To evaluate the effect of shortening the latent period for distraction osteogenesis, the authors experimented with distraction osteogenesis for a 24-hour latent period in the mandibles of rabbits. This study was carried out on 32 New Zealand white rabbits, each weighting 2000 to 2500 gm. Twenty animals were used for the control group and 12 for the experimental group. A unilateral external fixation device was applied to the left mandible. The mandibles were lengthened at 1 mm per 24 hours for 10 days. Five rabbits from the control group and three from the experimental group by random selection were sacrificed on the first day, and at the second, fourth and eighth week of the consolidation period. After lengthening bone densities at the site of the left mandibular bony lengthening were measured by quantitative computer tomography (QCT) and dual energy x-ray absorptiometry (DXA). As a result, the DXA value showed no difference compared to the control group after two week's consolidation. The trabeculae were thicker and had begun to be surrounded by lamellar bone both in the control and experimental groups histologically. In conclusion, the results of this study indicate that the osteogenetic effect in the experimental group was nearly the same as in the control group. If stable fixation and minimal periosteal dissection were performed during the procedure, the latent period would not be an important factor in distraction osteogenesis of membranous bone.
Absorptiometry, Photon ; Animals ; Bone Density ; External Fixators ; Mandible* ; Osteogenesis* ; Osteogenesis, Distraction ; Rabbits*

Intestinal metaplasia and dysplasia of the stomach have been stressed as precursors of gastric carcinoma of the intestinal type, although their preneoplastic nature is still debated. In this study, the cytomorphometric and cytokinetic spectra of the suggested preneoplastic and neoplastic lesions of the stomach were investigated. From the resected stomachs of early gastric carcinoma of intestinal type, areas of normal, intestinal metaplasia, dysplasia, and carcinoma were selected. They were immunostained for proliferating cell nuclear antigen, counterstained with propidium iodide, and various nuclear parameters were measured by image analysis. Normal and intestinal metaplastic mucosae differed by the localization of proliferation zone, but not by nuclear profile area, circular shape factor, and proliferation index. In dysplasia, proliferation zone covered large parts of the dysplastic area. Nuclear profile area and proliferation index were larger whereas circular shape factor was smaller than in normal or intestinal metaplasia. Carcinomatous lesion had diffuse proliferation activity, the largest nuclear profile area and proliferating index, and circular shape factor in-between those of normal or intestinal metaplasia and dysplasia. The above results showed a structural spectrum among normal of intestinal metaplasia, dysplasia, and carcinoma of intestinal type in cytomorphometric and cytokinetic terms. The structural spectrum raises the possibility that dysplasia of the stomach is a preneoplastic lesion.

Recently, a method of fabricating an esthetic anterior fixed prosthesis by integrating data such as three-dimensional facial scan and jaw motion to form a virtual patient with dynamic occlusion has been introduced. This enables smooth communication with patients during the diagnosis process, improves the predictability of esthetic prosthetic treatment, and lowers the possibility of occlusal adjustment. In this case report, a virtual patient with dynamic occlusion was created in which the results of the treatment were simulated, and esthetic maxillary anterior fixed prosthesis was fabricated. With the aid of the virtual patient, the final restorations were satisfactory both in terms of esthetic and function.

