Dental Implants have been proved to be successful prosthetic modality in edentulous patients for 10 years. However, there are few reports on the survival of implant according to location in molar regions. The purpose of this study was to evaluate the 4~5 years' cumulative survival rate and the cause of failure of dental implants in different locations for maxillary and mandibular molars. Among the implants placed in molar regions in Gwangju Mir Dental Hospital from Jan. 2001 to Jun. 2002, 473 implants from 166 patients(age range; 26~75) were followed and evaluated retrospectively for the causes of failure. We included 417 implants in 126 periodontally compromised patients, 56 implants in 40 periodontal healthy patients, and 205 maxillary and 268 mandibular molar implants. Implant survival rates by various subject factors, surgical factors, fixture factors, and prosthetic factors at each location were compared using Chi-square test and Kaplan-Meier cumulative survival analysis was done for follow-up(FU) periods. The overall failure rate at 5 years was 10.2%(subject level) and 5.5%(implant level). The overall survival rates of implants during the FU periods were 94.5% with 91.3% in maxillary first molar, 91.1% in maxillary second molar, 99.2% in mandibular first molar and 94.8% in mandibular second molar regions. The survival rates differed significantly between both jaws and among different implant locations(p<0.05), whereas the survival rates of functionally loaded implants were similar in different locations. The survival rates were not different according to gender, age, previous periodontal status, surgery stage, bone graft type, or the prosthetic type. The overall survival rate was low in dental implant of too wide diameter(> or =5.75 mm) and the survival rate was significantly lower for wider implant diameter(p<0.01) in mandibular second molar region. Among 5 surface types(acid etched, SLA, TPS, RBM, and HA), the survival rate of SLA type implant was the highest during the FU periods and the failure rates of HA type implants was significantly high following functional loading. Among 26 failed implants, 20 resulted in early failure of osseointegration or infection prior to functional loading, and 6 were removed because of progressive bone loss or implant fracture. In conclusion, implant survival rates were different in different locations on the posterior jaws, and the fixture diameter and surface type were the significant factor for implant survival in mandibular 2nd molar region. This observation suggests that implant treatment planning might require region-specific manner.
Dental Implants* ; Gwangju ; Humans ; Jaw ; Mandible ; Maxilla ; Molar* ; Osseointegration ; Retrospective Studies ; Survival Analysis* ; Survival Rate ; Transplants

Pulmonary thromboembolism is a leading cause of morbidity and mortality. Many patients dying of pulmonary thromboembolism have serious underlying illness such as cancer and congestive heart failure. Cancer patients are prone to both thrombotic and tumor embolism. In cancer patients, tumor pulmonary embolism and thrombotic pulmonary embolism can be associated with dyspnea, cor pulmonale and pulmonary hypertension. We presented a female patient of 63 year-old age of a hepatoma with inferior vena cava thrombosis. She had been transferred to the intensive care umt in state of refractory hypoxemia with 100% oxygen inhalation. Perfusion scan showed 60.71% defect in right lung and 39.28% defect in left lower lung field. Heparin infusion was done with the impression of pulmoary embolism without effect. Initial hemodynamic data with insertion of pulmonary ery catheter showed that cardiac index, 1.62 L/minute/M2, right atrial pressure, 28 mmHg, pulmonary capillary wedge pressure 14 mmHg. Cardiac index did not increase in spite of dobutamine and dopamine infusion. Right atrial pressure increased to 29 mmHg but pulmonary capillary wedge pressure was 11 mmHg with fluid administration. Echocardiogram revealed that mass, 7X8 cm of size, was in right heart in connection to inferior vena cava thrombus. Tumor embolism from hepatoma would be suspected in our patient, but we did not confirm that case with the biopsy or autopsy. Echocardiography with pulmoary artery catheter insertion would be helpful to diagnose the disease which was suspected of pulmonary embolism and tumor embolism in cancer patient.
Anoxia ; Arteries ; Atrial Pressure ; Autopsy ; Biopsy ; Carcinoma, Hepatocellular* ; Catheters ; Dobutamine ; Dopamine ; Dyspnea ; Echocardiography ; Embolism ; Female ; Heart Failure ; Heart* ; Hemodynamics ; Heparin ; Humans ; Hypertension, Pulmonary ; Inhalation ; Critical Care ; Lung ; Middle Aged ; Mortality ; Neoplastic Cells, Circulating* ; Oxygen ; Perfusion ; Pulmonary Embolism ; Pulmonary Heart Disease ; Pulmonary Wedge Pressure ; Thrombosis* ; Vena Cava, Inferior*

