Effects of SLA surface treated with NaOH on surface characteristics and response of osteoblast-like cell / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the surface characteristics and response of osteoblast-like cell at SLA surface treated with NaOH. MATERIALS AND METHODS: Three kinds of specimens were fabricated for the experiment groups. Control group was a machined surface, SLA group was a conventionally SLA treated surface, and SLA/NaOH gorup was SLA surface treated with NaOH. To evaluate the surface characteristics, the surface elemental composition (XPS), surface roughness and surface contact angle were evaluated in each group. And the cytotoxicity, cell adhesion, cell proliferation and ATP activity of osteoblast-like cells (MG-63 cells) were compared in each group for evaluatation of the cell responses. Statistical comparisons between groups were carried out via one-way ANOVA using the SPSS software (SPSS Inc., Chicago, USA), and then performed multiple comparisons. The differences were considered statistically significant at P<.05. RESULTS: SLA surface treated with NaOH (SLA / NaOH group) was changed to hydrophilic surface. All groups did not show the cytotoxicity to the MG-63. In cell adhesion studies, SLA / NaOH group showed the higher degree of adhesion than anothers (P<.05), Up to 7 days of incubation, the proliferation was showed the increasing tendency in all groups but SLA / NaOH group showed the highest cell proliferation between the three groups (P<.05). At 7 days of incubation, there was no difference in ALP activities between the three groups, but at 14 days, SLA / NaOH group showed significant increase in ALP activities (P<.05). CONCLUSION: In this study, SLA surface treated with NaOH promoted cell adhesion, proliferation and differentiation. It means that SLA/NaOH group is possible to promote osseointegration of implants.

A Case of Adenosquamous Carcinoma of the Papilla of Vater / 대한소화기학회지

Adenosquamous carcinoma of the papilla of Vater is a rare tumor and only a few cases have been reported so far. Here, we report a case of adenosquamous carcinoma in a 76-year-old male who presented with jaundice and right upper quadrant abdominal pain. Ultrasonography and enhanced abdominal CT scans showed dilated common bile duct (CBD) and intrahepatic bile duct (IHD) with a suspicious obstructing mass in distal CBD. On endoscopy, obstructing and ulcerated mass was noted on the papilla of Vater. Histopathological inspection of the biopsied specimens from mass showed adenosquamous cell carcinoma of the papilla of Vater. Since the patient refused operation, we inserted a self-expandable metallic stent in distal CBD. This is the first case report on adenosquamous carcinoma of the papilla of Vater in Korea.

Comparison Analysis of 3D CT and Cephalometrics in Craniofacial Measurements

The cephalometry can not always to evaluate accurate the real human skull. The reconstructed 3 dimensional image of CT(Computed Tomogram) is more popular method of human skull evaluation. The purpose of this study was to evaluate the difference between the measurements with the cephalometry and that with the 3 dimensional image of CT. Fifteen patients who visited yeungnam university hospital(from Nov. 1999 to Feb. 2000) underwent computed tomography and cephalometry. The average age was a 32-years-old. We measured the midface height(ANS-N, SE-PNS, ANS-SD), the total face height (Me-N, Me-ANS, ANS-UIE, Me-LIE, Me-ID), the midface horizontal(ANS-PNS, PNS-A, PNS-UIE), and the lower face horizontal(Go-Pog, Go-B, Go-LIE). After the acquisition of measurements using 3 dimensional CT and cephalometry statistical analysis was done with paired t-test(p< 0.05). Measured data of the midface height, the total face height and the midface horizontal showed no difference between the length at the cephalometry and that of reconstructed 3 dimensional image of CT, but the lower face horizontal showed statistically significant difference between the two. Both cephalometry and 3 dimensional CT image were accurate method for the measurement of midface height, total facial height and midface horizontal. However for the measurement of lower face horizontal, 3 dimensional CT seems to be a more accurate and reliable method.