PURPOSE: Differentiated thyroid cancer is known to be one of cancers which have a favorable prognosis and long-term survival resulting from slow growth of tumor and late distant metastasis. Patients are nearly cured of thyroid cancer after first operation. But, some of those have high risk factors of recurrence. Practically it has been reported that 20% of those have recurrence of cancer and 50~60% of patients died of recurrence. We analyzed factors involving to recurrence after initial treatment, frequency and site of recurrence, disease-free interval, and results of treatment. Based on this information, we investigated therapeutics to decrease the rate of recurrence and prognostic factors to expect death. METHODS: 1803 patients were primarily operated for thyroid cancer in Kyungpook National University Hospital between 1985 and 2003. Among the cases, we reviewed the clinical records of 124 patients (6.9%) who had recurrent thyroid cancer. We analyzed the difference in frequency of recurrence on the basis of sex, age, histologic types, risk groups, and lymph node metastases when they had a first operation. The correlation between these factors and mortality rate was analyzed statistically by using Chi-square test and Fisher's exact probability test. RESULTS: Post-operative recurrence of thyroid cancer was highly observed in over 40 years old at first operation (8.4% vs. 4.9%), men (17.1% vs. 3.9%). Similarly, in the case of medullary or poorly-differentiated thyroid cancers, the groups of patients with high-risk (12.3% vs. 3.9%) or with lymph node metastases (13.5% vs. 3.7%) have high frequency of recurrence. Among the 124 patients, 53.3% cases have regional recurrence sites and 20.1% have local, 17.7% distant metastases, and 1.6% combined locoregional. The number of patients who died of recurrent cancer was 32 of 124 cases. Major cause of the death was distant metastases. In the case of 104 patients who had recurrent differentiated thyroid cancer, significant prognostic indicators of low survival rates are age greater than 45 years, neck dissection at second operation and distant metastases. CONCLUSION: In order to decrease the rate of local and regional recurrence in thyroid cancer, we conclude that complete resections of thyroid tissue and cervical lymph nodes have to be operated specially in the group with high-risk. Although adjacent organs are infiltrated, active treatment should be carried out. The treatment of most medullary or poorly-differentiated thyroid cancers which result in the death of distant metastases still remains to be studied.
Gyeongsangbuk-do ; Humans ; Lymph Nodes ; Male ; Mortality ; Neck Dissection ; Neoplasm Metastasis ; Prognosis* ; Recurrence ; Risk Factors* ; Survival Rate ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: This study analyzed the significant prognostic factors in terms of age, rupture side (lateral or medial), existence of associated lesion, length and zone-that affect clinical healing after meniscal repair. MATERIALS AND METHODS: Data were obtained from 55 patients who had been observed at least for 18 months after meniscal repair. Healing was decided based on the patients'clinical symptoms, and analyses were made according to clinical data. RESULTS: The clinical healing rate of meniscal repairs was found to be 82% (45 patients), and was higher in ruptures accompanied by anterior cruciate ligament injury than meniscus rupture alone, when the length of the meniscal rupture was less than 2 cm. Age and rupture side (lateral or medial, peripheral or central) had no significant effect upon clinical healing. CONCLUSION: The length of meniscal rupture and meniscal rupture associated with ACL were found to be infinately correlated with good prognosis, but age, site, and zone of meniscal rupture probably do not affect prognosis.
Anterior Cruciate Ligament ; Humans ; Prognosis ; Rupture

PURPOSE: To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty. MATERIALS AND METHODS: The study was conducted on 46 patients in whom 296 patients were performed during last 9 years. We were especially concerned with the restoration rate of vertebral height and kyphotic angle and estimated them on simple X-ray films. RESULTS: In patients experienced subsequent vertebral fractures and no subsequent vertebral fractures after vertebroplasty, the mean height restoration rate of treated vertebra were 16.7% and 7.07%, and the kyphotic angle difference were 2.53 degree and 4.2 degree. The greater degree of height restoration of the vertebral body, especially in middle vertebral height and the lesser degree of kyphotic angle difference increased the risk of adjacent vertebral fracture risk. This results were available statistically (all p<0.05, Logistic regression test, SPSS 13.0). CONCLUSION: It may be thought that the vertebral body height restoration rate will become risk factor of adjacent vertebral fractures.
Body Height ; Fractures, Compression* ; Humans ; Logistic Models ; Risk Factors* ; Spine* ; Vertebroplasty* ; X-Ray Film

PURPOSE: As the number of patients with localized renal cell carcinoma has increased, there are conflicting reports on the nuclear grade as a prognostic factor. The aim of this study was to evaluate the significance of the nuclear grade as a prognostic factor. MATERIALS AND METHODS: We retrospectively enrolled 172 patients with localized renal cell carcinoma and who underwent radical nephrectomy. The patients were staged according to the 1997 TNM stage and the Fuhrman grading. The survival rate was analyzed by the Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazard model. RESULTS: The overall 1- , 5- and 10-year survival rates were 98.1, 72.5 and 68.4%, respectively. The 5-year survival rates for grades I, II, III and IV were 100, 92.6, 85.0 and 60.9%, respectively (p<0.0001). According to the Fuhrman grade in each T stage, 1) for patients with pT1b, the 5-year survival rates were 100, 85.0, 85.71 and 33.3% for patients with grade I, II, III and IV, respectively (p=0.002). 2) for patients with pT2, the 5-year survival rates were 100, 92.3, 60.0 and 25.0% for patients with grade I, II, III and IV, respectively (p<0.0001). A comparison of the survival curves by the Fuhrman grade showed a statistically significant difference. CONCLUSIONS: The Fuhrman grade is an important prognostic factor for patients with localized renal cell carcinoma. A high nuclear grade tends to have metastatic potential and a poor prognosis. This group of patients with a high nuclear grade must be followed up more closely. Determining the pathologic stage along with using the Fuhrman grade-based surveillance protocols are a logical approach to follow-up.
Carcinoma, Renal Cell* ; Cell Nucleus Shape ; Follow-Up Studies ; Humans ; Logic ; Multivariate Analysis ; Nephrectomy ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate

Cardiovascular disease is a major cause of mortality and disability worldwide and in Korea as well. Dyslipidemia is considered as a major and modifiable risk factor of cardiovascular disease. In Korea, the prevalence of dyslipidemia in people aged 30 years or older was 47.8% in 2013, with prevalence increasing as age increases. Men had higher prevalence of dyslipidemia than women (men, 57.6%; women, 38.3%). However, the prevalence of dyslipidemia in women increased rapidly after menopause. Furthermore, dyslipidemia is also rising in childhood and adolescents. The prevalence of hypo-HDL cholesterolemia and hypertriglyceridemia were higher than hyper-LDL cholesterolemia. However, hyper-LDL cholesterolemia also has been increasing due to the westernized diet and other lifestyle changes. Atherogenic dyslipidemia, which is the combination of these lipoprotein abnormalities, seems to be increasing. The prevalence of dyslipidemia was higher in obese people, and the prevalence of the metabolic syndrome, which included dyslipidemia as a component of abnormalities, also increased in accordance with dyslipidemia. Also, dyslipidemia in patients with diabetes increased from 27.8% in 2006 to 49.5% in 2013. The awareness and treatment rate of dyslipidemia were lower in comparison with other chronic diseases. By providing information about the risk of dyslipidemia, primary prevention such as weight loss, dietary treatment, and quit smoking and secondary prevention such as early detection and drug treatment are required for reducing the development of cardiovascular disease.
Adolescent ; Cardiovascular Diseases ; Chronic Disease ; Diet ; Dyslipidemias* ; Epidemiology ; Female ; Humans ; Hypertriglyceridemia ; Korea* ; Life Style ; Lipoproteins ; Male ; Menopause ; Mortality ; Obesity ; Prevalence ; Primary Prevention ; Risk Factors ; Secondary Prevention ; Smoke ; Smoking ; Weight Loss

To evaluate the usefulness of computed tomography (CT) in radiotherapy treatment planning in malignant tumors of thoracic cage, the computer generated dose distributions were compared between plans based on conventional studies and those based on CT scan. 22 cases of thoracic malignancies, 15 lung cancers and 7 esophageal cancers, diagnosed and treated in Department of Therapeutic Radiology of Seoul National University Hospital from September, 1982 to April, 1983, were analyzed. In lung cancer, dose distribution in plans using AP, PA parallel opposing ports with posterior spinal cord block and in plans using box technique both based on conventional studies were compared with dose distribution using AP, PA and two oblique ports based on CT scan. On esophageal cancers, dose distribution in plans based on conventional studies and those based on CT scans, both using 3 port technique were compared. The results are as follows: 1. Parallel opposing field technique were inadequate in all cases of lung cancers, as portion of primary tumor in 13 of 15 cases and portion of mediastinum in all were out of high dose volume. 2. Box technique was inadequate in 5 of 15 lung cancers as portion of primary tumor was not covered and in every case the irradiated normal lung volume was quite large. 3. Plans based on CT scan were superior to those based on conventional studies as tumor was demarcated better with CT and so complete coverage of tumor and preservation of more normal lung volume could be made. 4. In 1 case of lung cancer, tumor localization was nearly impossible with conventional studies, but after CT scan tumor was more clearly defined and localized.
Esophageal Neoplasms ; Lung ; Lung Neoplasms ; Mediastinum ; Radiation Oncology ; Radiotherapy* ; Seoul ; Spinal Cord ; Tomography, X-Ray Computed

BACKGROUND: Ropinirole is a non-ergoline D2 agonist which has a highly selective affinity to D2 receptor. The aim of this study was to evaluate the efficacy and safety of ropinirole in the treatment of Parkinson's disease (PD). METHODS: Seventy-six cases with PD (Hoehn and Yahr stage II to IV) were included in this trial. Each patient was randomly allocated to receive either ropinirole (n=37) or bromocriptine (n=39) over a 16-week period. All subjects were not optimally controlled on levodopa due to motor fluctuations. The response rate was defined as the percentage of patients who had at least 20% reduction of levodopa doses. The clinical status was also assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), Clinical Global Impression (CGI), and reduction of off durations. RESULTS: The end-point analysis, on an intention-to-treat basis, revealed significantly higher response rate in the ropinirole group compared with the bromocriptine group (odds ratio 2.995, 95% C.I. (1.157, 7.751)). A statistically significant improvement in CGI was also observed in the ropinirole group (p=0.046). The mean off duration was significantly reduced in the ropinirole group (p=0.0001). Other parameters using the UPDRS motor score or off duration did not show significant differences between the two groups. The overall incidence of adverse effects was not significantly different between the two groups. The most common side effects were dizziness, dyskinesia, and nausea/vomiting. No subjects were withdrawn from the study due to side effects. CONCLUSION: Ropinirole is a safe and well-tolerated drug and provides superior overall efficacy compared with bromocriptine as an adjunct to levodopa. (J Korean Neurol Assoc 19(2):102~109, 2001)
Bromocriptine ; Dizziness ; Dyskinesias ; Humans ; Incidence ; Levodopa* ; Parkinson Disease*