PURPOSE: The aim of this study was to evaluate the effect of dimensional stability of splinting material on the accuracy of master casts. MATERIALS AND METHODS: A stainless steel metal model with 6 implants embedded was used as a master model. Implant level impressions were made after square impression copings were splinted using 5 different techniques as follows. (1) Splinted with autopolymerizing resin and sectioned, reconnected to compensate polymerization shrinkage before the impression procedure. (2) Splinted with autopolymerizing resin just before impression procedure. (3) Primary impression made with impression plaster and secondary impression were made over with polyether impression material. (4) Splinted with impression plaster. (5) Splinted with VPS bite registration material. From master model, 5 impressions and 5 experimental casts, total 25 casts were made for each of 5 splinting methods. The distortion values of each splinting methods were measured using coordinate measuring machine, capable of recordings in the x-, y-, z-axes. A one-way analysis of variance (ANOVA) at a confidence level of 95% was used to evaluate the data and Tukey's studentized range test was used to determine significant differences between the groups. RESULTS: Group 1 showed best accuracy followed by Group 3 & 4. Group 2 and 5 showed relatively larger distortion value than other groups. No significant difference was found between group 3, 4, 5 in x-axis, group 2, 3, 4 in y-axis and group 1, 3, 4, 5 in z-axis (P<.0001). CONCLUSION: Both Splinting impression copings with autopolymerizing resin following compensation of polymerization shrinkage and splinting method with impression plaster can enhance the accuracy of master cast and impression plaster can be used simple and effective splinting material for implant impression procedure.
Compensation and Redress ; Humans ; Jaw Relation Record ; Polymerization ; Polymers ; Splints ; Stainless Steel

In management of foot deformity, the operative procedures such as tendon transplantation and bone stabilization are of the relatively recent origin. The first tendon transfer was performed by Nicoladoni in 1881. Since that original report, a voluminous literature was appeared on the subject of tendon trasplantation. During the period, from Jan. 1960 to May. 1992, we have done clinical studies of the 189 feet on 167 patients who had been undergone tendon transfer. The results are as followes, 1. Residual poliomyelitis, leprosy, cerebral palsy and club foot are common etiology. Among them, residual poliomyelitis was the most common, especially in 1960 to 1969. Recently trauma and aged leprosy were increased. 2. Among 189 feet, the equinovaurs deformities were 90 cases. 3. Posterior tibial tendon, peroneus tendons, anterior tibial tendon, Achilles tendon and extensor hallucis tendon were transferred. 4. Posterior tibial tendon was mostly used. 5. The evaluation for surgery, for Good to Excellent was 114 feet 60. 3% 6. The poor results were noticed in the cases of the calcaneal deformity and showed in the age below 5 years old.
Achilles Tendon ; Cerebral Palsy ; Congenital Abnormalities ; Foot Deformities ; Foot ; Humans ; Leprosy ; Poliomyelitis ; Surgical Procedures, Operative ; Tendon Transfer ; Tendons

Although there are various methods of operative treatment for hony mallet finger, the operative technique is not so easy and complications such as joint stiffness, sott tissue prohlems, infection, change of nail shape and arthrosis are common. The authors performed operations for 26 cases of hony mallet fingers, fixing the hony frapment by Kirschner wire, pull-out wire suture and miniscrew respectively, from Jan. l988 to Jun. l996. The results were as follows. l. According to Niechajev's classification. there were 3 cases of type B, 7 cases of type C, l4 cases of type D, and 2 cases of type E. And 11 cases were accompanied hy crushing injury. 2. Involved fingers were third finger in 11cases, fit'th finger in 7 cases, fourth finger in 5 cases, second finger in 2 cases. and thumb in I case. 3. The hony mallet finger was caused hy occupational injury in l6 cases, direct blow in 7 cases and sports injury in 3 cases. 4. The fractured fragment was fixed hy Kirschner wire in 9 cases, by pull-out suture in 9 cases and by miniscrew in 8 cases. 5. The results were evaluated hy Kanies scale. Sixteen cases had satisfactory results. Seven cases (87.5%) were satisfactory in miniscrew fixations. 5 cascs (55.6%) in pull-out wire suture methocls and 2 cases (22.2%) in Kirschner wire tixations. 6. The complications were joint incongruity in 4 cases, dorsal prominece in 6 cases, painful limitation of motion in 2 cases which were treated by arthrodesis, pin site infection in 2 cases and hreakage of wire suture in 1 case. 7. The miniscrew fixation offered relatively firm fixation, low complication rate, and good results. so it can be considered as one of the good methods of treatment for hony mallet finger.
Arthrodesis ; Athletic Injuries ; Classification ; Fingers* ; Joints ; Occupational Injuries ; Sutures ; Thumb

