This investigation evaluated patients who received Steri-Oss implants from the Dental Hospital of Chosun University during the period from March 1989 to August 1997. 346 fixtures of 127 patients were included in this study . The results were as follows ; 1.The follow-up period was defined as the period between the surgical placement of the implants and the last follow-up examination. The mean follow-up period was 2.17+/-1.21 years. 2.The period between fixture installation and second surgery was 0.71+/-0.44 years in the maxilla and 0.46+/-0.21 years in the mandible. 3.The number of fixtures which were installed in the upper jaw(112) was less than that in the lower jaw(234) and in the posterior region(260) was more than in the anterior region(86). 4.The length of fixture which was most frequently used was 12 mm and least was 8mm. Screw implants were installed more than cylindrical implants. 3.8mm implant was the most common implans, followed by 4.5mm and 3.25mm. 5.The number of augmentation cases was more than that of non-augmentation cases and the rate of augmentation cases in the maxilla was more than that in the mandible. 6.Implant restorations for partial edentulos patients(94cases) were more than single-tooth implant restorations(33cases) or implant restorations for complete edentulos patients(10cases). 7.Free-standing prostheses for partially edentulous patients were more commom than any other type of connection between implants and natural teeth. 8.Plaque Index(0.95+/-0.74) and Gingival Index(0.31+/-0.52) were very similar around the natural teeth and reflected an acceptable level of plaque and gingivitis control. Mean value for keratinized mucosa index(1.93+/-1.20) remained fairly constant around level 2(1-2 mm keratinized epithelium). 9.Patients were generally satisfied with implant in terms of comfort, function, speech and esthetics. 10.There was not a statistically significant differences in overall survial rate between implants placed in the maxilla (91.5%) and those placed in the mandible (93.8%). Fourteen implants lost before the prosthetic rehabilitation and eleven implants lost following variable periods in function after the prosthetic phase of the treatment. 11.Cause of implant failures was exfoliation or removal of fixture due to non-osseointegration before the prosthetic rehabilitation or due to fracture of fixture, masticatory pain after the prosthetic rehabilitation. 12.The survival rate of Steri-Oss implants using the Kaplan-Meier statistical analysis was 93.8% at 2 year and 86.6% at 5 year. In all cases, implant losses occured predominantly in the healing period. There was a steep decline in the rate of implant loss after the first year. 13.The survival rate of Steri-Oss implants in the anterior region was 94.8% at 2 year and 94.8% at 5 year and that in the posterior region was 92.8% at 2 year and 75.9% at 5 year. In conclusion, this study revealed a number of parameters and guidelines for achieving an optimal success rate in osseointegration.
Dental Implants, Single-Tooth ; Esthetics ; Follow-Up Studies ; Gingivitis ; Humans ; Mandible ; Maxilla ; Mucous Membrane ; Osseointegration ; Prostheses and Implants ; Rehabilitation ; Survival Rate ; Tooth

p53 is a tumor suppressor gene product identified in a wide range of tumor including colorectal carcinoma. Genetic alterations in the p53 tumor suppressor gene are common in human colorectal carcinoma. bcl-2 is a protooncogene that inhibits apoptosis. The products of mutant p53 gene and bcl-2 have been associated with prognosis in several malignancies including colorectal carcinomas. This study was undertaken to evaluate values of p53 and bcl-2 oncoproteins as prognostic factors relative to clinicopathological factors and correlation of their expression. Analyses were made on achieval pathologic tissues of 80 patients with colorectal carcinomas including 34 patients able to follow-up over 5 years. The oncoproteins were localized using commercially available monoclonal antibodies:DO-7 for p53, clone124 for bcl-2. Expression of bcl-2 was cytoplasmic, whereas nuclear p53 expression was localized in carcinoma cells. The patients were 17 to 83 years of age. The expression of p53 and bcl-2 was determined respectively in 30 (37.5%) and 21 (26.3%)cases. The expression of p53 nuclear expression was not correlated with tumor location, size, histologic grade, Duke's classification, regional lymph node metastasis and tumor recurrence. The cytoplasmic expression of bcl-2 was not correlated with tumor location, size, histologic grade, Duke's classification, regional lymph node metastasis and recurrence. Univariate analysis showed that patients with p53 nuclear expression were not associated with poorer overall survival than patients with p53 negative, and also showed in patients with bcl-2 expression. The expression of p53 did not affect to that of bcl-2. We concluded that the p53 nuclear and bcl-2 cytoplasmic expression were not independent prognostic factors in colorectal carcinomas. Evidence of reciprocity of bcl-2 and p53 expression was not found.
Apoptosis ; Classification ; Colorectal Neoplasms* ; Cytoplasm ; Follow-Up Studies ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Oncogene Proteins ; Prognosis ; Recurrence

