STATEMENT OF PROBLEM: Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE: This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS: Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS: The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION: To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.
Humans ; Molar ; Mucous Membrane ; Silicones ; Tooth

Background & Objective: The number of ischemic stroke is increasing steadily. The recent stroke prevention strategies have targeted risk factors for preventing ischemic stroke. Community-based data that quantify the prevalence of these risk factors are needed to develop effective stroke prevention strategies. This study was performed aiming to establish customized prevention strategies by investigating vascular risk factors of ischemic stroke among the healthy adults in an urban population in Korea. Methods: The Prevention of Stroke and Dementia (PRESENT) survey collected data associated with stroke risk factors between 2007 and 2009 in Ansan city, Korea. Of 46,537 people, 2,843 were selected by random sampling, and final population included 358 men and 422 women over 50 years old. We checked modifiable risk factors, such as hypertension, diabetes mellitus, smoking, hyperlipidemia, atrial fibrillation, cardiovascular disease, obesity, and physical inactivity. Results: The mean age of study subjects was 60.1±8.2 years; 55.5% had hypertension, 18.6% had diabetes mellitus, 17.7% were current smoker, 44.9% had hyperlipidemia, 1.7% had atrial fibrillation, and 4.5% had cardiovascular disease. Men had more risk factors for stroke, and higher rates of diabetes mellitus and current smoking. However, women had higher cholesterol and obesity rates and lower physical activity. The proportion of individuals with >1 risk factor for stroke increased with age. Hypertension, diabetes mellitus, and cardiovascular diseases also increased with age, but low-density lipoprotein levels and current smoking decreased. Conclusions: This study provides valuable information to develop customized strategic policies for primary and secondary stroke prevention.
Stroke

Angiographic findings were analysed in 11 cases of Behcet'sdisease which was diagnosed clinically in Seoul national University Hospital from July 1982 to June 1983. Arterial involvement was noted in 5 cases and venous involvement in 6 cases respectively. Arterial aneurysm and occlusion were arteriographic findings. Arterial aneurysm was noted at large arteries in all 5 cases and multifocal involvement was noted in 4 cases. Characteristic finding of arterial involvement was protruding saccular aneurysm. Venous involvement was thrombotic occlusion of deep veins in iliac, femoral and tibial areas in all 6 cases. Behcet's disease should be differentiated whenever these arterial or venous angiographic findings are revealed in a young adult.
Aneurysm ; Arteries ; Humans ; Seoul ; Veins ; Young Adult

Primary chondrosarcoma of the extraskeletal soft tissue is extremely rare. Extraskeletal chondrosarcoma was first described as entity in 1953 by Stout and Verner, who were able to collect a series of seven cases. Because of the rarity of this lesion in extremities, neither the clinical course nor the preferred method of treatment has been clearly established. Authors report a case of extraskeletal chondrosarcoma which occurred on the right forearm of a thirty-nine-year-old man. The lesion was completely excised with free resection margins. There was no recurrence or metastasis for four years follow up.
Chondrosarcoma ; Extremities ; Follow-Up Studies ; Forearm ; Methods ; Neoplasm Metastasis ; Recurrence

BACKGROUND: The circadian rhythm of circulating melatonin is regulated by the endogenous oscillators, the suprachi-asmatic nuclei, and entrained by the light-dark cycle of the environment, but it seems that the rhythm can be affected by variable lesions outside the retina-pineal pathway. We intended to know how acute cerebral infarction affects on the cir-cadian rhythm of plasma melatonin secretion. METHODS: Plasma melatonin level was measured from 64 patients with acute cerebral infarction. On admission, blood samples were collected by venipuncture at 2AM, 4AM, 10AM, and 2PM and melatonin level was measured by radioimmunoassay. The state of consciousness of each patient was assessed clini-cally and the infarction site and size were evaluated clinically and radiographically. RESULTS: Among 64 patients with acute cerebral infarction, dramatic blunting or obliteration of nocturnal melatonin surge in the blood was found in 29 patients. The circadian rhythm of melatonin secretion was absent in 12 of 35 alert patients, in 10 of 20 drowsy patients, and in 5 of 7 stuporous patients. Melatonin secretion into plasma was markedly decreased in all 2 comatose patients. Of 14 patients with brainstem lesions, 8 patients showed decreased melatonin levels with the absence of a nocturnal rise, although most of them were alert. CONCLUSIONS: This study suggests that brainstem and the initial mental state might contribute to the regulation of the circadian rhythm of plasma melatonin even though the lesion does not involve the retina-pineal pathway, but further extensive study is required to elucidate it. (J Korean Neurol Assoc 19(4):359~363, 2001)
Biological Clocks ; Brain Stem ; Cerebral Infarction* ; Circadian Rhythm* ; Coma ; Consciousness ; Humans ; Infarction ; Melatonin* ; Phlebotomy ; Photoperiod ; Pineal Gland ; Plasma ; Radioimmunoassay ; Stupor

