No abstract available.
Carnitine* ; Renal Dialysis*

Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of individuals has been developed. The analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. This study was to clarify the Korean craniofacial skeletal pattern using Enlow's counterpart analysis considering the fact that the craniofacial skeletal pattern has racial and regional variations. This research will be helpful in the future for growth research and research of the orthognathic For this study, the samples were consisted of 100 Korean adult subjects(50 males and 50 females) who had normal occlusion and pleasing face. Measurement points and lines were established using Enlow's counterpart analysis and they were statistically evaluated. The results indicated that: 1. The average angle between PCF and PMV was 38.54 degrees in males and 38.43 degrees in females, and the average Wits' appraisal was -2.51 in males and -2.3 in females. The ramus alignment(R4) was 1.89 in males and 2.36 in females. 2. It shows that females have a longer ramus than the PCF compared to the males, because there was a significant difference in Ramus/PCF horizontal dimensions (Skeletal A3-B3) between female and male subjects 3. It shows that males have a longer mandibular corpus than the maxilla compared to the females, because there was a significant difference in Maxillary/Mandibular arches(Skeletal A4-B4) between male and female subjects 4. In cranial floor+maxilla/ramus+corpus at A and B points(A1-B1), which represents difference in total horizontal length between the maxilla and mandible, there was no significant difference between males and females. In conclusions, compared to Caucasian, Korean have more depressed midface, prognathic mandible, and ramus that rotates inferioposterior. Also, we observe that Korean women have larger ramus posterior cranial base, as compared with Korean men. Consequently, the total length of maxilla and mandible does not show any difference, because man's mandible is longer than maxilla in comparison with woman's one.
Adult ; Female ; Humans ; Male ; Mandible ; Maxilla ; Reference Values ; Skull Base

In Patients with severe skeletal discrepancy, surgical orthodontic treatment must be accompanied, and recently two jaw surgery has become a common procedure, resulting in improved esthetics and function. Choosing the position of the occlusal plane in this two jaw surgery is an important factor in postoperative stability. Therefore this must be taken into consideration during the diagnosis and treatment plan. In this study, among patients with skeletal Class III occlusion, 25 patients(8 male, 17 female, average age 23.2+/-3.17) who have undergone two jaw surgery, setting the ideal occlusal plane according to Delaire's architectural and structural cranial analysis. In comparing preoperative(T1). postoperative(T2, average of 15.4 days), and long-term postoperative(T3, average of 32.6 months) lateral cephalometric radiography, the following conclusions have been made. 1. There were no significant changes of the occlusal plane angle after the two jaw surgery, and there were no significant differences between the surgical technique(SSRO and IVRO). 2. The postoperative changes of the occlusal plane had no relationship with the amount of jaw movement, amount of posterior impaction, nor the time relapse after surgery. 3. After two jaw surgery, in the SSRO group there was significant forward movement of the mandible, and in the IVRO group the lower incisors extruded as the mandible moved backward and downward which makes the gonial angle and the mandibular plane angle significantly increased.
Dental Occlusion* ; Diagnosis ; Esthetics ; Female ; Humans ; Incisor ; Jaw ; Male ; Mandible ; Orthognathic Surgery* ; Radiography ; Recurrence

A membrane glycoprotein CD4 functions as a co-receptor of a T lymphocyte. The co-receptor function has been attributed to a protein tyrosine kinase, p56lck, which is activated upon CD4 binding to MHC molecule. In this study, we present evidences that one of the pathways through which CD4 transmits its signal is cytoskeleton association of p56lck tyrosine kinase as well as CD4 itself. Cytoskeletal association of both proteins is inhibited by a tyrosine kinase inhibitor, genistein, indicating that tyrosine protein kinase activation is important for cytoskeletal association of CD4 and p56lck. Cytoskeletal association of these proteins by CD4 cross-linking is not affected by inhibitors of protein kinase C nor PI3-kinase. Taken together, these results suggest that CD4 cross-linking activates a tyrosine kinase which then induces the simultaneous association of CD4 and p56lck with cytoskeleton.
Antigens, CD4/metabolism* ; Antigens, CD4/drug effects ; Cross-Linking Reagents ; Cytoskeleton/metabolism* ; Down-Regulation (Physiology) ; Enzyme Inhibitors/pharmacology ; Flow Cytometry ; Genistein/pharmacology ; Human ; Lymphocyte Specific Protein Tyrosine Kinase p56(lck)/metabolism* ; Lymphocyte Specific Protein Tyrosine Kinase p56(lck)/antagonists & inhibitors ; Phosphorylation/drug effects ; Protein Binding ; Tetradecanoylphorbol Acetate/pharmacology ; Tumor Cells, Cultured ; Tyrosine/metabolism

