This study was aimed to clarify the effects of systemic kainic acid (KA) administration (10 mg/kg i.p.) on somatostatin containing neurons, and to examine the distribution of somatostain immunoreactive neurons in the cerebral cortex of the rats. Animals were sacrificed at three time points at the two, six, and ten days after the injection of KA. Thirty-six rats were observed by using the free-floating immunohistochemical method (modified ABC method). The results were as follows: 1) In the anterior and posterior cingulate cortex, somatostatin immunoreactive neurons were not observed in 2,6,10days after treatment of KA including control group except Cg 1 showing some somatostatin immunoreactive neurons in 10days and control groups. 2) In the insular cortex, somatostatin immunoreactive neurons also were not observed in any groups except AIV showing few somatostatin immunoreactive neurons in control group. 3) In the perirhinal cortex, few somatostatin immunoreactive neurons were observed in 2 days and 6 days groups. In control group, a number of somatostatin immunoreactive neurons observed. 4) A strong decrease of somatostatin immunoreactive neurons were observed in the frontal, arietal, temporal and occipital cortex 2 days after treatment of KA. Initially decreased somatostatin immunoreactive neurons had recovered to control 10 days after treatment. 5) Distribution of the somatostatin immunoreactive neurons was observed marked difference according to the cortical areas. Somatostatin immunoreactive neurons in isocortex were more increased in number than the allcotex by control study. The changes in somatostatin immunoreactive neurons after systemic treament of KA were marked in 2 days and 6 days, but these had recovered to control 10 days the treatment of KA. It suggested the normalization of the cerebral function 10 days after seizure. According to the cerebral cortex, the different distribution of somatostatin immunoreactive neurons in number was observed.
Animals ; Cerebral Cortex* ; Gyrus Cinguli ; Kainic Acid* ; Neurons* ; Rats* ; Seizures ; Somatostatin*

There are various methods for restoring the dentition of completely edentulous patients. Removable complete dentures have the advantage of being relatively economical, but they can be uncomfortable to wear. With the introduction of implant prosthodontics, various options such as implant-supported overdentures and hybrid prostheses have become available. If there is inadequate remaining ridge or limited financial resources, an overdenture supported by a few implants with additional attachments may be more suitable. In this case, due to severe peri-implantitis and other complications, the implants were removed. Subsequently, four implants (two on each side) were placed in the maxilla and a milledbar with attachment was fabricated for each side of the maxilla.

In human, Human Papilloma Virus(HPV) is associated with benign squamous tumors in a variety of body sites. But the relationship between HPV infection and malignant epithelial lesions is not clear. Esophageal squamous papilloma is relatively rare tumor but it is reported with increasing frequency recently. We reviewed twenty six patients of esophageal papilloma diagnosed by endoscopic biopsy from 1990 to 1994. The results are as follows; The peak age is fifth decade, men and women ratio is 1: 1.2. Most papillomas located in distal esophagus and have no specific symptoms related to papilloma. All case are sessile form and no malignant change in follow up endoscopy.
Biopsy ; Endoscopy ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Male ; Papilloma*

BACKGROUND: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). MATERIAL AND METHOD: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. RESULT: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline I was superior to Guideline II overall in patients with both AVR and MVR/DVR. CONCLUSION: The guideline suggested in this study could be useful when the dosage adjustment of warfarin is necessary in outpatients with mechanical heart valves.
Anticoagulants ; Aortic Valve ; Dose-Response Relationship, Drug ; Food-Drug Interactions ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Humans ; International Normalized Ratio ; Outpatients* ; Retrospective Studies ; Seoul ; Thromboembolism ; Warfarin*

BACKGROUND: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). MATERIAL AND METHOD: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. RESULT: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment (21%), nonadherences to dosing regimen (13%), drug/herbal interactions (12%), changes in diet (7%), and indeterminate cause (42%). Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. CONCLUSION: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy positively whereas younger age and longer duration of warfarin therapy affected negatively.
Anticoagulants ; Blood Coagulation ; Diet ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Humans ; International Normalized Ratio* ; Outpatients* ; Retrospective Studies ; Seoul ; Thromboembolism ; Warfarin

BACKGROUND/AIMS: According to the recent research, mutations in the HBV pre-S region may have an impact on the progression of hepatitis B virus(HBV)-related liver disease. The aim of this study was to clarify the frequency and location of naturally occurring mutations in the pre-S region of HBV, and their possible effects on the clinical course of HBV-associated chronic liver diseases. METHODS: HBV DNA was extracted from the sera of 15 patients (8 with liver cirrhosis and 7 with hepatocellular carcinoma). The pre-S sequence was amplified via polymerase chain reaction, subcloning and sequenced. RESULTS: All patients had point mutations in the pre-S region. Nine of 10 mutation sites (90%) in the pre-S1 region, and 4 of 5 mutation sites (80%) in the pre-S2 region were identical in both liver cirrhosis and hepatocellular carcinoma. Deletions were detected in seven patients (4 with liver cirrhosis and 3 with hepatocellular carcinoma). Among the 4 patients with liver cirrhosis, three had deletion in 5'-end of the pre-S2 region and one spanning the 3'-end of the pre-S1 to 5'-end of the pre-S2 region. All 3 patients with hepatocellular carcinoma had deletions in 5'-end of the pre-S1 region, and two patients had simultaneous deletion spanning the 3'-end of the pre-S1 to the 5'-end of the pre-S2. CONCLUSION: The pre-S mutants were frequently detected in HBV-associated liver cirrhosis or hepatocellular carcinoma and the point mutations or deletions in the pre-S gene were clustered in specific regions.
Carcinoma, Hepatocellular* ; DNA ; Hepatitis B ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Point Mutation ; Polymerase Chain Reaction

