Effects of a Thermoelectric ElementBandon Venipuncture-associatedPain and Anxiety: A RandomizedControlledTrial

Purpose@#Venipuncture is an invasive procedure for diagnosis and treatment, which is often attributed to pain and anxiety. In this study, a thermoelectric element (TEE) band was developed to apply heat therapy (40∼45°C), cold therapy (0∼10°C), or thermal grill illusion (TGI) therapy (40∼45°C, 0∼10°C) to cause an illusion of pain by simultaneously applying heat and cold. This band was subsequently used to investigate its effect on patient pain, anxiety, and satisfaction. @*Methods@#This was a randomized controlled study. Participants, who were to undergo venipuncture, were randomly assigned to the heat therapy, cold therapy, TGI therapy, or control groups. Each group had 30 participants. The interventions were employed for 10 seconds during venipuncture, and the pain, anxiety, and satisfaction were measured before and after the procedure. @*Results@#Subjective pain, anxiety, and physiological responses after TEE band intervention were not significantly different between the four groups. However, there was a significant difference in satisfaction (F = 4.21, p = .007) between the four groups, and the cold therapy group showed the highest satisfaction. @*Conclusion@#In this study, when heat, cold, and TGI therapy were applied with a TEE band, pain and anxiety relief effects were not confirmed, but satisfaction was high. TEE band is a newly developed product that can easily apply hot and cold treatments without using ice packs or hot water packs. Further studies with various individual characteristics of chronic pain or repeated venipuncture are warranted to evaluate the effect of TEE.

Time-course changes of hippocalcin expression in the mouse hippocampus following pilocarpine-induced status epilepticus

Hippocalcin participates in the maintenance of neuronal calcium homeostasis. In the present study, we examined the time-course changes of neuronal degeneration and hippocalcin protein level in the mouse hippocampus following pilocarpine-induced status epilepticus (SE). Marked neuronal degeneration was observed in the hippocampus after SE in a time-dependent manner, although neuronal degeneration differed according to the hippocampal subregions. Almost no hippocalcin immunoreactivity was detected in the pyramidal neurons of the cornu ammonis 1 (CA1) region from 6 h after SE. However, many pyramidal neurons in the CA2 region showed hippocalcin immunoreactivity until 24 h after SE. In the CA3 region, only a few hippocalcin immunoreactive cells were observed at 12 h after SE, and almost no hippocalcin immunoreactivity was observed in the pyramidal neurons from 24 h after SE. Hippocalcin immunoreactivity in the polymorphic cells of the dentate gyrus was markedly decreased from 6 h after SE. In addition, hippocalcin protein level in the hippocampus began to decrease from 6 h after SE, and was significantly decreased at 24 h and 48 h after pilocarpine-induced SE. These results indicate that marked reduction of hippocalcin level may be closely related to neuronal degeneration in the hippocampus following pilocarpine-induced SE.

Odontogenic ghost cell carcinoma arising from odontogenic epithelial tumor in maxilla: A case report

The neoplastic variant of calcifying odontogenic cyst has various designation, and its malignant counterpart has been reported as aggressive epithelial ghost cell tumor or odontogenic ghost cell carcinoma. Odontogenic ghost cell carcinoma(OGCC) is a rare carcinoma first documented in 1985. It is composed of varying sized islands of anucleated cells with homogenous, pale eosinophilic cytoplasm, so called ghost cells, were admixed with nucleated cells. We report a case of maxillary OGCC developed from odontogenic epithelial tumor in a 25-year-old man with literature review.

