in fewer complications and a lower mortality rate. Therefore, we propose the establishment of plans to be followed during various major disasters.
Adolescent ; Burns ; Cicatrix ; Contracture ; Contusions ; Disasters ; Emergency Medical Services ; Fires* ; Humans ; Hypoxia, Brain ; Inhalation ; Lacerations ; Laryngeal Edema ; Medical Records ; Mortality ; Pulmonary Edema ; Restaurants* ; Retrospective Studies ; Sepsis ; Smoke ; Survivors ; Triage