Maxillary bone defects may follow surgical treatment of benign and malignant tumors, trauma, and infection. Palatal defects often lead to problems with swallowing and pronunciation from the leakage of air into the nasal cavity and sinus. Obturators have been commonly used to solve these problems, but long-term use of the device may cause irritation of the oral mucosa or damage to the abutment teeth. Utilizing implants in the edentulous area for the fabrication of the obturators has gained attention. This case report describes a patient, who had undergone partial resection of the maxilla due to adenocarcinoma, in need of a new obturator after losing abutment teeth after long-term use of the previous obturator. Implants were placed in strategic locations, and an implantretained maxillary obturator was fabricated, showing satisfactory results in the rehabilitation of multiple aspects, including palatal defect, masticatory function, swallowing, pronunciation, and aesthetics.

A accidental spills of phenol(100%) to the river Nakdong with subsequent contamination of the tap water for about two million consumers in Taegu city of Korea were occurred in March 1991. A historical cohort study of 6,913 individuals was undertaken to determine the associated with illness. Population subjects were divided into two groups of exposed and unexposed. Exposed subjects were reported to be phenol associated symptoms significantly higher than those in a nearby unexposed area(39.6% vs 9.4%, p<0.01). Especially, in the related symptoms, highly significant differences were noted in the number of subjects reporting gastrointestinal illness such as nausea, vomiting, diarrhea, or abdominal pain. During the accident, study subjects who experienced peculiar taste or odor in the tap water were significantly higher in the exposed areas(92% vs 34.3%). Chlorophenols formed from chlorination of water may have aggravated the problem.
Abdominal Pain ; Chlorophenols ; Cohort Studies ; Daegu ; Diarrhea ; Drinking Water* ; Drinking* ; Equipment and Supplies* ; Halogenation ; Korea ; Nausea ; Odors ; Phenol* ; Rivers ; Vomiting ; Water

We report two cases of cutaneous Mycobacterium(M.) marinum infections in a 43-year-old man and a 31-year-old woman who had multiple subcutaneous nodules on the left upper extremity and an erythematous ulcer on the right elbow, respectively. Skin biopsy specimens revealed chronic granulamatous inflammation and AFB positive bacilli in the dermis. The culture from tissue specimens on Lowenstein-Jensen media at 30'C for 10 days, yielded cream-colored colonies, which became yellow when exposed to light. The organism was identified as M. marinum by selected biochemical reactions. The patients were treated with surgical excision followed by administration of minocycline and administration of minocycline, respectively.
Adult ; Biopsy ; Dermis ; Elbow ; Female ; Humans ; Inflammation ; Minocycline ; Mycobacterium marinum* ; Mycobacterium* ; Skin ; Ulcer ; Upper Extremity

PURPOSE: To evaluate contrast enhancement patterns of hemangioma according to size, as seen during thearterial and portal venous phase of spiral CT. MATERIAL AND METHODS: During a recent six month-period, 52patients with hemangiomas underwent two-phase spiral CT examination with 10mm collimation at 10mm/sec table speed,and with 100mL of contrast material(37g iodine) injected at a rate of 2.5 mL/sec. CT images of the hepaticarterial and portal venous phase were obtained with 30-second and 65-second delay, respectively. In 52 patients,82 hemangiomas were seen. The diameter of the tumors were as follows ; < or =10 mm(n=31), 11-20 mm(n=19), and> or =21mm(n=32). The enhancement patterns of tumors compared with attenuation of surrounding liver parenchyma weredivided into four types : peripheral high, uniform high, iso, and low. RESULTS: Overall, the most commonenhancement pattern was peripheral high(44/82, 53.7%), during the arterial and portal venous phase. The second andthird most common patterns were uniform high(11/82, 13.4%) and peripheral high-uniform high(9/82, 11.0%), alsoduring the arterial and portal venous phase. Sixty-one(74.4%) showed peripheral high attenuation andeleven(13.4%), uniform high attenuation, during the arterial and/or portal venous phase. In tumors smaller than20mm, low-low attenuation was seen in eight(9.8%), and iso-low attenuation in two(2.4%), during the arterial andportal venous phase, respectively. CONCLUSION: On two-phase spiral CT, the most common enhancement pattern ofhemangioma was peripheral high, seen during the arterial and portal venous phase. However, a small hemangioma lessthan 2 cm may show atypical patterns, including low and iso attenuation.
Hemangioma* ; Liver ; Tomography, Spiral Computed*

