In the progression of the Temporomandibular Joint Disorder(TMD), not only deformation and perforation of disc occur. But also fibrotic adhesion and inflammatory changes to the retrodiscal tissue can be seen in addition to the condylar degenerative change (e.g. osteoarthritis). However, the correct diagnosis,?planning for appropriate treatment, and prediction of prognosis are limited, because there are no means to stage the progression of the disorder. In this study relative signal intensity of retrodiscal tissue in MRI and the synovial fluid concentration of matrix metalloproteinase-2 (MMP-2), MMP-9, and Interleukin-6 (IL-6) in the 23 temporomandibular joints(TMJ), from 17 patients with TMD were evaluated as a possible diagnostic marker. The relative signal intensity of retrodiscal tissue was referenced to brain gray matter with same region of interest(ROI) size. The concentrations of MMP-2, MMP-9, and IL-6 were evaluated by Enzyme Linked Immunosorbent Assay (ELISA). The collected data were compared with condylar degenerative change, joint effusion and disc position observed in MRI. The relative signal intensity of the retrodiscal tissue was increased significantly when degenerative changes were present. In addition, there was significantly high signal intensity in the presence of a disc displaced without reduction. The concentration of IL-6 was significantly increased when condylar degenerative change was no observed. And there were no changes in the levels of IL-6 according to disc position and joint effusion measurement. Moreover, there were no significant relevance between the concentration of total MMP-2 and active MMP-9 in synovial fluid, relative to degenerative changes in the mandibular condyle, to joint effusion, and to disc position observed on MRI images. In conclusion, the relative signal intensity of the retrodiscal tissue can be regarded as a mean of diagnosing the procession of TMD in a non-invasive manner. But more additional studies are required for the levels of MMP-2. MMP-9, and IL-6 to determine their potentials as a diagnostic marker for TMD.
Brain ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6* ; Joints ; Magnetic Resonance Imaging* ; Mandibular Condyle ; Matrix Metalloproteinase 2 ; Prognosis ; Synovial Fluid* ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*

Purpose: After kidney transplantation (KT), a large amount of drainage can delay postoperative recovery. Viscum album extract is an agent used in pleurodesis, and the purpose of this study was to evaluate the efficacy of this agent in reducing the amount of drainage after KT. Methods: Medical records of patients with a large amount of drainage (≥ 100 mL/day) on postoperative day (POD) 7 after KT who had undergone V. album extract instillation through drainage tube (n = 115) or conservative management (n = 177) were retrospectively reviewed. The primary endpoint was a decrease in the amount of drainage on POD 14 from POD 7. Results: A decrease in the amount of drainage on POD 14 from POD 7 was larger in the V. album extract instillation group than in the conservative management group (–228.3 ± 181.6 mL vs. –144.6 ± 202.0 mL, P < 0.001). Duration of hospitalization after operation was shorter in the V. album extract instillation group than in the conservative management group (15.9 ± 3.2 days vs. 18.1 ± 5.3 days, P < 0.001). In multivariate analysis, there was a statistically significant association of V. album extract instillation with lower risk of persistent large amount of drainage (≥ 100 mL/day on POD 14), with an odds ratio of 0.57 (95% confidence interval, 0.35–0.93; P = 0.026). Conclusion Retroperitoneal V. album extract instillation could be effective in reducing the amount of drainage and promoting postoperative recovery in patients with a large amount of drainage after KT.