PURPOSE: Nowadays pharmacologic provocation tests and physiologic tests are usually used to determine growth hormone(GH) deficiency in short stature. But this method has many problems. We know GH stimulates the release and synthesis of insulin-like growth factor-I(IGF-I) and measuring the level of IGF-I is relatively simple. So we measured plasma IGF-I to watch the correlation with the GH levels and to determine it may replace the complicated stimulation tests. METHODS: At the department of Pediatrics in Dong San Hospital from Dec. 1996 to Aug. 1998, childrens who visited for evaluation of short stature and measured GH and IGF-I simultaneously were reviewed. After clonidine and insulin administration, exercise and sleep, we measured their peak GH level and IGF-I level by the immunoradiometric assay(IRMA) kit. RESULTS: The ratio of boys and girls were 22 to 31 and the cases below 3 rd percentile were 26 which was the most. With phamacologic provocation test, there were 43 cases whose level of peak GH below 7 ng/mL(group I) but with combined phamacologic provocation and physiologic tests there were 27 cases of group I. The mean IGF-I level showed correlation with aging in both male and female(r=0.53, P<0.05). The relationship between peak GH and IGF-I level are found when we tested both phamacologic and physiologic combined tests. The mean IGF-I level did not correlate with height percentile. CONCLUSION: Measuring the IGF-I value was useful to detect GH deficient children but combined tests were more helpful.
Aging ; Child* ; Clonidine ; Female ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor I* ; Male ; Pediatrics ; Plasma

Opposition of the thumb is necessary for pinch-one of the three most important functions of the hand. Frequently, opposition is either partially or totally lost in poliomyelitis or median nerve palsy. Several types of operations have been devised for restoration of opposition, and in 1973, Burkhalter et al. announced extensor indicis proprius opponensplasty: the tendon of extensor indicis proprius is brought out in the area of the pisiform and then passed against subcutaneously across the palm to the thumb, being attached to the abductor pollicis brevis and extensor pollicis longus tendon. It is useful in the case of loss of opposition without available finger flexor or wrist motors. Of nine patients who underwent operation-one with Riordan and eight with Burkhalter type of opponensplasty-at National Medical Center, seven had excellent results: one had a fair, and another one had a poor result. Six patients were with low combined median and ulnar nerve injury: one with high combined median and ulnar nerve injury: one with brachial plexus injury: and one with myotmesis of the thenar muscles. From the results, we conclude that Burkhalter type of opponensplasty makes satisfactory result for the hand without opposition movement; it is indicated in high median nerve injury and any combined median and ulnar nerve injury6; early restoration of opposition to the thumb in median nerve injury and in those limbs with multiple tissue trauma adds immeasurably to the over-all early rehabilitative effort.
Brachial Plexus ; Extremities ; Fingers ; Hand ; Humans ; Median Nerve ; Muscles ; Paralysis ; Poliomyelitis ; Tendons ; Thumb ; Ulnar Nerve ; Wrist

