The left parasternal impulse was evaluated by inspection and palpation, and it's contour was confirmed with graphic display using a pilse pickup in 45 normal subjects and 33 patients with various cardiac disease.Using an upper limit of normal echocardiographic LV end-diastolic dimension insides, 3.7cm/m2, LV mass index, 80g/m2, RV dimension index, 2.9cm/m2, and RV free wall thickness, 0.4cm, the patients were subdivided into four groups. In 9 patients with pure RV hypertrophy or dilation, the hyperdynamic impulse or sustained heave was noticed in 7 cases(sensitivity 78%, specificity 76%). In 12 patients with pure LV hypertrophy or dilation, striking parasternal systolic retraction was noticed in 5 cases(sensitivity 42%, speccificity 86%). But in 7 patient with biventricular hypertrophy or dilation, either striking systolic retraction or hyperdynamic impulse was noticed in 4 cases. These findings suggest that the evaluation of the parasternal movement is helpful for the cardiac examination.
Echocardiography ; Humans ; Hypertrophy ; Palpation ; Sensitivity and Specificity ; Strikes, Employee

Adult worms of Parvatrema spp. (Digenea: Gymnophallidae) were found in the intestines of 2 species of migratory birds, i.e., a great knot, Calidris tenuirostris, and 2 Mongolian plovers, Charadrius mongolus, in the coastal area of Gunsan-si, Jeollabuk-do in October 2009. The recovered Parvatrema worms were 79 in total number and composed of 2 species. The worms from a great knot were 289 micrometer in length with the oral and ventral sucker ratio of 2 : 1. They had a single vitellarium, and their intrauterine eggs were 25.0 x 17.5 micrometer in size. These findings were compatible with P. duboisi (Dollfus, 1923) Bartoli, 1974 (syn. P. timondavidi Bartoli, 1963). The worms recovered from the Mongolian plovers were smaller in length than P. duboisi and had 2 vitellaria. The oral and ventral sucker ratio was 2.5 : 1, and the eggs were 17.5 x 8.8 micrometer in size. These worms were assigned to be P. homoeotecnum James, 1964. This is the first report on the natural final hosts of Parvatrema spp. in Korea.
*Animal Migration ; Animals ; Bird Diseases/*parasitology ; Charadriiformes/*parasitology/physiology ; Trematoda/anatomy & histology/*isolation & purification ; Trematode Infections/parasitology/*veterinary

We have already reported good effect of meperidin and pentazocin as the sole agent for spinal anesthesia. The present study was undertaken to examine toxic effects of pentazocin and meperidine on peripheral nerve tissue. 11 rats were divided into three groups i.e. pentazocine, meperidine and control group. The sciatic nerves of adult rats were exposed and injected with pentazocin 0.5ml(15mg) or meperidine 0.5ml (25mg). Two specimens of normal nerve and another two specimens injected with normal saline 0.5 ml were used as the controIs. The nerve was examined under electron microcopy at 24 hours, 48 hours, 1 week and 4 weeks after the injection of each of the drugs. A total of twenty injections were carried out in 11 rats. The results were as follows: The pentazocien group revealed hydropic changes in the mitochondria and ER of axon and Schwann cell but the degree of injury was not significant and was reversible. The meperidine group showed hydropic changes that were not significant but the specimen taken at one week revealed severe axonal and myeline changes, admixed with fat globules and Schwann cell with severe fatty changes in the cytoplasm. Although most of the above mentioned changes may reverse, it is not certain yet that pentazocin and meperidine are free of toxicity on nerve cells until further study is done to find the causes of the severe histolgical changes which were shown in the one week specimen with demerol.
Adult ; Anesthesia, Spinal ; Animals ; Axons ; Cytoplasm ; Humans ; Meperidine ; Mitochondria ; Myelin Sheath ; Narcotics* ; Neurons ; Pentazocine ; Peripheral Nerves* ; Rats* ; Sciatic Nerve

This study was investigated to observe the effect of Treponema denticola(TDC) and Treponema lecithinolyticum(TLC) on cultured human periodontal ligament cells. Several experiments were performed including MTT test for the inhibition effect of cell proliferation, LDH test for the cytotoxicity , gelatin zymography for the gelatinase activation and observation of cell morphology change using the phase-contrast microscopy. The results were as follows. 1. The effect of concentration on cell proliferation with time showed an inhibitory effect at high concentration(150microgram/well) for TLC and at low concentration( 9.4microgram/well ) for TDC. 2. The effect of time on cell proliferation with concentration showed an inhibitory effect at 150microgram/well on 2-day incubation for TLC and at 9.4microgram/well on 2-day incubation for TDC. 3. The effect of heat-treated TDC and TLC on the inhibition of cell proliferation showed the difference in the heat-treated group compared to the non-heat treated group for TDC, whereas no difference was found for TLC. 4. The morphological changes which were observed from the phase-contrast microscopy showed the difference in the test group compared to the control group. The loss of spindle-like appearance, cell-to-cell detachment and inhibition of cell proliferation were observed. 5. There was no difference of the cytotoxicity effect between the test group and the control group in the LDH test. 6. The active form of progelatinase A with molecular weight 72kDa was activated in both TDC and TLC on the gelatin zymography. Regarding to the above results, TDC and TLC have an effect on periodontal ligament cells by playing an inhibitory role in cell proliferation and appears to activate progelatinase A which degrades type IV collagen.
Cell Proliferation ; Collagen Type IV ; Gelatin ; Gelatinases ; Humans ; Matrix Metalloproteinase 2 ; Microscopy, Phase-Contrast ; Molecular Weight ; Periodontal Ligament* ; Treponema denticola* ; Treponema*