BACKGROUND: Hepatolithiasis is rarely associated with a cholangiocarcinoma and the etiologic relationship between them has not been proved. Hepatolithiasis is a risk factor for cholangiocarcinoma. Accurate preoperative diagnosis remains low, and the survival outcome is still dismal, despite improvements in imaging studies. METHODS: Eighteen cases of intrahepatic cholangiocarcinomas among the 522 cases undergoing treatments from Jan. 1984 to May 1998 for hepatolithiasis at the Department of Surgery, Kyung Hee University Hospital were reviewed. RESULTS: The patients had a significantly long duration of symptoms, a high incidence of previous biliary surgery, and a lower rate of preoperative diagnosis. The eighteen cases accounted for 3.4% of the hepatolithiasis cases and 8.5% of the cholangiocarcinomas. There were 17 women and 1 man, and the most prevalent age group was in the 5th and the 6th decades. HBsAg was positive in one case who had chronic hepatitis, 3 patients had clonorchiasis, and 2 patients had liver cirrhosis. CEA and CA19-9 were elevated in 42.9% (3/7) and 27.3% (3/11) of the patients. Various imaging studies, including ultrasonography, CT, choangiography, angiography, and ERCP were performed for diagnosis. The malignant lesions could not be detected preoperatively in 9 patients, and the presence of a coexisting malignant tumor was confirmed by frozen section or by permanent tissue pathology. The operative methods were as follows; a lobectomy in 4 patients, a segmentectomy in 4 patients, and a CBD resection for palliation or explo-laparotomy only in 4 patients because of multiple hepatic metastases. During the operation, the exact location of the stones and the gross pathology of the tumor were recorded in each case. The left side was more prevalent than the right. The mean survival was 15 months for resection group and 9 months for non resection group. CONCLUSIONS: The lower survival rates may be attributed to delayed diagnosis, lower diagnostic accuracy, and relatively fewer curative resections in the patients with stone-containing cholangiocarcinomas. Hepatolithiasis is one of the risk factors of a cholangiocarcinoma. During the diagnostic and operative procedures, we should not overlook a cholangiocarcinoma which can coexist with hepatolithiasis, and we should examine tumor markers, the results of imaging studies and tissue examinations, and the operative findings.
Angiography ; Biomarkers, Tumor ; Cholangiocarcinoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Clonorchiasis ; Delayed Diagnosis ; Diagnosis ; Female ; Frozen Sections ; Hepatitis B Surface Antigens ; Hepatitis, Chronic ; Humans ; Incidence ; Liver Cirrhosis ; Mastectomy, Segmental ; Neoplasm Metastasis ; Pathology ; Risk Factors ; Surgical Procedures, Operative ; Survival Rate ; Ultrasonography

No abstract available.
Transplants*

Carcinoma, Squamous Cell ; Cell Differentiation ; Humans ; Immunohistochemistry ; Korea ; Lymph Nodes ; Mouth Neoplasms ; Neoplasm Metastasis ; Peptide Hydrolases ; Prognosis ; Radiotherapy ; Saints ; Tissue Inhibitor of Metalloproteinase-1 ; Tongue

The purpose of this study was to detect where the center of pressure in foot would be located at the end point of loading response and the terminal stance by the dynamic plantar pressure measurement. Seventeen adults who had the usual feet without a pathologic gait were evaulated simultaneously by the motion analysis using VICON 370, and the plantar pressure measurement using EMED-SF. Two devices were set in the 60 Hz frame. The foot was divided into 3 different zones; hindfoot, midfoot, and forefoot. The end point of loading response was located at the 1.92+/-1.46 frame distal to the hindfoot- midfoot borderline. The end point of terminal response was located at the 2.27+/-1.96 frame distal to the maximal pressure points of metatarsal head. Authors could differentiate each period of stance phase; the initial contact, loading response, mid-stance, terminal stance, and preswing, using the analysis of center of pressure by the dynamic plantar pressure measurement.
Adult ; Foot* ; Gait* ; Head ; Humans ; Metatarsal Bones

OBJECTIVE: This study was designed to evaluate the relation of leg length discrepancy on ankle muscle strength. METHOD: Twenty four adult women were tested (12 leg length equality and 12 leg length discrepancy). Leg length was measured by tape ruler from anterior superior iliac spine to medial malleolus, three times by three different trained examiners. The muscle strength (bilateral ankle dorsiflexors and plantarflexors) was measured by using Cybex 340 dynamometer at 30 degree/sec and 120 degree/sec. RESULTS: The mean value of leg length discrepancy was 0.89+/-0.24 cm. In leg length discrepancy group, the peak torque of ankle plantarflexor were 44.50+/-20.94 Nm in long leg and 51.83+/-12.75 Nm in short leg at 30 degree/sec angular velocity (p<0.05). CONCLUSION: We concluded that there were significant increase in plantar flexor peak torques of short leg than those of long legs at 30 degree/sec (P<0.05). Perhaps the difference of the muscle strength might be due to compensatory mechanism of short leg in propulsion during gait.
Adult ; Ankle* ; Female ; Gait ; Humans ; Leg* ; Muscle Strength ; Spine ; Torque