To clarify the exact role of endomyocardial biopsy in the diagnosis and monitoring of adriamycin-induced cardiotoxicity and to observe the actual relationship between pathologic changes and cardiac dysfunction, a cross-sectional clinical study was conducted. Echocardiography was used to evaluate cardiac dysfunction in 18 patients who had received chemotherapy including adriamycin(mean dose : 410mg/m2 of B.S.A.) without clinical evidence of congestive heart failure, and in 19 normal controls. Six patients receiving adriamycin underwent 7 transfemoral endomyocardial biopsy procedures, and the specimens were evaluated by light and electron microscopy for evidence of drug-related cardiotoxicity. Indexes of cardiac systolic function obtained by M-mode echocardiography(left ventricular dimension, excursion of interventricular septum and left ventricular posterior wall, shortening fraction and ejection fracton) did not show any statistically significant difference between patients who received adriamycin and normal controls. In transmitral flow-velocity curves recorded by Doppler echocardiography with a 2.25MHz probe, the patients showed less E peak velocity and decreased E/A ratio compared with normal controls, which suggests left ventricular diastolic dysfunction in the patients who received adriamycin. All the specimens of the endomyocardial biopsy showed significant pathologic changes of adriamycin indnced cardiotoxicity which was characterized by myofibrillar loss and vacuolization of the cytoplasm. In 2 specimens, pathologic grade was II, while 5 specimens showed pathologic changes of grade III and further chemotherapy with adriamycine was not done in thse 5 cases. From these results it is suggested that pathologic changes precede the clinical onset of congestive cardiomyopathy in the patients receiving adriamycin and left ventricular diastolic dysfunction occurrs before ejection fraction falls to subnormal levels. We conclude that sequential endomyocardial biopsy is absolutely indicated for exact diagnosis and monitoring of adrinamycin-induced cardiotoxicity to prevent the development of irreversible and often fatal cardiomyopathy.
Biopsy ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cytoplasm ; Diagnosis ; Doxorubicin* ; Drug Therapy ; Echocardiography ; Echocardiography, Doppler ; Heart Failure ; Humans ; Microscopy, Electron

BACKGROUND: Mitral regurgitation is a valvular heart disease that produce complex hemodynamic alternations and myocardial dysfunction occurs subclinically, so result in a high incidence of left ventricular dysfunction that might affect postoperative result. In order to assess preoperative factors affecting the outcome of mitral valve replacement in patients with chronic mitral regurgitaion, we evaluated prognostic factors from preoperative clinical, laboratory, and echocardiographic findings in 71 patients with chronic mitral regurgitation who received mitral valve replacement. METHODS: From 1985 to 1994, 71 patients with chronic mitral regurgitation, who received mitral valve replacement, were included in this study. The patients were defined as group I who had improved symptom and / or decreased left ventricular end-diastolic dimension after operation, and group II who had persistent symptom and / or over 60mm of left ventricular end-diastolic dimension after operation. RESULTS: 1) In clinical findings, preoperative systolic blood pressure was higher in Group I patients(p<0.05). 2) Hemoglobin, serum creatinine, and blood urea nitrogen level were not significantly different in both groups. 3) In echocardigraphic findings, left atrial dimension, left ventricular end-systolic / end-diastolic dimension, and left ventricular volume index of Group II were much higher than those of Group I patients(p<0.05). 4) In the discriminant analysis, left ventricular end-diastolic dimension, age, NYHA functional class, and left ventricular mass index were defined as important prognostic factors. CONCLUSION: According to the above results, preoperative age, NYHA functional class are significant prognostic factors in clinical and laboratory findings. And left atrial dimension, left ventricular end-systolic and end-diastolic dimensions, left ventricular volume index, and left ventricular mass index are significant prognostic factors in echocardiographic findings.
Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Echocardiography ; Heart Valve Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Insufficiency* ; Mitral Valve* ; Ventricular Dysfunction, Left

Dieulafoy lesion is an uncommon cause of gastrointestinal bleeding, reported to be only 2% of acute or chronic upper gastrointestinal bleeding episodes. Bleeding occurs from a small mucosal erosion involving an unusually large submucosal artery in an otherwise normal mucosa. It is associated with massive, life threatening hemorrhage and is difficult to diagnosis. In most cases the lesion is encountered in the proximal stomach, antrum, duodenum, colon and rectum. In particular, extragastric Dieulafoy lesion is an extremely rare source of intestinal bleeding. In Korea, no case of bleeding from a Dieulafoy lesion of the small intestine has been previously reported. We experienced one case of bleeding from a jejunal Dieulafoy lesion, which was confirmed by the pathologic examination of the resected specimen, and report here.
Adult ; Arteries/abnormalities* ; Case Report ; Female ; Gastric Mucosa/blood supply* ; Gastrointestinal Hemorrhage/etiology* ; Human ; Intestinal Mucosa/blood supply*

