OBJECTIVE: The purpose of this study was to compare the static (SFF) and kinetic frictional forces (KFF) of a computer-aided design and computer-aided manufacturing lingual bracket (CAD/CAM-LB) with those of conventional LB (Con-LB) and Con-LB with narrow bracket width (Con-LB-NBW) under 3 tooth displacement conditions. METHODS: The samples were divided into 9 groups according to combinations of 3 LB types (CAD/CAM-LB [Incognito], Con-LB [7th Generation, 7G], and Con-LB-NBW [STb]) with 3 displacement conditions (no displacement [control], maxillary right lateral incisor with 1-mm palatal displacement [MXLI-PD], and maxillary right canine with 1-mm gingival displacement [MXC-GD]; n = 6/group). While drawing a 0.016-inch copper or super-elastic nickel-titanium archwire with 0.5 mm/min for 5 minutes in a chamber maintained at 36.5℃, SFF and KFF were measured. The Kruskal-Wallis method with Bonferroni correction was performed. RESULTS: The Incognito group demonstrated the highest SFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD, Stb-MXC-GD] < [7G-MXC-GD, 7G-MXLI-PD, 7G-control] < [Incognito-MXLI-PD, Incognito-control, Incognito-MXC-GD]; p < 0.001). However, there were no significant differences in SFF among the 3 displacement conditions within each bracket group. Within each displacement condition, the Incognito group demonstrated the highest KFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD] < Stb-MXC-GD < 7G-MXLI-PD < [7G-control, 7G-MXC-GD] < [7G-MXC-GD, Incognito-MXLI-PD, Incognito-control] < [Incognito-control, Incognito-MXC-GD]; p < 0.001). MXC-GD exhibited higher KFFs than MXLI-PD in the same bracket group. CONCLUSIONS The slot design and ligation method of the CAD/CAM-LB system should be modified to reduce SFF and KFF during the leveling/alignment stage.

No abstract available.
Stomach Neoplasms

No abstract available.
Stomach Neoplasms

PURPOSE: Transforming growth factor (TGF)-beta is recognized as being associated with cataractogenesis. We quantitated the mRNA expression of TGF-beta isoforms in cataractous crystalline lens to determine the effect of the isoforms on cataractogenesis. METHODS: With lens epithelial cells from thirty eyes in thirty patients, the mRNA expressions of TGF-beta1, beta2 and beta3 were quantitated by real-time SYBR Green polymerase chain reaction and the results were compared according to cataract type and presence of diabetes mellitus. RESULTS: Each isoform mRNA of TGF-beta was expressed: TGF-beta3 in all 30 eyes, TGF-beta1 in 29 eyes (96.7%), with the exception being one diabetic senile cataract, and TGF-beta2 in 9 eyes. The amount of TGF-beta1 mRNA expression was significantly lower in the diabetic cataracts than in the non-diabetic cataracts (P=0.056). CONCLUSIONS: TGF-beta was associated with cataractogenesis. It is significant that the expression of TGF-beta2 mRNA was decreased in all cataracts. The decrease of TGF-beta1 mRNA expression was more meaningful in the diabetic cataracts than in the non-diabetic cataracts.
Cataract* ; Diabetes Mellitus ; Epithelial Cells* ; Humans ; Lens, Crystalline ; Polymerase Chain Reaction ; Protein Isoforms ; RNA, Messenger* ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1 ; Transforming Growth Factor beta2 ; Transforming Growth Factor beta3 ; Transforming Growth Factors

BACKGROUND/AIMS: As the incidence rate of and mortality from pseudomembranous colitis (PMC) are increasing worldwide, it is important to study the simple predictive risk factors for PMC among patients with hospital-acquired diarrhea (HAD). This study focused on identifying the clinical risk factors that can easily predict PMC. METHODS: The presumed HAD patients were prospectively recruited at the Hallym University Kangdong Sacred Heart Hospital. RESULTS: Age of 70 and older (adjusted odds ratio [OR], 1.76; 95% confidence interval [CI], 1.12 to 0.75), use of proton pump inhibitors (adjusted OR, 4.07; 95% CI, 2.512 to 6.57), use of cephalosporins (adjusted OR, 2.99; 95% CI, 1.82 to 4.94), and underlying cancer (adjusted OR, 1.72; 95% CI, 1.04 to 2.82) were independent risk factors for PMC in the multivariate logistic regression analysis. The prevalence of PMC was very low in the patients with HAD who exhibited no risk factors. CONCLUSIONS: The risk factors for PMC in patients with HAD included cephalosporin use, proton pump inhibitor use, old age, and cancer. Considering the strongly negative predictive values of these risk factors, endoscopic evaluation can be delayed in patients with HAD without risk of developing PMC.
Adult ; Aged ; Aged, 80 and over ; *Clostridium difficile ; Cross Infection/complications/*epidemiology ; Diarrhea/complications/*epidemiology ; Enterocolitis, Pseudomembranous/complications/*epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Factors

