STATEMENT OF PROBLEM: when using resin for class II restoration, micoleakage by instrumentation can be regarded as the primary negative characteristic. A review of the available literature suggests that using flowable resin as liner to decreased microleakage. PURPOSE: The aim of this study was to determine the influence of the nanofilled flowable resin lining on marginal microleakage after load cycling in class II composite restoration fillings using nanofiller resin. MATERIAL AND METHODS: 24 extracted premolars were prepared with class II cavity. F group was restored the nanofilled resin with the nanofilled flowable resin as liner. NF group was restored the nanofilled resin only. After restoration, an experiment was performed on 2 groups using a 300N load at 104, 105 and 106 cycles. Prior to and before each load cycling, it was gauged length on total marginal microleakage, axial marginal microleakage and buccal, gingival, lingual marginal microleakage. Data were analyzed with the Mann-Whitney test & Kruskal-Wallis test. RESULTS: There were statistically significant differences between 2 groups and between individual groups. (P < .05) The result showed less microleakage in teeth restored by the nanofilled resin, which was lined by the nanofilled flowable resin. CONCLUSION: There was significant reduction in microleakage when the nanofilled flowable resin lining was placed underneath the nanofilled resin in class II composite restoration fillings.
Bicuspid ; Tooth

Benign tumors of the esophagus occur rarely as compared with the incidence of carcinomas. Among the benign tumors of the esophagus such as leiomyoma, lipoma, hemangioma, papilioma. polyp, cystetc. leiomyoma is the most common, although less than 10 percents of leiomyomas of the gastrointestinal tract are found in the esophagus. Most of leiomyomas of the esophagus present as solitary lesions but multiple tumors occur in about 4 percents of cases. Leiomyomas of the esophagus are diagnosed by thorough clinical evaluation, esophagogram and upper gastrofiberscopic examination but histological confirmation requires surgical or necropsy specimens. Occasionally gastrofiberscopic polypectomized specimens are used. We report one case of multiple leiomyomas of the esophagus located in between 25 cm and 40 cm distance from the incisor in a 38-year-old man who complained of vague substernal discomfort for about 10 years. Gastrofiberscopic polypectomized specimen was used for preoperative histological confirmation. The pathologic examination of the specimen showed leiomyoma of the esophagus.
Adult ; Esophagus* ; Gastrointestinal Tract ; Hemangioma ; Humans ; Incidence ; Incisor ; Leiomyoma* ; Lipoma ; Polyps

BACKGROUND: Recently introduced plateletpheresis systems (AmicusTM software version 2.41 and MCS + LDP Rev. C) were evaluated for their performance. METHOD: Single-needle procedure was used for all donors, 127 with the AmicusTM and 85 with the MCS +. The targeted platelet yield was 3.2x1011. Components were evaluated for component yields, collection time, collection efficiency and incidence of donor reactions due to citrate. RESULTS: The collection time was significantly shorter with the AmicusTM (mean 57 min vs. 71 min, p< 0.05), and in 9 donors with a mean preapheresis platelet count of 325x103 /microliter the whole procedure could be completed within 40 minutes. However, the total processing time, including preprocessing and postprocessing time, between AmicusTM (78.0 min) and MCS + (74.3 min) was not statistically different. Mean platelet yield for AmicusTM and MCS + were 3.6x1011 and 3.4x1011, respectively. With 82.4% of SDPs collected with the MCS + having a platelet count of 3.0~3.9x1011, compared to 65.4% with the AmicusTM, the MCS + was more accurate in predicting the platelet yield of the final products. All components showed a residual WBC count of 5.0x106, and in 99.2% and 97.6% of components collected with the AmicusTM and MCS +, respectively, had a residual WBC count of less than 1.0x106. Mild donor reactions due to citrate tended to be more common on the MCS + (14.1%), which also used significantly more ACD (mean 342.5 mL vs. 268.0 mL, p< 0.05), than on the AmicusTM (5.5%). CONCLUSION: The plateletpheresis systems evaluated in this study allow the collection of leukoreduced SDPs of high quality within a reasonable time.
Blood Platelets ; Citric Acid ; Humans ; Incidence ; Platelet Count ; Plateletpheresis* ; Tissue Donors

Objective: To evaluate the radiographic characteristics of the ampulla of Vater cancer. Subjects and Methods:The authors analyzed retrospectively the US(n=25) and CT(n=15) findings in 25 cases of ampulla of Vater cancer, with emphasis on the potential of CT & US in regand to the detectibility of the mass. ERCP(n=15) and hypotonic duodenography(n=5) were also evaluated for the configuration of obstructed duct. RESULTS: The tumor was detected on sonography in only 12 cases(48%) as a small, relatively well delinated mass with slighty low echogenicity to the pancreas. The tumor was shown by CT in 8 cases(53% ) as a well delinated mass protruding into the second portion of duodenal lumen with slightly low attenuation to the pancreas. CBD was dilated in 25 cases(100%), but pancreatic duct was dilated in 15 cases(60%). Obstructed end of CBD was nipple shaped in 7 cases(47%), clubbed in 3, flat in 3, and indistict in 2 by ERCP. Hypotonic duodenogram showed irregular filling defect in the medial wall of second portion of the duodenum in 5 cases (100%). CONCLUSION: Mas detection rate crsing US or CT were not high in ampulla of Vater cancer. Except for a CT finding of a small mass protruding into the regional duodenal lumen, other finclings were nonspecific. Therefore, additional studies or more afgressive approach should be attempted for a correct diagnosis.
Ampulla of Vater* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Duodenum ; Nipples ; Pancreas ; Pancreatic Ducts ; Retrospective Studies

