A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

Coagulants have been used for a long time to promote the hemostasis during operation. We have carried out the study to see the effect of the thromboplastin preparation. Thrombokinase, on the coagulation mechanism, thrombin time, partial thromboplastin time, Ca++, and operation time and amount of bleeding in the twenty patients undergoing laminectomy or femur fracture operation. The patients were divided into two groups, in the control group(n=10), disllied water 20ml, and in the Thrombokinase group(n=10), 20ml of Thrombokinase(4 amles) was administered intravenously during 5 minutes. The results were as follows: 1) Prothrombin time and partial thromboplastin time were significantly prolonged in the control group compared to the Thrombokinase group(p<0.05). 2) In the Thrombokinase group, the duration of operation was shorter and the amount of blood loss was less than in the control group, but there was no significant statistical difference(p>0.05).3) There was no change in either blood pressure or pulse rate and also no side reaction during or after the Thromobkinase injection.
Blood Coagulation* ; Blood Pressure ; Coagulants ; Factor Xa* ; Femur ; Heart Rate ; Hemorrhage ; Hemostasis ; Humans ; Laminectomy ; Partial Thromboplastin Time ; Prothrombin Time ; Thrombin Time ; Thromboplastin* ; Water

STATEMENT OF PROBLEM: Although zirconium oxide ceramics are more and more commonly used in restorative dentistry, for many clinical applications only limited data can be found in the literature. However, it is quite clear that hydrofluoric acid etching is impossible with zirconia ceramics. Therefore, other bonding techniques are required in order to lute these materials adhesively. PURPOSE: The purpose of this study was to evaluate the effects of surface treatments on shear bond strengths between two resin cements and a zirconia ceramic. MATERIALS AND METHODS: Experimental industrially manufactured yttrium-oxide-partially-stabilized zirconia ceramic discs (Adens, Korea) were used for this study. The ceramic specimens divided into five experimental groups and a control group (as received). Five surface treatments were studied. 1) sandblasting with 110 micrometer Al2O3 at 3 bars pressure 13 seconds at a distance of 10mm, 2) flame-treated with the Silano-Pen for 5 s/cm2, 3) grinding with a diamond bur, 4) sandblasting + Silano-Pen treatment, 5) diamond bur preparation+ Silano-Pen treatment. Acrylic plastic tube (5 mm in height and 3 mm in diameter) were filled with composite to fabricate composite cylinders. The composite cylinders were bonded to the ceramic specimens with either Superbond C & B or Panavia F resin luting agents. All cemented specimens were tested under shear loading until fracture on universal testing machine at a crosshead speed 1mm/min, the maximum load at fracture was recorded. Shear bond strength data were analyzed with oneway analysis of variance and Tukey HSD tests (p<.05). Treated ceramic surfaces and fracture surfaces after shear testing were examined morphologically using scanning electron microscope. Results: Ceramic surface treatment with Silano-Pen after sandblasting improved the bond strength of Superbond C & B resin cement. Superbond CandB resin cement at Silano-Pen after sandblasting(27.4 +/- 3.8 MPa) showed statistically higher shear bond strength than the others. CONCLUSION: Within the limitation of this study, Superbond C & B resin cement are suitable for cementation of zirconia ceramics and flame-treated with the Silano-Pen after sandblasting is required to enhance the bond strength.
Cementation ; Ceramics* ; Dental Cements ; Dental Instruments ; Dentistry ; Hydrofluoric Acid ; Plastics ; Resin Cements* ; Zirconium