PURPOSE: Fournier's gangrene is a rapidly progressive fulminant infection of the perineum and abdominal wall along with the scrotum in men and the vulva in women. If the effective surgical treatment is delayed, the patients result in fatal. Modern surgical series report a mortality of 8-67%. Objective: The aims of this study were to examine the outcomes of 20 consecutive patients with Fournier's gangrene caused by a perianal abscess and to identify the factors leading to improved survival in these patients. METHODS: The medical records of all patients who had been treated at Chosun University Hospital between January 1991 and December 1999 for Fournier's gangrene caused by a perianal abscess were retrospectively reviewed. RESULTS: Twenty patients were identified (mean age 47 years, range 20-66). The sexual ratio was 2.3:1 (male:female). The etiologies included perianal fistula (35%), unknown (35%), hemorrhoidectomy (10%), rectal cancer perforation (10%), and injection therapy (10%). Associated conditions included diabetes mellitus (50%), liver cirrhosis (10%), pulmonary tuberculosis (5%), intestinal tuberculosis (5%), ulcerative colitis (5%), Crohn's disease (5%) and iron deficiency anemia (5%). Escherichia coli and bacteroid fragilis were most commonly identified. All 20 patients initially received multiple incisions and debridement. At the time of first surgery, a diverting colostomy was required in 35% of the cases and a ileostomy in 5%. Over the past 10 years, the survival rate of patients with Fournier's gangrene caused from perianal abscess has been high (100%). CONCLUSION: The keys to a successful outcome included early diagnosis, prompt surgical intervention with radical debridement, prompt fluid resuscitation, rapid initiation of broad-spectrum antibiotics, and hemodynamic support in an intensive care setting.
Abdominal Wall ; Abscess* ; Anemia, Iron-Deficiency ; Anti-Bacterial Agents ; Critical Care ; Colitis, Ulcerative ; Colostomy ; Crohn Disease ; Debridement ; Diabetes Mellitus ; Early Diagnosis ; Escherichia coli ; Female ; Fistula ; Fournier Gangrene* ; Hemodynamics ; Hemorrhoidectomy ; Humans ; Ileostomy ; Liver Cirrhosis ; Male ; Medical Records ; Mortality ; Perineum ; Rectal Neoplasms ; Resuscitation ; Retrospective Studies ; Scrotum ; Survival Rate ; Tuberculosis ; Tuberculosis, Pulmonary ; Vulva

Intrascrotal extratesticular malignancies are rare, and the radiologic findings of extraskeletal chondrosarcoma have not been reported. We describe the radiologic findings of a case of mesenchymal chondrosarcoma arising from intrascrotal extratesticular soft tissue and represented by a complex, cystic, solid mass containing calcifications and hematoma.
Chondrosarcoma ; Chondrosarcoma, Mesenchymal* ; Hematoma ; Sarcoma

