Rapid crestal bone resorption following maxillary tooth loss is further accentuated in the posterior regions because of pneumatization and enlargement of the maxillary sinuses. A treatment rationale that allows preservation and augmentation of vertical available bone at the time of posterior maxillary tooth extraction may offer numerous therapeutic benefits which are more short courses of therapy and no needs of additional surgical augmentation. The present study comprised 3 patients who had 4 posterior maxillary teeth with no evident bone between the tooth apex and sinus floor, as estimated through preoperative radiographic analysis. Sinus floor augmentation at the time of tooth extraction was chosen for the ltreatment of these patients. After the tooth was carefully extracted, the empty alveolus was thoroughly debrided and a trephine approach was performed. Particulated autogenous bone was gently pushed beyond the empty alveolus to elevate the sinus membrane using an osteotome. The distance between bone crest and sinus floor was radiographically estimated 4 months after the first procedure. Another procedure was then carried out to place the implants of 11 mm length without another augmentation procedure. All implant were clinically stable, with no sign of infection. The presented surgical procedure performed at the time of extraction of posterior maxillary teeth in close proximity to the sinus floor allowed placement of implants of proper length.
Bone Resorption ; Humans ; Maxillary Sinus ; Membranes ; Sinus Floor Augmentation* ; Tooth Apex ; Tooth Extraction ; Tooth Loss ; Tooth*

OBJECTIVE: To estimate the long-term skeletal responses to hormone replacement therapy(HRT) with or without active vitamin D(VD) by using short-term changes of bone markers in postmenopausal women (PMW). METHODS: Biochemical markers of bone formation(osteocalcin,OC) and (&) resorption(deoxypyridinoline, Dpd ) at 3 months & lumbar bone mineral density(BMD) at 1 year were measured in 64 natural PMW taking HRT(n=41) & HRT with calcitriol 0.25 microgram/day(n=23). The correlation of percent changes of bone markers after 3 months of Tx with those in lumbar BMD after 1 year was evaluated. RESULTS: 1. serum-OC & urine-Dpd showed decrease of 20.9% & 30.1% at 3months respectively & BMD increase of 3.8% after 1 year of Tx. 2. Among 58 PMW with decreased u-Dpd change, 49 (84.5%) revealed increase in BMD, while 40 (81.6%) among 49 PMW with decreased serum-OC change showed increased BMD. 3. Bone gainers showed significant decrease in changes of serum-OC(18.1% vs 9.2% p<0.05) & urine-Dpd(32.6% vs 20.4%, p<0.05) compared with those of bone losers. 4. No correlations of change of serum-OC (r=-0.174 p>0.05) & urine-Dpd (r=-0.091 p>0.05) at 3month with BMD changes at 1year were seen in total PMW, but urine-Dpd changes in HRT without active VD group revealed significantly inverse correlation(r=-0.376 p<0.05). CONCLUSION: Short-term changes of bone markers did not precisely predict the long-term changes of BMD in total PMW except urine- Dpd in HRT without active VD.
Biomarkers ; Bone Density* ; Calcitriol ; Estrogen Replacement Therapy* ; Female ; Humans ; Osteocalcin ; Vitamin D* ; Vitamins*

No abstract available.
Duodenal Ulcer* ; Mandibular Fractures*

OBJECTIVE: This study had three objectives: 1) to investigate the rehabilitation professionals' way of thinking on physical, psychological and social characteristics of older patients: 2) to assess their actual knowledge level about aging; and, 3) to deduce and analyze the influences that cause these different kinds of perceptions and attitudes. METHOD: Total 239 rehabilitation professionals (including rehabilitation doctors, nurses, physical therapists, occupational therapists, speech therapists, social workers, psychologists, prosthetists & orthotists) responded to our questionnaire were included in this study. Self-addressed questionnaires were composed of two categories: 1) the perception of older patients compared with younger patients: and 2) the actual knowledge level about aging. RESULTS: 1) There were significant (p<0.05) differences by job classification on a speculative disposition with the physical characteristics, motive of treatment, emotional characteristics, and discharge problem of older patients. 2) There were also significant (p<0.05) differences by job classification in the actual knowledge level about aging by job classification. A higher score on the questionnaire correlated with a more optimistic view of the motive of treatment, emotional characteristic and discharge problem. CONCLUSION: Many rehabilitation professionals have a misconceptions about older patients due to insufficient knowledge on aging. Therefore we propose an objective understanding of older patients along with proper education on aging to provide an effective rehabilitation treatment.
Aging* ; Classification ; Education ; Humans ; Physical Therapists ; Psychology ; Surveys and Questionnaires ; Rehabilitation* ; Social Workers ; Sociology ; Thinking

