No abstract available.
Craniocerebral Trauma* ; Head*

Acquired perforating disease(APD) is characterized by hyperkeratotic papules with transepidermal elimination of degenerated material and is associated with renal disease and/or diabetes. Particular attention has been directed to transepidermal elimination because the articles on perforating diseases among patients with chronic renal failure and/or diabetes have been increasingly reported. We describe four patients with chronic renal failure and/or diabetes whose skin biopsy specimens showed transepidermal elimination.
Biopsy ; Humans ; Kidney Failure, Chronic* ; Skin

Foreign body aspiration (especially peanut) is the leading cause of accidental death in children under 1 year of age and most cases of serious aspiration occur between the age of 1 and 3. We report a case of severe pulmonary complication and adult respiratory distress syndrome (ARDS) secondary to peanut aspiration in 15 month old male in spite of all removal (9 pieces) by ventilating bronchoscope. Chest X-ray showed pulmonary interstitial emphysema, marked subcutaneous emphysema, pneumothorax and autopsy findings showed interstitial inflammatory cell infiltration with destruction of acinar septal architecture and formation of hyaline membranes. Chest X-ray and pathologic findings are compatible with the late ARDS. A brief review of related literature was made.
Autopsy ; Bronchoscopes ; Child ; Emphysema ; Foreign Bodies ; Humans ; Hyalin ; Infant* ; Male* ; Membranes ; Pneumothorax ; Respiratory Distress Syndrome, Adult ; Subcutaneous Emphysema ; Thorax

PURPOSE: We performed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. METHODS AND MATERIALS: One hundred and six patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (9 4%) and ranged from 1 month to 92 months (median; 6 months). RESULTS: The median age was 62 years old and male to female ratio was 104:2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was performed in 83%. Mean tumor dose delivered with curative aim was 58.6 Gy (55-70.8 Gy) and median duration o f the radiation therapy was 53 days. The median survival of all patients was 6 months and 1-year and 2-year overall survival rte was 27% and 12%, respectively. Improvement of dysphagia was obtained in most patients except fo 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32% (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30% respectively, while those of the nonresponder was 4 months and 0% respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 rnonths and 16% while those of the patients who could not tolerate regular diet was 3 months and 0%, respectively (p=0.004). The survival difference between the patients with 5 cm or less turnor length and those with more than 5 cm tumor length was rnarginally statistically significant (p=0.06). However, the survival difference according to the periesophageal invasion or mediastinal lymphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor length, and initial degree of dysphagia in a decreasing order. The complication was observed in 10 patients (9%). CONCLUSION: The survival outcome for advanced esophageal cancer patients treated by external be am radiotherapy alone was very poor, In the treatment of these patients, the brachytherapy and chemotherapy should be added to improve the treatment outcome.
Brachytherapy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Diet ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Female ; Follow-Up Studies ; Gastrostomy ; Humans ; Lymphatic Diseases ; Male ; Middle Aged ; Multivariate Analysis ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Thorax ; Tomography, X-Ray Computed ; Treatment Outcome

