No abstract available.
Atrial Fibrillation* ; Mitral Valve Stenosis*

STATEMENT OF PROBLEM: Crestal bone loss, a common problem associated with dental implant, has been attributed to excessive bone stresses. Design of implant's transgingival (TG) part may affect the crestal bone stresses. PURPOSE: To investigate if concavely designed geometry at a dental implant's TG part reduces peri-implant bone stresses. MATERIAL AND METHODS: A total of five differently configured TG parts were compared. Base model was the ITI one piece implant (Straumann, Waldenburg, Switzerland) characterized by straight TG part. Other 4 experimental models, i.e. Model-1 to Model-4, were designed to have concave TG part. Finite element analyses were carried out using an axisymmetric assumption. A vertical load of 50 N or an oblique load of 50 N acting at 30degrees with the implant's long axis was applied. For a systematic stress comparison, a total of 19 reference points were defined on nodal points around the implant. The peak crestal bone stress acting at the intersection of implant and crestal bone was estimated using regression analysis from the stress results obtained at 5 reference points defined along the mid plane of the crestal bone. RESULTS: Base Model with straight configuration at the transgingival part created highest stresses on the crestal bone. Stress level was reduced when concavity was imposed. The greater the concavity and the closer the concavity to the crestal bone level, the less the crestal stresses. CONCLUSION: The transgingival part of dental implant affect the crestal bone stress. And that concavely designed one may be used to reduce bone stress.
Axis, Cervical Vertebra ; Dental Implants ; Finite Element Analysis ; Models, Theoretical

Carcinoembriogenic antigen (CEA) was widely used as a marker for staging and detection of recurrence and metastases, and evaluation of response of radical opertion or chemotherapy in colorectal cancer patients. METHODS: We examined 50 patients with sigmoid colon and rectal cancer patients who had a radical operation between 1994 May and 1995 April. We checked the level of CEA of peripheral blood preoperatively and postoperatively, and inferior mesenteric vein, bile of gall bladder and peritoneal fluid during surgery. We review clinical characters of the patients, and analyzed the importance of CEA level. RESULTS: The mean CEA levels of peripheral blood (postoperation), inferior mesenteric vein, bile, peritoneal fluid were 5.35+/-2.65, 13.23+/-2.13, 9.23+/-1.65, 7.42+/-2.34 ng/ml respectlively. The mean CEA level of inferior mesentiric vein (13.23+/-2.13 ng/ml) was significantly higher than that of preoperative peripheral blood (8.13+/-2.34 ng/ml) (p<0.05). Falling of postoperative peripheral blood CEA level was also significantly lower than that of preoperative level (p<0.05). CONCLUSIONS: Level of postoperative peripheral blood was related to recurrence rate and survival rate, but tumor size, tumor location, tumor differentiation, Dukes' stage were not related to the CEA level. Bile and peritoneal fluid CEA levels were related with the liver metastasis or local recurrence respectively. We suggest that CEA was useful indicator for evaluation, management, and prognosis of colorectal cancer not only preoperatively but also postoperatively.
Ascitic Fluid* ; Bile* ; Colon, Sigmoid* ; Colorectal Neoplasms ; Drug Therapy ; Humans ; Liver ; Mesenteric Veins* ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms* ; Recurrence ; Survival Rate ; Urinary Bladder ; Veins*

