Closure of interdental spaces using proximal build-ups with resin composite is considered to be practical and conservative. However, a comprehensive approach combining two or more treatment modalities may be needed to improve esthetics. This case report describes the management of a patient with multiple diastemas, a peg-shaped lateral incisor and midline deviation in the maxillary anterior area. Direct resin bonding along with orthodontic movement of teeth allows space closure and midline correction, consequently, creating a better esthetic result.
Diastema ; Esthetics ; Humans ; Incisor ; Tooth ; Tooth Movement

We have cloned a cDNA encoding a cysteine proteinase of the Acanthamoeba healyi OC-3A strain isolated from the brain of a granulomatous amoebic encephalitis patient. A DNA probe for an A. healyi cDNA library screening was amplified by PCR using degenerate oligonucleotide primers designed on the basis of conserved amino acids franking the active sites of cysteine and asparagine residues that are conserved in the eukaryotic cysteine proteinases. Cysteine proteinase gene of A. healyi (AhCP1) was composed of 330 amino acids with signal sequence, a proposed pro-domain and a predicted active site made up of the catalytic residues, Cys(25), His(159), and Asn(175). Deduced amino acid sequence analysis indicated that AhCP1 belongs to ERFNIN subfamily of C1 peptidases. By Northern blot analysis, no direct correlation was observed between AhCP1 mRNA expression and virulence of Acanthamoeba, but the gene was expressed at higher level in amoebae isolated from soil than those from clinical samples. These findings raise the possibility that Ahcp1 protein may play a role in protein metabolism and digestion of phagocytosed bacteria or host tissue debris rather than in invasion of amoebae into host tissue.
Acanthamoeba/*enzymology/genetics/pathogenicity ; Amebiasis/parasitology ; Amino Acid Sequence ; Animals ; Base Sequence ; Cathepsins/*genetics ; DNA, Protozoan/chemistry/genetics/*isolation & purification ; Encephalitis/parasitology ; Gene Expression ; Genes, Protozoan ; Humans ; Molecular Sequence Data ; Polymerase Chain Reaction ; Protozoan Proteins/chemistry/genetics/physiology ; Sequence Alignment ; Virulence

OBJECTIVES: To investigate the differences in accessing regional hospitals and the utilization rate of hospitals located in other regions for cancer patients by regions. METHODS: Data for the utilization of regional hospitals for cancer patients were obtained from the Korean National Cancer Incidence Databases in 1999 and 2002. We divided the regions into 16 provinces by administrative districts. We using the SAS 9.1.3 to analyze difference of regional self-sufficiency and the Arcview 3.2 to show in a schematize for regional variation of the regional self-sufficiency. RESULTS: There were regional variations in the regional self-sufficiency of cancer patients. Especially, Jeollanam-do(1999 13.6%, 2002 12.8%), Gyeongsangbuk-do(1999 22.0%, 2002 20.7%), and Chungcheongnam-do(1999 27.8%, 2002 27.1%) had low regional self-sufficiency. The regional self-sufficiency in Gyeonggi-do and utilization rate of cancer patients who lived in other regions were increased between 1999 and 2002(regional self-sufficiency: 1999 37.2%, 2002 48.2%). CONCLUSION: The results of this study showed that there were regional variation in utilization of regional hospitals for cancer patients. Accessibility of cancer patients in metropolitan areas was higher than in small size cities, medium size cities, and rural county areas. These results suggested that it should be considered support medical facilities for cancer patients in rural areas where have lower relevance rate.
Gyeonggi-do ; Humans ; Incidence

BACKGROUND: The clinical and radiological outcomes of revision total knee arthroplasty with a cemented posterior stabilized (PS), condylar constrained knee (CCK) or a fully constrained rotating hinge knee (RHK) prosthesis were evaluated. METHODS: This study reviewed the clinical and radiological results of 36 revision total knee arthroplasties with a cemented PS, CCK, and RHK prosthesis in 8, 25, and 13 cases, respectively, performed between 1998 and 2006. The mean follow-up period was 30 months (range, 24 to 100 months). The reason for the revision was aseptic loosening of one or both components in 15, an infected total knee in 18 and a periprosthetic fracture in 3 knees. The average age of the patients at the time of the revision was 65 years (range, 58 to 83 years). The original diagnosis for all primary total knee arthroplasties was osteoarthritis except for one case of a Charcot joint. All revision prostheses were fixed with cement. The bone deficiencies were grafted with a cancellous allograft in the contained defect and cortical allograft fixed with a plate and screws in the noncontained defect. A medial gastrocnemius flap was needed to cover the wound dehiscence in 6 of the 18 infected cases. RESULTS: The mean Knee Society knee score improved from 28 (range, 5 to 43) to 83 (range, 55 to 94), (p < 0.001) and the mean Knee Society function score improved from 42 (range, 10 to 66) to 82 (range, 60 to 95), (p < 0.001) at the final follow-up. Good or excellent outcomes were obtained in 82% of knees. There were 5 complications (an extensor mechanism rupture in 3 and recurrence of infection in 2 cases). Three cases of an extensor mechanism defect (two ruptures of ligamentum patellae and one patellectomy) were managed by the RHK prosthesis to provide locking stability in the heel strike and push off phases, and two cases of recurrent infection used an antibiotic impregnated cement spacer. The radiological tibiofemoral alignment improved from 1.7degrees varus to 3.0degrees valgus in average. Radiolucent lines were observed in 18% of the knees without progressive osteolysis. CONCLUSIONS: Revision total knee requires a more constrained prosthesis than primary total knee arthroplasty because of the ligamentous instability and bony defect. This short to midterm follow-up analysis demonstrated that a well planned and precisely executed revision can reduce pain and improve the knee function significantly. Infected cases showed as good a result as those with aseptic loosening through the use of antibiotics-impregnated cement beads and proper soft tissue coverage with a medial gastrocnemius flap.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects/*methods ; Bone Transplantation ; Cementation ; Humans ; Knee Joint/radiography ; *Knee Prosthesis ; Middle Aged ; Osteoarthritis, Knee/surgery ; Prosthesis Design ; Prosthesis Failure ; Reoperation

