OBJECTIVES: The purpose of this study was to evaluate the polymerization shrinkage stress among conventional methacrylate-based composite resins and a silorane-based composite resin. MATERIALS AND METHODS: The strain gauge method was used for the determination of polymerization shrinkage strain. Specimens were divided by 3 groups according to various composite materials. Filtek Z-250 (3M ESPE) and Filtek P-60 (3M ESPE) were used as a conventional methacrylate-based composites and Filtek P-90 (3M ESPE) was used as a silorane-based composites. Measurements were recorded at each 1 second for the total of 800 seconds including the periods of light application. The results of polymerization shrinkage stress were statistically analyzed using One way ANOVA and Tukey test (p = 0.05). RESULTS: The polymerization shrinkage stress of a silorane-based composite resin was lower than those of conventional methacrylate-based composite resins (p < 0.05). The shrinkage stress between methacrylate-based composite resin groups did not show significant difference (p > 0.05). CONCLUSIONS: Within the limitation of this study, silorane-based composites showed lower polymerization shrinkage stress than methacrylate-based composites. We need to investigate more into polymerization shrinkage stress with regard to elastic modulus of silorane-based composites for the precise result.
Composite Resins ; Elastic Modulus ; Light ; Polymerization ; Polymers ; Sprains and Strains

To elucidate whether dismembered pyeloplasty improves renal function, the authors studied 37 patients with ureteropelvic junction obstruction. Changes in various renal parameters pre-and postoperatively by 99mTc-DTPA diuretic renal scintigraphy(DTPA scan) and intravenous urography were evaluated. Subjects included 24 pediatric(mean age 9.7 years) and 13 adult(mean age 33 years) patients. Postoperative split renal function was improved in 79 % (l9/24) of pediatric patients and in 69%(9/13) of adult ones. While, the excretory slope was improved in 71%(17/24) of pediatric patients and in 77%( 10/13) of adult ones. Hydronephrosis on intravenous urogram was improved in 58% (14/24) and 54% (7/13), respectively between pediatric and adult patients. There was no statistically significant differences of improvement in split renal function and renographic washout curve between pediatric and adult patients. In summary, renal function was improved by dismembered pyeloplasty in both pediatric and adult patients.
Adult ; Humans ; Hydronephrosis ; Urography

STUDY DESIGN: Retrospective controlled study. OBJECTIVES: The aim of this study was to determine if unilateral TLIF is comparable to conventional PLIF with regard to radiologic and clinical outcomes, and to examine the viability of local bone for bone grafting in lumbar interbody fusion. SUMMARY OF LITERATURE REVIEW: TLIF, a modified form of PLIF, is a new spinal fusion technique that avoids the typical complications of PLIF. MATERIALS AND METHODS: We analyzed 32 cases of single-level TLIF or PLIF in patients with degenerative or isthmic spondylolisthesis, who were followed for more than 1 year. The patients in group 1 underwent TLIF, and the patients in group 2 underwent PLIF. The fusion rate, changes in disc height, and degree of anterolisthesis in the fused segment were analyzed radiologically. The clinical results were evaluated using the Oswestry Disability Index and visual analog scale. We also analyzed operative time, blood loss, and complications in both groups. RESULTS: Radiologically and clinically, there were no significant differences between the two groups in terms of fusion rate, changes in disc height, or degree of anterolisthesis in the fused segment. The mean operative time was 200 minutes in group 1 and 240 minutes in group 2. The mean blood loss was 854 ml in group 1 and 1102 ml in group 2(p>0.05). CONCLUSIONS: TLIF is a potentially useful alternative to conventional PLIF in patients with degenerative or isthmic spondylolisthesis. Additionally, local bone may be a viable source of bone grafts for single-level TLIF and PLIF.
Bone Transplantation ; Humans ; Operative Time ; Retrospective Studies ; Spinal Fusion ; Spondylolisthesis ; Transplants