STATEMENT OF PROBLEM: Use of custom tray and tray adhesive is clinically recommended for elastomeric impression material. However there is not clear mention of drying time of tray adhesive in achieving appropriate bonding strength of tray material and impression material. PURPOSE: This study is to investigate an appropriate drying time of tray adhesives by evaluating tensile bonding strength between two types of polyvinylsiloxane impression materials and resin tray, according to various drying time intervals of tray adhesives, and with different manufacturing company combination of impression material and tray adhesive. MATERIAL AND METHODS: Adhesives used in this study were Silfix (Dentsply Caulk, Milford, Del, USA) and VPS Tray Adhesive (3M ESPE, Seefeld, Germany) and impression materials were Aquasil Ultra (monophase regular set, Dentsply Caulk, Milford, Del, USA) and Imprint II Garant (regular body, 3M ESPE, Seefeld, Germany). They were used combinations from the same manufacture and exchanged combinations of the two. The drying time was designed to air dry, 5 minutes, 10 minutes, 15 minutes, 20 minutes, and 25 minutes. Total 240 of test specimens were prepared by auto-polymerizing tray material (Instant Tray Mix, Lang, Wheeling, Il, USA) with 10 specimens in each group. The specimens were placed in the Universal Testing machine (Instron, model 3366, Instron Corp, University avenue, Nowood, MA, USA) to perform the tensile test (cross head speed 5 mm/min). The statistically efficient drying time was evaluated through ANOVA and Scheffe test. All the tests were performed at 95% confidence level. RESULTS: The results revealed that at least 10 minutes is needed for Silfix-Aquasil, and 15 minutes for VPS Tray Adhesive-Imprint II, to attain an appropriate tensile bonding strength. VPS Tray Adhesive-Imprint II had a superior tensile bonding strength when compared to Silfix-Aquasil over 15 minutes. Silfix-Aquasil had a superior bonding strength to VPS Tray Adhesive-Aquasil, and VPS Tray Adhesive-Imprint II had a superior tensile bonding strength to Silfix-Imprint II at all drying periods. CONCLUSION: Significant increase in tensile bonding strength with Silfix-Aquasil and VPS Tray adhesive-Imprint II combination until 10 and 15 minutes respectively. Tray adhesive-impression material combination from the same company presented higher tensile bonding strength at all drying time intervals than when using tray adhesive-impression material of different manufactures.
Adhesives ; Collodion ; Dental Impression Materials ; Elastomers ; Head ; Polymers ; Polymethyl Methacrylate ; Polyvinyls ; Siloxanes

OBJECTIVE: To report the pregnancy which was made by in vitro fertilization using recombinant follicle stimulating hormone and gonadotropin releasing hormone antagonist. MATERIAL AND METHOD: Case report. RESULTS: Six oocytes were retrieved and all were fertilized by intracytoplasmic sperm injection. Six embryos were transferred and the pregnancy was confirmed. CONCLUSION: It is envisaged that the availability of recombinant gonadotropins and gonadotropin releasing hormone antagonists will ultimately lead to shorter, cheaper and safer treatments, using reduced dosages.
Pregnancy ; Female ; Humans

Acute organophosphate (OP) poisoning produces cholinergic symptoms resulting from the inhibition of cholinesterase, and the overstimulation of muscarinic and nicotinic receptors in the synapses. The dominant clinical features of acute cholinergic toxicity include bradycardia, miosis, lacrimation, salivation, bronchorrhea, and bronchospasm. All symptomatic patients should receive therapy with oxygen, atropine, and pralidoxime. Atropine works as a physiologic antidote by competitively occupying muscarinic receptor sites, reducing the effects of excessive acetylcholine. Atropine should be immediately administered, and the dose can be titrated according to the severity of OP poisoning. A large dose may be necessary to overcome the excessive cholinergic state in case of severe poisoning. Pralidoxime is a biochemical antidote that reactivates acetylcholinesterase by removing OP from it. It is effective in treating both muscarinic and nicotinic symptoms. After some period of time, the acetylcholinesterase-OP compound undergoes a conformational change, known as aging, which renders the enzyme irreversibly resistant to reactivation by a pralidoxime. There has been a great deal of controversy over the effectiveness of pralidoxime in acute OP poisoning. However, it may be beneficial to administer pralidoxime for a sufficient period in case of severe poisoning with a large quantity of OP, which is common in Korea.
Acetylcholine ; Acetylcholinesterase ; Aging ; Atropine* ; Bradycardia ; Bronchial Spasm ; Cholinesterases ; Humans ; Korea ; Miosis ; Oxygen ; Poisoning* ; Pralidoxime Compounds ; Receptors, Muscarinic ; Receptors, Nicotinic ; Salivation ; Synapses

