Intentional replantation with preapplication of orthodontic force on mandibular second molar

Intentional replantation has been used for alternative treatment for conventional root canal therapy. This case report describes that the intentional replantation with application of extrusive orhodontic force for 6 weeks, on which tooth of previous root canal the-rapy. As preapplicatory orthodontic force, tooth moblity was increased so that extraction of the designated tooth was more easily accomplished and augmented volume of periodontal ligament is expected to acceleated gingival reattachment.

The effect of priming etched dentin with solvent on the microtensile bond strength of hydrophobic dentin adhesive / 대한치과보존학회지

Deterioration of long-term dentin adhesion durability is thought to occur by hydrolytic degradation within hydrophilic domains of the adhesive and hybrid layers. This study investigated the hypothesis that priming the collagen network with an organic solvent displace water without collapse and thereby obtain good bond strength with an adhesive made of hydrophobic monomers and organic solvents. Three experimental adhesives were prepared by dissolving two hydrophobic monomers, bisphenol-A-glycidylmethacrylate (Bis-GMA) and triethyleneglycol dimethacrylate (TEGDMA), into acetone, ethanol or methanol. After an etching and rinsing procedure, the adhesives were applied onto either wet dentin surfaces (wet bonding) or dentin surfaces primed with the same solvent (solvent-primed bonding). Microtensile bond strength (MTBS) was measured at 48 hrs, 1 month and after 10,000 times of thermocycles. The bonded interfaces were evaluated using a scanning electron microscope (SEM). Regardless of bonding protocols, well-developed hybrid layers were observed at the bonded interface in most specimens. The highest mean MTBS was observed in the adhesive containing ethanol at 48 hrs. With solvent-primed bonding, increased MTBS tendencies were seen with thermocycling in the adhesives containing ethanol or methanol. However, in the case of wet bonding, no increase in MTBS was observed with aging.

A Human Case of Clinostomum complanatum Infection in Korea

A 33-year-old Korean man visited a medical clinic with complaints of throat discomfort and pain for one week. The symptoms occurred one day after eating raw brackish water fish, perch. Endoscopy revealed a fluke, about 5 mm in length, attaching to and peristaltically moving on the surface of the mucosa at the arytenoid region of the larynx. Microscopically, the testes were triangular, tandem, and separated by the uterus. The ovary and cirrus pouch were placed apart from median line between testes. Numerous blood cells were observed in the ceca. The worm was identified to be Clinostomum complanatum. This is the second human case of clinostomiasis in Korea.

Effect of cavity shape, bond quality and volume on dentin bond strength / 대한치과보존학회지

The aim of this study was to evaluate the effect of cavity shape, bond quality of bonding agent and volume of resin composite on shrinkage stress developed at the cavity floor. This was done by measuring the shear bond strength with respect to iris materials (cavity shape; adhesive-coated dentin as a high C-factor and Teflon-coated metal as a low C-factor), bonding agents (bond quality; Scotchbond(TM) Multi-purpose and Xeno(R)III) and iris hole diameters (volume; 1 mm or 3 mm in diameter x 1.5 mm in thickness). Ninety-six molars were randomly divided into 8 groups (2 x 2 x 2 experimental setup). In order to simulate a Class I cavity, shear bond strength was measured on the flat occlusal dentin surface with irises. The iris hole was filled with Z250 restorative resin composite in a bulk-filling manner. The data was analyzed using three-way ANOVA and the Tukey test. Fracture mode analysis was also done. When the cavity had high C-factor, good bond quality and large volume, the bond strength decreased significantly. The volume of resin composite restricted within the well-bonded cavity walls is also be suggested to be included in the concept of C-factor, as well as the cavity shape and bond quality. Since the bond quality and volume can exaggerate the effect of cavity shape on the shrinkage stress developed at the resin-dentin bond, resin composites must be filled in a method, which minimizes the volume that can increase the C-factor.

Surgical Treatment of Root Injury after Percutaneous Vertebroplasty: Case Report / 대한척추외과학회지

Percutaneous vertebroplasty using PMMA was first performed in France by Deramond in 1984. It was later used to treat vertebral compression fractures caused by osteoporosis. With osteoporotic compression fractures, reported complication were few and minor. However, the principal risk of such a percutaneous technique is the leak of PMMA into the spinal canal or neural foramina. Despite being uncommon, major neurologic complications demand surgical interventions that prevent permanent neurologic dysfunction. We experienced a case of root compression during percutaneous vertebroplasty, which was treated by early surgical posterior decompression.

