Impetigo herpetiformis is a rare pustular eruption that may be seen in late pregnancy. It is associated with severe maternal and fetal complications in case of misdiagnosis and delayed treatment. The patient was a 25-years-old multigravida with psoriasis in her past history. At 20weeks gestation, she had been developed erythematous scaly annular patchs with papules and pustules on inner thigh. At 37weeks' gestation, the patient was suffered from a severely pruritic pustular rash with fever and leukocytosis. The skin of the affected areas was biopsied and showed intraepidermal pustular abscess with a neutrophilic infiltrate. Treatment commenced with intravenous fluids, antibiotics, systemic prednisone, steroid creams, and phototherapy(UVB) under the careful fetal well being monitoring. Cesarean section was done due to fetal distress, and a normal healthy male infant was delivered, following which the patient's condition improved rapidly.
Abscess ; Anti-Bacterial Agents ; Cesarean Section ; Diagnostic Errors ; Exanthema ; Female ; Fetal Distress ; Fever ; Humans ; Impetigo* ; Infant ; Leukocytosis ; Male ; Neutrophils ; Prednisone ; Pregnancy* ; Psoriasis ; Skin ; Thigh

PURPOSE: Pelvic actinomycosis is a rare infection which presents difficulty in establishing a correct preoperative diagnosis. The aim of this study is to find diagnostic clues for pelvic actinomycosis preoperatively. METHODS: A retrospective analysis performed at Chonbuk National University Hospital identified 9 patients with a diagnosis of pelvic actinomycosis from 1998 to 2006. RESULTS: All patients were women with a history of intrauterine device (IUD) use. Abdominal pain (7 cases), palpable mass (3 cases), defecation difficulty (3 cases) and leucorrhea (2 cases) were the main presenting complaints. The median duration of presenting symptoms was 78 days (range: 10~365 days). The median duration of using an IUD unchanged was 11 years (range: 4~30 years). A correct diagnosis was made in 3 patients (33%) without exploration. All patients were treated with antibiotics after pathologic diagnosis. There was no recurrence. CONCLUSIONS: It is very difficult to diagnose pelvic actinomycosis preoperatively. Howere, if a mass or a pelvic abscess is found in women with an IUD that has been unchanged for a long time, pelvic actinomycosis should be suspected to avoid unnecessary exploration.
Abdominal Pain ; Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Defecation ; Diagnosis ; Female ; Humans ; Intrauterine Devices ; Jeollabuk-do ; Recurrence ; Retrospective Studies

PURPOSE: To evaluate the clinical features of neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy and the effect of Ahmed valve implantation. METHODS: The medical records of 217 eyes of 178 patients who had undergone pars plana vitrectomy for proliferative diabetic retinopathy were reviewed. The clinical data on preoperative, intraoperative, and postoperative factors of these patients were compared with that of those who developed neovascular glaucoma (20 eyes of 18 patients) after vitrectomy. The effect and complications of Ahmed valve implantation were also reviewed. RESULTS: The type 1 diabetes, the presence of NVD, grade of NVE, grade of preoperative PRP, presence of postoperative vitreous hemorrhage, and postoperative tractional retinal detachment were significantly correlated with the development of neovascular glaucoma. Ahmed valve implantation in these patients was effective in controlling intraocular pressure and improving visual acuity. Complications of the Ahmed valve implantation were hyphema, tube exposure, recurrent vitreous hemorrhage, hypotony, and choroidal effusion. CONCLUSIONS: The risk factors for the development of neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy were evaluated. Ahmed valve implantation in these patients is considered an effective treatment for controlling intraocular pressure.
Choroid ; Diabetic Retinopathy* ; Glaucoma, Neovascular* ; Humans ; Hyphema ; Intraocular Pressure ; Medical Records ; Retinal Detachment ; Risk Factors ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Primary tumors of the heart are uncommon lesions that can mimic almost any type of cardiac disease. Over 90 per cent of myxoma which are the most common cardiac tumor occur in the atria, with 3 to 4 times as many occuring on the left as on the right. The development of nonivasive echocardiographic technique has made it possible to screen large numbers of patients with atrial myxoma with ease and safe. A 28 year old housewife was admitted because of dyspnea for 5 months. Clinical diagnosis of right atrial myxoma was made by echocardiography and right atrial angiocardiogram. Surgical resection was performed successfully. We presented a case of right atrial myxoma with a review of literatures.
Adult ; Diagnosis ; Dyspnea ; Echocardiography ; Heart ; Heart Diseases ; Heart Neoplasms ; Humans ; Myxoma*