Ganglia are the most common soft tissue tumors of the hand. Ganglia found on the dorsum of the wrist usually arise from the scapholunate ligament and are usually located between the extensor digitorum communis tendon of the index finger and extensor pollicis longus tendon. Intratendinous ganglion is a very rare lesion of unknown etiology and natural history that originates within the tendon. A patient is described who presented with a painful mass on the dorsolateral aspect of the wrist due to an intratendinous ganglion of the extensor pollicis longus tendon. Treatment consisted of excision of the extensor pollicis longus tendon with ganglion followed by mini free tendon graft using palmaris longus tendon.
Fingers ; Ganglia ; Ganglion Cysts ; Hand ; Humans ; Ligaments ; Natural History ; Tendons ; Transplants ; Wrist

VSD is the most common congenital carciac malformation and the natural history depends not only on the age ofpatients and the size of defect but the subtype of VSD as well, important factor in clinical management or thosepatients. In 110 patients, with surgically repaired VSD in Yonsei Medical Center in 1984, the subtype of VSDs evaluated by surgical observation were correlated with LV angiogram findings to verify the incidence of subtype inKorean and the diagnostic accuracy to predict the subtype by angiogram. 1. 110 patients included 64 boys and 46 girls, the age ranged from 3 months to 14 years(average 4.6 years old) 2. Angiographic findings were interpretedas follows; a. Perimembranous defects were profiled in LAO 60 degrees LV angiogram and located below the aorticvalve. In inlet excavation the shunted blood opacified the recess between septal leaflet of tricuspid valve and interventricular septum in early phase, in infundibular excavation opacified the recess between anterior leafletof TV and anterior free wall of RV and in travecular excavation the shunted blood traversed anterior portion of TVring, opacified trabecular portion of RV cavity. b. Subarterial type were profilled in RAO 30degrees LV angiogram,just below aortic valve as well as pulmonic valve. Total infundibular defects were profilled in RAO 30degrees andLAO 60 degrees LV angiogram subaortic in location in both views. c. In muscular VSD the profilled angle was variedaccording to the subtype but the defects were separated from the aortic valve as muscular septum interposedbetween the aortic valve and the defect. 3. The incedence of subtype of VSDs evaluated by surgical observationwere as follows. Subaterial type 32 cases(29.1%) Total infundibular defect 5 cases( 4.5%) Perimembranous type 73cases(66.3%) Infundibular excavation 32 cases(29.1%) Trabecular excavation 28 cases(25.5%) Inlet excavation 10cases(9.1%) Mixed 3 cases(2.7%) Muscular type 1 cases(0.9%) Total 63.6% of VSD, were the varieties of theinfundibular septum type. 4. The prediction of VSD subtype accoridng to the angiographic findings described above,were compared to the surgical observation. Diagnostic rate was 100% in perimembranous type, 75% in subarterialtype, 0% in total infundibular type, so 88% of cases were in accordance with the surgical findings.
Aortic Valve ; Bays ; Female ; Humans ; Incidence ; Natural History ; Tricuspid Valve

Pancreatic tuberculosis is a rare clinical entity, presenting as malignancy mimicking pancreatic mass. Therefore, it represents a diagnostic challenge. To date, ten cases have been reported in Korea. I report an additional case and review all Korean reports about pancreatic tuberculosis. A 57-year-old woman presented with abdominal pain. Abdominal computed tomography (CT) revealed a 2.2x1.2 cm cystic mass in pancreatic body. She was followed for nine months, at which time a cystic mass was enlarged to 3.3x2.2 cm in size on the CT. An exploratory laparotomy was performed for the accurate diagnosis and to rule out the possibility of malignant change. Pathological examination of the resected specimen revealed chronic granulomatous inflammation with caseous necrosis and multinucleated giant cells, which was compatible with tuberculosis. Among the 11 cases of pancreatic tuberculosis, five cases were combined with pulmonary tuberculosis. The pancreatic tuberculosis frequently presented with multicystic pancreatic mass (81%) and the most common anatomic locations were the head (73%), tail (18%), and body (9%). Three cases were diagnosed by using US or EUS guided fine needle aspiration biopsy (FNAB), and all cases were medically cured without exploratory laparotomy. In summary, pancreatic tuberculosis, despite its rarity, should be considered for differential diagnosis of pancreatic cystic mass in endemic countries. Clinical suspicion and accurate diagnostic approach including FNAB of pancreatic tuberculosis are needed to avoid performing unnecessary laparotomy.
Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Pancreatic Diseases/*diagnosis/pathology/radiography ; Pancreatic Neoplasms/diagnosis ; Tomography, X-Ray Computed ; Tuberculosis/*diagnosis/pathology/radiography

