BACKGROUND: The growth of elderly population increased the need for oral health care. Elderly patients with poor teeth alignment needs more attention with orthodontic treatment METHODS: Elderly patients visiting department of orthodontics, Kangdong Sacred Heart Hospital between 2000-2004 were treated with fixed appliances in one or both dental arches. Treatment plans were different from than that of younger patients and included uncommon and strategic removals of teeth and prosthesis. RESULTS: There was decrease in orthodontic treatment forces with increasing age, and the observation made from this study was favorable in the patients' as well as in the orthodontist's, point of view. It was possible to move the remaining teeth considerably, and the retention was made with various fixed appliances. CONCLUSIONS: Orthodontic treatment is not limited by patient age. However, it is wise not to extend treatment goals too far beyond the patients' objective needs
Aged* ; Dental Arch ; Heart ; Humans ; Oral Health ; Orthodontics ; Prostheses and Implants ; Tooth

No abstract available.
Colitis, Ulcerative* ; Ulcer*

No abstract available.
Carcinoma, Renal Cell* ; Colon* ; Colonic Neoplasms*

In this study, we are to produce the single chain variable fragment (scFv) antibodies against surface protein of hepatitis B virus (HBV) using antibody phage display technique. Balb/c mice were immunized with preS1 and cDNAs of heavy and light chains of splenic B cells from immunized mice were prepared using RT-PCR. Two cDNAs were linked with (64S) linker DNA under recombination PCR to produce single chain Fv DNA. After digestion of scFv DNA with Sp 1 and Not 1, the digested DNA was ligated into pCANTAB 5E and electroporated into E. coli XL1-Blue to prepare scFv-library. The size of library was 1 * 10' pfu/ml. Phage antibodies (phabs) against preS1 were rescued with M13K07 helper phages, and preS1-binders were selected through 3 times of panning using 96 well microtitre plates. Phage antibody clones were assayed directly for the ability to bind preS1 by ELISA. And then 7 phage antibody clones had high ELISA signals against preS1. Phabs from preS1-specific pMsc-17 had the strongest ELISA signal to preS1. Phabs from pMsc-17 were used for Western blot to preS1 and the results revealed that it was specific to preS1. To prepare the soluble scFv antibody, phabs from pMsc-17 were transfected into non-suppressor E. coli HB2151, and grown under 1 mM IPTG. Soluble scFv antibody was mainly accumulated in the periplasmic space, but small amount of antibody was secreted into culture media.
Animals ; Antibodies ; B-Lymphocytes ; Bacteriophages* ; Blotting, Western ; Cell Surface Display Techniques ; Clone Cells ; Culture Media ; Digestion ; DNA ; DNA, Complementary ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Isopropyl Thiogalactoside ; Mice* ; Periplasm ; Polymerase Chain Reaction ; Recombination, Genetic ; Single-Chain Antibodies*

Human monoclonal antibodies have considerable potential in the prophylaxis and treatment of viral disease. By cloning human Ig gene segments from the B cells of volunteer into pComb3 phagemid vector, antibody library was created of filamentous phage particles displaying Fab fragments on their surface after being rescued with M13KO7 helper phages. The size of library was 7x10' pfu. Phage antibodies (phabs) were panned against biotinylated preS1 using streptavidine coated Dynabead. The soluble Fab antibodies were prepared from phagemid colonies and assayed directly for the ability to bind preS1 by ELISA. And then 3DW and SGW specific to preS1 which have both heavy and light chain to form Fab fragment, were selected. The soluble Fab antibody from 3DW was expressed highly at the concentration of 0.1 - 1.0 mM of IPTG, and 5 hours postinduction. The soluble antibodies from 3DW and SGW showed their relative affinities of 2x10' M ', and Sx10 M ', respectively, and the specificities to preS1 on ELISA. Our results suggest that antibody phage display library is very useful method to generate the human monoclonal antibody and that the human Fab monoclonal antibodies specific to preS1 selected in this study open the way to treat hepatitis B as a component of passive irnmunotherapeutics.
Antibodies ; Antibodies, Monoclonal ; B-Lymphocytes ; Bacteriophages* ; Clone Cells ; Cloning, Organism ; Enzyme-Linked Immunosorbent Assay ; Genes, Immunoglobulin ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans* ; Immunoglobulin Fab Fragments ; Isopropyl Thiogalactoside ; Streptavidin ; Virus Diseases ; Volunteers

