Maintaining the blood supply of the interdental alveolar bone is crucial for preserving the interdental papilla. Rebuilding the interimplant papilla between adjacent implants is more difficult than rebuilding the interdental papilla between the natural tooth and implant. Therefore, preserving the interimplant tissue is necessary when adjacent implants are closely placed. In this case report, three effective methods for maintaining the surrounding tissue, namely strategic serial extraction, immediate implantation, and provisionalization of adjacent maxillary central incisors, were performed. The marginal gingiva and interimplant papilla were well maintained for 24 months.
Gingiva* ; Incisor ; Serial Extraction* ; Tooth

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

PURPOSE: We performed this study to evaluate the changes of total leukocytes and leukocyte types in CSF and peripheral blood (PB) in the early course of aseptic meningitis. METHODS: One hundred and eighty-nine children with aseptic meningitis, who were admitted to the Pediatric Department of Dong-A University Hospital during the period from June 1996 to October 1997 were included. Patients were divided into 4 groups by 12-hour intervals according to the time between the onset of illness and initial diagnostic lumbar puncture. We analyzed clinical pictures, total leukocytes and leukocyte types in CSF and peripheral blood (PB) in each group. RESULTS: 1) There was no significant difference in average total leukocyte counts in CSF between each group, and all groups were considered to be acute stage of illness. 2) The PMNL proportion of CSF leukocytes was 57.0+/-31.6% in group I, 44.1+/-32.3% in group II, 39.4+/-33.1% in group III and 26.9+/-27.9% in group IV. The PMNL percentage was significantly higher in group I than group III and IV and the proportion of patients with a predominance of PMNL was higher in group I than group III and IV (p<0.05) 3) The proportion of neutrophils in PB was highest in group I (76.5+/-15.7%) and significantly higher in group I and II than group III and IV (p<0.05). 4) Significant correlations were found between the proportion of PMNL in CSF and PB of patients (r=0.62, p<0.001) CONCLUSION: The change from a predominance of PMNL to a predominance of mononucler leukocytes was occurred 12-24 hours after onset, and there was a strong correlation between the proportion of neutrophils in CSF and PB.
Cerebrospinal Fluid* ; Child ; Humans ; Leukocyte Count ; Leukocytes* ; Meningitis, Aseptic* ; Neutrophils ; Spinal Puncture

A nineteen year-old boy with progressive enlargement of the joints and distal extremities, clubbing, coarse facial features and hyperhidrosis was investigated. In physical examination, thickening of the scalp with furrowing (cutis verticis gyrata) and greasy thickening of skin (pachyderma) was prominent. His endocrine profile was normal. Radiological studies demonstrated bilateral symmetrical periosteal new bone formation with acroosteolysis and incidental microadenoma of pituitay gland. After extensive investigation to exclude systemic and endocrine causes, the patient was diagnosed as pachydermoperiostosis (PDP). PDP is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified though few endocrine abnormalities were seen. To aware of these clinical phenotype would help to differentiate PDP from acromegaly.
Acro-Osteolysis ; Acromegaly ; Extremities ; Fingers ; Humans ; Hyperhidrosis ; Joints ; Male* ; Osteoarthropathy, Primary Hypertrophic* ; Osteogenesis ; Phenotype ; Physical Examination ; Scalp ; Skin ; Young Adult*

To analyze the improvement of shouder function after arthroscpic subacrominal decompression and open repair for complete rotator cuff tear, we performed a prospective study in 14 patients using self evaluation form from the American Shouder and Elbow Society(ASES). All patients were treated with arthrscopic biplanar subacromial decompression and open repair by use of bony trough and followed for more than 1 year from November 1994 to June 1996 in Dankook university hospital. All patients were assessed preoperatively and at final follow-up using the standardised method of research committee of American shoulder & elbow surgeons. Tears of the rotator cuff were divided into medium(8 shoulders), large(3 shoulders) and massive(3 shoulders). Most of the patients were heavy laborers. Average age was 56.2 years (51-73 years). There were 9 male and 5 female patients. The dominant arm was affected in 8 shoulders. Postoperative abduction brace was used in all cases and passive range of mortion exercise was started from postoperative third day. At average follow-up of 17 months, average pain scores decreased to 0.8+/-1.1 from 6.9+/-2.3. Scores of ASES evaluation form increased to 87.3+/-12.2 from 35.8+/-16.3(p<0.05). As to the range of mortion, only internal rotation improved from T12 to T8(p<0.05). Thirteen patients achieved excellent or good result. Twelve patients returned to initial occupations. Arthroscopy is helpful to define the tear size which may affect the surgical approach and open repair by use of bony trough and tunnel is useful to recovery of shoulder function.
Arm ; Arthroscopy ; Braces ; Decompression* ; Diagnostic Self Evaluation ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Occupations ; Prospective Studies ; Rotator Cuff* ; Shoulder

