PURPOSE: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. MATERIAL AND METHODS: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. RESULT: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries free and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss (3.59+/-1.69% vs 3.42+/-2.95%) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. CONCLUSION: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program.
Aged ; Alveolar Bone Loss ; Follow-Up Studies ; Hemorrhage ; Humans ; Molar ; Periodontitis ; Prognosis ; Surveys and Questionnaires ; Retrospective Studies ; Root Caries ; Tooth ; Tooth Mobility

The objectives of this study were to assess the ultrasonographic (US) findings in patients with knee osteoarthritis (OA) with pes anserinus tendinitis or bursitis (PATB) syndrome and to determine the correlation between the US findings and the response to local corticosteroid injection. We prospectively studied 26 patients with knee OA with clinically diagnosed PATB syndrome. A linear array 7 MHz transducer was used for US examination of the knee. Seventeen patients were injected locally with tramcinolone acetonide in the anserine bursa area. Response to local corticosteroid injection was evaluated by pain visual analog scale (VAS), Western Ontario and MacMaster (WOMAC) osteoarthritis index and Global patient/physician assessment using Likert scale. On US examination, only 2 patients (8.7%) showed evidence of PATB. Pain VAS, WOMAC pain index and WOMAC physical function index improved significantly after corticosteroid injection. Global patient assessment revealed that 2 patients showed best response, 6 good, 1 fair, 8 the same, and none worse. It is of note that the 2 patients who showed the best response were those who showed US evidence of PATB. This finding shows that US can serve as a useful diagnostic tool for guiding treatment in PATB syndrome of OA patients.
Adrenal Cortex Hormones/*pharmacology ; Aged ; Bursitis/ultrasonography ; Female ; Glucocorticoids/pharmacology ; Humans ; Knee/*pathology ; Male ; Middle Aged ; Osteoarthritis, Knee/*diagnosis/drug therapy/*ultrasonography ; Pain ; Pain Measurement ; Research Support, Non-U.S. Gov't ; Tendinitis/pathology/ultrasonography ; Treatment Outcome

PURPOSE: There are numerous reports about the usefulness of antibiotics such as doxycycline or metronidazole in the conventional treatment for the patients with chronic periodontal diseases. However, seldom are the reports about effects of vitamins or nutraceuticals. The purpose of this study was to evaluate the effects of nutrient supplement including multiple vitamins and neutraceuticals with PRF-K2 from plants and seaweed in treatment of the patients with chronic periodontitis which is needed a nonsurgical or a surgical treatment by evaluating the clinical parameters and the gingival crevicular fluid volume. METHODS:The systemically healthy and nonsmoking patients diagnosed with chronic periodontitis were divided into a nonsurgical group and a surgical group. They were also divided into the test group with nutrient supplements and the control group without nutrient supplements. In the nonsurgical group, the clinical parameters (probing depth, clinical attachment level, sulcus bleeding index, and plaque index) and the gingival crevicular fluid volume were checked on baseline, at 1 week, at 3 week and at 9 week after a supplement treatment. In the surgical group, the clinical parameters and the gingival crevicular fluid volume were also checked at 15 week after a surgical treatment. RESULTS: In both nonsurgical and surgical groups, reduction of pocket depth and increment of clinical attachment level were revealed in the test group compared with the control group, but there was not statistically significant difference (p>0.05), and sulcus bleeding index was decreased with statistically significant difference (p<0.05). In addition, plaque index was decreased with statistically significant difference (p<0.05) in the nonsurgical group. Gingival crevicular fluid volume was decreased with statistically significant difference (p<0.05) at week 9 in both non-surgical and surgical groups. CONCLUSIONS: In conclusion, our results demonstrate that providing nutrient supplement in both nonsurgical or surgical periodontal treatments may improve gingival inflammation and gingival crevicular fluid.
Anti-Bacterial Agents ; Ascorbic Acid ; Chronic Periodontitis ; Dietary Supplements ; Doxycycline ; Gingival Crevicular Fluid ; Hemorrhage ; Humans ; Inflammation ; Metronidazole ; Periodontal Diseases ; Periodontitis ; Seaweed ; Vitamins ; Wound Healing

