OBJECTIVES: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. METHODS: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI) : control (n=24), and patients with sleep apnea (n=70). RESULTS: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p< 0.05) CONCLUSION: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method.
Humans ; Medical Records ; Oropharynx ; Palatine Tonsil ; Physical Examination ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

PURPOSE: The effects of gonadotropin-releasing hormone agonist (GnRHa) treatment on the energy metabolism in girls with central precocious puberty (CPP) are controversial. We focused the changes and related factors of serum levels of leptin and adiponectin in girls with CPP before and during GnRHa treatment. METHODS: Thirty girls with idiopathic CPP were enrolled in the study. Their auxological data and fasting blood were collected at the baseline and after six months of GnRHa treatment. RESULTS: After treatment, height (P<0.001), weight (P<0.001), and serum leptin levels (P=0.033) were significantly increased, whereas body mass index (BMI), homeostasis model of assessment-insulin resistance, serum adiponectin levels, and adiponectin/leptin ratio exhibited no significant changes. A Pearson correlation analysis showed that height, weight, BMI, and their standard deviation scores (SDSs), but not basal LH, FSH, and estradiol, were significantly correlated with serum leptin levels before and after GnRHa treatment. After a multiple linear regression analysis, only BMI was associated with serum leptin levels. Moreover, leptin SDSs adjusted for BMI were not significantly different before and after GnRHa. The Δ leptin levels (r2=0.207, P=0.012), but not with Δ leptin SDS (r2=0.019, P=0.556), during GnRHa treatment were positively correlated with Δ BMI. CONCLUSION: These results suggest that GnRHa treatment in girls with CPP does not affect serum levels of leptin and adiponectin and insulin resistance. Serum leptin levels were depend on the changes in BMI during GnRHa treatment.

PURPOSE: The effects of gonadotropin-releasing hormone agonist (GnRHa) treatment on the energy metabolism in girls with central precocious puberty (CPP) are controversial. We focused the changes and related factors of serum levels of leptin and adiponectin in girls with CPP before and during GnRHa treatment. METHODS: Thirty girls with idiopathic CPP were enrolled in the study. Their auxological data and fasting blood were collected at the baseline and after six months of GnRHa treatment. RESULTS: After treatment, height (P<0.001), weight (P<0.001), and serum leptin levels (P=0.033) were significantly increased, whereas body mass index (BMI), homeostasis model of assessment-insulin resistance, serum adiponectin levels, and adiponectin/leptin ratio exhibited no significant changes. A Pearson correlation analysis showed that height, weight, BMI, and their standard deviation scores (SDSs), but not basal LH, FSH, and estradiol, were significantly correlated with serum leptin levels before and after GnRHa treatment. After a multiple linear regression analysis, only BMI was associated with serum leptin levels. Moreover, leptin SDSs adjusted for BMI were not significantly different before and after GnRHa. The Δ leptin levels (r2=0.207, P=0.012), but not with Δ leptin SDS (r2=0.019, P=0.556), during GnRHa treatment were positively correlated with Δ BMI. CONCLUSION: These results suggest that GnRHa treatment in girls with CPP does not affect serum levels of leptin and adiponectin and insulin resistance. Serum leptin levels were depend on the changes in BMI during GnRHa treatment.

Small cell carcinoma does originate from APUD cells of any parts of the body. Usually the cases discovered in the lung and have poor prognosis. In esophagus only about 100 cases are reported world widely after McKneown reports in 1952 and only 2 cases were reported in Korea. There was a cese of small cell carcinoma developed multiple lesions in esophagus but no reports said that small cell carcinoma developed syncronously in esophagus and other organs. We are to report a case that showed a multiple lesions in esophagus and cardia. The patient 60 yeata old man, has suffered from the substernal discomfort and significant weight loss for one month.
APUD Cells ; Carcinoma, Small Cell* ; Cardia* ; Esophagus* ; Humans ; Korea ; Lung ; Prognosis ; Stomach ; Weight Loss

Recently, new trials for the treatment of the vesicoureteral reflux have been proposed. These trials convince us of the need to reevaluate the ureterovesical junction and to reinvestigate the role of the detrusor muscle and the ureteral sheath. We studied forty adult and five infant human bladders and distal ureters. Microscopic sections were studied, taken serially from the ureterovesical junction and adjacent urinary bladder with the hematoxylin-eosin and the Gomori trichrome staining method. The slit shaped ureteral orifice was most commonly observed ( 57.0 %). The approximate ratio of the submucosal length to the intramural ureter was 2:3. Ureteral sheath consists of smooth muscle fibers (bundles) arranged in a helical fashion and loose connective tissues which envelope the distal ureter over a 3 cm distance to the juxtavesical portion. These structures are independent from the ureter proper. The muscle bundles of ureteral sheath are of 4 types: 1. Those which extend from the outer bladder wall to the juxtavesical ureters (JVU) and, 2. continuing from JVU, these become the detrusor muscle after entering the bladder. 3. Bundles run from the JVU to the trigone, and 4. bundles run to the trigone from the mid-circular layer of the detrusor muscle. In the bladder, most roof muscle bundles of ureteral sheath run to the upper portion of the trigone after crossing the intramural ureter ventrally. Most floor bundles run to the inferolateral portion of the bladder. In infants, the deep trigone and basal detrusor muscle are relatively thicker and not compactly organized. We conclude that ureteral sheath is of detrusor muscle origin. We suggest that ureteral sheath functions as a part of a preventive mechanism with compressing the intravesical ureter by contraction in voiding and filling phase independently against vesicoureteral reflux.
Adult ; Connective Tissue ; Humans ; Infant ; Muscle, Smooth ; Ureter ; Urinary Bladder ; Vesico-Ureteral Reflux