Population-based survival reflect the average prognosis of unselected patients with a variety of natural histories as well as treatment patterns and are also useful for evaluating effectiveness and efficiency of cancer-directed health services in a given region. Although survival data have been reported based on hospital data, the survival data from population-based registry have been rarely reported in Korea. Based on the Korea National Cancer Incidence Database, we report the results from survival analysis for cancer patients diagnosed during 1993-2002 and followed up until 31 December 2005 at primary cancer sites. The five-year relative survival rates (RSR) were calculated using the Ederer II method. The Kaplan-Meier method was used to estimate median survival and the 95% confidence intervals. In males, the five-year RSR for all cancers was 32.5% during 1993-1997 and was 37.8% during 1998-2002. In females, the five-year RSR for all cancers was 53.7% during 1993-1997 and was 57.0% during 1998-2002. The largest improvement in survival was shown in prostate cancer in males and breast and stomach cancer in females. The median survival durations were 16.3 months in males and 81.6 months in females. This result will be useful for evaluation of cancer treatment outcomes in Korea.
Databases, Factual ; Epidemiologic Factors ; Female ; Humans ; Kaplan-Meiers Estimate ; Korea/epidemiology ; Male ; Neoplasms/*mortality ; Registries ; Survival Rate

National surveys on the prevalence of intestinal parasitic infections have been carried out every 5-7 years since 1971 in the Republic of Korea in order to establish control measures. The present nationwide survey was conducted from June to December 2004. The 10% population sampling data of Population and Housing Census by the Korean government in 2000 was used as the survey population. One sample was selected randomly from each of the 22,858 registered subjects, and a total of 20,541 people were ultimately included in this survey. Fecal examinations were performed by the cellophane thick smear and saturated brine flotation techniques. Pinworm infection was examined by cello-tape anal swab method. This survey also included a questionnaire study for a socioeconomic analysis. The total helminth egg positive rate was 3.7%, and the estimated total positive number among nationwide people was 1,780,000. The rates in urban and rural areas were 3.1% and 6.8%, respectively. As the total egg positive rate in the 6th survey in 1997 was 2.4%, the present survey showed that there was a considerable degree of increase in the prevalence rate of intestinal parasitic infections over the 7-year period following the 6th survey. The largest increases occurred in the egg positive rates of Clonorchis sinensis and heterophyids including Metagonimus yokogawai.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Child ; Child, Preschool ; Data Collection ; Feces/parasitology ; Female ; Helminthiasis/*epidemiology/parasitology ; Helminths/*isolation & purification ; Humans ; Infant ; Intestinal Diseases, Parasitic/*epidemiology ; Korea/epidemiology ; Male ; Middle Aged ; Parasite Egg Count ; Prevalence ; Rural Population ; Urban Population ; Young Adult

Wernicke's encephalopathy is a neuropsychiatric condition generally caused by acute thiamine deficiency. Although it is common in the severe alcoholics, several other causes also have been identified, such as total parenteral nutrition (TPN) use, persistent vomiting, hyperemesis gravidarum, anorexia nervosa and malnutrition. The classic triad of Wernicke's encephalopathy are ataxia, altered mentation and ophthalmoplegia. A 19-year-old boy had been treated with high dose Ara-C and mitoxantrone for acute myelogenous leukemia and intravenous hyperalimentation due to persistent vomiting. He suddenly complained of diplopia, gait disturbance and generalized weakness at 36th day after chemotherapy. Physical examinations showed disorientated mentality, oculomotor palsy and horizental nystagmus. The diagnosis of Wernicke's encephalopathy was made with classical brain MRI and decreased thiamine level. The patient was successfully treated with vitamin B1. We presented a case of acute Wernicke's encephalopathy developed after high dose Ara-C chemotherapy followed by intravenous hyperalimentation in a patient with acute myelogenous leukemia.
Alcoholics ; Anorexia Nervosa ; Ataxia ; Brain ; Cytarabine ; Diagnosis ; Diplopia ; Drug Therapy* ; Female ; Gait ; Humans ; Hyperemesis Gravidarum ; Leukemia, Myeloid, Acute ; Magnetic Resonance Imaging ; Male ; Malnutrition ; Mitoxantrone ; Ophthalmoplegia ; Paralysis ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Physical Examination ; Pregnancy ; Thiamine ; Thiamine Deficiency ; Vomiting ; Wernicke Encephalopathy* ; Young Adult