BACKGROUND: Acute variceal bleeding is a serious complication of liver cirrhosis, which has an attendant mortality of approximately 60% over two years, and a variety of treatments, such as balloon tamponade, endoscopic varix ligation, sclerotherapy, histoacryl injection and vasoactive drugs, have been used. The aims of the present trial were to compare the effectiveness and complications of somatostatin and vasopressin in the treatment of acute variceal bleeding. METHODS: Forty-three cirrhotic patients, with endoscopically proven acute variceal bleeding, were included in this trial. Both drugs were given as continuous intravenous infusions for 48 hours. Twenty patients received the somatostatin (250 mcg per hr after a bolus of 50 mcg) and twenty-three the vasopressin (0.4 units per min). RESULTS: There were no significant differences between the two groups in relation to age, sex, etiology of cirrhosis, Child-Pugh classification, characteristics of bleeding episode, laboratory findings before randomization and units of transfused blood during therapy. Rebleeding, within 6 hours after beginning of therapy, was regarded as failure to control initial bleeding, and was observed in 3 (13.0%) of the patients who received vasopressin and in 1 (5.0%) treated with somatostatin (p> 0.05). Five patients in both the somatostatin (25.0%) and vasopressin (21.7%) groups rebled during the first 5 days following the initial therapy (p> 0.05). Meaningful complications related to the use of vasopressin were observed in 5 patients (chest pain or abdominal pain requiring nitroglycerin), but no complications were associated with the use of somatostatin (p< 0.05). The mortalities during hospitalization were similar in both the treatment groups. Two of the vasopressin and 1 of the somatostatin group died due to the uncontrolled rebleeding, and 1 of the vasopressin group died due to hepatic failure (2 weeks later after theropy). CONCLUSION: This study showed no differences in the effectiveness of somatostatin and vasopressin, but the somatostatin group had a lower risk of the complications.
Comparative Study ; Esophageal and Gastric Varices/*drug therapy/etiology ; Female ; Gastrointestinal Hemorrhage/*drug therapy/etiology ; Hemostatics/*administration & dosage/adverse effects ; Human ; Infusions, Intravenous ; Liver Cirrhosis/*complications/mortality/therapy ; Male ; Middle Aged ; Prospective Studies ; Somatostatin/*administration & dosage/adverse effects ; Treatment Outcome ; Vasopressins/*administration & dosage/adverse effects

BACKGROUND: Acute variceal bleeding is one of serious complications of liver cirrhosis that has an attendant mortality of approximately 60% during two years and a variety of treatments like balloon tamponade, sclerotherapy and vasoactive drugs have been used. The aim of the present trial was to compare the effectiveness and complications of somatostatin and vasopressin in the treatment of acute variceal bleeding. METHODS: Fourty-three cirrhotic patients with endoscopically proven acute variceal bleeding were included. Both drugs were given as continuous intravenous infusions for 48 hour. Twenty patients received somatostatin (250 mcg per hour after a bolus of 50 mcg) and twenty-three recieved vasopressin (0.4 units per min). RESULTS: There was no significant difference between two groups in relation to age, sex and etiology of cirrhosis, Child-Pugh classification, characteristics of bleeding episode, laboratory findings before randomization and units of transfused blood during therapy. Rebleeding within 6 hour after beginning of therapy, that is failure of initial control of bleeding, was observed in 3 (13.0%)patients receiving vasopressin and in 1 (5.0%) of those treated with somatostatin (p>0.05). Five patients (25.0%) in the somatostatin group and 5 (21.7%) in the vasopressin group rebled during 5 days after initial therapy (p>0.05). The meaningful complications related with vasopressin were observed in 5 patients (chest pain or abdominal pain requiring nitroglycerin) but serious complications of somatostatin were not found. Mortalities during hospitalization were similar in both treatment groups. Two of the vasopressin group and one of the somatostatin group died because of the uncontrolled rebleeding and one of the vasopressin group died due to hepatic failure. CONCLUSION: This study shows that the effectiveness of somatostatin and vasopressin was not different but somatostatin had a lower risk of the complication than vasopressin.
Abdominal Pain ; Balloon Occlusion ; Classification ; Esophageal and Gastric Varices* ; Fibrosis ; Hemorrhage ; Hospitalization ; Humans ; Infusions, Intravenous ; Liver Cirrhosis* ; Liver Failure ; Liver* ; Mortality ; Prospective Studies* ; Random Allocation ; Sclerotherapy ; Somatostatin* ; Varicose Veins ; Vasopressins*