PURPOSE: Activity of enzymes involved in the metabolism of various carcinogenic xenobiotics is one of the most important host factor for cancer occurrence. N-acetyltransferase (NAT) and glutathione S-transferase(GST) are enzymes which reduce the toxicity of activated carcinogenic metabolites. Slow N-acetylation and lack of glutathione S-transferase mu(GSTM1) were reported as risk factors of bladder tumor. Since the cause of bladder cancer is not fully explained by single risk factor, many kinds of enzymes would be involved in the metabolism of carcinogens excreted in urine. This study was performed to investigate whether the polymorphisms of N-acetyltransferase type 2(NAT2) and GSTM1 are risk factors of bladder tumor and to evaluate the effects of their interaction on bladder tumor development. MATERIALS AND METHODS: 113 bladder tumor and 221 non-cancer patients, hospitalized in the Chungbuk National University Hospital, Samsung Medical Center, and Asan Medical Center from March to December 1996 participated in this case-control study. Questionnaire interview was done and the genotypes of NAT2 and GSTM1 were identified using PCR methods with DNA extracted from the venous blood. The effects of the polymorphism of NAT2 and GSTM1 and their interaction on bladder cancer were statistically tested after controlling the other risk factors. RESULTS: The frequencies of slow, intermediate, and rapid acetylators were 7.1%, 37.5%, and 55.4% for the cases, and 11.0%, 43.4%, and 45.7% for the controls, respectively. The risk of bladder tumor was not associated with the increase of NAT2 activity (chi2trend=3.16, p-value>0.05). GSTM1 was deleted in 69.6% of the cases and 55.9% of the controls (Chi2=5.86, p-value<0.05), and the odds ratio (95% CI) was 1.81 (1.12 - 2.93). Smoking history turned out to be insignificant as a risk factor of bladder tumor (OR=1.34, 95%CI: 0.78 - 2.31), and occupation could not be tested because of the extremely small number of occupational history related to the increase of bladder tumor. Medical history of tuberculosis and bronchial asthma were significant risk factors for bladder tumor, and their ORs (95% CI) were 3.61 (1.57-8.26) and 4.15 (1.61-10.75), respectively. In multiple logistic analysis controlling the effects of other risk factors, GSTM1 deletion (OR: 1.80, 95% CI: 1.07-3.05), and histories of tuberculosis (OR: 2.99, 95% CI: 1.22-7.32) and of bronchial asthma (OR: 3.38, 95% CI: 1.24-9.22) were the significant risk factors for bladder tumor, but slow acetylation was not. CONCLUSIONS: These results suggest that GSTM1 deletion may be a significant risk factor of bladder tumor. The medications for tuberculosis and bronchial asthma could possibly cause bladder tumor, or immune mechanism might be involved in the development of bladder tumor.
Acetylation ; Asthma ; Carcinogens ; Case-Control Studies ; Chungcheongbuk-do ; Chungcheongnam-do ; DNA ; Genotype ; Glutathione Transferase* ; Glutathione* ; Humans ; Metabolism ; Occupations ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Tuberculosis ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Xenobiotics