PURPOSE: To evaluate the hemodynamic change by portal tumor thrombus in hepatocellular carcinoma(HCC). MATERIALS AND METHODS: We reviewed 35 cases of combined spiral CTHA and CTAP in 25 HCC patients with portal tumorthrombus from April 1993 to October 1994, regarding to portal tumor thrombus, the involved area of arterioportal(AP) shunt and the development of cavernous transformation of portal vein, in comparison with hepaticand superior mesenteric arteriography. RESULTS: Spiral CTHA showed hyperattenuating tumor, portal tumor thrombus and hyperattenuating peritumoral parenchymal area. Spiral CTAP showed perfusion defect area including tumor, portal tumor thrombus and peritumoral area distal to portal vein obstruction. In 15 cases, portal tumor thrombus showed intraluminal and marginal hyperattenuating linear structures on CTHA due to transvasal AP shunt and tumor feeding arteries, which were corresponding to thread and streaks sign on hepatic arteriography. Cavernous transformation of portal vein was demonstrated in 15 cases as irregular periportal hyperattenuating collateral vessels on spiral CTAP. In 32 cases, portal vein was visualized on CTHA due to AP shunt. And according to shunt amount, we classified AP shunt into 4 grades. Grade I means only the presence of portal tumor thrombus without AP shunt, grade II with segmental AP shunt, grade III with one lobar AP shunt, and grade IV with both lobar AP shuntor the presence of cavernous transformation of portal vein. Grade I was seen in 3, grade II in 4, grade III in 13 and grade IV in 15 cases. CONCLUSION: Variable CTHA and CTAP findings were shown in HCC patients with portal tumor thrombus according to the amount of AP shunt and the presence of cavernous transformation of portal vein. Combined CTHA and CTAP are useful to differentiate the tumor thrombus from simple thrombus and are very sensitive method for detecting AP shunt. Understanding these findings related with portal tumor thrombus is important topredict patient}s prognosis and to decide treatment method.
Angiography* ; Arteries ; Carcinoma, Hepatocellular* ; Hemodynamics* ; Humans ; Perfusion ; Portal Vein ; Portography* ; Prognosis ; Thrombosis*

BACKGROUND: The expression and secretion of ABH antigens in epithelial cells of glands are controlled by secretor type alpha (1,2)fucosyltrasnferase activity and the human secretor alpha (1,2)fucosyltransferase gene (Sec2) determines the ABH secretor status and influences the Lewis phenotype of an individual. Homozygosity of the mutation for this allele is responsible for the nonsecretor phenotype in nonsecretor individual. The aim of this study was to investigate the status and the distribution of the Sec2 genotype in the Korean population. METHODS: In order to explore the secretory genotypes of the Korean population, the 158 specimens were analyzed by the PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) method designed for the detection of the A385T, the C357T and the G428A mutations of Se alleles. RESULTS: The frequencies of Se1, Se2 and sej among 316 alleles examined in a random sample of 158 Korean individuals were 11.1%, 40.5% and 48.4%. The frequencies of Se1/Se1, Se1/Se2, Se2/Se2, Se1/sej, Se2/sej and sej/sej among 158 genotypes were 3.2%, 3.2%, 20.3%, 12.7%, 37.3% and 23.4%. The G428A nonsense mutation discovered in the Sec2 gene of nonsecretors in Caucasian was not found in any of 158 Korean population. CONCLUSIONS: The distribution of the genotypes of the Sec2 gene in the Korean population showed a rather wide distribution of the sej allele than the Caucasian population and was similar to the Japanese population. PCR-RFLP method can be effectively used for the genotyping of the Sec2 gene.
Alleles ; Asian Continental Ancestry Group ; Codon, Nonsense ; Epithelial Cells ; Genotype ; Humans ; Phenotype