BACKGROUND: Adequate depth of anesthesia requires a sufficient amount of the agent to secure unconsciousness and other components of anesthesia as needed for that particular surgical procedure, without jeopardizing vital organ functions. To evaluate the relationship of depth of anesthesia to EEG, we studied the effects of increasing minimum alveolar concentration (MAC) of isoflurane (arousal, 1, 1.3, 1.5 MAC) on power spectral analysis of the EEG. METHODS: To determine 1 MAC, we studied sixty patients undergoing general anesthesia who were randomly allocated to receive isoflurane at several predetermined end-tidal concentration. A minimum of 15 min was allowed between induction and skin incision to allow steady state condition. Patients were observed for gross purposeful movement for 60 seconds after incision. The MAC was calculated using maximum likelihood solution to a logistic regression model. Another forty patients were randomly allocated to have their EEGs recorded. General anesthesia was induced with oxygen and isoflurane only. After loss of consciousness, succinylcholine 1.5 mg/kg was given and intubation followed. The EEG was recorded awake and after 15 min at steady state conditions of 1, 1.3 and 1.5 MAC isoflurane had been achieved. Spectral edge frequency 95% (SEF95), median spectral frequency (MSF), total power (TP) and relative power in the delta, theta, alpha and beta band were calculated. RESULTS: The MAC of isoflurane was 1.21 vol% (20 - 40 years) and 1.09 vol% (40 - 60 years). The distribution of spectral EEG indices of the EEGs were established and compared. The threshold value of SEF95 14 Hz to differentiate between arousal and 1.3 and 1.5 MAC had a sensitivity of 60.5% (1.3 MAC), 71% (1.5 MAC) and specificity of 74.4% (1.3 and 1.5 MAC) and that of MSF 5 Hz had a sensitivity of 71% (1.3 MAC), 81.5% (1.5 MAC) and specificity of 48% (1.3 MAC), 48.8% (1.5 MAC). CONCLUSIONS: With regard to the dose-related decrease in SEF95 and MSF under increasing end- expiratory concentrations of isoflurane as described in the present study, future studies may have todetermine whether EEG feedback control of volatile anesthetic administration may be used successfully. It seems that if neglected parts by MSF and SEF95, which are really true values are considered in the future studies, those would increase the sensitivity and specificity of EEG could be used as tool for determining depth of anesthesia.
Anesthesia ; Anesthesia, General ; Arousal ; Electroencephalography* ; Humans ; Intubation ; Isoflurane* ; Logistic Models ; Neurofeedback ; Oxygen ; Sensitivity and Specificity ; Skin ; Succinylcholine ; Unconsciousness

