1.Is stopping of anticoagulant therapy really required in a minor dental surgery?: How about in an endodontic microsurgery?.
Restorative Dentistry & Endodontics 2013;38(3):113-118
Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.
Anticoagulants
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Avena
;
Hemorrhage
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Humans
;
Thromboembolism
2.Utility of CoaguChek XS for Monitoring the Prothrombin Time.
Rojin PARK ; Yong Hyun KIM ; Kyung Ock KWON ; Jongsung NA ; Yong Soon WON ; Ki Bum SUNG ; Nae Hee LEE ; Tae Youn CHOI ; Jeong Won SHIN ; Hee Bong SHIN ; Yong Wha LEE ; You Kyeong LEE
Tuberculosis and Respiratory Diseases 2008;65(6):471-475
BACKGROUND: In order to achieve a maintenance level and to prevent hemorrhagic complications, regular monitoring of the INR is mandatory for patients on oral anticoagulation therapy (OAT). A point-of-care instrument for INR monitoring is convenient for users, but the accuracy of the results has been controversial, and so this calls for exact evaluation of the point-of-care instrument that is used for INR monitoring. METHODS: From Aug 2007 through Feb 2008, 85 patients on OAT among the all the patients who were admitted to Soonchunhyang University Bucheon Hospital were involved in this study. Parallel measurements of the PT INR were performed using a CoaguChek-XS and, a CA-7000 laboratory reference instrument and the results were analyzed. In addition, the patients' clinical data, including the diagnosis and the frequency and interval of the INR measurements, were also analyzed. RESULTS: Of the 85 patients, 25 were admitted more than once to undergo INR testing and the mean interval between testing was 8.6 weeks with 39% and 38% of the tests being less than INR 2 units with using the CoaguChek-XS and the reference method, respectively. The coefficients of variation of CoaguChek-XS were 4.50 and 2.45 for the high and low INR patients, respectively. An excellent correlation was found between the two methods with a R2 of 0.966 (p<0.001). Through Bland-Altman analysis, the mean INR difference between the two methods was 0.13 with the limit of agreement being -0.47 +0.72 with a 95% confidence interval. CoaguChek-XS was shown to overestimate the INR value for patients with an increasing INR, as compared to the reference method. CONCLUSION: CoaguChek-XS demonstrated great precision and accuracy for patients on OAT when compared to the laboratory INR results. Accordingly, the instrument should help to monitor the INR in the patients on OAT.
Avena
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Humans
;
International Normalized Ratio
;
Organothiophosphorus Compounds
;
Prothrombin
;
Prothrombin Time
3.A Comparison of Clinical Outcomes after Osteochondral Autologous Transplantation & Arthroscopic Microfracture Surgery for Treating of Osteochondral Lesions of the Knee.
Dong Chul LEE ; Ook Jin SOHN ; Min Chul SUNG
The Journal of the Korean Orthopaedic Association 2009;44(3):320-328
PURPOSE: We wanted to compare the clinical outcomes after osteochondral autologous transplantation (OAT) and arthroscopic microfracture for treating of osteochondral lesions of the knee. MATERIALS AND METHODS: We reviewed 12 cases (12 patients) of arthroscopic microfracture and 10 cases (9 patients) of OAT. The mean patient ages were 33.5 years in the microfracture group and 31.3 years in the OAT group. The mean follow-up period was 31.1 months. The mean lesion sizes were 12.9x17.4 mm in the microfracture group and 16.1x21.4 mm in the OAT group. We compared clinical results using the Tegner activity score, the Lysholm knee scoring scale, the IKDC and the VAS. MRI was used to determine the recovery of the osteochondral lesions at last follow-up. RESULTS: There was no statistically significant difference between the groups for the Tegner Activity Score. Regarding the Lysholm Knee Scoring Scale, the OAT group had a better overall score than did the microfracture group (p<0.05). Both groups had similar results for the IKDC and VAS. The MRI at the last follow-up showed cartilage recovery in 53% of the microfracture cases (compared to the surrounding cartilage) and in 96.1% of the OAT cases. CONCLUSION: Microfracture and OAT both offered good clinical results when used to treat active persons in the 3rd or 4th decades of life and who have osteochondral lesions of the knee. However, OAT led to better cartilage recovery on MRI, as well as to better functional results. Therefore, OAT is the recommended method of treatment.
Avena
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Cartilage
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Follow-Up Studies
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Humans
;
Knee
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Transplantation, Autologous
5.Comparison between intracytoplasmic sperm injection and intracytoplasmic morphologically selected sperm injection in oligo-astheno-teratozoospermia patients.
Hyung Jun KIM ; Hye Jin YOON ; Jung Mi JANG ; Hwa Soon OH ; Yong Jun LEE ; Won Don LEE ; San Hyun YOON ; Jin Ho LIM
Clinical and Experimental Reproductive Medicine 2014;41(1):9-14
OBJECTIVE: The aim of this study was to evaluate the efficiency of the intracytoplasmic morphologically selected sperm injection (IMSI) technique compared with conventional ICSI and previous ICSI attempts in oligo-astheno-teratozoospermia (OAT) patients. METHODS: The sperms were selected under high magnification (6,600x) and used to induce fertilization in previous ICSI patients by IMSI. These results were compared with previous conventional ICSI cycles in patients with OAT infertility. RESULTS: These results demonstrated no significant difference in the fertilization rate between IMSI and previous ICSI cycles (67.7% vs. 65.0%). However, the pregnancy and implantation rates with IMSI were significantly higher than those of the ICSI cycles (33.3% vs. 12.5% and 14.6% vs. 5.4%, respectively; p<0.05). The miscarriage rate among pregnant patients (18.2% vs. 37.5%) showed no statistically significant difference between groups. CONCLUSION: Compared to conventional ICSI, this study found that IMSI increased the IVF-ET success rates in patients with OAT.
Abortion, Spontaneous
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Avena
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Female
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Fertilization
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Humans
;
Infertility
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Pregnancy
;
Sperm Injections, Intracytoplasmic*
;
Spermatozoa*
6.Beta-glucan for Glycemic Control Effects in Adults: a Meta-analysis.
Gyo Soon HWANG ; Yong Kyun ROH ; Hong Ji SONG ; Yoon Young LEE ; Hyung Joon KIM ; In Hong HWANG ; Soo Young KIM ; Hye Min CHO
Journal of the Korean Academy of Family Medicine 2008;29(7):475-483
BACKGROUND: Recently, there has been an increase of emerging concerns between dietary fiber and diabetics. Increasing intake of dietary fiber leads to delaying absorption of glucose, and lowering of serum insulin levels. In the past studies, there were inconsistent glycemic control effect of beta-glucan. Our purpose was to assess the glycemic control effect of beta-glucan in adults. METHODS: Electronic searches (Cochrane, PubMed, EMBase), hand-searching and review of reference were done. The search term for beta-glucans [mh], "Avena sativa" [mh], "Hordeum" [mh], beta glucan* [tw], oat [tw], barley [tw], with no language restriction were used. All RCT that included available data of beta-glucan or that could impute dose of beta-glucan, at least one relevant outcome of glycemic control, run-in period more than 2 weeks, and intervention period of more than 2 weeks or greater were selected. A fixed-effect model was used to assess the summary effect of studies. RESULTS: A total of 43 articles were identified, 4 studies met our inclusion criteria and then analyzed. In pooled analysis, the effect size of fasting glucose level was 0.13 (95%CI: -1.25 to 1.51), and serum insulin level was -0.95 (95%CI, -2.37 to 0.47). It was impossible to adjust for sex and age owing to the lack of raw data. CONCLUSION: In this review, the results suggested that there were negative impacts of beta-glucan on fasting glucose and serum insulin level in adults, but we concluded that there was insufficient evidence to confirm about glycemic control effect. More powerful and well-designed RCT were required to confirm about glycemic control effect of beta-glucan.
Absorption
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Adult
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Avena
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beta-Glucans
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Diabetes Mellitus
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Dietary Fiber
;
Electronics
;
Electrons
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Fasting
;
Glucose
;
Hordeum
;
Humans
;
Insulin
7.Genetic analysis for Polymorphism of 5, 10-Methylenetetrahydrofolate Reductase (MTHFR) A1298C and Infertile Males in Korea.
Yu Mi JEONG ; Tae Gue CHUNG ; Hyun Joo KIM ; Sook Hwan LEE ; Jung Hoon PARK ; Nam Keun KIM ; Se Hyun KIM ; Kwang Yul CHA ; Suman LEE
Korean Journal of Fertility and Sterility 2003;30(4):325-331
OBJECTIVE: To investigate the association of genetic background between MTHFR A1298C genotype and male infertility. MATERIALS AND METHODS: We compared 377 infertile males with 396 healthy fertile males with one or more offspring. Infertile males were classified into four subtypes (281 azoospermia, 26 oligoasthenoteratozoospermia (OAT), 59 severe OAT and 11 remnants) by World Health Organization (WHO). Pyrosequencing analysis for MTHFR (methylenetetrahydrofolatereductase) A1298C variation was performed on polymerase chain reaction (PCR) product of study group. To validate pyrosequencing data of A1298C variation for randomly selected 50 samples, we compared the pyrosequencing result with the PCR-RFLP (Restriction Fragment Length Polymorphism) result of MTHFR A1298C genotype. RESULTS: We studied MTHFR A1298C variation by pyrosequencing. A1298C variation data (1298 AC; p=0.2166 and 1298 CC; p=0.5056) of MTHFR gene was no significant difference in between fertile and infertile males. CONCLUSION: The genetic analysis in MTHFR gene didn't appear genetic difference in Korean fertile and infertile males. We require further study for MTHFR gene in infertile males.
Avena
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Azoospermia
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Genotype
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Humans
;
Infertility, Male
;
Korea*
;
Male*
;
Oxidoreductases*
;
Polymerase Chain Reaction
;
World Health Organization
8.Comparison between the Portable Prothrombin Time Self Monitor CoaguChek XS and a Standard Laboratory Method, Sysmex CA-1500 for Monitoring Anticoagulant Therapy of Outpatients.
Ja Won KIM ; Moo Hyun KIM ; Kyung Ho KIM ; Jin HAN ; Jeung Hoan PAIK ; Long Hao YU ; Tae Ho PARK ; Kwang Soo CHA ; Young Dae KIM ; Kyung Eun KIM ; Jin Yeong HAN
Korean Circulation Journal 2007;37(5):216-220
BACKGROUND AND OBJECTIVES: Patients on oral anticoagulation therapy (OAT) require regular monitoring of the prothrombin time (PT) and dosage adjustment to prevent thromboembolic diseases without the risk of hemorrhage. Portable self PT monitors have been recently developed because the standard PT measurements are complicated and take considerable time. This study compared the International normalized ratio (INR) results that were obtained with using the CoaguChek XS device (Roche Diagnostic, Mannheim, Germany) with those obtained using a standard laboratory method Sysmex CA-1500 (Sysmex Corporation, Kobe, Japan) in the patients on OAT and also a healthy control group. SUBJECTS AND METHODS: 100 outpatients on OAT and 20 healthy controls were enrolled on a volunteer basis after providing informed consent at the Dong-A University Hospital. The outpatients and the healthy control group provided us the INR measurements with using both the CoaguChek XS and the Sysmex CA-1500. RESULTS: The coefficients of variation for CoaguChek XS and Sysmex CA-1500 were less than 10%. The PT (INR) results of CoaguChek XS and Sysmex CA-1500 were 2.0+/-0.7 and 2.2+/-0.7, respectively (p<0.001). There was a good correlation between CoaguChek XS and Sysmex CA-1500 (r=0.974, p<0.001). On the regression analysis, the slope of the regression line was 0.9197 and the y-intercept was 0.0058. On the Bland-Altman analysis, the INR mean difference (bias) between the two methods (CoaguChek XS INR-Sysmex CA-1500 INR) was -0.2 and the limit of agreement was +0.168~-0.568. CONCLUSION: The measurement with using CoaguChek XS has high repeatability, rapid availability and good accuracy that are comparable to the standard laboratory method. Therefore, CoaguChek XS can be a valuable tool for the self-monitoring of patients on OAT.
