PURPOSE: The aim of the present study was to analyze 7-year cumulative survival rate (CSR, %) of dental implants in the controlled diabetic patients and to evaluate the influence of the position, diameter and length of fixture, bone quality, age, gender and the method of maxillary sinus elevation on the survival rate. METHODS: The data of 342 placed implants in the 104 diabetic patients collected between 1995 and 2007 at the Department of Periodontology in Yonsei University Hospital were analyzed. RESULTS: Seven-year CSR of the 342 dental implants in the 104 controlled diabetic patients was 96.5%. The survival rates of the placed implants according the position have no statistically significant difference. The survival rates according to the length or diameter of the fixtures have no statistically significant difference. The survival rates according to the bone quality were 100% (Type I), 97.1% (Type II), 97.7% (Type III) and 85.7%(Type IV). The difference between the survival rate of Type I, II and III and that of Type IV was statistically significant. The survival rates according to patient gender were 96.8% (male), 95.5% (female). The survival rates according to patient age were 100% (< or = 59), 93.8% (> or = 60). The survival rates according to the method of sinus elevation in the maxillary posterior area were 96.8% (without sinus elevation), 92.9% (lateral approach) and 89.8% (crestal approach). CONCLUSIONS: Dental implants can be used successfully in the controlled diabetic patients. In case of upper posterior region which has poor bone density and older patients, the implant treatment should be more properly planed, executed, and followed-up.
Bone Density ; Dental Implants ; Diabetes Mellitus ; Humans ; Maxillary Sinus ; Retrospective Studies ; Survival Rate

PURPOSE: The purpose of this study was to preliminarily evaluate the influence of diabetes mellitus (DM) on periodontal tissue without establishment of periodontitis. METHODS: Seven-week-old db/db mice were used for the diabetic experimental group and systematically healthy mice of the same age were used as controls. After 1 week of acclimatization, the animals were sacrificed for hard and soft tissue evaluation. The pattern of bone destruction was evaluated by stereomicroscope evaluation with alizarin red staining and radiographic evaluation by microscopic computerized tomography images. Histological evaluation was performed with hematoxylin and eosin stain for evaluation of soft tissue changes. RESULTS: In both stereomicroscope evaluation and radiograph image analysis, aggressive form of bone destruction was observed in diabetic animals when compared to the systematically healthy controls. In histological evaluation, apical migration of junctional epithelium with slight inflammatory cell infiltration was observed with disarrangement of connective tissue fibers. CONCLUSIONS: Within the limits of this study, diabetic animals presented distortion in periodontal attachment and an aggressive bone loss pattern when compared to the healthy controls, suggesting that DM has an independent effect on periodontal tissue destruction irrespective of the presence or absence of periodontal disease.
Acclimatization ; Animals ; Anthraquinones ; Connective Tissue ; Diabetes Mellitus ; Eosine Yellowish-(YS) ; Epithelial Attachment ; Hematoxylin ; Inflammation ; Mice ; Periodontal Diseases ; Pilot Projects

Amyloidosis is a rare disease defined by extracellular deposits of amorphous fibrillar proteins, derived from aggregations of misfolded proteins. Localization of amyloidosis in the gallbladder is uncommon; only eight cases have been reported. We describe a case of amyloidosis diagnosed by cholecystectomy, which possibly also affected the liver and kidney. The patient was misdiagnosed with polymyalgia rheumatica, but after a cholecystectomy to treat chronic cholecystitis, we ultimately diagnosed him with amyloidosis. We review amyloidosis with gallbladder involvement in the literature.
Amyloidosis* ; Cholecystectomy ; Cholecystitis* ; Gallbladder ; Humans ; Kidney ; Liver ; Polymyalgia Rheumatica* ; Rare Diseases

The aim of the present study was to examine the causal-effect of baseline (year 2004) serum gamma-glutamyl transpeptidase (GGT) level with the prevalence of metabolic syndrome (MS) in year 2008. The study was comprised of male workers who underwent a regular health check-up in 2004 and 2008. MS was diagnosed according to the American Association of Clinical Endocrinologists (AACE) criteria. In the subgroup analysis according to serum GGT level, triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) showed a significant increasing tendency (p < 0.001). In addition, unexpectedly results were consistent in non-drinkers (p < 0.001). GGT level was significantly associated with risk factors of MS (waist circumference [WC]: r = 0.18, p < 0.001; fasting blood glucose [FBG]: r = 0.16, p < 0.001; TG: r = 0.29, p < 0.001). As the secondary biomarker, homeostasis model assessment of insulin sensitivity (HOMA-S) and TC had significant correlations with GGT level (HOMA-S: r = -0.14, p < 0.001; TC: r = 0.21, p < 0.001). In the 4-year prospective analysis, the predictive effect of baseline GGT concentrations on change in MS status was evaluated using Cox proportional model. Elevated GGT concentrations measured in 2004 were associated with the risk of MS incidence after 4 years (GGT: HR 1.7 [95% CI: 1.2-2.3]) (p < 0.01). This observation indicates that an elevated GGT level could be suggested as a subsidiary marker for MS and partially reflects dyslipidemia as a component of MS.
Blood Glucose ; Cholesterol ; Cholesterol, LDL ; Cohort Studies* ; Dyslipidemias ; Fasting ; gamma-Glutamyltransferase* ; Homeostasis ; Humans ; Incidence ; Insulin Resistance ; Male* ; Prevalence ; Prospective Studies ; Risk Factors ; Triglycerides

