No abstract available.
Angiofibroma ; Carbon ; Carbon Dioxide ; Lasers, Gas

PURPOSE: The purpose of this study was to compare the functional abilities of the low bulb obturators with those of high bulb obturators in terms of patients' evaluation. MATERIAL AND METHODS: This study included 11 maxillectomy patients who underwent postoperative prosthodontic rehabilitations. Two obturators of the same design except for different bulb heights, were fabricated for each of the maxillectomy patient. After two months of alternate use, the functions of the obturators were measured by investigating the patients' subjective evaluations in terms of convenience, speech, nasality, leakage, and mastication and identifying their preferred prostheses. Wilcoxon signed rank test was used as a statistical method (P < .05). RESULTS: There were no significant differences in patient evaluations of low and high bulb obturators (P >.05). And patients' preferences varied. CONCLUSION: In extreme situation such as in mouth opening limitation, the use of low bulb obturators can be recommended and result in comparable speech function to that of obturators with high lateral walls.
Humans ; Mastication ; Mouth ; Prostheses and Implants ; Prosthodontics

BACKGROUND: The role of platelet in the pathogenesis of acute coronary syndrome and cerebral thrombosis is well known and the platelet inhibitors are used widely for primary and sccondary prevention of cardiovascular disease. Aspirin is the least expensive and most widely used antiplatelet agent and its effect is associated with its ability to inhibit plateletthromboxane A2 synthesis. The effectiveness of aspirin is dependent on its ability to block the formation of thromboxane A2. Ticlopidine is another popular antiplatelet agent used today in the era of stent implantation for treating coronary artery obstructive disease(CAOD) with aspirin. The mechanism of action of ticlopidine is clearly different from that of aspirin. It is concluded recently that ticlopidine is an inhibitor of ADP binding to platelets. The inhibition of ADP binding to platelets by ticlopidine is very nicely correlated with its does and the inhibition of platelet aggregation. Therefore, in this study, antiplatelet effect of low dose enteric-coated aspirin in place of aspirin and combined therapy with low does enteric-coated aspirin plus ticlopidine were evaluated in the normal subjects. METHOD: IN twenty normal subjects, platelet aggregation tests with adenosine diphosphate(ADP) and collagen were performed baseline, after I week adminisrtation of enteric-coated aspirin, and in randomly selected ten among twenty normal subjects, I week administration of enteric-coated aspirin and ticlopidine. The maximal aggregation rate was calculated by measuring the maximal change of the light transmittance after addition of aggregating agents. RESULT: Low does enteric-coated aspirin inhibited platelet aggregation in response to collagen significantly. Less than 25% of antiaggregation effect was noted in about 50% of subjects with low dose enteric-coated aspirin when platelet aggregation was induced by ADP. Ticlopidine in combination with low does enteric-coated aspirin potentiated the inhibitory effect significantly on platelet aggregation in response to ADP. CONCLUSION: Effect of low dose enteric-coated aspirin alone on platelet aggregation in response to ADP stimulation was weak and showed variablity, comparing to collagen stimulation. The combined treatment of ticlopidine plus aspirin was synergistically inhibited platelet aggregation responding to ADP stimulation. Therefore to achieve the synergistic inhibition of platelet aggregation to ADP and collagen stimulation, combination theraphy might be a effective regimen.
Acute Coronary Syndrome ; Adenosine ; Adenosine Diphosphate ; Aspirin* ; Blood Platelets* ; Cardiovascular Diseases ; Collagen ; Coronary Vessels ; Intracranial Thrombosis ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; Stents ; Thromboxane A2 ; Ticlopidine*

BACKGROUND: Patients with end-stage renal disease have farther excess rate of coronary artery disease (CAD) than nonuremic population. There is a possibility that atherosclerosis may aggravate renal insufficiency, but it is not certain. Pulse pressure was also significantly increased in patients with chronic renal disease (CRD), and had been implicated in the development of atherosclerosis. The purpose of this study is to identify the association of atherosclerotic CAD and pulse pressure with renal disease progression in patients with mild CRD METHODS: The patients with mild CRD who had been followed up more than 3 years in Asan medical center, Seoul, Korea, were included. We evaluated their CAD via coronary angiography, and followed up their serum creatinine levels and other parameters assumed to be associated with progression of CRD. All clinical and laboratory parameters were analyzed by multivariate logistic method. And we examined the association between pulse pressure and progression of CRD with related factors via multivariate logistic analysis. RESULTS: Total 87 patients (54 were men and 33 were women) were included in this study. 45 patients had coronary heart disease and 42 had not. Comparison of CRD progression between the patients who had CAD (n=45) and those who had not (n=42) showed a significant difference (76% vs 52%, p< 0.05). Mean arterial pressure, pulse pressure, presence of diabetic nephropathy, 24hour urine protein, total cholesterol were the parameters associated with the progression of CRD. Among of them, proteinuria and mean arterial pressure were independent risk factors for renal disease progression. There was a significant association between CAD and pulse pressure. CONCLUSION: Atherosclerotic CAD and increased pulse pressure were associated with renal disease progression in the patients with mild renal insufficiency.
Arterial Pressure ; Atherosclerosis ; Blood Pressure* ; Cholesterol ; Chungcheongnam-do ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Creatinine ; Diabetic Nephropathies ; Disease Progression ; Humans ; Kidney Failure, Chronic ; Korea ; Male ; Proteinuria ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Risk Factors ; Seoul

