We present herein case of allergic contact dermatitis associated with implants. A 30 year-old male patient has had oozing, crusted, eczematous lesion on the right anterior tibia for five months after tibial osteosynthesis with plate and screw made of vitalliurn. He showed positive patch test, reaction to cobalt on second and fourth days. The skin lesion disappeared after removal of T-plate.
Adult ; Cobalt ; Dermatitis, Allergic Contact* ; Humans ; Male ; Orthopedics* ; Patch Tests ; Skin ; Tibia ; Vitallium

The casting removable partial denture (RPD) is one of most commonly prosthesis methods in present. Vitallium is one kind of dental alloy with cobalt, chromium and molybdenum etc. It has three ranks respectively: Vitallium, Vitallium 2000 and Vitallium 2000 plus. Although the traditional casting RPD are commonly used, but it has been limited in the physical capabilities of traditional dental alloy. It would not been done to flexible design on denture especially on denture base. The elasticity of casting clasp is not good, the volume is thick. Because of the Vickers hardness and elongation of Vitallium 2000 and Vitallium 2000 plus are better than traditional dental alloys, so the RPD with Vitallium 2000 has good bending control, deformation rebound and fracture resistance. The benefit of Vitallium 2000 or Vitallium 2000 plus is the RPD with splitting can be designed for some free end clinical cases, to solve some clinical problems.
Chromium ; Chromium Alloys ; Cobalt ; Dental Alloys ; Denture, Partial, Removable ; Elasticity ; Hardness ; Humans ; Vitallium

OBJECTIVETo introduce cryotreat technique into prosthetic dentistry by testing the tensile properties of CW-H Co-Cr-Mo cast alloy before and after cryotreat and to observe the image changes by SEM to study the mechanism that changes the tensile properties of the alloy.

METHODS15 CW-H cast alloy were divided into 3 groups, i.e. control group (G1), cryotreated group (G2) and cryotreated plus post-cryogenic treated group (G3). The gauge test technique was employed to test the modulus of elasticity. Then the strength and percentage elongation (PE) were tested. SEM images were used to analyze the mechanism that improved the tension properties of the alloy.

RESULTSFor CW-H alloy the strength and the modulus of elasticity of both G2 and G3 were effectively increased but PE effectively decreased than G1. There was no effectively difference between G2 and G3, but G3 was larger than G2. SEM images of G2 and G3 showed that secondary-carbonide separated out all over the alloy.

CONCLUSIONThe results obtained above suggest that cryotreat is an effective method in enhancing tensile properties of CW-H Co-Cr-Mo cast alloy.

Dental Alloys ; chemistry ; Dental Casting Technique ; Elasticity ; Hardness ; Temperature ; Tensile Strength ; Vitallium ; chemistry

In the practice of modern craniomaxillofacial surgery, there is a general agreement in favor of obtaining solid bony union through the use of titanium and vitallium rigid fixation. These metallic osteosynthesis are not free from inherent drawbacks and limitation. They are liable to have an adverse effect on the growth of the craniofacial skeleton, be a cause of secondary bony resorption, increase risk of infection, result in palpability or exposure and cause artifact in radiologic imaging. These can lead to undue secondary operations necessitating their removal. To overcome there shortcomings, there had been a continuous research on the development of a bioabsorbable skeletal fixation system using polymer of polylactic and polyglycolic acid. Recently, with introduction and commercial availability of a product(Lactosorb, Walter Lorenz) with a minimized resorption period and foreign body reaction, there is an increasing acceptance of its use as an alternative fixation device in craniomaxillofacial surgery. In effort to extend its use in facial bone fractures, Tatum and Eppley were the first report in its successful application in a clinical setting. We report on the clinical experience of such bioabsorbable rigid fixation in patients with maxillofacial trauma. In included one adult and three children in their growth period, underwent open reduction of facial bone fractures. They were followed up in terms of clinical and radiologic outcome for six months. Stalbe and adequate longterm fixation was obtained and no recurrences were noted.
Adult ; Artifacts ; Child ; Facial Bones* ; Foreign-Body Reaction ; Fracture Fixation* ; Humans ; Polyglycolic Acid ; Polymers ; Recurrence ; Skeleton ; Titanium ; Vitallium

Resorption and osteolysis of periimplant bones resulting from the wear debris of artificial joint will cause long-term loosening. A new type of rolling knee artificial joint without UHMWPE based on the mechanics of rolling friction is designed for alleviating this problem. Because of low friction force, the resistance of extension and flexion is reduced strikingly and the stress on the interface between prosthesis and bone is reduced evidently. In addition, the bio-toxicity caused by the wear debris of UHMWPE will not occur absolutely. In consequence, the rolling artificial joint can prevent the trend of long-term loosening of the prosthesis efficiently.
Animals ; Arthroplasty, Replacement, Knee ; Ceramics ; chemistry ; Computer-Aided Design ; Dogs ; Humans ; Knee Prosthesis ; Materials Testing ; Polyethylenes ; Prosthesis Design ; Vitallium ; chemistry

