OBJECTIVE: The purpose of this study was to investigate the changes in dentofacial morphology of non-orthodontically treated female patients with TMJ disk displacement. METHODS: The sample consisted of 25 Korean female patients with bilateral TMJ disk displacement who visited the Department of Orthodontics, Seoul National University Dental Hospital from 1996 to 2006. Disk displacements were diagnosed using the magnetic resonance imaging (MRI) of both TMJs. Baseline (T1) and follow-up (T2) lateral cephalograms were analyzed. The mean age of samples at T1 was 18.1 +/- 3.5 years (range 14.2 - 25.8 years) and at T2, 21.1 +/- 3.5 years (range 16.2 - 28.0 years). The mean observation period was 3.0 +/- 1.9 years. Descriptive statistics for each variable were calculated at baseline (T1) and follow-up (T2) stages, and during the observation period (T2-T1). RESULTS: Skeletal changes were found in 64% of the non-orthodontically treated female patients with TMJ disk displacement during the observation period. The L1 to Mandibular plane distance (mm) increased significantly by 0.8 mm (p < 0.01). But there were no significant differences in the other dental relationship variables (overjet, overbite, U1 to palatal plane) during the observation period. Most patients with skeletal changes showed a backward rotation of the mandible. The ratio of the rotation was a decrease of SNB by 0.43degrees for every 1degrees increase of FMA (Spearman rho = -0.660, p < 0.01). A few patients showed a distal shift of the mandible without rotation or significant changes in the vertical dimension. CONCLUSIONS: During observation periods without orthodontic treatment, non-growing patients with TMJ disk displacement showed dentoskeletal changes, mainly backward rotation of the mandible.
Displacement (Psychology) ; Female ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging ; Mandible ; Orthodontics ; Overbite ; Temporomandibular Joint ; Temporomandibular Joint Disorders

No abstract available.
Krukenberg Tumor*

Service diversification is recognized as an important strategy against turbulent environmental change. This study is designed to find out the trend of service diversification in Korean health care organizations and also to identify factors associated with the degree of service diversification. Data were collected from 69 hospitals out of 71 hospitals with over 300 beds. Important findings are summarized below. 1. Types of diversification are closely related to hospital size. Large hospitals have a tendency to provide sophisticated service requiring specialized skills and equipment, while small hospital have concentrated their efforts on health screening programs. 2. The more competitive and bigger hospitals are, the greater number of services that provide. Also, hospitals operating rational management information systems provide more services. Contrary to the expectation, hospitals with a low performance during last 3 years showed more service diversification. 3. A trend of more diversification was observed in hospitals whose chief executive officer used a prospector strategy. 4. A multiple regression analysis revealed that bed size, competitive environment, degree of rational management, and the growth pattern were significantly associated with teh service diversification.
Delivery of Health Care ; Health Facility Size ; Hospital Bed Capacity ; Management Information Systems ; Mass Screening

BACKGROUND: In recent studies, tacrolimus ointment has been shown to be effective for the treatment of atopic dermatitis with an excellent safety profile. OBJECTIVE: This study was done to assess the efficacy and side-effects of tacrolimus ointment for the facial atopic dermatitis(AD) in Korean. PATIENTS AND METHODS: Open-label, non-comparative study with 2 months' follow-up was done to assess the efficacy and safety of tacrolimus ointment (Protopic0ointment 0.1%, Fujisawa, Japan) in moderate to severe facial AD. Patients were instructed to apply it two times daily for 8 weeks. Facial lesions were evaluated at baseline, 4 and 8 weeks of treatment with in-tensity score by investigator. RESULTS: In comparing of intensity scores and each clinical score at baseline with those of 4 and 8 weeks of treatment, a significant decrease was noticed at all follow-up periods. Burning sense(54.5%) and pruritus(18.2%) were detected. CONCLUSION: Tacrolimus ointment is effective in treatment of severe facial AD and has tolerable mild adverse effects at the site of application in Korean.
Burns ; Dermatitis, Atopic* ; Follow-Up Studies ; Humans ; Research Personnel ; Tacrolimus*

The status of DNA synthesis and the effect of UV radiation on the DNA synthesis were studied in mouse skin by microautoradiography. Mice exposed to 100mJ/cm of UVB were injected intradermally with tritiated thymidine, 5 minutes, 2, 6 and 24 hours after irradiation and biopsies were processed for light microscopic autoradiography, A total of 25 ICR female albino haired mice were used as subjects. We compared heavily labeled cells(>10 grains/nucleus) and sparsely labeled cells (3-10 grains/nucleus) in UVL irradiated skin with nonirradiated control skin. 1. Within 5 minutes after UVL exposure an apparent depression in the number of heavily labeled cells occurred. This reduction was statistically significant and remained so for at least six hours post,irradiation. By 24 hours after UVL exposure, the reduction was recovered to nearly control level. 2. By five minutes after UVL exposure, sparsely labeled cells were observed in basal cell layer and differentiated cell layer. The nurriber of sparsely labeled cells appeared highest at five minutes after UVL exposure and then tended to fall to nearly control level at 24 hours. This aberrant type of TdR H incorporation is thought to represent unscheduled DNA synthesis to repair pyrimidine dimers formed in UVL injured DNA molecules,
Animals ; Autoradiography* ; Biopsy ; Depression ; DNA* ; Female ; Hair ; Humans ; Mice* ; Pyrimidine Dimers ; Skin* ; Thymidine ; Ultraviolet Rays

