The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy

In an epidemiological study of metal workers exposed to metalworking fluids(MWF), the prevalence time of evoultion, seasonal occurrence and clinical type of contact dermatitis were investigated. Composinal analyses of MWF with HPLC, dermatological examination and two consecutive questionnaire surveys were conducted. Study population was divided into two groups ; workers contact to cutting oil and workers contact to rust preventive oil. In the analysis of MWF, aliphatic hydrocarbons, having 12-20 carbons, was most common composition(49.04%) of cutting oil otherwise, major contents (90.99%) of the rust preventives oil were aliphatic hydrocarbons composed of 6-9 carbons. The frequency (point prevalence) of contact dermatitis(CD) was 7(12.7 per 100 subjects) in the dermatological examination of 55 workers. As the result of second survey for contact dermatitis, cumulative prevalence of oil working full-time and recent 1 year prevalence in two groups were 28.0, 16.7 and 15.1, 12.5 per 100 subjects. There were no difference in the prevalence of CD by oil, age, oil contact duration. Summer is the most common evolution season in workers exposed to cuttiogs, but not in workers exposed to rust preventive oil. Major clinical type of CD was erythematous papules in both groups. It presents the importance of preventive measures that 51.1% suffer from contact dermatitis had medical care at their own expense, and 47.1% of them felt serious about their contact dermatitis. From the fact that 68.6% think cotton gloves protective apparatus, we emphasize the need for health education.
Carbon ; Chromatography, High Pressure Liquid ; Dermatitis, Contact* ; Epidemiologic Studies ; Health Education ; Humans ; Hydrocarbons ; Male* ; Prevalence ; Surveys and Questionnaires ; Seasons

Carotid balloon angioplasty and stenting has been suggested to be a safer and more cost-effective alternative to carotid endarterectomy for the management of carotid artery stenosis, especially in high risk patients or poor candidates for standard carotid endarterectomy. We conducted anesthetic management in patients receiving carotid balloon angioplasty and stenting. General anesthesia was performed in 2 cases and anesthesia care was monitored in 5 cases to ensure hemodynamic stability. No severe complications such as major stroke occurred during the procedures. One case with monitored anesthesia care showed a rapid decrease in arterial pressure and transient bradycardia during balloon inflation, but these immediately resolved.
Anesthesia ; Anesthesia, General ; Angioplasty, Balloon* ; Arterial Pressure ; Bradycardia ; Carotid Stenosis ; Endarterectomy, Carotid ; Hemodynamics ; Humans ; Inflation, Economic ; Stents* ; Stroke

No abstract available.

Calcium sulfate has a long history of medical use as an implant material. The biocompatibility of the material has been clearly established. Bone ingrowth concomitant with resorption occurs rapidly with efficient conduction of bone from particle to particle. Calcium sulfate also has a potential for functioning as a good barrier membrane. The purpose of this study was to compare the biocompatibility of different types of calcium sulfate grafting materials including an experimental calcium sulfate compound on periodontal ligament cells in vitro as a preliminary test towards the development of a more convenient and useful form of grafting material which could promote regeneration of periodontal tissue. Human periodontal ligament cells were collected from the premolar teeth extracted for orthodontic treatment. Cells were cultured in alpha-MEM culture medium containing 20% FBS, at 37degrees C and 100% humidity, in a 5% CO2 incubator. Cells were cultured into 96 well culture plate 1x104cells per well with alpha-MEM and incubated for 24 hours. After discarding the medium, those cells were cultured in alpha-MEM contained with 10% FBS alone(control group), in medcal-grade calcium sulfate(MGCS group), in plaster(plaster group), experimental calcium sulfate paste(CS paste group) for 1, 2, 3 day respectively. And then each group was characterized by examining of the cell counting, MTT assay, collagen synthesis. The results were as follows. 1. In the analysis of cell proliferation by cell counting, both medical-grade calcium sulfate group and plaster group showed no stastically significant difference at day 1, 2, 3 accept for plaster group at day 1 compared to control group, but there was stastically significant difference between CS paste group and all other groups at day 1, 2, 3(P<0.05). 2. In the analysis of cytotoxicity by MTT assay, both medical-grade calcium sulfate group and plaster group showed no stastically significant difference compared to control group at day 1, 2, 3 but there was stastically significant difference between CS paste group and all other groups at day 1, 2, 3(P<0.05). 3. In the analysis of collagen synthesis by immunoblotting assay, high level was detected for medical-grade calcium sulfate group and plaster group at day 1, 2, 3 compared to CS paste group. On the basis of these results, medical-grade calcium sulfate and plaster was shown to possess biocompatibility whereas the CS paste had unfavourable outcome. This observation shows a need for modification of the materials contained in calcium sulfate paste.
Bicuspid ; Calcium Sulfate* ; Calcium* ; Cell Count ; Cell Proliferation ; Collagen ; Humans ; Humidity ; Immunoblotting ; Incubators ; Membranes ; Periodontal Ligament* ; Regeneration ; Tooth ; Transplants

