The purpose of this study was to assess the current materials, methods and difficulties according to the year of licence and educational background of Korean dentists in Class II direct composite resin restorations. Total 17 questions were included in the questionnaire. Questions were broadly divided into two parts; first, operator's information, and second, the materials and methods used in Class II posterior composite restoration. The questionnaire was sent to dentists enrolled in Korean Dental Association via e-mail. Total 12,193 e-mails were distributed to dentists, 2,612 e-mails were opened, and 840 mails (32.2%) were received from respondents. The data was statically analyzed by chi-square test using SPSS(v. 12.0.1, SPSS Inc, Chicago, IL, USA). Male dentists among respondents was 79%. 60.3% of the respondents acquired their licences recently (1998-2007), and 77% practiced in private offices. 83.4% have acquired their knowledge through school lectures, conferences and seminars. For the Class II restorations, gold inlays were preferred by 65.7% of respondents, while direct composite resin restorations were used by 12.1% amalgam users were only 4.4% of respondents. For the restorative technique, 74.4% of respondents didn't use rubber dam as needed. For the matrix, mylar strip (53.4%), metal matrix (33.8%) and Palodent system (6.5%) were used. 99.6% of respondents restored the Class II cavity by incremental layering. Obtaining of the tight interproximal contact was considered as the most difficult procedure (57.2%) followed by field isolation (21%). Among various bonding systems, 22.6% of respondents preferred SE Bond and 20.2% used Single Bond. Z-250 was used most frequently among a variety of composite resins.
Bisphenol A-Glycidyl Methacrylate ; Chicago ; Composite Resins ; Congresses as Topic ; Surveys and Questionnaires ; Dentists ; Electronic Mail ; Humans ; Inlays ; Korea ; Lectures ; Male ; Polyethylene Terephthalates ; Postal Service ; Rubber Dams ; Surveys and Questionnaires

PURPOSE: Deterioration of consciousness is the most critical problem in patients with fulminant hepatic failure (FHF). Electroencephalography (EEG) is a standard procedure to determine the brain activity in unconscious patients. The bispectral (BIS) index derived from EEG was primarily developed to monitor the depth of unconsciousness. METHODS: A prospective study was performed to assess the clinical utility of peritransplant BIS monitoring in 11 fulminant hepatic failure (FHF) patients who were undergoing emergency living donor liver transplantation (LT) with using a right liver graft. All the patients recovered their consciousness after LT. RESULTS: There was a significant correlation between the BIS index values and the derived GCS score (r2=0.634, p <0.001). Timing of eye opening to voice command matched the BIS index value of 64+/-9.5, which was after 14+/-9.4 hours passing BIS index of 50. All the patients with endotracheal intubation during the early posttransplant period showed progressive increase of their BIS index, which appeared slightly earlier and more evident than the rise of derived GCS scores. CONCLUSION: BIS monitoring is a noninvasive, simple and easy-to-interpret method and it also appears to be a useful to assess and predict the recovery of a patient's consciousness level after LT. Therefore, we concluded that BIS monitoring can be an indispensable component of the peritransplant intensive care for patients with FHF and who require emergency LT.
Brain ; Consciousness ; Consciousness Monitors ; Electroencephalography ; Emergencies ; Eye ; Humans ; Critical Care ; Intubation, Intratracheal ; Liver ; Liver Failure, Acute ; Liver Transplantation ; Living Donors ; Organothiophosphorus Compounds ; Prospective Studies ; Transplants ; Unconscious (Psychology) ; Voice

PURPOSE: When performing donor screening for living donor liver transplantation (LDLT) for an adult patient with end- stage liver disease, ABO blood group incompatibility is the most common cause of donor exclusion. To cope with this problem without performing ABO-incompatible LDLT, living donor exchange program has been maintained at the Asan Medical Center, Seoul, Korea since September 2003. Here we introduce the clinical experience of 6 cases of adult LDLT allocated by living donor exchange program. METHODS: From February, 1997 to December 2006. 1208 cases of adult LDLT were performed in our institution. Among them, there were 6 cases allocating through donor exchange program to avoid ABO blood group mismatching. Three sets of 2 donor-recipient combination pairs were made after direct one-to-one donor-recipient matching. RESULTS: Two sets of donor exchange LDLT were performed on elective surgery basis, but one in emergency situation. Two living donors and 2 recipients underwent LDLT operations at the same time at the same institution. All 6 living donors recovered well. All of the 6 recipients are doing well to date although 1 recipient had undergone prolonged intensive care for surgical complications. There was no emotional or psychological conflict related to donor exchange program. CONCLUSION: This is the world-first report on donor exchange adult LDLT. Although this is a preliminary report with only 3 sets, donor exchange program for adult LDLT appears to be a feasible modality to promote LDLT. We believe it can be applicable to a wider population of LDLT after widespread consensus formation.
Adult ; Blood Group Incompatibility ; Critical Care ; Consensus ; Donor Selection ; Emergencies ; Humans ; Korea ; Liver ; Liver Diseases ; Liver Transplantation ; Living Donors ; Phosphatidylethanolamines ; Tissue Donors

