PURPOSE: Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the long-term outcome of this grafted gingiva. METHODS: A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap. RESULTS: At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue. CONCLUSIONS: Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.
Dental Implants ; Follow-Up Studies ; Gingiva ; Humans ; Oral Hygiene ; Palate ; Transplants*

PURPOSE: This study was performed to assess the clinical and epidemiological changes after the introduction of the rotavirus vaccine in Korea, as well as to determine the efficacy of the rotavirus vaccine among hospitalized rotaviral gastroenteritis patients over the past two years. METHODS: We analyzed yearly and seasonal patterns of 1,165 inpatients who were hospitalized for rotaviral gastroenteritis under the age of 5 years between 2006 and 2013. We also conducted a survey among 460 gastroenteritis patients who were hospitalized between 2012 and 2013 regarding the rotavirus vaccination and the symptoms of gastroenteritis. Among those individuals surveyed, clinical indices were analyzed for 124 patients who were tested positive for the rotavirus antigen. RESULTS: The incidence of Rotaviral gastroenteritis have decreased significantly by year 2010. After the introduction and widespread dissemination of the rotavirus vaccine, the onset of the disease and the seasonal peak have been delayed. Overall, the vaccinated group showed a lower rate of positivity than the unvaccinated group. Among the hospitalized rotaviral gastroenteritis patients, the vaccinated group had a shorter hospitalization period, less severe clinical symptoms of gastroenteritis, and better laboratory test results. CONCLUSIONS: After introduction of the rotavirus vaccine in Korea, there were two main trends observed: 1) the overall level of disease incidence was reduced; 2) the severity of rotaviral gastroenteritis cases also decreased. Based on this data, more children should receive vaccination in order to prevent the rotavirus infection and decrease the severity of rotaviral gastroenteritis.
Child ; Epidemiologic Studies* ; Epidemiology ; Gastroenteritis* ; Hospitalization ; Humans ; Incidence ; Inpatients ; Korea ; Rotavirus Infections ; Rotavirus* ; Seasons ; Vaccination

No abstract available.
Esophageal Neoplasms ; Muscular Diseases

PURPOSE: To assess and compare the clinical outcomes of primary trabeculectomy with mitomycin C and Ahmed valve implantation for secondary open-angle glaucoma following uveitis. METHODS: This study was conducted retrospectively on 30 eyes of 25 patients with open-angle glaucoma secondary to uveitis that had undergone trabeculectomy with mitomycin C and 33 eyes of 24 patients that had undergone Ahmed valve implantation. The clinical outcome indicators used in this study were intraocular pressure (IOP), number of anti-glaucoma agents, surgical success rate and occurrence of complications. RESULTS: Mean IOP and surgical success rate in patients who had undergone trabeculectomy with mitomycin C after a 12 month postoperative period were 14.0+/-8.2 mmHg and 76.7%, respectively, while those of patients with Ahmed valve implantation were 13.2+/-7.7 mmHg and 81.8%. The data did not show clinical significance. There was greater risk of surgical failure in patients at a younger age and/or with diabetes mellitus in cases of having gone through trabeculectomy with mitomycin C. CONCLUSIONS: Both trabeculectomy with mitomycon C and Ahmed valve implantation can be considered as primary surgical treatments for patients with open-angle glaucoma secondary to uveitis. However, trabeculectomy with mitomycin C should only be applied to a limited extent in patients that are young and/or have diabetes mellitus.
Diabetes Mellitus ; Eye ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Mitomycin ; Postoperative Period ; Retrospective Studies ; Trabeculectomy ; Uveitis

OBJECTIVE: To evaluate the effects of shoe lift to the unaffected limb on hemiplegic gait after stroke. METHOD: Three dimensional gait analysis was performed in 20 chronic hemiplegic patients with shoe lifts (5, 10, 15 mm) to the unaffected limb. The order of experimental series was randomized among subjects. Temporal gait parameters were measured and compared according to the height of shoe lifts in the affected and unaffected limbs. RESULTS: The stride time of both limbs and step time of the affected limb were decreased, and stride length of both limbs and step length of unaffected limb were increased after shoe lift apply (p<0.05). Thus walking velocity and cadence were increased. In gait cycle, there was decreased double limb support phase of affected limb (p<0.05). These improvement of gait patterns of hemiplegics was maximum after shoe lift of 10 mm height. CONCLUSION: Weight bearing with shoe lift may contribute to improved postural control and gait performance in hemiplegics. Furthermore, the study about long-term effects of shoe lifts to the unaffected limb may be necessary.
Extremities* ; Gait Disorders, Neurologic ; Gait* ; Humans ; Shoes* ; Stroke* ; Walking ; Weight-Bearing

A chronic intestinal pseudo-obstruction is a rare disorder and a severe digestive syndrome. It is characterized by deranged gut propulsive motility that resembles a mechanical obstruction, but no obstructive process is present. An intestinal pseudo-obstruction may be classified as acute or chronic; the chronic form may also be classified as idiopathic or secondary to a variety of diseases. Treatment of intestinal pseudo-obstruction involves nutritional, pharmacological, and surgical therapies. Surgery should be limited to patients who are refractory to medical therapy and show a deteriorating course. Despite available medical and surgical interventions, the outcome remains poor. Here, we describe a case of a 54-year-old female with chronic constipation and abdominal distension, who was subsequently found to have segmental aganglionosis. The patient was treated with a subtotal colectomy and ileosigmoidostomy without sequelae.
Adult ; Colectomy ; Colonic Pseudo-Obstruction ; Constipation ; Female ; Fluconazole ; Hirschsprung Disease ; Humans ; Intestinal Pseudo-Obstruction ; Middle Aged

