Anxiety* ; Depressive Disorder ; Depressive Disorder, Major* ; Electroencephalography ; Humans

STATEMENT OF PROBLEM: The effects of various core buildup materials which differs in the mechanical properties on the fracture strength of metal-free crowns is unknown. PURPOSE: This study was carried out to evaluate the fracture strengths of Artglass ceromer crowns supported by 3 different core materials in clinically simulated anterior tooth preparation. Material and methods. Ten crowns from each group were constructed to comparable dimensions on the various dies made by gold alloy, Ni-Cr alloy, and composite resin. The ten crowns were then cemented onto the dies and loaded until catastrophic failure took place. Fracture resistance to forces applied to the incisal edges of the anterior crowns supported by three types of dies was tested. RESULTS: The ceromer crowns on the composite resin dies fractured at significantly lower values(287.7 N) than the ceromer crowns on the metal dies(approximately 518.4 N). No significant difference was found between the fracture values of the ceromer crowns on the dies of gold alloy and Ni-Cr alloy. CONCLUSION: The failure loads of the ceromer crowns on the metal dies were almost the same and not affected by the differences of casting alloys. However, the fracture values of the ceromer crowns on the resin dies were significantly reduced by the relative weak properties of composite resin core material.
Alloys ; Crowns* ; Resin Cements ; Tooth Preparation

Multiple biliary papillomatosis involves an epithelial field change of the intrahepatic and extrahepatic portions of the biliary tree. Pathologically it is benign, occasionally with dysplasia, but the clinical behavior is regarded as having a low-grade malignant potential. Such malignancy is rare but the prognosis is poor if it is impossible to remove the tumor completely. Here, we report one case of multiple biliary papillomatosis in the biliary tree.
Biliary Tract ; Papilloma* ; Prognosis

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease. Despite of proper treatment and improving treatment regimens, HLH patients still show a fatal prognosis. Therefore the evaluation of prognostic factor is important and there are many studies about hyperbilirubinemia as a prognostic factor in HLH. So we studied the prognostic value of hyperbilirubinemia in HLH children. METHODS: A retrospective analysis was performed about 33 patients who were diagnosed with HLH at Pusan National University Hospital and Yangsan Pusan University Hospital between January 2000 to December 2012. We reviewed the clinical characteristics, laboratory findings, and results of treatment to identify hyperbilirubinemia as a prognostic factor in HLH patients. RESULTS: The median age of patients at diagnosis was 32 months. Most of patients presented with fever, pale appearance, abdominal pain and jaundice. Forty-eight point five percentage of patients showed normal serum bilirubiln level (<2.0 mg/dL) and 51.5% showed hyperbilirubinemia (> or =2.0 mg/dL). In normal serum bilirubin group, 1 patient (6.3%) was relapsed and 1 patient (5.9%) was relapsed in hyperbilirubinemia group. In the hyperbilirubinemia group, the mortality was higher than the normal bilirubin group but, there was no statistical significance. CONCLUSION: As a prognostic factor serum bilirubin at diagnosis in HLH patients, there was no significant correlation between hyperbilirubinemia and poor outcome. But, our study has a limitation that the number of patients is too small and almost showed good prognosis.
Abdominal Pain ; Bilirubin* ; Busan ; Child ; Diagnosis ; Fever ; Fibrinogen ; Gyeongsangnam-do ; Humans ; Hyperbilirubinemia ; Jaundice ; Lymphohistiocytosis, Hemophagocytic* ; Mortality ; Prognosis ; Retrospective Studies

PURPOSE: Paradoxical embolism due to the presence of patent foramen ovale(PFO) is a well-established possible mechanism of ischemic stroke of unknown origin, and the closure of PFO seems to be a kind of most effective method of the prevention of stroke recurrence. We report the initial and intermediate-term result of transcatheter closure of PFO associated with paradoxical embolism leading to cryptogenic transient ischemic attack or cerebrovascular accident using the Amplatzer(R) PFO Occluder. METHODS: From January 2003 through May 2005, 10 patients with PFO(4 male, 6 female) with history of at least 1 cryptogenic transient ischemic attack or cerebrovascular accident underwent percutaneous transcatheter closure of PFO using Amplatzer(R) occluder assisted by transesophageal echocardiography(TEE). All procedure were performed under general anesthesia and assisted by TEE. RESULTS: In all patients, the implantation procedure was successful and no significant complication was observed(in one case, peri-interventional ST-segment elevation observed). During the follow-up period of mean 13.1 months(range, 1-28 months), no recurrence of neurologic episode were observed and there was no residual shunt through PFO. CONCLUSION: We were able to implant the device without significant complication in all our patients and close PFO effectively. No recurrence of neurologic episode were observed. We conclude that in this initial and intermediate-term follow up, the transcatheter closure of PFO associated with paradoxical embolism using the Amplatzer(R) PFO Occluder is a safe and effective method in prevention of stroke recurrence and there is no significant adverse effect until now. And this procedure may be the treatment choice in patients with the high risk of recurrence ischemic attack. However, in this study, the number of patients included[5 patients(50%) had multiple thromboembolic events] is small and follow-up period is not long. So, we need more clinical cases and long-term clinical follow-up.
Anesthesia, General ; Embolism, Paradoxical* ; Follow-Up Studies ; Foramen Ovale, Patent* ; Humans ; Ischemic Attack, Transient ; Male ; Recurrence ; Stroke