PURPOSE: Phospholipase C (PLC) isozymes ply significant roles in transmembrane signal transduction. PLC-i 1 acts as the intracellular effector in signal transduction for cellular proliferation and differentiation. Ras oncoprotein is also involved in cell growth. We determined the biological significance of PLC and ras oncoprotein in regeneration following radiation and the effect of different modes of administration of 5-FU. MATERIALS AND METHODS: To determine the effect of the administration mode of 5-FU on the regeneration of intestinal mucosa of rats following radiation, we compared the expression of PLC and ras oncoprotein in six groups. Group I had no treatment. GroupII received radiation( 8 Gy) only. Group III received radiation(8 Gy) and 5-FU(150mg/kg) continuous intravenous (iv) infusion for 12 hours. Group iv bolus injection. Group V received only 5-FU(150mg/kg) iv bolus injection. Through immunoblotting and immunohistochemistry, we examined the expression of PLC and ras oncoprotein in rat jejunum at 96 hours after radiation or 5-FU administration and at 120 hours after radiation and 5-FU administration. We also investigated the histological findings using hematoxylin and eosin stain. RESULTS: In the immunohistochemistry study, PLC-i 1 expression was the highest in group III followed by groups II and VI in that order and was weakly positive in groups V and VI. PLC-i 1 was hardly detected in the control group. The expression of ras oncoprotein wss the same as the PLC-i 1 expression for all groups. These results were confirmed by the histological findings regarding the mucosal regeneration. In the immunoblotting analysis, PLC-i 1 expression was the highest in group III followed by group IV and II in that order. This difference between the immunoblotting and immunohistochemistry study was due to the high expression of PLC-i 1 on the damaged surface epithelium rather than to its expression in the regeneration region as observed in the immunohistochemistry study for group IV. The expression of PLC- 1 was positive only in group V and VI, which received both radiation and 5-FU, and the expression of PLC-b 1was negligible for all groups. CONCLUSION: These results suggest that PLC-i 1 mediated signal transduction and ras oncoprotein may have a significant role in mucosal regeneration after radiation, and that continuous iv infusion of 5-FU may induce active regeneration in intestinal mucosa following radiation. In addition, the expression of PLC- 1 in combined group of radiation and 5-FU implies that PLC- 1 may be involved in signal transduction mediated by concerted action between radiation and 5-FU.
Animals ; Cell Proliferation ; Eosine Yellowish-(YS) ; Epithelium ; Fluorouracil* ; Hematoxylin ; Immunoblotting ; Immunohistochemistry ; Intestinal Mucosa* ; Isoenzymes ; Jejunum ; Phospholipases* ; Rats* ; Regeneration* ; Signal Transduction ; Type C Phospholipases*

PURPOSE: To investigate the safety and usefulness of Lipiodol-percutaneous transhepatic ethanolinjection(L-PEI) and to determine the appropriate concentration of Lipiodol during L-PEI. This was achieved byevalvating CT findings and histopathologic changes according to the concentration of Lipiodol, amount of ethanol,and the time interval after injection into normal rabbit liver. MATERIALS AND METHODS: This experimental studyinvolved 18 New Zealand rabbits under US guidance. They were divided into five groups according to injectedmaterials; two rabbits with 0.4cc of normal saline(group I), six with 0.4cc of ethanol in the left hepaticlobe(group II), and 0.4cc of Lipiodol in the right hepatic lobe(group III), five rabbits with 5%Lipiodol-ethanol(5% vol. of Lipiodol+95% vol. of ethanol), 0.2cc in the right hepatic lobe, and 0.4cc in theleft(group IV); and five rabbits with 10% Lipiodol-ethanol as per group IV(group V). CT was performed immediately,one week, two weeks, and three-four weeks after injection, and pathologic specimens were obtained on the thirdday(acute phase) and during the third or fourth week(chronic phase) after injection. RESULTS: On CT, intrahepaticlocalization of the L-PEI injection site was well demonstrated as a focal high attenuated area which graduallydecreased in attenuation on follow up CT. The opacification of the inferior vena cava by Lipiodol, the lineardistribution of Lipiodol along portal veins or fissures, and peritoneal leakage were clearly demonstrated ingroups III-V, though the effects gradually disappeared during follow-up CT. There was no remarkable difference ingross CT attenuation between group IV and group V. The main pathologic findings during the acute phase of group IIwere coagulation necrosis surrounded by macrophage, inflammatory reaction, and early periportal and subcapsularfibrosis. The findings in group IV and V were similar to those in group II and additional fat vacuoleaccumulations in the necrotic area were also seen. During the chronic phase of group II, areas of necrosis wereabsent or smaller and were surrounded or replaced by more organized fibrosis, macrophage or multinucleated giantcell infiltration. Periportal, subcapsular fibrosis was also found. In group IV and V, the findings were similarto those of group II, though additional fat vacuoles in fibrotic or necrotic areas, foreign body reaction to fatvacuole, regenerating nodule and calcification were also observed. CONCLUSION: L-PEI is more useful for thedetection by CT of an injection site than PEI alone, and with regard to CT and histopathologic findings, there wasno significant difference between the 5% and 10% Lipiodol-ethanol groups. Compared to PEI, L-PEI provoked nosighificant additional hepatic injury; only fatty change and foreign body reaction were noted. Thus, L-PEI is moreuseful than PEI for the management of HCC.
Animals ; Contrast Media ; Ethanol* ; Ethiodized Oil* ; Fibrosis ; Follow-Up Studies ; Foreign-Body Reaction ; Liver* ; Macrophages ; Necrosis ; Portal Vein ; Rabbits ; Vacuoles ; Vena Cava, Inferior

