Platelet-derived growth factor(PDGF) and lipopolysaccharide(LPS) may be the important regualtors of bone metabolism. Exogenous PDGF is recognized to have a stimulating effect on bone resorption in organ culture, but to stimulate the formation of new bone ultimately. LPS is known to be a stimulating agent on the osteoclastic activity. The purpose of this study was to evaluate the effects and the interaction of PDGF and LPS on periodontal ligament(PDL) cells which have important roles in bone remodeling. Cultured human periodontal ligament cells were treated with various concentration of PDGF and/or LPS. The cellular viability was measured by Microtitration(MTT) assay according to the lapse time of culture. The obtained results were as follows: 1. The viability of PDL cells was not different from the control in O.lng/ml of PDGF, but was significantly increased to be over the level of control in lng/ml of PDGF at the second day of culture, and in lOng/ml of PDGF at the second and the third day of culture. 2. The cellular viability was decreased in O.5microgram/ml or 5microgram/ml of LPS at the third day of culture. 3. Incubation with both 1ng/ml or 10ng/ml of PDGF and 0.5microgram/ml or 5microgram/ml of LPS resulted in the increased cellular viability at the third day, which. was greater than LPS only treated group. It was greater than even the control group in lOng/ml of PDGF. From the above findings, we could summarize that the admixture of PDGF and LPS could not less increase the viability of the human periodontal ligament cells than PDGF only.
Bone Remodeling ; Bone Resorption ; Humans* ; Metabolism ; Organ Culture Techniques ; Osteoclasts ; Periodontal Ligament*

The avulsion fracture of calcaneal apophysis by Achilles tendon in children is quite rare. It may occur with the injury of the apophysis on the calcaneal tuberosity in the children below the age of 12 to 15 before the union of the apophysis. The authors surgically treated a 14-year-old gymnast with the avulsion fracture of the calcaneal tuberosity who injured at the landing of the floor exercise. Radiographs at the fourteen months of follow-up showed slight irregularity of the calcaneal tuberosity but there were no pain or limitation of activity. We report a case with the review of literatures.
Achilles Tendon ; Adolescent ; Calcaneus ; Child ; Floors and Floorcoverings ; Follow-Up Studies ; Humans

BACKGROUND: The role of ultrasound in the thoracic spine has been underappreciated, partly because of the relative efficacy of the landmark-guided technique and the limitation of imaging through the narrow acoustic windows produced by the bony framework of thoracic spine. The aim of this study was to make a comparison between the 12th rib and the spinous process of C7 as a landmark for effective ultrasound-guided target segment identification in the thoracic spine. METHODS: Ultrasonography of 44 thoracic spines was performed and the same procedure was carried out 1 week later again. The target segments (T3–4, T7–8, and T10–11) were identified using the 12th rib (group 1) or the spinous process of C7 (group 2) as a starting landmark. Ultrasound scanning was done proximally (group 1) or distally (group 2) toward the target transverse process and further medially and slightly superior to the target thoracic facet. Then, a metal marker was placed on the T3–4, T7–8, and T10–11 and the location of each marker was confirmed by fluoroscopy. RESULTS: In the total 132 segments, sonographic identification was confirmed to be successful with fluoroscopy in 84.1% in group 1 and 56.8% in group 2. Group 1 had a greater success rate in ultrasound-guided target segment identification than group 2 (p = 0.001), especially in T10–11 (group 1, 93.2%; group 2, 43.2%; p = 0.001) and T7–8 (group 1, 86.4%; group 2, 56.8%; p = 0.002). The intrarater reliability of ultrasound-guided target segment identification was good (group 1, r = 0.76; group 2, r = 0.82), showing no difference between right and left sides. Ultrasound-guided target segment identification was more effective in the non-obese subjects (p = 0.001), especially in group 1. CONCLUSIONS: Ultrasound-guided detection using the 12th rib as a starting landmark for scanning could be a promising technique for successful target segment identification in the thoracic spine.
Acoustics ; Fluoroscopy* ; Nerve Block ; Ribs ; Spine* ; Ultrasonography

