No abstract available.
Phenylketonurias*

STATEMENT OF PROBLEM: It could be hypothesised that attachments, which provide more retention against vertical and horizontal dislodgement, will be associated with more favorable parameters of oral function. PURPOSE: This study was to provide data of initial retentive force and retention loss of different bar attachment systems recommended for use with maxillary implant overdentures. MATERIAL AND METHOD: 4 implants were placed in the anterior region of edentulous maxilla, five different systems of bar attachment were fabricated as follows: cantilevered Hader bar using clips (Type 1), Hader bar using clips without cantilever (Type 2), Hader bar using clip and ERA attachment orange male (Type 3), Hader bar using clip and ERA attachment white male (Type 4), and Bar using magnets (Type 5). Each samples were placed in the universal testing machine for determination of retentive forces(at initial and after every 200 cycles up to 1,000 cycles). Results and Conclusion 1. Attachment type 1 showed the biggest initial retentive force followed by type 3, type 2, type 4, and lastly type 5( p<0.001). 2. After 1,000 cycles of repeated removals of attachments, significant loss of retentive forces was taken place except for attachment type 5. 3. After 1,000 cycles of repeated removals, the loss of retentive force between type 1 and type 2, which used Hader bar and clip attachments, was greater in type 1 that had wider clip formation. And between type 3 and type 4, which used ERA attachments, the loss of retentive force was greater in type 4 that had white male attached (p<0.001). 4. After 1,000 cycles of repeated removals, attachment type 3 showed the biggest retentive force followed by type 2, type 4, type 1 and lastly type. 5. There was no significant difference between attachment type 3 and 4, and type 4 and 1(p<0.001).
Citrus sinensis ; Denture, Overlay* ; Humans ; Male ; Maxilla

Anesthesia, General ; Cephalometry ; Follow-Up Studies ; Head ; Humans ; Joint Diseases ; Joints ; Korea ; Mouth ; Open Bite ; Osteoarthritis ; Prostheses and Implants ; Temporomandibular Joint

BACKGROUND/AIMS: Spontaneous bacterial peritonitis (SBP) has been known to greatly influence the survival rate of patients with liver cirrhosis. However, the factors that affect the survival rate in patients with SBP need to be clarified. METHODS: This study enrolled 95 liver cirrhosis patients diagnosed with SBP. The laboratory findings of their serum and ascitic fluid were examined and the characteristics of the isolated microorganisms in their peritoneal fluid were analyzed. RESULTS: The proportion of patients with culture-positive SBP was 41.1%, and 47 microorganisms were isolated from the ascitic fluid. The proportions of cultured bacteria that were Gram negative and Gram positive were 57.4% and 40.4%, respectively. The proportions of Escherichia coli, Klebsiella species, and Streptococcus species were 25.5%, 19.1%, and 19.1%, respectively. Enterococcus species represented 12.8% of the microorganisms cultured. The overall survival rates at 6, 12, and 24 months were 44.5%, 37.4%, and 32.2%, respectively. There was no relationship between the bacterial factors and the survival rate in SBP. Multivariate analysis revealed that the presence of hepatocellular carcinoma (HCC; P=0.001), higher serum bilirubin levels (> or =3 mg/dL, P=0.002), a prolonged serum prothrombin time (i.e., international normalized ratio >2.3, P<0.001), renal dysfunction (creatinine >1.3 mg/dL, P<0.001), and lower glucose levels in the ascitic fluid (<50 mg/dL, P<0.001) were independent predictive factors of overall survival rate. CONCLUSIONS: HCC, higher serum bilirubin levels, a prolonged serum prothrombin time, renal dysfunction, and lower ascitic glucose levels are associated with higher mortality rates in cirrhotic patients with SBP.
Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Ascitic Fluid/metabolism/microbiology ; Bilirubin/blood ; Carcinoma, Hepatocellular/complications/diagnosis ; Creatinine/blood ; Female ; Glucose/analysis ; Gram-Negative Bacteria/isolation & purification ; Gram-Positive Bacteria/isolation & purification ; Humans ; Liver Cirrhosis/complications/*mortality ; Liver Neoplasms/complications/diagnosis ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Peritonitis/complications/*diagnosis/drug therapy ; Prognosis ; Prothrombin Time ; Survival Rate