The Fate of Grafted Bone and the Satisfaction of Patient in Brachymetatarsia after Autogenous Iliac Bone Graft

The purpose of this study was to analyze the fate of intercalated bone graft and the satisfaction of patients with brachymetatarsia of the 4th toe on the clinical results after one-stage lengthening with autogenous iliac bone graft. In last 6 years, 30 feet in 17 patients with brachymetatarsia were corrected with one-stage operation that was composed of Z-plasty of skin, extensor tendon and intercalated iliac bone graft, which appeared as ball-and- socket figure at the metatarsophalangeal joint. The length of harvested iliac bone graft was 18 mm in average(14 -23 mm) and there was bone resorption about 1.1 mm(0.1- 3.0), (7.1%) postoperatively. Postoperative digital fluoroscopy showed 83%(25/30) new joint(pseudojoint) formation of intercalated iliac bone grafts between proximal phalangeal bone and metatarsal bone. The objective functional evaluation with AOFAS scale was 89.4 in average(80 - 100) and subjective satisfaction on the aesthetic aspect was also high. There was no neurovascular impairment nor recurrence of brachymetatarsia even after one-stage lengthening with intercalated iliac bone graft.

Pyoderma Gangrenosum in Ulcerative Colitis / 대한소화기내시경학회지

Ulcerative colitis is an inflammatory disorder that affects the rectum and extends proximally to affect a variable extent of the colon. The major symptoms of ulcerative colitis include diarrhea, rectal bleeding, the passage of mucus, and abdominal pain. Ulcer-ative colitis also may be complicated by many local and systemic disorders as extrain-testinal manifestations. Pyoderma gangrenosum is the most severe dermatologic com-plication associated with ulcerative colitis. It is a painful , chronic, ulcerating skin disease of unknown cause. Diagnosis is clinical, there being no accepted histological diagnostic criteria. Conventional therapy is empirical, usually with high dose corticosteroids, but var-ious other agents have been tried with occasional success including topical antibiotics, cyclosporine, disodium cromoglycate, and dapsone. This patient was treated with high dose corticosteroid (prednisolone 1 mg/kg/day) and discharged with clinical improvement. So we report this case with a literature review.

Clinical Aspects in Patients with Thyrotoxic Periodic Hypokalemic Paralysis / 영남의대학술지

BACKGROUND: Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However. the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clnical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center (YUMC) during the past decade. METHODS: The medical records of 997 YUMC patients, seen between 1986 and 1996, with dignosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyrodism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, compasons were made on age. sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. RESULTS: the prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfuntional state of the throid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their throid hormon levels were significantly more increased than those of the patients without hypokalemia. interestingly, our study shows the recurrence of paralysis after treatment. CONCLUSION: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyrodism. The interactive roles of thyroid hormon. Na-K pump. and genetically inherited defect in the celluar membrance potential of the skeletal muscle can be speculated. Further investigation will be neede to firmly establish the mechanism of thyrotoxic periodic paraysis.

Subcapital Stress Fracture of the Femur after Internal Fixation of Intertrochanteric Fracture: A case report / 대한정형외과학회잡지

Fracture of the femoral neck occurred after internal fixation of intertrochanteric fracture of the femur is very rare and have been described previously in terms of stress fracture, stress-riser fracture, Youngs modulus fracture or iatrogenic fracture in the literature. This fracture documented about 20 cases in the English literature and usually occurred in elderly patients with osteoporosis and it always occur in the subcapital region. We report a case of subcapital stress fracture of the femur occurred after internal fixation with compression hip screw of intertrochanteric femur fracture.

