No abstract available.
Nuchal Cord* ; Ultrasonography*

BACKGROUND: Nonsyndromic craniosynostosis is a relatively common craniofacial anomaly and various techniques were introduced to achieve its operative goals. Authors found that by using smaller bone fragments than that used in conventional cranioplasty, sufficiently rigid bone union and effective regeneration capacity could be achieved with better postoperative outcome, only if their stable fixation was ensured. METHODS: Through bicoronal incisional approach, involved synostotic cranial bone together with its surrounding areas were removed. The resected bone flap was split into as many pieces as possible. The extent of this ‘multi-split osteotomy’ depends on the degree of dysmorphology, expectative volume increment after surgery and probable dead space caused by bony gap between bone segments. Rigid interosseous fixation was performed with variable types of absorbable plate and screw. In all cases, the pre-operational three-dimensional computed tomography (3D CT) was checked and brain CT was taken immediately after the surgery. Also about 12 months after the operation, 3D CT was checked again to see postoperative morphology improvement, bone union, regeneration and intracranial volume change. RESULTS: The bony gaps seen in the immediate postoperative brain CT were all improved as seen in the 3D CT after 12 months from the surgery. No small bone fragment resorption was observed. Brain volume increase was found to be made gradually, leaving no case of remaining epidural dead space. CONCLUSION: We conclude that it is meaningful in presenting a new possibility to be applied to not only nonsyndromic craniosynostosis but also other reconstructive cranial vault surgeries.
Absorbable Implants ; Brain ; Craniosynostoses* ; Osteotomy* ; Regeneration

Purpose: The present study aimed to investigate the effective cleaning of healing abutment (HA) using Healing abutment case (HA case) by observing oral microorganisms with phase contrast microscope. Materials and methods: 32 patients with two or more implants placed in the same jaw, a total of 64 HAs (experimental group 32, control group 32) were selected and the control was cleaned with an alcohol swab. At the first and second visits, each group was observed before cleaning, and the experimental group was additionally observed after cleaning at the first visit. A 400× phase contrast microscope was used for the observation of oral microorganisms for its amounts. Results: There was no significant difference in the amount of oral microorganisms was found between the groups at the first visit, no significant difference according to gender, maxilla or mandible, and buccal or lingual surface. There was a statistically significant difference in the amount of oral microorganisms according to supra-gingival and sub-gingival (P<.05), There was also a significant difference in the comparison before and after cleaning in the experimental group (P<.05). There was a significant difference in the amount of oral microorganisms in each group at second visit (P<.05). Conclusion Healing abutment cleaning using healing abutment case solution is more effective than simple cleaning with alcohol swab.

No abstract available.
Mucocele*

Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-term use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4-fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd anti-tuberculosis regimens for the first time. We separated the patients by two groups.(Group I: OFX+PTA+CS+PAS + Injection, Group II: PZA+PTA+CS+PAS+Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by chi2-test and T-test. Results: 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced state was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group I and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1% in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5% in Group I and 83.3% in Group II but had no significant difference. Conclusion: In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.
Age Distribution ; Arthralgia ; Ciprofloxacin ; Cohort Studies ; Drug Resistance ; Hospitals, Chronic Disease ; Humans ; Korea ; Ofloxacin ; Pyrazinamide* ; Recurrence ; Retreatment* ; Retrospective Studies ; Sex Distribution ; Sputum ; Tuberculosis, Pulmonary*

No abstract available.
Empyema, Tuberculous* ; Lymphoma, Non-Hodgkin* ; T-Lymphocytes*

OBJECTIVE: We evaluate the cerebral protective effect of thiopental, propofol and dantrolene in middle cerebral artery occlusion(MCAO) model of rats, which ventilated spontaneously and showed definitely decreased EEG activities which is compatible with cerebral focal ischemia. METHODS: Sprague-Dawley rats were anesthetized with halothane. In control group, halothane(1-1.3 vol%) was inhaled by mask. In thiopental and propofol group, halothane was switched to each drug about 20 minutes before MCAO. In dantrolene group, dantrolene was administered 20 minutes before MCAO with halothane inhalation. Middle cerebral artery was occluded for 120 minutes. The focal ischemic proess was confirmed by ipsilateral suppression of EEG, expressed by compressed spectral array. The volume percentage of infarcted brain was measured. RESULTS: The percentage of infarct volume in thiopental group(13.7+/-4.6%) was significantly smaller than other groups(control group : 28.4+/-4.2%, propofol group:32.3+/-6.7%, dantrolene group : 31.9+/-5.4%). But, there was no statistically meaningful difference between control group, propofol group, and dantrolene group. CONCLUSION: The results of this study indicate that only thiopental has brain protective effect against focal cerebral ischemia.
Animals ; Brain ; Brain Ischemia* ; Dantrolene* ; Electroencephalography ; Halothane ; Infarction, Middle Cerebral Artery* ; Inhalation ; Ischemia ; Masks ; Middle Cerebral Artery* ; Propofol* ; Rats* ; Rats, Sprague-Dawley ; Thiopental*

Atherosclerotic cardiovascular disease(AVD) is a major cause of the mortality and morbidity in end-stage renal disease(ESRD) patients undergoing chronic dialysis therapy. The factors such as lipopretein metabolism abnormality, diabetes, hypertension, hyperhomocysteinemia and oxidative stress have been implicated as underlying causes related AVD. Malnutrition, chronic inflammation, increased oxidative stress, hyperparathyroidism and its related lipoprotein abnormalities are suggested to accelerate AVD in ESRD patients. High-resolution B-mode ultrasono-graphy has been used to evaluate atherosclerotic change in carotid artery in a number of epidemiologic or clinical studies because of its non-invasive advantage and proven effects in predicting AVD or cardiovascular mortality. Using high-resolution B-mode sonography, we evaluated the presence of plaque and carotid intima-media area(cIM area), which is known to be a good predictor of athero-sclerosis. We compared and analyzed those sonographic findings according to a number of selected clinical and laboratory factors. Study subjects were 27 stable ESRD patient receiving hemodialysis(HD) or chronic ambulatory peritoneal dialysis(CAPD) at least over 24 months. The patients with present or past coronary, cerebral or peripheral vascular disease, history of anti-platelet agents or age over 70 years were excluded. Nine HD and 18 CAPD patients were included and mean age was 52.1+/-2.6 years and number of male and female patients were sixteen and eleven. Among many factors, sex, age, dialysis duration, diabetes, smoking history, blood pressure, body mass index, albumin, creatinine, high-density lipoprotein, triglyceride, C-reactive protein, total calcium, phosphorus, intact-parathyroidid hormone were selected and analyzed for their correlation with carotid sonograpic findings. 1) Mean cIM area of all patients was 15.4+/-0.7 mm2. cIM area was significantly increased in CAPD patients compared to HD patients(16.5+/-1.2 vs 14.9+/- 0.9mm2, p<0.05). Atherosclerotic plaques were found in 48.1% and bilateral lesion was found in 18.5% of all patients. The incidence of the plaque was 42.1% in HD and 55.6% in CAPD patients. 2) cIM area was more significantly increased in male than female(16.7+/-0.8 vs 13.6+/-1.2mm2, in diabetes than non-diabetes(16.4+/-0.8 vs 14.7+/-l.lmm2) and in smoker than non-smoker(18.8+/-0.7 vs 12.8+/-0.7mm2, p<0.05). It was also significantly inereased in patients with body mass index more than 2.3kg/ m(18.3+/-1.1 vs 14.6+/-0.8mm), systolic blood pres-sure more than 14mmHg(16.6+/-0.7 vs 13.0+/-1.2mm) and C-reactive pretein more than 0.5 mg/dL(18.9+/-1.5 vs 14.2+/-0.77mm2p<0.05). Among those factors, age, systolic blood pressure, body mass index and C-reactive protein were proven to positively correlate to cIM area with statistical significance(p<0.05). Even though cIM area was increased in patients with high serum parathyroid hormone, high total cholesterol and triglyceride and low high-density lipoprotein level, no statistical significances were found in these factors. 3) In comparison of each factor according to the presence of the plaque, age and the presence of diabetes were proven to be significantly different between patients without the plaque and with the plaque(45.7+/-2.7 vs 59.5+/-3.8 year, 33.3% vs 53.8%, respectively, p<0.05). Systolic blood pressure and C-reactive protein were increased in patients with the plaque but no statistical significance was shown. In conclusions, we found that old age, male sex, presence of diabetes, smoking history, high systolic blood pressure, increased body mass index and increased C-reactive protein were significantly related to increased cIM area and the plaque was more frequent in old age and diabetes patients using high resolution B-mode ultrasonography. It can be assumed that inflammatory state as reflected by C-reactive protein would be more related with atherosclerosis in ESRD patients than such as nutritional state, parathyroid hormone or lipoprotein metabolism based on these results. Fusing prospective analysis demonstrating causeeffect relationship or analyzing inflammatory index such as TNF-a or interleukin would be necessary to prove this assumption.
Age Factors ; Atherosclerosis* ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Calcium ; Carotid Arteries* ; Cholesterol ; Creatinine ; Dialysis ; Female ; Humans ; Hyperhomocysteinemia ; Hyperparathyroidism ; Hypertension ; Incidence ; Inflammation ; Interleukins ; Kidney Failure, Chronic* ; Lipoproteins ; Male ; Malnutrition ; Metabolism ; Mortality ; Oxidative Stress ; Parathyroid Hormone ; Peripheral Vascular Diseases ; Peritoneal Dialysis, Continuous Ambulatory ; Phosphorus ; Plaque, Atherosclerotic ; Sex Factors ; Smoke ; Smoking ; Triglycerides ; Ultrasonography*

