PURPOSE: The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. MATERIALS AND METHODS: A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. RESULTS: In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age 65 +/- 10.58 years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P<.05). No significant differences were found in relation to the following factors: gender, diameter and bone quality (P>.05). CONCLUSION: Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival.
Dental Implants ; Dental Records ; Hospitals, Veterans ; Humans ; Kaplan-Meier Estimate ; Male ; Prognosis ; Prostheses and Implants ; Retrospective Studies ; Survival Rate

Abdominal compartment syndrome (ACS) involves adverse physiologic consequences arising from the increased intra-abdominal pressure, leading to high mortality. However, this syndrome has been scarcely reported in pediatric emergency settings. We describe a 10-year-old boy with ACS presenting with painful abdominal distension, oliguria, and dyspnea. Despite the absence of known congenital anomalies, he had undergone frequent episodes of constipation since 5 years of age, and had not defecated for recent 2 months. With computed tomography scans showing the entire colorectal distension, his manifestations were considered to have stemmed from congenital aganglionic megacolon, which had gone undetected. This case underlines the needs for considering ACS and consequent surgical decompression in a child with severe abdominal distension.

BACKGROUND: Abdominal pain is one of the most common complaints in the emergency department and the evaluation presents an extraordinary challenge to the emergency physician's skill. C-reactive protein, an acute phase protein which is increased in the presence of inflammation in various clinical conditions, has been proven useful in assessing disease severity, in monitoring the development of complications, and in evaluating the response to specific treatments. So we tried to determine whether CRP offers an advantage over other clinical or laboratory variables for decision-making in the management of acute abdominal pain in the emergency department. METHOD: Patients who came to a University Hospital ED with acute abdominal pain, between september 1, 1998 and November 30, 1998, were included in this study, Data collection included age, sex, duration of symptom, location of pain, and laboratory dta(white blood cell count, portion of neutrophils, ESR, CRP, amylase). RESULT: This study included 85 patients, 34 of whom were men. The mean age was 36.9+/-19.1 years. CRP might be useful to detect the serious condition, sensitivity 81%, but more useful to differentiate normal condition from serious condition in acute abdominal pain patients, specificity 83%. CONCLUSION: CRP is an useful indicator of decision-making to abdominal patients in the emergency department. Hospitalization or operation is very unlikely when CRP value is normal.
Abdominal Pain* ; Acute-Phase Proteins ; Blood Cell Count ; C-Reactive Protein* ; Data Collection ; Emergencies ; Emergency Service, Hospital ; Hospitalization ; Hospitals ; Humans ; Inflammation ; Male ; Neutrophils ; Sensitivity and Specificity

No abstract available.

PURPOSE: As the survival rate of children with malignancies has increased over past decades, the follow-up in adult long-term survivors of childhood malignancies should focus on late effects of disease and treatment. This study was undertaken to find out whether sexual development was affected by the previous chemotherapy and reproductive function could be evaluated by Tanner stage and serum sex hormone level. METHODS: Pubertal stage and gonadal function were studied in 15 male adults survived 4.3~14.3 years after treatment for acute lymphoblastic leukemia, malignant lymphoma or lymphoma-leukemia during childhood or adolescence. RESULTS: All patients showed more than stage IV sexual maturity rating. Patients treated with cyclophosphamide including maintenance (CY group) had lesser testicular volume (P=.0001). All patients except one who has testicular involvement at diagnosis, showed normal follicle-stimulating hormone, leutenizing hormone, and testosterone level. Semen analysis was done in 2 patients. One patient with Non-CY group showed normal, whereas one with CY group showed azoospermia. It seemed that treatment period (before or during puberty) or prophylactic cranial radiation therapy did not affect sexual development. CONCLUSION: Previous chemotherapy did not affect sexual development. Physical examination, sex hormone level, bone age were not sufficient for detecting reproductive impairment. Semen analysis and GnRH or hCG hormone stimulation test should be done in high risk patients treated with chemotherapeutic agents affecting germ cell function or testicular radiation therapy.
Adolescent ; Adult* ; Azoospermia ; Child ; Cyclophosphamide ; Diagnosis ; Drug Therapy ; Follicle Stimulating Hormone ; Follow-Up Studies ; Germ Cells ; Gonadotropin-Releasing Hormone ; Gonads ; Humans ; Lymphoma* ; Male* ; Physical Examination ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Semen Analysis ; Sexual Development* ; Survival Rate ; Survivors ; Testosterone