We report a case of chronic bullous dermatosis of childhood occurring in a 8-year-old girl, who has multiple, pruritic, tense, vesicobullous eruptions on the both extremities and pelvic region without mucous membrane inuolvement. A skin biopsy revealed subepidermal vesicles infiltrated with many neutrophiles and a few eosinophiles. Direct immunofluorescent study of the perilesional skin demonstrated moderate intensity of linear IgA and to a lesser degree of IgG deposition at the dermoepidermal junction. The skin lesions responded dramatically to oral dapsone therapy, initially 4mg/kg, and taporing to 2mg/kg for 27 days.
Biopsy ; Child ; Dapsone ; Eosinophils ; Extremities ; Female ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Mucous Membrane ; Neutrophils ; Pelvis ; Skin ; Skin Diseases* ; Transcutaneous Electric Nerve Stimulation

BACKGROUND: The insulin resistance is common in the patients with essential hypertension, even in the absence of non-insulin-dependent diabetes mellitus(NIDDM) or hyperlipidemia. It is well known that the offspring of patients with NIDDM have shown less insulin sensitivity compared with that of normal parents. But it is not yet known whether the insulin resistance is common in the offspring of patients with essential hypertension in Korea, who have no hypertension, NIDDM and hyperlipidemia. The aims of this study were to find out whether the insulin resistance exist in the middle aged normal offspring of the patients with essential hypertension and whether the insulin resistance is dependent on the metabolic abnormalities such as the body mass index(BMI), obesity and hyperlipidemia. METHODS: The serum lipid profiles and oral glucose tolerance test were performed. The anthropometrical measurement was done. The abdominal CT scan at umbilicus level and thigh CT was performed in the 11 offspring of parents with essential hypertension(group I;male : 7, female : 4)and 24 offspring of parents without essential hypertension, NIDDM, ischemic heart disease and hyperlipidemia(group II; male : 9, female : 15). RESULTS: The average age of group I was 44.1+/-6.9 years, and that of the group II was 47.5+/-9.5 years. There were no significant differences in the blood pressure, weight, BMI, waist to hip ratio, waist to thigh ratio. And there were no significant differences in the serum cholesterol, triglyceride, HDL-cholesterol, serum Na, and plasma renin activities between both groups. Fasting plasma insulin and 2 hour insulin after 75gm glucose ingestion were significantly higher in group I than in group II(8.5+/-3.0mU/mL versus 5.0+/-1.8mU/mL, 61.6+/-31.7mU/mL versus 33.3+/-16.8mU/mL, p<0.05). The insulin sensitivity index was significantly lower in group I than in group II(355.1+/-92.6 versus 451.8+/-88.1, p<0.05). The visceral fat area was wider in group I than in group II(102.0+/-30.7cm2 versus 64.5+/-28.5cm2, p<0.05). The multiple regression analysis with the fasting plasma insulin and insulin sensitivity index as the dependent variables and family history of essential hypertension, visceral fat area and BMI as the predictor variables revealed that only the family history was associated with the fasting plasma insulin and insulin sensitivity index. CONCLUSIONS: The offspring of the parents with essential hypertension showed the insulin resistance with increased visceral fat area in comparison with the offspring of the parents without essential hypertension.
Blood Pressure ; Cholesterol ; Diabetes Mellitus, Type 2 ; Eating ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperlipidemias ; Hypertension ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat ; Korea* ; Male ; Middle Aged* ; Myocardial Ischemia ; Obesity ; Parents* ; Plasma ; Renin ; Thigh ; Tomography, X-Ray Computed ; Triglycerides ; Umbilicus ; Waist-Hip Ratio