BACKGROUND: Surgical resection is a standard treatment for pulmonary metastases in patients with osteosarcoma, but the role of performing repeated resections is not clear. This study was designed to clarify the feasibility of performing a repeated pulmonary metastasectomy and the prognostic factors for pulmonary metastases in patients with osteosarcoma. MATERIAL AND METHOD: Between January 1990 and July 2005, 62 patients with osteosarcoma were diagnosed with pulmonary metastases and 36 patients underwent pulmonary resection. We reviewed the patients retrospectively. RESULT: The total number of pulmonary metastasectomies was 62 in 36 patients. Among 36 patients, 18 had a second metastasectomy, 7 had a third metastasectomy, and one patient had a fourth metastasectomy. There was no distinctive difference between the first and second metastatectomy in terms of median survival time, and the 3-year and 5-year survival rate (first resection: 20.5 months, 32.6% and 29.4%; second resection: 11.3 months, 34.9% and 34.%). However, the median survival time (7.1 months) was shorter in patients with a third metastatectomy than in patients with one metastatectomy (p=0.01). In long-term survivors, the number of female patients, patients with a disease free time longer than 12 months, patients with a single metastasis and patients with anatomic resection was larger when compared to non-long term survivors, but showed no statistical significance. CONCLUSION: Repeated pulmonary metastasectomy is expected to prolong survival time in patients with osteosarcoma, and is expected to increase long-term survival in selected cases. Further studies with a large number of patients are necessary.
Female ; Humans ; Lung Neoplasms ; Metastasectomy* ; Neoplasm Metastasis ; Osteosarcoma* ; Retrospective Studies ; Survival Rate ; Survivors

BACKGROUND: Combined spinal-epidural anesthesia has been used to reduce the side effect of spinal or epidural anesthesia. The epinephrine test dose to prevent intravascular injection of local anesthetics after subarachnoid block has not been clearly understood. The purpose of present study is to see the efficacy of simulated intravenous test dose during subarachnoid block. METHODS: 20 ASA physical status 1 and 2 patients underwent subarachnoid block with tetracaine 10 mg in hyperbaric solution at the L3-4 interspace and were divided into two groups, Group 1 (n=10) and Group 2 (n=10). 3 ml of Normal saline was injected intravenously to group 1, while 1:200,000 epinephrine 3 ml (15 microgram) was injected intravenously to group 2 at regression of sensory block to T8-10. 1:200,000 epinephrine 3 ml (15 microgram) was given to each volunteer (Group 3, n=10). Heart rate (HR) was measured at 15 seconds intervals for 3 minutes and systolic blood pressure (SBP) was measured at 1 minute intervals for 5 minutes. RESULTS: SBP increased significantly in group 2 and group 3 at 1 minute after epinephrine test dose injection. Maximal HR changes was 39.7 3.7 beat per minute in group 2 and 25.8 5.2 beat per minute in group 3. There was 100% incidence of detection of intravascular injection of 15 microgram epinephrine in both group when HR increase > or = 20 beats per minute is regarded as positive response. CONCLUSIONS: This study demonstrates that the epinephrine test dose is useful method to detect intravascular injection of local anesthetics either in the combined spinal-epidural anesthesia or epidural anesthesia. The heart rate response after injection of epinephrine was greater than the blood pressure response.
Adult* ; Anesthesia* ; Anesthesia, Epidural ; Anesthetics, Local ; Blood Pressure ; Epinephrine* ; Heart Rate ; Humans ; Incidence ; Tetracaine ; Volunteers

