All ceramic restorations except In-Ceram Alumina system gave a good esthetics and an exellent marginal fidelity. The flexural strength of them had about 150MPa, so the indication is only single crown. By using In-ceram Alumina System(450MPa), it is thought to be possible to construct bridge for its high flexural strength. But the prognosis is unclear. The purposes of this study are to clear short term prognosis of In-Ceram bridge restorations, to elucidate its clinical significance. Among 22 In-Ceram Bridge restored in our department, 11 In-Ceram bridges with follow up were used. The period of placement is from 1 to 18 months. The results were as follow : 1. Among follow up 11 bridges, 2 bridges were fractured. One is 4 unit in maxillary lateral incisors, the other is 3 unit bridge in maxillary canine and premolar. Including 11 bridge without follow up, failure rate is very low(2/22). 2. The fracture sites are connector areas between abutment and pontic. To maintain In-Ceram bridge for long term period, it is needed to remove the nonphysiologic occlusal force and to have sufficient thickness of alumina core. For estabilishing clinical use of In-Ceram bridges, it is thought to need clinical research during long term period.
Aluminum Oxide* ; Bicuspid ; Bite Force ; Ceramics ; Crowns ; Denture, Partial, Fixed ; Esthetics ; Follow-Up Studies ; Incisor ; Prognosis*

Alveolar Process ; Dental Implants ; Humans ; Lifting ; Mandibular Nerve ; Maxillary Sinus ; Nose ; Rehabilitation

PURPOSE: To describe our initial experience with a novel method of adenoma retrieval using a pneumovesicum (PNV) after Holmium laser enucleation of the prostate (HoLEP). METHODS: From January 2016 to April 2018, a total of 93 consecutive patients treated with HoLEP were enrolled in this study. For tissue morcellation, we used the PNV morcellation technique for an initial series of 21 patients and the conventional technique (Lumenis VersaCut) for a consecutive series of 72 patients. We compared efficiency and safety between the novel technique and the traditional technique. Subgroup analysis was performed to assess the effectiveness of the current technique in the large prostate (>70 mL). RESULTS: There were significant differences in mean age and prostate volume between the 2 groups. However, there were no significant differences in the baseline characteristics and preoperative parameters in the subgroup analysis of large prostates (>70 mL). The mean morcellation efficiency was higher (8.50±1.94 minutes vs. 1.76±0.45 minutes, P<0.05) and the time of morcellation (7.81±1.25 minutes vs. 34.04±11.14 minutes, P<0.05) was shorter in the PNV group. Moreover, there were no significant differences between groups in hospitalization period (2.62±1.10 days vs. 2.90±1.26 days, P=0.852) and any other postoperative events, including recatheterization, reoperation, clot retention, and urethral stricture (P-value range, 0.194–0.447). In the PNV group, there were some cases of procedure-related complications, including postoperative extravesical leakage (5th case), clot retention (8th case), and recatheterization (9th case). CONCLUSIONS: This method has a higher tissue retrieval efficacy, with the advantage of excellent visibility compared to conventional morcellation. The current method can be applied when a transurethral morcellator is out of order or cannot be used.
Adenoma ; Holmium ; Hospitalization ; Humans ; Lasers, Solid-State ; Methods ; Morcellation ; Prostate ; Prostatic Hyperplasia ; Reoperation ; Urethral Stricture

No abstract available.
Humans ; Peritonitis*

BACKGROUND: Intraperitoneal(IP) vancomycin has been widely used for the treatment of peritonitis or exit-site infection associated with continuous ambulatory peritoneal dialysis(CAPD). However, some previous reports in the literature have suggested that IP administration of certain vancomycin may be associated with chemical peritonitis in CAPD patients. METHODS: Between 1 February 1994 and 1 February 1997, 35 consecutive CAPD patients requiring treatment with intraperitoneal vancomycin for either exit-site infection or peritonitis in the Yeungnam University Hospital were recruited retrospectively into the study. We compared retrospectively the incidence of chemical peritonitis after using two different preparations of vancomycin from different pharmaceutical companies, namely vancocin CP(R) and vancomycin(R). RESULTS: Thirty-three cases(all 26 cases given vancocin CP(R) and 7 out of the 9 cases given vancomycin(R)) showed improvement. None of them developed fever, abdominal pain or cloudy dialysate. Out of the 9 cases given IP vancomycin(R), two who currently did not have abdominal pain and cloudy dialysis effluent develolped these symptom and sign at 5 and 6 hours after administration of IP vancomycin. The chemical peritonitis may be secondary to prolonged contact of the peritoneal membrane with one or more of the impurities present in vancomycin preparation. CONCLUSION: In summary, it is necessary for the nephrologists to be aware of the possible chemical peritonitis which can be caused by the impurities of certain brand of vancomycin.
Abdominal Pain ; Dialysis ; Fever ; Humans ; Incidence ; Membranes ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Retrospective Studies ; Vancomycin*