Tumoral calcinosis is a periarticular calcific lesion and rare complication in patients with maintenance hemodialysis. The pathogenesis of tumoral calcinosis is poorly understood but may be due to elevated serum phosphorus, a high calcium phosphorus (Ca x P) product or secondary hyperparathyroidism in hemodialysis patients. A 30-year-old man presented with pain and palpable mass of left shoulder. He had been on maintenance hemodialysis with high flux dialyzer for 10 years. Laboratory finding showed hyperphosphatemia and elevated intact PTH concentration. A shoulder X-ray and CT scan demonstrated a massive calcification. Following partial resection, pain was relieved. Here we report a case of tumoral calcinosis of shoulder in a hemodialysis patient with untreated hyperphosphatemia and secondary hyperparathyroidism.
Adult ; Calcinosis ; Calcium ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperphosphatemia ; Phosphorus ; Renal Dialysis ; Shoulder

BACKGROUND AND OBJECTIVES: In Kawasaki disease (KD), high dose intravenous immunoglobulin (IVIG) significantly lowers the coronary complications. However, some patients either do not respond to initial therapy or develop coronary complications. We aimed to identify the predictive factors for unresponsiveness to initial IVIG therapy and coronary artery dilatation (CAD; defined by Z-score≥2.5) in the acute phase and convalescent phase. SUBJECTS AND METHODS: A retrospective review was conducted of 703 patients with KD, admitted to Gachon University Gil Medical Center between January 2005 and June 2013. The patients were divided into two groups-IVIG responders vs. non-responders-based on the IVIG treatments, and presence of fever after treatment. Further, these groups were divided into two subgroups based on their CAD. RESULTS: Among the 703 patients with KD, the rate of non-responders to initial IVIG was 16.8%. Serum total bilirubin, platelet count, and neutrophil proportion were independent predictive parameters of unresponsiveness (p<0.05). CAD was found in 234 patients (33.3%) in the acute phase, and in 32 patients (4.6%) in the convalescent phase. Male gender, fever duration, serum C-reactive protein, and white blood cell count were related to CAD (p<0.05). CAD was detected more frequently in non-responders than in the responders (47.5% vs. 31.5%, p=0.001). Kobayashi, Egami, and Sano scoring systems applied to our study population reflected low sensitivities (28.0-33.9%). CONCLUSION: Several independent parameters were related to unresponsiveness to the initial IVIG or CAD. These parameters might be helpful in establishing more focused and careful monitoring of high-risk KD patients in Korea.
Bilirubin ; C-Reactive Protein ; Child* ; Coronary Vessels* ; Dilatation* ; Fever ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Korea ; Leukocyte Count ; Male ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils ; Platelet Count ; Retrospective Studies

PURPOSE: This retrospective study was designed to know the relation between clinical features, genetics, and immunostaining findings among children with Duchenne muscular dystrophy (DMD)/Becker muscular dystrophy (BMD) and the validity of the diagnostic tools for muscular dystrophy. METHODS: The medical records and computerized databases of 93 patients diagnosed with DMD/BMD from June 1989 to December 2008 were reviewed retrospectively. Demographic characteristics including clinical features, serum creatinine kinase(CK) level, electromyogram(EMG) and nerve conduction velocity(NCV), muscle biopsy, immunochemical staining for dystrophin, and the deletion of dystrophin gene were analyzed. We calculate the concordance rate between type of frame (in or out of frame) and phenotype. RESULTS: 58(62%) children were diagnosed with DMD, 13(14%) BMD, 19(20%) unclassified dystrophy, and 3(3%) DMD/BMD carriers. The mean age of symptom onset was 5.0+/-3.5 years(range, 1-17). 46(49%) children presented gait disturbance and 35(37%) elevation of liver enzymes. The mean value of serum CK enzyme was 14,758+/-11,792 IU/L (range, 633-61,349). There was no dystrophin in the immunochemical stain among 48 DMD children and at least partial or incomplete dystrophin among 10 BMD children. 28/54(51%) children had dystrophin gene deletion in multiplex PCR and 13/14(92%) in Multiplex Ligation-dependent Probe Amplification(MLPA). The loss of heterozygosity was shown in 2 children by MLPA. The overall concordance rate between type of frame(in or out of frame) and phenotype was 95% in this study. CONCLUSION: Despite of small population, this finding indicates that the determination of type of frame (in or out of frame) by MLPA may be helpful in differential diagnosis of DMD/BMD. In addition, we surmise that the detection of carrier by MLPA is helpful in genetic counseling.
Biopsy ; Child ; Creatinine ; Diagnosis, Differential ; Dystrophin ; Gait ; Gene Deletion ; Humans ; Liver ; Loss of Heterozygosity ; Medical Records ; Multiplex Polymerase Chain Reaction ; Muscles ; Muscular Dystrophies ; Muscular Dystrophy, Duchenne ; Neural Conduction ; Phenotype ; Retrospective Studies