Surgical Treatment Of Recurrent Tmj Dislocation By Eminectomy With Discoplasty

PURPOSE: Various treatment methods have been utilized for recurrent dislocation of the TMJ (temporomandibular joint). The purpose of this study is to define the effect of the eminectomy with discoplasty that had been performed in patients with TMJ luxation. MATERIALS AND EMTHODS: Twenty patients (22 joints), whose diagnosis were TMJ dislocation were selected in 772 patients (871 joints) who had been underwent TMJ surgery between 1988 and 2000. The selected patients were divided into two groups. Group I (12 joints) was the habitual-luxation group which involves the recurrent TMJ dislocation patients. Group II (10 joints) was the open lock-history group which involves the patients who had more than two episodes of TMJ luxation and TMJ disorders. The history of TMJ luxation, maximum mouth opening and other TMJ signs and symptoms before and after surgery were reviewed. RESULTS: In group I, one patient who had been underwent both TMJ operation had a intermittent locking, but it disappeared after post-operative 32 months. In group II, intermittent pain was present in one patient who had bruxism, but it was disappeared by splint therapy. No more TMJ dislocations and other pains were checked in other patients of group I and II. CONCLUSION: Eminectomy with discoplasty may be used to successfully treat the TMJ habitual luxation accompanied with abnormal condition of the disc-condyle complex.

Clinical Characterization of the Maxillary Sinus Aspergillosis

Nine cases of maxillary sinus aspergillosis during a period from February of 1992 to June of 2000 were investigated to analyze the clinical, radiologic and pathologic features. Maxillary sinus aspergillosis is rare disease, but it was increasing tendency with overuse antibiotics, steroid hormones, and anticancer agents. Aspergillosis of the maxillary sinus may occur as a chronic disease in an otherwise healthy person. The clinical features of maxillary sinus aspergillosis were similar to the non-fungal, chronic sinusitis. Intrasinus calcification is known to be a characteristic feature of maxillary sinus aspergillosis. It is suggested that excess root filling materials containing zinc oxide in the maxillary sinus could favour the formation of a local, non-invasive maxillary sinus aspergillosis. And this "dental" model of pathogenensis of maxillary sinus aspergillosis is an alternative to the widely accepted concept of spore inhalation and "aerogenic" pathogenensis of maxillary sinus aspergillosis. The radical surgery such as Caldwell-Luc operation was one of the most effective treatment modalities. Our results of this study indicate that maxillary sinus aspergillosis might occur mainly in healthy individuals rather than debilitating patients. It could efficiently treated with radical surgery alone without the antifungal agents. 4 cases were suspected to be related with teeth extraction and endodontic treatment. There were no recurrence in all cases.

Mean values of lateral cephalometric analysis from Korean adults with normal occlusion in relation to the diagnosis of obstructive sleep apnea syndrome

Changes of the symptoms following surgical treatment of temporomandibular joint internal derangement with disc adhesion

A RETROSPECTIVE STUDY ON THE RELATIONSHIP BETWEEN MRI EVIDENCE OF TEMPOROMANDIBULAR JOINT EFFUSION AND CLINICO-SURGICAL FINDINGS

PURPOSE: Although joint effusion caused by the inflammatory changes of synovium has been known to be associated with joint pain, it is still controversial. This study is to clarify the relationship between the evidence of joint effusion seen high signal intensity in T2-weighted magnetic resonance imaging and clinico-surgical findings. MATERIALS AND METHODS: All of the patients were diagnosed as temporomandibular joint internal derangement and received unilateral open surgery. The authors classified the joint effusion as four categories by size and shape: degree 0-no evidence; degree 1a-a line of high signal along articular surface in unfolded disc; degree 1b-high signal spot in the folded disc; degree 2-pooling in the anterior recess and folded disc; degree 3-pooling in the glenoid fossa and along articular eminence. The authors evaluated clinical and surgical findings. RESULTS: Two-hundred eighty-nine patients(242 females) with mean age of 30.2 years(range: 14 to 74) were included. High signal intensity was seen in 166 joints(57.4%): degree 1 in 82 joints, degree 2 in 69 joints(23.9%), degree 3 in 15 joints(5.2%). Maximal mouth opening of degree 0 group was 38.07mm, degree 1: 36.34mm, degree 3: 33.47mm. Mean TMJ pain score of the joint effusion groups was 1.58, no evidence group was 1.41. Click of degree 0 group was 44.7%, degree 3 was 43.4%. Crepitus of degree 0 group was 17.1%, degree 3 was 26.7%. Mean pain score of headache of degree 0 group was 1.80, degree 2 was 1.22. Neck and shoulder pain of degree 0 group was 50.4%, degree 1 was 39.0%. Perforation, adhesion, hyperemia of degree 0 was 27.6%, 35.8%, 18.7%, degree 2: 23.2%, 29.0%, 29.3%(degree 1). CONCLUSIONS: TMJ pain, TMJ sound and surgical findings did not relate significantly to the joint effusion of TMJ, but referred symptoms such as headache, neck and shoulder pain were less severe in the joint effusion groups.

