The biocompatibility of the titanium has been estabilished through various experimental studies such as cell culture toxicity test, pyrogen test, mutagen test and others. In order to confirm biocompatibility after fabrication of titanium and to clarify the difference between the bone reaction after insertion of the lathed titanium rods and the bone reaction after insertion of the finished and polished rods, both rods were implanted into the proximal femur of a rabbit. Histologic reactions in the bone were observed according to the ASTM standards at the intervals of 6 weeks, 12 weeks and 26 weeks after implantation. The result were as follows In 6 weeks after implantation of lathed titanium rods, inflammatory reactions, such as minimal degree infiltration of polymorphonuclear leukocytes and lymphocytes were observed in all cases. This was thought to be caused by surgical trauma. However, inflammatory cell infiltration was not seen after implantation of polished and finished rods in all cases. The cellular infiltration and the histologic reaction of the bone after implantation of lathed group were significantly more pronounced than those after implantation of the finished group. In 12 weekt after implantation of lathed rods, two of four cases revealed a minimal degree of cellular infiliration and histologic reaction seemed to be more pronounced in the lathed group, but they were not significant statistically.
Cell Culture Techniques ; Femur ; Lymphocytes ; Neutrophils ; Titanium* ; Toxicity Tests

OBJECTIVE: Although heterotopic pregnancy is a rare disorder, it is on an increasing tendency due to frequent use of intrauterine device, pelvic inflammatory disease, ovulation induction, assisted reproductive technology. This study was performed the clinical experiences of seven patients with heterotopic pregnancy. METHODS: Seven patients diagnosed as heterotopic pregnancy were analyzed by various factors such as age, symptoms, beta-hCG levels, gestational age at the time of diagnosis, postoperative course, sites of ectopic pregnancy, use of assisted reproductive technology, multiple pregnancy, and mode of surgery. RESULTS: The mean age of patients was 29.1 years, and chief complaint was abdominal pain. Laparotomy was done in 5 patients, and laparoscopy was done in 2 patients. Four of seven patients delivered at term, two were twins, two singletones. CONCLUSION: In heterotopic pregnancy, identification of intrauterine pregnancy without confirmation of ectopic pregnancy is associated with poor prognosis for both mother and fetus, and hence early dignosis and careful examination are need. Ectopic pregnancy should be removed and intrauterine pregnancy should be maintained.
Abdominal Pain ; Diagnosis ; Female ; Fetus ; Gestational Age ; Humans ; Intrauterine Devices ; Laparoscopy ; Laparotomy ; Mothers ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Pregnancy, Multiple ; Prognosis ; Reproductive Techniques, Assisted ; Twins

Benign symmetrical lipomatosis(BSL) is a rare disease of unknown origin characterized by symmetrical and diffuse deposits of nonencapsulated fatty tissue. It is located on the neck, the shoulder, the proximal regions of the extremities and the abdomen. It is strongly associated with alcoholism. Other associated diseases include liver disease, dyslipidemia, gout, abnormal glucose tolerance, and malignancies of the upper airways. BSL is found mainly in middle-age, mediterranean men. Imaging using either computed tomography or magnetic resonance imaging is often recommended. Dietary restriction provides no relief. Abstinence from alcohol may delay further progression but does not cause regression of the deformity. The only effective therapy for BSL is surgical removal but recurrence is common. Physicians should be aware of this condition because of its association with metabolic disease and malignancies
Abdomen ; Adipose Tissue ; Alcoholism ; Congenital Abnormalities ; Dyslipidemias ; Extremities ; Glucose ; Gout ; Humans ; Lipomatosis* ; Lipomatosis, Multiple Symmetrical ; Liver Diseases ; Magnetic Resonance Imaging ; Male ; Metabolic Diseases ; Neck ; Rare Diseases ; Recurrence ; Shoulder

Benign symmetrical lipomatosis(BSL) is a rare disease of unknown origin characterized by symmetrical and diffuse deposits of nonencapsulated fatty tissue. It is located on the neck, the shoulder, the proximal regions of the extremities and the abdomen. It is strongly associated with alcoholism. Other associated diseases include liver disease, dyslipidemia, gout, abnormal glucose tolerance, and malignancies of the upper airways. BSL is found mainly in middle-age, mediterranean men. Imaging using either computed tomography or magnetic resonance imaging is often recommended. Dietary restriction provides no relief. Abstinence from alcohol may delay further progression but does not cause regression of the deformity. The only effective therapy for BSL is surgical removal but recurrence is common. Physicians should be aware of this condition because of its association with metabolic disease and malignancies
Abdomen ; Adipose Tissue ; Alcoholism ; Congenital Abnormalities ; Dyslipidemias ; Extremities ; Glucose ; Gout ; Humans ; Lipomatosis* ; Lipomatosis, Multiple Symmetrical ; Liver Diseases ; Magnetic Resonance Imaging ; Male ; Metabolic Diseases ; Neck ; Rare Diseases ; Recurrence ; Shoulder