OBJECTIVE: The present study aimed to evaluate the efficacy of low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (DLPFC) for the treatment of obsessive-compulsive disorder (OCD). METHODS: Twenty-seven patients with treatment resistant OCD were randomly assigned to 3 week either active (n=14) or sham (n=13) rTMS. The active rTMS parameters consisted of 1 Hz, 20-minute trains (1,200 pulses/day) at 100% of the resting motor threshold (MT). OCD symptoms, mood, and anxiety were assessed at baseline and every week throughout the treatment period. RESULTS: A repeated-measures analysis of variance (ANOVA) was used to evaluate changes on the Yale-Brown Obsessive Compulsive Scale (YBOCS). Our results revealed a significant reduction in YBOCS scores in the active group compared with the sham group after 3 weeks. Similarly, a repeated-measures ANOVA revealed significant effect of time and time×group interaction on scores on the Hamilton Depression Rating Scale and the Clinical Global Impression-Severity scale. There were no reports of any serious adverse effects following the active and sham rTMS treatments. CONCLUSION: LF rTMS over the right DLPFC appeared to be superior to sham rTMS for relieving OCD symptoms and depression in patients with treatment-resistant OCD. Further trials with larger sample sizes should be conducted to confirm the present findings.
Anxiety ; Depression ; Humans ; Obsessive-Compulsive Disorder* ; Prefrontal Cortex* ; Sample Size ; Transcranial Magnetic Stimulation*

PURPOSE: The purpose of this study was to describe nurses' recognition of, and practice level in management of general nosocomial infections, and methicillin resistant staphylococcus aureus (MRSA) and vancomycin resistant enterococci (VRE) infections. METHODS: A self-administered questionnaire was used to collect data. Data were collected on June, 2003 from 190 nurses in one university affiliated hospital located in Suwon. RESULTS: The mean score for nurses' recognition of general nosocomial infection control was 3.57, MRSA control was 3.54, and VRE control was 3.86. The mean score on practice for control of general nosocomial infection was 3.19, for MRSA control, 3.20, and for VRE control, 3.63. There were statistically significant relationships between the recognition level and practice level for general nosocomial, MRSA, and VRE infection control. According to the general characteristics of the nurses, the mean scores for both recognition and practice were higher for those nurses who had had infection control education, for those who had worked longer in nursing, and for those who worked in the ICU. CONCLUSION: It is suggested that appropriate hospital infection control programs should be developed through continuous education and practice to improve nurses' level of the practice in general infection control, and especially in MRSA and VRE infection control.
Cross Infection* ; Education ; Gyeonggi-do ; Infection Control* ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus* ; Nursing ; Surveys and Questionnaires ; Staphylococcus aureus ; Vancomycin ; Vancomycin Resistance

OBJECTIVE: Although several prior works showed the white matter (WM) integrity changes in amnestic mild cognitive impairment (aMCI) and Alzheimer's disease, it is still unclear the diagnostic accuracy of the WM integrity measurements using diffusion tensor imaging (DTI) in discriminating aMCI from normal controls. The aim of this study is to explore diagnostic validity of whole brain automated probabilistic tractography in discriminating aMCI from normal controls. METHODS: One hundred-two subjects (50 aMCI and 52 normal controls) were included and underwent DTI scans. Whole brain WM tracts were reconstructed with automated probabilistic tractography. Fractional anisotropy (FA) and mean diffusivity (MD) values of the memory related WM tracts were measured and compared between the aMCI and the normal control groups. In addition, the diagnostic validities of these WM tracts were evaluated. RESULTS: Decreased FA and increased MD values of memory related WM tracts were observed in the aMCI group compared with the control group. Among FA and MD value of each tract, the FA value of left cingulum angular bundle showed the highest area under the curve (AUC) of 0.85 with a sensitivity of 88.2%, a specificity of 76.9% in differentiating MCI patients from control subjects. Furthermore, the combination FA values of WM integrity measures of memory related WM tracts showed AUC value of 0.98, a sensitivity of 96%, a specificity of 94.2%. CONCLUSION: Our results with good diagnostic validity of WM integrity measurements suggest DTI might be promising neuroimaging tool for early detection of aMCI and AD patients.
Alzheimer Disease ; Anisotropy ; Area Under Curve ; Brain ; Diffusion Tensor Imaging ; Humans ; Memory ; Mild Cognitive Impairment* ; Neuroimaging ; Sensitivity and Specificity ; White Matter