A Clinical Study of Judet Plate Fixation for Subtrochanteric Fractures of the Femur / 대한정형외과학회잡지

Fractures in the subtrochanteric region of the femur present more formidable problems in treatment than do other trochanteric fractures, because such severe stresses exit at the fracture site. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many internal fixation devices have been recommanded for use in subtrochanteric fractures and each of these devices have advantages in certain types of subtrochanteric fractures, and their selection should be based on the individual fracture anatomy. A total of 20 patients with fracture of the subtrochanteric region of the femur, who were treated by internal fixation with Judet plate between January 1982 and December 1988 have been reviewed. Our conclusions were as follows; 1. Average age was 38 years old and most common cause of injury was traffic accident. 2. Cast immobilization was done after Judet plate fixation. Partial weight bearing ambulation was enabled from POD 10 weeks and full weight bearing ambulation was enabled from POD 16 weeks. 3. 18 in 20 cases, primary bony union was happened and the mean duration of radiological bony union was 24 weeks. 4. 3 cases of complications, metal failure with refracture (2 cases) and screw loosening (1 case), were occured due to early weight bearing in the post operative course. 5. Judet plate fixation was gave satisfactory result in uncomminuted subtrochanteric fracture, especially Seinsheimer's type I, II-A,B,C or Fieldings type I, II. 6. From a consideration of these series, Judet plate showed easy to use, perfect adaptation and rigid fixation. We thought Judet plate is one of a good implants for rigid fixation of subtrochanteric fracture without severe medial cortical disruption.

The Clinical Analysis of Acetabular Fractures / 대한정형외과학회잡지

Acetabular fractures assume great clinical importance because acetabular is weight bearing joint in the lower extremity. The undisplaced fractures of the acetabulum gave satisfactory results with closed method, but the treatment of displaced fractures have been controversial. A clinical analysis was performed on the 72 patients with displaced acetabular fractures, who had been treated at Soonchunhyang University Hospital from January 1980 to December 1989. The results obtained were as follows. 1. The prevalent age ranged from 21 to 50 years, which comprised 86.1% of all, and the ratio between male and female was 3:l. 2. The most common cause of injury was traffic accident, which comprised 76.4%. 3. According to Letournel's classification, simple fracture was 38 cases (52.8%), associated fracture was 34 cases (47.2%) and hip dislocation was associated in 28 cases (38.9%) and most common was posterior (20.8%). 4. Closed treatment was done in 47 cases and open treatment in 25 cases. 5. Results of open treatment group were better than closed treatment group in both clinical and roentgenographic study. 6. The complication were occured in 14 (29.8%) out of 47 cases of closed treatment group, and 10 (40.0%) out of 25 cases of open treatment group. 7. Not only choice of treatment but also determination of surgical approach require accurate assessment of the fracture pattern in this region of complex bony architecture by careful radilogic analysis.

Clinical Evaluation of Cementless Total Hip Arthroplasty in Avascular Necrosis of the Femoral Head in Adult / 대한정형외과학회잡지

