BACKGROUND: It has been well known that absolute and interpeak latencies of brainstem auditory evoked potentials (BAEP) are usually prolonged in diabetics. However, Its etiology is still controversial. We tried to identify whether the cause is structural or metabolic in origin by performing BAEP and brain MRI in the diabetic patients. METHODS: BAEP were performed in both the diabetic patients (DM) group (16 males and 15 females) and the normal control group (25 males and 33 female). A brain MRI was performed in the DM group on those who showed abnormal BAEP and com-pared the results of BAEP of the DM group with those of the control group. RESULTS: 7 patients (22.6%) showed abnor-mal BAEP (male; 6, female; 1, unilateral; 4, bilateral; 3) when abnormal BAEP was defined as being larger than two and a half standard deviations of the control group BAEP results. Two males of the DM group who showed abnormal structural lesions of the pons in their brain MRI were not included in the statistical analysis. The remaining 14 diabetic male patients (mean age: 58.7 +/-9.1 years, mean disease duration: 6.1 +/-4.7 years, mean hemoglobin (Hb) A1C: 7.7 +/- 2.0%) and 15 diabetic female patients (mean age: 60.6 +/-10.8 years, mean disease duration: 5.4 +/-5.1 years, mean HgA1C: 7.8 +/-2.1%) were stastistically analyzed. Interpeak latencies of I-III, III-V, and I-V were found to be signifi-cantly prolonged in the DM group. The prolongation of interpeak latencies of I-III and I-V were found to be signifi-cantly correlated with the disease duration only in the diabetic female patients, but not with age and HbA1c. CONCLUSIONS: These findings suggest that both metabolic derangement and structural lesion contribute to prolonging the central conduction time on BAEP pathway in diabetics.
Brain ; Brain Stem* ; Diabetes Mellitus ; Evoked Potentials, Auditory, Brain Stem* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pons

PURPOSE: The purpose of this study was to evaluate the bone regeneration of particulated hydroxyapatite(HA) and block type of hydroxyapatite graft in rabbit calvarial defects. METHODS: An 8 mm calvarial circular defects were created in sixteen young adult New Zealand white male rabbits (weight 3.0~3.5 kg). Each defects were filled with Bio-Oss, particulated HA and block type HA. Sham surgery control defects were filled with blood clots. The pecimens were harvested at 4 weeks and 8 weeks for histologic and histomorphometric evaluation. RESULTS: Histomorphometric analysis demonstrated statistical differences in defect closure, new bone formation, and bone density of the four groups. Block type of HA group showed increased bone formation and bone density at 4 weeks and 8 weeks compared with Bio-Oss group or sham surgery control group(p<0.05). CONCLUSIONS: Block type of HA is an effective material for osteoconduction in rabbit calvarial defects, which may acts as a guide in use of these products in human application.
Bone Density ; Bone Regeneration ; Bone Substitutes ; Durapatite ; Humans ; Hydroxyapatites ; Male ; Minerals ; New Zealand ; Osteogenesis ; Rabbits ; Salicylamides ; Transplants ; Young Adult

Vigabatrin (VGB) is one of the most frequently prescribed new anti-epileptic drugs in the world since 1989. It has minimal side effects and fewer drug interactions with other anti-epileptic drugs. Recently, concern of the prevalence and pathophysiology of visual impairment with VGB has been increased since the reports of visual field constriction in patients treated with VGB. We report a 46-year-old man with a visual field defect who has been suffering from complex partial seizures for 29 years. Brain magnetic resonance image (MRI) and electroencephalogram (EEG) were non-specific. The frequency of seizures was about 5 times a month for the past 5 years. VGB, in a dose of 1500 mg/day, was prescribed as an add on drug in addition to carbamazepine. 19 months after VGB treatment, the patient complained of visual dimness especially in the lower half of the visual field. He expressed it as "waving". He had no metabolic derangement. Fundus examination, visual evoked potential, and electroretinogram showed normal findings. A visual field analysis showed a bilateral field defect in the lower half. A follow up visual field analysis, 6 months after the withdrawal of VGB, revealed a slight improvement of visual field defects which were noted without significant clinical improvement. This case implicates that visual field defects due to VGB may be partially reversible.
Brain ; Carbamazepine ; Constriction ; Drug Interactions ; Electroencephalography ; Evoked Potentials, Visual ; Follow-Up Studies ; Humans ; Middle Aged ; Prevalence ; Seizures ; Vigabatrin* ; Vision Disorders ; Visual Fields*