BACKGROUND: Long-term maintenance of smoking cessation is important to reduce smoking related diseases. There are few studies that evaluated long-term maintenance and related factors. For effective cessation treatment, we analyzed the relapse pattern after cessation and related factors. METHODS: We selected people who visited a health care center more than two times between January 1995 and December 2006 and who have succeeded in cessation after the first visit. Telephone survey was done and their medical records was analyzed. A total of 308 people whose medical records corresponded to the results of the telephone survey were finally included and analyzed. RESULTS: The mean follow-up duration was 112 months and the mean age of the first visit was 47.9 years. The median maximum duration of abstinence was 5.50 years, and the annual hazard ratio of relapse was about 2.5-4.2% from two to seven years of duration of abstinence. Mean age of smoking onset was 22.9 years, the mean smoking duration was 24.5 years, and the mean smoking amount per a day was 20.0 cigarettes. In single-variate analysis, the total number of cessation success, the age of smoking onset, the mean smoking duration, the mean smoking amount per day, the cessation method, the reason for trying cessation were related with the long-term cessation maintenance. In multivariate analysis, the total number of success for cesstion, the reason for trying cessation, the cessation method, the mean number of cigarettes per day were related. CONCLUSION: The experience of relapse, the motive of cessation and self-willingness were shown to be important for long-term maintenance of smoking cessation.
Delivery of Health Care ; Follow-Up Studies ; Medical Records ; Multivariate Analysis ; Recurrence ; Smoke ; Smoking ; Smoking Cessation ; Telephone ; Tobacco Products

Medullary carcinoma of the thyroid gland(MTC) constitutes approximatesly 3% to 10% of all malignant thyroid tumors. It appears in both familial and sporadic forms. Metastases are frequently present at diagnosis and are resistant to chemotherapy and radiotherapy. Surgical resection of the primary tumor and the metastases is the mainstay of treatment. Although MTC can be detected by elevated serum calcitonin, localization of residual or metastatic foci may be difficult. Many scintigraphic methods have been used for identification of the residual tumor or metastasis. However, most of them have either low sensitivity or low specificity. MTC frequently secretes somatostatin and may express somatostatin receptors. Recently, somatostatin-receptor imaging has been known to be useful for the detection of residual and recurrent medullary thyroid carcinoma. A 25 year-old woman who was dignosed as medullary carcinoma by biopsy of thyroid mass is presented. Thirteen years ago, she underwent left thyroidectomy due to thyroid cancer(MTC). Laboratory tests revealed an increase in the levels in serum CEA(CEA=557.6 ng/ml) and calcitonin(calcitonin= 720 pg/ml). The second patient, a 30 year-old female, complained of a palpable mass in the left anterior neck. Ten years ago, she underwent a right lobectomy of thyroid gland due to adenomatous goiter. Laboratory tests revealed an increase in the levels in serum CEA(CEA=617 ng/ml) and Calcitonin (Calcitonin=2,300 pg/ml). In both cases, pre- and postoperative In-111 pentetreotide scintigraphy were done and compared with "'I scintigraphy. In-111 pentetreotide scan may be useful for the localization of residual or metastatic medullary thyroid carcinoma. Further study is warranted to define the sensitivity and specificity of the technique.
Biopsy ; Calcitonin ; Carcinoma, Medullary ; Diagnosis ; Drug Therapy ; Female ; Goiter ; Humans ; Neck ; Neoplasm Metastasis ; Neoplasm, Residual ; Radionuclide Imaging ; Radiotherapy ; Receptors, Somatostatin ; Sensitivity and Specificity ; Somatostatin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

. The findings indicate that analog facebow transfer produced a linear deviation ranging from 3 to 16 mm and an angular deviation of the occlusal plane between 5 to 7 degrees. This case report confirms that, across two patients, analog facebow transfer can result in varying degrees of positional deviation, thereby potentially leading to inaccuracies in the fabrication of dental pros-theses. These results suggest that, in clinical practice, the use of analog facebow transfer may yield significant deviations during the process of mounting maxillary casts.

An air-compressor system takes atmospheric air, and filters, pressurises and dries it, before delivering it to the pipeline as a medical air. Because the air supplied by the air compressor may be used to wentilate patients or to drive surgical tools, its quality and purity must be carefully controlled. Atmospheric air contains a variable amount of water vapour but always more than is specified for medical air. Water vapour must be removed from medical air since it can damage surgical tools and some ventilators and can condense in low-lying parts of the pipeline system. Reeently we have had experience of pneumothorax by pulmonary barotrauma associated with obstruction of the ventilator exhalational valve. As a result of investigating the possible causes, we concluded the cause as high moisture content in the compressed air due to the malfunctioning air drier and filters. Therefore we submit this case report along with discussion and literature reviews.
Barotrauma ; Compressed Air* ; Humans ; Pneumothorax ; Ventilators, Mechanical* ; Water