No abstract available.
Blood Platelets* ; Humans ; Infant, Newborn*

Secondary cutaneous cryptococcosis may occur earlier than other manifestations of disseminated cryptococcosis. A 68-year-old woman presented with multiple ulcerative lesions on the right calf of 2 weeks duration. She had been treated with antibiotics, but the lesions spread rapidly. The initial clinical impression was necrotizing fasciitis, but routine KOH mounting from the ulcerative lesions showed numerous budding yeast cells with peripheral clear zones and further investigations including a skin biopsy, tissue cultures and India ink preparations allowed a rapid and definitive diagnosis of cutaneous cryptococcosis. Studies for other evidence of infection elsewhere revealed an asymptomatic pulmonary lesion. We report a case of secondary cutaneous cryptococcosis clinically mimicking necrotizing fasciitis that occured before other manifestations of disseminated cryptococcosis.
Aged ; Anti-Bacterial Agents ; Biopsy ; Cryptococcosis* ; Diagnosis ; Fasciitis, Necrotizing* ; Female ; Humans ; India ; Ink ; Saccharomycetales ; Skin ; Ulcer

No abstract available.
Cisplatin* ; Humans ; Nausea* ; Ondansetron* ; Vomiting*

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as pruritus, nausea, vomiting, and respiratory depression. The purpose of this study was to evaluate the analgesic efficacy and side effects of epidural morphine compared with epidural nalbuphine. METHODS: Fifty nine patients were randomly divided into 2 groups. For group M (n = 30), a bolus of 7 ml of saline and 2 mg of morphine were administered and for group N (n = 29), a bolus of 7 ml of saline and 4 mg of nalbuphine were administered. Continuous epidural analgesia was induced with morphine 4 mg, 0.5% bupivacaine 20 ml, 2% lidocaine 20 ml and normal saline 60 ml by a 2day infuser in group M, and with nalbuphine 20 mg, 0.5% bupivacaine 20 ml, 2% lidocaine 20 ml and normal saline 58 ml by a 2day infuser in group N. We compared the analgesic effect and side effects of the two groups for 48 hours. RESULTS: No significant hemodynamic changes were seen in any of the groups. The analgesic effects were good in the two groups (mean VAS < 3.0). The patients of group M had lower pain scores continually compared with group N and pain scores were statistically significant at 6, 12 and 24 hours. However, side effects occurred more frequently in group M. CONCLUSIONS: These results suggest that an adequate dosage of epidural morphine provides good analgesic effects and reduces the occurrence of side effects.
Analgesia, Epidural ; Bupivacaine ; Cesarean Section* ; Female ; Hemodynamics ; Humans ; Lidocaine ; Morphine* ; Nalbuphine* ; Nausea ; Pain, Postoperative ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Vomiting

No abstract available.
Pleura* ; Rhabdomyosarcoma*

This report describes two cases of complete heart block associated with acute myocarditis. Both cases developed Adams-Stokes attack. One patients was considered to be due to viral infection as judged by clinical course and the other patient was confirmed as Korean hemorrhagic fever by indirect immunofluorescent antibody test. Both cases improved during about 4 weeks admission without sequelae with general supportive treatment only.
Heart Block* ; Heart* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Myocarditis*

Among objectives of periodontal therapy, the principal one is the morphological and functional reconstruction of lost periodontal supporting tissues. This includes de novo formation of connective tissue attachment and the regrowth of alveolar bone. The use of enamel matrix derivative(EMD) may be a suitable means of regeneration new periodontal attachment in the infrabony defects. Implant used to replace lost tooth but, implantitis occurred after installation. The purpose of this study was to investigate the effects of EMD on differentiation and growth of osteoblast in titanium disc. Twentyfive millimeter diameter and 1mm thick Ti disc which was coated 25, 50, 100, 200microgram/ml of EMD(Emdogain(R)) used as experimental group, 25, 50, 100, 200ng/ml of rhBMP-2 as positive control group, and no coat as negative control group. A human osteosarcoma cell line Saos-2 was cultured in Ti disc and cell proliferation and Alkaline phosphatase (ALP) activity were measured at 1 and 6 days. PCR was performed at 2 and 8 hours. Semi-quantitative RT-PCR for mRNA expressions of various osteoblastic differentiation markers - type I collagen, ALP, osteopontin, and bone sialoprotein - were performed at appropriate concentrations based upon the results of MTT and ALP assay. Cultured cell-disc complexes were prepared for scanning electron microscopy (SEM) at 2 hour. Data were analyzed using Mann-Whitney and repeated- measures 1-way analysis of variance(SPSS software version 10,SPSS, Chicago, IL). After culture, there was more osteoblast in EMD100microgram/ml than in EMD50, 200microgram/ml on day 6. There was significant difference in experimental and positive control group compared control group, as times go by(1 and 6 days). Alkaline phosphatase activity was different significantly in EMD100, 200microgram/ml and BMP100, 200ng/ml on day 6. The results of reverse transcriptase-polymerase chain reaction (RT-PCR) showed that expression of mRNA for ALPase, collagen type I, osteopontin, bone sialoprotein and BMP-2 was detected at 2 hour and 8 hour in EMD200microgram/ml subgroup and BMP100ng/ml subgroup. The results of this study suggest that application of enamel matrix derivative on osteoblast attached to titanium surface facilitate the expression of bone specific protein and the differentiation and growth of osteoblast.
Humans