Endoscopic Release in Carpal Tunnel Syndrome / 대한정형외과학회잡지

Carpal tunnel syndrome is known as the most common peripheral nerve entrapment neuropathy which results from compression of the median nerve within the carpal tunnel. Recently, endoscopic carpal tunnel release was introduced as an alternative of open carpal tunnel release. The purpose of this study is to find out the clinical usefulness of endoscopic carpal tunnel release through analyzing results of symptom, physical sign and E.M.G. finding. We analyzed 20 patients (29 cases) who had been treated by endoscopic carpal tunnel release, and followed up over 6 mos at Department of Orthopedic Surgery, Bongseng Memorial Hospital from August 1994 to December 1996. The results were excellent or good in 27 cases (93%) in Cseuz criteria, poor in only 1 case. Grip strength recovered to preoperative strength level in 28 cases (96.6%) at 3 mos postoperatively. The EMG checked postoperatively demonstrated improvement in both sensory and motor function. In conclusion, although endoscopic carpal tunnel release is a technically demanding procedure and the learning curve in steep, it has the advantage of lesser palmar scarring, lesser ulnar pillar pain, rapid and complete return of strength and to work. Therefore, endoscopic carpal tunnel release can be a good method in the treatment of carpal tunnel syndrome.

A Case of Sponataneous Regressing Retroperitoneal Fibrosis after Ureteral Stent Insertion / 대한신장학회잡지

A 76 year old man was admitted because of periumbilical aMominal pain and nausea for 20days before admission. Initial serum creatinine level was 6.1mg/dL. Radioisotope renography showed obstruc- tive uropathy in both ureters. Retrograde pyelography of the left kidney revealed about 1cm of filling defect on the level of L5. Percutaneous nephrostomography of the right kidney revealed ureteral stricture in the lower ureter. In order to preserve renal function, a double J stent was inserted into each ureter. Serum creatinine level decreased to 1.5mg/dL after the insertion of ureteral stents. 12 weeks later, both stents were removed. 3 months after removal of the ureteral stents, retroperitoneal fibrosis and hydronephrosis disappeared in follow up abdominal CT. Recent his serum creatinine has shown about 1.5mg/dL. The patient is under continuing observation with serum creatinine level and sonography for detection of recurrence. This is a rare case of retroperitoneal fibrosis which showed spontaneous regression after ureteral stent insertion for 12 weeks without ureterolysis or corticosteroid therapy. In this case, the ureteral stent played a important role in preserving renal function by relieving ureteral obstruction. But the key point was that in the early stage in the early stage of retroperitoneal fibrosis, it was thaught having reversible process. There are some reports that ureteral obstruction was relieved only by correction of fluid and electrolytes balance or ureter diversion such as percutaneous nephro-stomy. Corticosteroid therapy promotes this rever-sible change in early stage of this disease by immunosuppression and antiinflammatory reaction. But once fibrosis has established in late stage of retroperitoneal fibrosis, corticosteroid is not effective for reducing the fibrosis and ureteral obstruction. In that case, operation is the choice for preservation of renal function. We reported an idiopathic retroperitoneal fibrosis case which showed spontaneous regression after preserving renal function by double J stent insertion without ureterolysis or corticosteroid therapy. We thought that idiopathic retroperitoneal fibrosis is a reversible process in the early stage.

A Case of Ulcerative Colitis with Growth Disturbance

Ulcerative colitis is a chronic relapsing inflammatory disease of the colonic and rectal mucosa, which affects children as well as adults. Inflammation caused by ulcerative colitis is limited to the colon and rectum, to the mucosa and submucosa, and is involved continuously, with varying degrees of ulceration, hemorrhage, edema, and regenerating epithelium. Ulcerative colitis most commonly presents with the onset of diarrhea, later associated with hematochezia, but usually without systemic signs of fever, weight loss, or hypoalbuminemia. Approximately 30% of cases have moderate signs of systemic illness. Although less commonly seen than in Crohn's disease, the first sign of ulcerative colitis may be growth failure characterized by decreased linear growth velocity. We experienced a case of ulcerative colitis with growth disturbance and treated with sulfasalazine. During follow up for a year, the symptoms subsided, and the height and weight increased.

