The retraction of anterior teeth could be performed more easier by inducing of skeletal anchorage system rather than by conventional method on orthodontic treatment. But, we wonder how effective the system draws well without anchorage loss and draws anterior teeth aside posteriorly, and if the system can reduce the time, in comparison with the anchorage of posterior teeth. For that reason we have studied on the subject of patients, who were required the maximum anchorage on orthodontic treatment and the cases without crowding. The subjects of the experimental group are 35 areas of 20 people who were inserted miniscrews after Mx or Mn 1st premolar extracted. Also, the subjects of the control group are 81 areas of 45 people who were not inserted miniscrews. Compared the anchorage loss of experimental group with control one, we could get the result that the anchorage loss of experimental group is 1.034+/-0.891mm and control group is 2.790+/-1.882mm(P<0.01). Compared the space closing time of experimental group with control one, we could get the result that the space closing time of experimental group is 369.40+/-110.81days and control group is 406.56+/-231.63days. But the result of comparing space closing time has no significance in statistics. We recognized that the experimental group is more faster than the control group in the canine retraction velocity from the result ; the speed of a experimental group has as much as 0.60+/-0.23mm/30days while the speed of a control group has 0.44+/-0.35mm/30days(P<0.05). So, we could convince that orthodontic miniscrew is used effectively in the cases required the maximum anchorage.
Bicuspid ; Crowding ; Humans ; Tooth*

The contour of mandibular angle is important for facial esthetics in the oriental population, because the wide and square face is thought to have had an unhappy life. A prominent mandibular angle produces a characteristics quardrangle, coase, and muscular appearance. So, uni- or bi-lateral mandibular angle reduction is usually performed. However, there is little guideline for bi-lateral angle reduction. So, this study was to investigate the pattern of Korean mandibular angle for bi-lateral mandibular angle reduction as guideline. This study was included 66 adult men and women over 19 years old who are having the normal mandibular angle. We measured the posterior border, angle, and inferior border of mandible using cephalometric view. The results of study was as followed : 1. The ratio of posterior mandible was 96.6, 97.3% in male, and 103.0, 106.0% in female. 2. The ratio of mandibular angle(R1-Go/R1-R2) was 120.2% in male, and 117.3% in female. 3. The ratio of inferior mandible(D5, 6, 7, E, F, G/D4) was 97. 3, 90.9, 79.5, 65.2, 57.8, 46.9% in male, and 98.5, 91.2, 80.5, 67.6, 59.1, 50.2 % in female. The results of this study should be useful to decide accurate amount of reduction.
Adult ; Esthetics ; Female ; Humans ; Male ; Mandible ; Young Adult

At orthodontic treatment, we have made every effort to get rigid anchorage which is not stirred when teeth move. As a result, the miniscrew that is rigid anchorage was invented recently, and now it is used widely. Concerning the advantage of miniscrew, it is reduced dependence of extraoral anchorage and it shortens treatment time for rapid tooth movement. In contrast, the defect of miniscrew is falling off it resulted from increasing of the mobility. So the purpose of this research is to be of help to prognose clinical use of miniscrew, which is inserted for intraoral anchorage, by investigating and comparing the failure rate of miniscrew for loading time. This study researches the failure rate of miniscrew for teeth movement at the orthodontic treatment. The failure rate of miniscrew in mid course, after inserting 147 miniscrews in 51 patients, is 13%(20/147). It showed no statistically significant differences as compared man with woman, maxilla with mandible, double-head with uni-head miniscrew, and drilling and non-drilling before inserting the miniscrew. In comparison below twenties with over twenties and the times that we give load to miniscrew, it produced that the failure rate of miniscrew is 9.7% higher in the case of below the twenties than over the twenties. Also, the failure rate of loading immediately is 10.8% higher than loading after 7 days. According to using driver for the insertion of miniscrew, the failure rate of miniscrew is higher in the case of using machined driver than in the case of using hand driver when the level of significance is 95%. According to the research, we can suppose that the failure rate has no concern with using miniscrew on man or woman, maxilla or mandible, the shape of head, and drilling or non-drilling before insertion of miniscrew. Therefore, we can choose eclectic miniscrew as demands. In addition, we must notify the patient, below twenties, to be possibility of high failure rate. And It is strongly recommended to give load after 1.2 weeks for healing of the insertion area.
Female ; Hand ; Head ; Humans ; Mandible ; Maxilla ; Tooth ; Tooth Movement