The incidence of osteoporotic vertebral compression fracture (OVCF) is increasing with the increase in the elderly population. Kümmell’s disease following OVCF occurrence is not a rare complication and is frequently associated with severe pain or neurologic deficit with progressive kyphotic deformity. Kümmell’s disease initially meant post-traumatic delayed vertebral collapse, but now it is also termed nonunion, osteonecrosis, or intravertebral vacuum cleft, all of which suggest the disruption of the healing process.Current Concepts: The major pathogenesis of Kümmell’s disease is a vascular compromise caused by mechanical stress or intravascular pathology. The key radiologic sign to diagnose Kümmell’s disease is the presence of intravertebral vacuum cleft, observed using simple X-ray, computed tomography, or magnetic resonance imaging. Magnetic resonance imaging is the most useful diagnostic tool showing gas or fluid signals. The risk factors for the progression of Kümmell’s disease after OVCF include middle-column injury, confined low signal intensity on T2-weighted image, posterior wall combined fracture, kyphotic angle >10°, and a height loss >15%. Its treatment can be broadly classified as conservative treatment, bone cement injection, and surgical treatment. The appropriate treatment method is selected based on the pain intensity, neurological symptoms, and the severity of the kyphotic deformity.Discussion and Conclusion: Kümmell’s disease usually develops along with osteoporosis. Therefore, the treatment should be focused on relief from symptoms associated with Kümmell’s disease and osteoporosis. It is recommended that an anabolic agent should be administered after the diagnosis of Kümmell’s disease, regardless of the treatment modality.

We introduce a simple rehabilitation program after the miniplate fixation of high-condylar fracture of mandible. Intermaxillary fixation with arch bar is used. The length of the fixation period is about 14 days after surgery. At the end of this period, the bracket is applied to maxillary incisor, the occlusion becomes stable and reproducible and then aggressive jaw opening excercise begins. From postoperative day 15 to 21, elastics are applied 24 hours a day. They are placed lightly during the daytime to assist guiding protrusion of the mandible. The patient is instructed to protrude the mandible and to open the mouth simultaneously. From postoperative day 22 to 28, the exercise is modified to lateral movement. After the bracket is removed on postoperative day 29, the patient excercised the chin laterally without any guiding elastic fixation for approximately 1 week. This regimen can be widely used in ostectomy-osteosynthesis cases.
Chin ; Fracture Fixation ; Humans ; Incisor ; Jaw ; Mandible ; Mandibular Condyle ; Mouth ; Rehabilitation*

Colitis Cystica Profunda(CCP) is an uncommon disease in Korea, and little knowledge exists about CCP, including knowledge about its incidence and prevalence. However, it may be speculated that the disease will be diagnosed more often due to advancement in diagnostic tool and growing interest. CCP is essentially the same disorder as Solitary Rectal Ulcer Syndrome(SRUS), but it has been reported separately because of its external appearances such as broad shaped polyps or nodules. Both CCP and SRUS are called MPS. Of importance is that a submucosal-cyst-containing lesion needs to be differentiated from mucus- producing adenocarcinoma. This differentiation is obvious from the CCP histologic features, such as fibromuscular obliteration of lamina propria and submucosal cysts. In light of these facts, it is important to obtain a sufficient biopsy specimen to examine accurately. It is not uncommon for CCP to be accampanied by rectal prolapse or incomplete intussusception, so diagnostic approaches of these associated disorders should be done at the same time. The authors have recently experienced one case of CCP associated with rectal prolapse. The case was treated effectively and is reported in this paper along with a review of the literature on this subject.
Adenocarcinoma ; Biopsy ; Colitis* ; Incidence ; Intussusception ; Korea ; Mucous Membrane ; Polyps ; Prevalence ; Rectal Prolapse ; Ulcer