PURPOSE: To determine the CT factors which predict positive results of bronchoscopic biopsy in cases of lung cancer with CT-bronchus sign. MATERIALS AND METHODS: In 30 patients who on CT showed a lung mass with CT-bronchus sign and who had undergone bronchoscopic biopsy, lung cancer was confirmed histopathologically and/or clinically. The CT findings were evaluated for the location, nature and size of the mass, and the type of CT-bronchus sign, and the diagnostic rate of bronchoscopic biopsy and of CT findings was compared. RESULTS: Seventeen of 30 patients (56.7%) were diagnosed by bronchoscopic biopsy and their diagnostic rates according to the location were as follows: 100% (10/10) in cases involving the lobar bronchus; 60% (6/10) in cases involving the proximal segmental bronchus and 10% (1/10) in cases involving the distal segmental bronchus. In 20 cases of peripheral lung cancer, 16.7% (1/6) of masses with less than 3cm in diameter, 44.4% (4/9) of masses with more than 3cm and less than 6cm, and 40.0% (2/5) of masses with more than 6cm were diagnosed bronchoscopically. In addition, 57.1% (4/7) of cases with abrupt bronchial obstruction, 33.3% (3/9) with a patent bronchus within the mass, 0% (0/3) with bronchial displacement or a marginally located bronchus and 0% (0/1) with tapered bronchial obstruction were diagnosed on bronchoscopic biopsy. One of two cases with perilesional lymphangitic spread and two of four cases with a large cavity were diagnosed bronchoscopically. CONCLUSION: In cases of lung cancer, bronchoscopic biopsy is a useful initial diagnostic method where the mass is located in 1cm proximal to segmental bronchial bifurcation and is more than 3cm in diameter, there is CT-bronchus sign with abrupt bronchial obstruction or a patent bronchus within the mass, and associated perilesional lymphangitic spread or large air-cavity. In most cases where there is peripheral lung mass less than 3cm in diameter, however, bronchoscopic biopsy alone is not adequate, and the use of a further diagnostic modality is required.
Biopsy* ; Bronchi ; Humans ; Lung Neoplasms* ; Lung*

In vitro ethylene-diamine-tetra-acetic acid (EDTA) dependent satellitism and phagocytosis of platelets by neutrophils have been considered to be rare phenomena. It is associated with pseudothrombocytopenia, abnormal histogram of platelets and pseudoleukocytosis on complete blood cell count (CBC) by automated blood cell counter, but these findings are not found in heparinized or sodium citrated blood. It has no clinical significance such as bleeding tendency or abnormal platelet function. EDTA dependent platelet satellitosis and phagocytosis must be differentiated from true thrombocytopenia. We report a case of EDTA dependent platelet phagocytosis by neutrophils in a 68 year-old male patient who was diagnosed as mycosis fungoides. His EDTA blood smear showed frequent phagocytosis of platelets by neutrophils and occasional platelet satellitism. The bood cell counts were within normal limits without pseudothrombocytopenia. Phagocytized platelets were confirmed by immunohistochemistry using GpIIb/IIIa antibody and transmission electron micrographs.
Aged ; Blood Cell Count ; Blood Platelets* ; Cell Count ; Edetic Acid* ; Hemorrhage ; Heparin ; Humans ; Immunohistochemistry ; Male ; Mycosis Fungoides* ; Neutrophils* ; Phagocytosis* ; Sodium ; Thrombocytopenia

No abstract available.
Eyelids ; Tinea* ; Trichophyton*