PURPOSE: The aim of this study was to examine the correlation of the subjective and the objective evaluation of edentulous ridge bone quality, and to evaluate the change of the dental implant stability in each bone density group for early healing period after implant installation. METHODS:Sixty-seven implants(Osstem implant(R), Seoul, Korea) were included in this study. We evaluated the bone density by 2 methods. The one was the subjective method which was determined by practitioner's tactile sense, the other was the objective bone type was based on Hounsfield units. The implant stability in each bone type group was assessed by resonance frequency analyzer(Osstell mentor(R)). Data were analyzed for the change of the implant stability, and they were compared to verify the difference of groups at the time of installation, 2, 6, 10, 14 weeks postoperatively. Spearman's correlation was used to demonstrate the correlation between the subjective and the objective evaluation of the bone density, and analysis of variance(ANOVA) was used to analyze the differences of implant stability at each time point. RESULTS: There was no close relation between the subjective and the objective evaluation of the bone density(r=0.57). In the subjective groups, there was statistically significant difference between the type 1 and 3 at 10 weeks and between the type 2 and 3 at 14 weeks. In the objective groups, there was no statistically significant difference between the D 1, 2, 3, 4, and 5 group with regard to RFA from baseline to 14 weeks(p>0.1). CONCLUSIONS: The implant stability increased over time during the study, and it was improved with bone density proportionally after 2weeks postoperatively. It is recommended that the decision of bone density is base on Hounsfield unit for implant loading time.
Bone Density ; Dental Implants ; Osseointegration

Transesophageal echocardiography(TEE) is a new acoustic window to the cardiac structures and great vessels via retrocardiac esophagus. Because of the close relation between the esophagus and the heart, higher transducer frequencies can be applied, therefore leading to improved resolution and more accurate images than transthoracic echocardiography. We describe our experience with the first 353 awake patients. The procedure was well tolerated by the patients and associated with no major complications, within examination 10 to 20 minutes. Clinical diseases which appear to be suited for TEE includes 1) evaluation of native valve diseases, particulary mitral valve, pathologic valvular abnormalities and color Doppler regurgitant flows ; 2) assesment of prosthetic heart valves to better define malfunction and important pathologic associations ; 3) congenital heart disease, particularly atrial septal defect ; 4) endocarditis and detection of vegetations and complications ; 5) detection of thrombus and tumors, size, location, morphology, stalk ; and 6) aortic pathology including atherosclerosis, aneurysm and dissection. We conclude that transesophageal echocardiography is a new imaging technique that is rapidly evolving into a major tool for general cardiac imaging in a variety pathologic conditions and is a safe and useful tool in patients. Future advances in probe technology will continue to expand its applications.
Acoustics ; Aneurysm ; Atherosclerosis ; Echocardiography ; Echocardiography, Transesophageal* ; Endocarditis ; Equidae ; Esophagus ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Valves ; Humans ; Mitral Valve ; Pathology ; Thrombosis ; Transducers

No abstract available.

Phlegmonous gastritis is a rare disease of acute suppurative inflammation in the stomach wall. It is rapidly progressive and potentially fatal. Its mortality rate remains very high because the clinical diagnosis is often delayed. Many patients with phlegmonous gastritis undergo surgery. We present the case of 63-year-old woman with epigastric pain, fever, nausea and vomiting. The presumed diagnosis of acute phlegmonous gastritis was made by esophagogastroduodenoscopy, abdominal computed tomography, endoscopic ultrasonography and deep submucosal biopsy assisted with hook knife. Acinetobacter baumannii was cultured in the aspiration from the stomach. We treated the patient with antibiotics alone. Early recognition of phlegmonous gastritis by endoscopic biopsies and bacteriological study may improve the prognosis of these patient.
Acinetobacter baumannii ; Anti-Bacterial Agents ; Biopsy ; Biopsy, Needle ; Cellulitis ; Endoscopy, Digestive System ; Endosonography ; Female ; Fever ; Gastritis ; Humans ; Inflammation ; Middle Aged ; Nausea ; Prognosis ; Rare Diseases ; Stomach ; Vomiting