BACKGROUND: Pulmonary fibrosis is the most common pulmonary complication in patients with end stage renal disease undergoing hemodialysis. The diffusing capacity is sensitive and reliable methods for diagnosis for pulmonary fibrosis. The aim of this study was to investigate the change of diffusing capacity for dialysis duration and membranes (synthetic vs cellulosynthetic) in maintenance hemodialysis patients. METHODS: We evaluated prospectively pulmonary diffusing capacity (DLCO/VA) of the patients who had been receiving regular hemodialysis for a period of at least 3 months at Gyeongsang National University Hospital from April 1, 2002 to June 30, 2003. Seventy one patients were divided into two groups by dialysis duration: less than 24 months; more than 24 months. Also, we divided patients into two groups by dialysis membrane: cellulosynthetic membrane (Hemophan); synthetic membrane (Polysulfone). RESULTS: The diffusing capacity and dialysis durations were presented for negative correlation [r= -0.321 (p=0.01) in DLCO/VA]. According to dialysis membranes, DLCO/VA values were significantly decreased in patients in Hemophan group rather than Polysulfone Group [92.4+/-20.5% vs 107.5+/-19.3%, (p= 0.01)]. According to dialysis durtation and membranes, DLCO/VA values were significantly decreased in patients in Hemophan group rather than Polysulfone group at duration for more than 24 months [84.9+/-20.1% vs 105.2+/-20.8%, (p=0.003)]. CONCLUSION: Patients undergoing long-term maintenance hemodialysis showed a gradual reduction in lung diffusing capacity for dialysis duration. Our results suggested that lung diffusing capacity was more severely reduced in hemodialysis patients using bioincompatible membrane rather than biocompatible membrane.
Diagnosis ; Dialysis* ; Humans ; Kidney Failure, Chronic ; Lung* ; Membranes* ; Prospective Studies ; Pulmonary Diffusing Capacity ; Pulmonary Fibrosis ; Renal Dialysis*

OBJECTIVES: Over the last 30 years, despite the increasing sophistication in medical care, the mortality of acute renal failure(ARF) has remained virtually unchanged at 40-50%, but the reasons remain unknown. This study intend to identify prognostic risk factors influencing survival and predict the mortality in ARF patients. METHODS: We retrospectively analyzed 152 patients with ARF who required renal replacement therapy, or whose serum creatinine level above 5 mg/dl, from Jan. 1988 to May. 1995. Multiple factors which may influence mortality were evaluated by univariate and multivariate analysis. RESULTS: 1) Of the 152 patients, 97 were male and 55 were female. The mean age was 47 years and the overall mortality was 36.8%. 2) Based on the univariate analysis, age>60 years, cause of ARF, APACHE II score, number of failing organs, peak serum creatinine level, PaO2, coma, hypotension, ARDS, GI bleeding, ventilatory support, need for antiarrhythmics, DIC, cardiovascular failure, pulmonary failure, neurological failure, and gastrointestinal failure were all significant factors discriminating between survivors and nonsurvivors(p<0.05) 3) By multivariate analysis, hypotension, coma, ventilatory support, and age over 60 years were significant independent predictors influencing survival in ARF patients and logistic equation and logit score were as follows : z=-2.04+1.32(age over 60)+2.18(hypotension)+2.88 (ventilatory support) + 3.28(coma) P=ez/(1+ ez) 4) In ROC(receiver-operating characteristic)curve, when the cutoff point was 0.2, maximum sensitivity was 75% and maximum specificity was 82%. CONCLUSION: In ARF, prognostic risk factors for mortality were age over 60 years, hypotension, assisted ventilation and coma. The logit score by multiple analysis is a reliable predictor of mortality in ARF patients, however the further studies are required to confirm these results.
Acute Kidney Injury* ; APACHE ; Coma ; Creatinine ; Dacarbazine ; Female ; Hemorrhage ; Humans ; Hypotension ; Male ; Mortality* ; Multivariate Analysis ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors* ; Sensitivity and Specificity ; Survivors ; Ventilation