No abstract available.
Centric Relation* ; Tooth Wear*

PURPOSE: Gastric variceal bleeding in cirrhotic patient is an emergent, life threatening disease of which the adequate treatment is still in dispute. The periesophagogastric devascularization (PD) would be the alternative operative procedure. The aim of this study is to evaluate the safety and long-term results of PD for the gastric fundal variceal bleeding. METHODS: A retrospective analysis was made of fifty-two patients with gastric variceal bleeding who underwent PD with or without fundectomy from August 1994 to March 2006. We evaluated the clinical characteristics, operative morbidity, mortality and long-term follow up results. RESULTS: The operative morbidity was 34.9% and overall mortality was 17.3%. The Child-Pugh classification at operation, the number of previous varix bleeding episode, the success of preoperative intervention, splenectomy, esophageal transection, and ongoing bleeding at operation had a significant effect on postoperative mortality. Most common cause of postoperative death was hepatic failure. Child-Pugh classification and esophageal transection were significant risk factor for postoperative mortality comparing before and after year 2001. During the mean follow-up period of 33.58+/-27.08 months, there was no recurrent bleeding from gastric varices. The cumulative 5-year survival rate was 64.1%. 0f 14 patients deceased, 6 patients died of hepatocellular carcinoma. Not only there was no death caused by recurrent variceal bleeding, but there was no recurrent gastric variceal bleeding. Hepatic functional reserve and concomitant hepatocellular carcinoma were the most important prognostic factors in the long term survival by multiple regression analysis. CONCLUSION: We concluded that PD reached both low postoperative mortality and recurrent bleeding rate with good long-term survival. So it could be one of the most effective treatment for the gastric fundal variceal bleeding.
Carcinoma, Hepatocellular ; Classification ; Dissent and Disputes ; Esophageal and Gastric Varices* ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver Cirrhosis ; Liver Failure ; Mortality ; Retrospective Studies ; Risk Factors ; Splenectomy ; Surgical Procedures, Operative ; Survival Rate ; Varicose Veins

BACKGROUND AND OBJECTIVES: 'Partial deafness' characterized by normal or slightly impaired hearing in the low frequency band and nearly total deafness in the high frequency range, is difficult to assess with conventional behavioral tests in infants and young children. Therefore, this study aimed to assess the usefulness of objective hearing tests, such as auditory brainstem response (ABR) and auditory steady state response (ASSR) in evaluating patients with partial deafness. SUBJECTS AND METHOD: One hundred thirty three patients who underwent ASSR in Ajou University Hospital from January 2008 to January 2013 were enrolled to this study. Correlations between ASSR, ABR and pure tone audiometry (PTA) thresholds were analyzed. RESULTS: ASSR thresholds of 133 patients were highly correlated with both ABR and PTA thresholds in majority of the tested frequencies. Partial deafness was detected in 9 out of 133 patients, based on the results of PTA and ASSR. ASSR thresholds of patients with partial deafness were significantly correlated with PTA thresholds in all frequencies, with especially high correlation found at 1 and 4 kHz. However, there was no significant correlation between ASSR and ABR thresholds. ABR thresholds of partial deafness patients were measured at 65 dB in one patient, 70-90 dB in 3 patients, and no response at 90 dB in 5 patients, respectively. In 8 (6%) out of 124 patients, ABR thresholds were measurable with profound hearing loss and residual hearing was observed at low frequencies. CONCLUSION: ASSR is useful for predicting residual hearing at low frequencies of infants and young children for whom assessment of hearing is difficult using conventional behavioral tests.
Audiometry ; Child ; Deafness* ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Hearing Tests* ; Hearing* ; Humans ; Infant ; Mass Screening*