BACKGROUND: Doxylamine, an antihistamine with sleep inducing property, is the most commonly intoxicated drug in the urban ED. This drug is relatively safe but is known to induce rhabdomyolysis in rare occasion. The purpose of this study is to determine the incidence of rhabdomyolysis after doxylamine overdose and prognostic factors that contributes to this complication. METHOD: This study was conducted from 26 patients admitted to our hospital after doxylamine intoxication during the period from April 1999 to June 1999. Using the protocol made beforehand, the amount ingested, past history, laboratory results were recorded. Rhabdomyolysis was defined as serum myoglobin over 300 ng/mL or serum creatine phosphokinase(CK) over 1,000 IU/L. Data were analyzed using SPSS program with t-test, Fisher's exact test and discriminant analysis. RESULTS: The rhabdomyolysis was diagnosed in 57.7% of patients. The amount ingested per body weight, prehospital vomiting and low arterial pCO2 predicted occurrence of rhabdomyolysis. The sensitivity of serum CK and myoglobin were 67% and 80% respectively and specificity was 100% for both. The diagnosis was possible for CK after an average of 14hr 20min time after ingestion and 8hr 12min for myoglobin. CONCLUSION: Rhabdomyolysis is a common complication of doxylamine intoxication and if the amount ingested was more than 1 tablet(25mg) per body weight, the incidence of rhabdomyolysis was higher. So, CK measurement after 14 hour postingestion and myoglobin after 8 hour is recommended to decide whether rhabdomyolysis occur.
Body Weight ; Creatine ; Diagnosis ; Doxylamine* ; Eating ; Humans ; Incidence* ; Myoglobin ; Rhabdomyolysis* ; Sensitivity and Specificity ; Vomiting

PURPOSE: Recently Wilms tumor gene (WT1) transcripts have been detected in leukemia regardless of the disease subtype and the specific DNA markers suggesting that WT1 gene might be a useful panleukemic marker for monitoring minimal residual disease (MRD). This study was performed to investigate the expression of WT1 gene by a quantitative methods and to find the prognostic value of WT1 gene in childhood acute leukemia. METHODS: From the mononuclear cells isolated from bone marrow aspirates and peripheral bloods of 22 childhood acute and chronic leukemia patients, mRNA were extracted for the reverse transcriptase-polymerase chain reactions (RT-PCR). Relative levels of WT1 gene expression was calculated by using the value in K562 cell line to be 1.00 as a positive control. RESULTS: The sensitivity of detection of MRD with WT1 primers was 10 4 and comparable to that of bcr/abl expression in K562 cells and a patient with CML in blast crisis. WT1 gene expression was detected in 17 of 22 (77%) patients; 9/10 of acute lymphoblastic leukemia (ALL), 6/10 acute myelogenous leukemia (AML), 1 acute mixed lineage leukemia (AMLL) and 1 chronic myelogenous leukemia (CML) in blast crisis. In 4 AML patients who received autologous peripheral blood stem cell transplantation (PBSCT), two patients relapsed after reappearance of WT1 gene expression in bone marrow aspirates and the remaining two were in complete remission without expression of WT1 gene. CONCLUSION: These results show that WT1 gene expression is frequently noted in childhood acute leukemia and can be a useful sensitive marker for the detection of MRD comparable to bcr/abl transcripts. WT1 gene can be used as a panleukemic marker for the MRD monitoring for the evaluation of the remission status and in predicting early relapse in children with acute leukemia in the molecular levels. It may also be a useful tool for the detection of leukemic cell contamination in the process of peripheral blood stem cell transplantation.
Blast Crisis ; Bone Marrow ; Cell Line ; Child ; Gene Expression ; Genetic Markers ; Humans ; K562 Cells ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Neoplasm, Residual ; Peripheral Blood Stem Cell Transplantation ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence ; RNA, Messenger ; Wilms Tumor