PURPOSE: A number of researchers have suggested the use of sodium hyaluronate carboxymethyl cellulose (HA-CMC) membrane for preventing postoperative adhesion. This study evaluated the antiadhesive effect and safety of HA-CMC membrane in thyroidectomy for papillary thyroid cancer. METHODS: One hundred sixty-two patients who underwent thyroidectomy were prospectively randomized. In the study group of 80 patients, the 7.5 cm x 13 cm HA-CMC membrane was applied to the operative field after thyroidectomy. The subjects were asked about complications including adhesive symptoms using an 8-item questionnaire at 2 weeks, 3 months, and 6 months after surgery. In addition, items on the appearance of neck wrinkles and scars were evaluated by a physician who had no information about the patient's allocation. RESULTS: There were no significant differences in complications such as swallowing difficulty, and wrinkles between study and control groups. Both groups presented significantly decreased scores over time in swallowing difficulty, and wrinkles. There were no complications regarding the HA-CMC membrane. CONCLUSION: The antiadhesive effect of HA-CMC membrane in thyroid surgery is still uncertain, although it is biologically safe. Further investigation is needed to confirm the antiadhesive effect of HA-CMC membrane in thyroid surgery.
Adhesives ; Carboxymethylcellulose Sodium ; Cellulose* ; Cicatrix ; Deglutition ; Humans ; Hyaluronic Acid ; Membranes* ; Neck ; Prospective Studies ; Surveys and Questionnaires ; Sodium* ; Thyroid Gland* ; Thyroidectomy

The edentulous posterior maxilla generally provides a limited amount of bone height because of atrophy of the ridge and pneumatization of the maxillary sinus. Maxillary sinus augmentation is one of the surgical techniques for reconstruction of the severely resorbed posterior maxilla. The purpose of this study was to evaluate the survival rate of implants and the long-term changes of graft height after maxillary sinus augmentation by lateral window approach. From September 1996 to July 2004, maxillary sinus augmentation with mixed grafts of autograft, allograft, xenograft and alloplast were performed on 45 patients and 100 implants were placed. We evaluated the survival rate of implants and the changes of BL(bone length)/IL(implant length) according to time using panoramic radiographs. The survival rate of implants was 91.0% for follow-up period. The mean reduction of graft heights was 0.34mm(3.0%) for 6 months and 1.22mm(10.66%) for 3 years after augmentation. The total mean BL/IL was 1.34+/-0.21 during 5 year observation period after augmentation and decreased slightly over time. The result means that graft materials were stable above the implant apex. BL/ILs of 1 stage procedure were significantly decreased at 1-2 year, 3-4 year after augmentation and no statistically significant changes were observed in those of 2 stage procedure. The graft materials of both procedures were stable above the implant apex. No statistically significant changes of BL/IL were observed in the grafts combined with low amount of autogenous bone or without autogenous bone. The graft materials of both groups were stable above the implant apex. The results indicated that the placement of dental implants with maxillary sinus augmentation showed predictable clinical results and the grafts combined with low amount of autogenous bone or without autogenous bone had long-term resistance to resorption in maxillary sinus.
Allografts ; Atrophy ; Autografts ; Dental Implants* ; Follow-Up Studies ; Heterografts ; Humans ; Maxilla ; Maxillary Sinus* ; Survival Rate ; Transplants*

Paragonimiasis is caused by ingesting crustaceans, which are the intermediate hosts of Paragonimus. The involvement of the brain was a common presentation in Korea decades ago, but it becomes much less frequent in domestic medical practices. We observed a rare case of cerebral paragonimiasis manifesting with intracerebral hemorrhage. A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. An occult vascular malformation or small arteriovenous malformation compressed by the hematoma was initially suspected. The lesion progressed for over 2 months until a delayed surgery was undertaken. Pathologic examination was consistent with cerebral paragonimiasis. After chemotherapy with praziquantel, the patient was monitored without neurological deficits or seizure attacks for 6 months. This case alerts practicing clinicians to the domestic transmission of a forgotten parasitic disease due to environmental changes.
Animals ; Anthelmintics/therapeutic use ; Brain/parasitology/pathology ; Cerebral Hemorrhage/*etiology ; Child ; Dysarthria/etiology ; Facial Paralysis/etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Paragonimiasis/*diagnosis/drug therapy/parasitology ; Paragonimus/isolation & purification ; Praziquantel/therapeutic use ; Tomography, X-Ray Computed ; Vascular Malformations/etiology