It is well known that circulating antibodies are produced by plasma cells derived from B lymphocytes, and T lyphocytes are endowded with the capacity to regulate the type and intensity of virtually all immune responses. Therefore, the measurement of relative and absolute number of lymphocytes in the peripheral blood of myasthenia gravis patients could be of value. We have studied the distribution pattern of lymphocytes and helper/suppressor ratio in the peripheral blood of 28 myasthenic patients in comparison with 10 patients of other neurologic diseases as control by using immunobead method. There was no significant differences between 17 myasthenic patients who had taken only anticholinesterase and control. But in 17 patients who had taken steroid, Helper T lymphocyte was decreased significantly compared to control. Both T lymphocyte and B lymphocyte were also decreased significantly compared to 17 myasthenic patients who had taken only anticholinesterase without steroid therapy. In 3 patients who had undergone thymectomy, there was significant decreases of suppressor T lymphocyte. Plasma exhange as a treatment for myasthenia gravis is currently the subject of clinical interest and research. Clinical response and muscle power measured by using sphygmomanometer were followed in 2 patients in myasthenic crisis and in 4 patients with severe disease refractory to all other treatment modalities, received 4-6 cycles of plasma exchange with Hemonetics 30-S. 2 patients had a recurrence 1.5 and 6 months after first course of plasma exchange respectively, Therefore, they had to take a second course of plasma exchange. The satisfactory increment of muscle power was noticed in 5 out of 6 cases after fourth plasma exchange.
Antibodies ; B-Lymphocytes ; Humans ; Lymphocytes* ; Myasthenia Gravis* ; Plasma Cells ; Plasma Exchange* ; Plasma* ; Recurrence ; Sphygmomanometers ; Thymectomy

No abstract available.
Ascitic Fluid* ; Endometriosis* ; Female ; Humans ; Interleukins*

Moyamoya disease is characterized by a bilateral progressive narrowing of the distal internal carotid and proximal portions of the anterior and middle cerebral arteries. The cerebral vessels of the 11 to 14 mm embryonic period are extremely similar to these moyamoya vessels. The vertebral arteries unite with a contralateral homologue to form the basilar artery during embryonic development and rarely, the failure of complete fusion results in duplication of these arteries. It is well known that moyamoya disease sometimes is accompanied by persistent primitive arteries, cerebral aneurysm, or rarely arteriovenous malformation. However, no case of the moyamoya disease with complete duplication of basilar artery has been previously reported. These two types of vascular abnormality are probably associated in certain developmental period, and moyamoya disease causes hemodynamic load in the basilar artery system as a collateral pathway and these effects are also involved in duplication of basilar artery. The relationship between these two varieties of vascular abnormality and possible pathogenesis of the moyamoya disease are discussed.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Basilar Artery* ; Cerebral Arteries ; Embryonic Development ; Female ; Hemodynamics ; Middle Cerebral Artery ; Moyamoya Disease* ; Pregnancy ; Vertebral Artery

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier's disease, is a common disorder characterized by ossification and calcification of soft tissues such as the enthuses and joint capsules, particularly affecting the spine. This condition affects approximately 3~30% of men older than 50 years of age. We present the case of a 39-year-old woman diagnosed with DISH combined with extensive ossification of the posterior longitudinal ligament (OPLL) and ossification of ligamentum flavum (OLF). The emergency physician should understand the typical radiologic findings associated with DISH and its clinical presentations in order to diagnose and treat this problem.
Adult ; Emergencies ; Female ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal ; Joint Capsule ; Ligamentum Flavum ; Longitudinal Ligaments ; Lower Extremity ; Male ; Ossification of Posterior Longitudinal Ligament ; Paralysis ; Spine

Endoscopic variceal ligation (EVL) is effective for the management of bleeding esophageal varices, and its use is widespread now. EVL necessitates the use of overtubes. Two primary techniques have been used for overtube placement; one is with endoscope, and the other is with bougie dilator. Overtube placement with endoseope is not without risk. There are reportd of esophageal or pharyngeal laceration or perforation. Overtube placement with bougie dilator circumvents this risk, but it is rather cumbersome to use. The authors devised a safe and easy method for overtube placement, and applied it to a number of patients to test its safety and convenience. First, overtube-dilator assembly was prepared as follows. A Rigiflex achalasia dilator (balloon 30mm OD, 10cm length; Microvasive Co) was lubricated and inserted into the overtube. A tenth of the balloon tip was protruded out of the overtube, then the balloon was insufflated with air at 10-15 psi. Second, standard endoscopy was performed, followed by placement of guide wire in the stomach. Overtube-dilator assembly was lubricated and introduced over the wire as a rail. Once the overtube was properly positioned, the balloon was deflated, and the balloon and wire were removed as a whole, which completed overtube placement. For 65 patients with esophageal variceal bleeding, 82 procedures of EVL were performed using the new technique. Overtube-dilator assembly was easy to prepare and handle. This technique added little time to the procedure and minimizes patients discomfort. No patient suffered major complications such as bleeding, laceration or perforation. This novel method for overtube placement was safe and convenient for use in EVL. It can also be applied to other procedures using overtube such as endoscopic foreign body removal.
Endoscopes ; Endoscopy ; Esophageal Achalasia ; Esophageal and Gastric Varices ; Foreign Bodies ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Stomach