Recently, Prosthetic replacement of hip was recognized as a reliable technique for the treatment of avascular necrosis of femoral head in adult. There were many reports about post-operative evaluation of functional difference between hemiarthroplasty and total hip arthroplasty and which revealed that the revision rate for the total hip arthroplasty was less compared with the femoral endoprosthesis. Also, controversy was existed between the porous coating system and bone cement fixation. In order to evaluate the functional difference among each prosthetic replacement, authors reviewed the result of 10 cases of cementless unipolar endoprosthesis (abbreviated as UE), 10 cases of cementless bipolar endoprosthesis (abbreviated as BE), and 25 cases of cementless total hip replacement arthroplasy (abbreviated as THRA), performed at Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital, during the period from September, 1985 to August, 1988. The following results were obtained: 1. The incidence was higher in 6th decade in UE, THRA groups, 4th decade in BE group. 2. The average follow up of UE, BE, and THRA groups were 30.7, 15.2, and 16.9 months, respectively. 3. By radiological classification of Marcus et al., the average stages of UE, BE, and THRA were 4.9, 4.0, and 5.3respectively. 4. According to Harris hip rating system, post-op. Harris scores were increased as much as 33.1, 37.2, and 43.4 in UE, BE, and THRA groups respectivelycompared with pre-op. score. 5. In this study, the last follow up results of hip function in BE, and THRA groups were better than that evaluated at 6 months after surgery in most cases. 6. External rotation, which was one of needed motion in cross leg sitting position, was significantly influenced by the degree of excision of joint capsule, the type of replacement prosthesis, the regimen of post-op. starting exercise, and a history of previous surgical treatment. 7. Because serious complications were not developed at recent follow up, the UE, BE, and THRA groups showed insignificant difference in functional difference in prosthetic replacement.

Clinical Results of Segmental spinal instrumentation in Unstable Fracture and Fracture / 대한정형외과학회잡지

Segmental Spinal Instrumentation (S.S.I.) is considered to the effective operative procedure in unstable fracture and fracture-dislocation of the thoracolumbar spine, providing improved correction effect, high rate of fusion and immediate rigid fixation which obviates the need for postoperative immobilization. Retrospective study was carried out of 24 cases of fracture or fracture-dislication of the thoracolumbar spine, There were treated with Harrington rod instrumentation and sublaminar wiring (8 cases) and Luque rod instrumentatiom and sublaminar wiring (16 cases) in Soonchnhyang University, from January 1986 to June 1988. We have analyzed the results of treatment, which were as follows ; 1. Thoracolumbar junction (T12 Ll) was most commomly involved segment (63%) and falling from a height was most common cause of injuries. 2. The most common type by Denis classification was burst fracture (38%). 3. About improvement of neurologic status by injury site and type of instrumentation, thoracolumbar junction (38.5%) and lumbar spine (35%) were better prognosis than thoracic spine (8.75%). 4. In commparison with kyphotic deformity and displacement, Harrington rod (66.4%) was better than Luque rod (58.9%) in postoperative correction. Also in total correction, Harrington rod was better than Luque rod in spite of more or less large amount of loss of correction. words : Thoracolumbar spine, Unstable fracture-dislocation, Segmental spinal instrumentation (S.S.I.)

Flexible Intramedullary Nailing for Femoral Fractures / 대한정형외과학회잡지

Various methods of internal fixation have been used for the treatment of femoral fractures. In 1970, Ender and Simon-Weidner described their method of flexible intramedullary nailing for the treatment interterochanteric and subtrochteric fractures. This method was widely used and obtained good result but Pankovich described that the intertrochsnteric fraeture, particullary unstable, is the worst indication due to many complications and difficulties in the procedure, We used flexible intramedullary nailing fot 115 cases of the femoral fractures from Jan. 1985 to Mar, 1988 at the Department of Orthopedir Surgery, Soonchunhyang University Hopsital with following results. 1. The intertrochanteric, subtrochanteric and shaft fractures were healed within 12.6 weeks, 15.8 weeks and 17.3 weeks respectively, however, unstable or comminuted fractures took more time to be healed. 2. The most frequent complication was shortening (20 cases), flollowed by nail migration, broken nail, delayed and non-union in orders. 3. Nonunion and delayed union were frequently occured at the distal shaft fractures and developed broken nail. the healing time is longer than those of other sites, So, the flexible intramedullary nailing on the distal shaft fractures of femur may be inappropriate. 4. In 8 cases of unstable or comminuted fractures of subtrochanteric and shaft, open reduction and cerclage wiring were done before nail insertion. We could prevent shortening and start early weight bearing and obtain the good result of bone union. 5. In 8 cases of locking with screw through the nail eyes, there was no nail migration and knee joint pain was almost none. 6. Among 4 cases of secondary Ender nailing and bone graft, one case was infected and the others were united after 11.7 weeks. In nonunion, this method may be useful. 7. Varization and shortening were developed in the unstable intertrochanteric fractures but clinically they were not significant. We recommed ender nailing for the unstable intertrochanteric fractures for experienced surgeons.