No abstract available.
Anesthesia, General* ; Humans ; Multiple System Atrophy*

No abstract available.
Anesthesia, General* ; Humans ; Multiple System Atrophy*

Background: Direct immunofluorescence (DIF) is a histochemical technique used to detect tissue-bound autoantibodies and diagnose various immune-mediated skin diseases. Objective: This study aimed to evaluate the sensitivity of DIF for each disorder, and the consistency between clinical, histopathological, and DIF results. Methods: A retrospective study was conducted in 194 patients who underwent skin biopsy and DIF testing at our hospital between January 2011 and December 2021. An antibody panel against immunoglobulin G (IgG), IgA, IgM, C3, C1q, and fibrinogen was used. The concordance rate and κ-coefficient between the clinical, histopathological, and DIF results were evaluated. Results: DIF was observed to be positive in 87 cases; 51 cases of immune-mediated bullous diseases, seven cases of connective tissue diseases (CTDs), 25 cases of vasculitis, and four cases of other diseases. The overall sensitivity of DIF for immune-mediated bullous diseases was 71.8%, which was higher than that of histopathology (64.8%). In CTDs and vasculitis, the overall sensitivities of DIF were 30.4% and 65.8%, respectively, which were lower than those of histopathology (73.9% and 84.2%, respectively). In addition, good concordance among the clinical, histological, and DIF results was observed. Conclusion DIF is a useful diagnostic method, especially for immune-mediated bullous diseases, lupus erythematosus, and Henoch-Schonlein purpura. However, in other CTDs and vasculitis cases, the sensitivity of DIF is relatively low. Therefore, the diagnostic value of DIF along with clinical and histopathological findings will be maximized only when the DIF test is performed for appropriate diseases.

PURPOSE: To evaluate the usefulness of CT and ERCP in the diagnosis of traumatic pancreatic injury, and the degree of such injury. MATERIALS AND METHODS: Using CT (n=30) and ERCP (n=8), we retrospectively analyzed 30 cases of surgically proven traumatic pancreatic injury. Both CT and surgical findings were evaluated according to intra-and extra- pancreatic change and assigned to one of five grades, according to their pattern. ERCP findings were categorized as normal mass effect, parenchymal staining, or extravasation of contrast material. In all 30 cases CT and ERCP findings were compared with surgical findings. RESULTS: Pancreatic enlargement was the most common finding of intrapancreatic change in 21(67%) cases (67%). In 20 of 30 cases, there was good correlation between the CT grade and surgical grading. Of the remaining ten cases, seven cases (23%) were underestimated and three(10%) were overestimated. CT grade III or IV suggest pancreatic duct injury ; in two of 13 cases with this grade, such injury was not seen on surgery, however. Of the eight cases in which ERCP was performed, two were normal, one showed mass effect, one showed parenchymal staining, and four, all of which showed pancreatic duct injury on surgery, showed extravasation of contrast material. Two of these four cases were CT grade II, but on surgery, proven duct injury was seen. CONCLUSION: In cases of pancreatic duct injury, ERCP is superior to CT; where such injury is suspected, it should therefore be used to determine whether or not the injury is in fact present.
Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Pancreatic Ducts ; Retrospective Studies

OBJECTIVES: This study aimed to examine current educational experiences, knowledge, intention to report, and requests for child abuse education in medical interns. METHODS: A descriptive cross-sectional study was conducted in 2006 and 2007. The study sample consisted of 193 medical interns who served their internships at the university hospital. They answered 11 self-administered questionnaires related to child abuse. RESULTS: Although respondents indicated a strong will to assist in eradicating abuse of children, about 90% had no educational experiences and knowledge of child abuse. Ignorance was a major factor for low reported cases of abused children. The preferred nominated reporting agency for child abuse was the National Child Protection Agency in 47.9% of female respondents, while 48.3% of males nominated Police Stations as their preferred option. In relation to sexual abuse, Police Stations were the preferred reporting agency by 49.2% of males and 37.0% of females. Medical school curricula were chosen by the majority of interns as the most appropriate stage where child abuse education should be introduced. CONCLUSION: This study found that medical graduates had limited experience and knowledge related to child abuse. The medical school curricula for child abuse needs to be further developed, implemented, and evaluated when appropriate.
Child ; Child Abuse ; Child Abuse, Sexual ; Cross-Sectional Studies ; Curriculum ; Surveys and Questionnaires ; Female ; Humans ; Intention ; Internship and Residency ; Male ; Police ; Schools, Medical ; Sex Offenses

