BACKGROUND: To prevent the platelet refractoriness, repeated plateletpheresis is often required in HLA matched single-donors. Korean Transfusion Standard permits the repeated plateletpheresis of a single donor at 72-hour intervals. To evaluate this standard, hematological responses of donors were assessed after plateletpheresis by Haemonetics V50 (Haemonetics Co., USA). METHODS: The pre- and post-donated hematological indices of 22 healthy donors(17 males and 5 females) were evaluated. Single donated donors were 12 males and 4 females. Multiple donated donors were 5 males and one female. Post-donated platelet counts were measured immediately, 6 hours, 12 hours, 1 day, 3 days, 5 days, 7 days and 9 days after plateletpheresis. Platelet aggregation test, serum protein, PT, and aPTT were also examined before and after platelet collection. RESULTS: Only 9 (56.2%) of 16 single-donated donors and 4 (66.7%) of 6 multiple donated donors showed normal restoration up to 97% of platelet counts of pre-donation levels at the day 3. In 9 (75%) of 12 single donated males restoration of platelet count was observed within 3 days, but 3 (75%) of 4 single donated females showed restoration of platelet count within 5 days. Changes of other indices were not significantly different between the pre- and post-donations of platelet. CONCLUSIONS: Although no clinical complication was noted after plateletpheresis, these data suggested that Korean Transfusion Standard on plateletpheresis should be reconsidered.
Blood Platelets ; Female ; Humans ; Male ; Platelet Aggregation ; Platelet Count ; Plateletpheresis* ; Tissue Donors*

The provision of adequate soft tissue cover for a complex hand and forearm wound-dirty, infected and exposed bone can be a challenging problem. Conventionally, a distant flap or free flap have been used, but these have been associated with several problems such as joint stiffness, risk of microsurgical procedures, negligible donor site morbidity, prolonged operation time and economic restriction. As well, fasciocutaneous flap has been the limitation of infection control. In these situations, the ipsilateral muscle flap provides the ideal cover with its rich blood supply and single operative field. Previously described by Lendrum(1980), by Lae et al.(1981), and later by McGeorge(1991), the brachioradilis muscle is the most superficial muscle on the radial side of the forearm. Its flap is based on the radial artery and venae comitantes. From August 1996 to October 1997, we performed branchioradialis muscle flap in seven patients. Despite the sacrifice of the major hand artery, brachioradialis muscle flap has many advantages including the reliability of flap survival, easy dissection, early mobilization and absence of functional and aesthetic problems at the donor site. It is a relatively simple and rapid method for resurfacing soft tissue defect in the hand and forearm. We obtained satisfactory and reliable results.
Arteries ; Early Ambulation ; Forearm* ; Free Tissue Flaps ; Hand* ; Humans ; Infection Control ; Joints ; Radial Artery ; Tissue Donors

No abstract available.
Drainage* ; Prognosis*

BACKGROUND: Many studies in severe acute pancreatitis have demonstrated an increase in intestinal permeability, but not in mild acute pancreatitis. The current methods to measure intestinal permeability need much time and also laborious work. Therefore, we investigate the changes of intestinal permeability in patients with mild acute pancreatis and clinical predictive factor for the intestinal permeability in patients with acute pancreatitis. METHODS: The intestinal permeability were measured in 14 normal heathy controls, 41 patients with mild acute pancreatitis (alcoholic 14, biliary 12, idiopathic 15) by measuring 24 hour urine excretion of 51Cr-EDTA (51Cr-ethylenediaminetetraacetic acid) for evaluation of the gut barrier dysfunction. We compared the intestinal permeability with clinical characteristics of patients. RESULTS: The intestinal permeability was significantly increased in patients with mild acute pancreatitis (6.01+/-4.11%, p<0.001) versus control subjects (1.86+/-0.52%). There was no significant difference in the intestinal permeability among the patients with alcoholic, biliary and idiopathic pancreatitis. The correlation was not found between intestinal permeability and clinical characteristics in patients with mild acute pancreatitis. CONCLUSIONS: The intestinal permeability is increased in patients with mild acute pancreatitis regardless of etiology of pancreatitis. The predictive factor for gut barrier dysfunction is not detected in patients with mild acute pancreatitis.
Alcoholics ; Humans ; Pancreatitis* ; Permeability*