Research regarding the treatment of metastatic prostate cancer has been undergoing dramatic progress. Treatment of hormone-naïve metastatic prostate cancer includes surgical castration and medical castration that lowers androgen level in the blood using drugs. Although these androgen deprivation therapies are very effective, hormone-naïve metastatic prostate cancer finally leads to castration-resistant prostate cancer because resistance to surgical or medical castration occurs. The treatment at this stage includes not only docetaxel, but also new androgen synthesis inhibitor or androgen receptor inhibitors such as abiraterone or enzalutamide, new cytotoxic anticancer agents such as carbazitaxel, and radioisotope treatment such as radium-223. Recently, studies on the effect of chemotherapy on hormone-naïve metastatic prostate cancer before the development of castration-resistant prostate cancer have been actively published. As a result, various guidelines have recommended docetaxel as the first-line therapy for hormone-naïve metastatic prostate cancer. In this manuscript, we will summarize the basic concepts of androgen deprivation therapy for hormone-naïve metastatic prostate cancer and the main results of research on chemotherapy for hormone-naïve metastatic prostate cancer.
Antineoplastic Agents ; Castration ; Drug Therapy* ; Prostate* ; Prostatic Neoplasms* ; Receptors, Androgen

The hemodynamic feature of the tetralogy of Fallot (TOF) is best characterized by equality of left and right ventricular peak systolic pressure. The interventricular septum is flattened and thickened. Even after the right ventricular pressure is normalized in the postoperative period, the morphological abnormality continues for some time We have analyzed the morphological changes of the IVS echocardiographically after total correction and tried to correlate them with the prognosis of the patients. Forty five patients underwent total correction of TOF between May 1991 and July 1992.The IVS morphology was assessed with 2-D echocardiography before and after surgery. The control group consisted of 15 normal subjects(8 with functional cardiac murmur and 7 with non-cardiac diseases).We also evaluated the influence of the residual pulmonary regurgitation(PR) or pulmonic stenosis (PS) upon sequential changes in the end-systolic configuration and the thickness of the IVS. The following results were obtained. 1) Four months after total correction the IVS thickness and configuration at end-systole of the study patients were normalized, and they were not significantly different compared to those of the control group. 2) The postoperative residual PR of mild to moderate degree did not influence the course of morphological normalization. On the other hand, the postoperative residual PS greater than moderate degree hindered the normalization process. And the morphological abnormalities in the patients with the residual PS lasted longer than in the patients with the residual PR. 3) It would be necessary to perform cardiac catheterization in order to evaluate and to take care of the residual hemodynamic abnormalities if the IVS morphology remains to be abnormal even after one year after total correction.
Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Hand ; Heart Murmurs ; Hemodynamics ; Humans ; Postoperative Period ; Prognosis ; Pulmonary Valve Stenosis ; Tetralogy of Fallot* ; Ventricular Pressure