PURPOSE: Although obstructive jaundice is a rare presentation, it is an ominous sign of poor prognosis in patients with gastric cancer. Thus, we investigated the incidence, the clinical features, the pathologic characteristics, the treatment modality, and the prognosis for obstructive jaundice in patients with gastric cancer. METHODS: A retrospective analysis was done for patients with gastric cancer who had presented with obstructive jaundice at Korea University Guro Hospital from January 1988 to December 1998. RESULTS: During that period, 2546 patients were diagnosed with gastric cancer, and obstructive jaundice was revealed in 20 (0.78%). The mean age was 58 13 years, and the sex ratio (male:female) was 5.7:1. Jaundice was the first presentation in two patients, and it developed in the other 18 patients during the follow-up period after the initial operation or chemotherapy. The level of total bilirubin was 16.7 8.1 mg/dl, and the cause of the jaundice was lymph-node enlargement at the porta hepatis. A percutaneous transhepatic biliary drainage (PTBD) was done in 17 patients, and improvement was seen in 13 (76%). The most common site of the obstruction was common hepatic duct (CHD) (60%). Antrally located, moderately differentiated and Borrmann type-III gastric cancers were commonly associated with obstructive jaundice. The mean duration from jaundice to death was 4.6 6.2 month. CONCLUSION: Obstructive jaundice is very rare in patients with gastric cancer and is associated with poor survival. Although the bilirubin level was decreased by a PTBD, the survival was not improved. An extended lymphadenectomy along the hepatoduodenal ligament is necessary to prevent obstructive jaundice due to recurrence particularly, in patients with antrally located, moderately differentiated and Borrmann type-III carcinomas.
Bilirubin ; Drainage ; Drug Therapy ; Follow-Up Studies ; Hepatic Duct, Common ; Humans ; Incidence ; Jaundice ; Jaundice, Obstructive* ; Korea ; Ligaments ; Lymph Node Excision ; Prognosis ; Recurrence ; Retrospective Studies ; Sex Ratio ; Stomach Neoplasms*

In South Korea, most imported malaria has been caused by Plasmodium falciparum and little mixed infection has been reported which is frequently observed in other countries. We report a case of mixed malarial infection with P. falciparum/P. vivax. It was diagnosed by using three kinds of dipstick tests (two malarial antibody tests and one pLDH immunocapture assay), polymerase chain reaction (PCR), and a peripheral blood smear in a nineteen-year-old woman who had traveled to Bangladesh. The patient was diagnosed with P. falciparum on the first-visit blood sample and P. vivax with the second-visit sample by using all three kinds of dipstick tests. Peripheral blood smears and a PCR of the patient's blood also showed P. falciparum and P. vivax parasites and DNA bands of two species of malaria. In conclusion, an imported malaria case should be accurately diagnosed using the malarial antibody detection kit, pLDH immunocapture assay, and PCR in addition to the peripheral blood smear for the possibility of mixed infection with malaria.
Bangladesh ; Coinfection ; DNA ; Female ; Humans ; Korea ; Malaria* ; Parasites ; Plasmodium falciparum ; Plasmodium vivax* ; Plasmodium* ; Polymerase Chain Reaction

PURPOSE: The aim of this study was to clarify the clinicopathological differences between T1N1M0 and T2N0M0, particularly the survival rates, and the role of chemotherapy in the stage Ib gastric cancer. METHODS: From January 1992 to December 1999, 118 cases were confirmed as having stage Ib gastric cancer in the Korea University Medical Center. Among them 31 patients were classified as being T1N1M0 and the other 87 cases were T2N0M0. The clinicopathological features and the prognosis were evaluated retrospectively. RESULTS: The overall 5-year survival rate of the stage Ib gastric cancer patients was 94%. Overall 5-year survival rates in T1N1M0 and T2N0M0 were 100% and 91%, respectively. Though T1N1M0 group showed better prognosis, there was no significant difference between two groups (P=0.14). D1, D2, and D2+alpha resections were performed in 28 cases (23.7%), 81 (68.6%), and 9 (7.6%), respectively, and there was no difference in the survival rate (P>0.05). The 5-year survival rates were analyzed according to whether or not they had received chemotherapy. There was a 98% 5-year survival rate with those who had chemotherapy and a 90% 5-year survival rate with those who had not had chemotherapy, but there was no significant difference between them (P=0.18). In the T2N0M0 group, the 5 year survival rates of patients with or without chemotherapy were 97% and 86%, respectively, but there was no significant difference (P=0.16). CONCLUSION: Though T1N1M0 group showed a better prognosis than the T2N0M0 group, there was no significant difference between the two groups (P=0.14). There was no significant survival difference between D1, D2, or D2+alpha procedures. It appears that post operative intravenous chemotherapy does not affect the prognosis of stage Ib gastric cancer, and the role of the chemotherapy in patients with T2N0M0 diseases is minimal.
Academic Medical Centers ; Drug Therapy ; Humans ; Korea ; Prognosis ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

