Liver function tests before treatment showed abnormalities of liver function tests during treatment, while 15(68. 2%) of 22 patients who had abnormal liver function tests before treatment showed abnormalities during treatment. In 12 of the 25 patients who showed abnormalities of liver function tests during treatment with allopurinol, allopurinol was stopped and all patients showed improvement of liver function tests. In remaining 13 patients, 10 patients were improved and other 2 patients showed only mild abnormalities of liver function tests despite of continuing allopurinol and 1 patient was lost during follow-up. CONCLUSION: Abnormalities of liver function tests were common during treatment with allopurinol. Most patiensts who had mild abnormalities of liver functions tests during treatment with allopurinol were improved regardless of continuing allopurinol.
Allopurinol* ; Follow-Up Studies ; Gout* ; Humans ; Liver Function Tests* ; Liver*

OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

OBJECTIVES: The purpose of this study was to evaluate the optimal distance and angle of observers by modulation transfer functions(MTFs) and receiver operating characteristics(ROCs). MATERIALS AND METHODS: Digital periapical radiograms were taken from 43 patients who have dental diseases(19 patients : dental caries, 12 patients : periapical lesions, 12 patients : periodontal diseases). Segmental images(4x4cm) were evaluated by 4 MTFs and ROC analysis. RESULTS: The optimal distance(magnification) using MTF by Mannos & Sakrison was 12.97, and those by Nill, Ngan and Rao were 8.39, 4.78, 5.84 respectively. The optimal distance obtained from 4 radiologists by ROC analysis was 32cm(Az value : 0.89), and it was 40cm(Az value : 0.78) from 4 non-radiologists. There were significant differences of Az values between 4 radiologists and 4 non-radiologists at 24, 32 and 40cm (p<0.05). No significant differences of optimal distances were observed using 4 MTFs among +20, +10, 0, -10, -20 degrees(p>0.05). The optimal angle obtained from 4 radiologists by ROC analysis was +20 degrees (Az value : 0.91), and no significant differences of Az values were observed among +20, +10, 0, -10 and 20 degrees(p>0.05). The optimal angle obtained from 4 non-radiologists by ROC analysis was 0 degree(Az value : 0.81), and no significant differences of Az values were observed among +20, +10, 0, -10 and 20 degrees(p>0.05). And there was significant difference of Az value between 4 radiologists and 4 non-radiologists at +20 degree(p<0.05), but no significant differences of Az values were observed among +10, 0, -10 and -20 degrees(p>0.05).
Dental Caries ; Humans ; ROC Curve

Diffuse interstitial lung disease(DILD) is a large group of heterogeneous diseases that diffusely involve the pulmonary connective tissues, principally subpleural, interlobular and alveolar wall portions. Terminology and classification of these diseases are not uniform, and the cause and the pathogenesis are unknown in many entities. It is generally accepted that the response to therapy is related to the relative degree of cellularity and fibrosis present, therefore a histologic evaluation of the relative extent and severity of these changes is required. We reviewed 52 cases of DILD from January 1990 to May 1995 diagnosed by open lung biopsy to reappraise classification and quantitative assessment of the histopathologic features. Differential histopathologic features between usual interstitial pneumonia(UIP) and nonspecific interstitial pneumonia(NIP) were examined with a correlation of HRCT findings and clinical findings. Among 52 cases of DILD, 18 cases(34.6%) were UIP, 6 cases(11.5%) were hypersensitivity pneumonia was NIP was 5 cases(9.6%), interstitial lung diseases associated with the connective tissue diseases were 5 cases(9.6%), inorganic dusts were 4 cases(7.7%), infections were 4 cases(7.7%), durgs were 2 cases(3.8%), acute interstitial pneumonia was 1 case(1.9%), sarcoidosis was 1 case(1.9%) in order of frequency plus 6 other cases(11.5%). UIP was the most frequent DILD in this study which seemed to be a criteria bias of patient selection on open lung biopsy. Quantitative assessment of histopathologic features was useful in the differential diagnosis of DILD and differentiation of UIP from NIP was possible based on histopathologic features and supported by HRCT. UIP disclosed a significantly high score of fibrotic changes, especially in the interstitial fibrosis, smooth muscle proliferation and honeycombing, otherwise NIP appeared relatively high score in inflammatory changes. Correlation between histopathologic scores and the clinical outcome after steroid therapy or no therapy in UIP was not evident.
Diagnosis, Differential ; Biopsy