The total knee replacement is an excellent method for the treatment of osteoarthritis, rheumatoid arthritis, etc. of the knee joint. The tendency of the use of total knee prosthesis is increasing now in Korea. But domestic production of the prosthesis is not avaliable and all are imported from abroad. Moreover, these prosthesis are not well adapted to Korean people, and in occation, the custom-made prosthesis should be needed. So, domestic production of the prosthesis is required. For production of new prosthesis, in cooperation with KAIST(Korea Advanced Institute of Science and Technology), we developed the new alloy 15-57 for total knee prosthesis. We conducted an animal experimental study to confirm the biocompatibility of the new alloy. In this experiment, the Zimmer® company vitallium was compared with this new alloy as control study. The results are as follows: 1. Biocompatibility of the new alloy 15-57 is similar than that of Zimmer® company vitallium in histological study of metal-bone interspace area. 2. Surface corrosion of both metal was nearly absent. 3. In summary, the new alloy 15-57 is suggested as an acceptable metal for the production of total knee prosthesis.
Alloys ; Animal Experimentation ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Corrosion ; Knee Joint ; Knee Prosthesis ; Knee ; Korea ; Methods ; Osteoarthritis ; Prostheses and Implants ; Vitallium

Interposition arthroplasty of the hip is to create a new joint by interposing an inert and durable substance between the reshapened ends of the femoral head and acetabulum, usually for the treatment of the primary and secondary osteoarthritis of the hip. The major goals of arthroplasty of the hip are to relieve pain, restore joint motion, correct deformity, and to provide stability of the joint. We reviewed the follow-up results of 23 Smith-Patersen vitallium cup arthroplasties in a consecutive series of 20 patients with various arthritides of the hip, who were treated at the National Medical Center between January 1962 and December 1970. Average duration of follow-up was 2 year and 10 months. 1. Male to female ratio was 12:8. Average of the patients was 30 years. 2. Seven patients had rheumatoid arthritis or ankylosing spondylitis and five patients had ankylotic hips. Three patients had primary osteoarthritis and another three osteoarthritis secondary to Legg-Calve-Perthes disease. There were one case each of tuberculous arthritis and traumatic dislocation. 3. Average duration of admission was 7 weeks. 4. Weight bearing was started gradually at 12 weeks post-operatively in majority of the cases. 5. Over-all results of the 20 patients were satisfactory in 12 (60%), and unsatisfactory in 8 (40%). 6. Results of cup arthroplasty in patients with primary osteoarthritis and osteoarthritis secondary to Legg-Calve-Parthes disease were satisfactory in all 6 cases, but were unsatisfactory in 5 out of the 7 cases of the rheumatoid arthritis and ankylosing spondylitis. 7. Three patients with bilateral cup arthroplasties yielded poor results. 8. Complications included eight infections and one each of early dislocation of the cup and periarticular new bone formation.
Acetabulum ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Congenital Abnormalities ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Legg-Calve-Perthes Disease ; Male ; Osteoarthritis ; Osteogenesis ; Spondylitis, Ankylosing ; Vitallium ; Weight-Bearing

Short gaps in the ureter may be spanned by uretero-ureterostomy, or if in proximity to the bladder, by uretero-neocystostomy Longer defects defy such anastomoses and most surgeons have employed nephrostomy, ureterostomy and cutaneous ureterostomy or uretero-sigmoidostomy in this condition to avoid further damage to the affected kidney. These procedures are not ideal, do not solve the problem of reconstructing the ureter and often lead to a diminution of renal function. For the past several decades investigators have attempted to insert or construct a conduit that could adequately substitute for the ureter. For this purpose, inorganic tubes of polyethylene, vitallium, tantalum and autogenous tissues such as ileal loops, oviduct, bladder flaps and blood vessel grafts have been utilized without success. In 1954, Hardin attempted to reconstruct the ureteral detect by homologous ureteral transplantation. He concluded that homologous ureteral grafts failed because of stenosis, dehiscence and leakage. By the time proliferating capillary vascular buds have permeated the free graft, necrosis and scar formation have taken place. He utilized polyethylene tubing as a splint catheter for a maximum of seven days in two of five experimental dogs and no splint catheter at all in the other three. He was unable to observe the dogs for long periods since the animals died on the 30th. 65th and 70th postoperative days. Complete ureteral stenosis had occurred in all dogs. An attempt to reestablish the ureteral defect with autogenous ureteral transplantation is described. Mongrel dogs, weighing from 15~25kg were utilized without special preoperative preparation. Pentothal sodium was administered intravenously for anesthesia. The right ureter was exposed through paravertebral incision retroperitoneally in two dogs simultaneously by two operative groups. The middle third of the right ureter was mobilized. A 3 to 7cm segment of the right ureter was removed and transplantated to the other dog. In 4 of 10 dogs, a splint catheter of polyethylene tubing slightly longer than the transplanted graft was inserted. In 6 dogs, a splint catheter was inserted from the renal pelvis to the bladder making it easy to remove the polyethylene tubing subsequently. The ends of the ureter were anastomosed with 4-0 chromic catgut using for interrupted sutures. The wound was closed without drainage. The splint catheter was removed in the fourth to sixth postoperative week. The animals were sacrificed after one to six months and an autopsy was performed. The results are summarized in Table 1. Gross and microscopic changes in the graft in all dogs were contracture, shrinkage or thickening, calcification or ossification within the graft, and round cell infiltration. Hydronephrosis also was seen in all animals. Animals sacrificed after one to two months postoperatively showed epithelial loge and degenerative changes, but the animals sacrificed after six months showed partial normal epithelial lining and capillarization in the submucosal layer of the transplanted segment. No fistula was seen, and at the time of sacrifice, the NPN and creatinine were elevated.
Anesthesia ; Animals ; Autopsy ; Blood Vessels ; Capillaries ; Catgut ; Catheters ; Cicatrix ; Constriction, Pathologic ; Contracture ; Creatinine ; Dogs ; Drainage ; Fistula ; Humans ; Hydronephrosis ; Kidney ; Kidney Pelvis ; Necrosis ; Oviducts ; Polyethylene ; Research Personnel ; Sodium ; Splints ; Sutures ; Tantalum ; Thiopental ; Transplants ; Ureter* ; Ureterostomy ; Urinary Bladder ; Vitallium ; Wounds and Injuries