PURPOSE: Prompt initiation of effective cardiopulmonary resuscitation (CPR) and defibrillation is underlined in the guideline. Many people search health-related information on the internet. The objective of this study was to evaluate the content and quality of videos for adult basic life support (BLS) on the internet. METHODS: We searched 'Daum' for the term 'CPR' in Korean. Videos dealing with BLS over 5 sequences were included. Videos inserted in the news and drama or used for advertisement or entertainment, or which only contained pediatric BLS were excluded. Two emergency physicians analyzed videos using a standardized checklist. RESULTS: Of 1,600 videos, 32 met the inclusion criteria, except for duplicate videos. More than 90% of videos showed appropriate demonstration for check response, activate emergency response system, correct hand placement, minimize interruptions in chest compression, 30:2 compression to ventilation ratio, open airway, and deliver rescue breath; 13 (40.6%) and 12 (37.5%) videos demonstrated 'call for automated external defibrillator (AED)' and 'apply AED', respectively; 25 (78.1%), 23 (71.9%), and 27 (84.4%) videos showed correct demonstration for chest compression rate and depth, and complete chest recoil, respectively; 6 (18.8%) and 10 (31.3%) videos contained instructions for 'complete chest recoil' and 'minimize interruptions in chest compression', respectively. Only 2 (6.3%) videos dealt with hands-only CPR. CONCLUSION: A large proportion of educational videos for adult BLS contained basic sequence of BLS, except for 'call for AED' and 'apply AED'. There is a lack of instruction for high-quality CPR, particularly for minimizing interruptions in chest compression and complete chest recoil, and hands-only CPR.
Adult* ; Cardiopulmonary Resuscitation ; Checklist ; Defibrillators ; Drama ; Emergencies ; Hand ; Humans ; Internet ; Korea ; Out-of-Hospital Cardiac Arrest ; Thorax ; Ventilation

PURPOSE: Emergency physicians are often asked to predict a patient's functional outcome after an acute stroke. However, very little information is usually available to a physician to help predict the likelihood of severe permanent disability. The purpose of this study was to determine useful Initial prognostic predictors in patients with an acute stroke presenting to the emergency department. METHODS: Between March 1, 2004 and May 31, 2004, we analyzed 74 patients diagnosed to have an acute stroke by diffusion weighted magnetic resonance imaging obtained within 24 hours from symptom onset at the emergency department. Seven factors were evaluated as prospective variables including The National Institutes of Health Stroke Scale (NIHSS) measured by emergency physician (NIHSSEM) and neurologist (NIHSS-NR) at the time of presentation to the emergency department. The outcome variables were Barthel Index (BI), modified Rankin Scale (mRS), and the NIHSS measured at the time of discharge from hospital. RESULTS: The intraclass correlation coefficient between NIHSS-EM and NIHSS-NR was 0.94 (p < 0.001). History of stroke, gender, NIHSS-EM, large vessel disease and lacuna infarctions were statistically significant outcome predictors. In a multivariate logistic regression analyses, NIHSSEM was the only independent variable that correlated with NIHSS, mRS, and BI at hospital discharge. CONCLUSION: Among the many prognostic predictors studied, the NIHSS appeared to be the only independent variable showing a correlation with the patients's prognosis. The NIHSS perfomed in the emergency department may help emergency physicians provide more accurate initial prognosis in an acute stroke patient.
Diffusion ; Emergencies ; Emergency Service, Hospital ; Humans ; Infarction ; Logistic Models ; Magnetic Resonance Imaging ; National Institutes of Health (U.S.) ; Prognosis* ; Prospective Studies ; Stroke*