No abstract available.
Animals ; Dogs* ; Magnolia* ; Periodontitis*

Hydroxyapatite(HA) has been extensively used as bone graft materials and tooth implant surface coating materials because of its biocompatibility and osteoconductive properties. However, as HA is intrinsically poor in mechanical properties, zirconia(ZrO2) was incorporated with HA as reinforcing phases for improvement of mechanical properties. The purpose of this study was to investigate the biological activities of HA-coated zirconia through the cell proliferation test, measurements of alkaline phosphatase activity, and histologic examination. Four kinds of tested blocks were prepared according to the pore size (300-500micrometer/500-700micrometer) and the porosity (70%/90%). Cell proliferation and alkaline phosphatase activity was measured at 1, 7, 14 days. The number of cells proliferate after 7, 14 days were significantly increased in all groups when compared with that of the first day, but there was no significant difference between the 4 groups at each time period. At the 7 day, alkaline phosphatase activities of cells cultured in 4 groups were higher than that of the first day, but there was no significant difference between the 4 groups at each time period. The human gingival fibroblast and MG 63 cell was used to evaluate the cell cytotoxicity using MTT test. The materials tested in the current study turned out to be non-cytotoxic. In histologic examination(SEM), at 1 day there were many cells attached on the surfaces of all kinds of tested blocks. The number of cells were increased over time. At the 14 day, there were more cells proliferated than 1 day and some of the pores of blocks were partially filled with the proliferated cells. The in vitro response of osteoblast-like cells to the HA-coated zirconia showed comparable effect on transformation comparable to hydroxyapatite.
Alkaline Phosphatase ; Bone Regeneration ; Cell Proliferation ; Durapatite ; Fibroblasts ; Humans ; Porosity ; Tooth ; Transplants

BACKGROUND: In spite of the improvement in the quality of artificial heart valves and surgical techniques, the incidence of the complications following valve replacement is still high. We reviewed the clinical results of the valve replacements performed in Korean University Anam Hospital during the last 26 years. MATERIAL AND METHOD: The data of 571 patients who received valve replacement between December 1976 and December 2003 were reviewed. RESULT: There were 304 cases of MVR which was the most common procedure performed. There were 122 cases of AVR, and 111 cases of AVR with MVR. Among the 47 patients who received redo operation 38 cases were redo cases including 31 cases of MVR. 32.5% of the patients who had tissue valve replacement had second valve replacement with 10.2+/-3.9 years interval. 24.3% (139/571) of the patients developed valve related complications and cerebral infarction was the highest in frequency. Atrial fibrillation was related with increased complication rates and the mechanical valve replaced group had higher hemorrhagic complication rate than tissue valve replaced group. The operative mortality was 3.68% and the most common cause of the failure was low output syndrome. The operative mortality was higher in the patient group who had valve replacement before the year 1990. The patient group who had mechanical valve replacement had higher operative mortality rate than the tissue valve group. The 5-year survival rate was 92.2% and 10 year survival rate was 85.7%. CONCLUSION: The operative mortality of valve replacement has been improved. The mechnical valve replaced patients had higher hemorrhagic complication rate than the tissue valve replaced patients and more tissue valve replaced patients received redo valve replacement.
Atrial Fibrillation ; Cerebral Infarction ; Heart Valve Diseases ; Heart Valves* ; Heart* ; Heart, Artificial ; Humans ; Incidence ; Mortality ; Survival Rate