PURPOSE: The incidence of accidentally detected small renal tumors is increasing throughout the world. In this multi-institutional study performed in Korea, histopathological characteristics of contemporarily surgically removed renal tumors were reviewed with emphasis on tumor size. MATERIALS and METHODS: Between January 1995 and May 2005, 1,702 patients with a mean age of 55 years underwent surgical treatment at 14 training hospitals in Korea for radiologically suspected malignant renal tumors. Clinicopathological factors and patient survival were analyzed. RESULTS: Of the 1,702 tumors, 91.7% were malignant and 8.3% were benign. The percentage of benign tumors was significantly greater among those < or = 4cm (13.2%) than those > 4cm (4.5%) (p < 0.001). Among renal cell carcinoma patients, the percentage of tumors classed as stage > or = T3 was significantly less among tumors < or = 4cm (5.2%) than those > 4cm (26.8%) (p < 0.001). The percentage of tumors classed as Fuhrman's nuclear grades > or = 3 was also significantly less among tumors < or = 4cm (27.3%) than tumors > 4cm (50.9%) (p < 0.001). The 5-year cancer-specific survival rate was 82.7%, and T stage (p < 0.001), N stage (p < 0.001), M stage (p = 0.025), and Fuhrman's nuclear (p < 0.001) grade were the only independent predictors of cancer-specific survival. CONCLUSION: In renal tumors, small tumor size is prognostic for favorable postsurgical histopathologies such as benign tumors, low T stages, and low Fuhrman's nuclear grades. Our observations are expected to facilitate urologists to adopt function-preserving approach in the planning of surgery for small renal tumors with favorable predicted outcomes.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney Neoplasms/classification/*pathology/*surgery ; Male ; Middle Aged ; Neoplasm Staging

BACKGROUND: There are many arguments that Helicobacter pylori is a protective factor or a risk factor for GERD. Some authors reported a high incidence of reflux esophagitis in patients who had received Helicobacter pylori eradication therapy. We studied the prevalence of pathologic gastroesophageal reflux in Helicobacter pylori positive peptic ulcer patients and the effects of Helicobacter pylori eradication therapy on development of pathologic gastroesophageal reflux. METHODS: A total of 44 patients with endoscopically documented peptic ulcer disease and Helicobacter pylori infection underwent 24-hour esophageal pH monitoring and received a week of triple therapy. After three months of cessation of triple therapy, patients underwent 24-hour esophageal pH monitoring again. 24-hour esophageal pH monitoring of 44 patients were compared before and after the triple therapy. Helicobacter pylori status was evaluated by Giemsa stain, rapid urease test and urea breath test at each examination. RESULTS: The patients were classified into cured and ongoing Helicobacter pylori infection group. In cured patients group, there was no significant difference in the prevalence of pathologic gastroesophageal reflux before and after Helicobacter pylori eradication (p=0.8). In 44 patients, 30 patients had pathologic gastroesophageal reflux before eradication. In these patients, 27 patients cured Helicobacter pylori infection and 3 patients were ongoing Helicobacter pylori infection. Among 27 patients who cured Helicobacter pylori infection, 5 patients recovered from pathologic gastroesophageal reflux after eradication. In patients without pathologic gastroesophageal reflux before eradication, the prevalence of pathologic gastroesophageal reflux was not associated with Helicobacter pylori eradication (p=1). CONCLUSION: We find that the prevalence of pathologic gastroesophageal reflux in patients with peptic ulcer is high before Helicobacter pylori eradication. We suggest that Helicobacter pylori eradication in patients with peptic ulcer disease is not associated with development of pathologic gastroesophageal reflux.
Azure Stains ; Breath Tests ; Esophageal pH Monitoring ; Esophagitis, Peptic ; Gastroesophageal Reflux ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Peptic Ulcer* ; Prevalence ; Risk Factors ; Urea ; Urease