BACKGROUND: Postoperative nausea and vomiting (PONV) is a distressing adverse effect of anesthesia. This study was designed to evaluate antiemetic effects of metoclopramide, ondansetron and granisetron in middle ear surgery. METHODS: We compared the antiemetic activity of prophylactic administration of metoclopramide, ondansetron and granisetron in 103 patients undergoing middle ear surgery (tympanomastoidectomy and tympanoplasty). All Study drugs were given as a short intravenous infusion 30 minutes before the end of anesthesia. The incidence of PONV were assessed by direct questioning of patients at 6, 12, 24 and 48 hr after recovery from anesthesia. RESULTS: For the first 6 hr recovery period after surgery, the percentages of emesis in patients were 46.7%, 16%, 12% and 16% in the control, metoclopramide, ondansetron and granisetron groups respectively. After 6 hr, the percentage of emesis in patients significantly decreased in the control, ondansetron and granisetron groups when compared with the first 6 hr, but in the metoclopramide group there was no changes after 6 hr. CONCLUSIONS: The antiemetic drugs, metoclopramide, ondansetron and granisetron, were all effective in controling PONV in middle ear surgery.
Anesthesia ; Antiemetics* ; Ear, Middle* ; Granisetron* ; Humans ; Incidence ; Infusions, Intravenous ; Metoclopramide* ; Ondansetron* ; Postoperative Nausea and Vomiting ; Vomiting

Open structure rhinoplasty combines the open(external) approach to rhinoplasty with innovative nasal restructuring techniques especially for the lower third of the nose. It involves minimal resection of the nasal structure, dome-dividing maneuvers with reconstitution of the lateral crural strip, and columellar strut and tip-grafting methods. A total of 14 patients are presented, 1 with congenital flat nose, 1 with congenital nasal deformity, 1 with congenital bulbous tip and deviation, and 11 with posttraumatic nasal deformities, with age between 14 and 41 years old and a follow-up period of 2 years. These patients underwent humpectomy, septal cartilage shield graft, corrective rhinoplasty, and augmentation rhinoplasty through a transverse midcolumellar incision with bilateral marginal incisions. These incisions provide the exposure necessary to precisely assemble a structurally sound nasal skeleton. The nasal tip graft and alar cartilage realignment are essential for determining nasal tip projection. We used sutured-in-place tip graft in 3 patients. The aesthetic results were excellent with improved nasal dorsal profile including nasal tip projection. The open structure rhinoplasty, however, has its disadvantages. The procedure is more time consuming, mainly because the nasal restructuring maneuvers and transcolumellar incision require meticulous execution. Nevertheless if proper techniques are used, columellar scar is rarely noticed and almost disappears with the lapse of time. In conclusion, unlike all closed techniques, the open approach to rhinoplasty permits accurate diagnosis and precise realignment of deformed nasal structures(both cartilage and bone) during the operation.
Adult ; Cartilage ; Cicatrix ; Congenital Abnormalities ; Diagnosis ; Follow-Up Studies ; Humans ; Nose* ; Rhinoplasty* ; Skeleton ; Transplants

Nasal bone fracture is the most common fracture among facial fractures. The nasal bone fracture has a very complex and infinitive variety but often is undermanaged only by closed reduction. The prognosis and outcome after operation had been reported by many surgeons and it's result is dependant upon many factors such as etiology, experience of surgeons, type of anesthesia and maintenance of fixation after surgery. In our study, we have grouped our fractures as favorable and unfavorable fractures. Favorable fractures are simple fractures that are easily reduced by closed reduction, whereas unfavorable fractures were fractures that remain unstable after reduction. In our opinion, the method of reduction and fixation after reduction plays an important role in unfavdrable fracture. We applied a new method of external fixation for unfavorable fractures After closed reduction to gain optimal reduction and maintenance.
Anesthesia ; Nasal Bone* ; Prognosis