BACKGROUND/AIMS: Pegylated interferon (peginterferon) and ribavirin combination therapy is less effective and associated with a higher frequency of serious complications in chronic hepatitis C patients with cirrhosis than in noncirrhotic patients. This study evaluated the efficacy and tolerability of peginterferon and ribavirin treatment in patients with hepatitis C virus (HCV)-related cirrhosis. METHODS: Eighty-six patients with clinically diagnosed liver cirrhosis were treated with either peginterferon alpha-2a (n=51) or peginterferon alpha-2b (n=35) plus ribavirin. The sustained virologic response (SVR) and adverse effects were analyzed retrospectively. RESULTS: Of the 86 patients (55 males), 48 patients (55.8%) had HCV genotype 1 infection and 38 (44.2%) had genotype non-1 infection. The overall SVR rate was 34.9% (30/86), and the rates of SVR in the genotype 1 and non-1 patients were 20.8% (10/48) and 52.6% (20/38), respectively. The multivariate analysis revealed that having HCV genotype 1 (P=0.003) and high baseline viral load (>8.0x10(5) IU/mL, P=0.012) were the independent predictive factors for SVR failure. In 20.9% (18/86) of the patients, treatment was not completed due to adverse events (27.8%), loss to follow-up (50.0%), and other reasons (22.2%). CONCLUSIONS: Peginterferon and ribavirin combination therapy was relatively effective and feasible for clinically diagnosed HCV patients, especially in those with genotype non-1 infection and low baseline viral load.
Adult ; Aged ; Antiviral Agents/*therapeutic use ; Drug Therapy, Combination ; Female ; Genotype ; Hepacivirus/*genetics ; Hepatitis C, Chronic/complications/*drug therapy/virology ; Humans ; Interferon-alpha/*therapeutic use ; Liver Cirrhosis/*diagnosis/etiology/virology ; Male ; Middle Aged ; Polyethylene Glycols/*therapeutic use ; RNA, Viral/blood ; Recombinant Proteins/therapeutic use ; Retrospective Studies ; Ribavirin/*therapeutic use ; Viral Load

OBJECTIVE: It is controversial whether routine or selective iron supplementation during gestation is needed. The aim of this study is to evaluate whether screening with serum ferritin during the first trimester of pregnancy could be identify women who need prophylactic iron supplementation. METHODS: According to the serum ferritin level of cut-off point of 30 microgram/L during the first trimester of pregnancy and the presence of iron supplementation during gestation, the subject was divided into 4 group that were as follows: serum ferritin level of 30 microgram/L and iron- supplemented group (n=40), serum ferritin level of >30 microgram/L and non iron-supplemented group (n=15). Maternal serum ferritin, TIBC, iron, hemoglobin, hematocrit, red cell indices (MCV, MCH, MCHC, RDW) were measured before 14 weeks of gestation and after 34 weeks of gestation. RESULTS: All hematologic and biochemical markers indicated more severe anemic status in the late pregnancy than during the first trimester of pregnancy. The effect of iron supplementation was profounder on the pregnant woman whose ferritin levels were below 30 microgram/L during the first trimester of pregnancy. Regardless of iron supplementation, the group (ferritin >30 microgram/L during the first trimester of pregnancy) showed relatively higher ferritin level in late pregnancy. CONCLUSION: The screening with serum ferritin level of cut-off point of 30 microgram/L during the first trimester of pregnancy may be useful to identify women who need prophylactic iron supplementation.
Biomarkers ; Erythrocyte Indices ; Female ; Ferritins ; Hematocrit ; Humans ; Iron* ; Mass Screening ; Pregnancy Trimester, First ; Pregnancy* ; Pregnant Women

The aim of this study is to determine whether the posterior cervical fusion methods with the plate-screw system applied to the lateral mass of cervical spine are radiologically safe to patients. The lateral cervical X-rays and CT scans were done on 40 normal adults without cervical problem. Based on Roy-Camille and Magerl's method, the theological trajectory of screw was shown on films and the parameters were measured. The study based on Roy-Camille's method showed less than one percent chance of injury on the facet joint and the mean depth of the screw to be 10.5+/-1.4mm. On the other hand, Magerl's method showed the mean depth of screw to be 11.9+/-1.5mm which is slightly larger than that of Roy-Camille's method and no chance of facet injury occurred. A reduced lateral angle of screw (19.6+/-3.5 degrees) performed with the concept based on Magerl's method resulted a longer depth of screw (13.5+/-2.1mm). Both Roy-Camille and Magerl's methods seemed to be radiologically safe to normal persons. However, the authors recommend the reduced lateral angle (19.6+/-3.5 degrees) of screw based on the Magerl's method more than an original Magerl's methods.
Adult ; Bone Plates ; Bone Screws ; Cervical Vertebrae/*radiography/*surgery ; Female ; Human ; Male ; *Spinal Fusion ; Support, Non-U.S. Gov't ; Tomography, X-Ray Computed/*methods