STATEMENT OF PROBLEM: The screws of dental implant, having various thread types, can be categorized into different classes by their geometrical form, and each type transmits dissimilar amount and form of stress to alveolar bone. PURPOSE: The purpose of this study was to find an inclination angle of the screw thread that is favorable in distributing the stresses to alveolar bone. MATERIAL AND METHODS: In this study, We used three dimensional finite element analysis with modeling having three types of thread inclination angles and fixed pitch-0.8 mm (single thread type with 3.8 degrees inclination, double thread type with 7.7 degrees inclination, triple thread type with 11.5 degrees inclination). RESULTS: The results obtained from this study were as follows; 1. When the number of thread increased, the amount of Von-Mises stress was reduced since the generated stress was effectively distributed. 2. Since the maximum principal stress affects on the alveolar bone can influence deeply on the longevity of the implants when comparing the magnitude of the maximum principal stress double thread had least amount of stress. This shows that the double thread screw gave best result. CONCLUSION: In conclusion, double, and triple thread screws were found to be more effective on distribution of the stress than the single thread screws. But, increasing in the thread inclination angle such as triple thread screw relate on the magnitude of the maximum principal stress affecting on the alveolar bone can become problematic. Thus, effective combination of thread number and thread inclination angle can help prolonging the longevity of implant.
Dental Implants ; Finite Element Analysis* ; Longevity

Ovarian remnant syndrome is a rare condition which develops when functional ovarian tissue is left in situ after intended bilateral oophorectomy. It produces clinically significant syndrome, namely chronic pelvic pain and dysmenorrhea. Although the true incidence of this syndrome is unknown, an apprant increase in incidence has been reported. We have experienced a case of ovarian remnant syndrome showing chronic pelvic pain and palpable abdominal mass after difficult gynecologic operation. So, we report this case with a brief review of literatures.
Dysmenorrhea ; Female ; Incidence ; Ovariectomy ; Pelvic Pain

PURPOSE: The biocompatibility and bio-adhesive property of a dental implant abutment are important for proper soft tissue healing and maintenance of osseointegration of implant. However, studies of soft tissue healing and mucosal attachment of various materials of implant abutment other than titanium are still needed. In this study, cell attachment, proliferation, cytotoxicity of human gingival fibroblast for ceramic, gold alloy, Ni-Cr alloy and, commercially available pure titanium as a control were evaluated, using MTS and scanning electron microscopy. MATERIALS AND METHODS: Specimen was designed to disc, 4mm diameter and 1mm thickness, made of ceramic, gold alloy, Ni-Cr alloy and commercially available pure titanium. Primary culture of human gingival fibroblasts were grown in Dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. Cells were inoculated in the multiwell plates placed the specimen disc. Cell Titer 96 AQucous One Solution Cell Proliferation Assay were done after 1hour, 3hours, 24hours, 3days, 5days of incubation. The discs were processed for scanning electron micrography to evaluate cell attachment and morphologic change. RESULTS: The results were obtained as follows. 1. The ceramic showed high cell attachment and proliferation and low cytotoxicity, which is as much bioadhesive and biocompatible as titanium. 2. The gold alloy represented limited proliferation of human gingival fibroblast and the highest cytotoxicity among tested materials (p<0.05). 3. The Ni-Cr alloy limited the proliferaion of the human gingival fibroblast compared to titanium(p<0.05), but cytotoxicity on the bottom of well was not so considerable, compared to titanium. 4. On the scanning electron micrographs, the ceramic showed good attachment and proliferation of human gingival fibroblast, which was similar to titanium. But gold alloy and Ni-Cr alloy showed the shrinkage of gingival fibroblast both after 24 hours and 3 days. On 5th day, small amount of the human gingival fibroblast proliferation was observed on the Ni-Cr alloy, while the shrinkage of gingival fibroblast was still observed on the gold alloy. CONCLUSIONS: These results suggest that the ceramic abutment is as biocompatible as titanium to make proper mucosal seal. The gold alloy has a high cytotoxicity to limit proliferation of gingival fibroblast, which suggest limited use on the anterior tooth where soft tissue healing is recommeded.
Alloys ; Anti-Bacterial Agents ; Cell Proliferation ; Ceramics ; Dental Implants ; Fibroblasts* ; Humans* ; Microscopy, Electron, Scanning ; Osseointegration ; Titanium ; Tooth

