No abstract available.
Lymphadenitis*

The purpose of this study was to evaluate the microtensile bond strength (microTBS), failure modes and bonding interfaces of self-etching and three self-adhesive resin cements to dentin and indirect composite resin. Cylindrical composite blocks (Tescera, Bisco Inc.) were luted with resin cements (PA: Panavia F 2.0, Kuraray Medical Inc., RE: RelyX Unicem Clicker, 3M ESPE., MA: Maxem, Kerr Co., BI: BisCem, Bisco Inc.) on the prepared occlusal dentin surfaces of 20 extracted molars. After storage in distilled water for 24 h, 1.0 mm x 1.0 mm composite-dentin beams were prepared. microTBS was tested at a cross-head speed of 0.5 mm/min. Data were analyzed with one-way ANOVA and Tukey's HSD test. Dentin sides of all fractured specimens and interfaces of resin cements-dentin or resin cements-composite were examined at FE-SEM (Field Emission-Scanning Electron Microscope). In conclusion, PA and RE showed higher bond strength and closer adaptation than MA and BI when indirect composite blocks were luted to dentin using a self-etching and three self-adhesive resin cements.
Dentin ; Dentin-Bonding Agents ; Electrons ; Molar ; Resin Cements ; Water

PURPOSE: The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the anglographic causes, findings, and the usefulness of DSA in cerebral infarction. MATERIALS AND METHODS: The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional anglogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. RESULTS: Among the 51 patients of cerebral infarction 43 patients(84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in anglogram. DSA findings of cerebral atherosclerosis were multiple narrowings in 42 patients(97,7%), tortuosity in 22(51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients(86.0%), middle cerebral artery in 29(67.4%), posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement(16.2%). CONCLUSION: In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered.
Aneurysm, Dissecting ; Angiography ; Angiography, Digital Subtraction* ; Anterior Cerebral Artery ; Basilar Artery ; Brain ; Carotid Artery, Internal ; Cerebral Arteries ; Cerebral Infarction* ; Contrast Media ; Diagnosis ; Dilatation ; Humans ; Intracranial Arteriosclerosis ; Magnetic Resonance Imaging ; Mass Screening ; Middle Cerebral Artery ; Moyamoya Disease ; Posterior Cerebral Artery ; Retrospective Studies ; Ulcer ; Vertebral Artery

Pneumoperitoneum, Pneumomediastinum, subcutaneous emphysema and a pneumothorax are some of the mechanical complications of bronchial asthma. The incidence of pneumoperitoneum during an attack of acute asthma is rare. The pathogenesis is free gas track from the overdistended alveoli, through the bronchovascular sheaths to the mediastinum. If the high pressure is maintained, air can escape retroperitoneally into the abdomen and burst into the peritoneal cavity. A 43-year-old woman was admitted due to a severe asthma attack. She was required endotracheal intubation and AMBU(air mask bag unit) ventilation. Immediately after these procedures, pneumoperiotneum, pneumomediastinum, and subcutaneous emphysema daveloped. She was treated with mechanical ventilation and medical therapy. The pneumoperitoneum was resolved after 27 days. Here, we report this case with the review of the relevant literature.
Abdomen ; Adult ; Asthma* ; Female ; Humans ; Incidence ; Intubation, Intratracheal ; Masks ; Mediastinal Emphysema* ; Mediastinum ; Peritoneal Cavity ; Pneumoperitoneum* ; Pneumothorax ; Respiration, Artificial ; Subcutaneous Emphysema ; United Nations ; Ventilation*