OBJECTIVE: The aim of the present study was to analyze the relation between p53 mutation and cervical adenocarcinoma without HPV infection. METHODS: From 1998 to 2002, 54 patients were diagnosed with cervical adenocarcinoma and underwent radical hysterectomy at Seoul National University Hospital. Of them, 50 patients were available for review of medical records and histologic examination. Using ABC method, we performed immunohistochemical staining. If there is 10% or more of staining positive, it was read positive. And we used HPVDNAChip for detection of HPV. RESULTS: Of the 50 patients, 45 (90.0%) patients were positive for high risk HPV and 4 patients (8.0%) were p53 positive. In the patients with negative for p53, there were significantly more patient with HPV positive (p=0.04). Advanced stage of cervical adenocarcinoma was related to high rate of positivity of p53, but it was not statistically significant. CONCLUSION: In patients who diagnosed cervical adenocarcinoma without HPV infection, there were over expression of p53. This suggests that abnormality of p53 may be related to pathogenisis of cervical adenocarcinoma without HPV infection.
Adenocarcinoma* ; Cervix Uteri* ; Female ; Humans* ; Hysterectomy ; Medical Records ; Papillomavirus Infections* ; Seoul

A hemangioma is a common soft tissue tumor, usually affecting the cutaneous regions of the head and neck in infancy and childhood. A hemangioma in the gastrointestinal tract is rare occurrence which is usually found in the submucosa of the small and large intestine, but rarely in the stomach. Infrequently, multiple cavernous hemangiomas have been reported on skin and in the intestines. A 23-year-old man was admitted with hematemesis. An upper endoscopy revealed a purple colored sessile lesion at the posterior wall side of the fundus which had surface erosion and erythema. This lesion was easy to bleed when the patient retched. Another sessile lesion was detected at the greater curvature side of the upper body. The patient had two intradermal soft masses at the back and left forearm. An X-ray revealed a phebolith that suggested a cavernous hemangioma. An abdomen CT and angiography revealed that these lesions were highly suggestive of hemangioma. Gastric wedge resection was performed and the histological diagnosis was gastric cavernous hemangiomas.
Abdomen ; Angiography ; Diagnosis ; Endoscopy ; Erythema ; Forearm ; Gastrointestinal Tract ; Head ; Hemangioma ; Hemangioma, Cavernous* ; Hematemesis ; Humans ; Intestine, Large ; Intestines ; Neck ; Skin ; Stomach ; Young Adult

PURPOSE: Cervical neoplasias are known to be preventable. But the outcome of our efforts for early detection in Korea is disappointing. This study was undertaken to determine the level of screening participation in Korean women with cervical cancer and how the early detection of cervical cancer might be improved. MATERIALS AND METHODS: Two hundred and forty-nine women with cervical cancer diag- nosed and treated at Seoul National University Hospital from September 1996 to February 1998 were subjected to this study. Self-reported cervical cancer screening histories, med- ical records obtainable were reviewed and analysed. RESULTS: One hundred forty-seven women (147/249; 59.0%) hadn't got through the screen- ing at proper intervals. Ninety-nine women (39.9%) had never been screened and remain- ing 48 (19.3%) hadn't had their last Pap test 3 years before their diagnosis of nvasive cancer. Of the 150 women (60.1%) who had ever had a Pap test, only 47 (18.9%) had had annual Pap test during recent 5 years and 55 (22.1%) had had routine Pap test with interval between 1-3 years. Among 102 women who had at least one Pap test during recent 3 year, 73 (71.6%) had had a normal Pap report within three years of diagnosis, including 36 (35.3%) whose last normal Pap report was within a year of diagnosis. This results suggest the possibilities of smear-taking and/or reading errors. Women who had had routine Pap with interval less than 3 years had significantfy less chance of advanced tumor (FIGO stage Ib < ) than unscreened population. There was a statistically significant trend for the more younger and educated groups to be participated at the screening program with more shortened interval. All the other factors had failed to show significant correlation with adequacy or regularity of screening interval. CONCLUSIONS: Despite widespread chance of opportunistic cervical cancer screening, non-participants form the main reason for the failure of cervical cancer screening in Korea. So, far much efforts should be aimed at participating more women in cervical cytologic screening program, especially in the old-aged and less-educated groups.
Diagnosis ; Female ; Humans ; Korea ; Mass Screening* ; Nose ; Seoul ; Uterine Cervical Neoplasms*