Treatment of Tibial shaft Fracture Using Flexible Intramedullary Nailing / 대한정형외과학회잡지

There are many controversies concering primary treatment of fractures of the tibial shaft. Recently, flexible intramedullary nailing for the tibial shaft fracture has gained popularity, because of promotimg osteogenesis with early weight bearing and preventing ankylosis of the joints. Authors carried out retrospective study of the 142 tibial shaft fractures in 141 patients, and results were as analyzed. The results were as follow:l. Among 141 patients, 116 cases were male and 25 cases were female. The average age was 37 years and the most cause of injury was traffic accident. 2. The number of cases of closed and open fractures were 71 cases, respectively. The most common type of the fracture was comminuted and the level was middle third. 3. The number nails were inserted from two to five according to width of the medullary cavity and to gain of the stability after reduction at the fracture site. 4. Average bone union in X-ray was 17.8 weeks, 96 cases were united within 20 weeks and 43 cases were united after 21 weeks. 5. Complications were 3 cases of non-union and 17 cases of valgus deformity, within 12 degrees.

Traumatic Spondylolisthesis of Cervical Spine Treated by Contoured Loop Fixation and Sublaminar Wiring / 대한정형외과학회잡지

Rigid posterior fixation of the atlas to the third and fourth cervical spine was achieved in a patient in whom axis pedicle fracture and dislocation of axis on the third cervical spine. Althouth there was no evidence of neurologic disorder, marked instability of axis on the third cervical spine should inevitably be fused in any procedures. An anatomically contoured loop was secured to the posterior arch of the atlas and the laminae of the third and the fourth cervical spine by sublaminar wirings. The technique has the advantage over bone graft, either alone or with cement, in that it affords rigid stabilization, allows early mobilization and some flexion movement of atlanto-occipital joint.

Malignant Granular Cell Tumor: Report of One Case / 대한정형외과학회잡지

Granular cell tumor is one of the rare tumorous condition. At present there are estimated 600 reported examples of the tumor in the medical literature. Malignant granular cell tumor is a well established but extremely rare entity that is found in appr- oximately 2 % of all granular cell tumor. Diagnosis should be restricted to neoplasms that are similar in their histological appearance to benign granular cell tumors but can be seperated on the basis of cellular pleomorphism, mitotic activity, and, most importantly, their capacity to produce metastases. The authors had experienced that a 55 years old male patient had two large malignant granular cell tumors at the left thigh and left inguinal area with metastatic lesion.

Treatment of Subtrochanteric Fracture of the Femur / 대한정형외과학회잡지

Subtrochanteric fracture of the femur is more difficult to treat than other bone fracture. Subtrochanteric fracture occurs in bone that is predominently cortical and biomechanical analyeis of stress in the femur ahowed that there is a high concentration of stress in the subtrochanteric region. These two factors, involvement of cortical bone tissue and concentration of stress, frequently have been mentioned as reasons for the high incidence of complications in the treatment of these fractures. The authors treated 23 cases of subtrochanteric fracture of the femur in 1974 through 1981, at the Department of Orthopaedic Surgery, School of Medicine, Soon Chun Hyang College. The results were as follows: 1. Of 23 cases of subtrochanteric fracture, 15 cases occurred in man, 8 cases in woman. 2. The most common cause of fracture was due to traffic accident. 3. Of 23 cases of subtrochanteric fracture, 9 cases were type lI, and 7 cases were type I & II by Fielding's classification. 4. 19 cases out of 23 were treated by means of the open reduction and internal fixation. As the internal fixation material, we used Kuntscher nail, Smith-Peterson and Thornton plate, Compression hip screw and plate until December 1978, and Zickel nail from January 1979. 5. The mean duration of bony union in subtrochanteric fracture treated by Zickel nail was shorter than the other implants. The incidence of complications such as coxa vara, delayed union, metal breakage occurred higher in the cases treated by Kuntscher nail, Smith-Peterson nail and Thornton plate, Campression hip screw and plate. 6. Zickel nail is one of the good implant for the treatment of subtrochanteric fracture of the femur.