Purpose: This study aims to investigate the feasibility of Zenith Fenestrated AAA Endovascular Graft (Z-FEN, Cook Medical) from a single Korean institution database by evaluating the vascular anatomy of Korean abdominal aortic aneurysm (AAA) patients with hostile aortic neck. Methods: This is a retrospective study on patients with AAA who underwent endovascular aortic repair (EVAR) and open surgery repair between January 2012 and December 2021 (n = 211). The anatomic characteristics of the aortic neck were evaluated using 3-dimensional reconstructed computed tomographic scans. For the juxtarenal AAA patients (n = 39), feasibility of fenestrated stent graft was evaluated under the protocol of fenestrated EVAR. For those who were not suitable for the application of Z-FEN, the reasons for unsuitability were analyzed. Results: Among 211 AAA patients, 108 patients (51.2%) had complex aortic neck, and 39 (18.5%) had insufficient aortic neck length (<15 mm) for conventional EVAR. Of the 39 patients with juxtarenal AAAs, 13 (33.3%) were determined feasible for Z-FEN. Twenty-six patients (66.7%) were noncandidate for Z-FEN due to severe neck angulation, short aortic neck length, inadequate iliac artery anatomy, large aortic neck diameter, and severe calcification and thrombosis. Proximal aortic neck length of the non-feasible group was significantly shorter than that of the feasible group (P = 0.002). Conclusion Z-FEN was applicable to 33.3% of the juxtarenal AAA patients. As recent studies confirm, the effectiveness and safety of fenestrated EVAR, Z-FEN can be an option for AAA patients with short aortic neck.

PURPOSE: This study was undertaken to evaluate the immunogenicity and reactogenicity of Td booster immunization in early preadolescents of Korea. METHODS: Healthy preadolescents, who had been vaccinated with 4 or 5 doses of DTaP vaccines until 6 years old age, were enrolled in this study from August 2006 to April 2007 . Diphtheria and tetanus anti-toxoid antibodies in sera were measured by ELISA just before vaccination and 4 weeks after vaccination to evaluate immunogenicity. Local and systemic adverse reactions observed for 4 weeks after vaccination to access reactogenicity. RESULTS: 183 preadolescents were enrolled and mean age was 11.40+/-0.51 years old. All subjects achieved seroprotective diphtheria and tetanus anti-toxoid antibodies (titers > or =0.1 IU/mL) after Td booster vaccination. Among 183 vaccinees, 73.8% showed local adverse reactions and 37.2% systemic adverse reactions. Pain at injection site (66.1%) was the most common local reaction, and the most commonly shown systemic reaction was myalgia (17.5%). The adverse reactions were spontaneously relieved within three days after vaccination. CONCLUSION: Td vaccine in this study was high immunogenic and showed an acceptable tolerance in Korean preadolescents. Td booster vaccination at 11 -12 years old is the most effective method to increase compliance of the vaccination and to decrease the incidence of diphtheria and tetanus.
Aged ; Antibodies ; Compliance ; Diphtheria ; Diphtheria-Tetanus Vaccine ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunization ; Immunization, Secondary ; Incidence ; Korea ; Tetanus ; Vaccination

Intimal hyperplasia is defined as the abnormal migration and proliferation of vascular smooth muscle cells (VSMCs) with deposition of extracellular matrix. However, the cell cycle regulatory mechanisms of injury-induced VSMC proliferation are largely unknown. To examine the expression kinetics of cell cycle regulatory factors which is known to be worked positively or negatively, we used rat balloon injury model. Marked induction of proliferating cell nuclear antigen (PCNA), G1/S cyclin-dependent kinase (cdk2), and its regulatory subunit (cyclin E) occurred between 1 and 3 days after balloon arterial injury, and this was sustained for up to 7 days and then declined. However, the induction of the negative regulators, p21 and p27, occurred between 3 and 5 days of injury, peaked after 7 and 14 days and was then sustained. VSMC proliferation after balloon catheter injury of the rat iliac artery is associated with coordinated expression of positive (cdk2, cyclin E and PCNA) and negative (p21, p27) regulators. Cell cycle regulators such as cdk2, cyclin E, p21, p27 may be suitable targets for the control of intimal hyperplasia.
Animals ; Arteries/*pathology ; Balloon Dilatation/*adverse effects ; Blotting, Western ; CDC2-CDC28 Kinases/biosynthesis ; Cell Cycle ; Cell Cycle Proteins/biosynthesis ; Cell Division ; Cyclin E/biosynthesis ; Cyclins/biosynthesis ; Endothelium, Vascular/pathology ; Extracellular Matrix/metabolism ; Hyperplasia/pathology ; Iliac Artery/pathology ; Immunohistochemistry ; Male ; Myocytes, Smooth Muscle/*cytology ; Proliferating Cell Nuclear Antigen/biosynthesis ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't ; Time Factors ; Tumor Suppressor Proteins/biosynthesis