BACKGROUND: Clinical concern and incidence of mycotic keratitis in ophthalmic practice has been increasing. OBJECTIVE: The purpose of this study was to investigate clinical and mycological feature of mycotic keratitis. METHODS: We evaluated the clinical and mycological aspect of mycotic keratitis in 14 patients from October 1993 to March 1997 in Dongguk Unversity Hospital. RESULTS AND CONCLUSION: Mycotic keratitis showed high incidence in fifth (42.9%), sixth (35.7%), and fourth decade (14.3%). The ratio of male to female patient was 1:3.6. The seasonal prevalence was highest in autumn. A scratch or abrasion from vegetation was the most common type of the eye trauma in mycotic keratitis. The positive rate of KOH examination and culture was 92.9%, respectively. The common causative organisms of mycotic keratitis were Fusarium sp. (38.5%) and Alternaria sp. (38.5%), followed by Curvularia sp. (7.7%), Aspergillus flavus (7.7%) and Acremonium sp. (7.7%).
Acremonium ; Alternaria ; Aspergillus flavus ; Female ; Fusarium ; Humans ; Incidence ; Keratitis* ; Male ; Prevalence ; Seasons

PURPOSE: The purpose of this study was to evaluate if short-term serum thyroglobulin (Tg) elevation after radioiodine administration can predict successful radioiodine remnant ablation (RRA) and whether comparable RRA effectiveness is exhibited between a group administered with recombinant human thyrotropin (rhTSH) and a group experiencing thyroid hormone withdrawal (THW), in preparation for RRA. MATERIALS AND METHODS: A retrospective chart review was performed on 39 patients in the rhTSH group and 46 patients in the THW group. They were treated for differentiated thyroid carcinoma by total or near total thyroidectomy, and referred for RRA between 2003 and 2006 (the rhTSH group) and between January and June of 2006 (the THW group). They were assessed for serum Tg levels just before I-131 administration (TgD0), reassessed 9 days later (TgD9), and again 6-12 months later. RESULTS: RRA was successful in 64 (37 from the THW group and 27 from the rhTSH group) of the total 85 patients. The success rates of RRA had no statistically significant differences between the two groups. In both groups, TgD9/TgD0 values were significantly higher in the RRA success group (the rhTSH group; P=0.03, the THW group; P=0.04). By combining cutoff values of TgD0 and TgD9/TgD0, the successful RRA value was determined to be 96.7% (29/30) with TgD0< or =5.28 ng/mL and TgD9/TgD0>4.37 in both groups (the rhTSH group; 100% (16/16), the THW group; 92.9% (13/14)). Using logistic multivariate analysis, only TgD0 was independently associated with successful RRA. CONCLUSION: We may predict successful ablation by evaluating short-term serum Tg elevation after I-131 administration for RRA, in both rhTSH and THW patients.
Humans ; Multivariate Analysis ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin ; Thyrotropin Alfa

PURPOSE: Our purpose was to evaluate F-18 FDG uptake in pulmonary lymphangitic carcinomatosis (PLC) according to CT findings and histology of lung cancer. Materials and METHODS: Thirty-three lung cancer patients with PLC were enrolled in this retrospective study. All the patients had a CT-based diagnosis of PLC. Chest CT findings of PLC were classified on the basis of involvement of axial interstitium. We categorized the involvement of axial interstitium as group 1, and the involvement of peripheral interstitium only as group 2. Visual and semiquantitative analyses by F-18 FDG PET/CT were performed in the PLC lesions. At first, we analyzed the F-18 FDG uptake in the PLC by visual assessment. If abnormal uptake was seen in the PLC, we drew regions of interest in the PLC lesions to obtain the maximum SUVs (maxSUVs). RESULTS: Of the 33 patients, 22 had abnormal F-18 FDG uptake in the visual assessment. There was no significant difference in the frequency of abnormal F-18 FDG uptake between group 1 and group 2 (p=0.17), although the frequency of group 1 tended to be higher than group 2 (15/19 (78.9%) in group 1, 7/14 (50.0%) in group 2). However, group 1 had a higher maxSUV than group 2 (p<0.01, group 1: 2.9+/-1.4, group 2: 1.5+/-0.6). There was no significant difference in the frequency of abnormal F-18 FDG uptake and maxSUV among the histology of the lung cancers. CONCLUSION: The involvement of axial interstitium in the PLC by lung cancer has a higher maxSUV than the involvement of only peripheral interstitium.
Carcinoma ; Humans ; Lung ; Lung Diseases, Interstitial ; Lung Neoplasms ; Retrospective Studies ; Thorax