PURPOSE: Cancer development depends on activities of enzymes involved in metabolisms of various carcinogenic xenobiotics. N-acetyltransferase(NAT) and glutathione S-transferases(GST) are enzymes, reducing the toxicity of activated carcinogenic metabolites. Carcinogens of bladder cancer can not be fully explained by single risk factor and many kinds of enzymes would be involved in the metabolism of carcinogens excreted in urine. This study was performed to investigate whether the polymorphisms of NAT2, GSTM1, and GSTT1 were risk factors of bladder cancer and to evaluate the effects of their interaction on bladder cancer occurrence. MATERIALS AND METHODS: One hundred and thirteen bladder cancer and 221 non-cancer patients hospitalized in the Chungbuk National University Hospital participated in the present case-control study. Questionnaire interview was performed and the genotypes of NAT2, GSTM1 and GSTT1 were identified using PCR methods with DNA extracted from venous blood. Effects of the polymorphism of NAT2, GSTM1 and GSTT1 and their interaction on bladder cancer were statistically analyzed after controlling other risk factors. RESULTS: The frequencies of slow, intermediate, and rapid acetylators were 7.1%, 37.5%, and 55.4% for the cases, and 11.0%, 43.4%, and 45.7% for the controls, respectively. The risk of bladder cancer was not associated with the increase of NAT2 activity(x2trend=3.16, p>0.05). GSTM1 was deleted in 69.6% of the cases and 55.9% of the controls(x2=5.86, P<0.05), and the mean odds ratio(95% CI) was 1.81 (1.12 - 2.93). The GSTT1 deletion, the rate of which were 42.0% for the bladder cancer patients and 45.9% for the controls, showed the protective effect against bladder cancer, but was not statistically significant. Smoking history turned out to be insignificant as a risk factor of bladder cancer(OR=1.34, 95%CI: 0.78 - 2.31), and occupation was not analyzed due to the extremely small number of occupational history related to the increase of bladder cancer. Medical histories of tuberculosis and bronchial asthma were significant risk factors for bladder cancer, and their average ORs(95% CI) were 3.61(1.57-8.26) and 4.15(1.61-10.75), respectively. In multiple logistic analysis controlling the effects of other risk factors, GSTM1 deletion (OR: 1.80, 95% CI: 1.07-3.05), and histories of tuberculosis(OR: 2.99, 95% CI: 1.22-7.32) and of bronchial asthma(OR: 3.38, 95% CI: 1.24-9.22) were the significant risk factors for bladder cancer, but slow acetylation and GSTT1 deletion were not. CONCLUSIONS: These results suggest that GSTM1 deletion may be a significant risk factor of bladder cancer, and GSTT1 deletion may have the protective effect against bladder tumor development. Since tuberculosis and bronchial asthma, in the present study, appeared to be involved in the development of bladder tumor, possible associated relationships are under experimental investigation in every aspect.
Acetylation ; Asthma ; Carcinogens ; Case-Control Studies ; Chungcheongbuk-do ; DNA ; Genotype ; Glutathione ; Humans ; Metabolism* ; Occupations ; Polymerase Chain Reaction ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Tuberculosis ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Xenobiotics*

BACKGROUND AND AIMS: Long term results of an endoscopic sphincterotomy (EST) have still been poorly estimated. The aim of this study was to assess late complications of EST. METHODS: The rate of late complications were retrospectively evaluated in with 91 patients (mean age, 59.1 years; range, 28~86 years; M:F, 44:47), who underwent EST for choledocholithiasis. RESULTS: Forty six patients (50.5%) had their gallbladder in situ, and 45 patients (49.5%) underwent cholecystectomy. Early complications (<30 days) such as hemorrhage, pancreatitis, and perforation occurred in 7 patients (7.7%). During a mean period of 53.4 months (range, 24~134 months), 26 patients (28.0%) developed late complications, including a recurrence of CBD stones in 20 patients (22.0%) (8-gallbladder in situ, 12-cholecystectomized). An univariate analysis of risk factors for stone recurrence revealed dilated ducts, stone sizes, and stone numbers which were not related with stone recurrence. The history of choledocholithotomy with cholecystectomy was significantly related to stone recurrence. CONCLUSIONS: After EST for bile duct stones, late complications occurred in a significant proportion of patients and it was determined that a history of choledocholithotomy with cholecystectomy was significantly correlated with stone recurrence.
Bile Ducts ; Cholecystectomy ; Choledocholithiasis ; Gallbladder ; Hemorrhage ; Humans ; Pancreatitis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Sphincterotomy, Endoscopic