A Case of Congenital Lymphedema

Congenital lymphedema is a rare disorder of unknown etiology which affects the extremities, preponderantly the lower extremities, at or immediately after birth. We experienced a case of congenital lymphedema in a newborn with generalized edema on the left lower extremity. We performed lymphangioscintigraphy and MRI for diagnosis. Microlymphaticovenous anastomosis was done on 16 days after birth and the patient showed clinical improvement. We report this case with brief review of the related literature.

A Case of Hematogenous Tuberculosis of Skeletal Muscle / 대한내과학회지

Tuberculosis infection of skeletal muscle is rare even in countries in which tuberculosis is a relatively common disease. Because tuberculosis of muscle is almost always secondary to underlying tuberculosis of the bone or adjacent joint, hematogenous tuberculosis of skeletal muscle is extremely rare. Therefore, We report a case of hematogenous tuberculosis of skeletal muscle with the review of literatures. A 79-year-old man presented with a history of left shoulder pain, edema, fever and chill. MRI showed inflammatory changes of infraspinatus and deltoid muscle. The histopathology of skeletal muscle showed granulomas surrounded by epithelioid cells and Langhans' giant cells. Mycobacterium tuberculosis was grown from the specimens of sputum, pleural fluid and muscle tissue. The patient improved on anti-tuberculosis treatment.

A Comparative Study of Immunohistochemistry and PCR-SSCP for Detection of p53 Mutation In Gastric Carcinoma

Mutation of the p53 tumor-suppressor gene in exons 4 through 9 was examined in 34 cases of primary advanced gastric cancer using PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism) and the results were compared with p53 protein expression as determined by immunohistochemistry (IHC) using a monoclonal antibody(DO-1). p53 protein detected by IHC was observed in 14 cases (41.2%) and genotypic mutation detected by PCR-SSCP in exons 4-9 was observed in 13 cases (38.2%) One case showed an aberrant band on PCR-SSCP both in Exon 7 and Exon 8/9. p53 alteration detected by either IHC or PCR-SSCP was observed in 19 cases (55.9%), but only 8 cases (23.5%) showed both p53 mutation and protein expression. We also tried to obtain the correlation between relative intensity of the shifted bands on PCR-SSCP and percentage of positive cells by IHC, but a significant correlation was not seen between relative intensity of shifted bands on PCR-SSCP and positve cell ratio. A discrepancy between p53 protein expression and p53 mutation is observed in primary gastric carcinomas. The reason for this discrepancy are not apparent. However, examination of gastric carcinomas for mutations in other exons may identify a better correlation with protein overexpression. The results obtained in this study suggest that the negative reaction for p53 immunohistochemistry may not necessarily mean no genetic alteration of the p53 locus.

A Case of Intestinal Tuberculosis Extensively Involving the Upper and Lower Intestinal Tract, Accompanied by Tuberculous Lymphadenitis / 대한소화기내시경학회지

The prevalence of intestinal tuberculosis has been markedly decreased with the development of anti-tuberculous chemotherapy, preventive medicine, vaccinations, early detection and treatment of pulmonary tuberculosis, and improved eeonomic conditions. Nowadays, intestinal tuberculosis is a disease that should be differentiated from the inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, Behcet's disease, and colon cancer and amebic colitis. This disease also has a new clinical significance in that it has an increased infection rate and unfavorable outcomes in patients infected by HIV or in those who undergo organ transplantation or receive immunosuppressive agents. Tuberculosis of the duodenum was a rare disease and was not reported in the last decade. Moreover Intestinal tuberculosis extensively involving the small bowel including the duodenum and colon was very rarely reported in the various relateid literature. Recently we experienced a case of advanced intestinal tuberculosis involving the duodenum, jejunum, ileum, and colon accompanied by tuberculous cervical and abdominal lymphadenopathies, in a 49-year-old woman who manifested profound general weakness, diarrhea, and marked weight loss. She was diagnosed pathologically by upper gastrointestinal endoscopy, colonoscopy, and fine needle aspiration cytology as well as by roentgenologic examination. The patient was given antituberculous medication which resulted in dramatic clinical improvement. In this report, we present this case with review of the related literature.