OBJECTIVES: This study is intended to evaluate the effects of promotion of periodontal health in the elderly, through professional toothbrushing and education on the use of the interdental brush, using the Gingival Bleeding Index and the Patient Hygiene Performance Index (PHP index). METHODS: The study was conducted on 87 participants, who had given the informed consent to participate in the study at a general hospital 'B' in Busan from June to August, 2011. After assessing the general health condition and the medical history of the participants, the Watanabe toothbrushing method was used for professional toothbrushing on four different visits, along with imparting of education on the use of the interdental brush for self-management. The periodontal health of the participants was assessed based on the extent of gingival bleeding, by using the Gingival Bleeding Index, and the degree of plaque accumulation, by using the Patient Hygiene Performance Index. The data thus obtained was analyzed using Statistical Analysis Systems (SAS) (ver 9.13), followed by frequency analysis, analysis of variance (ANOVA), and the mixed effect model. RESULTS: The average gingival bleeding index was 1.65 at the commencement of the study and 1.25, 0.88, and 0.65, after the first, second and third trial, respectively. The PHP index of dental plaque was 2.90 prior to commencement of the study, 2.79, 2.77, and 2.76 after the first, second, and third trials, respectively, thus significantly improving with every successive visit. Gingival bleeding index and PHP index significantly reduced with every visit, regardless of age, smoking habits, or systemic chronic diseases such as diabetes, hypertension, central nervous system or cardiovascular diseases. CONCLUSIONS: Education on the use of the interdental brush and professional tooth brushing promotes periodontal health, regardless of the chronic diseases seen in the elderly. Education on self-management of oral health, along with professional care at regular intervals should be recommended to effectively maintain periodontal health in the elderly.
Aged ; Central Nervous System ; Chronic Disease ; Dental Plaque ; Hemorrhage ; Hospitals, General ; Humans ; Hygiene ; Hypertension ; Informed Consent ; Oral Health ; Self Care ; Smoke ; Smoking ; Tooth ; Toothbrushing

Myoepithelial carcinoma is a rare malignant tumor of the salivary glands with an incidence of less than 1%. Most cases arise in the parotid gland but have also been described in the submandibular gland and in the minor salivary glands. Myoepithelial carcinoma shows almost exclusively tumor cells with myoepithelial differentiation, although epithelial-myoepithelial carcinoma is characterized by a biphasic cell population represented by myoepithelial and ductal epithelial cells. Although myoepithelial carcinoma arising in the maxillary sinus has been reported, there is no report of myoepithelial carcinoma that has originated from inferior turbinate. We report, with a review of literature, a 72-year-old female patient diagnosed as myoepithelial carcinoma that has originated from the inferior turbinate of left nasal cavity.
Aged ; Epithelial Cells ; Female ; Humans ; Incidence ; Maxillary Sinus ; Myoepithelioma ; Nasal Cavity ; Parotid Gland ; Salivary Glands ; Salivary Glands, Minor ; Submandibular Gland ; Turbinates

PURPOSE: The study was done to examine undergraduate student' suicidal ideation and to identify influences of individual characteristics including psychological resilience and self-control on suicidal ideation. METHODS: Data were collected from 400 students in 11 universities in D city from May 1 to June 30, 2011. Data were analyzed with t-test, one-way ANOVA and Pearson' correlation using SPSS 19.0. RESULTS: Of the students, 11.3% reported suicidal ideation levels higher than average. Woman students and those with high career anxiety, perceived poor health condition and bad relationships showed higher points on suicidal ideation. Suicidal ideation was also negatively correlated with psychological resilience and self-control. CONCLUSION: Over 10.0% of students need careful attention on suicidal ideation, especially counselling service related to suicide prevention for students with poor health, high career anxiety, and bad relationships. Various programs should be developed to promote psychological resilience to improve health and relationships, as well as job guidance for students. It is also suggested the students' experiences be examined to determine how they overcame suicidal ideation.
Anxiety ; Female ; Humans ; Resilience, Psychological* ; Suicidal Ideation* ; Suicide

OBJECTIVE: The aim of this study was to investigate the effects of intravenous magnesium sulfate on the prevention of pain during the injection of microemulsion propofol. Magnesium is a known calcium channel blocker and a physiological N-methyl-D-aspartate receptor antagonist. METHODS: American Society of Anesthesiologists I and II adults (n=114) undergoing general anesthesia for surgery were randomly assigned into two groups (n=57 per group). This study was designed in prospective and double-blind manner. Patients in the LM group (n=57) received pretreatment with 2% lidocaine (40 mg) and magnesium sulfate 10 mg/kg, while patients in group L (n=57) received pretreatment with 2% lidocaine (40 mg) and normal saline (2 mL) accompanied by venous occlusion. Induction with microemulsion propofol (Aquafol) 2 mg/kg was accomplished following the release of venous occlusion. Pain intensity was assessed on a four-point scale according to patient movement (grade 0, no movement; grade 1, movement in wrist only; grade 2, movement in the upper arm & shoulder of injected arm; grade 3, generalized movement). Systolic blood pressure, diastolic blood pressure, and heart rate were evaluated. RESULTS: A significant difference in pain intensity following injection of microemulsion propofol between the groups was found (P<0.05). In addition, the incidence of hypertension after injection was lower in the LM group than in the L group (P<0.05). CONCLUSION: The combination of magnesium and lidocaine are effective in attenuating the pain induced by microemulsion propofol injection when compared with lidocaine alone.
Adult ; Anesthesia, General ; Arm ; Blood Pressure ; Calcium Channels ; Heart Rate ; Humans ; Hypertension ; Incidence ; Lidocaine ; Magnesium Sulfate* ; Magnesium* ; N-Methylaspartate ; Propofol* ; Prospective Studies ; Shoulder ; Wrist