Clinical Features of Ectopic Thyroid Gland / 대한내분비학회지

BACKGROUND: Ectopic thyroid gland is relatively rare condition and a developmental anomaly characterized by an aggregated of thyroid tissue in the midline anywhere from the base of the tongue to the mediastinum. The role of ectopic thyroid in the pathogenesis of non-goitrous sporadic cretinism and primary hypothyroidism has been emphasized. 19 cases of ectopic thyroid for 12 years was presented with Tc-pertechnetate or radioactive iodine, which were diagnosed by scintigraphy. METHODS: We wish to report these 19 cases and 12 cases of brief review of literatures on the incidence, etiology and development, symptomatology, diagnosis and treatment of ectopic thyroid gland was done. RESULTS: The most frequent incidental age was between the age 1 year and 29 years. And the frequency of ectopic thyroid was about 7 times more common in female(27 cases) than in male(4 cases). The location of ectopic thyroid were found to be lingual in 18 cases, sublingual in 9 cases, prelaryngeal in 1 case, and combine with lingual and sublingual in 3 cases. In chief complaints, palpable mass was most common and there were foreign body sensation on throat, dysphagia, dysphonia, and hoarseness. In 15 cases of hypothyroidism, l2 cases were taken thyroid hormone replacement therapy, 1 case was removed ectopic thyroid gland. In 2 of 10 cases of euthyroidism, replacement of thyroid hormone were done and 2 cases were removed ectopic thyroid gland, in 6 cases of unknown thyroid function, 1 case was removed ectopic thyroid gland and 131I therapy was done in 1 case, and others were observed with following up thyroid function test. CONCLUSION: These results suggest that the long terms thyroid function test, thyroglossal duct eyst and malignant change in ectopic thyroid tissue when finding the ectopic thyroid in thyroid scintigraphy were recommended highly.

Comparison of Double Phase 99mTc-sestamibi Scintigraphy with Evaluation of Hyperparathyroidism / 대한내분비학회지

"BACKGROUND: Between 80 to 85% of patients with hyperparathyroidsm have a solitary adenoma of the parathyroid glands and another 15% have a parathyroid hyperplasia. Preoperative localization of the parathyoid glands is generally accepted as warranted in patients who have failed an initial attempt at parathyroidectomy, ectopic locations and inexperienced surgeons. Different imaging techniques have been used for detection of abnormal parathyroid glands such as high resolution ultrasonography, computerized tomography, arteriography, venous sampling or magnetic resonance imaging and 201Tl/99mTc subtraction scintigraphy. But these methods have had varying rates of success, with low specificity and low sensitivity. Among the several different techniques available for parathyroid radionuclide imaging, the most common is the use of a dualradioisotope procedure combining of Tl with Tc. However, there are some controversies regarding the optimal technical aspects of this procedure, including the relative amount of injected dose of radiotracers, failed detection for small sized and deeper cervical located parathyroids, and not easy procedures. Recently, double phase Tc-sestamibi scintigraphy would be useful to solve these technical limitations, more convenient and have higher sensitivities. The purpose of this study was to compare the diagnostic accuracy of 99mTc-sestamibi with 201Tl/ 99mTc subtraction scintigraphy in the localization of hyperparathyroidism. METHODS: 9 patients with hyperparathyroidism underwent preoperative evaluation with double phase 99mTc-sestamibi scintigraphy and 201Tl/99mTc subtraction scintigraphy for attempted localization of abnormal parathyroid glands and surgical explorations. Imaging results were compared to surgical findings. RESULTS: Of 9 patients, 7 had a solitary parathyroid adenoma, 1 had a carcinoma and 1 had parathyroid hyperplasia. The 201Tl/99mTc subtraction scintigraphy preoperatively localized 8 of 9 patients(sensitivity: S9%) and 99mTc-sestamibi scintigraphy correctly localized all lesions for a sensitivity of 100%. In one case, 201Tl/99mTc subtraction scan show only a hot uptake at left upper parathyroid area, but 99mTc-sestamibi scan was shown the three site of hot uptake at left upper, both inferior parathyroid area. CONCLUSION: In patients with hyperparathyoridism, 99mTc-sestamibi scintigraphy may be used as the single imaging technique as it show a very high sensitivity and specificity in the preoperative localization of pathological parathyroid glands.

A Case of Parathyroid Carcinoma with Systemic Calcification / 영남의대학술지

Hyperparathyroidism due to parathyroid cancer is rare. It is difficult to diagnose preoperatively but there should be an increased index of suspicion in those parathyroid Patient with palpable neck masses, profound hypercalcemia(greater than 14mg/dl), made increase of the parathyroid hormone level to greater than twice normal, and significant metabolic complications. In parathyroid cancer, systemic calcinosis is an extremely rare manifestation. The most common metastatic calcification site is lung and the other involved site is stomach, liver, skin and heart. After resection of parathyroid tumor, this systemic calcinosis is self-limiting. We experienced a patient with primary hyperparathyroidsm, presented with metastatic calcification in the lung and stomach disappeared by successful parathyroidectomy.