The mammographic or physical evaluation of breast parenchymal abnormalities in the presence of radiopaque implants or silicone injections is difficult; mammography often fails to discriminate between breast cancer and a radiopaque dense breast. Although the sonographic evaluation of a palpable mass in an augmented breast may be impaired by the presence of posterior acoustic shadowing, the modality may be helpful in evaluating such masses, and dynamic contrast-enhanced MR imaging facilitates differentiation. FDG-PET is a possible alternative diagnostic tool for the evaluation of parenchymal lesions under these circumstances, but its drawbacks are its high cost and limited availability. The sensitivity and specificity of both FDG-PET and MRI can be improved by correlating their findings with those of radiological studies, and through an awareness of potential false-negative and false-positive causes.
Acoustics ; Breast Neoplasms* ; Breast* ; Foreign Bodies* ; Granuloma, Foreign-Body* ; Magnetic Resonance Imaging* ; Mammography* ; Sensitivity and Specificity ; Shadowing (Histology) ; Silicones ; Ultrasonography

PURPOSE: Heptaplatin (Sunpla) is a cisplatin derivative. A phase IIb trial using heptaplatin resulted in a 34% response rate with mild nephrotoxicity. We conducted a randomized phase III trial of heptaplatin plus 5-FU compared with cisplatin plus 5-FU in patients with advanced gastric cancer. MATERIALS AND METHODS: One hundred seventy-four patients (heptaplatin, n=88; cisplatin, n=86) from 13 centers were enrolled. The eligibility criteria were as follows: patients with pathologically-proven adenocarcinoma, chemonaive patients, or patients who had received only single adjuvant chemotherapy, and who had a measurable or evaluable lesion. On day 1, heptaplatin (400 mg/m2) or cisplatin (60 mg/m2) was given over 1 hour with 5-FU (1 gm/m2) on days 1~5 every 4 weeks. RESULTS: At the time of survival analysis, the median overall survival was 7.3 months in the 5-FU + heptaplatin (FH) arm and 7.9 months in the 5-FU + cisplatin (FP) arm (p=0.24). Of the FH patients, 34.2% (complete response [CR], 1.3%; partial response [PR], 32.9%) experienced a confirmed objective response compared with 35.9% (CR 0%, PR 35.9%) of FP patients (p=0.78). The median-time-to-progression was 2.5 months in the FH arm and 2.3 months in the FP arm. The incidence of neutropenia was higher with FP (28%) than with FH (16%; p=0.06); grade 3~4 nausea and vomiting were more frequent in the FP than in the FH arm (p=0.01 and p=0.05, respectively). The incidence of increased proteinuria and creatininemia was higher with FH than with FP; however, there was no statistical difference. There were no treatment-related deaths. CONCLUSION: Heptaplatin showed similar effects to cisplatin when combined with 5-FU in advanced gastric cancer patients with tolerable toxicities.
Adenocarcinoma ; Arm ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy, Combination ; Fluorouracil ; Humans ; Incidence ; Malonates ; Nausea ; Neutropenia ; Organoplatinum Compounds ; Proteinuria ; Stomach Neoplasms ; Vomiting

Patients with acromegaly have high incidence of benign or malignant neoplasia than general population. Around fifteen percent of the deaths reported in acromegaly are attributable to malignancy of cancer. On the whole, mortality in acromegaly has been shown to be correlated with the degree of growth hormone (GH) control. Especially, the levels of insulin like growth factor-1 (IGF-1) may be higher in neoplasm, but there is no clear evidence to prove that tumor development is triggered by IGF-1 in acromegaly. Henceforth, we report a case of acromegaly associated with lung and gastric cancer in a 58-year-old man, suggesting the possible carcinogenic role of IGF-1.
Acromegaly* ; Growth Hormone ; Humans ; Incidence ; Insulin ; Insulin-Like Growth Factor I ; Lung Neoplasms ; Lung* ; Middle Aged ; Mortality ; Stomach Neoplasms*