An accidental spill of phenol (100%) into the Nakdong river with subsequent contamination of the tap water for about two million consumers in Teagu city of Korea occurred in March 1991. A historical cohort study of 6,913 individuals was undertaken to determine association with illness. Population subjects were divided into two groups of exposed and unexposed. Exposed subjects were reported to have significantly more phenol associated symptoms than those in a nearby unexposed area (39.6% vs. 9.4%, p < 0.01). Especially, in the related symptoms, highly significant differences were noted in the number of subjects reporting gastrointestinal illness such as nausea, vomiting, diarrhea, or abdominal pain. During the accident, study subjects who experienced peculiar taste or odor in the tap water were significantly more in the exposed areas (92% vs. 34.3%).
*Accidents ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cohort Studies ; Female ; Human ; Infant ; Infant, Newborn ; Male ; Middle Age ; Phenol ; Phenols/*toxicity ; Water Pollutants, Chemical/analysis/*toxicity ; Water Supply/*analysis

BACKGROUND: The hemodynamic effects of an episode of ventricular tachycardia (VT) may vary from mild decrease in blood pressure to sustained hypotension, collapse, and death. Little is known about the factors responsible for these diverse effects. Ventricular function, vasomotor tone, and tachycardia cycle length could be major determinants of variable hemodynamic responses to VT. The site of origin was found to be a factor affecting pulse pressure even in an isolated ventricular premature contraction. However, the role of origin site in hemodynamics of VT is not yet elucidated. The purposes of this study were to evaluate the effects of VT origin site and VT cycle length to their hemodynamic changes. And we also have assessed the role of cardiac autonomic receptor activation in hemodynamic recovery during and immediate after VT. METHODS: In 18 open chest dogs anesthetized with chloralose, bipolar ventricular pacing (VP) was performed using sutured epicardial electrodes at 3 different sites ; left ventricular apex (LVA), right ventricular outflow tract (RVOT), and right ventricular apex (RVA). At each site, VP was repeated for 60 seconds at 3 different rates; 1.75X, 2X, and 2.25X of baseline heart rate (BHR). Mean arterial pressure (MAP), mean left atrial pressure (MLAP) and mean pulmonary artery pressure (MPAP) were monitored during VP. deltaMAP was defined as the difference between the baseline MAP and lowest MAP during VP. deltaMLAP was defined as the difference between highest MLAP during VP and baseline MLAP. Cardiac vagal and beta-adrenoreceptor blockades were achieved by intravenous bolus administration of propranolol (1 mg/kg and then 1 mg/kg/hr) and atropine (0.5 mg/kg and then 0.5 mg/kg/hr). After cardiac autonomic blockade, VP was repeated at 2X of baseline heart rate for 60 seconds at each site. RESULTS: Baseline MAP, MLAP, and MPAP were 101+/-8.1 mmHg, 0.3+/-0.41 mmHg, and 10+/-2.4 mmHg, respectively. At the same pacing site of VP, MAP was decreased significantly with VP and deltaMAP was increased significantly as VP cycle length shortened (all P<0.001). At the same pacing cycle length of VP, deltaMAP was significantly greater at RVA or RVOT than LVA: LVA vs RVOT ; all P<0.001 at 3 different rates, LVA vs RVA ; P<0.05 (1.75X & 2X of BHR), P<0.001 (2.25X of BHR). But there was no significant difference in deltaMAP between RVA and RVOT. At the same pacing site of VP, MLAP and deltaMLAP were increased significantly as VP cycle length shortened (all P<0.01), but at the same cycle length of VP, there was no significant differences in deltaMLAP at 3 different VP sites. Ventricular pacing after autonomic blockade induced a greater increase in deltaMAP and deltaMLAP compared to controls (all P<0.01 at 3 pacing sites). And cardiac autonomic blockade also resulted in significant blunting of recovery of MAP during VP compared to controls. CONCLUSION: Above results showed that pacing cycle length plays a major role in determining the hemodynamic outcomes during ventricular pacing, and that the site of origin could be an independent factor of ventricular tachycardia hemodynamics. And also modulation of tone of the adrenergic nervous system is essentially required for the hemodynamic recovery during ventricular tachycardia.
Animals ; Arterial Pressure ; Atrial Pressure ; Atropine ; Blood Pressure ; Chloralose ; Dogs* ; Electrodes ; Heart Rate ; Hemodynamics* ; Hypotension ; Nervous System ; Propranolol ; Pulmonary Artery ; Tachycardia ; Tachycardia, Ventricular ; Thorax ; Ventricular Function