To evaluate the clinical efficacy and safety of newly developed recombinant human erythropoietin (Epokine(R)), a phase III clinical trial was performed in patients with end-stage renal disease undergoing maintenance hemodialysis. Epokine(R)was given initially at a dosage of 50unit/kg, intravenously, three times a week after each dialysis session and the dosage was adjusted according to the changes in hemoglobin level. Out of total 79 patients who were enrolled initially, data of 64 patients who have completed 12 weeks study period were analyzed. The results were as following: 1) Hemoglobin(g/dL) and hematocrit(%) increased significantly from baseline levels beginning from 2 weeks after Epokine(R) administration. Hemoglobin increased significantly from 6.8+/-0.8 to 10.4+/-1.3 and hematocrit increased significantly from 20.9+/-2.2 to 31.1+/-5.2 after 12 weeks(P<0.05). Corrected reticulocyte count(%) increased significantly from 0.6+/-0.4 to 1.4+/-0.7 after 2 weeks and to 1.3+/-0.6 after 12 weeks(P<0.05). 2) A significant increase in platelet count was observed from 2 weeks after Epokine(R) administration (P<0.05). 3) Serum ferritin and serum iron decreased significantly and total iron binding capacity increased significantly after 2 weeks(P<0.05). 4) The mean of pre-hemodialysis systolic blood pressure(mmHg) increased significantly from 148+/-21 to 154+/-25 at 12 weeks(P<0.05). Also, post-hemodialysis blood pressure(systolic/diastolic) at 12 weeks increased significantly from baseline levels(146+/-28/ 82+/-15 vs. 153+/-25/87+/-14mmHg, P<0.05). 5) Anti-erythropoietin antibody was not detected in all subjects. 6) Side effects observed in this study were similar to those reported by earlier reports. Headache(9 cases), and flu-like syndrome(7 cases) were the most common side effects. These side effects were not severe and disappeared without discontinuation of Epokine(R) administration in most of the patients. In conclusion, Epokine(R) is safe and effective in treating anemia of hemodialysis patients with end stage renal disease.
Anemia ; Dialysis ; Erythropoietin ; Ferritins ; Hematocrit ; Humans* ; Iron ; Kidney Failure, Chronic ; Platelet Count ; Renal Dialysis* ; Reticulocytes

Adenosquamous carcinoma of the pancreas is a rare form of pancreatic cancer. Its biological behavior and clinical features are known to be similar to the much more common ductal adenocarcinoma or to pure squamous cell carcinoma, another rare form of pancreatic malignancy. However, the unusual manifestations of cancer, including cystic degeneration and extravasation of contrast to the mass, have also been reported. A 64-year-old man was admitted complaining of abdominal pain. An abdomial CT scan demonstrated an ovoid and cyst-like lesion in the pancreatic head and endoscopic retrograde balloon pancreatography showed segmental narrowing of the main pancreatic duct associated with extravasation of contrast into the cyst-like lesion. Under the impression of pancreatic pseudocyst with chronic pancreatitis, medical therapy including pancreatic stent insertion was given to the patient for four weeks. Finally, a laparotomy was performed due to persistent abdominal pain and a poorly demarcated mass with cystic cavity was resected. Histologic findings were consistent with adenosquamous carcinoma of the pancreas. The unusual features of this rare malignancy which led us to an errorneous initial diagnosis were emphasized.
Abdominal Pain ; Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Diagnosis ; Head ; Humans ; Laparotomy ; Middle Aged ; Pancreas* ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Stents ; Tomography, X-Ray Computed

Biliary Papillomatosis is an extremely rare pathologic entity. Only about 40 cases of intrahepatic or diffuse intra- and extrahepatic papillomatosis have been described since the first report in 1959 by Caroli. Although this is a histologically benign lesion, its course is unfavaurable because of its tendency to extend to the entire biliary tract, high recurrence rate following local excision and the probability of progression to malignancy. We described herein a case of biliary papillomatosis associated with diffuse bile duct dilatation. The patient, a 59-year-old male, was admitted to our hospital because of right upper abdominal pain and weight loss. Cholangiogram revealed multiple round filling defects in common hepatic duct with intrahepatic bile duct dilatation. The patient underwent Whipple's operation with right lobectomy. Grossly, multiple small pin-head sized polypoid masses were seen in common bile duct, common hepatic duct and right intrahepatic duct. Microscapically, papillary epithelial hyperplasia with moderate cellular atypia was seen and there was no evidence of stromal invasion. He is healthy with a follow-up for 7 months.
Abdominal Pain ; Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Common Bile Duct ; Dilatation ; Follow-Up Studies ; Hepatic Duct, Common ; Humans ; Hyperplasia ; Male ; Middle Aged ; Papilloma* ; Recurrence ; Weight Loss