BACKGROUND: Atherosclerotic vascular disease is the major cause of morbidity and mortality in dialysis patients. C-reactive protein (CRP) appears to be clinically useful in prediction of coronary heart disease. Elevated pulse pressure has been associated with an increased risk of cardiovascular disease among apparently healthy adults. Therefore, we evaluated the association between a persistent elevation of C-reactive protein level, pulse pressure and the presence of ischemic heart disease in patients with continuous ambulatory peritoneal dialysis (CAPD). METHODS: A total of 71 CAPD patients (42 males, 29 females) who underwent thallium SPECT and followed up more than 6 months were included. We collected the data about age, sex, smoking, diabetes, hypertension, pulse pressure and body mass index. Blood levels of albumin, total cholesterol, fibrinogen, lipoprotein (a) and C-reactive protein were measured. RESULTS: The values of C-reactive protein, pulse pressure, smoking and fibrinogen were significantly higher in thallium SPECT positive group (p<0.05). A 0.01 mg/dL increase in C-reactive protein was associated with a 1.014 increase in the odds of having an elevated risk of coronary artery disease (95% confidence interval 1.008-1.019) and a 1 mmHg increase in pulse pressure was associated with a 1.017 increase in the odds of having an elevated risk of coronary artery disease (95% confidence interval 1.011-1.023). By multivariate logistic regression analysis, C-reactive protein and pulse pressure were independent risk factors for ischemic heart disease. Log CRP level was positively correlated with pulse pressure level (p<0.01). CONCLUSION: The baseline level of CRP and pulse pressure independently predicts the risk of coronary heart disease in CAPD patients. For patients who have a persistent elevation of CRP and pulse pressure without an apparent cause, we recommend a workup for ischemic heart disease.
Adult ; Blood Pressure* ; Body Mass Index ; C-Reactive Protein* ; Cardiovascular Diseases ; Cholesterol ; Coronary Artery Disease ; Coronary Disease ; Dialysis ; Fibrinogen ; Humans ; Hypertension ; Lipoprotein(a) ; Logistic Models ; Male ; Mortality ; Myocardial Ischemia* ; Peritoneal Dialysis, Continuous Ambulatory* ; Risk Factors ; Smoke ; Smoking ; Thallium ; Tomography, Emission-Computed, Single-Photon ; Vascular Diseases

Since a decade ago, apolipoprotein (apo) E polymorphism has been focussed as a risk factor for cardiovascular disease. ApoE plays a central role as a receptor ligand for the uptake of lipoproteins from the circulation. There was an agreement on apoE polymorphism being one of the major risk factors for coronary artery disease (CAD) by its effects on lipid profiles. However, the effects of apoE have not been noted in all populations and conflicting results in the risk of CAD have been noted. Recently, in situ expression of apoE on the atherosclerotic plaque has been studied. We, therefore, investigated the effects of apoE genotype on patients with acute coronary syndrome, including unstable angina and acute myocardial infarction, in non-diabetic patients. While we could not find significant risk effects of apoE on coronary artery disease and lipid profiles on simple comparison with the normal control group, we could find significantly decreased frequencies of apo epsilon 3 allele in patients with acute coronary syndrome compared with stable angina patients (77.8% vs 88.8%). We suggest that the apoE genotype could be associated with acute coronary events in CAD and further study with in situ biochemical methods will be needed on the effects of apoE polymorphism on plaque stability.
Apolipoproteins E/genetics* ; Coronary Disease/genetics* ; Genotype ; Human ; Polymorphism (Genetics)/genetics* ; Syndrome