Ovarian carcinoma is a serious disease in women. Some reports revealed all-trans-retinoic acid (tRA) inhibited the proliferation of ovarian carcinoma cell lines and induced apoptosis. The aim of this study was to evaluate the anticancer and apoptotic effects of tRA and the expression of the retinoic acid receptor (RAR) alpha, beta, gamma, p53, bcl-2, and c-myc genes on the ovarian carcinoma cell lines, NIH OVCAR3 and SKOV3. In both cell lines, the proliferation of tumor cells was inhibited and characteristic morphologic patterns of apoptosis were shown after treatment of tRA. The number of apoptotic cells and the percentage of apoptosis were increased after treatment of tRA. The gel electrophoresis revealed the DNA ladder pattern in the NIH OVCAR3. Gene expressions were observed using northern blotting. There was no RARalpha expression in both cell lines. In NIH OVCAR3, there was no changes in the expression of RARbeta and bcl-2 gene. The RARgamma gene expression of tRA treated group was slightly increased, but p53 gene expression was decreased, and c-myc gene was not expressed. In SKOV3, the expressions of RARbeta, gamma, and p53 genes were increased and that of bcl-2 was decreased in the tRA treated group. There was no change in c-myc gene expression. These results suggest tRA has anticancer and apoptotic effect on both ovarian carcinoma cell lines. RARbeta, RARgamma, bcl-2, and p53 gene expressions were correlated with these effects of tRA on SKOV3 but not on NIH OVCAR3.
Apoptosis* ; Blotting, Northern ; Cell Line* ; DNA ; Electrophoresis ; Female ; Gene Expression ; Genes, bcl-2 ; Genes, myc ; Genes, p53 ; Humans* ; Receptors, Retinoic Acid ; Tretinoin*

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on qPality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.
Delivery of Health Care ; Female ; Health Services ; Humans ; Inpatients ; Logistic Models ; Marketing ; Middle Aged ; Outpatients ; Patient Selection

Double J stents have been advocated for drainage or splintage of the ureter. Fifty-four attempts at double J stent insertion were made in 46 patients. In 93% attempts the stent was satisfactorily placed. Their use in adjunct to urologic and gynecologic surgery, percutaneous nephrolithotomy and ureterorenoscopy has been encouraging but poor results have been obtained in patients with ureteral obstruction due to tuberculosis and malignancy.
Drainage ; Female ; Gynecologic Surgical Procedures ; Humans ; Nephrostomy, Percutaneous ; Stents* ; Tuberculosis ; Ureter ; Ureteral Obstruction ; Urinary Diversion*

PURPOSE: To compare standard laparoscopy-assisted Billroth I gastrectomies including standard lymph node dissection (LABIG) with hand-assisted laparoscopic surgery with the HandPort system (HALS) for the removal of early gastric cancers (EGC). METHODS: A prospective study was performed on 26 patients of EGC at Ewha Womans University Mok-Dong Hospital from July 1999 to August 2001. Seventeen patients (Group L) received LABIG using conventional laparoscopy-assisted methods and 9 patients received LABIG using HALS (Group H). We used staplers for the anastomosis, and a standard D2 lymph node dissection was done with ultrasonic shears or electrocautery. RESULTS: In group L, pathologic reports revealed 14 EGC (stage IA 14 cases), and 3 pm cancers (stage IB 1 case, II 2 cases). In group H, there were 9 early gastric cancers (stage IA 8 cases, IB 1 case). Significant differences (P<0.05) were present between group L and H in regards to the number of harvested lymph nodes (30.8 vs 18.9), estimated blood loss (462.1 vs 286.7 ml) and postoperative transfusion amounts (0.59 vs 0 unit). There were no differences in the mean operating time, distance from the lesion to the resection margin, postoperative leukocyte count, frequencies for pain control, wound size, time to diet, weight loss, serum protein, and postoperative hospital stay. Complications were present in 1 case in group L (enterocutaneous fistula) and 1 case in group H (gastric atony). There was one conversion to open surgery in group H. CONCLUSION: LABIG including standard lymph node dissections with both standard laparoscopic surgery and HALS were performed with equal outcome. The choice of surgical method depends on the characteristics of the lesion and the patient's physical factors.
Conversion to Open Surgery ; Diet, Reducing ; Electrocoagulation ; Female ; Gastrectomy* ; Gastroenterostomy* ; Hand-Assisted Laparoscopy* ; Humans ; Laparoscopy ; Length of Stay ; Leukocyte Count ; Lymph Node Excision ; Lymph Nodes ; Prospective Studies* ; Stomach Neoplasms* ; Ultrasonics ; Wounds and Injuries

It has been claimed that CNS lymphoma, a rare neoplasm accounting for only a small fraction of malignant brain tumors, occurs with increasing frequency in immunologically normal as well as immunocompromised individuals. We investigated the prognostic value of Ki-67 index, p53, and bcl-2 oncoprotein expression in relation to the clinicopathological parameters in the primary CNS lymphoma patients. The tumors were graded by Kiel classification and the Working formulation and included 33 high-grade, 4 intermediate-grade, and 5 low-grade lymphomas. The phenotype was determined in 38 cases: 30 were B cell type and 8 were T cell type. All cases displayed variable degrees of nuclear Ki-67 staining from 1.0% to 92.0% (mean 51.1%). A highly significant correlation was established between the proportion of Ki-67 positive cells and the classification into grades (p=0.0002) and phenotypes (p=0.0002). Overexpression of p53 and bcl-2 protein was found in 37.1% and 51.4% of 35 patients, respectively. And p53 expression was significantly increased in B cell type (p=0.02). On Kaplan-Meier survival curve, the phenotype, grade of tumors, and p53 and bcl-2 protein expression were not correlated with overall survival. On multivariate analyses, overall survival was independently influenced by Ki-67 index. In conclusion, it is suggested that Ki-67 proliferating index is the most important marker for predicting biologic behavior of the primary CNS lymphoma.
Brain Neoplasms ; Central Nervous System* ; Classification ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Multivariate Analysis ; Phenotype