PURPOSE: The biocompatibility and bio-adhesive property of a dental implant abutment are important for proper soft tissue healing and maintenance of osseointegration of implant. However, studies of soft tissue healing and mucosal attachment of various materials of implant abutment other than titanium are still needed. In this study, cell attachment, proliferation, cytotoxicity of human gingival fibroblast for ceramic, gold alloy, Ni-Cr alloy and, commercially available pure titanium as a control were evaluated, using MTS and scanning electron microscopy. MATERIALS AND METHODS: Specimen was designed to disc, 4mm diameter and 1mm thickness, made of ceramic, gold alloy, Ni-Cr alloy and commercially available pure titanium. Primary culture of human gingival fibroblasts were grown in Dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. Cells were inoculated in the multiwell plates placed the specimen disc. Cell Titer 96 AQucous One Solution Cell Proliferation Assay were done after 1hour, 3hours, 24hours, 3days, 5days of incubation. The discs were processed for scanning electron micrography to evaluate cell attachment and morphologic change. RESULTS: The results were obtained as follows. 1. The ceramic showed high cell attachment and proliferation and low cytotoxicity, which is as much bioadhesive and biocompatible as titanium. 2. The gold alloy represented limited proliferation of human gingival fibroblast and the highest cytotoxicity among tested materials (p<0.05). 3. The Ni-Cr alloy limited the proliferaion of the human gingival fibroblast compared to titanium(p<0.05), but cytotoxicity on the bottom of well was not so considerable, compared to titanium. 4. On the scanning electron micrographs, the ceramic showed good attachment and proliferation of human gingival fibroblast, which was similar to titanium. But gold alloy and Ni-Cr alloy showed the shrinkage of gingival fibroblast both after 24 hours and 3 days. On 5th day, small amount of the human gingival fibroblast proliferation was observed on the Ni-Cr alloy, while the shrinkage of gingival fibroblast was still observed on the gold alloy. CONCLUSIONS: These results suggest that the ceramic abutment is as biocompatible as titanium to make proper mucosal seal. The gold alloy has a high cytotoxicity to limit proliferation of gingival fibroblast, which suggest limited use on the anterior tooth where soft tissue healing is recommeded.
Alloys ; Anti-Bacterial Agents ; Cell Proliferation ; Ceramics ; Dental Implants ; Fibroblasts* ; Humans* ; Microscopy, Electron, Scanning ; Osseointegration ; Titanium ; Tooth

PURPOSE: The reflux of pancreatic enzymes into the biliary tract is associated with chronic inflammation and increases cellular proliferation of the biliary epithelium, leading to biliary carcinoma. The aim of this study is to detect the incidence of occult pancreaticobiliary reflux (OPBR) in patients who underwent elective cholecystectomy. METHODS: Forty-seven patients with symptomatic gallstones who underwent cholecystectomy were recruited for this study. The gallbladder bile samples were obtained from the specimen of gallbladder and the amylase level was measured. The immunohistochemistry of p53, SMAD4 and Ki-67 were performed for the detection of metaplasia and dysplasia. RESULTS: Biliary amylase was higher than the serum amylase in 10 patients (group A, 15,402.66 +/- 33,592.43 IU/L; group B, 13.06 +/- 18.12 IU/L). The mean age was 67.2 years in group A and 51.2 in group B (P < 0.01). The ratio of male to female was 1:2.3 and 1:1.8 in group A and B, respectively (P = 0.297). Eight patients in group A and thirteen patients in group B had inflammation (P = 0.014). The positive results of the Ki-67 test were exhibited in five cases in each group (P = 0.024). CONCLUSION: Results from the study indicate that the age was older, degree of inflammation and positive rate of Ki-67 were higher when OPBR was suspected. In conclusion, the patients with OPBR would need long-term follow-up, because the OPBR can cause dysplasia and the reflux of pancreatic juice may be considered as a risk factor for extrahepatic bile duct carcinoma.
Adult ; Amylases ; Bile ; Bile Ducts, Extrahepatic ; Biliary Tract ; Cell Proliferation ; Cholecystectomy ; Epithelium ; Female ; Gallbladder ; Gallstones ; Humans ; Immunohistochemistry ; Incidence ; Inflammation ; Ki-67 Antigen ; Male ; Metaplasia ; Pancreatic Juice ; Risk Factors

STATEMENT OF PROBLEM: Titanium has many advantages of high biocompatibility, physical properties, low-weight, low price and radiolucency, but it is incompatible with conventional dental porcelain due to titanium's oxidative nature. Many previous studies have shown that they used the method of sandblast for surface treatment prior to porcelain application, the researches are processing about the method of acid etching or surface coating. PURPOSE: The purpose of this research is to study the effect on bond strength of surface roughness between titanium and porcelain with the same surface topography. MATERIAL AND METHOD: In this study, we evaluated the bond strength by using 3-point bending test based on ISO 9693 after classified 8 groups - group P : polished with #1200 grit SiC paper, group S10 : 1.0 micrometer surface roughness with sandblasting, group S15 : 1.5 micrometer surface roughness with sandblasting, group S20 : 2.0 micrometer surface roughness with sandblasting, group S25 : 2.5 micrometer surface roughness with sandblasting, group S30 : 3.0 micrometer surface roughness with sandblasting, group S35 : 3.5 micrometer surface roughness with sandblasting, group E : 1.0 micrometer surface roughness with HCl etching. RESULTS: Within the confines of our research, the following results can be deduced. 1. In the results of 3-point bending test, the bond strength of sandblasting group showed significant differences from one of polishing group, acid etching group(P<.05). 2. The bond strength of sandblasting groups did not show significant differences. 3. After surface treatments, the group treated with sandblasting showed irregular aspect formed many undercuts, in the SEM photographs. The bond strength of sandblasting group was higher than 25 MPa, the requirement of ISO 9693. CONCLUSION: In above results, bond strength of titanium and low-fusing porcelain is influenced more to surface aspect than surface roughness. And titanium has clinically acceptable bond strength below surface roughness of 3.5 micrometer.
Dental Porcelain ; Titanium