PURPOSE: Sarcomatoid hepatocellular carcinoma (HCC) is a rare neoplasm and it has been found in only 1.8% of the surgically resected HCC patients, and in only 3.4~9.4% of the autopsied HCC cases. The pathogenesis of this tumor has't yet been thoroughly clarified, and such a tumor has been variously referred to as spindle cell carcinoma, sarcomatoid carcinoma, pseudosarcoma, or carcinosarcoma. There is only a little difference between the clinical characteristics of the sarcomatoid HCC and those of ordinary HCC. The diagnosis of the sarcomatoid HCC is made by pathological and immunohistochemical techniques after surgical resection, biopsy, or autopsy. METHODS: We reviewed the 10 cases of pathologically confirmed sarcomatoid HCC that were registered at the Yonsei University Medical Center from 1992 to 2004. RESULTS: Surgical operation was performed in seven cases, and curative resection was done only in five. Three patients were treated with chemotherapy or transarterial chemoem-bolization (TACE) with or without concurrent radiotherapy after the diagnosis of sarcomatoid HCC by liver biopsy. Six patients expired within 4 months after the diagnosis. The 6 month and 12 month survival rates for sarcomatoid HCC were 40% and 20%, respectively. The 6 month survival rates for radical resection and non-radical resection were 60% and 0%, respectively. The difference in cumulative survival according to the treatment of sarcomatoid HCC was statistically significant. CONCLUSION: The prognosis of sarcomatoid HCC is very poor; therefore, curative resection, adjuvant chemoradiotherapy, and close follow-up are necessary for patients suffering with sarcomatoid HCC.
Academic Medical Centers ; Autopsy ; Biopsy ; Carcinoma, Hepatocellular ; Carcinosarcoma ; Chemoradiotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Liver ; Prognosis ; Radiotherapy ; Survival Rate

BACKGROUND/AIMS: This study aimed to develop and validate a risk prediction model for the development of hepatocellular carcinoma (HCC) in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B (CHB). METHODS: We investigated 2,061 Korean treatment-naïve patients with CHB treated with entecavir as an initial therapy. A risk score model for HCC development was developed based on multivariable Cox regression model in a single center (n=990) and was validated using the time-dependent area under the receiver operating characteristic curve (AUROC) in three other centers (n=1,071). The difference of HCC development among risk groups (low, intermediate, and high) categorized by risk score was also investigated. RESULTS: The cumulative incidence rates of HCC at 5 years were 11.2% and 8.9% in the testing and validation cohorts, respectively. HCC-Risk Estimating Score in CHB patients Under Entecavir (HCC-RESCUE) is formulated as (age+15×gender [female=0 / male=1]+23×cirrhosis [absence=0 / presence=1]). The AUROCs at 1 year, 3 years, and 5 years were 0.82, 0.81, and 0.81, respectively, in the validation cohort. A significant difference of HCC development in each risk group was determined by the 5-year HCC risk score in the validation cohort (low risk group, 2.1%; intermediate risk group, 9.3%; high risk group, 41.2%, p<0.001). CONCLUSIONS: The study presents a new risk score model with a good ability to predict HCC development and determine high risk patients for HCC development consisting of readily available clinical factors in treatment-naïve CHB patients receiving entecavir.
Antiviral Agents ; Carcinoma, Hepatocellular* ; Cohort Studies ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Incidence ; Risk Assessment ; ROC Curve

OBJECTIVES: This study was carried out to establish human embryonic stem cells derived from frozen-thawed embryos using mouse embryonic fibroblasts (mEFs), human fetal skin and muscle fibroblasts as feeder cells, and to identify the characteristic of embryonic stem cells. METHODS: When primary mEFs, human fetal skin and muscle fibroblasts were prepared, passaging on 4 days from replating could have effective trypsinization and clear feeder layers. Eight of 23 frozenthawed 4~8 cell stage embryos donated from consenting couples developed to blastocysts. Inner cell mass (ICM) was isolated by immunosurgery. ICM was co-cultured on mEFs, human fetal skin or muscle fibroblasts. The ICM colonies grown on mEFs, human fetal skin or muscle fibroblasts were tested the expression of stage specific embryonic antigen-3, -4 (SSEA-3, -4), octamer binding transcription factor-4 mRNA (Oct-4) and alkaline phosphatase surface marker. RESULTS: We obtained 1 ICM colony from 2 ICM co-cultured on mEFs as feeder cells and did not obtain any ICM colony from 6 ICM clumps co-cultured on human fetal skin or muscle fibroblasts. The colony formed on mEFs could be passaged 30 times every 5 days with sustaining undifferentiated colony appearance. When the colonies cultured on mEFs were grown on human fetal skin or muscle fibroblasts, the colonies could be passaged 15 times every 9 days with sustaining undifferentiated colony appearance. The colonies grown on mEFs and human fetal fibroblasts expressed SSEA-4 and alkaline phosphatase surface markers and positive for the expression of Oct-4 by reverse transcription-polymerase chain reaction (RT-PCR). The produced embryoid body differentiated spontaneously to neural progenitorlike cells, neuron-like cells and beating cardiomyocyte-like cells, and frozen-thawed embryonic stem cells displayed normal 46, XX karyotype. CONCLUSIONS: The human embryonic stem cells can be established by using mEFs and human fetal fibroblasts produced in laboratory as feeder cells.
Alkaline Phosphatase ; Animals ; Blastocyst ; Embryoid Bodies ; Embryonic Stem Cells* ; Embryonic Structures ; Family Characteristics ; Feeder Cells* ; Fibroblasts* ; Humans* ; Karyotype ; Mice* ; RNA, Messenger ; Skin ; Trypsin