PURPOSE: A prospective study was performed to compare the efficacy and safety of intravesical mitomycin C (MMC) instillation for the prophylaxis of bladder cancer at different concentrations (30 mg or 40 mg). MATERIALS AND METHODS: Ninety-seven patients that received complete transurethral resection for superficial bladder cancer were divided into two-randomized groups. One group (n=53) received 30 mg and the other group (n=44) received 40 mg dose of MMC weekly for 8 weeks, which was followed monthly for 10 months as maintenance therapy. The recurrence rates and side effects in both groups were recorded. The mean follow-up period was 32.4 months in the 30 mg group, and 32.0 months in the 40 mg group. RESULTS: The overall one and two year recurrence rates were 19% and 24% in the 30 mg group, and 12% and 22% in the 40 mg group, which was not significantly different (p>0.05). Most of the side effects were mild and transient. Moreover, the rates of the individual side effects were not statistically different in the two groups. CONCLUSION: Our comparison of 30 mg and 40 mg intravesical MMC instillation showed no difference in either response or side effects. Thus, we tentatively conclude that we can use 30 mg instead of 40 mg as an intravesical MMC instillation dose.
Administration, Intravesical* ; Follow-Up Studies ; Humans ; Mitomycin* ; Prospective Studies* ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Purpose: Pathologic T3b (pT3b) prostate cancer, characterized by seminal vesicle invasion (SVI), exhibits variable oncological outcomes post–radical prostatectomy (RP). Identifying prognostic factors is crucial for patient-specific management. This study investigates the impact of bilateral SVI on prognosis in pT3b prostate cancer. Materials and Methods: We evaluated the medical records of a multi-institutional cohort of men who underwent RP for prostate cancer with SVI between 2000 and 2012. Univariate and multivariable analyses were performed using Kaplan-Meier analysis and covariate-adjusted Cox proportional hazard regression for biochemical recurrence (BCR), clinical progression (CP), and cancer-specific survival (CSS). Results: Among 770 men who underwent RP without neo-adjuvant treatment, median follow-up was 85.7 months. Patients with bilateral SVI had higher preoperative prostate-specific antigen levels and clinical T category (all p < 0.001). Extracapsular extension, tumor volume, lymph node metastasis (p < 0.001), pathologic Gleason grade group (p < 0.001), and resection margin positivity (p < 0.001) were also higher in patients with bilateral SVI. The 5-, 10-, and 15-year BCR-free survival rates were 23.9%, 11.7%, and 8.5%; CP-free survival rates were 82.8%, 62.5%, and 33.4%; and CSS rates were 96.4%, 88.1%, and 69.5%, respectively. The bilateral SVI group demonstrated significantly lower BCR-free survival rates, CP-free survival rates, and CSS rates (all p < 0.001). Bilateral SVI was independently associated with BCR (hazard ratio, 1.197; 95% confidence interval, p=0.049), CP (p=0.022), and CSS (p=0.038) in covariate-adjusted Cox regression. Conclusion Bilateral SVI is a robust, independent prognostic factor for poor oncological outcomes in pT3b prostate cancer.

STUDY DESIGN: A prospective radiological assessment was performed using computerized tomography measurements. OBJECTIVES: The aim of this study was to assess the changes in the dimensions of the neural foramen after anterior interbody fusion with posterior fixation in spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Anterior lumbar interbody fusion distracts the height and width of the neural foramen. MATERIALS AND METHODS: Anterior interboody fusion with posterior fixation was performed in twenty-five patients. The sagittal parameters were the height and area of the neural foramen. The fused lumbar segments was imaged in the direct sagittal projections in a CT (SOMATOM Senstaion; SIMENS, Germany) and 1-mm slice thickness before surgery and after solid fusion. Computer digitation was used for the measurements independently by three different observers. Statistical analysis was performed using a Wilcoxon signed test and a paired T-test to determine the correlation between the measurements, and Pearson correlation to determine the level of interobserver and intraobserver agreement. RESULTS: After anterior interbody fusion and posterior fixation, the height and the area of the neural foramen had increased significantly by 15.5+/-14.0%(p.0.001) and 23.2+/-17.7%(p.0.001). There was a significant confidence in interobserver (0.9466~0.9996) and intraobserver(0.8896~0.9991) agreement. CONCLUSIONS: Anterior interbody fusion significantly increased the changes in the dimensions of the neural foramen. Anterior distraction and decompression with anterior interbody fusion increased the area of the neural foramen This study shows that anterior interbody fusion can be used to decompress the neural foramen in the spondylolisthesis.
Decompression ; Humans ; Prospective Studies ; Spondylolisthesis*