PURPOSE: The efficacy of stenting for the right-side colonic malignant obstruction is unknown. The purpose of this study was to evaluate the safety and feasibility of self-expandable metallic stent insertion for the right-side colonic malignant obstruction and its clinical benefits. METHODS: We retrospectively reviewed clinical data from 460 patients who underwent right hemicolectomy for right-side colon cancer from January 2006 to January 2014 at Korea University Anam Hospital. Twenty four patients who developed malignant obstruction in the right -side colon were identified and analyzed. RESULTS: Self-expandable metallic stent insertion was attempted in 14 patients, and initial technical success was achieved in 13 patients (92.9%). No immediate stent-related complications were reported. Complete relief of obstruction was achieved in all of the 13 patients. Eleven patients who failed stenting underwent emergency operation. All of the 13 patients with stent underwent laparoscopic surgery and only one case was converted to open. Only three patients in the emergency group underwent laparoscopic surgery but one was converted. Operative time and number of retrieved lymph nodes did not differ between the two groups. Postoperative hospital stay (9.8+/-3.2 in stent group vs. 16.3+/-10.9 days in emergency group, p=0.082) tended to be shorter in the stent group. Estimated blood loss (38.5+/-138.7 in stent group vs. 381.8+/-411.9 in emergency group, p=0.010) and duration for resuming diet (3.2+/-2.2 in stent group vs. 6.6+/-7.0 days in emergency group, p=0.017) were significantly better in the stent group. CONCLUSION: Self-expandable metallic stent appears to be safe and feasible in the right-side colonic malignant obstruction. It facilitates minimally invasive surgery and may result in better short-term surgical outcome.
Colon* ; Colonic Neoplasms ; Diet ; Emergencies ; Humans ; Korea ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Operative Time ; Retrospective Studies ; Stents* ; Surgical Procedures, Minimally Invasive

PURPOSE:Despite the worldwide interests in the quality of life issues in children with epilepsy, only few studies have been conducted in Korea yet. This study is aimed to analyze clinical factors related with the issues of life in children with epilepsy. METHODS:A total of 158 children(79 patients/79 control) were involved in the study from the Department of Pediatrics at Asan Medical Center and 79 normal children who completed the Korean Child Behavior Checklist(K-CBCL). We used the Korean version of the Quality of Life in Childhood Epilepsy Questionnaire(K-QOLCE) to evaluate the quality of life. The differences of the quality of life between the patients and the controls were compared and the influencing factors were evaluated. RESULTS:The scores of physical functions, well-being, cognition, social functions, behaviors, general health, and quality of life were lower in the patients than in the controls. We found higher scores of quality of life in the patients with epilepsy who were younger when diagnosed, had shorter disease period, took fewer drugs, and took drugs for a shorter time(P<0.05). Higher scores of physical restriction(P=0.017), self-esteem(P=0.006), cognition(P=0.02), and behaviors(P=0.019) were noted for the patients with partial seizures, compared to those with generalized seizures. CONCLUSION:We found that the quality of life in the pediatric epilepsy patients was lower than that of normal children and various factors associated with the treatment of epilepsy influenced the quality of life. The information obtained from this study will help us offer better epilepsy management.
Child Behavior ; Child* ; Chungcheongnam-do ; Cognition ; Epilepsy* ; Humans ; Korea ; Pediatrics ; Quality of Life* ; Seizures

PURPOSE: As Gwangju Wide Regional Emergency Medical Center was newly opened during February 2001, a comparative analysis was performed of patients who had visited the emergency department before and after the opening in order to measure the difference and to provide basic data for its management. METHODS: The 9,995 patients who had visited between February 1, 1999, and July 31, 1999, before the opening and the 12,457 patients who visited between February 1, 2001, and July 31, 2001, after its opening were compared according to sex, age, non-trauma or trauma, means and form of visit, attending department, length of stay in the emergency department, form of discharge, and time of death verification (dead-on-arrival (D.O.A) versus deadafter-arrival (D.A.A)). RESULTS: The total number of patients increased by 24%. The admission rate was 31.8% before the opening and 40.6% after the opening; the mean length of stay in the emergency department was 15.7 hours before the opening and 12.2 hours after the opening. The mean length of stay of admitted patients decreased from 26.6 hours before the opening to 18.3 hours after the opening. CONCLUSION: The decrease in the mean length of stay in the emergency department from 15.7 hours before the opening to 12.2 hours after the opening is viewed as a positive result, but is still not satisfactory. Accordingly, it is considered urgent that every clinical department take an active part in improving circulation of patients both in the Emergency Intensive Care Unit (EICU) on the second floor and in the emergency ward on the fifth floor, as well as in providing rapid medical care and decisions on treatment strategies in the emergency department on the first floor.
Emergencies* ; Emergency Service, Hospital ; Gwangju* ; Humans ; Intensive Care Units ; Length of Stay