BACKGROUND/AIMS: To investigate the use of measurements of liver stiffness (LS) by two-dimensional real-time shear wave elastography (SWE) for predicting the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). METHODS: We retrospectively collected data on 291 enrolled patients with CHB whose LS had been measured using SWE. RESULTS: The mean age of the patients was 46.8 years; males predominated (67%), and 40 of the patients (14%) had clinical cirrhosis. Among the patients, 165 (56.7%) received antiviral treatment. The median LS value was 7.4 kPa, and the median follow-up period was 35.8 months (range, 3.0 to 52.8 months). During follow-up, HCC developed in 13 patients (4.5%), and the cumulative incidence rates of HCC at 1, 2, and 4 years were 1.1%, 3.6%, and 8.4%, respectively. Based on a multivariate analysis, older age (≥50 years) and higher LS value (≥10 kPa) were independently associated with the risk of developing HCC (hazard ratio [HR], 4.53, p=0.023; and HR, 4.08, p=0.022). The cumulative incidence rate of HCC was significantly higher in patients with higher LS values (≥10 kPa) than in those with lower LS values ( < 10 kPa) (p=0.001). CONCLUSIONS: Increased LS measured by SWE at any time point regardless of antiviral treatment is associated with an increased risk of HCC in patients with CHB.
Carcinoma, Hepatocellular* ; Elasticity Imaging Techniques* ; Fibrosis ; Follow-Up Studies ; Hepatitis B ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Incidence ; Liver ; Male ; Multivariate Analysis ; Retrospective Studies

CATCH 22 is a medical acronym for cardiac defects, abnormal faces, thymic hypoplasia, cleft palate, and hypocalcemia, and a variable deletion on chromosome 22. It includes DiGeorge syndrome, conotruncal anomaly face syndrome, and velo-cardio-facial syndrome. It has a prevalence estimated at 1:3,000-1:6,000. Most deletions occur at de novo, but autosomal dominant inheritance is observed in 6-10% of cases. Hormonal disorders are common in patients with CATCH22 syndrome. While hypoparathyroidism was the predominant endocrine disturbance that has been documented in the DiGeorge syndrome, other hormonal defects, such as growth hormone deficiency, hypothyroidism, and hyperthyroidism have been occurred in patients with CATCH22 syndrome. The spectrum of parathyroid gland dysfunction in this syndrome ranges from severe neonatal hypocalcemia to normal parathyroid function. Most patients are usually diagnosed in young age, but a few patients with mild abnormality are presented later in life. We report a case of CATCH22 syndrome with normal parathyroid hormone and calcium level in an adult. The diagnosis of CATCH22 syndrome was confirmed by fluorescence in situ hybridization analysis.
Adult ; Calcium ; Chromosomes, Human, Pair 22 ; Cleft Palate ; DiGeorge Syndrome ; Fluorescence ; Growth Hormone ; Humans ; Hyperthyroidism ; Hypocalcemia ; Hypoparathyroidism ; Hypothyroidism ; In Situ Hybridization ; Parathyroid Glands ; Parathyroid Hormone ; Prevalence ; Wills

BACKGROUND: There is increasing evidence that more aggressive pain management is needed in patients undergoing craniotomy in Korea. However, no consensus or standardized analgesic regimen has been established to date. To achieve this consensus, we undertook a survey of the current state of post-craniotomy pain management in Korea. METHODS: A postal questionnaire was sent to anesthesiologists, neurosurgeons and nurses of neurosurgical departments at 44 university hospitals in Korea. Of the 44 centers that were sent questionnaires, 35 centers returned these from their anesthesiology department resulting in a response rate of 73%, and 25 returned the questionnaires from their neurosurgery department (response rate: 57%). RESULTS: Fifty-three percent of neurosurgeons answered that current postoperative pain management was adequate after craniotomy, whereas only 8% of anesthesiologists agreed. However, 72% of neurosurgeons also agreed that a more aggressive pain management was needed for post-craniotomy patients. Fifty-two percent and 23% of neurosurgeons used non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen as a first-line analgesic, respectively. Twenty-five percent of neurosurgeons used opioids as a first-line analgesic. Fifty percent of anesthesiologists used strong opioids alone or with NSAIDs as a first-line analgesic. About 10% of both groups used weak opioids as a first-line drug. CONCLUSIONS: Many clinicians agree that post-craniotomy pain is not adequately managed and more aggressive strategies are needed. Nevertheless, opioid analgesics are still avoided because of the concern of side effects despite no evidence to suggest increased risk when use carefully.
Acetaminophen ; Analgesia ; Analgesics, Opioid ; Anesthesiology ; Anti-Inflammatory Agents, Non-Steroidal ; Consensus ; Craniotomy ; Hospitals, University ; Humans ; Korea ; Neurosurgery ; Pain Management ; Pain, Postoperative ; Surveys and Questionnaires