The HACEK group of microorganisms is responsible for approximately 3-6% of endocarditis cases and is a major cause of culture-negative endocarditis. Here, we report a case of Haemophilus parainfluenzae infective endocarditis that was diagnosed by direct PCR sequencing of 16S rRNA from resected vegetation. A healthy 26-yr-old man was admitted to the emergency room (ER) on March 27, 2011 because of intermittent high fever. The patient was prescribed cefpodoxime for 5 days at the ER. Six and 11 sets of blood cultures were performed at the ER and in a general ward, respectively, using BACTEC Plus Aerobic/F (Becton-Dickinson, USA) and Lytic Anaerobic/F Plus (BD) together. Echocardiography revealed a large vegetation at the posterior mitral valve leaflet. After performing mitral valvoplasty on hospital day (HD) 11, the vegetation tissue was cultured in thioglycolate broth, blood agar, Brucella agar, and MacConkey agar for 7 days, but no organism was grown. Direct PCR sequencing of 16S rRNA of the tissue revealed the presence of H. parainfluenzae. In the 17 sets of blood cultures, bacterial growth was detected in only 2 aerobic bottles of 5 sets taken at HD 9 after 10-day and 14-day incubation. The organism was identified as H. parainfluenzae by using the VITEK NHI card (bioMerieux, France). Direct PCR sequencing of vegetation could be useful in diagnosing bacterial pathogens in infective endocarditis patients, especially in culture-negative cases.
Agar ; Brucella ; Ceftizoxime ; Echocardiography ; Emergencies ; Endocarditis ; Fever ; Haemophilus ; Haemophilus parainfluenzae ; Humans ; Mitral Valve ; Paramyxoviridae Infections ; Patients' Rooms ; Polymerase Chain Reaction ; Sequence Analysis, RNA

PURPOSE: To investigate the correlations between parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and prognostic factors in rectal cancer. MATERIALS AND METHODS: We studied 29 patients with rectal cancer who underwent gadolinium contrast-enhanced, T1-weighted DCE-MRI with a three Tesla scanner prior to surgery. Signal intensity on DCE-MRI was independently measured by two observers to examine reproducibility. A time-signal intensity curve was generated, from which four semiquantitative parameters were calculated: steepest slope (SLP), time to peak (Tp), relative enhancement during a rapid rise (Erise), and maximal enhancement (Emax). Morphologic prognostic factors including T stage, N stage, and histologic grade were identified. Tumor angiogenesis was evaluated in terms of microvessel count (MVC) and microvessel area (MVA) by morphometric study. As molecular factors, the mutation status of the K-ras oncogene and microsatellite instability were assessed. DCE-MRI parameters were correlated with each prognostic factor using bivariate correlation analysis. A p-value of <0.05 was considered significant. RESULTS: Erise was significantly correlated with N stage (r=-0.387 and -0.393, respectively, for two independent data), and Tp was significantly correlated with histologic grade (r=0.466 and 0.489, respectively). MVA was significantly correlated with SLP (r=-0.532 and -0.535, respectively) and Erise (r=-0.511 and -0.446, respectively). MVC was significantly correlated with Emax (r=-0.435 and -0.386, respectively). No significant correlations were found between DCE-MRI parameters and T stage, K-ras mutation, or microsatellite instability. CONCLUSION: DCE-MRI may provide useful prognostic information in terms of histologic differentiation and angiogenesis in rectal cancer.
Adult ; Aged ; Aged, 80 and over ; Cell Differentiation ; Contrast Media/*pharmacology ; DNA Mutational Analysis ; Female ; Gadolinium/pharmacology ; Genes, ras ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Microcirculation ; Microsatellite Instability ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; Prognosis ; Rectal Neoplasms/*diagnosis/genetics/*pathology ; Retrospective Studies ; Time Factors