Eosinophilic dermatosis of hematological malignancy (EDHM) is a rare condition associated with various hematologic malignancies, characterized by pruritic skin eruptions. We present a case of a 66-year-old woman with follicular lymphoma who developed urticarial and vesicular lesions indicative of EDHM following chemotherapy.The diagnosis was confirmed through histological analysis, revealing eosinophilic infiltration. Treatment included additional chemotherapy sessions and topical corticosteroids, resulting in complete resolution of skin lesions and lymphoma. EDHM requires careful differentiation based on clinical and histological findings. The pathogenesis remains unclear, but addressing underlying hematologic malignancies appears crucial in management. Early recognition of EDHM is essential for appropriate intervention due to its limited therapeutic options.

Polymyositis (PM) is a chronic inflammatory disease that predominantly affects muscles. Systemic organ involvement, including the respiratory and gastrointestinal tracts, is frequently observed in PM, but renal involvement is rare. Herein, we report the case of a 56-year-old woman presenting with weight gain, edema, and generalized myalgia. Laboratory tests revealed elevated creatinine kinase level, hypoalbuminemia, and proteinuria. Histopathological examination of muscle biopsy revealed inflammatory myositis, and a renal biopsy confirmed immunoglobulin A (IgA) nephropathy. Based on the clinico-pathological results, the patient was diagnosed with PM with IgA nephropathy. This is a report of a rare occurrence of IgA nephropathy in a patient with PM presenting with chronic glomerulonephritis.
Biopsy ; Creatinine ; Edema ; Female ; Gastrointestinal Tract ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Humans ; Hypoalbuminemia ; Immunoglobulin A* ; Immunoglobulins* ; Middle Aged ; Muscles ; Myalgia ; Myositis ; Phosphotransferases ; Polymyositis* ; Proteinuria ; Weight Gain

BACKGROUND/AIMS: Portal-vein thrombosis (PVT) develops in 10-25% of cirrhotic patients and may aggravate portal hypertension. There are few data regarding the effects of anticoagulation on nonmalignant PVT in liver cirrhosis. The aim of this study was to elucidate the safety, efficacy, and predictors of response to anticoagulation therapy in cirrhotic patients. METHODS: Patients with liver cirrhosis and nonmalignant PVT were identified by a hospital electronic medical record system (called BESTCARE). Patients with malignant PVT, Budd-Chiari syndrome, underlying primary hematologic disorders, or preexisting extrahepatic thrombosis were excluded from the analysis. Patients were divided into two groups (treatment and nontreatment), and propensity score matching analysis was performed to identify control patients. The sizes of the thrombus and spleen were evaluated using multidetector computed tomography. RESULTS: Twenty-eight patients were enrolled in this study between 2003 and 2014: 14 patients who received warfarin for nonmalignant PVT and 14 patients who received no anticoagulation. After 112 days of treatment, 11 patients exhibited significantly higher response rates (complete in 6 and partial in 5) compared to the control patients, with decreases in thrombus size of >30%. Compared to nonresponders, the 11 responders were older, and had a thinner spleen and fewer episodes of previous endoscopic variceal ligations, whereas pretreatment liver function and changes in prothrombin time after anticoagulation did not differ significantly between the two groups. Two patients died after warfarin therapy, but the causes of death were not related to anticoagulation. CONCLUSIONS: Warfarin can be safely administered to cirrhotic patients with nonmalignant PVT. The presence of preexisting portal hypertension is a predictor of nonresponse to anticoagulation.
Aged ; Anticoagulants/*therapeutic use ; Female ; Humans ; Liver Cirrhosis/complications/*diagnosis ; Male ; Middle Aged ; Portal Vein ; Propensity Score ; Severity of Illness Index ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*drug therapy/pathology ; Warfarin/therapeutic use