BACKGROUND: Klebsiella pneumoniae is an opportunistic pathogen which causes a spectrum of extra- intestinal infections. Since early 1980s, many outbreaks of extended-spectrum beta-lactamase (ESBL) producing K. pneumoniae have been reported. Using quinolone as an alternative therapeutic antibiotics also induced increased resistance to quinolones. Therefore, we evaluatedted the clinical and microbiological features of pneumonia caused by quinolone-resistant K. pneumoniae (QRKP). METHODS: From March of 1998 to April of 2000, 345 cases of K. pneumoniae pneumonia had been admitted to Korea University Guro Hospital. We retrospectively reviewed medical records of 75 cases. Thirty patients with pneumonia due to QRKP (case patients) were compared to 45 patients with pneumonia due to quinolone-susceptible K. pneumoniae (QSKP: control patients). We also performed antimicrobial susceptibility test (disc diffusion method and agar dilution method) and RAPD (random amplified polymorphic DNA) analysis to differentiate the isolates in resistant strains. RESULTS: Of 345 episodes of pneumonia, 30 (8.7 %) were caused by QRKP. Multivariate analysis re-vealed that prior antibiotics use was an independent risk factor for QRKP pneumonia. Among prior antibiotics, quinolone and the third generation cephalosporin were independently related to quinolone resistance. Although mortality rate was not high, QRKP pneumonia was associated with a significantly longer treatment duration and poor treatment response (P=0.009 and 0.007 respectively). According to the antimicrobial susceptibility test, quinolone resistance was significantly associated with the multi-drug resistance. RAPD analysis showed that 28 quinolone resistant strains belonged to only 4 genotypes, suggesting that patient- to-patient transmission of a few strains within the hospital occurred. CONCLUSION: QRKP pneumonia had a significant impact on clinical outcome and quinolone resistance was associated with multiple resistance to other antibiotics. It should be emphasized that judicious use of antibiotics as well as barrier precautions is required to reduce future outbreak and spread of QRKP.
Agar ; Anti-Bacterial Agents ; beta-Lactamases ; Diffusion ; Disease Outbreaks ; Drug Resistance, Multiple ; Genotype ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Medical Records ; Mortality ; Multivariate Analysis ; Pneumonia* ; Quinolones ; Retrospective Studies ; Risk Factors

OBJECTIVE: The purpose of this study was to investigate the efficacy and tolerability of atypical antipsychotics (AAPs) with augmentation by blonanserin in schizophrenic patients. METHODS: aA total of 100 patients with schizophrenia who were partially or completely unresponsive to treatment with an AAP were recruited in this 12-week, open-label, non-comparative, multicenter study. Blonanserin was added to their existing AAP regimen, which was maintained during the study period. Efficacy was primarily evaluated using the Positive and Negative Syndrome Scale (PANSS) at baseline and at weeks 2, 4, 8, and 12. Predictors for PANSS response (≥20% reduction) were investigated. RESULTS: The PANSS total score was significantly decreased at 12 weeks of blonanserin augmentation (-21.0±18.1, F=105.849, p<0.001). Moreover, 51.0% of participants experienced a response at week 12. Premature discontinuation of blonanserin occurred in 17 patients (17.0%); 4 of these patients dropped out due to adverse events. The patients who benefited the most from blonanserin were those with severe symptoms despite a treatment with a higher dose of AAP. CONCLUSION: Blonanserin augmentation could be an effective strategy for patients with schizophrenia who were partially or completely unresponsive to treatment with an AAP.
Antipsychotic Agents* ; Humans ; Prospective Studies* ; Schizophrenia

BACKGROUND: Influenza is a pandemic disease because of the frequent antigenic variation. There is an international influenza network by WHO, but no national surveillance system has been established in Korea. The purpose of this study was to understand the influenza epidemiology by examining the incidence of influenza-like illness (ILI) and the subtype of isolated viruses in Korea during the winter of 1997 and 1998. METHODS: The consultation rates and clinical features of ILI were based on the weekly reports by 71 sentinel physicians (SP) from October 1997 to March 1998. Throat swabs from patients with ILI were collected and inoculated to Madin-Darby Canine Kidney (MDCK) cells. Isolates were identified by hemagglutination (HA), indirect immunofluorescence assay (IFA) and confirmed by hemagglutination inhibition (HI), and restriction fragment length polymorphism (RFLP). RESULTS: The incidence of ILI and virus isolation peaked in December 1997 and decreased to the baseline in February 1998. Influenza occurred mostly in 1- to 5-years old children and systemic symptoms were the main clinical features. One-hundred and thirty two influenza viruses among 2,071 specimens were isolated. The major subtype of isolates was A/H3N2 (A/Sydney/05/97). A/H1N1 subtype was isolated at low levels (4 strains), whereas B and A/ H5N1 were not. RFLP for M gene was compatible with those bands of A/H3N2 and A/H1N1. CONCLUSION: Influenza epidemiology was studied on the basis of a nationwide surveillance system during 1997 and 1998. The incidence of ILI and virus isolation peaked in December 1997 and predominant strains of isolates were closely related to A/H3N2. To establish a more effective system, it is necessary to increase the number of participating SP and laboratories.
Antigenic Variation ; Child ; Child, Preschool ; Epidemiology ; Fluorescent Antibody Technique, Indirect ; Hemagglutination ; Humans ; Incidence ; Influenza, Human* ; Kidney ; Korea* ; Orthomyxoviridae ; Pandemics ; Pharynx ; Polymorphism, Restriction Fragment Length