BACKGROUND: Blood typing is an essential test for transfusion. Generally, blood typing is performed using a slide test, tube test or microcolumn agglutination test. The aims of this study were to develop a new blood typing kit using micromachining, microfluidics and microseparation methods, and to evaluate the clinical usefulness of the new blood typing kit. METHODS: We designed and manufactured a blood typing microchip using polydimethylsiloxane (PDMS), which contained a microchannel (25~200 micrometer). The blood sample and antisera to be tested were dropped on the microwell for movement and mixing by capillary action. Once agglutination occurred, the microchannel acts as a filter and the blood type was determined by observation by the naked eye. To evaluate the newtyping kit, we tested sensitivity using artificially diluted blood and compared the results of the new typing method with the slide and tube methods using 70 samples. RESULTS: The new blood typing kit could differentiate a +4~+2 agglutination reaction, but could not detect a +1 agglutination reaction as observed by the naked eye. Among 70 samples, the results of ABO and Rh typing by the new typing method (n=66, > or = +2 agglutination reaction by the column agglutination method) were in accord with the results of the tube and slide methods, but couldnot detect agglutination in all 4 clinical samples, below a +1 agglutination reaction. CONCLUSION: The new blood typing kit is inadequate for routine use in the clinical laboratory due to low sensitivity, but with further improvement, it can be used economically, conveniently and objectively for blood typing without any special equipment. Moreover, the microfludics and separation method may be broadly applicable in other tests using the hemagglutination method.
Agglutination ; Agglutination Tests ; Blood Grouping and Crossmatching* ; Capillary Action ; Hemagglutination ; Immune Sera ; Microfluidics* ; Microtechnology

PURPOSE: The purpose of this study was to compare the clinical and oncological outcomes between the primary and metastatic malignant tumor of humerus. MATERIALS AND METHODS: Between May 2005 and May 2014, 42 cases of malignant tumor in humerus that were followed-up for at least 1 year were entered into the study and analyzed retrospectively. Cases were divided into two groups, the primary (group 1, 15 cases) and metastatic (group 2, 27 cases), according to the origin of the tumor. The clinical and oncological outcomes between the primary and metastatic malignant tumor of humerus were analyzed and compared. RESULTS: In the group 1, nine cases were osteosarcoma and six cases were chondrosarcoma. The tumor lesions were distributed in the proximal area of the humerus. In the group 2, 12 cases originated from lung cancer, six cases from liver cancer, and two cases from bladder cancer. The lesions were usually distributed in the midshaft area. The patients underwent various surgical treatments, including wide excision with tumor prosthesis, curettage with bone grafting, intramedullary nailing, open reduction, and internal fixation with plate. Kaplan-Meier 5-year survival estimates were 87.5% for group 1, and 1-year survival estimates were 70.1% and 2-year survival estimates were 40.1% for group 2. The mean Musculoskeletal Tumor Society score was high in both groups. However group 1 showed a higher score on the functional index compared to group 2. CONCLUSION: Primary malignant bone tumors of the humerus usually involve the proximal site and tumor prosthesis is the main treatment. The metastatic malignant bone tumor usually involves the midshaft area and intramedullary nailing and radiation therapy is the main therapy. Although treatment of the primary malignant tumor increases the survival rate, treatment of metastatic malignant tumor does not affect the survival rate, though it helps in relieving pain.
Bone Transplantation ; Chondrosarcoma ; Curettage ; Fracture Fixation, Intramedullary ; Humans ; Humerus* ; Liver Neoplasms ; Lung Neoplasms ; Methods* ; Osteosarcoma ; Outcome Assessment (Health Care) ; Prostheses and Implants ; Retrospective Studies ; Survival Rate ; Urinary Bladder Neoplasms