OBJECTIVES: This study investigated the hypothesis that increasing light-curing time would leave the oxygen-inhibited layer (OIL) of the adhesive thinner, and in turn, result in lower shear bond strength (SBS) than those obtained by the routine curing procedures. METHODS: 120 human extracted posterior teeth were randomly divided into three groups for bonding with three adhesives: All Bond 2(R), One Step(R), and Adper Prompt(R). They were subsequently divided into four subgourps with different light-curing time (10, 20, 30 and 60 s). The assigned adhesives were applied on superficial occlusal dentin according to the manufacturer's instructions and cured with one of the four curing times. Composite resin cylinder, 2.35 mm in diameter, were built on the cured adhesive and light-cured for 40 s. SBS were measured after 24 h from the bonding using a universal testing machine (crosshead speed 1.0 mm/min). The relative thickness of the OIL and the degree of conversion (DC) were determined from the adhesive on a slide glass using FT-NIR in an absorbance mode. Data were analysed with One-way ANOVA and Duncan's multiple test (p < 0.05). RESULTS: With increasing cure time, although there were no significant difference in th SBS of One-step and Adper Prompt (p > 0.05), those of All Bond 2 decreased significantly (p < 0.05). The relative thicknesses of the OIL on each adhesive were not affected by the cure time (p > 0.05). Although the DC of All-Bond 2 were statistically not different with increasing cure time (p > 0.05), those of One-Step and Adper Prompt showed an increasing trends with increasing cure time (p < 0.05). CONCLUSIONS: Increasing light-curing time did not affect on the relative thickness of the OIL of the adhesives, and in turn, on the SBS to dentin.
Adhesives* ; Dentin* ; Glass ; Humans ; Tooth

OBJECTIVES: This study investigated the hypothesis that increasing light-curing time would leave the oxygen-inhibited layer (OIL) of the adhesive thinner, and in turn, result in lower shear bond strength (SBS) than those obtained by the routine curing procedures. METHODS: 120 human extracted posterior teeth were randomly divided into three groups for bonding with three adhesives: All Bond 2(R), One Step(R), and Adper Prompt(R). They were subsequently divided into four subgourps with different light-curing time (10, 20, 30 and 60 s). The assigned adhesives were applied on superficial occlusal dentin according to the manufacturer's instructions and cured with one of the four curing times. Composite resin cylinder, 2.35 mm in diameter, were built on the cured adhesive and light-cured for 40 s. SBS were measured after 24 h from the bonding using a universal testing machine (crosshead speed 1.0 mm/min). The relative thickness of the OIL and the degree of conversion (DC) were determined from the adhesive on a slide glass using FT-NIR in an absorbance mode. Data were analysed with One-way ANOVA and Duncan's multiple test (p < 0.05). RESULTS: With increasing cure time, although there were no significant difference in th SBS of One-step and Adper Prompt (p > 0.05), those of All Bond 2 decreased significantly (p < 0.05). The relative thicknesses of the OIL on each adhesive were not affected by the cure time (p > 0.05). Although the DC of All-Bond 2 were statistically not different with increasing cure time (p > 0.05), those of One-Step and Adper Prompt showed an increasing trends with increasing cure time (p < 0.05). CONCLUSIONS: Increasing light-curing time did not affect on the relative thickness of the OIL of the adhesives, and in turn, on the SBS to dentin.
Adhesives* ; Dentin* ; Glass ; Humans ; Tooth

BACKGROUND/AIMS: Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea. METHODS: This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of >250 cells/mm3 in the absence of data compatible with secondary peritonitis. RESULTS: The mean age of the cohort was 56 years, and 121 (77%) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42%): Gram-negative bacteria in 54 (81.8%), Gram-positive in 11 (16.7%), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17%), to ciprofloxacin in 11 (20.8%), and to penicillin in 33 (62.3%). The treatment failure and in-hospital mortality rates were 12.1% and 21%, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum beta-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality. CONCLUSIONS: SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.
Anti-Bacterial Agents ; Ascitic Fluid ; Candida ; Carcinoma, Hepatocellular ; Cell Count ; Ciprofloxacin ; Cohort Studies ; Fibrosis ; Gram-Negative Bacteria ; Hospital Mortality ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Male ; Penicillins ; Peritonitis ; Prognosis ; Retrospective Studies ; Treatment Failure