A Case of SKull Bone Metastasis in Uterine Leiomyosarcoma / 대한산부인과학회잡지

Uterine leiomyosarcoma is a rare malignant tumor, and distant metastasis to skull bone is very uncommon. We experienced a case of parietal skull bone metastasis from uterine leiomyosarcoma in a 52-year-old woman who had undergone simple total hysterectomy and bilateral salpingoophorectomy with the diagnosis of uterine myoma. We treated this patient with combination chemotherapy using cisplatin and adriamycin and radiotherapy after craniectomy. She is alive now without particular symptoms. We report this case with a brief review of some literatures.

A Case of Bartter's Syndrome in an Adult / 대한신장학회잡지

Bartter's syndrome is characterized by hypokalemia and secondary hyperaldosteronism without edema or hypertension. Its pathogenesis is obscure and the characteristic renal potassium wastage is difficult to treat. We experienced a case of Bartter's syndrome in 47 year-old diabetic female. She had felt dizziness, muscle weakness and cramping for about two years. During diagnostic evaluation, hypokalemic metabolic alkalosis and hyperreninemic hyperaldosteronism were discovered. The patient denied ingestions of laxatives, diuretics, licorice and she had no nausea, vomiting, diarrhea or edema. She had normal blood pressure. The patient improved with potassium supplements and spironolactone therapy along with oral hypoglycemic agent. So we report this case with the review of literature.

The Study of Chromosomal Aberration in NSCLC Patients which Developed after Administration of Chemotherapeutic Agents / 대한암학회지

PURPOSE: Except hormonal agents and biologic response modifier, the biologic effects of chemotherapy and radiotherapy as anti-cancer therapy have the mechanism of DNA injury. They cause not only cancer cell necrosis, but also infertility, bone marrow suppression, secondary malignancy, and individual death. There are many reports to human genome or chromosomal injuries by radiation but few by chemotherapy. Therefore this study is designed for systemic evaluation of the frequency of chromosomal damage by chemotherapy. MATERIALS AND METHODS: We performed evaluation of chromosomal aberration, sister chromatid exchange, and mitotic index were examined in 3 patient with NSCLC. Two of them were stage IIIb and the other one was stage IV. Venous blood was taken from patients before chemotherapy and one day after last administration of combination chemotherapy. Microscopic examination for chromosomal aberration, chromatid aberration, and SCEs was done after cell culture and FPG stain. RESULTS: The incidence of chromatid break was 3 before chemotherapy and 26 after chemotherapy. The incidence of SCEs was 9.85 1.93 before chemotherapy and 40.47 7.12 after chemotherapy. CONCLUSION: Incidence of chromatid break and SCEs increased after combination chemotherapy.

Detection of Human Papillomavirus in Lesions of Uterine Cervix Immunohistochemistry and in situ Hybridization

To evaluate the detection of HPV DNA according to subtype of lesions of uterine cervix and its clinical applicability, in situ hybridization (ISH) and immunohistochemistry for HPV were performed in 189 cases of uterine cervical lesion, including 23 cases of low grade squamous intraepithelial lesion (SIL), 115 cases of high grade SIL and 51 cases of invasive carcinoma. Positive immunostaining, brown precipitate, was mainly noted in the nucleus of koilocytes in the superficial and intermediate layer. Positivity of immunostaining was 21.7% in low grade SIL, 13.0% in high grade SIL and 9.8% in invasive carcinoma. Positive reaction in ISH, red precipitate, was noted in the nucleus of not only koilocytes but also non-koilocytes in the superficial and intermediate layer, and dot precipitate was rarely identified in the nest of squamous cell carcinoma. Based on HPV subtype, 6/11 was 21.7% in low grade SIL, 16/18 was 32.2% and 39.2% in high grade SIL and invasive carcinoma, respectively. With regard to their associated HPV types, low grade SILs were heterogeneous and high grade SILs and invasive carcinomas were related with the high oncogenic risk group only. The correlation of HPV subtypes with panHPV was 91.3% in low grade SIL, 91.3% in high grade SIL and 98.0% in invasive carcinoma. These results suggest that detection of HPV infection by ISH may be a more useful method than immunohistochemistry and application of the HPV subtype probe with the panHPV probe could improve the sensitivity of ISH.