Osteogenesis Imperfecta (OI) is a relatively rare hereditary disease, which is characterized by multiple bone fractures and spine scoliosis, due to the fragility of bone, and is often associated with blue sclerae, deafness and dentinogenesis imperfecta. Four types of OI can be distinguished, according to the clinical findings. Although mutations affecting type I collagen are responsible for the disease in most patients, the mechanism by which the genetic defects cause abnormal bone development remains to be fully understood. Here, the clinical characteristics of 10 OI patient cases are reported, with a review of the literature. All the cases, including 4 type I, 4 type III and 2 type IV, inherited OI as an autosomal dominant trait. All the subjects had multiple old fractures and decreased bone densities. In this study, the biochemical marker of bone formation, serum alkaline phosphatase, was found to be increased only in the pediatric OI patients, while the biochemical marker of bone resorption, urinary deoxypyridinoline, was increased in all cases. The mobility score was found to correlate with the severity of the type on diagnosis.
Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Development ; Bone Resorption ; Collagen Type I ; Deafness ; Dentinogenesis Imperfecta ; Diagnosis ; Fractures, Bone ; Genetic Diseases, Inborn ; Humans ; Osteogenesis Imperfecta* ; Osteogenesis* ; Sclera ; Scoliosis ; Spine

Objective: Emergency medicine residents are expected to exhibit a poor health status due to excessive working hours and high stress. Because much of patient care depends on them, their health conditions will have a significant impact on patient outcomes. Our study was designed to analyze the health status of emergency medicine residents and the affecting factors using the 2019 Korean Emergency Medicine Residents Survey (KEMRS) results. Methods: The study evaluated the self-rated health-defined percentage of responders who thought they were in good health. Based on this response, the influencing factors were categorized statistically. These factors included personal characteristics, lifestyle (drinking, smoking, eating, sleeping, and exercise), and emotional stress. Results: Of a total of 384 respondents, 176 (46%) thought they were in good health. Participants who perceived themselves to be unhealthy included residents who were married, female, and those in the 3rd grade. Drinking and smoking were not perceived to affect health status, but regular exercise and proper eating patterns were seen to be positive influencing factors. Daytime sleepiness, depressive moods, and personal well-being were correlated with health status. Conclusion While personal characteristics and emotional problems cannot be changed easily, lifestyle changes can be made for better health. The health conditions of emergency residents have not been considered a matter of importance thus far. To overcome their health problems, responsible improvements in schedules and a program of long-term follow-ups need to be implemented, followed by training programs.

PURPOSE: This study aims to investigate the trend in medical travel by non-Seoul residents to Seoul for treatment of prostate cancer and also to investigate the possible factors affecting the trend. MATERIALS AND METHODS: This study represents a retrospective cohort study using data from theKoreanNationalHealth Insurance System from 2002 to 2015. Annual trends were produced for proportions of patients who traveled according to the age group, economic status and types of treatment. Multiple logistic analysiswas used to determine factors affecting surgeries at medical facilities in Seoul among the non-Seoul residents. RESULTS: A total of 68,543 patients were defined as newly diagnosed prostate cancer cohorts from 2005 to 2014. The proportion of patients who traveled to Seoul for treatment, estimated from cases with prostate cancer-related claims, decreased slightly over 9 years (28.0 at 2005 and 27.0 at 2014, p=0.02). The average proportion of medical travelers seeking radical prostatectomy increased slightly but the increase was not statistically significant (43.1 at 2005 and 45.4 at 2014, p=0.26). Income level and performance ofrobot-assisted radical prostatectomy were significant positive factors for medical travel to medical facilities in Seoul. Combined comorbidity diseases and year undergoing surgery were significant negative factors for medical travel to medical facilities in Seoul. CONCLUSION: The general trend of patients travelling from outside Seoul for prostate cancer treatment decreased from 2005 to 2014. However, a large proportion of traveling remained irrespective of direct distance from Seoul.
Cohort Studies ; Comorbidity ; Geography ; Health Services Accessibility ; Humans ; Insurance ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Retrospective Studies ; Seoul*