PURPOSE: The purpose of this study is to compare three different CAD/CAM systems through the fracture strength of zirconia core and to evaluate the clinical availability of each system. MATERIAL AND METHODS: The following three groups of 30 maxillary mesial incisor core for all-ceramics(each group 10) were fabricated as follows: group 1. Adens(R) CAD/CAM system, group 2. Cerasys(R) CAD/CAM system, group 3. 3M LAVA(R)CAD/CAM system. All specimens were manufactured consistently thickness 0.5mm and relief 40 micrometer. Specimens were subjected to compressive loading on the lingual area by Z250/SN5S(R). Each group's mean and standard deviation were calculated and Kruskal Waillis test, Wilcoxon Rank Sum test were utilized to find out the relationship among the groups. RESULTS: The results were as follows: 1. The mean fracture strength of Adens(R) system was 615.89+/-156.1N, the Cerasys(R) system was 863.98+/-151.5N, and the 3M LAVA(R) system was 1143.1+/-286.6N. 2. The fracture strength of the systems showed the significant statistical differences in order of 3M LAVA(R) system, Cerasys(R) system, Adens(R) system. CONCLUSION: In this study, in spite of the differences among the groups, every group showed clinically useful results. It is necessary to study further clinical experiments on a long term basis.
Incisor ; Zirconium

Neonatal diabetes mellitus (NDM) is defined as hyperglycemia that presents clinical symptoms within the first month of life and requires insulin therapy to maintain euglycemia. The diabetic condition may be transient, permanent, or transient with recurrence later in life. NDM is a rare clinical disorder. Three cases of NDM have been reported in Korea so far. We experienced two cases of NDM in twin brothers who were born with small for gestational ages. Their HLA typings were DR9 and DR14, and insulin autoantibody, islet cell antibody, GAD-reactive autoantibody, and insulin receptor antibody were not found. The genetic analysis with polymorphic DNA markers for chromosome 6 indicated paternal uniparental isodisomy.
Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Gestational Age ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Insulin ; Islets of Langerhans ; Korea ; Receptor, Insulin ; Recurrence ; Siblings* ; Twins* ; Uniparental Disomy

A 5-year-old male patient was admitted due to fever, and right upper abdominal pain for 2 weeks. He showed severe right upper quadrant tenderness on palpation, hepatomegaly 5 cm below the right costal margin, no mass, and no splenomegaly. On biochemical studies, ALT was 380IU/ml, AST 462IU/ml, alkaline phosphatase 1,069IU/ml, GTP 239IU/ml, and total bilirubin 2.1mg/dl. Endoscopic retrograde cholangiopancreatography (ERCP) showed cylindrical dilatations of CBD and cystic dilatations with strictures of extrahepatic and both bilateral intrahepatic bile ducts (choledochal cyst type IVa) with multiple stones in the CBD and extra- and intrahepatic bile ducts. Endoscopic sphincterotomy (EST) and stone extraction with basket and balloon were performed successfully. The bile was severely purulent and the stones were pigment stones. Klebsiella pneumoniae were dominantly grown on bile culture. An endoscopic nasobiliary drainage (ENBD) tube was inserted to treat biliary sepsis. The bile ducts were irrigated with tobramycin-mixed normal saline twice a day for 2 week, when ALT, AST, total bilirubin and liver size were normalized and no more bacteria was grown on bile culture. The clinical symptoms were improved just after the therapeutic ERCP. There was no side effect by ERCP, EST and ENBD.
Abdominal Pain ; Alkaline Phosphatase ; Bacteria ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Bilirubin ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis* ; Choledochal Cyst* ; Choledocholithiasis* ; Constriction, Pathologic ; Dilatation ; Drainage* ; Fever ; Guanosine Triphosphate ; Hepatomegaly ; Humans ; Klebsiella pneumoniae ; Liver ; Male ; Palpation ; Sepsis ; Sphincterotomy, Endoscopic ; Splenomegaly