PURPOSE: A telomerase reverse transcriptase (TERT) promoter mutation was identified in thyroid cancer. This TERT promoter mutation is thought to be a prognostic molecular marker, because its association with tumor aggressiveness, persistence/recurrence, and disease-specific mortality in papillary thyroid carcinoma (PTC) has been reported. In this study, we attempted to determine whether the impact of the TERT promoter mutation on PTC persistence/recurrence is independent of clinicopathological parameters. MATERIALS AND METHODS: Using propensity score matching, 39 patients with PTC persistence or recurrence were matched with 35 patients without persistence or recurrence, with a similar age, sex, tumor size, multifocality, bilaterality, extrathyroidal extension, and lymph node metastasis. The TERT promoter and the BRAF V600E mutations were identified from PTC samples. RESULTS: The TERT promoter mutation was detected in 18% of PTC patients (13/74). No significant difference in the frequency of the TERT promoter mutation was observed between the persistence/recurrence group and the non-recurrence group. CONCLUSION: These results suggest that the prognostic implications of the TERT promoter mutation are dependent on clinicopathological parameters.
Humans ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Propensity Score ; Recurrence ; Telomerase ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: To investigate the efficacy of botulinum toxin type A chemodenervation in various types of esotropia(ET). METHODS: Enrolled eleven esotropic patients treated with botulinum toxin type A and examined the amount of esotropic correction and success rate of less than 10 PD (prism diopter) of postinjection deviation at 5 months after injection. RESULTS: Among the eleven esotropic patients, there were 7 cases of infantile ET, 2 cases of partially accommodative ET and 2 cases of basic ET. The mean preinjection deviation was 30.5 +/- 7.3 PD. The amount of correction was 17.7 +/- 4.3 PD and correction rate of deviation was 57.5%. In 6 of 11 cases, the postinjection deviation was within 10 PD and therefore success rate was 54.5%. In 5 patients (45.5%), their ET was undercorrected. In patients with under 20 PD of preinjection deviation, success rate was 75% (3/4) and those with over 20PD, the rate was 42.9% (3/7). In partially accommodative ET, 2 (100%) of 2 cases were aligned within 10PD. CONCLUSIONS: In comitant ET, botulinum toxin chemodenervation shows high undercorrection rate. The effects of botulinum toxin type A chemodenervation were better for relatively small angle and in partially accommodative ET than nonaccommodative one. But further study with more cases is needed.
Botulinum Toxins* ; Botulinum Toxins, Type A* ; Esotropia* ; Humans ; Nerve Block

Diabetic nephropathy is a common and serious complication in diabetic patients. Renal diseases other than diabetic nephropathy (non-diabetic nephropathy) can occur in diabetic patients with nephrosis. The presence of non-diabetic nephropathy is noted in type 2 diabetes patients, but no data exists for type 1 diabetes. In this report we describe the case of a 15-year-old girl with type 1 diabetes mellitus, who presented with an acute elevation of urinary microalbumin excretion, general edema, and liver enzyme elevation. She had shown microalbuminuria about 3 years earlier, as well as an uncontrolled hemoglobin A1c level, but she had no diabetic retinopathy and neuropathy. A renal biopsy was conducted, and she was diagnosed with primary focal segmental glomerulosclerosis. She was treated with corticosteroids and an angiotensin converting enzyme inhibitor.
Adolescent ; Adrenal Cortex Hormones ; Biopsy ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies ; Diabetic Retinopathy ; Edema ; Glomerulosclerosis, Focal Segmental ; Hemoglobins ; Humans ; Liver ; Nephrosis ; Peptidyl-Dipeptidase A

OBJECTIVE: The aim of this study was to investigate whether single nucleotide polymorphisms (SNPs) of dopamine receptor D2 (DRD2) are associated with schizophrenia in Korean population. METHODS: Four SNPs (rs4648317, rs7131056, rs4936270, and rs1076562) of DRD2 were selected and genotyped by direct sequencing in 197 schizophrenia patients and 370 control subjects. SNPAnalyzer, SNPStats, and Haploview version 4.2 programs were performed to analyze the genetic data. Multiple logistic regression models (codominant1, codominant2, dominant, recessive, overdominant, and log-additive) were used to evaluate the odds ratios (ORs), 95% confidence intervals (CIs), and p values. For multiple testing, p values (pc) were re-evaluated by Bonferroni's correction. RESULTS: The genotype frequency of DRD2 rs4936270 SNP was associated with the development of schizophrenia (p=0.0007, OR=1.71, 95% CI=1.16-2.52 in the codominant1 model; p=0.011, OR=1.63, 95% CI=1.12-2.37 in the dominant model; p=0.035, OR=1.41, 95% CI=1.03-1.95 in the log-additive model). The allele frequency of rs4936270 was also associated with the development of schizophrenia (p=0.024, OR=1.45, 95% CI=1.05-1.98). After Bonferroni's correction, the genotype distribution of rs4936270 was still related to the development of schizophrenia (pc=0.0028 in the codominant1 model; pc=0.044 in the dominant model). A linkage disequilibrium block consisted of rs4648317, rs7131056, and rs4936270. The CAT haplotype frequency was different between schizophrenia and controls (p=0.039). CONCLUSION: These results suggest that DRD2 SNPs may be associated with the development of schizophrenia in Korean population.
Animals ; Cats ; Dopamine ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Linkage Disequilibrium ; Logistic Models ; Odds Ratio ; Polymorphism, Single Nucleotide ; Receptors, Dopamine ; Schizophrenia

