Ilizarov technique has been successfully applied to limb lengthening for several decade, one of its main drawback is, however, long application of external fixator over 6 months. To lessen this time, simultaneous intramedullary fixation which convert later to static fixation by insertion of interlocking screws has been proposed. The indication for surgical limb lengthening includes familial short stature below the 3rd percentile. We compared the results of thirteen tibial lengthening with Ilizarov method to that of eleven hybrid methods. The hybrid system is composed of an unreamed AO intramedullary nail (IM) and ring fixator. Once the lengthening is completed, distal interlocking screws were inserted. In the group who were treated by hybrid system, the mean lengthening of tibia was 7.1cm (range, 6.3-9.5), the mean of external fixation period 7 months (range, 5-9), the mean healing index 1.2 month/cm (range, 1.1-1.4). On the other hand, the mean lengthening of tibia was 7.5cm (range, 5-10.3), the mean of external fixation period 9.8 months (range, 6-15), the mean healing index 1.4 month/cm (range, 1.1-1.8) in the group treated by Ilizarov method. Mean follow-up period was 23 months (range 14-47). There was no rotational or angular deformities and no loss of lengthening in the hybrid group. However we experienced three cases of angular deformity at the distraction site during lengthening in Ilizarov group. There was no deep infection in both groups. In the hybrid group we found several advantages such as no deformity, no loss of lengthening, and less scar by early removal of fixator, but some disadvantages such as need of subsequent procedures and limitation in intramedullary nailing.
Cicatrix ; Congenital Abnormalities ; External Fixators ; Extremities ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Hand ; Ilizarov Technique* ; Tibia

This investigation evaluated the fracture toughness (KIC) of eight currently available core materials, and relate the fracture toughness value to fractography analysis and surface characteristics using a atomic force microscope (AFM). Single-edge notched (SEN) test specimens (n=10) and compact tension (CT) test specimens (n=10) were prepared conforming to the ASTM Standard E-399 for a high copper amalgam, three composite core materials (Core-Max II, Core Paste, Bisfil Core), two reinforced composite core materials (Ti-Core, Ti-Core Natural), a resin-modified glass ionomer core material (Vitremer), and a conventional glass ionomer core material (Ketac-Molar). The specimens were tested with an Instron Universal Testing Machine. The maximum loads were measured to calculate the fracture toughness (KIC). Thereafter, fracture surfaces of SEN specimens of each material were investigated for fractography analysis using scanning electron microscope. And, disc-shaped specimens with 1mm thickness were fabricated for each material and were investigated under AFM for surface morphology analysis. The results were as follows : 1. Bisfil Core showed the highest mean fracture toughness regardless of test methods. 2. For the tooth-colored materials, Ti-Core Natural exhibited the highest fracture toughness. 3. Ketac Molar showed a significantly low fracture toughness when compared with the amalgam and the composite resin core materials (p<0.05). 4. The fracture toughness values obtained with the single-edge notched test, except Ketac Molar, were higher than those obtained in the compact tension test. 5. SEM revealed that the fracture surface of high fracture toughness material was rougher than that of low fracture toughness material. 6. AFM revealed that the surface particles of the composite resins were smaller in size, with a lower surface roughness than the glass ionomer core materials.
Composite Resins ; Copper ; Glass ; Molar

No abstract available.
Behavior Therapy* ; Self-Injurious Behavior*

Degenerative and regnerative changes are occurred in the dorsal root ganglion (DRG) cells after the peripheral nerve injury. This experiment aimed to study the changes of neurotrophic factors and their receptors mRNA expressions in the regenerating sensory neurons after nerve crush injury. To study the regenration process of DRG neurons, the peripheral nerve was crushed rather than transection. mRNA expression was examined by in situ hybridization with oligonucleotide probes to nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT-3), nerve growth factor receptor (NGFR), trkA, trkB and trkC. The results are as following: 1. After the peripheral nerve crush injury, the number of NGF and BDNF mRNA containing neurons are increased for 5 weeks with peak at 1 day and 3 days, respectively. NGFR mRNA containing neurons are transiently decreased during several days after the lesion but return to normal within 1 week. 2. The number of trkA and trkB mRNA containing neurons are not altered by nerve crush. 3. NT-3 and trkC mRNA containing neurons are not observed in the control and lesioned DRG. This study provides the morphological evidences of neurotrophins and their receptors mRNAs changes in the DRG neurons in response to crush nerve injury.
Animals ; Brain-Derived Neurotrophic Factor ; Diagnosis-Related Groups ; Ganglia, Spinal* ; In Situ Hybridization ; Nerve Crush ; Nerve Growth Factor ; Nerve Growth Factors* ; Neurons ; Neurotrophin 3 ; Oligonucleotide Probes ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; RNA, Messenger* ; Sensory Receptor Cells ; Spinal Nerve Roots*