Upper tract urothelial carcinoma (UTUC) has a relatively low prevalence rate of about 1.8 per 100,000 people. According to the recent literature, the development of diagnostic techniques has gradually increased the prevalence and diagnosis rate. In the past, when UTUC was diagnosed, more than 60% of the patients were diagnosed as locally advanced or metastatic cancer. However, since 2010, approximately 70% of the patients have been diagnosed as operable stage. Although radical nephroureterectomy is known as the basis of treatment for UTUC, overall survival is poor in patients with lymph node invasion. Especially, the finding that a localized UTUC is associated with a high risk of cancer metastasis in approximately 50% of patients suggests that these patients may not have sufficient treatment through surgery alone. The European Association of Urology and the National Comprehensive Cancer Network guideline 2017 suggested that postoperative adjuvant chemotherapy may be considered in patients with advanced UTUC beyond pT2. Also, recent meta-analyses have reported that cisplatin-based adjuvant chemotherapy can be expected to have a synergistic effect of overall survival and disease-free survival. However, many patients with UTUC undergo postoperative renal failure, which may result in failure to perform cisplatin-based adjuvant chemotherapy with adequate dose. For this reason, several researchers have suggested that it is beneficial to apply neoadjuvant chemotherapy when the preoperative renal function is maintained to a certain extent. But, neoadjuvant chemotherapy has not been used by many clinicians because of the lack of studies and the rarity of the disease. We are currently discussing the outcomes and prospects of perioperative chemotherapy.
Carcinoma, Transitional Cell ; Chemotherapy, Adjuvant ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prevalence ; Renal Insufficiency ; Urinary Tract ; Urology

OBJECTIVES: To compare the incidence of osteoporosis and the related factors among fracture sites in above 50 year-old patients with fractures caused by low-energy trauma. MATERIALS AND METHODS: Seven hundred and fourteen patients with fracture from low energy trauma were evaluated retrospectively. By the Dual-energy x-ray absorptionmetry, we measured bone mineral density (BMD) at lumbar spine and proximal femur, and compared the incidence of osteoporosis, age, sex, body mass index (BMI), previous fracture history, past osteoporosis medication history according to each fracture sites. RESULTS: BMD was decreased according to increasing age with statistical significance (P<0.001). Sex has no significant difference according to fracture site (P=0.141). Average age of patients with osteoporotic fracture was 73.8, 72.8, 66.3, 73.4, 78.3 years old according to fracture site as T-spine, L-spine, distal radius, proximal humerus and proximal femur, respectively. There was significant difference among groups (P<0.001). Average BMI related with osteoporotic fracture site was 22.9 kg/m2, 22.7 kg/m2, 23.4 kg/m2, 23.0 kg/m2, 21.7 kg/m2, respectively and it showed significant difference among groups (P<0.001). Average bone mass and T-score related with osteoporotic fracture site was 0.587 g/cm2 (-3.5), 0.614 g/cm2 (-3.1), 0.647 g/cm2 (-2.6), 0.597 g/cm2 (-3.1), 0.554 g/cm2 (-3.5), with significant difference among groups (P<0.001). Previous fracture history had no significant difference among groups (P=0.078). Previous osteoporosis medication history had significant difference among the groups (P<0.001). CONCLUSIONS: In low-energy traumatic fracture, age, BMI and previous osteoporosis medication history are significantly related factors with BMD and osteoporotic fracture. Early diagnosis of osteoporosis and osteoporotic medication use is effective for decrease incidence of low-energy osteoporotic fracture.
Body Mass Index ; Bone Density ; Early Diagnosis ; Femur ; Humans ; Humerus ; Incidence ; Middle Aged ; Osteoporosis ; Osteoporotic Fractures ; Radius ; Retrospective Studies ; Spine

In Korea, scrub typhus usually occurs in October and November. Hemophagocytic lymphohistiocytosis (HLH) is a distinct clinical entity characterized by a high fever, pancytopenia, hepatosplenomegaly, histiocyte proliferation, and hemophagocytosis. We encountered a summertime case of severe scrub typhus presenting as HLH. A 49-year-old female complained of abdominal pain and fever 3 days in duration. On hospital day 3 she was transferred to the intensive care unit because of clinical deterioration accompanied by severe sepsis. As an eschar was evident on the right shoulder, we commenced doxycycline. Her condition improved dramatically and she was discharged on day 14. Although the indirect immunofluorescence antibody test (IFA) for Orientia tsutsugamushi was negative on admission, a repeat IFA test was positive; the antibody titer was 1:5,120 on hospital day 10. Scrub typhus should be considered during differential diagnosis in a patient with severe sepsis in any season except the fall.
Abdominal Pain ; Diagnosis, Differential ; Doxycycline ; Female ; Fever ; Fluorescent Antibody Technique, Indirect ; Histiocytes ; Humans ; Intensive Care Units ; Korea ; Lymphohistiocytosis, Hemophagocytic* ; Middle Aged ; Orientia tsutsugamushi ; Pancytopenia ; Scrub Typhus* ; Seasons ; Sepsis ; Shoulder