No abstract available.
Lymphangioma*

During the arthroscopic surgery of the shoulder, there was extravasation of fluid into the surrounding soft tissue due to the use of pressure pump irrigator. Clinically, the shoulder region became tense and intramuscular pressure of the deltoid could be elevated. To analyze the change of the intramuscular pressure of the deltoid and the efficiency of cryotherapy in the shoulder arthroscopy with pressure pump, we studied 35 consecutive patients who underwent various arthroscopic shoulder procedures at the Dankook University Hospital. We monitored intramuscular pressure using spinal needle connected to the patient monitoring system during arthroscopic procedures and postoperative period until return to preoperative pressure level. Twenty-seven patients were fitted with a cryotherapy. device in the operating room, and 8 were not according to the patient opinions. We evaluated the effect of cryotherapy with visual analog scales and amounts of analgisics for 3 days postoperatively. The results were followed; 1. Intraoperative highest intramuscular deltoid pressure was 293mmHg (average 169+/-68mmHg, 71293mmHg). 2. Immediate postoperative deltoid pressure was average 58.3+/-28.1mmHg (24-145mmHg). 3. Average time that the pressure had returned to the preoperative level was 114.3+/-38.6 minutes (p<0.05). There were no statistically significant between two groups, 113.9+/-41.1 min in the cryotherapy group and 115.7+/-32.6 min in the non-cryotherapy group. 4. Shoulder pain was less in the cryotherapy cases until second postoperative day. In conclusion, arthroscopic surgery of the shoulder can be performed with minimal complication in spite of high intramuscular deltoid pressure. More than 60 minutes may be needed for returning to normal intramuscular deltoid pressure. Cryotherapy is eftective in the pain relief but cannot minimize swelling postoperatively.
Arthroscopy* ; Cryotherapy* ; Humans ; Monitoring, Physiologic ; Needles ; Operating Rooms ; Postoperative Period ; Shoulder Pain ; Shoulder* ; Transcutaneous Electric Nerve Stimulation ; Visual Analog Scale

Bilateral diaphragmatic paralysis(BDP) is a rare disorder, which can be secondary to spinal cord injury, motor neuron disease, myopathy, noninfectious polyneuropathy, infection, iced saline cardioplegia performed during cardiac surgery, or idiopathic causes. there may be typical presentations such as dyspnea, paradoxical respiratory movement, and hypercapnic respiratory failure. It needs to exclude above secondary causes to consider idiopathic bilateral diaphragmatic paralysis. We report a 51-years-old man who presented with idiopathic bilateral diaphragmatic paralysis combined with acute pancreatitis. We couldnt, find out the association of these two clinical conditions. The patient was improved by mechanical ventilation.
Dyspnea ; Heart Arrest, Induced ; Humans ; Motor Neuron Disease ; Muscular Diseases ; Pancreatitis* ; Polyneuropathies ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Paralysis* ; Spinal Cord Injuries ; Thoracic Surgery

No abstract available.
Mosaicism* ; Trisomy*

A case of congenital rhabdomyoma of the heart in a 5-month-old Korean infant is described. The patient presented with a congenital supraventricular tachyarrhymia that was detected in utero by fetal sonography. The tumor was multiple, but no obvious association with tuberous sclerosis complex was demonstrated. Microscopic examination revealed classic "spider cells" with rich glycogen content. Ultrastructurally, the cells contained numerous leptofibrils, clumped Z band material, and desmosome-like cell junctions. The case is a second documented case of cardiac rhabdomyoma in this country, and its presentation as an etiological factor of supraventricular tachycardia is a very unusual manifestation.
Female ; Heart Neoplasms/complications/*congenital/ultrastructure ; Humans ; Infant ; Rhabdomyosarcoma/complications/*congenital/ultrastructure ; Tachycardia, Supraventricular/*congenital/etiology