Eosinophilic infiltration into skeletal muscles has been rarely reported in a variety of conditions such as parasite infection, sarcoidosis, rheumatoid arthritis, eosinophilia-myalgia syndrome, and idiopathic hypereosinophilic syndrome. Eosinophilic myositis (EM) is one of idiopathic inflammatory muscle diseases associated with muscle and/or blood eosiophilia. The case of EM complicated with hypercapnic respiratory failure has been extremely rarely reported. A 61-year-old woman was admitted with sudden-onset pain in both calves. She had elevated serum muscle enzymes and peripheral eosinophil count. Findings of electromyography were consistent with inflammatory myopathy. MRI showed diffuse hyperintensity of calf muscles on T2-weighted and enhanced T1 images. Muscle biopsy showed eosinophils' infiltration in the endomysium and perivascular area. During the diagnostic work-up, she presented with hypercapnic respiratory failure. She was successfully treated with mechanical ventilation and high doses of prednisolone. This case suggests EM can cause respiratory failure secondary to respiratory muscle involvement.
Arthritis, Rheumatoid ; Biopsy ; Electromyography ; Eosinophilia-Myalgia Syndrome ; Eosinophils* ; Female ; Humans ; Hypereosinophilic Syndrome ; Magnetic Resonance Imaging ; Middle Aged ; Muscle, Skeletal ; Muscles ; Myositis ; Parasites ; Polymyositis* ; Prednisolone ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Muscles ; Sarcoidosis

The pancreatic duct stenting is now recognized as the treatment option for a number of pancreatic disorders. Although the stent-induced ductal changes may result, there is little information regarding the frequency of these stent-induced changes in chronic pancreatitis. Pancreatic stents may occlude with time, but there is only little information available on the nature of the clogging process. Although a short-term efficacy of endoscopic pancreatic duct stenting has been proved, the long-term efficacy continues to be controversial. The aim of this study was to report a case of chronic pancreatitis with pancreatolith after the incidental long-term pancreatic stenting for 3 years due to a pancreas divisum with acute pancreatitis. Also, this study described the analysis of the ultrastructural changes in the surface of an occluded pancreatic stent. A scanning and transmission electron microscopy showed an amorphous protein matrix in whole stent that arranged as a network in some areas but arranged as the layers in other areas. A variable number of bacteria of mixed species, calcium carbonate or calcium oxalate crystal, round leukocyte were scattered in the protein matrix. The yeast and plant material were seen in some part of the stent as well.
Cholangiopancreatography, Endoscopic Retrograde ; Humans ; Lithiasis/etiology ; Male ; Middle Aged ; Pancreas/*abnormalities ; Pancreatic Ducts/*pathology ; Pancreatitis/complications/*therapy ; *Polyethylene ; Stents/*adverse effects

Primary small cell carcinoma occasionally occurs in the gastrointestinal tract; however, primary small cell carcinoma is extremely rare in common bile duct (CBD). Moreover, synchronous advanced gastric cancer has not been reported in the medical literature. We herein report on a case of synchronous primary cancer in the CBD and stomach. A 51-year-old male was admitted because of painless jaundice. Abdominal CT and ERCP showed an exophytic mass that obscured the mid-CBD and there was also intrahepatic duct dilatation. In addition, a large ulcerofungating mass was seen at the lesser curvature of the mid-body on gastrofiberscopy. The biopsy specimen obtained from ulcer was confirmed to be poorly differentiated adenocarcinoma. Explorative laparotomy was performed to remove CBD mass and gastrectomy, however, the surgery was stopped after just biopsy because of the invasion of tumor to the portal vein and difficulty in diseection. Small cell carcinoma was diagnosed from the surgical biopsy specimen by immunohistochemical stains. The tumor cells were strongly positive for neuroendocrine markers such as CD56 and synaptophysin. The patient received chemotherapy with irinotecan and cisplatin.
Adenocarcinoma ; Biopsy ; Camptothecin ; Carcinoma, Small Cell ; Cholangiopancreatography, Endoscopic Retrograde ; Coloring Agents ; Common Bile Duct ; Dilatation ; Gastrectomy ; Humans ; Jaundice ; Laparotomy ; Male ; Middle Aged ; Portal Vein ; Stomach ; Stomach Neoplasms ; Synaptophysin ; Ulcer

We report a case of AIDS-related Kaposi's sarcoma in a 47-year-old male. He was diagnosed as HIV-positive 3 years ago. He developed two asymptomatic purple-colored papules on the nose and right elbow. The histopathological finding showed abnormally proIiferated and dilated vessels, vascular slits, spindle shaped cells, and extravasated erythrocytes. In immunohistochemical studies, the cryptic vessels was positive with CD34, but negative with factor XIIIa and factor VIII-related antigen, Human herpesvirus-8 was found by PCR. We think that this is the first reported case of AIDS-related Kaposi's sarcoma in Korean dermatologic literature.
Elbow ; Erythrocytes ; Factor XIIIa ; Humans ; Male ; Middle Aged ; Nose ; Polymerase Chain Reaction ; Sarcoma, Kaposi* ; von Willebrand Factor