Neurofibromatosis is a complex hereditary disease involving many organs and systems. The incidence in pregnancy is less frequent and has been reported as 1/5000 to 1/18500 deliveries. Therefore, little is known about the interactions between neurofibromatosis and pregnancy. A survey of relevant literature suggests that patients with NF have an increased risk of perinatal complications (pregnancy induced hypertension, IUGR, preterm labor, abortion, stillbirth, high cesarean section rate) and maternal disease aggravation (rupture of an aneurysm, sarcomatous degeneration of neurofibroma, activation of pheochromocytoma). Refined ultrasound, flow studies and fetal monitoring allow us to provide improved pregnancy care for neurofibromatosis. However, It should be remembered that even now, neurofibromatosis places pregnant women and their fetuses in a high risk group with the potential to develop life threatening complications. We report a case of vertebral artery aneurysm and preeclampsia complicating a pregnancy with neurofibromatosis."
Aneurysm* ; Cesarean Section ; Female ; Fetal Growth Retardation ; Fetal Monitoring ; Fetus ; Genetic Diseases, Inborn ; Humans ; Hypertension ; Incidence ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Obstetric Labor, Premature ; Pre-Eclampsia* ; Pregnancy* ; Pregnant Women ; Stillbirth ; Ultrasonography ; Vertebral Artery*

PURPOSE: The purpose of the study was to investigate the effect of work engagement (WE) on organizational citizenship behaviors (OCB) and ability to control career commitment (CC) in the relationship between work engagement and OCB. METHODS: Data were collected using structured self-report questionnaires from 205 nurses currently working at three national hospitals. Data were analyzed using descriptive statistics, ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression analysis using the SPSS 21.0 program. RESULTS: Mean scores for each variable were: WE 3.77 (on a 7-point scale), OCB 3.41 (on a 5-point scale), and CC 3.05 (on a 5-point scale). As a result, comparison showed that all research variables were higher with age, OCB was higher with total clinical career, and CC was higher with higher education level. Total clinical career, WE and CC had a significant effect on OCB, and CC had a moderate effect on work engagement and OCB. These variables had a total explanatory power of 38% for OCB. CONCLUSION: The nurses' WE had a positive effect on OCB, and the CC showed a moderating effect on the relationship between WE and OCB. Therefore, we suggest that CC is an important factor in improving nurses' OCB.
Education

The purpose of this study was to determine the effect of finish line design, amount of incisal reduction, and loading condition on the stress distribution in anterior all-ceramic crowns. Three-dimensional finite element models of an incisor all-ceramic crown with 3 different finish line designs : 1) shoulder with sharp line angle 2) shoulder with rounder line angle 3) chamfer : and 2 different incisal reductions : 2mm and 4mm were developed. 300 N force with the direction of 45 degree to the long axis of the tooth was applied at 3 different positions : A) incisal 1/3, B) incisal edge, C) cervical 1/5. Stresses developed in ceramic and cement were analyzed using three-dimensional finite element method. The results were as follows : 1. Stresses were concentrated in the margin region, which were primarily compressive in the labil and tensile in the lingual. 2. Stresses were larger in the area near line angle than on the crown surface of the margin region. In case of shoulder with sharp line angle, stresses were highly concentrated in the porcelain near line angle. 3. At the interface between porcelain and cement and at the porcelain above the margin on crown surface, stresses were the highest in chamfer, and decreased in shoulder with sharp line angle and shoulder with rounded line angle, respectively. 4. At the interface between cement and abutment on crown surface, stresses were the highest in shoulder with sharp line angle, and decreased in shoulder with rounded line angle and chamfer, respectively. 5. The amount of incisal reduction had little influence on the stress distribution in all-ceramic crowns. 6. When load was applied at the incisal edge, higher stresses were developed in the margin region and the incisal edge than under the other loading conditions. 7. When load was applied at the cervical 1/5, stresses were very low as a whole.
Axis, Cervical Vertebra ; Ceramics ; Crowns* ; Dental Porcelain ; Finite Element Analysis* ; Incisor ; Shoulder ; Tooth