PURPOSE: Mutations in the Bruton's tyrosine kinase(Btk) gene are responsible for X-linked agammaglobulinemia(XLA), an immunodeficiency caused by a block in B cell differentiation. In this report we characterize the protein expression and genetic mutations of Btk in four Korean patients with three unrelated XLA families. METHODS: The resulting Btk proteins were characterized by a flow cytometry and the mutations were analyzed using single strand conformation polymorphism(SSCP) and direct sequencing. RESULTS: Two deletions, including one novel genetic alteration, and one splicing error, were found in these three XLA families. Along with the identification of mutations, Btk protein analysis using flow cytometry clearly showed cellular mosaicism in monocytes from five obligate carriers, findings consistent with those by SSCP. We attempted to determine the origin of mutation in an XLA family with a novel 4-bp deletion of exon eight, suggesting a germline mutation in this family. In addition, we found some clinical heterogeneities in the affected brothers with the same gene mutation. CONCLUSION: These identified genetic alterations provided valuable clues to the pathogenesis of XLA in Korea. The flow cytometric analysis is suggested as a useful tool for rapid detection of XLA patients and carriers.
Cell Differentiation ; Exons ; Flow Cytometry ; Germ-Line Mutation ; Humans ; Korea ; Monocytes ; Mosaicism ; Polymorphism, Single-Stranded Conformational ; Siblings ; Tyrosine*

PURPOSE: The purpose was to describe comparative analysis of the surgical outcome of percutaneous K-wire fixation of bony mallet fingers reduced with towel clip and 18-gauge needle. METHODS: We analyzed the bony mallet finger patients with more than twelve months follow-up after percutaneous K-wire fixation. The patients were randomly divided into two groups. Eighteen fingers were treated with closed reduction using towel clip and 18 other fingers were treated with closed reduction using 18-gauge needle. RESULTS: Radiographs showed bony union and no subluxation in all cases after K-wire removal. The average extension lag was 2.8degrees/1.9degrees, and range of motion of distal interphalangeal joint was 70.3degrees/75degrees respectively. According to Crawford's criteria, excellent results were obtained in 9/11 fingers, good results in 8/7 fingers, and poor result in 1/0 finger, respectively. CONCLUSION: 18-gauge needle reduction in percutaneous K-wire fixation is considered less invasive and useful method for treatment of bony mallet finger with comparable results with towel clip reduction.
Fingers ; Follow-Up Studies ; Humans ; Joints ; Needles ; Range of Motion, Articular