The duodenum is the second most common site, after the colon, of diverticuli in the alimentary tract. Although most patients with duodenal diverticuli are asymptomatic, previous studies have demonstrated a possible association between duodenal diverticuli and choledocholithiasis and pancreatitis. In addition, duodenal diverticuli mimicking periampullary tumors and cystic neoplasms of the pancreas have been reported. We report a case of a duodenal diverticulum that mimicked a peripancreatic abscess. A 65-year-old woman was admitted for epigastric pain and vomiting. Abdominal CT confirmed the diagnosis of acute pancreatitis. Follow-up abdominal CT performed for a sustained fever revealed several newly developed peripancreatic abscesses. Most of the abscesses were drained percutaneously, but those around the uncinate process seldom respond to treatment. This patient was confirmed to have a duodenal diverticulum by endoscopy and duodenography. Duodenal diverticuli must be considered in a differential diagnosis of peripancreatic abscesses.
Abscess ; Choledocholithiasis ; Colon ; Diagnosis, Differential ; Diverticulum ; Duodenum ; Endoscopy ; Female ; Fever ; Follow-Up Studies ; Humans ; Pancreas ; Pancreatitis ; Vomiting

The preparation for video capsule endoscopy (VCE) of the bowel suggested by manufacturers of capsule endoscopy systems consists only of a clear liquid diet and an 8-hour fast. While there is evidence for a benefit from bowel preparation for VCE, so far there is no domestic consensus on the preparation regimen in Korea. Therefore, we performed this study to recommend guidelines for bowel preparation before VCE. The guidelines on VCE were developed by the Korean Gut Image Study Group, part of the Korean Society of Gastrointestinal Endoscopy. Four key questions were selected. According to our guidelines, bowel preparation with polyethylene glycol (PEG) solution enhances small bowel visualization quality (SBVQ) and diagnostic yield (DY), but it has no effect on cecal completion rate (CR). Bowel preparation with 2 L of PEG solution is similar to that with 4 L of PEG in terms of the SBVQ, DY, and CR of VCE. Bowel preparation with fasting or PEG solution combined with simethicone enhances the SBVQ, but it does not affect the CR of VCE. Bowel preparation with prokinetics does not enhance the SBVQ, DY, or CR of VCE.
Capsule Endoscopy ; Consensus ; Diet ; Endoscopy, Gastrointestinal ; Fasting ; Korea ; Polyethylene Glycols ; Simethicone

BACKGROUND/AIMS: The efforts to improve biliary plastic stents (PSs) for decreasing biofilm formation and overcome short patency time have been continued. The aim of this study is to evaluate the effect of advanced hydrophilic coating for patency and biodurability of PS. METHODS: Using an in vitro bile flow phantom model, we compared patency between prototype PS with hydrophilic coating (PS+HC) and prototype PS without hydrophilic coating (PS-HC). We performed an analysis of the degree of luminal narrowing by microscopic examination. Using an in vivo swine bile duct dilation model made by endoscopic papillary closure and stent insertion, we evaluated biodurability of hydrophilic coating. RESULTS: In the phantom model, PS+HC showed less biofilm formation and luminal narrowing than PS-HC at 8 weeks (p<0.05). A total of 31 stents were inserted into the dilated bile duct of seven swine models, and 24 stents were successfully retrieved 8 weeks later. There was no statistical difference of stent patency between the polyethylene PS+HC and the polyurethane PS+HC. The biodurability of hydrophilic coating was sustained up to 8 weeks, when assessing the coating layer by scanning electron microscopy examination. CONCLUSIONS: Advanced hydrophilic coating technology may extend the patency of PS compared to uncoated PS.
Animals* ; Bile Ducts* ; Bile* ; Biofilms ; In Vitro Techniques ; Microscopy, Electron, Scanning ; Phenobarbital ; Plastics* ; Polyethylene ; Polyurethanes ; Stents* ; Swine