STATEMENT OF PROBLEM: Pier abutments act as a Class I fulcrum lever system when the teeth are incorporated in a fixed partial denture with rigid connectors. Therefore non-rigid connector incorporated into the fixed partial denture might reduce the stresses created by the leverage. PURPOSE: The purpose of this study was to evaluate, by means of finite element method, the effects of non-rigid connectors and supporting alveolar bone level on stress distribution for fixed partial dentures with pier abutments. MATERIAL AND METHODS: A 2-dimensional finite element model simulating a 5-unit metal ceramic fixed partial denture with a pier abutment with rigid or non-rigid designs, the connector was located at the distal region of the second premolar, was developed. In the model, the lower canine, second premolar, and second molar served as abutments. Four types of alveolar bone condition were employed. One was normal bone condition and others were supporting bone reduced 20% height at one abutment. Two different loading conditions, each 150 N on 1st premolar and 1st molar and 300N on 1st molar, were used. RESULTS: Two types of FPD were displaced apically. The amount of displacement decreased in an almost linear slope away from the loaded point. Non-rigid design tended to cause the higher stresses in supporting bone of premolar and molar abutments and the lower stresses in that of canine than rigid design. Alveolar bone loss increased the stresses in supporting bone of corresponding abutment. CONCLUSION: Careful evaluation of the retentive capacity of retainers and the periodontal condition of abutments may be required for the prosthetic design of fixed partial denture with a pier abutment.
Alveolar Bone Loss ; Bicuspid ; Ceramics ; Denture, Partial, Fixed ; Displacement (Psychology) ; Molar ; Tooth

STATEMENT OF PROBLEM: Delamination of veneering porcelain from underlying ceramic substructures has been reported for zirconia-ceramic restorations. Colored zirconia cores for esthetics have been reported that their bond strength with veneered porcelain is weaker compared to white zirconia cores. PURPOSE: This study aimed to investigate the shear bond strength by manufacturing the veneering porcelain on the colored zirconia core, using the layering technique and heat-pressing technique, and to evaluate the clinical stability by comparing the result of this with that of conventional metal ceramic system. MATERIAL AND METHODS: A Metal ceramic (MC) system was tested as a control group. The tested systems were Katana zirconia with CZR (ZB) and Katana Zirconia with NobelRondo Press (ZP). Thirty specimens, 10 for each system and control, were fabricated. Specimen disks, 3 mm high and 12 mm diameter, were fabricated with the lost-wax technique (MC) and the CAD-CAM (ZB and ZP). MC and ZB specimens were prepared using opaque and dentin veneering ceramics, veneered, 3 mm high and 2.8 mm in diameter, over the cores. ZP specimens were prepared using heat pressing ingots, 3 mm high and 2.8mm in diameter. The shear bond strength test was performed in a Shear bond test machine. Load was applied at a cross-head speed of 0.50 mm/min until failure. Mean shear bond strengths (MPa) were analyzed with the One-way ANOVA. After the shear bond test, fracture surfaces were examined by SEM. RESULTS: The mean shear bond strengths (SD) in MPa were MC control 29.14 (2.26); ZB 29.48 (2.30); and ZP 29.51 (2.32). The shear bond strengths of the tested systems were not significantly different (P > .05). All groups presented cohesive and adhesive failures, and showed predominance of cohesive failures in ceramic veneers. CONCLUSION: 1. The shear bond strengths of the tested groups were not significantly different from the control group (P > .05). 2. There was no significant different between the layering technique and the heat pressing technique in the veneering methods on the colored zirconia core. 3. All groups presented cohesive and adhesive failures, and showed predominance of cohesive failures in ceramic veneers.
Adhesives ; Ceramics ; Computer-Aided Design ; Dental Porcelain ; Dentin ; Esthetics ; Hot Temperature ; Humans ; Zirconium

Defects resulting from Mohs micrographic surgery may immediately be reconstructed with primary repair, flaps or grafts, or the wound may be allowed to heal by secondary intention. We experienced 3 cases of secondary intention healing using occlusive dressing and purse-string suture, and wounds were healed with excellent cosmetic and functional results. Therefore, we conclude that secondary intention healing of forehead and temple wounds is a safe and effective method of wound management after Mohs micrographic surgery.
Forehead* ; Intention* ; Mohs Surgery ; Occlusive Dressings ; Sutures ; Transplants ; Wounds and Injuries