PURPOSE: We investigated if there are some differences in characteristic of recent renal infection from the past one and evaluated the need of ultrasonography in acute renal infection and the efficiency of antibiotics that have been used primarily in treatment of past renal infection. MATERIALS AND METHODS: We reviewed charts of 232 patients with acute renal infection retrospectively, who took admission treatment from 1991 to 1995 at our hospital. The laboratory tests such as complete blood count, urinalysis and urine culture with sensitivity and radiologic evaluations such as abdominal ultrasonography, excretory urography or voiding cystourethrography were performed. RESULTS: The most common age groups were 3rd decade(26.7%) and 4th decade(24.1%). Female was predominant in all age groups(M:F=1:8.7) except 1st decade(M:F=1.6:1). Acute pyelonephritis was the most common disease (87.1%) and then followed by acute focal bacterial nephritis(8.2%), renal abscess(4.3%) and perirenal abscess(0.4%). Five cases(2.2%) were accompanied by vesicoureteral reflux. Abdominal ultrasonography was done in 90.5%, but 74.8% of them were completely normal and most of abnormal findings at abdominal ultrasonography were clinically insignificant. Result of ultrasonography did not affect the outcome of the disease or the treatment plan. The significant bacterial isolation(more than 10(5)CFU/ml) in urine culture was 46.6%. Among them, E. coli was the most common organism(92.6%) and others were Enterobacter, Klebsiella or Pseudomonas. Causative agents were resistant to some drugs such as ampicillin or bactrim which have been usually used for urinary tract infection. CONCLUSIONS: Routine ultrasonography in renal infections without urinary tract obstruction was not helpful in treatment plan or outcome of this disease and selection of antibiotics in treatment of recent renal infection should be changed from the past one.
Ampicillin ; Anti-Bacterial Agents ; Blood Cell Count ; Enterobacter ; Female ; Humans ; Klebsiella ; Pseudomonas ; Pyelonephritis ; Retrospective Studies ; Trimethoprim, Sulfamethoxazole Drug Combination ; Ultrasonography* ; Urinalysis ; Urinary Tract ; Urinary Tract Infections ; Urography ; Vesico-Ureteral Reflux

BACKGROUND: North Korea's economic and public health problems began in the early 1990s as a result of the gradual loss of economic support from its communist allies, combined with an inordinate number of natural disasters. The decline in public health has increased the incidence of tuberculosis in North Koreans and refugees. This study investigated tuberculosis situation in North Korean refugees in order to prepare for the future impact of tuberculosis control in Korea. MATERIAL AND METHODS: From 2001 to 2005, tuberculosis patients among North Korean refugees who were diagnosed before or after arriving in South Korea, based on the official records of OO hospital, were enrolled in this study. The demographic and clinical data of the cases were evaluated retrospectively. RESULTS: A total of 42 TB cases were reviewed during the study period. Of these, 37 (88.1%) cases were pulmonary TB. based on the cases identified among the number of North Korean refugees' arriving each year, the annual incidence of pulmonary TB were 900 per 100,000 in 2004, 700 in 2003, The number of smear-positive patients was 20 (47.6%) and the number of culture-positive patients was 18 (42.9%). Of the M. tuberculosis isolates, 2 cases were found to be susceptible to all anti-TB drugs available, 4 were resistant to isoniazid, and 3 were multi-drug resistant. CONCLUSION: The prevalence of pulmonary TB in North Korean Refugees is high. In addition, North Korean refugees suffer from more severe tuberculosis in bacteriological and radiological aspects.
Disasters ; Humans ; Incidence ; Isoniazid ; Korea ; Prevalence ; Public Health ; Refugees* ; Retrospective Studies ; Tuberculosis*

Intramedullary spinal cord metastases occurring from any malignant tumor are usually accompanied by frequent metastases in the intracranium. The clinical features of this disease have been described as the rapid progression of neurologic deficit that can lead to complete paraplegia. In this case, the authors treated a 76-year-old woman, who was diagnosed with an intramedullary spinal cord metastasis arising from a small cell lung cancer without an invasion of the brain, with decompressive surgery and posterior instrumentation. The patient suffered from weakness of her legs, walking difficulties, and urinary and fecal incontinence. Her preoperative neurologic symptoms were improved significantly after surgery. The patient did not want to have further treatment for the primary cancer, and she died from pneumonia caused by aggravation of the underlying disease 3 months after surgery. We report this rare case, which was diagnosed as a metastasis of a small cell lung cancer postoperatively, with a review of the relevant literature.
Aged ; Brain ; Fecal Incontinence ; Female ; Humans ; Leg ; Neoplasm Metastasis ; Neurologic Manifestations ; Paraplegia ; Pneumonia ; Small Cell Lung Carcinoma ; Spinal Cord ; Walking