A satisfactory method is needed for reestablishing continuity where the ureteral wall has been lost or compromised over a long segment. Experimental efforts to replace the ureteral segments with grafts of free fascia, skin, blood vessels and a pedicled fallopian tube have been reported; however, the results were not considered satisfactory. In 1943, Lord, Stefko and Stevens attempted to replace ureteral segments with free peritoneal flaps splinted with vitallium tubes. Slough and graft necrosis occurred prior to epithelialization. I believed that this failure was due to a disturbance of the blood supply. With this impression I utilized a pedicled peritoneal flap to develop an adequate blood supply. Mongrel dogs, weighing from 15~20kg, were used without special preoperative preparation. Pentothal sodium was administered intravenously for anesthesia. The right ureter was exposed through a paravertebral incision retroperitoneally. The middle third of the right ureter was mobilized. A 3 to 5 cm segment of the right ureter was removed. A pedicled peritoneal flap was fashioned and threaded on a thin polyethylene tubing the ends of which were then passed into the proximal and distal ureter. The ends of ureter were anastomosed with the ends of peritoneal tube using 4-0 chromic catgut. This procedure was technically difficult due to the extreme thinness of the peritoneal grafts. The wound was closed without drainage (Atlas 1: A,B,C, and D). No urinary diversion was performed. Determination of B.U.N. and creatinine were done preoperatively and just prior to sacrificing the animals. Dog No. 1 exhibited vomiting and a poor appetite on the 14th postoperative day, B.U.N. and creatinine were markedly elevated to 73.0mg% and 3.8mg% respectively on the 21st postoperative day compared with 9.8mg% and 1.4mg% preoperatively. Observations at the time of sacrifice revealed the replaced ureteral segment to be dilated and adherented to the surrounding tissues, leakage of urine into the peritoneum, no epithelialization of the peritoneal graft, and severe hydronephrosis of the right kidney. Dog No. 3 also developed a poor appetite on the 14th postoperative day and was sacrificed on the 20th postoperative day. The B.U.N. and creatinine were elevated to 75mg% and 2.8mg% respectively prior to sacrificing. The replaced segment was adherented to the surrounding tissues and showed abscess formation with leakage of urine. No organisms were found by culture. The right kidney showed marked hydronephrosis. Dog No. 4 was examined by intravenous pyelography on the 20th postoperative day when the B.U.N. elevated to 47.3mg%. There was no visualization of right collecting system at 30 minutes. The dog died on the 30th postoperative day. The replaced segment was shrunken and adherented to the surrounding tissues. Right hydronephrosis and hydroureter was found. Uremia developed in all dogs by the second or third postoperative week and severe adhesions, shrinkage and urinary leakage occurred in association with hydronephrosis and hydroureter.
Abscess ; Anesthesia ; Animals ; Appetite ; Blood Vessels ; Catgut ; Creatinine ; Dogs ; Drainage ; Fallopian Tubes ; Fascia ; Female ; Hydronephrosis ; Kidney ; Necrosis ; Peritoneum ; Polyethylene ; Skin ; Sodium ; Splints ; Thinness ; Thiopental ; Transplants ; Uremia ; Ureter* ; Urinary Diversion ; Urography ; Vitallium ; Vomiting ; Wounds and Injuries