Purpose: This study was conducted to examine the effects of an educational program based on mobile SMS and counseling for colonoscopy in elderly people. Methods: The study utilized a non-equivalent control group with a non-synchronized design as a quasiexperimental research. The study subjects consisted of 72 elderly people (36 elderly people in the experimental group and 36 in the control group). Among the subjects, 49 were male (68.1%) and 23 were female (31.9%), and the age was 69.04± 6.14 years. Fortyfive subjects (62.5%) answered that they had underlying diseases, eight subjects (11.1%) had a family history of colon disease, and 61 subjects (84.7%) had undergone a colonoscopy. The experimental group was provided with an educational program based on mobile SMS and counseling when three days and one day before the test. The control group received verbal explanations using information sheet. The data were analyzed using descriptive statistics, the Chi-squares test, and the independent t-test with SPSS/WIN 21.0. Results Significant differences were found in bowel cleanliness scores (t= 3.60, p= .003) between the groups. No significant differences were seen between the groups in the sedation drug dosage (propofol (t= 1.02, p= .730), midazolam (t= 0.66, p= .380)) and time for colonoscopy (t= 1.08, p= .235). Conclusion: Based on the results of this study, an educational program based on mobile SMS and counseling for colonoscopy was proposed as an educational program before colonoscopy.

PURPOSE: Intimal hyperplasia is a pathologic condition that is commonly observed with the atherosclerotic change of blood vessels; this condition is usually observed after arterial operation and interventions such as angioplasty, endaterectomy and bypass grafting, and it remains a major cause for hindering for arterial patency. It is a multiple processes that includes smooth muscle cell migration, proliferation, and expression of extracellular matrix proteins, such as fibronectin. Nitric oxide (NO) has been found to possess many different vasoprotective properties: inhibition of platelet aggregation and adherence, inhibition of leukocyte chemotaxis, inhibition of vascular smooth muscle cell proliferation and migration, inhibition of endothelial cell apoptosis and stimulation of endothelial cell growth. Overexpression of nitric oxide synthase (NOS) in the vascular wall has been used to regulate vasomotor function, prevent neointimal formation after balloon injury or vein grafting, and to prevent transplant vasculopathy. NOS gene transfer to the vascular wall holds great promise as a means of controlling local vascular function. METHOD: We investigated whether the inducible NOS (iNOS) gene transfer to the arterial wall has an inhibitory effect on intimal hyperplasia after endothelial denudation and on the change of the level of extracellular matrix fibronectin expression in the rabbit common carotid artery. Rabbits were divided into three groups: the saline only (without injury) normal group, the injury + saline intima injury group, and the injury + recombinant adenoviral vector encording human iNOS (AdiNOS) gene transfer group (n=5 per group). AdiNOS (1.6x10(10) plaque-forming units [pfu]) were used for the iNOS gene delivery and the virus was intraluminally infected to the balloon-injured common carotid arterial wall for 20 minutes. The NO levels were assessed in the blood of all the animals at the three time point: before-, 1 hr after-, and 14 days after the surgical procedures. The left common carotid arteries were harvested from the animals at 14 days after balloon injury and they were then assessed for fibronectin expression and intimal hyperplasia. RESULT: 14 days after AdiNOS infection, the NO levels were increased 67% in the gene transfer group compared with those levels obtained before the gene transfer (333.5+/-11.5 vs. 557.4+/-72.1, respectively, P<0.05), and the intima/intima+media ratio and the FN expression were reduced by 60% and 50%, respectively, in the gene transfer group compared with the intima injury group (41.5+/-5.6 vs. 16.6+/-2.8, respectively, P<0.05 and 307.9+/-38.3 vs. 154.3+/-20.2, respectively, P<0.05). CONCLUSION: Our results show that iNOS gene transfer to the arterial wall resulted in increased NO levels in the blood, and the procedure greatly inhibited intimal hyperplasia and it reduced fibronectin expression in the arteriaql wall.
Angioplasty ; Animals ; Apoptosis ; Blood Vessels ; Carotid Arteries* ; Carotid Artery, Common ; Cell Proliferation ; Chemotaxis, Leukocyte ; Endothelial Cells ; Extracellular Matrix ; Extracellular Matrix Proteins ; Fibronectins* ; Humans ; Hyperplasia* ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II* ; Platelet Aggregation ; Rabbits ; Transplants ; Veins