Rheumatic valvulitis produces at least three distinct pathologic changes, the degree varying widely among the patients: fusion of the valve leaflets at the commissures; fusion and shortening of chordae tendinae: and fibrosis of the leaflets with subsequent stiffening, contraction and calcification. The most extensive changes usually are seen in patients with recurrent attacks of rheumatic fever. We studied on outcome of the surgical treatments of rheumatic valvular diseases that have been experienced for 12 years since 1982 at Pusan National University Hospital. The diagnoses were made by rheumatic fever history, echocardiographic findings, gross operative findings and microscopic findings. Total 502 patients were performed surgery for valvular heart diseases and 440 patients of rheumatic origin have bene analysed. There were more female than male patients as 1.3:1, and the mean age was 37.8 years old. 96.3% of them affected to the mitral valve, 19.8% to aortic valve, 16.3% affected to the tricuspid valve. Most of them underwent valve replacement, and valve repair was done in 3.9% of patients. There were 36 hospital deaths (8.2%) mainly from low cardiac output syndrome, and 15 late deaths equally due to embolism and hemorrhage. Follow up was 90.1% completed (2890 patient-year). Linealized rates of late complication events are follows : thromboembolism 1.3% per patient year; anticoagulant related hemorrhage 0.8% per patient year. Overall actuarial survival including hospital mortality was 92.7+/-2.9% in 1 year, 88.0+/-4.5% in 5 year, 82.3+/-7.7% in 10 year. We conclude that the rheumatic disease is still the most frequent and the most important cause of heart valve disease. So more intensive study is needed in spite of the abrupt decreasing rate of rheumatic fever in U.S.A. and other industrial country.
Aortic Valve ; Busan ; Cardiac Output, Low ; Diagnosis ; Echocardiography ; Embolism ; Female ; Fibrosis ; Follow-Up Studies ; Heart Valve Diseases ; Heart Valves* ; Hemorrhage ; Hospital Mortality ; Humans ; Male ; Mitral Valve ; Rheumatic Diseases ; Rheumatic Fever ; Thromboembolism ; Tricuspid Valve

Cemento-ossifying fibromas are benign tumors, and, although cases of an aggressive type have been reported, no cases of cemento-ossifying fibroma transforming into osteosarcoma have been documented previously. Low-grade osteosarcoma is a rare type of primary bone tumor, representing 1%-2% of all osteosarcomas. A 45-year-old female patient was diagnosed with cemento-ossifying fibroma, treated with mass excision several times over a period of two years and eight months, and followed up. After biopsy gathered because of signs of recurrence, she was diagnosed with low-grade osteosarcoma. The patient underwent wide excision, segmental mandibulectomy, and reconstruction with fibula free flap. The aim of this report is to raise awareness of the possibility that cemento-ossifying fibroma can transform into osteosarcoma and of the consequent necessity for careful diagnosis and treatment planning.
Biopsy ; Diagnosis ; Female ; Fibroma* ; Fibula ; Free Tissue Flaps ; Humans ; Mandibular Osteotomy ; Middle Aged ; Osteosarcoma* ; Recurrence