Reduction in the extremity length of more than three to four centimeters has significant effect on both gait disturbance and aesthetic change. The method of Anderson has been one of the most successful procedures of surgical leg elongation but requires long period of bed rest and immobilization. Also. the lengthening occurs the tibia, although shortening occurs twice as frequently in the femur as in the tibia. Wagner in 1971 reported his experience with the technique that allows correction in both the femur and tibia yet does not require prolonged immobilizaton. This involves a two stage procedure with rigid external fixation and lengthening of 1.5mm per day. The second stage is for osteosynthesis and may be suppleniented by bone graft. We began using the Wagner's technique of leg lengthening at Chonju Presbyterian Medical Center about 18 months age. Two patients are presented with 7 and 9 month follow-ups after femoral lengthening of 5 cm each. Both femurs united well and the leg length discrepancy was corrected. These cases indicate that this method is a good addition to the armamentarium of treating leg length discrepancy. A subsequent review of more cases and their follow-up using this tretment program shall be forthcoming.
Bed Rest ; Extremities ; Femur ; Follow-Up Studies ; Gait ; Humans ; Immobilization ; Jeollabuk-do ; Leg ; Methods ; Protestantism ; Tibia ; Transplants

The skeleton is a frequent site of bone tumor metastasis. Radiographic examination Is not sufficiently reliable in early detection since an abnormality is unlikely to be observed until more than 50% of the bone material has been lost. Therefore there was much effort to discover radiographic materials for use in scanning. At the present tirne, 99m Tc-labeled diphosphonate is the best available material for bone scanning. We applied whole body scanning with 99m Tc-to 40 patients who had bone tumors (primary or secondary), infection and other cases. The results obtained are as follow: 1. The scan can detect the extensiveness of the tumor better than plain X-ray in the early stage. 2. In metastatic disease, 60% of all patients were positive in the scan and all of there were negative in X-ray. 3. In cases of cancer, definitive treatment planning can be facilitated by the information obtained from whole body scanning. 4. In inflammatory disease, we can differentiate osteomyelltis from cellulitis or pyogenic arthritis in the early stage. 5. In fibrous dysplasia, it was possible to differentiate monostatic from polyostotic disease. 6. In nonunion of bone, scan was positive but X-ray was eouivocal.
Arthritis ; Cellulitis ; Humans ; Neoplasm Metastasis ; Skeleton ; Whole Body Imaging

Transpedicular Screw fixation and Harrington distraction rod are effective means of managing unstable thoracolumbar fracture and fracture dislocation. The authors analysed the 52patients who were treated with above 2methods from March 1986 to February 1993. The results were as follows: 1. Most of patients were in 5th decade compare to younger group and most common cause of injury was fall down, but traffic accident is increasing. 2. The most commonly involved sites were T12and L1 vertebrae and most common type of injury is bursting fracture. 3. Postoperative anterior and posterior column of vertebrae body correction rate were 35.0%/34.4% in ISF group and 29.3%/27.9% in Harrington group. Postoperative correction loss rate were 0.13/0.04 in ISF group and 0.06/0.04 in Harrington group. 4. Postoperative correction of kyphosis angle were average 18 in ISF goup and average 15° in Harrington group. Loss of correction angle was average 23° in ISF group and average 4.4° in Harrington group. 5. Range of spinal fixation was average 3.1 segments in ISF group and average 6.2 segments in Harrington group. 6. There was no significant difference in neurologic recovery between ISF group and Harrington group. The patients who had been recovered neurologically more than 1 grade were 28.6% in Harrington group and 29.2% in ISF group. 7. ISF has some benefit in spnal vertebral body height correction and in maintenance of correction compare to Harrington group. Nevertheless disadvantages of ISF group such as long operative time and possibility of cord compression by pedicular screw, ISF has advantages of almost anatomical reduction and the least spinal fusion.
Accidents, Traffic ; Body Height ; Dislocations ; Humans ; Kyphosis ; Operative Time ; Spinal Fusion ; Spine