Paragonimiasis is caused by ingesting crustaceans, which are the intermediate hosts of Paragonimus. The involvement of the brain was a common presentation in Korea decades ago, but it becomes much less frequent in domestic medical practices. We observed a rare case of cerebral paragonimiasis manifesting with intracerebral hemorrhage. A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. An occult vascular malformation or small arteriovenous malformation compressed by the hematoma was initially suspected. The lesion progressed for over 2 months until a delayed surgery was undertaken. Pathologic examination was consistent with cerebral paragonimiasis. After chemotherapy with praziquantel, the patient was monitored without neurological deficits or seizure attacks for 6 months. This case alerts practicing clinicians to the domestic transmission of a forgotten parasitic disease due to environmental changes.
Animals ; Anthelmintics/therapeutic use ; Brain/parasitology/pathology ; Cerebral Hemorrhage/*etiology ; Child ; Dysarthria/etiology ; Facial Paralysis/etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Paragonimiasis/*diagnosis/drug therapy/parasitology ; Paragonimus/isolation & purification ; Praziquantel/therapeutic use ; Tomography, X-Ray Computed ; Vascular Malformations/etiology

PURPOSE: If bone grafts and guided tissue regeneration are effective individually in treating osseous defects, then the question is, what would happen when they are combined. Bone grafts using Calcium Carbonate(Biocoral) and Guided Tissue Regeneration using Calcium Sulfate(CALMATRIX) will maximize their advantages and show the best clinical results in intrabony defects. This study was to compare the effects of a combination of CS and CC with control treated only with modified widman flap in a periodontal repair of intrabony defects. MATERIALS AND METHODS: 30 patients with chronic periodontitis were used in this study. 10 patients were treated with a combination of CS and CC as the experimental groupII and another 10 patients were treated with CC as the experimental groupI, and the remaining 10 patients, the control group were treated only with modified widman flap. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded 6 months later. RESULTS: The probing depth changes were 3.30+/-1.34 mm in the control group, 4.2+/-1.55 mm in the experimental groupI(CC) and 5.00+/-1.33 mm in the experimental groupII(CS+CC). They all showed a significant decrease 6 months after surgery(p <0.01). There was a significant difference(p <0.05) between the control and experimental group. However there were no significant difference(p <0.05) between the experimental groupIand II. The gingival recession changes w -1.30+/-1.25 mm in the control group, This is a significant difference(p <0.01). However, there was a -0.50+/-0.53 mm change in the experimental groupI(CC) and -0.60+/-0.97 mm in the experimental groupII(CS+CC). In addition, in terms of gingival recession, there was a no significance difference(p <0.05) among the groups. The clinical attachment level changes were 2.00+/-1.33 mm in the control group, 3.60+/-1.58 mm in the experimental groupI(CC) and 4.40+/-1.17 mm in the experimental groupII(CS+CC). They all showed a significant decrease 6 months after surgery(p <0.01). There was a significant difference(p <0.05) between the control and experimental group. However there was a no significance difference(p <0.05) between the experimental groupI andII. The bone probing depth changes were 0.60+/-0.52 mm in the control group, 3.20+/-1.48 mm in the experimental groupI (CC) and 4.60+/-1.43 mm in the experimental groupII(CS+CC). All of them showed a significant decrease 6 months after surgery(p <0.01), there was a significance difference(p <0.05) among the groups. CONCLUSION: Treatment using a combination of CS and CC have a potential to improve periodontal parameters in intrabony defects and More efficient clinical results can be expected in intrabony defects less than 2 walls grafted with CS and CC.
Calcium ; Calcium Carbonate ; Calcium Sulfate ; Chronic Periodontitis ; Gingival Recession ; Guided Tissue Regeneration ; Humans ; Transplants

This study is an analysis of distribution of patients who installed Implantium(R) implant in Yonsei University Dental Hospital and types of implant site for about 1 years recall check and success rate. 164 implants were installed to 52 patients in this study. It shows the conclusion below. 1. Patients at the age of 40s and 50s were 65% of all implant cases and average number of implant was 4 (man), and 2.7 (woman). 75 implants were operated on maxilla and 89 were mandible. 19 implants on anterior region and 145 implants on posterior region. 2. Most distribution of bone qaulity for implant site was type III(37.2%) and bone quantity was type C(61.7%) 3. The majority of implants were those of 10, 12mm in length (85%) and regular diameter in width (48.8%). 4. 30 implants were installed with the advanced technique-GBR, window opening, osteotome technique. 5. Two implants were removed before prosthodontic treatment due to the osseointegraton failure. The success rate was 98.8% in 15.2 months follow up period and the marginal bone loss was 0.28mm. The results provided us with basic data on patient type, implant distribution, bone condition, and survival rate. Within the limit of present study, It was concluded that Implantium(R) implant could be used satisfactorily in various clinical situations.
Follow-Up Studies ; Humans ; Mandible ; Maxilla ; Prosthodontics ; Survival Rate