The heterotopic pancreas is defined as the presence of pancreatic tissue lacking anatomical and vascular continuity from the main body of pancreas. Its incidence has been reported as widely ranging from 0.55~13.7% in autopsy studies and 0.2% in upper abdominal laparotomies. The most common sites are the antrum of stomach, duodenum and proximal jejunum. But, lesions have also been found in the ileum, Meckel diverticulum, common bile duct and the esophagus. Most cases are incidentally encountered during surgery, and on rare occasions, epigastric pain, hemorrhage, gastric outlet obstruction and intussusception have been directly attributable to the presence of the heterotopic pancreas. A 3-month-old boy presented with 1-day history of vomiting and irritability. Intussusception was confirmed on ultrasound scan. At laparotomy there was an irreducible ileoileal intussusception, the intussuscepted portion of ileum was resected and end to end anastomosis was performed. Histologically, the mass was found to be composed of pancreatic tissue.
Autopsy ; Common Bile Duct ; Duodenum ; Esophagus ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Ileum* ; Incidence ; Infant ; Intussusception* ; Jejunum ; Laparotomy ; Male ; Meckel Diverticulum ; Pancreas* ; Stomach ; Ultrasonography ; Vomiting

39-year-old female had been treated for the exophytic mass on buccal aspect of the left maxillary posterior area 2 years and 8 months ago. Tentative diagnosis was obtained as fibrous dysplasia on clinical and radiographic examinations and histopathologic findings revealed as osteochondroma after bone trimming at that time. She revisited for the treatment of recurred lesions. We reviewed this case with clinical, radiologic and histopathologic standpoints retrospectively, and came to a conclusion that the tumor primarily occurred was juxtacortical osteogenic sarcoma and recurred due to inadequate treatment and then expanded over intramedullary. This case shows that the diagnosis of osteosarcoma should take account of the patient history, clinical, radiographic and histopathologic findings and it requires attentive follow up check. Retrospectively reviewed results were as follows ; At first visit, oral examination revealed a bony hard swelling on the buccal aspect of the left maxillary posterior area. Radiographically, a dense radiopaque mass was noted on the site. The lesion showed hot uptake of 99mTc-MDP. Histopathologic diagnosis was done as osteochondroma, but it was considered as osteogenic sarcoma when compared with the recurrent lesion. When she revisited for the treatment of multiple bony swelling on the left maxilla, radiograms showed typical features of malignancy such as widening of periodontal ligament space and sun-ray appearace, and coincided with benign characters as follows ; relatively well circumscribed lesion and expansion and displacement of the adjacent structures. Finally, histopathologic findings of the lesion was well differentiated chondroblastic osteogenic sarcoma.
Adult ; Chondrocytes* ; Diagnosis ; Diagnosis, Oral ; Female ; Follow-Up Studies ; Humans ; Maxilla* ; Osteochondroma ; Osteosarcoma* ; Osteosarcoma, Juxtacortical ; Periodontal Ligament ; Retrospective Studies ; Technetium Tc 99m Medronate

Heterotopic pregnancy occurs when there are coexisiting intrauterine and ectopic pregnances. It occure, more often, due to assisted reproductive technology such as IVF-ET, GIFT and increased pelvic inflammatory diseases. We present a case of heterotopic pregnancy confirmed by surgical removal of ruptured left ovarian pregnancy and sonographic finding of the intrauterine pregnancy following natural conception.
Female ; Fertilization ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted ; Ultrasonography