PURPOSE: The effect of intra-portal infusion of glucose-insulin-potassium (GIK) solution on the energy metabolism during cold preservation was investigated using a small-animal liver transplantation model. METHODS: Fifteen white rats were divided into 3 groups: the group A (feeding group) were fed normally before experiment. The group B (fasting group) and group C (GIK group) were fasted from 3 days before experiment, by which acute nutritional deficiency state was induced. In group A and B, the whole liver was procured after intra-portal perfusion of HTK solution and serial liver biopsies were performed during the cold preservation period with 4degrees C HTK solution. In group C, intra-portal GIK solution infusion for 1 hour preceded liver graft harvest. From the liver tissues, the relative intracellular glycogen contents and the ATP concentration were measured. RESULTS: Relative glycogen contents in group A were 100% at 0 h, 64.6% at 2 h, 54.9% at 4 h, and 16.2% at 8 h; 10.3%, 8.3%, 4.9% and 0%, respectively in group B; 109.2%, 96.9%, 54.2% and 9.7%, respectively in group C. There was a temporary supercharge of ATP level in group C only at 0 h. Apoptosis was less expressed in group C comparing with group A and B. CONCLUSION: Rapid intra- portal infusion of GIK solution could make intrahepatic glycogen content fully restored to the normal level. Considering that intracellular glycogen is the main energy source during immediate post-transplant period, its restoration may contribute to improvement of post-transplant graft function.
Adenosine Triphosphate ; Animals ; Apoptosis ; Biopsy ; Cold Temperature ; Energy Metabolism ; Glucose ; Glycogen ; Humans ; Insulin ; Liver ; Liver Transplantation ; Malnutrition ; Mannitol ; Perfusion ; Potassium ; Potassium Chloride ; Procaine ; Rats ; Transplants

PURPOSE: Although curative resection of hilar cholangiocarcinoma (HCCC) remains a difficult challenge, only curative resection with tumor free margins can guarantee a favorable outcome. In this report, we retrospectively analyzed the survival data after surgical resection of HCCC to determine the survival rate and the related factors at a single, large-volume medical institute. METHODS: Between June 1989 and June 2005, surgical intervention with curative intent was performed on 301 patients. We retrospectively analyzed the survival data via a review of the medical record. RESULTS: Among the 259 cases of resection, curative (R0) resection with tumor-free margins was achieved in 186 cases (71.8%). Of these 186 cases, 177 patients underwent various types of hepatectomy with caudate lobectomy and bile duct resection. Combined pancreatoduodenectomy was performed in 19 patients and portal vein resection was performed in 51 patients. In-hospital mortality developed in 11(4.3%) of the 259 patients who underwent resection. The 1-, 3- and 5-year survival rates of patients who underwent R0 resection were 83.3, 42.0 and 29.3%, respectively. Univariate analysis revealed that curability, T stage, lymph node involvement, histologic differentiation and perineural invasion were associated with patient survival. Multivariate analysis showed that curability and lymph node involvement were statistically significant prognostic factors. CONCLUSION: Tumor-positive margins and lymph node involvement resulted in poor outcomes. Intensive perioperative management and a surgeon's aggressive efforts to attain clearance of tumor can minimize the postoperative mortality and maximize survival for patients with HCCC.
Bile Ducts ; Cholangiocarcinoma* ; Hepatectomy ; Hospital Mortality ; Humans ; Klatskin's Tumor ; Lymph Nodes ; Medical Records ; Mortality ; Multivariate Analysis ; Pancreaticoduodenectomy ; Portal Vein ; Retrospective Studies ; Survival Rate

PURPOSE: Although a portal vein resection (PVR) can increase the chance for a successful curative resection, there is debate concerning the balance between the risk of the procedure and the effect on survival in patients with hilar cholangiocarcinoma. Therefore, we performed a retrospective study to determine the safety and survival after PVR for hilar cholangiocarcinoma. METHODS: We analyzed the cumulative survival rate and the associated clinical factors in 301 patients undergoing surgical intervention between June 1989 and June 2005. We divided 259 patients undergoing resection into two groups (51 PVR+ and 208 PVR-) and compared the survival and clinicopathological data. RESULTS: The 1-, 3- and 5-year survival rate of 186 patients undergoing curative resection was 83.3, 42.0 and 29.3%, respectively. The Bismuth-Corlette type IV, the infiltrative type, presence of perineural invasion, lymphovascular tumor emboli and lymph node metastases were more frequent in the PVR+ group. The survival rate was significantly lower in the PVR+ group but seven patients have survived for more than 5 years. Five (9.8%) operative mortalities occurred. However, the mortality directly related to the PVR was present in only one case. The morbidity and postoperative liver function were not different in comparisons between the two groups. In the PVR+ group, tumor invasion into the portal vein was observed in 28 of 51 patients. The tumor invasion on pathological examination did not affect survival in the PVR+ group. CONCLUSION: The results of this study showed that PVR in combination with hepatectomy, for hilar cholangiocarcinoma, could be performed with acceptable safety. Although the PVR has a negative impact on survival, a hepatectomy combined with a PVR can offer long-term survival to a few patients with advanced hilar cholangiocarcinoma.
Cholangiocarcinoma* ; Hepatectomy* ; Humans ; Klatskin's Tumor ; Liver ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Portal Vein* ; Retrospective Studies ; Survival Rate