We report an extremely rare case of metastatic common bile duct cancer from pulmonary adenocarcinoma presenting as obstructive jaundice. The patient was a 76-year-old male, who presented with generalized weakness and right upper quadrant pain. Plain chest X-ray noted multiple small nodules in both lung fields. Abdominal computed tomography scan showed a stricture of the mid common bile duct along with ductal wall enhancement. Endoscopic retrograde cholangiography revealed a concentric, abrupt narrowing of the mid-common bile duct suggestive of primary bile duct cancer. However, pathology comfirmed metastatic common bile duct cancer arising from pulmonary adenocarcinoma with immunohistochemical study with thyroid transcriptional factor-1 (TTF-1).
Adenocarcinoma/*diagnosis/pathology/radiography ; Aged ; Brain Neoplasms/radiography/secondary ; Bronchoscopy ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct Neoplasms/*diagnosis/secondary ; DNA-Binding Proteins/metabolism ; Humans ; Immunohistochemistry ; Jaundice, Obstructive/*etiology ; Lung Neoplasms/*diagnosis/pathology/radiography ; Male ; Positron-Emission Tomography ; Tomography, X-Ray Computed

BACKGROUND: Subarachnoid block is widely used for cesarean section due to the rapid induction, the complete analgesia, the low failure rate and the prevention of aspiration pneumonia. The addition of intrathecal opioids to local anesthetics seems to improve the quality of analgesia & prolong the duration of analgesia. Therefore we compared the effects of fentanyl 20 microg and sufentanil 2.5 microg, which were added to intrathecal hyperbaric bupivacaine. METHODS: Seventy two healthy term parturients were randomly divided into three groups: Group C (control), Group F (fentanyl 20 microg) and Group S (sufentanil 2.5 microg). In every group, 0.5% heavy bupivacaine was added according to the adjusted dose regimen by Harten et al. We observed the maximal level of the sensory block and motor block, the quality of intraoperative analgesia, the duration of effective analgesia and the side effects. RESULTS: There were significant differences between the control and the fentanyl 20 microg and sufentanil 2.5 microg groups for the degree of muscle relaxation, the quality of intraoperative analgesia, the maximal sedation level and the duration of effective analgesia. The frequencies of side effects such as nausea and pruritis in the opioid groups were higher than those in the control group. But there were no differences between fentanyl 20 microg and sufentanil 2.5 microg for the frequencies of nausea and pruritis. CONCLUSIONS: The addition of fentanyl 20 microg or sufentanil 2.5 microg for spinal anesthesia provides adequate intraoperative analgesia without significant adverse effects on the mother and neonate.
Analgesia ; Analgesics, Opioid ; Anesthesia, Spinal ; Anesthetics, Local ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Humans ; Infant, Newborn ; Mothers ; Muscle Relaxation ; Nausea ; Pneumonia, Aspiration ; Pregnancy ; Pruritus ; Sufentanil

BACKGROUND: Metformin is an effective oral antihyperglycaemic agent for type 2 diabetes mellitus, with a variety of metabolic effects. In addition to controlling blood glucose level, it has been appeared to decrease the long-period complications of diabetes, including macrovascular disease. Few reports have addressed the metabolite profiling of metformin. The study was to evaluate if targeted metabolic profiling approach is sensitive enough to predict the therapeutic effects of metformin after a single oral dose. METHODS: A randomized, open-label, single-dose study was conducted in twenty eight healthy Korean male volunteers. To determine the concentrations of endogenous metabolites in their pre-dose and post-dose plasma samples, blood samples were collected before and at 2 and 6 h after a single oral dose of 500 mg metformin. Both Modular P/Modular D analyzer and ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS)-based metabolic profiling was performed. RESULTS: We quantified pre-dose and post-dose creatinine, blood urea nitrogen (BUN), lactic acid, 7 amino acids (lysine, glutamic acid, alanine, valine, leucine, phenylalanine, tryptophan), and 5 lysophosphatidylcholines (14:0, 16:0, 17:0, 18:0, and 18:1) using autoanalyser and UPLC-MS/MS. The postdose levels of alanine, lactic acid, glutamic acid, lysine, valine, leucine, phenylalanine, tryptophan, and lysoPC (18:1) were slightly decreased with statistical significance, but there is no clinical significance. CONCLUSION: In order to explore the potential endogenous metabolites associated with the therapeutic effects of metformin, further study including non-targeted (global) metabolite profiling is needed.
Alanine ; Amino Acids ; Blood Glucose ; Blood Urea Nitrogen ; Chromatography, Liquid ; Creatinine ; Diabetes Mellitus, Type 2 ; Glutamic Acid ; Humans ; Lactic Acid ; Leucine ; Lysine ; Lysophosphatidylcholines ; Male ; Metformin ; Phenylalanine ; Plasma ; Tandem Mass Spectrometry ; Tryptophan ; Valine