A recombinant adenoviral vector encoding human GDNF gene (Ad -GDNF) was developed to investigate the effect of GDNF gene in 6 -OHDA -induced Parkinson's disease rat. The changes of rotatory behavior and density of TH -immunoreactive axon terminals and number of cell bodies were observed by the GDNF expression. Adult male Sprague -Dawley rats were used. Parkinson's disease (PD) rat models were prepared by the injection of 6 -OHDA into the striatum. After 1 week, the animals showing apomorphine -induced rotatory behavior above 7 turns/ min were defined as PD rat model. Ad -GDNF was injected into the striatum of animal model and tested the apomorphine -induced rotatory behavior at 1 week after injection. These animals were perfused with Zamboni fixative to investigate the morphological changes after rotatory behavior test. Instead of Ad -GDNF, Ad -LacZ injected PD rats were used as a control. The following results are obtained: 1. The apomorphine -induced rotational behavior was significantly reduced by the treatment of PD rat by the injection of Ad -GDNF. The Ad -LacZ injected PD rat showed no change in rotatory behavior. 2. The density of TH -ir axon terminals in the striatum was significantly increased by the Ad -GDNF injection (75% of normal side), but there was no change in the density by the Ad -LacZ injection (37% of normal side) compared to 6 - OHDA lesioned striatum. This means the Ad -GDNF injection prevented the degenerative change of TH -ir axon terminals in the stritum of the PD rat. 3. The number of TH -ir cell body was significantly recovered by the Ad -GDNF (82% of normal side), but there was not recovered by the Ad -LacZ injection (60% of normal side) compared to 6 -OHDA lesion. This means the retrogradely transported Ad -GDNF induced the TH expression in the dopaminergic neurons of the substantia nigra. Gene therapy with Ad -GDNF prevented the degeneration of dopaminergic neurons and axon terminals in the 6 - OHDA -induced PD rat.
Adult ; Animals* ; Apomorphine ; Dopaminergic Neurons ; Genetic Therapy* ; Glial Cell Line-Derived Neurotrophic Factor* ; Humans ; Immunohistochemistry ; Male ; Models, Animal* ; Parkinson Disease* ; Presynaptic Terminals ; Rats ; Substantia Nigra

PURPOSE: Isosulfan blue has been traditionally used as a tracer to map the lymphatic system during identification of the sentinel lymph node (SLN). However, this vital dye is difficult to obtain in Korea. Radioisotopes such as technetiumlabeled sulfur colloid or albumin colloid are also expensive and complex to use. The purpose of this study is to evaluate usefulness of a sentinel lymph node biopsy (SLNB) using methylene blue dye in breast cancer patients. METHODS: We evaluated the sentinel node mapping experience using methylene blue dye from July 2003 to January 2007. Fifty-eight patients with clinical T1-T2 breast cancer without palpable axillary lymph nodes were enrolled. All SLNs were submitted for intraoperative frozen section and hematoxyline and eosin (H & E) stain analysis. For the negative SLNs, serial sections of each SLN specimen were examined by permanent H & E staining and by immunohistochemical techniques (IHC) using cytokeratin. Regardless of the results of a frozen section for the SLNs, a backup level II or III axillary lymph node dissections (ALND) was performed. RESULTS: Of the 58 patients that underwent a SLNB using methylene blue dye, an SLN was identified in 56 patients (96.6%), and metastatic SLNs were detected in 14 cases. Axillary lymph node metastasis found in 18 out of 58 patients. Thus, the false negative rate for a SLNB was 22.2% (4/18). Two patients had a micrometastasis (pN1mi) and two patients had clusters of isolated tumor cells (pN0[i+]) that were identified in the SLNs by IHC with the additional use of cytoketatin. The sensitivity, specificity, and accuracy of the SLNBs were 77.8%, 100%, and 92.9%, respectively. The false negative rate improved with the accumulation of experience for performing a SLNB (12.5% vs 30.0%). The sensitivity, specificity, positive predictive value, and accuracy of preoperative ultrasonography (USG) for an axillary lymph node metastsis were 50.0%, 95.5%, 81.8% and 81.0% respectively. CONCLUSION: Based on our initial experience, methylene blue dye is safe, inexpensive, and a readily available tracer for the SLN mapping, and it could be an effective alternative to the use of isosulfan blue dye for accurately identifying SLNs in early breast caner patients. We expected that the findings of preoperative USG could serve as useful adjuncts to a SLNB.
Biopsy* ; Breast Neoplasms* ; Breast* ; Colloids ; Eosine Yellowish-(YS) ; Frozen Sections ; Hematoxylin ; Humans ; Keratins ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Lymphatic System ; Methylene Blue* ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Radioisotopes ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Sulfur ; Ultrasonography

Proliferating trichilemmal cyst(proliferating trchilemmal tumor, PTC) most commonly occurs in the scalp and is generally benign. Malignant transformation of PTC is rare, and the appearance of a spindle cell(sarcomatoid) carcinoma is extremely rare. The authors experienced a case of malignant proliferating trchilemmal tumor with spindle cell carcinoma on the scalp in a 41-year-old male. The tumor was widely resected and covered with split thickness skin graft after Terudermis(R) graft. Imaging studies and fine needle aspiration cytology showed no regional lymph node involvement or distant matastasis.
Adult ; Biopsy, Fine-Needle ; Humans ; Lymph Nodes ; Male ; Scalp ; Skin ; Transplants

A 23-year-old female with aggressive periodontitis was treated using dental implants and LAVA system. The severely compromised teeth were extracted irrespective of initial conservative periodontal treatment. An implant-supported overdenture with 4 implants was fabricated for the maxilla and all-ceramic restorations for the mandible. Esthetic and functional goals were achieved with team approach involving periodontists and prosthodontists. This case report describes a treatment procedure for a generalized aggressive periodontitis patient with severe bone resorption.
Aggressive Periodontitis ; Bone Resorption ; Dental Implants ; Denture, Overlay ; Female ; Humans ; Mandible ; Maxilla ; Tooth ; Young Adult