PURPOSE: As increased level of prostaglandin has been identified in the bony lesions of Langerhans cell histiocytosis (LCH), we speculated that indomethacin, a potent prostaglandin inhibitor, may be effective for patients with LCH. METHODS: Retrospective review of 8 children with LCH (male 7, female 1) treated with indomethacin at Seoul National University Children's Hospital from September 1999 to February 2001 was done. The dose of indomethacin ranged from 1.8 to 2.8 mg/kg/day in two divided doses. RESULTS: Four patients with single bony lesion had a complete response to treatment. Among them one patient was treated with indomethacin after fourth relapse. Two patients with multiple bony lesions seemed to have partial response to treatment with indomethacin initially but showed disease progression later. Two patients with extraosseous lesion did not respond, but skull lesions were resolved after treatment. No serious toxicities of indomethacin treatment were observed. CONCLUSION: Indomethacin seems to be a very convenient and useful therapy for LCH involving single bony lesion. The mechanism how the LCH imporves in response to indomethacin has to be elucidated. Whether it has a specific role in slowing disease progression or we are seeing merely a spontaneous remission has to be studied in large scale.
Child ; Disease Progression ; Female ; Histiocytosis, Langerhans-Cell* ; Humans ; Indomethacin* ; Prostaglandin Antagonists ; Recurrence ; Remission, Spontaneous ; Retrospective Studies ; Seoul ; Skull

PURPOSE: In most cases, myelodysplastic syndrome(MDS) transforms into a more aggressive state or acute myelogenous leukemia; it's prognosis is very poor. It is believed that hematopoietic stem cell transplantation(HSCT) is the only curative treatment of MDS, but available data in children are very sparse. In this report, the short term outcome of HSCT in childhood MDS was analyzed. METHODS: Ten children with MDS(CMMoL 5, RAEB 3, RAEBt 2) underwent HSCT(HLA- matched sibling transplantation 4, HLA-matched unrelated transplantation 4, cord blood transplantation 1, HLA-mismatched familial transplantation 1) between November 1995 and January 2001 at St. Mary's Hospital. Median follow-up duration was 11 months. RESULTS: Engraftment was successful in all cases and 8 patients are alive without disease. Three cases of VOD were observed and improved without complication. Four cases of grade II and 1 case of grade III acute GVHD were observed and well controlled with treatment. Three patients relapsed after transplantation. One patient is alive without disease after cytoreduction with allogenic stem cell rescue and 2 patients died of relapse. CONCLUSION: HSCT is a curative strategy of MDS and the survival rate is relatively higher than that of adults. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.
Adult ; Anemia, Refractory, with Excess of Blasts ; Child ; Fetal Blood ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes* ; Prognosis ; Recurrence ; Siblings ; Stem Cells ; Survival Rate

Emphysematous cystitis is a rare disease that is associated with diabetes mellitus, neurogenic bladder, chronic genitourinary infection, and malignancy. Fever, chill, abdominal pain, and urinary difficulties were the most frequent presenting symptoms associated with emphysematous cystitis. We report a case of incidentally detected asymptomatic emphysematous cystitis in a 67 years old female patient with diabetic nephropathy. We review characteristic features of all 19 cases that has been reported in korean medical journals till now. Risk factors for this condition appear to be female sex, old age, and diabetes mellitus.
Abdominal Pain ; Aged ; Cystitis* ; Diabetes Mellitus ; Diabetic Nephropathies ; Female ; Fever ; Humans ; Korea* ; Rare Diseases ; Risk Factors ; Urinary Bladder, Neurogenic