PURPOSE: To evaluate the portal venous anatomy in the right lobe of the liver, focusing particularly on the location and size of the anterior and posterior segmental branches of the portal vein and the relationship of the right subdiaphragmatic peripheral portal vein to the right hepatic vein. MATERIALS AND METHODS: From June 1995 to December 1995, 100 spiral CT scan which showed no abnormal findings in the hepatic area were retrospectively analysed. Portal dominant phase images were obtained after the administration of contrast media, with a delay of 60-65 seconds (100 - 120ml, 2-3ml/sec injection rate), slice thickness 10 mm and table speed 10mm/sec. On spiral CT scans, we assessed the location and size of the right portal vein and its branches and also observed the relationship of this vein to the right hepatic vein. RESULTS: In all patients, the right portal trunk divided into anterior and posterior branches. The anterior segmental portal vein was located cephalad to the posterior segment in 81 cases (81%), at the same level in 17 (17%), and caudad in two (2%). Its diameter was greater (>2mm)than that of its posterior segment in 33 cases (33%), smaller in three (3%), and similar in 64 (64%). In 95 cases, the right anterior segmetal portal vein which was directed posteriorly, supplied the subdiaphragmatic portion of segment 7. CONCLUSION: In 81% of cases, the position of the anterior segmental portal vein cephalad, and in 64%of cases it was similar in size to the posterior portal vein. In almost all cases, the subdiaphragmatic portion of segment 7 was supplied by the portal vein from segment 8. Therefore, the right hepatic vein is not in all cases an adequate landmark for dividing Couinaud segments 7 and 8 in the subdiaphragmatic portion.
Contrast Media ; Hepatic Veins ; Humans ; Liver* ; Portal Vein ; Retrospective Studies ; Tomography, Spiral Computed ; Veins

PURPOSE: To evaluate the portal venous anatomy in the right lobe of the liver, focusing particularly on the location and size of the anterior and posterior segmental branches of the portal vein and the relationship of the right subdiaphragmatic peripheral portal vein to the right hepatic vein. MATERIALS AND METHODS: From June 1995 to December 1995, 100 spiral CT scan which showed no abnormal findings in the hepatic area were retrospectively analysed. Portal dominant phase images were obtained after the administration of contrast media, with a delay of 60-65 seconds (100 - 120ml, 2-3ml/sec injection rate), slice thickness 10 mm and table speed 10mm/sec. On spiral CT scans, we assessed the location and size of the right portal vein and its branches and also observed the relationship of this vein to the right hepatic vein. RESULTS: In all patients, the right portal trunk divided into anterior and posterior branches. The anterior segmental portal vein was located cephalad to the posterior segment in 81 cases (81%), at the same level in 17 (17%), and caudad in two (2%). Its diameter was greater (>2mm)than that of its posterior segment in 33 cases (33%), smaller in three (3%), and similar in 64 (64%). In 95 cases, the right anterior segmetal portal vein which was directed posteriorly, supplied the subdiaphragmatic portion of segment 7. CONCLUSION: In 81% of cases, the position of the anterior segmental portal vein cephalad, and in 64%of cases it was similar in size to the posterior portal vein. In almost all cases, the subdiaphragmatic portion of segment 7 was supplied by the portal vein from segment 8. Therefore, the right hepatic vein is not in all cases an adequate landmark for dividing Couinaud segments 7 and 8 in the subdiaphragmatic portion.
Contrast Media ; Hepatic Veins ; Humans ; Liver* ; Portal Vein ; Retrospective Studies ; Tomography, Spiral Computed ; Veins