Afferent loop syndrome caused by an impacted enterolith is very rare, and endoscopic removal of the enterolith may be difficult if a stricture is present or the normal anatomy has been altered. Electrohydraulic lithotripsy is commonly used for endoscopic fragmentation of biliary and pancreatic duct stones. A 64-year-old man who had undergone subtotal gastrectomy and gastrojejunostomy presented with acute, severe abdominal pain for a duration of 2 hours. Initially, he was diagnosed with acute pancreatitis because of an elevated amylase level and pain, but was finally diagnosed with acute afferent loop syndrome when an impacted enterolith was identified by computed tomography. We successfully removed the enterolith using direct electrohydraulic lithotripsy conducted using a transparent cap-fitted endoscope without complications. We found that this procedure was therapeutically beneficial.
Abdominal Pain ; Afferent Loop Syndrome* ; Amylases ; Constriction, Pathologic ; Endoscopes ; Gastrectomy ; Gastric Bypass ; Humans ; Lithotripsy* ; Middle Aged ; Pancreatic Ducts ; Pancreatitis

PURPOSE: The aim of this study was to evaluate the rat periodontal ligament cell viability under 0℃/2 MPa condition up to one week using in vivo 3-(4,5-dimethylthiazol-2-y1)-2,5-diphenyltetrazolium bromide (MTT) assay. MATERIALS AND METHODS: As soon as 110 upper molar teeth of rats were extracted, they were stored in Hartman's solution under 0℃/2 MPa condition for 1, 2, 3, 4, and 7 days each. All specimens were treated with in vivo MTT assay and the value of optical density was measured by ELISA reader. These values were statistically analyzed by one-way ANOVA. RESULT: There was no statistical difference on MTT value between immediate and 1 day storage group. There were statistically significant differences between 1 day and 2 days tsorage, 2 and 3 days storage groups, respectively. Teeth of 3,4, and 7 days storage groups showed significantly lower MTT valuesc ompared with shorter period storage groups. CONCLUSION: When the MTT values were substituted in standard curve, 1 day storage group at 0℃/2 MPa condition showed 68% cell viability when compared with immediate group. It dropped to 13% at 2 days, and to less than 5% at 3 days or more.
Animals ; Cell Survival ; Enzyme-Linked Immunosorbent Assay ; Methods* ; Molar ; Periodontal Ligament* ; Rats* ; Tooth

PURPOSE: Transrectal ultrasound-guided prostate biopsy is the procedure of choice for diagnosing prostate cancer. We compared with pain-relieving effect of acetaminophen, a known drug for enhancing the pain-relieving effect of tramadol, and eutectic mixture of local anesthetics (EMLA), a local anesthetic agent, with that of the conventional periprostatic nerve block method. MATERIALS AND METHODS: This was a prospective, randomized, single-blinded study. A total of 430 patients were randomly assigned to three groups. Group 1 received a periprostatic nerve block with 1% lidocaine, group 2 received acetaminophen 650 mg, and group 3 received EMLA cream for pain control. All patients were given 50 mg of tramadol intravenously 30 minutes before the procedure. At 3 hours after completion of the procedure, the patients were asked to grade their pain on a horizontal visual analogue scale (VAS). The patients were also asked whether they were willing to undergo future biopsy if required. RESULTS: There were no significant differences between the three groups in terms of age, prostate-specific antigen, prostate size, or numbers of biopsy cores. The pain scores for groups 2 and group 3, which were 3.47+/-1.92 and 3.50+/-1.36, respectively, were similar and were significantly lower than that of group 1, which was 5.24+/-2.07. CONCLUSIONS: Acetaminophen and EMLA cream with intravenous injection of tramadol are safe, easy, and effective methods of controlling pain during the procedure. These methods were more effective for pain relief than was the conventional periprostatic nerve block method.
Acetaminophen ; Administration, Oral ; Anesthetics, Local ; Biopsy ; Biopsy, Needle ; Humans ; Injections, Intravenous ; Lidocaine ; Nerve Block ; Prilocaine ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Tramadol