BACKGROUND: Assessment of left ventricular function with conventional 2-dimensional echocardiography (2D echo) remains largely qualitative and subjective because the manual tracing of endocardial borders is laborious and tedious. An automatic border detection (ABD) echo has been recently developed that permits real-time measurements of chamber areas and cardiac function. METHODS: To determine usefulness of ABD echo, left ventricular cross-sectional areas were automatically measured from the parasternal short-axis image in 25 cases including 9 cardiac patients, and compared with those by off-line analysis of the conventional 2D echo image. RESULTS: In on-line ABD analysis, short axis end-diastolic area averaged 13.1+/-2.2cm2, end-systolic area 5.3+/-1.3cm2 and fractional area change 59.4+/-9.0% and off-line manual analysis yielded corresponding values of 14.7+/-2.5cm2, 6.2+/-1.3cm2, and 57.1+/-7.1%. The end-diastolic and end-systolic areas by both methods were significantly different, respectively. Left ventricular end-diastolic and end-systolic area and fractional area change obtained from ABD echo correlated significantly with those of off-line measurements(r=0.897, p<0.001 ; r=0.505, p<0.01 ; r=0.427, p<0.05). CONCLUSION: Thus, these facts suggest that ABD echo is useful for on-line continuous measurement of chamber areas and cardiac function.
Axis, Cervical Vertebra ; Echocardiography* ; Humans ; Ventricular Function, Left

BACKGROUND: Acid-base imbalances are common in critically ill patients; however, the incidence of acid-base imbalances in the medical intensive care units has not been fully determined. In this study, we investigated the incidence and the type of acid-base imbalances in critically ill patients and we assessed which variables were associated with the patients' outcome. METHODS: One hundred eighty-seven patients (122 men, age: 61.2+/-12.8 years) were enrolled. All the patients were admitted to the medical intensive care unit between January 2005 and December 2005. All the data sets included simultaneous measurements of an arterial blood gas with base excess, the serum electrolytes, the anion gap and the APACHE II scores. RESULTS: The mortality rate was 56.7%. The incidence of acid-base imbalances was as follows: 25.1% were single disorders that existed with only a single primary acid-base imbalance, 48.7% were double disorders, 13.4% were triple disorders and 12.8% were normal (no disorders). The incidence of metabolic acidosis was 57.8% and the mortality rate was not different according to the type of acid-base imbalances. There were significant differences between the nonsurvivors and survivors according to the pH (7.34 vs. 7.41, respectively), HCO(-)3 (20.68 mmol/L vs. 25.90 mmol/L, respectively), ECF base excess (-5.19 vs. 1.19, respectively), the anion gap (18.57 mmol/L vs. 13.77 mmol/L, respectively), the corrected anion gap (23.63 mmol/L vs. 17.96 mmol/L, respectively), the serum albumin (2.37 g/dL vs. 2.74 g/dL, respectively), and the APACHE II scores (20.7 vs 17.2, respectively). However, on the Cox proportional hazard regression analysis, only the APAHCE II scores affected the patients' outcome. CONCLUSIONS: There were diverse acid-base imbalances in the critically ill patients and the incidence of metabolic acidosis was highest among the acid-base imbalances. The best predictor of the patients' outcome was the APACHE II scores.
Acid-Base Equilibrium ; Acid-Base Imbalance ; Acidosis ; APACHE ; Critical Illness* ; Dataset ; Electrolytes ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Intensive Care Units* ; Critical Care ; Male ; Mortality ; Serum Albumin ; Survivors

This study was performed to develop the basic technique for standardization that will be used in the medical environment. The following paper describes the design and implementation of a software framework that could be used to construct an HL7 message server. HL7 message server is combined with existing HIS and generates the corresponding HL7 messages automatically whenever the predefined events occur. We developed HL7 message server modules which can automatically link patient data to the appropriate message component in order to populate ADT and ORU messages. The key modules are UIT monitor, message generator and TCP/IP connection module. UIT is designed to integrate all data items needed to create a message in this HIS database table. The UIT monitor module checks regularly the occurrences of predefined events in HIS. The message generator module links the UIT data to the appropriate message generating functions to create a message. And the TCP/IP connection module works as a socket module for the stable network connection. The prototype of HL7 message server showed the performance of creating 100 messages in a second. This evaluation result confirmed that our HL7 message server presents a promising model for the incorporation of HL7 standard into existing Korean HIS.
Humans ; Information Dissemination*

The authors regret that there was an important error in the results in Table 1; the ATP7A mutations detected in Patients 2 and 14 were incorrectly noted.