PURPOSE: To determine by quantitative evaluation of pancreatic and adjacent vascular enhancement during spiral CT, the ideal scan delay for examination of the pancreas. MATERIALS AND METHODS: Dual (n=90) and triple (n=90) phase spiral CT scans of patients whose pancreas showed no pathologic condition were retrospectively evaluated. Dual-phase scans were performed at 43 seconds (early), and 5-6 minutes (delayed) after the injection of 120ml of contrast material at an injection rate of 3ml/sec ; triple-phase scans were performed at 25 seconds (arterial), 60-65 seconds (portal) and 5-6 minutes (delayed) after the injection of 120-140ml of contrast material at an injection rate of 2-4ml/sec, and ten patients also underwent precontrast scanning. CT attenuation values (HU) were measured in the head, body and tail of the pancreas, aorta, and main portal vein during each phase of all scans. Triple-phase protocol was used to measure the effect of different total volumes and injection rates on enhancement of the pancreas and adjacent vessels. RESULTS: There was no significant difference in the degree of enhancement of the pancreas head, body and tail during each phase (p>0.05). The pancreas was maximally enhanced on 43 second delayed scan (132+/-20 HU)(p<0.05), and the aorta, on 25-second delayed scan (269+/-74 HU), but there was no significant difference between this enhancement and that seen at 43 seconds(p>0.05). The main portal vein showed maximum enhancement on 43-second delayed scan (207+/-44 HU)(p<0.05). Different total volume of contrast material did not change the enhancement of the pancreas and adjacent vessels. At an injection rate of 2ml/sec, peak enhancement of the pancreas, aorta and portal vein was obtained on 60-65 second delayed scan, and at 4ml/sec, peak enhancement was obtained on 25 second delayed scan(p<0.05). CONCLUSION: Observing the usual protocols for abdominal spiral CT scanning, the pancreas was most effectively evaluated using a 43-second delayed scan. An increased injection rate resulted in earlier enhancement of the pancreas, aorta and portal vein.
Aorta ; Evaluation Studies as Topic* ; Head ; Humans ; Pancreas* ; Portal Vein ; Retrospective Studies ; Tomography, Spiral Computed*

No abstract available.
Joints*

OBJECTIVE: To determine whether a routine ultrasonography (US) is necessary for diagnosis of developmental dysplasia of hip (DDH), presenting with congenital muscular torticollis (CMT). METHODS: Cases of 133 patients (81 males, 52 females) diagnosed as CMT were reviewed, retrospectively. We reviewed the medical charts and diagnostic examination. We also assessed the coincidence of CMT and DDH, and investigated the clinical features of CMT related to DDH. RESULTS: Twenty (15.0%) patients out of 133 CMT patients were diagnosed as having DDH by US. Of whom, 8 patients were radiographically positive and 4 patients were both clinically and radiographically positive. Nine patients were treated with a harness and 1 of them needed closed reduction and casting. Out of 9 patients treated with a harness, only 4 were clinically positive. The difference and ratio of the sternocleidomastoid (SCM) muscle thickness between the normal and abnormal side was significantly greater in DDH patients (p=0.014). Further, receiver operating characteristic analysis showed when the SCM ratio is greater than 2.08 and the SCM difference is greater than 6.1 mm, the efficiency of US for the diagnosis of the DDH was found to be the best (p<0.05). CONCLUSION: To evaluate DDH, physical examination showed low sensitivity and radiologic study has limitation for the child before 4 to 6 months of age. Therefore, we recommend that hip is screened by US for the diagnosis of DDH associated with CMT when physical examination is positive or CMT patients with large SCM difference and high SCM ratio.
Child ; Hip ; Hip Joint ; Humans ; Male ; Muscles ; Physical Examination ; Retrospective Studies ; ROC Curve ; Torticollis

Pneumonia is one of important complications after allogeneic bone marrow transplantation (BMT). It is essential to disclose the cause of pneumonia because the treatment depends on the cause. The cause of pneumonia which BMT recipients develop can be infectious as well as noninfectious in origin. Acute eosinophilic pneumonia is a very rare cause of noninfectious pneumonia after BMT. We here report a 42-year-old woman with acute myelogenous leukemia (AML, M4) who developed acute eosinophilic pneumonia on 160 days after unrelated BMT. She was diagnosed by bronchoalveolar lavage and was dramatically improved after steroid treatment.
Adult ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchoalveolar Lavage ; Eosinophils* ; Female ; Humans ; Leukemia, Myeloid, Acute ; Pneumonia ; Pulmonary Eosinophilia*