Gangliocytic paraganglioma (GP) is an extremely rare tumor that mostly occurs in the periampullary area of the duodenum. It is characterized by benign behavior and favorable outcomes, but sometimes shows regional lymph node dissemination. GP consist of three characteristic histological components: epithelioid, spindle, and ganglion cells. Therefore, it is often misdiagnosed as a neuroendocrine tumor when only endoscopic forceps biopsy is performed. The clinical management of GP has not yet been standardized. This case report describes an asymptomatic patient who was initially diagnosed with a grade-1 neuroendocrine tumor, but was confirmed as having benign GP after endoscopic papillectomy. Complete en-bloc resection was performed for this patient, without any significant adverse events. At a 6-month follow-up assessment, the patient remained asymptomatic and there was no evidence of recurrence.
Ampulla of Vater* ; Biopsy ; Duodenum ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Lymph Nodes ; Neuroendocrine Tumors ; Paraganglioma* ; Recurrence ; Surgical Instruments

PURPOSE: The presented study aims to evaluate the effects of osteoporosis on dental implants by analyzing a 12-year cumulative survival rate of implants placed in patients with osteoporosis. METHODS: 37 patients with history of osteoporosis were selected from a pool of dental implant patients treated at the Department of Periodontology in Yonsei University Hospital between 1993 and 2007. The cumulative survival rate is quantified using data collected from 164 placed implants in the selected 37 patients. RESULTS: 3 out of the 164 implants failed and the cumulative survival rate was observed at 95.1%. The survival rates of the implants according to patients' age were 97.41% (<60) and 100% (60< or =. The lower survival rate was directly proportional to younger age, and this relationship is statistically significant (P<0.05). The survival rates of implants according to diagnostic criteria were 95.45% (osteopenia) and 98.59% (osteoporosis; 2 out of 142 implants placed in osteoporosis patients failed). The difference in the two survival rates is statistically significant (P<0.05). The survival rates according to the region of implants do not have statistically significant difference. The survival rates according to the different length and diameter of the implants do not have statistically significant difference. The survival rates of implants accompanied and not accompanied by bone augmentation were 92.11% and 100%, respectively. The difference in the two survival rates is statistically significant (P<0.05). The survival rates of implants placed in patients with and without history of medication for osteoporosis treatment are 96.67% and 99.04%, respectively. The difference in the two survival rates is statistically significant (P<0.05). CONCLUSIONS: A high cumulative survival rate of dental implants, similar to one found in non-osteoporosis patients, is observed in osteoporosis patients, indicating the possibility that placing dental implants on patients with osteoporosis can be considered with high treatment predictability.
Dental Implants ; Humans ; Osteoporosis ; Retrospective Studies ; Survival Rate

The purpose of this study was to evaluate the efficacy of the Sonicare Elite(R) power toothbrush in plaque removal and reduction of gingivitis from hard-to-reach sites of the moderate periodontitis compared to regular manual toothbrush in 12 week follow-up. 82 subjects with incipient to moderate periodontitis were randomly assigned to use either the manual or sonic brush, instructed in its use, and asked to brush 2 times a day for 2 minutes. Plaque scores were taken at baseline, 1, 4, 12 weeks using Silness & Loe plaque index and gingival inflammation was assessed by the Loe & Silness gingival index. The results were as follows. 1. The Sonicare Elite(R) power toothbrush showed a significant reduction(p<0.0001) of the plaque( Silness & Loe) and gingival inflammation(Loe & Silness). 2. The Sonicare Elite(R) power toothbrush showed a significant better reduction of plaque and gingivitis(p<0.05) than the manual toothbrush after 1, 4, and 12 weeks. 3. The Sonicare Elite(R) power toothbrush demonstrated a significant reduction(p<0.0001) of the plaque in interproximal sites(p<0.0001), buccal sites(p<0.0001) and the lingual sites(p=0.0018) of the teeth. 4. The Sonicare Elite(R) power toothbrush demonstrated a significant reduction(p<0.0001) of the gingival inflammation in the interproximal sites(p<0.0001), the buccal sites(p<0.0001) and the lingual sites(p<0.0001) of the teeth. The results of this study support the findings that Sonicare Elite(R) power toothbrush has a great potential to remove the plaque and resolve the gingival inflammation during the period of 12 week.
Follow-Up Studies ; Gingivitis ; Inflammation* ; Periodontal Index ; Periodontitis* ; Tooth