No abstract available.
Acromegaly* ; Osteoarthropathy, Primary Hypertrophic*

BACKGROUND: Psoriasis is a common, scaly erythematous disease of unknown etiology, marked by remissions and exacerbations of unpredictable onset and duration. Among many etiologic factors, psoriatic keratinocyte is found to play the most important role. OBJECTIVE: The purpose of this study is to evaluate the hypothesis that the mechanism(s) responsible for the abnormal proliferation of psoriatic keratinocytes may be located within the cell themselves. METHODS: Human epidermal keratinocytes were isolated from lesion(PL) and from uninvolved skin (PN) with chronic plaque-like psoriasis and from the normal skin(NN). Keratinocytes were passaged onto culture vessels without the feeder layer and maintained with serum free medium. Growth rates were measured in secondary cultures by MTT assay and ultrastructural findings of cell differentiation were evaluated with a transmission electron microscope. Results : 1 Keratinocytes from PL reached 50% confluency in one week compared to two weeks of PN and NN in primary cultures. 2. By the MTT assay, keratinocyte proliferation from PL showed a significantly faster rate than those from PN and NN(p<0.01). But there was no significant difference of keratinocyte proliferation rate between PN and NN(p>0.05). 3. All of the three cell populations(PL, PN, NN) showed variable degrees of cell differentiation during secondary culturing in a serum-free medium. In the PL, however, small, compact basal cells were more prevalent than PN and NN. 4. When keratinocytes underwent differentiation by culturing in DMEM with serum, keratinocytes from PL formed more cell layers with incomplete formation of cornified envelopes suggests the presence of some unknown factors that induce or promote psoriasis. While keratinocytes from PN and NN were characterized by a complete codified layer as in normal skin. Conclusion : These results indicated that the characteristic hyperproliferation and the defective terminal differentiation of keratinocytes of PL were maintained throughout the culture period.
Cell Differentiation ; Feeder Cells ; Humans ; Keratinocytes* ; Psoriasis ; Skin

PURPOSE: To evaluate the role of postoperative radiotherapy in the management of primary or recurrent intracranial meningiomas. METHODS AND MATERIALS: A retrospective review of 34 intracranial meningioma patients referred to the Yonsei Cancer Center for postoperative radiotherapy between 1981 and 1990 was undertaken. Of the 34 patients, 24 patients received elective postoperative radiotherapy after total or subtotal resection(Group 1), and 10 patients received postoperative radiotherapy as a salvage treatment for recurrent tumors(Group 2). Ten patients received postoperative radiotherapy after total resection, and twenty-four after subtotal resection. Ten patients who had total tumor resection were referred for radiotherapy either because of angioblastic or malignant histologic type (4 patients in Group 1) or because of recurrent disease after initial surgery(6 patients in Group 2). Radiation dose of 50-56Gy was delivered over a period of 5-5.5 weeks using 4MV LINAC or Co-60 teletherapy unit. RESULTS: Overall actuarial progression free survival (PFS) at 5 years was 80%. Survival was most likely affected by histologic subtypes. Five year PFS rate was 52% for benign angioblastic histology, as compared with 100% for classic benign histology. For malignant meningiomas, 5 year PFS rate was 44%. The recurrence rates of classic, angioblastic, and malignant type were 5%(1/21), 80%(4/5), and 50%(4/8), respectively. The duration between salvage post-operative radiotherapy and recurrence was longer than the duration between initial surgery and recurrence in the patients of group 2 with angioblastic or malignant histology. CONCLUSION: Postoperative radiotherapy of primary or recurrent intracranial meningiomas appears to be effective modality, especially in the patients with classic meningiomas. In angioblastic or malignant histologies, a more effective approach seems to be needed for decreasing recurrence rate.
Disease-Free Survival ; Humans ; Meningioma* ; Radiotherapy* ; Recurrence ; Retrospective Studies

A 44-year-old woman who comlpained of dizziness and generalized weakness was admitted. The hemoglobin was 6.6g/dL, hematocrit 25.5%, and serum ferritin 2.14 ng/mL Stool occult blood was positive and microcytic hypochromic anemia was found on periyheral blood smear. Gastroscopic examination showed about 2 x 1 cm sized hemispherical sebmucosal tumor on antrum. The patient underwent operatioh for confirmatory diagnosis and treatment. The final pathologic diagnosis of the resected lesion was hemangioma of stomach. Cavernous hemangioma of stomach is a rare disease.Mostly, it has a benign course clinically, but early diagnosis is important because massive hemorrhage and anemia by chronic blood loss can occur. We report a case of hemangioma of stomach with review of literature.
Adult ; Anemia ; Anemia, Hypochromic ; Diagnosis ; Dizziness ; Early Diagnosis ; Female ; Ferritins ; Hemangioma ; Hemangioma, Cavernous* ; Hematocrit ; Hemorrhage ; Humans ; Occult Blood ; Stomach*

Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents 4.1% of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49years(range, 27~79years) and the peak incidence was in the group 50 to 59years of age. More half of the patients were postmenopausal (46/76=60.5%). Most patients(76%)had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage Iib was 43.4%. There were 4 major histologic subtypes: pure adenocarcinoma(48/76=63.2%), adenosquamous carcinoma(20/76=26.3%), papillary (5/76=6.6%) and clear cell carcinoma(3/76=3.9%). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was 68%, and the 5-year survival rates for stage Ib, II and III were 90%, 66% and 54%, respectively. Control of pelvic tumors was achieved in 938%, 90.2% and 50.0% of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.
Adenocarcinoma* ; Cervix Uteri* ; Female ; Humans ; Incidence ; Prognosis ; Radiation Oncology ; Retrospective Studies ; Survival Rate ; Uterine Hemorrhage

From 1988 to 1991, nineteen patients with unresectable localized pancreatic carcinoma were treated with radiotherapy and/or hyperthermia or in combination with chemotherapy. Radiation dose of 4500-5000 cGy with or without additional 500-1000 cGy was administered over 5 to 6 weeks to the pancreatic tumor area using 10 MV linear accelerator. Five of 19 patients were given chemotherapy, either neoadjuvant or maintenance setting with FAM regimen (5-FU, adriamycin and mitomycin C), which was repeated every 4 weeks for one year or until progression. Symptomatic palliation was achieved in 17 among 19 patients (89%) and objective response(complete or partial response in CT finding) was achieved in 5 among 11 patients (45%). The median survival time was 9 months and one-year survival rate, 32%. Local-regional failure was documented in 10 among 13 patients(77%) and distant failures were found in the liver (3 patients) and carcinomatosis (2 patients). Prognostic significance of various factors such as age, sex, performance status, tumor location, stage, etc. were assessed. Any factors did net have the prognostic significance in univariate analysis. Treatment was well tolerated in most of the patients with only wild to moderate toxicity.
Carcinoma ; Doxorubicin ; Drug Therapy ; Fever ; Humans ; Liver ; Mitomycin ; Particle Accelerators ; Radiotherapy* ; Survival Rate

To analyze biochemical changes of liver function following combined radiotherapy and hyperthermia, we reviewed retrospectively 37 patients with hepatocellular carcinoma treated with radiotherapy and hyperthermia between July 1988 and December 1990 at Department of Radiation Oncology, Yonsei University College of Medicine. Mean age was 52.7 years and male to female ratio was 11:1. The patients were classified as follows; to A and B group by Child's classification, to M and L group by irradiated volume, and subclassified into BM, BL, AM and AL group according to the combination of Child's classification and irradiated volume. Radiation dose to the primary tumor was 3060 cGy with daily 180 cGy, 5 fraction per week using 10 MV or 4 MV linear accelerator. Hyperthermia (Thermotron RF-8) was performed more than 4 times in all patients. Biochemical parameters including albHmin (Alb), total bilirubin(T. Bil), aspartate aminotransferase (AST or SGOT), alanine aminotransferase (ALT or SGPT), and alkaline phosphatase (ALP) were regularly followed from 1 week before the treatment to 3 months after the treatment. The results are summerized as follows; 1) In all the patient, mean ALP level peaked at 1 month, decreased at 2 months, slightly increased at 3 months after the treatment. Mean SGOT and SGPT levels peaked at 1 month after the treatment. Mean T. Bil level increased continuously and highest at 3 months after the treatment. Mean Alb level did not show significant changes.; 2) Mean ALP level retired to normal level at 3 month after the treatment in A but increased in B group and the differences were statistically significant(p<0.01). Mean SGOT and SGPT levels peaked 1 month in A and 2 months after the treatment in B group. All the biochemical parameters did not show significant difference between M and L group. Mean ALP level increased at 3 months after the treatment in BM and BL groups and decreased in AM and AL groups. Mean SGOT level increased at 3 months after the treatment in BL groups.; 3) Hepatic failure occurred within 3 months after the treatment in 4 patients, all of whom were in BL group. It is suggested that pre-treatment 1iver function and irradiated volume influence biochemical changes of liver in patients with hepatocellular carcinoma following combined radiotherapy and hyperthermia, and this treatment modality appears generally to be safe but might cause hepatic failure particularly in patient with poor liver function and large treatment volume.
Alanine Transaminase ; Alkaline Phosphatase ; Aspartate Aminotransferases ; Carcinoma, Hepatocellular* ; Classification ; Female ; Fever* ; Humans ; Liver Failure ; Liver* ; Male ; Particle Accelerators ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies