No abstract available.
Suction* ; Tonsillectomy*

No Abstract Available.
Arthroplasty* ; Knee Joint* ; Knee*

Laryngopharyngeal reflux disease (LPRD) is different with gastroesophageal reflux disease (GERD). The lower esophageal sphincter (LES) possesses an intrinsic nervous plexus that allows the LES to have a considerable degree of independent neural control. Sympathetic control of the LES and stomach stems from cholinergic preganglionic neurons in the intermediolateral column of the thoracic spinal cord (T6 through T9 divisions), which impinge on postganglionic neurons in the celiac ganglion, of which the catecholaminergic neurons provide the LES and stomach with most of its sympathetic supply. Sympathetic regulation of motility primarily involves inhibitory presynaptic modulation of vagal cholinergic input to postganglionic neurons in the enteric plexus. The magnitude of sympathetic inhibition of motility is directly proportional to the level of background vagal efferent input. Recognizing that the LES is under the dual control of the sympathetic and parasympathetic nervous systems, we refer the reader to other comprehensive reviews on the role of the sympathetic and parasympatetic control of LES and gastric function. The present review focuses on the functionally dominant parasympathetic control of the LES and stomach via the dorsal motor nucleus of the vagus.
Brain Stem* ; Esophageal Sphincter, Lower ; Ganglia, Sympathetic ; Gastroesophageal Reflux ; Laryngopharyngeal Reflux* ; Neurons ; Neurophysiology* ; Parasympathetic Nervous System ; Reflex* ; Spinal Cord ; Stomach

PURPOSE: Percutaneous transluminal angioplasty(PTA) with a balloon catheter is a standard method of treatment for membranous obstruction of inferior vena cava(MOIVC). But, correct therapeutic approach has not been established for MOIVC patients whose lesion is associated with extensive thrombotic IVC occlusion. We tried to treat MOIVC associated with or without thrombus. MATERIALS AND METHODS: We treated 13 cases of MOIVC(associated with thrombus in 7 cases, no thrombus in 6 cases) with PTA, thrombolysis and self-expandable metallic stents. RESULTS: PTA was successful in 8 cases, but failed in 5 cases. The recurred cases were retreated with PTA, but follow up study revealed recoiling restenosis in 4 cases and intimal hyperplasia in 1 case at previous PTA site which could be overcome with a self-expandable metallic stent. The complication were occurred in 3 cases which were hemothorax, hemopericardium, and hemoperitoneum respectively. However, those were resolved by conservative treatment only. CONCLUSION: Recanalization and dilatation could be done in MOIVC patients with or without thrombosis for improvement of patient's symptom. Gianturco self-expandable metallic stent is sueful in treatment of recurred MOIVC after balloon dilatation and preventing reocclusion of the IVC after PTA.
Catheters ; Dilatation ; Follow-Up Studies ; Hemoperitoneum ; Hemothorax ; Humans ; Hyperplasia ; Pericardial Effusion ; Stents* ; Thrombosis

PURPOSE: Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea. METHODS: Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. RESULTS: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%. CONCLUSION: The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.
Biological Products ; Colitis, Ulcerative ; Colorectal Neoplasms ; Colorectal Surgery ; Crohn Disease ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Insurance, Health ; Korea* ; Laparoscopy

BACKGROUND: The number of cases employing thoracic endovascular aortic repair (TEVAR) has been increasing due to lower morbidity and mortality compared to open repair technique. The aim of this study is to evaluate the outcome of TEVAR for thoracic aortic diseases. MATERIALS AND METHODS: Sixteen patients underwent TEVAR from October 2003 to April 2010. Mean age at operation was 59 years (20~78 years), and 11 were male. Indications for TEVAR were large aortic diameter (>5.5 cm) upon presentation in 6 patients, increasing aortic diameter during the follow-up period in 4, traumatic aortic rupture in 3, persistent chest pain in 2, and ruptured aortic aneurysm in one. The mean diameter, length and the number of the stents were 33 mm (26~40 mm), 12 cm (9.5~16.0 cm), and 1.25 (1~2), respectively. Aortography employing Multi-detector computerized tomography (MDCT) technique was performed at one week, and patients were followed up in the out-patient department at one month, 6 months, and one year postoperatively. RESULTS: Primary technical success showing complete exclusion of the aneurysm was achieved in 15 patients. One patient showed a small endo-leak (type 1). Four patients developed perioperative stroke: Three recovered without sequelae, and one showed mild right-side weakness. There was no operative mortality. Diameter of the thoracic aorta covered by stent graft changed within 10% range in 12 patients, decreased by more than 10% in 3, and increased by more than 10% in one during mean follow-up duration of 18 months (1~73 months). There was no recurrence-related death during this period. CONCLUSION: Intermediate-term outcome after TEVAR was encouraging. Indications for TEVAR could be extended for other thoracic aortic diseases.
Aneurysm ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Diseases ; Aortic Rupture ; Aortography ; Chest Pain ; Follow-Up Studies ; Humans ; Male ; Outpatients ; Stents ; Transplants

BACKGROUND AND OBJECTIVES: The main purpose of this study is to clarify perceptual and acoustic analysis for the patients with hypothyroidism after thyroidectomy especially focused on the characteristics of speech articulation with special reference to the consonant production. MATERIALS AND METHODS: The subjects of the research were 40 male and female adults (males : 5, females : 35). They were all received radioactive iodine treatment which after total thyroidectomy. Voice samples were collected during the three stages of after surgery, pre-radioisotope treatment (RIT), and post-RIT. The acoustic analysis was conducted by using Pratt (ver.5.2.21) after measuring voice onset time (VOT). The subjective evaluation of the voices used CAPE-V. RESULTS: A significant decrease in overall severity was displayed in the CAPE-V following RIT. It may be conjectured that this is connected to the change in voice following RIT. The loudness of the sound displayed a significant decrease in the CAPE-V following RIT. It is conjectured that this is connected to the decrease in vocal intensity following RIT. No statistically significant results were revealed for the comparative analysis on the voice onset time (VOT) in all plosives during the three periods. CONCLUSION: Perceptually, the overall severity of the voice with hypothyroidism was changed significantly before and after RIT. Eventhough VOT were not significantly changed, it tended to decrease VOT in patients with hypothyroidism.
Acoustics ; Adult ; Female ; Humans ; Hypothyroidism* ; Iodine ; Male ; Thyroidectomy ; Voice*

PURPOSE: One of the most important factors in evaluating the quality of fixed dental prostheses (FDPs) is their gap. The purpose of this study was to compare the marginal and internal gap of two different metal-ceramic crowns, casting and selective laser sintering (SLS), before and after porcelain firing. Furthermore, this study evaluated whether metal-ceramic crowns made using the SLS have the same clinical acceptability as crowns made by the traditional casting. MATERIALS AND METHODS: The 10 study models were produced using stone. The 20 specimens were produced using the casting and the SLS methods; 10 samples were made in each group. After the core gap measurements, 10 metal-ceramic crowns in each group were finished using the conventional technique of firing porcelain. The gap of the metal-ceramic crowns was measured. The marginal and internal gaps were measured by two-dimensional and three-dimensional replica techniques, respectively. The Wilcoxon signed-rank test, the Wilcoxon rank-sum test and nonparametric ANCOVA were used for statistical analysis (alpha=.05). RESULTS: In both groups, the gap increased after completion of the metal-ceramic crown compared to the core. In all measured areas, the gap of the metal cores and metal-ceramic crowns produced by the SLS was greater than that of the metal cores and metal-ceramic crowns produced using the casting. Statistically significant differences were found between cast and SLS (metal cores and metal-ceramic crown). CONCLUSION: Although the gap of the FDPs produced by the SLS was greater than that of the FDPs produced by the conventional casting in all measured areas, none exceeded the clinically acceptable range.
Computer-Aided Design ; Crowns ; Dental Porcelain ; Dental Prosthesis ; Fires ; Replica Techniques

Multiple primary cancer is defined as the case of primary malignant tumors of different histologic origins each other in one person, The incidence of multiple primary cancer has been increasing recently due to more developed diagnostie procedure and long survival of cancer patients. In esophageal cancer patients, comibined prevalence of other malignancy is rela tively high. We have experienced three cases of gastric adenocarcinoma with esophageal squamous cell carcinoma and report these cases with a review of literatures.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Esophagus* ; Humans ; Incidence ; Prevalence ; Stomach*

PURPOSE: Telomerase is a ribonucleoprotein enzyme that synthesizes telomeric DNA onto the ends of chromosomes, thereby preventing the replication-dependent shortening of those ends. This enzyme is essential for stability of eukaryotic chromosomes and may be necessary for cell immortalization. Telomerase activity is detected in a wide range of cancers of various tissues, and its expression may be a critical step in tumor progression. METHODS: The telomerase activity was measured using a telomeric repeat amplification protocol (TRAP) assay in 65 cases of breast cancers, 9 cases of fibroadenomas, and 7 cases of normal breast tissues. To compare the telomerase activity with cell cycle regulators, we measured the expression of the cyclin D1 and the p53 proteins by using immunohistochemical analysis. To compare the telomerase activity with traditional prognostic indicators, we measured the ER, PR, c-erbB-2 and ki-67 expression by using immunohistochemical analysis. Disease-free survival and overall survival in relation to telomerase activity were studied by using the Kaplan-Meier method. RESULTS: Telomerase activity was detected in 42 (64.6%) of the 65 breast cancers, 4 (44.4%) of the 9 fibroadenomas, and in none of the 7 normal breast tissues. There was no significant relationship between telomerase activity and cell cycle regulators such as cyclin D1 or p53. There was no statistical correlation between telomerase activity and tumor size, lymph nodal status, or histopathological prognostic parameters, such as ER, PR, p53, c-erbB-2 and ki-67, but a significant correlation was found (p=0.006) between telomerase activity and histologic grade. The telomerase activity was not significantly correlated with either the overall survival or the disease-free survival. CONCLUSION: These results suggest that telomerasemay play a role in the malignant transformation of breast tissue and that this enzyme was more activated in cancers of a poor histologic grade. However, the telomerase activity was not related to cell cycle regulators and traditional prognostic parameters. The possible significance of telomerase activity in breast cancer remains open to further investigation.
Breast Neoplasms* ; Breast* ; Cell Cycle* ; Cyclin D1 ; Disease-Free Survival ; DNA ; Fibroadenoma ; Ribonucleoproteins ; Telomerase*