A Case of Subsequent Papillary Carcinoma of the Thyroid gland and Hashimoto's Thyroiditis / 대한내분비학회지

The association of thyroid carcinoma and Hashimotos thyroiditis in same thyroid gland is controversial. Incidence of carcinoma who has Hashimotos thyroiditis has been reported from 0.5 to 22.5 per cent by Crile and by Hirabayashi et al. The reason that there are such great diffarences in the reported incidences of carcinoma in Hashimotos disease is the result of the way the material is reported. The carcinomas of the thyroid which occur in association with Hashirnotos thyroiditis are predominently papillary tumors of lower grade malignancy. Thyroid carcinoma need not be feared in patimts with Hashimotos thymiditis, if one examines the ghmd catefully. When patients with Hashimotos disease are treated with thyroxine, there is little or no tendency for Hashimotos disease propess to clinieally detectable carcinoma of the thymid, and the microcarcinoma does not appear. In this case, single thyroid nodule was detected in Hashiimotos disease patient who was treated with thyroxine. There was no significant volume change of thyroid nodule despite of TSH suppression therapy during six months. Therefore we perforrned FNABC twice, the results were highly suspicious thyroid malignancy and subtotoal thyroidectomy was performed. The final pathologic result was microscopic papillary carcinoma with background Hashlmotos thyroiditis. In conclusion, we experienced a case of subsequent microscopic papillary carcinoma of the thyroid in patient with Hashimotos thyroiditis who was TSH suppression therapy with thyroxine.

Cytopathologic Features of Primary Bronchial Adenoid Cystic Carcinoma: A Case Report / 대한세포병리학회지

Adenoid cystic carcinoma arising from the submucosal glands of the trachea and bronchial tree is rare. The histopathology and natural history of bronchial adenoid cystic carcinoma have been well documented, but detailed descriptions of its cytomor- phology are few. We report a case of primary bronchial adenoid cystic carcinoma in a 20-year-old female, diagnosed by bronchial brushing cytology. The cytologic specimens showed large clusters of small cells arranged around cystlike spaces containing globular basophilic material.

A Case of Autonomously Functioning Thyroid Nodule Treated with Percutaneous / 대한내분비학회지

Autonomously functioning thyroid nodules(AFTNs) are so named because they presumably are independent of TSH for growth and function. In general, surgery and radioactive iodine are effective therapies but reluctant to use because of complications such as hypothyroidism or cosmetic problems.Percutaneous ethanol injection therapy(PEIT) under sonographic guidance has recently been introduced as alternative therapy. But its adverse effects such as severe local pain, subcutaneous hematoma or palsy of the recurrent nerve are not negligible, therefore sufficient skill is required.In this case, the levothyroxine therapy in reducing the size of colloid thyroid nodules was not apparent within three months. Therefore we selected another sclerosing therapeutic method such as percutaneous tetracycline injection(PTI) and followed up thyroid function test, thyroid scan, ultrasonographical size and volume of nodule. The results were as follows: 1) With 0.5-0.8 cc tetracycline injection for three times, the volume of nodule was reduced after PTI; About 2.3 X 1.7 X 0.7 cm sized nodule was reduced to about 1.3 X 1.0 X 0.5 cm sized nodule. 2) There were significant improvements of TFT(subclinical hyperthyroidism to euthyroidism) and thyroid scan(solitary hot nodule to completely ablated AFTN) during 9 months follow-up after PTI as compared with the base line study. In conclusion, we experienced good results in a 22-year-old woman suffered from AFTN treated with PTI and think that PTI could be the effective, safe, simple, well tolerable procedure in the treatment of AFTN.

Posterior Cruciate Ligament Injury Combined with Patellar Fracture: Report of Four cases / 대한정형외과학회잡지

One of the patellar function is to protect the femoral condyle from direct blowing to knee, so it is known that ligament injuries of the knee are rare in the presence of patellar fracture. We experienced four cases of posterior cruciate ligament injury associated with patellar fracture. Unfortunately, three cases were initially neglected, and one case was identified by visualization on avulsed posterior tibial spine in plain X-ray film. We reviewed these cases and obtained several results as follows; 1. Among four cases, three cases(75%) are fractured at the lower pole of patella without displacement and one case is a longitudinal fracture. 2. We consider possible two mechanisms of this injury; first, in flexed knee, posteriorly directed force on the proximal tibia produces posterior cruciate ligament injury followed by avulsed fracture at the lower pole of patella. Second, by fall on a flexed knee, the load is sustained on the inferior pole of the patella first and continuously drives the tibia backwards producing posterior cruciate ligament injury. We recommend that all surgeon should be aware of possibility of the ligament injury in the presence of patellar fracture, especially in lower pole fracture.