Anticoagulants
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Avena
;
Hemorrhage
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Humans
;
Informed Consent
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International Normalized Ratio
;
Outpatients*
;
Prothrombin Time*
;
Prothrombin*
;
Volunteers
9.Neuroendocrine Tumors of the Larynx: Four Cases.
Yong Sik LEE ; Kwang Il KIM ; Hun Dae KIM ; Young Jo KWON
Korean Journal of Otolaryngology - Head and Neck Surgery 2004;47(12):1337-1343
Neuroendocrine neoplasms of the larynx arise from APUD (amine precursor uptake and decarboxylase) cells. Neuroendocrine neoplasms of the larynx canbe divided into those of epithelial or neural origin. The latter consists of paragangliomas while the group of the epithelial origin can be further divided into typical and atypical carcinoids, and small cell neuroendocrine carcinoma, which consist of the oat cell type, the intermediate cell type and the combined cell type. There are now over 500 cases of neuroendocrine neoplasms of the larynx reported in the literature. The diagnosis is primarily based on light microscopy and; in some instances, it may be supported by special histochemical studies. It should be confirmed by immunocytochemical and/or ultrastructural investigation. The different biological behavior of neuroendocrine neoplasms of the larynx makes a specific diagnosis of paramount importance, since treatment depends on accurate diagnosis. We experienced 4 cases of neuroendocrine carcinoma of the larynx, and which we report with a review of literatures.
Avena
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Carcinoid Tumor
;
Carcinoma, Neuroendocrine
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Diagnosis
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Laryngeal Neoplasms
;
Larynx*
;
Microscopy
;
Neuroendocrine Tumors*
;
Paraganglioma
10.Arthroscopic Treatment for Cartilage Lesions of the Talus.
Heui Chul GWAK ; Joo Yong KIM ; Jang Seok CHOI ; Chang Wan KIM ; Jung Han KIM ; Dae Hyun PARK
The Journal of the Korean Orthopaedic Association 2010;45(6):433-439
PURPOSE: To compare clinical results and to evaluate the factors affecting the clinical results after performing arthroscopic chondroplasty, microfracture, and osteochondral autologus transplantation (OAT) due to a chondral defect of the talus. MATERIALS AND METHODS: This study enrolled 35 patients (36 cases) diagnosed with a chondral defect of the talus and who could be followed over 12 months after arthroscopic chondroplasty, microfracture, or OAT between March 1998 and December 2007. The arthroscopic chondroplasties were carried out in 14 cases (13 patients), the microfractures were carried out in 12 cases (12 patients) and OAT was carried out in 10 cases (10 patients). The lesion staging used Berndt and Harty classification on simple radiographs and Anderson's classification on magnetic resonance images. Clinical results were evaluated and compared by measuring VAS and AOFAS scores at the time of operation, before the operation, and at the time of follow up. Clinical evaluation included location, size, and stage of each lesion as well as the age of individual patient. RESULTS: There were 13 medial and 23 lateral lesions. The average size of the chondral defects were 1.9 cm2 (range: 1-4 cm2). According to the classification of Berndt and Harty and Anderson, there were 8 stage II, 21 stage III, and 7 stage IV cases. The average follow up period was 15 months (range: 12-30 months). VAS and AOFAS scores showed significant improvement in all treatment groups. However, clinical results according to the operative methods did not show any differences. Lesion size, stage and location, as well as of age of patient had no significant impact on clinical results. CONCLUSION: We concluded that all three procedures, arthroscopic chondroplasty, microfracture, and OAT, are useful for treating a chondral defect of talus. Location of lesion, size, stage and age of patient did not make a significant difference.
Arthroscopy
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Avena
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Cartilage
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Follow-Up Studies
;
Humans
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Magnetic Resonance Spectroscopy
;
Talus
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Transplants