Immunodeficiency of the patients with end-stage renal disease and various side effects of hemodialysis have been studied. We want to evaluate the effects of the duration of chronic renal failure(CRF) and hemodialysis on transplanted kidneys. This report is based on 111 patients who had received kidney transplantation at Wonkwang university hospital from August 1987 to march 1996. The patients were classified into 3 groups according to the duration of CRF; Group I(1yr and 5yr, n=15). The incidence of acute rejection within 6months was 28(60.8%) in group I, 31(62%) in group II, 9(60%) in group III. The 3-year graft survival rate was 34(73.9%), 38(76%), and 14(93.3%), respectively. The bacterial infection rate of each group within 1 year was 10(22%), 8(15%), and 4(28%). The viral infection rate of each group within 1 year was 15(33%), 11(27%), and 5(35%). To evaluate the effects of hemodialysis, the patients were divided into 3 groups; Group A(without hemodialysis, n=8(7.2%)), Group B(6 months, n=63(56.7%)). The incidence of acute rejection within 6months was 6(75%) in Group A, 24(60%) in Group B, 38(60.3%) in group C. The 3-year graft survival rate was 6(75%), 30(75%), and 50(79.3%), respectively. The bacterial infection rate of each group with 1 year was 2(25%), 10(25%) and 13(26%). The viral infection rate within 1 year was 2(25%), 16(40%) and 13(20.6%). The authors' analysis reveal the 3-year survival rate in the group III was higher than the other groups. But there was no significant difference of acute rejection rate, infection rate and wound complication rate. We suggest more basic study of the immune status of chronic renal failure patients is needed to provide proper immunosuppressive regimen according to the duration of end stage renal disease and hemodialysis.
Bacterial Infections ; Graft Survival ; Humans ; Incidence ; Kidney Failure, Chronic* ; Kidney Transplantation ; Kidney* ; Renal Dialysis* ; Survival Rate ; Wounds and Injuries

PURPOSE: We wanted to evaluate the recurrence rate and risk factors of recurrent venous thrombosis after the endovascular management of acute iliofemoral deep vein thrombosis (DVT). METHOD: Between January 2002 and March 2005, catheter-directed thrombolysis with Urokinase (n=40) and/or stent placement (n=33) and/or aspiration (n=29) was performed in 40 patients with acute iliofemoral DVT. The patients were divided into two groups according to DVT recurrence during the follow-up period: Group A (n=9) with recurrence and Group B (n=31) without recurrence. The risk factors of each group were analyzed for the duration of symptom before the thrombolytic therapy, the risk factors, the dose of Urokinase, and the duration and results of thrombolytic therapy. RESULT: 15 patients were men (mean age; 56.8 yr) and 25 were women (mean age; 61.4yr). The mean duration of symptoms prior to the initiation of thrombolysis for each group was 16.3+/-11.3 days vs. 7.0+/-7.0 days (P=0.040), the average total Urokinase dose was 4.83 million IU vs 2.07 million IU, respectively (P=0.080), and the average duration of therapy was 86.1 hours vs. 59.1 hours, respectively. Complete thrombus resolution was obtained in 33/40 cases. The incidence of decreased anticoagulants such as protein C/S, Antithrombin did not show any difference between two groups. DVT recurred in 5/33 (15.1%) patients for whom the DVT were completely resolved, and in 4/7 (57.1%) patients among the incompletely resolved cases (P=0.034). The causes of recurrence (5/33) in the completely resolved cases were as follows; poor compliance, and other anatomical and systemic diseases (lumbar body anomaly, Behcet's disease and cancer peritonii, after obstetrical dilatation & curettage). CONCLUSION: We can conclude that the residual venous thrombosis and duration of symptom before the thrombolytic therapy are important risk factors for recurrent thrombosis. Its assessment may help to modify the duration of anticoagulation therapy for DVT patient. Whether the evaluation of DVT risk factors may help for the secondary preventive treatment should be assessed by specifically designed intervention studies.
Anticoagulants ; Clinical Trial ; Compliance ; Dilatation ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Recurrence ; Risk Factors* ; Stents ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis*