Lymphangioleiomyomatosis (LAM) is discovered mainly in the pulmonary area, and the typical presenting symptoms include progressive dyspnea, pneumothorax, and chylous pleural effusion. An initial presentation of LAM with extrapulmonary symptoms is extremely rare. Most reports and reviews have concentrated on the pulmonary symptoms and radiological image of LAM. Some of reports focused on the abdominal abnormalities or retroperitoneal abnormalities in addition to pulmonary features. However, LAM without pulmonary features is extremely rare. We encountered a 36-year-old woman with a retroperitoneal mass measuring 7 cm in the anterior aspect of the right adrenal gland. The patient did not have any pulmonary symptoms or radiological abnormalities, and underwent a laparoscopic excision. The tumor was diagnosed histologically as a lymphangioleiomyomatosis. LAM without pulmonary feature is unusual case. We report this case with a review of the relevant literature.
Adrenal Glands ; Adult ; Dyspnea ; Female ; Humans ; Laparoscopy ; Lymphangioleiomyomatosis* ; Pleural Effusion ; Pneumothorax

PURPOSE: To compare the sensitivity and staging accuracy of dynamically enhanced MR imaging(hereafter, DEI)and turbo spin-echo(TSE) T2-weighted imaging(hereafter, T2WI) in cases of cervical carcinoma. MATERIALS AND METHODS: MR images(T2WI and DEI) of 25 cervical carcinoma patients, diagnosed during surgery, were reviewed by tworadiologists. T2WI employed the TSE technique; dynamic MR imaging, the FLASH technique in the axial plane. DEimages were obtained immediately and at 30, 60, 120, and 180 seconds after rapid injection of Gd-DTPA. The degreeof visualization of the tumor, and its invasiveness, were graded as good, fair, or poor. By correlating thehistopathologic results, the accuracy of the two MR imaging techniques was compared. RESULTS: For tumorvisualization, T2WI was good in 13/25 cases (52%), fair in 3/25(12%), and poor in 9/25(36%); DEI was good in5/25(20%), fair in 7/25(28%), and poor in 13/25 cases (52%). CONCLUSION: For the detection and staging of cervicalcarcinoma, T2WI is superior to DEI. For the diagnosis and staging of cervical carcinoma, DEI is thereforeunnecessary.
Diagnosis* ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging* ; Uterine Cervical Neoplasms*

OBJECTIVE: To assess the diagnostic performance of MR arthrography in the diagnosis of the various types of partial-thickness rotator cuff tears by comparing the MR imaging findings with the arthroscopic findings. MATERIALS AND METHODS: The series of MR arthrography studies included 202 patients consisting of 100 patients with partial-thickness rotator cuff tears proved by arthroscopy and a control group of 102 patients with arthroscopically intact rotator cuffs, which were reviewed in random order. At arthroscopy, 54 articular-sided, 26 bursal-sided, 20 both articular- and bursal-sided partial-thickness tears were diagnosed. The MR arthrographies were analyzed by two radiologists for articular-sided tears, bursal-sided tears, and both articular- and bursal-sided tears of the rotator cuff. The sensitivity and specificity of each type of partial-thickness tears were determined. Kappa statistics was calculated to determine the inter- and intra-observer agreement of the diagnosis of partial-thickness rotator cuff tears. RESULTS: The sensitivity and specificity of the various types of rotator cuff tears were 85% and 90%, respectively for articular-sided tears, 62% and 95% for bursal-sided tears, as well as 45% and 99% for both articular- and bursal-sided tears. False-negative assessments were primarily observed in the diagnosis of bursal-sided tears. Conversely, both articular- and bursal-sided tears were overestimated as full-thickness tears. Inter-observer agreement was excellent for the diagnosis of articular-sided tears (k = 0.70), moderate (k = 0.59) for bursal-sided tears, and fair (k = 0.34) for both articular- and bursal-sided tears, respectively. Intra-observer agreement for the interpretation of articular- and bursal-sided tears was excellent and good, respectively, whereas intra-observer agreement for both articular- and bursal-sided tears was moderate. CONCLUSION: MR arthrography is a useful diagnostic tool for partial-thickness rotator cuff tears, but has limitations in that it has low sensitivity in bursal- and both articular- and bursal-sided tears. In addition, it shows only fair inter-observer agreement when it comes to predicting both articular- and bursal-sided tears.
*Arthroscopy ; Chi-Square Distribution ; Contrast Media/diagnostic use ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Image Interpretation, Computer-Assisted ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Predictive Value of Tests ; Rotator Cuff/*injuries ; Sensitivity and Specificity