No abstract available.
Drug Therapy* ; Humans ; Neutropenia*

STATEMENT OF PROBLEM: The use of Ceromer is increasing in dentistry. But, the research of Ceromer has not been conducted much. Purpose: This study was to evaluate the marginal fidelity and internal adaptation according to marginal position. MATERIALS AND METHODS: In this study 60 resin crowns were fabricated. The measurements of the marginal fidelity were carried out using stereomicroscope SZ-40(R)(Olympus, Japan) and the measurements of fracture strength were done using Instron 8871(R)(Instron Co., U.S.A.) at a cross head speed of 1mm/min. All of the measurements were statistically analyzed by ANOVA test, multiple range test and Weibull analysis. Statistical significance was set in advance at the probability level of less than 0.05. All of the measurements were analyzed with Window SPSS(R) Version 10.0 soft ware for the personal computer. RESULTS: 1. There were no statistical differences of the marginal fidelity between Targis(R) and Tescera(R), but difference between these two and BelleGlass(R) according to materials. 2. There were no statistical differences of the marginal fidelity between no fiber group and fiber group. There were no interactions between each maerial and with/without fiber group in the marginal fidelity. 3. There were statistical differences of the fracture strength between Tescera. and BelleGlass(R), but no statistical differences of the fracture strength between Targis(R) and Tescera(R), Targis(R) and BelleGlass(R) according to materials. 4. There were statistical differences of the fracture strength between no fiber group and fiber group. There were no interactions between each material and with/without fiber group in the fracture strength. 5. When comparing the fracture surface, no fiber group showed the resin which were fractured at the labial surface and separated from the adhesion surface. In fiber group, the fractures took a place in resin compartments. CONCLUSION: The marginal fidelity and the fracture strength were clinically acceptable. From these results, Targis(R) and Tescera(R) were superior than BelleGlass(R) in the marginal fidelity. But, when applying these resin crowns in clinic, more careful consideration is needed and further study is recommended.
Crowns ; Dentistry ; Head ; Microcomputers

No abstract available.
Adult* ; Evoked Potentials, Auditory, Brain Stem* ; Humans*

PURPOSE: The purpose of this paper is to test the hypothesis that combination therapy of serial cast and botulinum toxin type A (BTX-A) injection can further enhance the effects of a BTX-A injection in ambulant children with cerebral palsy (CP) who have an equinus foot. MATERIALS AND METHODS: Children in group A (30 legs of 21 children) received a serial casting application after an injection of BTX-A, and children in group B (25 legs of 17 children) received only a BTX-A injection. Assessments were performed before the intervention and 1 month after the intervention. RESULTS: After the intervention, there were significant improvements in tone, dynamic spasticity, and passive range of motion (ROM) in both groups. However, the changes were greater in group A than in group B. Dimension D (standing) in Gross Motor Function Measure (GMFM)-66 was significantly improved in group A but not in group B. On the other hand, there were no significant changes in di-mension E (walking, running, jumping) in GMFM-66 in either group. CONCLUSION: The results of our study suggest that a serial casting application after BTX-A injection can enhance the benefits of BTX-A injection in children with cerebral palsy.

Facial scar is one of the most common problems in plastic surgery department. Many various methods are attempted to improve facial scars, but there is no definite satisfactory method on scar revision. Authors have been interested in a tendency to show good results when traumatic lacerations were accompanied by abrasions. The improved appearance of the scars with this situation is the result that there were fewer elevations and depressions, and no break in continuity of the epidermal covering on both sides of the scar. But mechanical or other dermabrasive methods have a risk of hyperpigmentation. Authors suggest the scar revision with frostbite using dry ice. This method has little hyperpigmentation due to the sensitivity of melanocytes to cold injury. And the tissue destruction is progressed selectively because of the resistance of collagen against the cold injury and the preserved dermal fibrous network as the structural framework. These characteristics of cryotherapy improve the result of scar revision with fewer side effects rather than other dermabrasive methods. We performed this method to 349 patients from 1993 to 2003 and obtained high patients' satisfaction (85.9% more than fair). Moreover, this method is simple, cheap and handy. In conclusion, the scar revision with frostbite using dry ice is very useful method to improve facial scars.
Cicatrix* ; Collagen ; Cryotherapy ; Depression ; Dry Ice* ; Frostbite* ; Humans ; Hyperpigmentation ; Lacerations ; Melanocytes ; Surgery, Plastic