PURPOSE: Bipolar energy has recently been used for transurethral resection of bladder tumor (TURBT). Although this modality is thought to be safe, there are some controversies concerning the pathologic accuracy of the biopsy specimens. We compared clinical efficacy, safety, and pathologic characteristics of deep biopsy specimens between bipolar and monopolar devices. MATERIALS AND METHODS: From January 2002 to June 2007, a total of 115 patients underwent TURBT with deep biopsy with the use of bipolar (bipolar group, n=64) or monopolar (monopolar group, n=51) devices. We retrospectively analyzed tumor size, tumor number, urine cytology, perioperative blood loss (postoperative changes in hemoglobin levels), complications, duration of catheterization, duration of hospitalization, pathologic stage, WHO grade, deep biopsy specimen thickness, and grade of thermal damage. RESULTS: There were no statistical differences in tumor size, tumor number, urine cytology, complications, duration of hospitalization, pathologic stage, or WHO grade between the two groups. Postoperative changes in hemoglobin levels were significantly lower in the bipolar group (p=0.038), and the duration of catheterization was shorter in the bipolar group (p=0.026). The deep biopsy specimen thickness was significantly thinner in the bipolar group (2.25+/-0.94 mm vs. 3.02+/-1.39 mm, p<0.05). The grade of thermal damage was not statistically different between the two groups (p=0.862). CONCLUSIONS: In terms of clinical efficacy and safety, bipolar TURBT is comparable to monopolar TURBT, having advantages in perioperative blood loss and duration of catheterization. In addition, pathologic changes in deep biopsy after bipolar and monopolar TURBT are similar. Bipolar TURBT can be properly used for bladder tumors without pathologic error.
Artifacts ; Biopsy ; Catheterization ; Catheters ; Hemoglobins ; Hospitalization ; Humans ; Pathology, Surgical ; Retrospective Studies ; Urinary Bladder ; Urinary Bladder Neoplasms

Objectives: ：The purpose of this study was to investigate the effect of adult Attention-Deficit/Hyperactivity Disorder (ADHD) tendency on cognitive functions in the group of depression. Methods: ：117 male patients with depression (51 with adult ADHD and 66 with adult non-ADHD) were recruited in this study. All patients were subject to the following tests : Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV), Executive Intelligence Test, Rey-Kim memory test, Beck’s Depression Inventory II (BDI-II), and Beck’s Anxiety Inventory (BAI), Adult ADHD Self-Report Scale (ASRS), Lee Ji-Yeon’s adult ADHD scale. Results: ：Compared to the adult non-ADHD group, the adult ADHD group showed lower score in Rey-Kim memory test. Several test scores were negatively correlated with ASRS (free recall test trial 2 : r=-0.184, p=0.047, trial 3 : r=-0.277, p=0.002, trial 4 : r=-0.242, p=0.009, trial 5 : r=-0.264, p=0.004, delayed recall test : r=-0.187, p=0.044, recognition test : r=-0.209, p=0.024). No significant correlation was found between depression, anxiety and Rey-Kim memory test even though there is a meaningful correlation between adult ADHD tendency the severity of depression and anxiety. Conclusion ：In this study, we found the adult ADHD with depression group has difficulties in retaining information and maintaining attention. Interestingly, it was proved the difference comes from ADHD tendency, not from the severity of depression or anxiety.

Factitious fever has been a rare cause of fever of unknown origin. We herein report a case of a young soldier, who presented with persistent fever of unusual pattern and bullae on both palms. After numerous investigations had excluded organic diseases, factitious fever was diagnosed with measurement of the freshly voided urine temperatures and body temperatures while directly observed. Biopsy of skin lesions revealed friction blister. Early recognition of this cause of fever is needed to avoid the unnecessary investigation and prolonged hospitalization.
Biopsy ; Blister ; Body Temperature ; Factitious Disorders ; Fever of Unknown Origin ; Fever* ; Friction ; Hospitalization ; Humans ; Military Personnel ; Skin