Innate elastase inhibitors are known to be putatively involved in the regulation of tissue inflammation by inhibiting polymorphonuclear leukocyte (PMN) derived proteinases. The aim of this study was to evaluate affects of leukocyte elastase suppression and PMN infiltration on wound healing in mouse by administering the recombinant elastase inhibitor guamerin (rEIG) in two different wound models; 1) impaired pin-punctured dorsal mucosa of anterior tongue wound, 60 mice, treated with saline containing rEIG that were fed ad libitum and 2) stable linear excisional cutaneous wound, 40 mice, covered with fibrin sealant containing rEIG. The progress of healing was analyzed by histological methods. The tongue wounds treated with rEIG became edematous around the pin-punctured tongue wound, and influx of inflammatory cells and PMN into the underlying stromal tissue were seen rapidly after wounding and peaked between 2-4 days. Whereas the control mice showed almost no wheal formation in the pin-punctured wound, a far lesser levels of PMN infiltration, and almost complete wound closure in 4 days. In the other model, the liner excisional cutaneous wound treated with fibrin sealant containing rEIG showed early wound constriction, lesser degree of inflammatory cells influx, and complete reepithelialization in 4-5 days, whereas the wound of control mice with the fibrin sealant alone showed contrary delayed reepithelialization, greater degree of inflammatory cell infiltration, and consequencial formation of greater granulation tissue at wound site. Taken together, these data suggest paradoxical effects of rEIG on the wound healing where in the wound exposed to infiltrating milieu of microorganisms in the oral cavity, the rEIG aggravates the wound healing by interfering with other innate defensive factors and extended greater flux of PMNs to inflamed wound site, while in the wound enclosed by fibrin, the rEIG accelerated wound healing by inhibiting the inflammation-generated proteases and the acute inflammatory reaction.
Animals ; Enzyme Inhibitors/*pharmacology ; Female ; Fibrin Tissue Adhesive/pharmacology ; Invertebrate Hormones/analysis/pharmacokinetics/*pharmacology ; Leukocyte Elastase/*antagonists & inhibitors ; Macrophages/immunology ; Mice ; Research Support, Non-U.S. Gov't ; Skin/drug effects/*injuries/pathology ; Tongue/drug effects/*injuries/pathology ; Wound Healing/*drug effects

Colorectal cancer is the third most common cancer in Korea; it is the second most common cancer in men and the third most common in women. The incidence rate in Korea has continuously increased since 1999 when the National Cancer Registry statistics began. Currently; there are several screening modalities; that have been recommended by expert societies, including fecal occult blood test, colonoscopy, computed tomographic colonography The annual fecal immunochemical test (FIT) has been used in adults aged 50 and older as part of the National Cancer Screening Program in Korea since 2004. Although several study results from regional or national colorectal cancer screening programs in other countries have been reported, the National Cancer Screening Program in Korea has not yet been evaluated with evidence-based methods. Herein report the consensus statements on the National Screening Guideline for colorectal cancer developed by a multi-society expert committee in Korea, as follows: 1) We recommend annual or biennial FIT for screening for colorectal cancer in asymptomatic adults, beginning at 45 years of age and continuing until 80 years (recommendation B). 2) There is no evidence for the risks or benefits of FIT in adults older than 80 years (recommendation I). 3) Selective use of colonoscopy for colorectal cancer screening is recommended, taking into consideration individual preference and the risk of colorectal cancer (recommendation C). 4) There is no evidence for the risks or benefits of double-contrast barium enema for colorectal cancer screening in asymptomatic adults (recommendation I). 5) There is no evidence for the risks or benefits of computed tomographic colonography for colorectal cancer screening in asymptomatic adults (recommendation I).
Adult ; Barium ; Colonography, Computed Tomographic ; Colonoscopy ; Colorectal Neoplasms* ; Consensus ; Early Detection of Cancer ; Enema ; Female ; Humans ; Incidence ; Korea ; Male ; Mass Screening* ; Occult Blood

Background: Although respiratory tract infection is one of the most important factors triggering acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern of microbiology in South Korea. Methods: A multicenter observational study was conducted between January 2015 and December 2018 across 28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible to participate in the present study. The participants underwent all conventional tests to identify etiology of microbial pathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma–COPD (ACO) and pure COPD was performed. Results: We included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACO accounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth used systemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were detected in 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequently detected bacteria were Pseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). Conclusion Distinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in South Korea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis for further studies investigating infectious pathogens in patients with COPD.