OBJECTIVE: Traditionally, peritoneal catheter is inserted with midline laparotomy incision in ventriculoperitoneal (V-P) shunt procedures. Complications of V-P shunt is not uncommon and have been reported to occur in 5-37% of cases. The aim of this study is to compare the clinical outcomes and the operation time between laparotomy and laparoscopic groups. METHODS: A total of 155 V-P shunt procedures were performed to treat hydrocephalic patients of various origins in our institute between June 2006 to January 2010; 95 of which were laparoscopically guided and 65 were not. We reviewed the operation time, surgery-related complications, and intraoperative and postoperative problems. RESULTS: In the laparoscopy group, the mean duration of the procedure (52 minutes) was significantly shorter (p < 0.001) than the laparotomy group (109 minutes). There were two cases of malfunctions and one incidence of diaphragm injury in the laparotomy group. In contrast, there were neither malfunction nor any internal organ injuries in the laparoscopy group (p = 0.034). There were total of two cases of infections from both groups (p = 0.7). CONCLUSION: Laparoscopically guided insertions of distal shunt catheter is considered a fast and safe method in contrast to the laparotomy technique. This method allows the exact localization of the peritoneal catheter and a confirmation of its patency.
Catheters ; Diaphragm ; Humans ; Hydrocephalus ; Incidence ; Laparoscopy ; Laparotomy ; Ventriculoperitoneal Shunt

OBJECTIVE: Reduced tumor cell adhesion is associated with invasive growth and unfavorable prognosis. In endometrial carcinoma, the prognostic impact of adhesion marker such as E-cadherin is partly known. The purpose of this study is to investigate the correlation of the expression and the mutation of E-cadherin in endometrioid endometrial adenocarcinomas and endometrial hyperplasias and to correlate their results with various clinicopathological factors. METHODS: The expression of E-cadherin by using immunohistochemical staining (IHC) and the mutation of E-cadherin gene by using polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) and sequencing were performed in tissues of 20 endometrial adenocarcinomas and 30 endometrial hyperplasias. The results were compared with previously known prognostic factors such as the stage, tumor grade and lymph node metastasis. RESULTS: Decreased expression of E-cadherin was detected in 13 of 30 (43.3%) endometrial carcinomas and in 1 of 20 (5%) endometrial hyperplasias (P=0.009). There was no statistical significance of the mutation of E-cadherin gene in between the endometrial carcinomas and endometrial hyperplasias (6.7%: 0%) (P=0.06). The incidence of the expression loss of E-cadherin in endometrial carcinomas also showed significantly higher with tumor grade 3, tumor stage above Ic or lymph nodal metastasis (P=0.01, P=0.02, P=0.03). CONCLUSION: Decreased expression of E-cadherin was detected significantly higher in endometrial carcinomas than endometrial hyperplasias. And the incidence of decreased expression of E-cadherin was more frequent in advanced stage, high histopathologic grade, and lymph nodal metasis. The mutation of E-cadherin gene was detected in only 2 cases. These results suggests that the expression of E-cadherin seems to be important in endometrial carcinomas and associated with aggressive subgroups. But the mutation of E-cadherin gene would not be related to endometrial carcinomas.
Adenocarcinoma ; Cadherins ; Cell Adhesion ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Female ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Malignant germ cell tumors of the ovary are uncommon neoplasms. Although 20-25% of all ovarian tumors are derived from germ cells, only about 3% of germ cell tumors are malignant. Mixed germ cell tumors contain at least two malignant germ cell elements. These lesions should be managed with combination chemotherapy, preferably BEP. Recently we experienced a case of mixed germ cell tumor with 6 components of germ cell and sarcomatous change in a 11 year old girl. Preoperative CA-125, B-hCG, aFP, LDH, a-1-antitrypsin were elevated and the final pathologic report was mixed germ cell tumor composed of endodermal sinus tumor, embryonal carcinoma, mature and immature teratoma, choriocarcinoma, dysgerminoma and sarcomatous change, Postoperative chemotherapy with 6 courses of BEP regimen was performed and all tumor markers became normal after 4 courses of chemotherapy. What we interested in this case was several components of germ cells and sarcomatous change and the sarcomatous change might be derived from the mature cystic teratoma component, so we present this case with a brief review of the literatures here.
Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pregnancy ; Teratoma ; Biomarkers, Tumor