BACKGROUND AND OBJECTIVES: We carried out an acoustic analysis to investigate the phonatory characteristics of patients undergoing short-term endotracheal intubation with or without thyroidectomy, and who had no nerve injury. MATERIALS AND METHODS: The patients were divided into two groups, one undergoing thyroidectomy (39 cases) and the other not undergoing thyroidectomy (25 cases). All patients of the thyroidectomy group had undergone thyroidectomy using general anesthesia with endotracheal intubation. All patients of the other group had undergone chronic ear surgery with the same anesthetic method and duration. For the evaluation of voice, preoperative and postoperative acoustic analyses were done. RESULTS: On the acoustic analysis of thyroidectomy group, jitter, shimmer and the vocal range were significantly increased at one day after thyroidectomy. But one month after thyroidectomy, these changes return to statistically insignificant increments, except for shimmer and the vocal range. These acoustical changes were not related to the extent of surgery between total thyroidectomy and hemithyroidectomy. In comparison with acoustical changes after short-term endotracheal intubation, the change of jitter and shimmer of thyroidectomy group did differ significantly. CONCLUSION: Voice alteration after thyroidectomy without nerve injury may be associated with the disturbance of the prelaryngeal musculature. This voice changes emphasize the importance of the extralaryngeal skeleton for pitch control and early intensive speech therapy, especially in patients who need their voice professionally.
Acoustics* ; Anesthesia, General ; Ear ; Humans ; Intubation, Intratracheal* ; Skeleton ; Speech Therapy ; Thyroidectomy* ; Voice

BACKGROUND AND OBJECTIVES: Supraglottic laryngectomy is a well established technique for the treatment of appropriate carcinoma of supraglottic larynx. The purpose of this study was to determine factors that may contribute to postoperative aspiration related to deglutition problem following supraglottic laryngectomy. MATERIALS AND METHOD: A retrospective analysis of medical records of 19 patients who consecutively underwent supraglottic laryngectomy was undertaken. Contribution of the following factors was investigated: age, T stage, pack-years of smoking, and parameters of pulmonary function test. The authors used a computerized acoustic analysis program (CSL-MDVP) to measure fundamental frequency, jitter, shimmer, and noise to harmonics ratio. RESULTS: Eleven patients had no problem, 5 patients had clinically insignificant problem, and 3 patients had moderate problem in postoperative 6 months. A greater number of pack-years of smoking and decreasing FEV1/FVC were significantly correlated with poor outcome with regards to postoperative aspiration and deglutition problem. No statistically significant difference was seen between patients with supraglottic laryngectomy and the control group. CONCLUSION: This study showed that less than 60% FEV1/FVC signifies a greater risk for postoperative aspiration.
Acoustics ; Deglutition ; Forced Expiratory Volume ; Humans ; Laryngectomy* ; Larynx ; Medical Records ; Noise ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking ; Vital Capacity ; Voice

OBJECTIVE: The aim of this study was to identify the expression of nitric oxide synthases (NOS) in the mandibular condyle during mandible advancement by functional appliance and to correlate it with the histologic changes and bone remodeling. METHODS: Twenty-four female, 35-day-old Sprague-Dawley rats were randomly divided into 3 experimental groups. In all experimental groups, the mandibles of the rats were kept in a continuous forward position with a fixed bite jumping appliance. The rats were sacrificed on the 3rd, 14th, and 30th days of experiment. More than 2 rats in each group were used for staining. RESULTS: There were no remarkable histologic changes and NOS expression differences in the control group. The most prominent histologic changes occurred in the 14th day experimental group. NOS decreased in the 30th day experimental group. There was increased expression of NOS2 and NOS3 in all experimental groups, comparative to the control group. In all the experimental groups and control group, the expression of NOS2 was greater than that of NOS3. CONCLUSIONS: It is postulated that NOS2 and NOS3 in the mandibular condyle might play an important role in bone remodelling of the mandibular condyle.
Animals ; Bites and Stings ; Bone Remodeling ; Female ; Humans ; Mandible ; Mandibular Condyle ; Nitric Oxide ; Rats ; Rats, Sprague-Dawley

PURPOSE: The purpose of the present study was to evaluate and analyze the clinical outcomes of the percutaneous repair of acute achilles tendon ruptures. MATERIALS AND METHODS: We performed a retrospective study on 14 patients with acute closed rupture of the Achilles tendon and they were managed with percutaneous repair from Jan. 2006 to Jun. 2007. The clinical outcomes were analyzed according to the causes of the injury and the postoperative functional performances. RESULTS: All the cases showed good or excellent outcomes, according to the Arner-Lindholm scale for the evaluation of acute Achilles tendon rupture. The average AOFAS score was 95.6 (range: 91-100). Nine patients were very satisfied and five patients were satisfied. They were satisfied especially because of the minimal postoperative scar. Two cases of sural nerve injury were reported as complications, and these cases fully recovered at postoperative three months. No evidence of surgical wound infection, necrosis of the wound or rerupture of the tendon was seen. CONCLUSION: The percutaneous repair of acute Achilles tendon rupture achieved high functional outcomes, a successful return to previous work and high satisfaction, with a relatively low incidence of complications.
Achilles Tendon ; Cicatrix ; Humans ; Incidence ; Necrosis ; Organic Chemicals ; Retrospective Studies ; Rupture ; Sural Nerve ; Surgical Wound Infection ; Tendons