OBJECTIVE: To evaluate the effects of age, height, weight, body mass index (BMI), diabetes mellitus, osteoporosis, smoking and alcohol on postural sway (PS) and limb load asymmetry (LLA) in the rural inhabitants in Korea METHOD: Nine hundred and sixty inhabitants were included in this study. PS and LLA were recorded while the subjects were standing on two adjacent force platforms (Mediance(R); Human-Tech Inc, Korea) in a comfortable stance for 30 seconds. Bone mineral density was measured in the right calcaneus by ultrasonography (Sahara(R); Hologic Inc, USA). History of diabetes and smoking were taken through interview. RESULTS: PS and LLA were correlated with age (p<0.01). There were significant decreases in PS and LLA in the young age-group (p<0.01). There was no significant difference in PS and LLA in terms of sex, osteoporosis, height, weight, BMI and smoking. There was a significant difference in LLA (p<0.05) but no difference in PS between diabetic and normal groups. CONCLUSION: PS and LLA may be related with ageing. Diabetic group may have higher LLA than normal group. However, sex, osteoporosis, height, weight, BMI, and smoking may not affect on PS and LLA.
Body Weight ; Bone Density ; Calcaneus ; Diabetes Mellitus ; Extremities* ; Korea* ; Osteoporosis ; Smoke ; Smoking ; Ultrasonography

OBJECTIVE: This study was designed to investigate the effect of lateral wedged insole on foot of osteoarthritis patients. METHOD: 11 osteoarthritis patients participated in this study. Plantar peak pressures in shoes were measured by pedar(R) during a comfortable gait in three conditions (no wedge, with 5 degree wedged insole and with 10 degree wedged insole). Plantar pressure was analyzed by pedar C-expert program at TO (whole foot), M1 (medial heel), M2 (lateral heel), M3 (medial midfoot), M4 (lateral midfoot), M5 (1st, 2nd metatarsal area), M6 (3rd, 4th, 5th metatarsal area), M7 (great toe), M8 (2nd, 3rd toe area), M9 (4th, 5th toe area) zones respectively. RESULTS: There were significant differences in peak plantar pressures of whole foot, heel zone, and lateral midfoot zone according to wedge type. But there was no significant difference in peak plantar pressures at medial midfoot zone and forefoot zone according to wedge type. CONCLUSION: There were difference in peak plantar pressures of osteoarthritis patients according to wedge type.
Foot ; Gait ; Heel ; Humans ; Metatarsal Bones ; Osteoarthritis* ; Shoes ; Toes

OBJECTIVE: To analyze and evaluate the quality of the Korean web sites of medical information about degenerative osteoarthritis. METHOD: The search term 'degenerative osteoarthritis' was entered into five popular Korean web search engines. The web sites for the first 20 matches generated by each search engine were grouped by author and evaluated by DISCERN instrument, certification standard of internet health information by Korean Academy of Medical Sciences (KAMS instrument), and guidelines and items for evaluation of internet health information by Chung and Park (Chung & Park Instrument). RESULTS: Of the 100 sites identified, only 44 were unique and included in the analysis. Eight sites were commercial and each 21, 5, 3, 7 sites were authored by physician, public institute, oriental medical doctor and others, respectively. By DISCERN instrument, there was a significant difference in total score, reliability of publication and overall quality rating. By KAMS instrument, there was a significant difference in total score, reliability, and content. By Chung & Park instrument, there was a significant difference in total score, objectivity, accuracy, credibility and authority. CONCLUSION: The quality of degenerative osteorarthritis information on the internet varied greatly. Web sites authored by public institutes and physicians were ranked higher than others.
Academies and Institutes ; Certification ; Internet* ; Osteoarthritis ; Publications ; Search Engine

OBJECTIVE: The purpose of this study was to analysis the medial longitudinal arch of the foot with simple radiography METHOD: We reviewed 387 feet of 219 patients with no deformity who took weight-bearing foot simple radiography. Foot length, length from talonavicular joint to posterior heel (TN), length from cuneonavicular joint to posterior heel (CN), length from cuneiform-metatarsal joint to posterior heel (CM) were measured with the digital imaging and communication in medicine (DICOM) files of the picture archiving communication system (PACS) (PiViewSTAR(r), INFINITT, Korea). RESULTS: There was significant correlation of foot length and relative location of joints of medial longitudinal arch. In males, relative value to foot length of TN, CN, CM was 39.86+/-0.97%, 45.97+/-1.20%, and 57.12+/-1.15% respectively. In females, relative value to foot length of TN, CN, CM was 39.41+/-1.19%, 47.12+/-1.44%, and 56.51+/-1.37% respectively. There were significant differences between men and women for location of joints of medial longitudinal arch. CONCLUSION: Location of joints of the medial longitudinal arch of the foot can be given a numerical value.
Congenital Abnormalities ; Female ; Foot* ; Heel ; Humans ; Joints ; Male ; Radiography ; Weight-Bearing