Endometrial cancer is the most common malignancy of the female genital tract. The cancer spreads by direct extension, transtubal dissemination, lymphatic dissemination, and/or by hematogenous spread, usually results in lung metastasis, but may less commonly involve liver, brain, and bone. Here, we describe a patient with stage IA endometrial cancer who developed liver recurrence 17 months after surgery.
Brain ; Endometrial Neoplasms ; Female ; Humans ; Liver ; Lung ; Neoplasm Metastasis ; Recurrence

We evaluated long-term results of De Vega annuloplasty measured by cylindrical sizers for functional tricuspid regurgitation (FTR) and analyzed the impact of measured annular size on the late recurrence of tricuspid valve regurgitation. Between 2001 and 2011, 177 patients (57.9+/-10.5 yr) underwent De Vega annuloplasty for FTR. Three cylindrical sizers (actual diameters of 29.5, 31.5, and 33.5 mm) were used to reproducibly reduce the tricuspid annulus. Long-term outcomes were evaluated and risk factor analyses for the recurrence of FTR > or =3+ were performed. Measured annular diameter indexed by patient's body surface area was included in the analyses as a possible risk factor. Operative mortality occurred in 8 patients (4.5%). Ten-year overall and cardiac death-free survivals were 80.5% and 90.8%, respectively. Five and 10-yr freedom rates from recurrent FTR were 96.5% and 93.1%, respectively. Cox proportional hazard model revealed that higher indexed annular size was the only risk factor for the recurrence of FTR (P=0.006). A minimal P value approach demonstrated that indexed annular diameter of 22.5 mm/m2 was a cut-off value predicting the recurrence of FTR. De Vega annuloplasty for FTR results in low rates of recurrent FTR in the long-term. Tricuspid annulus should be reduced appropriately considering patients' body size to prevent recurrent FTR.
Adult ; Age Factors ; Aged ; Body Surface Area ; Cardiac Valve Annuloplasty ; Disease-Free Survival ; Echocardiography ; Female ; Humans ; Hypertension/complications ; Male ; Middle Aged ; Postoperative Complications ; Proportional Hazards Models ; Recurrence ; Risk Factors ; Treatment Outcome ; Tricuspid Valve/*physiopathology ; Tricuspid Valve Insufficiency/etiology/mortality/*surgery

Collagen ; Cyclosporine ; Extracellular Matrix ; Gingival Overgrowth ; Graft Survival ; Hemorrhage ; Kidney ; Kidney Transplantation ; Nifedipine ; Oral Hygiene ; Organ Transplantation ; Orthodontic Appliances ; Phenytoin ; Quality of Life ; Transplantation ; Transplants

Dieulafoy's lesion is a relatively uncommon disease which is minor cause of massive acute lower gastrointestinal bleeding. The lesion comprises mainly of an abnormally exposed submucosal artery associated with a minute mucosal defect on the top in the stomach, and it is a rare cause of profuse but intermittent gastrointestinal bleeding. Less commonly, similar lesions have also been identified in the duodenum, jejunum, colon, and in rare cases, the rectum. In this report, 70 year-old man is described, who has an massive hematochezia from a small rectal mucosal defect with an exposed vessel. Control of the bleeding was successfully achieved with endoscopic band ligation. The fact that rectal Dieulafoy's disease is rare but one of the causes of massive hematochezia should serve as a reminder in the future cases in the elderly.
Aged ; Arteries ; Colon ; Duodenum ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Jejunum ; Ligation* ; Rectum ; Stomach