BACKGROUND: Low dose dobutamine echocardiography has recently been introduced for use in identification of viable myocardium in patients with acute myocardial infarction and prediction of the response of dysfunctioning myocardial segments to coronary angioplasty. The aim of this study was to evaluate wheter tihs test could be used to predict the early response of dysfunctioning myocardial segements to coronary artery bypass grafting(CABG). METHODS: We studied in 23 patients with multi-vessel disease during CABG. Myocardial segments were monitored by intraoperative transesophageal echocardiography(TEE) in the transgastric short-axis view at papillary muscle level. The left ventricle was divided into five segments and sixty eight myocardial segments in 23 patients were analyzed. Percentage of systolic wall thickening(PSWT) was calculated in each segment for three times: at basline(early after pericardiectomy);before bypass during dobutamine infusion(3-5ug/kg/min);and after seperation from cardiopulmonary bypass. Segments showing baseline PSWT >_30% were considered normal and those < 30% were dysfunctional. Segments showing an increase in PSWT >_10% during dobutamine infusion were considered responders and those < 10% nonresponders. RESULTS: AT baseline, 24%(36%) of 68 segments had PSWT > 30%(normal) and 44(68%) had PSWT < 30%(dysfuctioning segments). During dobutamine infusion, 21(47.7%) among 44 dysfunctional segments showed increase in PSWT >_10%(from 12.3+/-7.2% to 33.5+/-11.8%, p<0.01 ; responder segments), and 23(52.3%) showed increase in PSWT < 10%(from 14.7+/-6.5% to 17.4+/-7.4%, p=NS ; nonresponder segments). After CABG, responder segments showed a significant increase in PSWT in comparison with baseline values(from 12.3+/-7.2% to 32.1 +/-11.0%,p<0.01). Segments not responded to dobutamine showed no significant changes in PSWT after CABG(from 14.7+/-6.5% to 16.0+/-8.2%, p=NS). Twenty-four normal segments (PSWT 41.9+/-6.2%) showed a slight but significant reduction in PSWT both during dobutamine infusion(38.7+/-6.9%;p<0.05) and after CABG(38.9+/-6.3%, p<0.05), suggesting that compensatory hyperfunction was present at baseline. Estimation of clinical accruacy of low dose dobutamine TEE yieded to 69% sensitivity, 93.9% specificity, 95.2% positive predictive value, 60.9% negavive predictive value, and 77.3% overall accuracy. In both responders and nonresponders of dysfunctioning segments, there was a correlation between PSWT during dobutamine infusion and that after CABG(r=0.61, r=0.63, respectively). CONCLUSION: Low dose dobutamine TEE test well predicts the early response of dysfunctioning myocardial segments to CABG.
Angioplasty ; Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Vessels* ; Dobutamine* ; Echocardiography* ; Heart Ventricles ; Humans ; Myocardial Infarction ; Myocardium ; Papillary Muscles ; Sensitivity and Specificity